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Erika Hamilton, MD, of Sarah Cannon Research Institute at Tennessee Oncology, discusses phase III data from the DESTINY-Breast03 study, which reinforced the consistent safety profile of fam-trastuzumab deruxtecan-nxki (T-DXd) vs ado-trastuzumab emtansine (T-DM1) in patients with HER2-positive unresectable and/or metastatic breast cancer. The findings also support T-DXd’s risk benefit over that of T-DM1 (Abstract 1000).
In a prespecified analysis from the phase III monarchE trial reported in JAMA Oncology, Miguel Martín, MD, PhD, and colleagues found that the addition of adjuvant abemaciclib to endocrine therapy was associated with improved outcomes among women with high-risk hormone receptor–positive,...
In a Canadian phase III trial reported in JAMA Oncology, Vesprini et al found that receipt of adjuvant breast radiotherapy in the supine position was associated with increased risk of moist desquamation of skin vs receipt in the prone position among large-breasted women with breast cancer. Study...
As reported in JAMA by Pamela J. Goodwin, MD, MSc, FRCPC, FASCO, the phase III MA.32 trial showed no invasive disease–free survival benefit with metformin vs placebo in patients without diabetes receiving standard therapy for high-risk nonmetastatic breast cancer. Study Details In the double-blind ...
Lisa A. Carey, MD, of the University of North Carolina Lineberger Comprehensive Cancer Center, and Shanu Modi, MD, of Memorial Sloan Kettering Cancer Center, discuss the phase III findings from the DESTINY-Breast04 trial, which compared fam-trastuzumab deruxtecan-nxki (T-DXd) vs treatment of physician’s choice (TPC) in patients with HER2-low unresectable and/or metastatic breast cancer. T-DXd is the first HER2-targeted therapy to demonstrate clinically meaningful improvement in progression-free and overall survival compared with TPC in this patient population, regardless of hormone receptor or immunohistochemistry status or prior use of CDK4/6 inhibitors (Abstract LBA3).
Ann H. Partridge, MD, MPH, of Dana-Farber Cancer Institute, and Kevin Kalinsky, MD, of Winship Cancer Institute at Emory University, discuss phase II findings from the MAINTAIN trial, which showed a benefit in progression-free survival for patients with hormone receptor–positive/HER2-negative metastatic breast cancer when they switched to endocrine therapy and received ribociclib after disease progression on another CDK4/6 inhibitor (Abstract LBA1004).
Nancy Davidson, MD, of the Fred Hutchinson Cancer Research Center, reviews results from four abstracts about the importance of long-term follow-up in studies of adjuvant endocrine therapy for hormone receptor–positive breast cancer. Because the natural history of hormone receptor–positive breast cancer is long, an effort is underway to improve selection of patients by clinical parameters or biomarkers, refine the endocrine therapy background, and administer more effective combinations of endocrine therapy with other agents.
In a study presented at the 2022 ASCO Annual Meeting (Abstract 103) and simultaneously reported in the Journal of Clinical Oncology, Lipsyc-Sharf et al found that personalized circulating tumor DNA (ctDNA) testing was successful in detecting measurable residual disease (MRD) prior to late clinical...
A new ASCO guideline update provides further recommendations on the use of biomarkers to guide decision-making on adjuvant endocrine therapy and chemotherapy in patients with early-stage breast cancer.1 The update includes clarification of the use of certain genomic tests, based on age or...
In the single-center phase II TUXEDO-1 trial of patients with advanced HER2-positive breast cancer, fam-trastuzumab-deruxtecan-nxki (T-DXd) showed efficacy in patients with active brain metastases, yielding intracranial responses in 73.3% of the population and a median progression-free survival of...
On May 4, 2022, fam-trastuzumab deruxtecan-nxki (T-DXd) was granted regular approval for patients with unresectable or metastatic HER2-positive breast cancer who have received a prior anti-HER2–based regimen in the metastatic setting or in the neoadjuvant or adjuvant setting and have developed...
Preliminary results of the basket BEGONIA trial showed that the antibody-drug conjugate datopotamab deruxtecan (Dato-DXd), paired with the immune checkpoint inhibitor durvalumab, has strong activity in advanced or metastatic triple-negative breast cancer among patients not biomarker-selected for...
Since the introduction of trastuzumab in the late 1990s, overall survival for patients with HER2-positive metastatic breast cancer has substantially improved. Median overall survival in the pivotal first-line trial was only 20.3 months in the chemotherapy arm, and 25.1 months in the...
In an updated analysis of the phase III MONALEESA-3 trial, which included postmenopausal patients with hormone receptor–positive, HER2-negative advanced or metastatic breast cancer, first-line treatment with ribociclib plus fulvestrant added nearly 16 months of overall survival time vs fulvestrant...
As reported in The New England Journal of Medicine by Javier Cortés, MD, PhD, of the International Breast Cancer Center, Barcelona, and colleagues, the phase III DESTINY-Breast03 trial has shown significantly prolonged progression-free survival with fam-trastuzumab deruxtecan-nxki (T-DXd) vs...
Timothy J. Whelan, MD, of McMaster University and Hamilton Health Sciences, discusses findings from the LUMINA study, which found that women aged 55 or older who had grade 1–2 T1N0 luminal A breast cancer following breast-conserving surgery and were treated with endocrine therapy alone had very low rates of local tumor recurrence at 5 years. These patients, the research suggests, may be able to forgo radiotherapy (Abstract LBA501).
Tara B. Sanft, MD, of Yale University, discusses the results of the LEANer study (Lifestyle, Exercise, and Nutrition Early After Diagnosis) in women with breast cancer. It showed that patients with newly diagnosed disease who were just starting chemotherapy could improve physical activity and diet quality. While both groups had high rates of treatment completion, women in the intervention who exercised at or above the recommended levels did better in terms of treatment completion, with fewer dose reductions and delays (Abstract 12007).
Richard Finn, MD, of the Geffen School of Medicine at UCLA and the Jonsson Comprehensive Cancer Center, discusses analyses from the PALOMA-2 trial on overall survival with first-line palbociclib plus letrozole vs placebo plus letrozole in women with ER-positive/HER2-negative advanced breast cancer. The study met its primary endpoint of improving progression-free survival but not the secondary endpoint of overall survival. Although patients receiving palbociclib plus letrozole had numerically longer overall survival than those receiving placebo plus letrozole, the results were not statistically significant (Abstract LBA1003).
Women younger than age 40 with advanced breast cancer often experience more aggressive disease and worse prognoses than their older counterparts. Knowing which types of genetic mutations these patients tend to have may inform treatment strategies and improve outcomes. In a recent study, researchers ...
Based on guidance from biomarker screening, patients with low-grade luminal A–type breast cancer aged 55 and older may need endocrine therapy alone following breast-conserving surgery and may be able to avoid radiation therapy entirely, according to new research findings presented by Timothy Joseph ...
Robert Hugh Jones, MD, PhD, of Cardiff University and Velindre Hospital, discusses results from an updated analysis of the FAKTION trial, which showed improved overall survival with fulvestrant plus capivasertib in women with metastatic estrogen receptor–positive breast cancer whose disease had relapsed or progressed on an aromatase inhibitor. The benefit may be predominantly in patients with PIK3CA/AKT1/PTEN pathway–altered tumors, a topic researchers continue to study in the phase III CAPItello-291 trial (Abstract 1005).
Although women of African descent experience a higher incidence and mortality from triple-negative breast cancer than women of other races or ethnicities, research findings presented by Hall et al at the 2022 ASCO Annual Meeting showed that the magnitude of gene-specific risks of triple-negative...
Lisa A. Carey, MD, of the University of North Carolina Lineberger Comprehensive Cancer Center, and Hope S. Rugo, MD, of the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, discuss phase III results from the TROPiCS-02 trial. This study showed that sacituzumab govitecan-hziy was more beneficial than single-agent chemotherapy in terms of progression-free survival in heavily pretreated patients with hormone receptor–positive/HER2-negative and unresectable advanced breast cancer (LBA1001).
Stephanie Walker, a former nurse and current activist with the Metastatic Breast Cancer Alliance, discusses findings from the BECOME project (Black Experience of Clinical Trials and Opportunities for Meaningful Engagement). They show that, even though Black patients comprise between 4% and 6% of all clinical trial participants, Black women with metastatic breast cancer are willing to consider taking part if steps were taken to increase their awareness, build trust through clear communication with health-care providers, involve people of shared racial/ethnic identity and health experience, and help patients find and access trials (Abstract 1014).
To fully evaluate hormone-blocking therapy following surgery for patients with early-stage high-risk hormone receptor–positive/HER2-negative breast cancer, researchers should continue to track patients for at least 5 years after the completion of active treatment, according to a study reported at...
The use of fam-trastuzumab deruxtecan-nxki doubled progression-free survival compared with the standard-of-care treatment plus conventional chemotherapy. It also significantly improved overall survival for patients with metastatic breast cancers expressing low levels of the HER2 receptor,...
A new genomic test designed to measure the endocrine sensitivity of estrogen receptor–positive breast cancer has the potential to identify patients diagnosed with the disease who could benefit more from dose-dense chemotherapy—a regimen in which chemotherapy is administered more frequently than...
Treatment with the antibody-drug conjugate sacituzumab govitecan-hziy resulted in longer progression-free survival compared to physician’s choice of chemotherapy in patients who have received many prior therapies for hormone receptor–positive/HER2-negative metastatic breast cancer, according to...
In a study reported in JCO Oncology Practice, Taparra et al identified differences in 10-year survival and surgery-to-radiotherapy intervals among disaggregated Asian American and Native Hawaiian/other Pacific Islander women with early-stage breast cancer. The study used National Cancer Database...
As reported in the Journal of Clinical Oncology by Thomas Bachelot, MD, PhD, and colleagues, the phase III UNIRAD trial showed no improvement in disease-free survival with the addition of everolimus to adjuvant endocrine therapy for patients with high-risk hormone receptor–positive, HER2-negative...
On a warm summer afternoon, I stood in front of tables at the local farmers market loaded with my favorite fruits and vegetables: peaches, tomatoes, corn, peppers, melons, kale. I practically drooled thinking about what I could make that week: corn and tomato salad, kale and mushroom quesadillas,...
A survey of patients with metastatic breast cancer found that 83% of Black respondents were somewhat or very likely to consider clinical trial participation; however, 40% of those respondents reported that they had not been informed by their care team about the opportunity to enroll in a trial. The ...
In a German phase IIb trial (GeparX) reported in JAMA Oncology, Jens-Uwe Blohmer, MD, PhD, and colleagues found that the addition of denosumab to neoadjuvant chemotherapy did not improve pathologic complete response rate in patients with breast cancer. They also found that weekly vs less frequent...
A rapid update to the ASCO Guideline on neoadjuvant therapy for breast cancer adds a recommendation on the use of pembrolizumab in patients with high-risk early-stage triple-negative breast cancer.1 The update follows a recent analysis from the randomized phase III KEYNOTE-522 trial that showed a...
Millions of elective surgeries and medical procedures were canceled or postponed by the COVID-19 pandemic. Now, research shows that COVID-19 restrictions were also associated with significant delays in breast cancer care.1 Findings of a cohort study, which compared breast cancer care before and...
More extensive surgery does not improve survival over less aggressive surgery in younger women with breast cancer, according to data presented at the 2022 American Society of Breast Surgeons Annual Meeting.1 The results of a retrospective study of nearly 600 patients showed that treatment with...
In this installment of Living a Full Life, Guest Editor Jame Abraham, MD, spoke with Sara M. Tolaney, MD, MPH, a faculty member of Dana-Farber Cancer Institute and Brigham and Women’s Hospital, where she is Chief of the Breast Cancer Program. Her current research focuses on the development of novel ...
In a subanalysis from the Dutch IMPACT-MBC study reported in the Journal of Clinical Oncology, van Geel et al found that qualitative whole-body 16α-[fluorine F-18]fluoro-17β-estradiol positron-emission tomography/computed tomography ([F-18]FES-PET) was highly accurate in predicting estrogen...
As reported in the Journal of Clinical Oncology by François-Clément Bidard, MD, PhD, and colleagues, the phase III EMERALD trial has shown prolonged progression-free survival with the oral selective estrogen receptor (ER) degrader elacestrant vs standard endocrine therapy among patients with...
In the INSITE study reported in JAMA Surgery, E. Shelley Hwang, MD, MPH, and colleagues found that use of an intraoperative imaging agent with a pegulicianine fluorescence–guided system (pFGS) was effective in detecting residual cancer in the tumor bed of women with breast cancer undergoing...
In an ancillary study of the ECOG-ACRIN Cancer Research Group E4112 study reported in JAMA Network Open, Fazeli et al found that patient preference of type of surgery and type of surgery received for ductal carcinoma in situ (DCIS) were influenced by preoperative magnetic resonance imaging (MRI)...
In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology® covering eight tumor types. Guidelines are now published for more than 60 tumor types, subtypes, and topics. During the NCCN’s 27th Annual Conference, which was again...
As reported in JAMA Oncology by Debu Tripathy, MD, and colleagues, the phase III ATTAIN trial has shown no difference in overall survival with etirinotecan pegol vs physician’s choice of chemotherapy for patients with metastatic breast cancer and brain metastases. As noted by the investigators,...
The risk of invasive breast cancer in men may be associated with self-reported infertility, according to a study published by Swerdlow et al in the journal Breast Cancer Research. The authors interviewed 1,998 males in England and Wales diagnosed with breast cancer, with 112 (5.6%) also...
In a systematic review and meta-analysis reported in the Journal of Clinical Oncology, Singleton et al found that electronic health interventions were associated with improved quality of life, distress, self-efficacy, and fatigue vs usual care during or after treatment in patients with breast...
As reported in The Lancet Oncology by Foerster et al, the African Breast Cancer–Disparities in Outcomes prospective cohort study has shown that a high proportion of women with newly diagnosed nonmetastatic breast cancer in sub-Saharan Africa did not initiate, did not fully complete, or abandoned...
In women aged 70 and older with hormone receptor–positive, HER2-negative, low-risk breast cancers, sentinel lymph node biopsy may not be a reliable indicator of the need for adjuvant chemotherapy, researchers reported at the 2022 American Society of Breast Surgeons Annual Meeting.1 “We found that...
In the Dutch phase III TEAM-IIB trial reported in the Journal of Clinical Oncology, Sonja B. Vliek, MD, and colleagues found that the addition of oral ibandronate to adjuvant endocrine therapy did not improve disease-free survival in postmenopausal women with estrogen receptor (ER)-positive stage I ...
What is so dismaying to me is that the statistic on survival for Black women with breast cancer has not changed since I was diagnosed with breast cancer 17 years ago. In 2005, Black women were 41% more likely to die of the disease than White women, even though Black women are less likely to be...
In an updated analysis of the phase III MONALEESA-3 trial, which included postmenopausal patients with advanced/metastatic hormone receptor (HR)-positive, HER2-negative breast cancer, first-line treatment with ribociclib plus fulvestrant lengthened overall survival by approximately 16 months vs...