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Breast Cancer

Expert Point of View: Anne Blaes, MD, MS, and Virginia Kaklamani, MD

Commenting on the update of RxPONDER presented at the 2021 San Antonio Breast Cancer Symposium were Anne Blaes, MD, MS, Associate Professor of Hematology/Oncology at the University of Minnesota and Co-Director of the Screening, Prevention, Etiology and Cancer Survivorship Program at the Masonic...

Breast Cancer

RxPONDER Update Explores Benefit of Chemotherapy in Subgroups

Updated results of the SWOG S1007 RxPONDER trial confirmed the key takeaway from the previous analysis: adjuvant chemotherapy benefits premenopausal women but not postmenopausal women with hormone receptor–positive, HER2-negative disease, one to three positive lymph nodes, and a 21-gene Oncotype DX ...

breast cancer

Meredith M. Regan, ScD, on Early Breast Cancer: Updated Results From the TEXT and SOFT Trials

Meredith M. Regan, ScD, of Dana-Farber Cancer Institute, discusses findings that point to the potential benefits of using adjuvant exemestane plus ovarian function suppression (OFS) to treat premenopausal women with hormone receptor–positive early breast cancer. This conclusion came after 13 years of median follow-up on the TEXT and SOFT trials, during which this regimen was compared with tamoxifen and OFS (Abstract GS2-05).

breast cancer
immunotherapy

Elizabeth A. Mittendorf, MD, PhD, on Making Strides in Managing Triple-Negative Breast Cancer

Elizabeth A. Mittendorf, MD, PhD, of Dana-Farber Brigham and Women’s Cancer Center, discusses the progress made in recent years treating patients with triple-negative breast cancer (TNBC), including approval of the immunotherapy agents pembrolizumab and sacituzumab govitecan-hziy, a new standard of care in the preoperative setting for early-stage disease, as well as a better understanding of the biology of TNBC and its heterogeneity.

Breast Cancer

Second-Line T-DXd Improves Progression-Free Survival Across HER2-Positive Metastatic Breast Cancer Subgroups

The antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) lengthened progression-free survival and improved objective response rate compared to the antibody-drug conjugate ado-trastuzumab emtansine (T-DM1) after trastuzumab and taxane therapy in women with HER2-positive metastatic breast...

Breast Cancer

Role of Radiologist Experience and Fatigue Level in Recommending Additional Imaging for Patients Undergoing Breast Cancer Screening

Less experienced radiologists are more likely to recommend additional imaging for women undergoing breast cancer screening when they read digital breast tomosynthesis (DBT) images later in the day, according to a new study published by Bernstein et al in the journal Radiology. The results highlight ...

Breast Cancer

EMERALD Trial: Oral Selective Estrogen Receptor Degrader as Second- or Third-Line Therapy for Advanced Breast Cancer

Use of the first investigational oral selective estrogen receptor degrader (SERD) elacestrant significantly reduced the risk of death or disease progression and lengthened progression-free survival compared with standard-of-care endocrine therapy with fulvestrant or an aromatase inhibitor in...

Breast Cancer

Study Finds Depression Screening Improves Behavioral Care for Patients With Breast Cancer

Research published by Hahn et al in JAMA showed depression screening for patients with newly diagnosed breast cancer was highly effective at identifying patients in need of behavioral health care. The new screening initiative was subsequently and successfully built into the patient care and daily...

breast cancer

Banu Arun, MD, on Fine-Tuning Risk Assessment and Risk Reduction in Breast Cancer

Banu Arun, MD, of The University of Texas MD Anderson Cancer Center, discusses a session she moderated that included discussion of how exercise and diet may reduce the risk of breast cancer, and emerging non-endocrine treatments that may help prevent the disease.

Breast Cancer

Long-Term Outcomes According to Residual Cancer Burden After Neoadjuvant Chemotherapy for Breast Cancer

In an analysis reported in The Lancet Oncology, Yau et al found that increasing residual cancer burden (RCB) after neoadjuvant chemotherapy was associated with poorer event-free survival across breast cancer subtypes. Study Details The study included patient-level data on RCB and other clinical and ...

breast cancer

Ann H. Partridge, MD, MPH, on SABCS Meeting Highlights: Expert Perspective

Ann H. Partridge, MD, MPH, of Dana-Farber Cancer Institute, discusses what she considers to be the most notable presentations at the 2021 San Antonio Breast Cancer Symposium. They include the focus on early-stage disease, especially in the TEXT/SOFT, RxPonder, and KEYNOTE-522 trials, as well as abstracts from the Early Breast Cancer Trialists’ Collaborative Group; and new data and novel therapeutics in the advanced setting.

breast cancer

Lisa A. Carey, MD, on HR-Positive and HER2-Negative Advanced Breast Cancer: Overall Survival by Subtype Across Three MONALEESA Studies

Lisa A. Carey, MD, of the University of North Carolina at Chapel Hill and the Lineberger Comprehensive Cancer Center, discusses findings from a pooled analysis of the MONALEESA-2, -3, and -7 trials. Among the findings was a consistent overall survival benefit with ribociclib plus endocrine therapy for patients with luminal A, luminal B, and HER2E breast cancer subtypes. Patients with the basal-like subtype did not derive a benefit from ribociclib, but the sample size was small (Abstract GS1-04).

breast cancer

Charles Coombes, MD, PhD, on Hormone Receptor–Positive HER2-Negative Breast Cancer: Use of Samuraciclib Plus Fulvestrant

Charles Coombes, MD, PhD, of Imperial College, London, discusses study results on samuraciclib, a first-in-class, oral, selective inhibitor of CDK7, in combination with fulvestrant in patients with advanced hormone receptor–positive HER2-negative breast cancer. The combination of agents has demonstrated evidence of anti-tumor activity for patients who have progressed on their prior CDK4/6 inhibitor treatment (Abstract GS3-10).

Breast Cancer

Breast Cancer Index May Predict Benefit of Extended Endocrine Therapy in Certain Patients With Hormone Receptor–Positive Disease

New data were presented at the 2021 San Antonio Breast Cancer Symposium demonstrating that the Breast Cancer Index (BCI) may predict preferential recurrence-prevention benefit from extended endocrine therapy and may also predict the overall benefit/risk and likelihood of improved health outcomes...

Breast Cancer
Genomics/Genetics

Personalized Therapy vs Physician’s Choice of Treatment for Patients With Residual Triple-Negative Breast Cancer After Neoadjuvant Chemotherapy

In a phase II trial reported in the Journal of Clinical Oncology, Schneider et al found that genomically directed therapy did not improve 2-year disease-free survival vs treatment of physician’s choice in patients with residual triple-negative breast cancer following neoadjuvant chemotherapy. Study ...

Breast Cancer
Gynecologic Cancers
Survivorship

Effect of Bupropion vs Placebo on Sexual Desire in Postmenopausal Female Cancer Survivors

In a phase II trial (NRG-CC004) reported in the Journal of Clinical Oncology, Barton et al found that bupropion, a dopaminergic agent, did not improve sexual desire vs placebo as measured by the Female Sexual Function Index (FSFI) desire subscale among postmenopausal women with low desire scores...

Breast Cancer

Expert Point of View: Matthew J. Ellis, MB, BChir, PhD, FACP

The final results of the phase III PALLAS trial1 are “deeply disappointing,” said session moderator Matthew J. Ellis, MB, BChir, PhD, FACP, Professor of Medicine and Director of the Lester and Sue Smith Breast Center at Baylor College of Medicine. The results of the final primary analysis of PALLAS ...

Breast Cancer

Final Analysis of PALLAS Trial: No Benefit of Adjuvant Palbociclib Plus Endocrine Therapy in Early Breast Cancer

The final protocol-defined analysis of the phase III PALLAS trial confirmed the negative results of the second interim analysis, showing no benefit of palbociclib plus endocrine therapy in the adjuvant breast cancer setting. Michael Gnant, MD, of the Medical University of Vienna, reported these...

Breast Cancer
Immunotherapy

Expert Point of View: Hope S. Rugo, MD, FASCO

Invited discussant of the ­KEYNOTE-355 trial, Hope S. Rugo, MD, FASCO, one of the coauthors of the study, had presented the survival data at the 2021 European Society of Medical Oncology (ESMO) Annual Congress.1 The San Antonio presentation was a more in-depth evaluation of survival by different...

Breast Cancer
Immunotherapy

Identifying Women With Triple-Negative Breast Cancer Who May Benefit From Pembrolizumab Plus Chemotherapy

Results of the phase III randomized KEYNOTE-355 trial showed that the addition of the PD-1 inhibitor pembrolizumab to investigator’s choice of first-line chemotherapy improved progression-free and overall survival in women with metastatic triple-negative breast cancer compared with placebo and...

Breast Cancer
Colorectal Cancer

Study Examines Rates of Breast and Colorectal Cancer Screening Among Rural Women

Women who live in urban areas and those residing in rural areas are screened for breast cancer at similar rates, but rural women are screened for colorectal cancer at significantly lower rates than their urban counterparts, research published by Shete et al in JAMA Network Open showed. The...

Breast Cancer
Immunotherapy

Adjuvant T-DM1/Pertuzumab vs Taxane/Trastuzumab/Pertuzumab in High-Risk HER2-Positive Breast Cancer

In the phase III KAITLIN trial reported in the Journal of Clinical Oncology, Ian E. Krop, MD, and colleagues found that adjuvant ado-trastuzumab emtansine (T-DM1) plus pertuzumab did not improve invasive disease–free survival vs a taxane plus trastuzumab/pertuzumab, both following...

Breast Cancer
Immunotherapy

Composite Biomarker Needed to Predict Benefit of Immunotherapy in Triple-Negative Breast Cancer

Although there is a biomarker that predicts response to the one approved immunotherapy agent for metastatic triple-negative breast cancer, “it is important to note there are no biomarkers of response to neoadjuvant immunotherapy in early-stage triple-negative breast cancer,” Elizabeth A....

Breast Cancer

Outcomes With Adjuvant Chemoendocrine vs Endocrine Therapy in Node-Positive Breast Cancer and Association With 21-Gene Assay Recurrence Score

In an interim analysis of the phase III RxPONDER trial reported in The New England Journal of Medicine, Kevin Kalinsky, MD, and colleagues found that the addition of adjuvant chemotherapy to endocrine therapy did not improve invasive disease–free survival among women with hormone receptor–positive, ...

breast cancer
genomics/genetics

Patricia A. Ganz, MD, on Early Breast Cancer, Olaparib, Chemotherapy, and Quality of Life

Patricia A. Ganz, MD, of the University of California, Los Angeles, discusses quality-of-life results from the phase III OlympiA study of adjuvant olaparib after (neo)adjuvant chemotherapy in patients with germline BRCA1/2 mutations and high-risk HER2-negative early breast cancer (Abstract GS4-09).

breast cancer
immunotherapy

Komal Jhaveri, MD, on Triple-Negative and Metastatic Breast Cancers: New Data on Neratinib, Fulvestrant, and Trastuzumab

Komal Jhaveri, MD, of Memorial Sloan Kettering Cancer Center, discusses the latest updates from the SUMMIT trial, which explored the combinations of neratinib/fulvestrant/trastuzumab and neratinib plus trastuzumab, as well as fulvestrant alone. The combination regimens appeared to benefit patients with hormone–receptor positive, HER2-mutated metastatic breast cancer who have had prior exposure to CDK4/6 inhibitors, and those with HER2-mutated triple-negative disease (Abstract GS4-10).

breast cancer

Michael Gnant, MD, on HR-Positive, HER2-Negative Early Breast Cancer: Trial Results With Palbociclib Treatment

Michael Gnant, MD, of the Medical University of Vienna, discusses phase III findings from the PALLAS study, which showed that adding 2 years of palbociclib to ongoing adjuvant endocrine therapy did not improve survival for patients with stage II to III hormone receptor–positive, HER2-negative early breast cancer. Dr. Gnant also talks about whether any correlative studies hint at patient subgroups that this regimen may benefit (Abstract GS1-07) .

breast cancer

François-Clément Bidard, MD, PhD, on Metastatic Breast Cancer: Endocrine Therapy and Palbociclib

François-Clément Bidard, MD, PhD, of the Institut Curie, discusses phase III findings of the PADA-1 study, which showed that optimizing endocrine therapy after detecting the ESR1 mutation in patients with hormone receptor–positive, HER2-negative metastatic breast cancer may double their median progression-free survival (Abstract GS3-05).

breast cancer
immunotherapy

Javier Cortés, MD, PhD, on Previously Untreated Triple-Negative Breast Cancer: Pembrolizumab Plus Chemotherapy

Javier Cortés, MD, PhD, of the International Breast Cancer Center, discusses the final phase III results of KEYNOTE-355, which showed that pembrolizumab and chemotherapy improved overall and progression-free survival, compared with placebo and chemotherapy, for patients with previously untreated, locally recurrent, inoperable or metastatic triple-negative breast cancer (Abstract GS1-02 ).

breast cancer

Kevin Kalinsky, MD, on HR-Positive HER2-Negative Breast Cancer: Endocrine Therapy and Chemotherapy

Kevin Kalinsky, MD, of the Winship Cancer Institute at Emory University, discusses updated phase III results from the SWOG S1007 (RxPONDER) study of women with one to three positive lymph nodes, and hormone receptor–positive, HER2-negative breast cancer. The data showed that postmenopausal women with recurrence scores (RS) from 0 to 25 continue not to benefit from adjuvant chemotherapy, whereas premenopausal women with a RS from 0 to 25 did benefit from the addition of chemotherapy to endocrine therapy (Abstract GS2-07).

Breast Cancer

Abemaciclib With Endocrine Therapy in Adjuvant Treatment of Early Breast Cancer

On October 12, 2021, abemaciclib was approved for use with endocrine therapy (tamoxifen or an aromatase inhibitor) for adjuvant treatment of adults with hormone receptor–positive, HER2-negative, node-positive, early breast cancer at high risk of recurrence and a Ki67 score ≥ 20%, as determined by...

Breast Cancer
Genomics/Genetics

Patients With Hormone Receptor–Positive Breast Cancer and Emergent ESR1 Mutations May Benefit From Early Switch to Fulvestrant/Palbociclib

Among patients with hormone receptor–positive breast cancer treated with an aromatase inhibitor plus palbociclib, those who displayed a rising ESR1 mutation detected in their blood before disease progression doubled their median progression-free survival following a switch to fulvestrant plus...

Breast Cancer

PHOEBE Trial: Pyrotinib/Capecitabine vs Lapatinib/Capecitabine for Previously Treated Patients With HER2-Positive Metastatic Breast Cancer

Among previously treated patients with HER2-positive metastatic breast cancer, those who received pyrotinib plus capecitabine had longer overall survival than those who received lapatinib plus capecitabine, according to updated results from the phase III PHOEBE trial presented by Binghe Xu, MD,...

Breast Cancer

To Elect or Forgo Radiation Therapy: An Informed Decision for Patients With Breast Cancer

Advances intreating breast cancer “increasingly create opportunities to consider where radiation therapy might safely be omitted,” Reshma Jagsi, MD, DPhil, told participants at the 2021 Lynn Sage Breast Cancer Symposium.1 “But, I would encourage us,” she continued, “not to assume that women who...

breast cancer
immunotherapy

Peter Schmid, MD, PhD, on Early-Stage Triple-Negative Breast Cancer: Neoadjuvant Treatment With Pembrolizumab and Chemotherapy

Peter Schmid, MD, PhD, of Barts Cancer Institute, discusses phase III findings from KEYNOTE-522, in which researchers found a generally consistent event-free survival benefit among patients with early-stage high-risk triple-negative breast cancer who were treated with neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab (Abstract GS1-01).

Breast Cancer

Elacestrant May Improve Outcomes for Postmenopausal Patients With Progressive ER-Positive HER2-Negative Metastatic Breast Cancer

The investigational oral selective estrogen receptor degrader (SERD) elacestrant significantly decreased the risk of death or disease progression and increased progression-free survival compared with standard-of-care endocrine monotherapy in the second- or third-line setting  for postmenopausal...

Breast Cancer

Elacestrant May Improve Outcomes for Postmenopausal Patients With Progressive ER-Positive HER2-Negative Metastatic Breast Cancer

The investigational oral selective estrogen receptor degrader (SERD) elacestrant significantly decreased the risk of death or disease progression and increased progression-free survival compared with standard-of-care endocrine therapy for postmenopausal patients with estrogen receptor...

Breast Cancer

PALLAS Trial: Addition of Adjuvant Palbociclib to Endocrine Therapy in Early HR-Positive, HER2-Negative Breast Cancer

As reported at the 2021 San Antonio Breast Cancer Symposium (Abstract GS1-07) and simultaneously in the Journal of Clinical Oncology by Michael Gnant, MD, and colleagues, the final analysis of the phase III PALLAS trial has shown no invasive disease–free survival benefit with the addition of...

Breast Cancer
Immunotherapy

Single-Cell Spatial Analysis May Help to Predict Response to Neoadjuvant Atezolizumab in Patients With Triple-Negative Breast Cancer

A next-generation technology that allows the study of protein expression at the single-cell level and the location of the cells within the tumor microenvironment was feasible and provided information on the benefit of adding the immune checkpoint inhibitor atezolizumab to chemotherapy as...

Breast Cancer
Genomics/Genetics

Molecular Tumor Profiling May Improve Treatment Matching for Patients With Metastatic Breast Cancer

The use of multigene sequencing and SNP array as a therapeutic decision tool improved the outcomes of patients with metastatic breast cancer if the patients carried alterations classified in the I/II tiers of the ESMO Scale for Clinical Actionability of Molecular Targets (ESCAT), according to...

Breast Cancer

I-SPY2 Study Finds Tumor Biology Is a More Significant Factor Than Race in Predicting Response to Breast Cancer Treatment

Data analysis from the I-SPY2 clinical trial found that among women with high-risk breast cancer, race did not significantly affect several key measures of breast cancer treatment outcomes, including pathologic complete response (pCR) and event-free survival. The study, which is being presented by...

Breast Cancer
Supportive Care
Symptom Management

Study Examines Rates of Lymphedema in Black and White Patients With Breast Cancer

Black women had a 3.85-fold increased risk of developing lymphedema following treatment for breast cancer compared to White women, according to the results from a study by Barrio et al being presented at the 2021 San Antonio Breast Cancer Symposium (Abstract GS4-01). In addition, the researchers...

Breast Cancer
Immunotherapy

KEYNOTE-355 Final Analysis Reveals Survival Benefit With Pembrolizumab in Triple-Negative Breast Cancer

The final overall survival results from the KEYNOTE-355 study showed a statistically significant 27% reduction in the risk of death for patients with metastatic triple-negative breast cancer whose tumors were strongly positive for PD-L1, defined as a combined positive score (CPS) of at least 10 and ...

Breast Cancer

To Elect or Forgo Radiation Therapy: An Informed Decision for Patients With Breast Cancer

Advances in treating breast cancer “increasingly create opportunities to consider where radiation therapy might safely be omitted,” Reshma Jagsi, MD, DPhil, told participants at the 2021 Lynn Sage Breast Cancer Symposium.1 “But, I would encourage us,” she continued, “not to assume that women who...

breast cancer
immunotherapy

Hans Wildiers, MD, on Metastatic Breast Cancer: Comparing Addition of Eftilagimod Alpha vs Placebo to Paclitaxel

Hans Wildiers, MD, of University Hospitals Leuven, discusses the final results from the phase IIb AIPAC study, which suggested that eftilagimod added to paclitaxel may be of benefit to patients older than 65 years with hormone receptor­–positive, HER2-negative metastatic breast cancer after endocrine-based therapy. Eftilagimod, which is a first-in-class antigen presenting cell activator, appeared to increase circulating CD4/CD8 T cells, which correlated to improved overall survival (Abstract 948).

Breast Cancer

Study Examines the Effect of Breast MRI on Short-Term Quality of Life in Women With DCIS

In a substudy of the ECOG-ACRIN E4112 cohort trial reported in JAMA Network Open, Fazeli et al found that approximately half of women with ductal carcinoma in situ (DCIS) undergoing magnetic resonance imaging (MRI) for pretreatment planning experienced fear or anxiety before and during the...

Breast Cancer
Immunotherapy

Eftilagimod Alpha Plus Paclitaxel May Improve Survival in HR-Positive, HER2-Negative Metastatic Breast Cancer: AIPAC Trial

The addition of the LAG-3 protein eftilagimod alpha to paclitaxel led to a significant improvement in overall survival in younger patients with hormone receptor (HR)-positive, HER2-negative metastatic breast cancer, according to data presented by Hans Wildiers, MD, and colleagues at the Society for ...

Breast Cancer

Aditya Bardia, MD, MPH, Comments on Findings From monarchE

The invited discussant of monarchE,1 Aditya Bardia, MD, MPH, Director, Breast Cancer Research, and Associate Professor of Medicine, Harvard Medical School, commented: “Based on a hazard ratio of 0.69 for invasive disease–free survival, the results are statistically significant and clinically...

Breast Cancer

Long-Term Follow-up of monarchE: Benefit of Abemaciclib Plus Endocrine Therapy Maintained in Early High-Risk Breast Cancer

Longer-term follow-up of the global phase III monarchE trial showed an increasing benefit for adding abemaciclib to endocrine therapy in the adjuvant treatment of early high-risk hormone receptor–positive, HER2-negative breast cancer, regardless of Ki67 index. The latest findings were reported at a ...

Breast Cancer

Phase II Breast Cancer Trial: Large Declines in Ki67 Index Seen With Oral Selective Estrogen Receptor Degrader

In the phase II coopERA Breast Cancer trial, which evaluated two endocrine neoadjuvant therapies in estrogen receptor–positive, HER2-negative early breast cancer, the oral selective estrogen receptor degrader giredestrant led to a greater reduction in Ki67 level—a measure of cancer cell...

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