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A meta-analysis of randomized trials has revealed a benefit to ovarian ablation or suppression in preventing breast cancer recurrence in premenopausal women with estrogen receptor–positive tumors.1 The findings, based on almost 15,000 women in studies spanning several decades, were presented at the ...
An analysis of patient-reported outcomes in the adjuvant phase III NATALEE trial of ribociclib plus endocrine therapy in early-stage breast cancer showed maintenance of health-related quality of life (QOL), as determined by a number of factors. For patients receiving the inhibitor of...
In an Italian single-institution retrospective study reported in JAMA Surgery, Martelli et al found that prophylactic salpingo-oophorectomy was associated with improved overall survival in patients who had undergone resection of germline BRCA1/2-mutant breast cancer. Study Details The study...
Jame Abraham, MD, FACP, has been in the field of oncology for more than 2 decades, he and says this is both one of the most exhilarating and challenging times in cancer care. “What excites me the most are the innovations in treatment that are literally transforming the lives of our patients and...
In a Japanese-U.S. phase I/II trial (U31402-A-J101) reported in the Journal of Clinical Oncology, Ian E. Krop, MD, PhD, and colleagues found that the HER3-targeted antibody-drug conjugate patritumab deruxtecan (HER3-DXd) produced durable responses in previously treated patients with HER3-expressing ...
In a noninferiority phase III trial (SOUND) reported in JAMA Oncology, Gentilini et al found that no axillary surgery was noninferior to sentinel lymph node biopsy (SLNB) in terms of distant disease–free survival among patients with small breast cancer and negative findings on preoperative...
Residing in more walkable neighborhoods could protect against the risk of overall obesity-related cancers in female patients, according to a recent study published by India-Aldana et al in Environmental Health Perspectives. Background Obesity has previously been linked to an increased risk of...
Breast milk from women with breast cancer who were diagnosed during pregnancy or postpartum contains circulating tumor DNA (ctDNA), according to researchers at the Vall d’Hebron Institute of Oncology (VHIO) in Barcelona. The investigators noted that ctDNA can be detected through liquid biopsy in...
As reported in the Journal of Clinical Oncology by PierFranco Conte, MD, PhD, and colleagues, the final analysis of the Italian phase III noninferiority ShortHER trial showed little difference in 10-year disease-free survival and overall survival with 9 weeks vs 1 year of adjuvant trastuzumab in...
Despite a steady increase in palliative care utilization from 2004 to 2020, racial and ethnic minority patients with metastatic breast cancer may be less likely to receive palliative care compared with non-Hispanic White patients with the disease, according to new findings presented by Freeman et...
In a first-of-its-kind study, patients with breast cancer who underwent implant-based breast reconstruction immediately following a mastectomy reported that getting fewer, higher doses of radiation was just as effective as standard radiation, did not increase side effects, and saved them time and...
Neoadjuvant immunotherapy may be effective prior to surgery in multiple types of cancers, according to a recent study published by Topalian et al in Cancer Cell. Background Neoadjuvant immune checkpoint blockades have been a rapidly growing area of research and are currently being tested across...
The novel imaging agent gallium (Ga)-68–ABY-025 may help to predict early metabolic response to HER2-targeted treatment in patients with HER2-positive metastatic breast cancer, according to a recent study published by Alhuseinalkhudhur et al in The Journal of Nuclear Medicine. These findings...
Researchers have uncovered elevated rates of hyperglycemia among patients who have breast cancer receiving treatment with alpelisib, according to a recent study published by Shen et al in Cancer. Background Alpelisib is designed to target the phosphoinositide 3-kinase (PI3K) protein, which is...
This is Part 3 of Ovarian Function Suppression in Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Jame Abraham, Erin Roesch, and Azka Ali discuss the management of a patient with de novo metastatic estrogen receptor–positive breast cancer. The patient is a 35-year-old premenopausal female with a patient-detected right breast mass; on imaging, the mass is 6 cm with suspicious lymph nodes. Biopsy confirms invasive carcinoma, grade 2, and her biomarkers are ER > 95%, PR 5%, and HER2 IHC 0. Breast MRI reveals nonmass enhancement in the right mass and at least seven abnormal axillary lymph nodes. She presents to the ER with back pain 4 days later and is found to have multiple lytic lesions on PET body imaging. In the conversation that follows, the faculty discuss the importance of staging scans in patients with larger tumors and lymph node involvement, choosing the most appropriate endocrine therapy and CDK4/6 inhibitor for first-line therapy, and monthly vs every-3-month dosing of GnRH analogs.
This is Part 2 of Ovarian Function Suppression in Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Jame Abraham, Erin Roesch, and Azka Ali discuss the management of a patient with recurrent estrogen receptor–positive breast cancer. The patient is a 39-year-old premenopausal female with a small T1aN0M0 estrogen receptor–positive, progesterone receptor–positive, HER2-negative left breast cancer. She opts for a mastectomy but declines adjuvant tamoxifen due to fertility concerns. She agrees to annual MRIs, and she presents to the clinic 10 years later at age 49 years with a palpable abnormality on the left side. Core-needle biopsy confirms the recurrence of breast cancer, and she undergoes left breast wide local excision, revealing multifocal invasive mammary carcinoma with mixed ductal and lobular features, grade 2 (10 mm). In the conversation that follows, the faculty discuss the use of adjuvant endocrine therapy in treating patients with breast cancer recurrences, the clinical implications of the CALOR trial, and the potential role of genomic assays in chemotherapy decision-making.
This is Part 1 of Ovarian Function Suppression in Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Jame Abraham, Erin Roesch, and Azka Ali discuss the management of stage I breast cancer. The patient is a 46-year-old female with a history of hysterectomy (with intact ovaries) and venous thromboembolism who was diagnosed with stage I cT1N0M0 estrogen receptor–positive, progesterone receptor–positive, HER2-negative breast cancer after a screening mammography. She has a right breast partial mastectomy with sentinel lymph node biopsy, which showed multifocal invasive tubular carcinoma (5 mm), grade 1, with ER > 90%, PR of 10%, and HER2-negative per IHC, as well as atypical ductal hyperplasia, and no nodal involvement. In the conversation that follows, the faculty discuss how to choose the most appropriate endocrine therapy for patients, understanding the side effects of ovarian function suppression vs tamoxifen, the optimal duration of ovarian suppression in patients, and the recent 13-year follow-up data from the SOFT/TEXT trials.
In a phase II trial (MC1631) reported in The Lancet Oncology, Robert W. Mutter, MD, and colleagues found that the 24-month complication rate associated with hypofractionated proton postmastectomy radiotherapy (PMRT) was not noninferior to standard fractionated PMRT in patients undergoing mastectomy ...
Investigators have discovered that significantly higher levels of endocrine-disrupting chemicals such as per- and poly-fluoroalkyl substances (PFAS) and phenols may be present in patients with breast, ovarian, skin, and endometrial cancers, according to a recent study published by Cathey et al in...
Investigators have found that residing in areas with high levels of particulate air pollution may be associated with an increased risk of developing breast cancer, according to a recent study published by White et al in the Journal of the National Cancer Institute. Background Particulate matter...
In the LEANer study, reported in the Journal of Clinical Oncology by Tara Sanft, MD, and colleagues, researchers found that an exercise and nutrition intervention did not improve relative dose intensity (RDI) among patients receiving neoadjuvant or adjuvant chemotherapy for breast cancer, but did...
In an analysis from the Canadian Cancer Trials Group MA.32 study reported in the Journal of Clinical Oncology, Pamela Goodwin, MD, MSc, FRCPC, FASCO, and colleagues found that adjuvant metformin did not reduce the risk of new primary invasive cancers vs placebo in patients with early breast cancer. ...
Breast milk from women with breast cancer who were diagnosed during pregnancy or postpartum may contain circulating tumor DNA (ctDNA), according to researchers at the Vall d’Hebron Institute of Oncology (VHIO) in Barcelona. The investigators noted that ctDNA can be detected through liquid biopsy in ...
Aki Morikawa, MD, PhD, of the University of Michigan, and her team explored the use of patient-derived organoids from breast cancer brain metastases to evaluate drug sensitivities in a clinically meaningful time frame. Along with molecular profiling, she says, this method may further personalize therapy and possibly lead to novel treatment options for this population.
In a phase II study (coopERA Breast Cancer) reported in The Lancet Oncology, Sara A. Hurvitz, MD, and colleagues found that 2 weeks of the addition of neoadjuvant giredestrant—a novel nonsteroidal selective estrogen receptor (ER) degrader—to palbociclib showed a stronger antiproliferative effect...
A commercially available artificial intelligence (AI) algorithm may perform comparably to human readers at assessing screening mammograms, according to a recent study published by Chen et al in Radiology. False-positive interpretations on screening mammograms can result in women without cancer...
In a study of SEER (Surveillance, Epidemiology, and End Results) data reported in JAMA Network Open, Stephens et al found that approximately 5% of patients with invasive breast cancer had missing components of receptor status and identified several factors associated with the lack of information....
Presented here are some brief summaries of novel therapies under study from the 2023 ASCO Breakthrough meeting in Yokohama, Japan. The subjects range from new observations about a HER2-directed bispecific antibody and systemic treatment of gastric cancer to an option for treating hand-foot syndrome ...
Researchers have launched a new clinical trial examining the effectiveness of behavioral and psychological interventions at reducing cardiovascular damage caused by anticancer therapies in patients with breast cancer. Background Breast cancer—the most common cancer type in the European...
In an 8-year follow-up of a Korean phase III trial (ASTRRA) reported in the Journal of Clinical Oncology, Baek et al evaluated the effects of adding adjuvant ovarian function suppression to tamoxifen in premenopausal patients with estrogen receptor (ER)-positive breast cancer, with a focus on the...
This is Part 3 of Novel Therapies for Advanced Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Aditya Bardia, Sara Tolaney, and Antonio C. Wolff discuss the treatment of relapsed/refractory triple-negative breast cancer. The patient is a 35-year-old female with metastatic PD-L1–positive triple negative breast cancer (HER2 IHC = 1+) who experiences disease progression on first-line therapy with carboplatin plus pembrolizumab. She has good performance status and is negative for germline BRCA mutations. The faculty discuss how best to choose between the antibody-drug conjugates sacituzumab govitecan and trastuzumab deruxtecan in the second-line setting and beyond, dose modifications to reduce toxicities and maintain quality of life, and the sequential use of antibody-drug conjugate after antibody-drug conjugate.
This is Part 2 of Novel Therapies for Advanced Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Aditya Bardia, Sara Tolaney, and Antonio C. Wolff discuss the role of HER2 expression in hormone receptor–positive metastatic breast cancer. The patient is a 55-year-old female with metastatic hormone receptor–positive metastatic breast cancer (HER2 IHC = 1). She has experienced disease progression various endocrine-based therapies, and recently capecitabine and paclitaxel. She has a good performance status, is negative for germline BRCA mutations, and is PIK3CA and ESR1 wild-type. The faculty review the shifting understanding of HER2 expression categories—particularly “HER2-low”—in breast cancer in the wake of the DESTINY-Breast04 study, best practices when it comes to distinguishing IHC 0 from IHC 1+, and current antibody-drug conjugates available and in the pipeline for metastatic breast cancer.
This is Part 1 of Novel Therapies for Advanced Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Aditya Bardia, Sara Tolaney, and Antonio C. Wolff discuss the treatment of hormone receptor–positive, HER2-negative metastatic breast cancer. The patient is a 65-year-old female who was diagnosed with localized hormone receptor–positive/HER2-negative breast cancer in 2010. After completion of adjuvant exemestane, she experiences disease recurrence in the bone 6 years later and starts treatment with letrozole plus a CDK4/6 inhibitor. Two years later, she experiences disease progression with continued bone involvement and new liver lesions. In the conversation that follows, the faculty discuss treatment options in the post–CDK4/6 inhibitor setting, the importance of genetic testing for actionable alterations, and novel therapies currently in development.
Researchers have found that about one-third of treatment recommendations from the artificial intelligence (AI) model ChatGPT 3.5 were nonconcordant with the NCCN Clinical Practice Guidelines in Oncology® (NCCN Guidelines®), according to a recent study published by Chen et al in JAMA Oncology. The...
In a single-center retrospective study reported in the Journal of Clinical Oncology, Eskreis-Winkler et al found that contrast-enhanced magnetic resonance imaging (MRI) using a high-temporal/high-spatial resolution (HTHS) protocol improved breast cancer detection and reduced unnecessary biopsies vs ...
The antibody-drug conjugate sacituzumab govitecan-hziy continued to demonstrate superior benefit for patients with hormone receptor–positive, HER2-negative metastatic breast cancer when compared with standard chemotherapy, according to the final analysis of the phase III TROPiCS-02 study published...
In an analysis from a phase II European trial reported in JAMA Oncology, Jens Huober, MD, and colleagues found no difference in overall survival with pertuzumab/trastuzumab, with or without chemotherapy, followed by second-line ado-trastuzumab emtansine (T-DM1) in patients with HER2-positive...
In a German prospective registry study (SenTa) reported in JAMA Surgery, Kuemmel et al found that targeted axillary dissection alone after neoadjuvant systemic therapy was associated with outcomes similar to those obtained with targeted axillary dissection plus axillary lymph node dissection in...
In a Canadian study reported in the Journal of Clinical Oncology, Wilkinson et al found that breast cancer screening was associated with greater 10-year breast cancer net survival among women aged 40 to 49 living in jurisdictions including mammography screening programs for this age group, compared ...
Researchers have identified genes that may be associated with breast cancer and could eventually be included in tests to identify high-risk patients, according to a recent study published by Wilcox et al in Nature Genetics. Background Currently, genetic tests for breast cancer consider a few genes...
New approaches are offering hope for better outcomes in metastatic triple-negative breast cancer, according to Suchita Pakkala, MD, of Emory University’s Winship Cancer Institute, Atlanta. She shared her thoughts on using PARP inhibitors and antibody-drug conjugates at the 2023 Debates and...
Long-molecule scars may help identify patients with BRCA1- and BRCA2-deficient cancer types, according to a recent study published by Setton et al in Nature. Background Once DNA is damaged by toxins, radiation, or normal cell division, human cells must continually fix DNA breaks to survive. When...
In a South Korean single-center retrospective cohort study reported in JAMA Surgery, Cheun et al identified locoregional recurrence patterns according to molecular subtypes of breast cancer among women undergoing surgery for the disease. The study involved data from 16,462 women who underwent...
Continued breast cancer screening after age 70 may be associated with a greater incidence of asymptomatic cancer, according to a recent study published by Richman et al in the Annals of Internal Medicine. These new findings suggested that overdiagnosis may be prevalent among older female patients....
In a preplanned analysis of the phase III PALLAS trial reported in the Journal of Clinical Oncology, Pfeiler et al found that higher body mass index (BMI) reduced the risk of neutropenia and treatment discontinuation in patients with early hormone receptor–positive breast cancer receiving adjuvant...
In a Swedish study (Mammography Screening with Artificial Intelligence [MASAI]) reported in The Lancet Oncology, Lång et al found that artificial intelligence (AI)-supported screen reading was associated with a similar cancer detection rate and a lower screen-reading workload vs standard double...
In a systematic review and meta-analysis reported in the Journal of Clinical Oncology, Bright et al found that interventions to promote adjuvant endocrine therapy adherence in breast cancer survivors were successful overall compared with control conditions, although some interventions appeared to...
Susan M. Love, MD, MBA, a renowned surgeon, author, researcher, and patient advocate who dedicated her life’s work to breast cancer care, died on July 2, 2023, at her home in Los Angeles. The cause of death was recurrent leukemia. She was 75. Born in Long Branch, New Jersey, on February 9, 1948,...
A report published by Kwan et al in the journal Cancer provides new information that may help oncologists answer one of the most common questions they hear from breast cancer survivors: Is it safe to drink alcohol? The findings suggest drinking alcohol is not associated with an increased risk of...
A machine-learning model found that background parenchymal enhancement (BPE) on breast magnetic resonance imaging (MRI) may be an indicator of breast cancer risk in patients with extremely dense breasts, according to a study published by Wang et al in Radiology. Patients with extremely dense...