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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 the objective response rate compared with the antibody-drug conjugate ado-trastuzumab emtansine (T-DM1) after trastuzumab and taxane therapy in women with HER2-positive metastatic...

Breast Cancer

Highlights From the 2021 San Antonio Breast Cancer Symposium

In its first return to a hybrid model since the COVID-19 pandemic began, the 2021 San Antonio Breast Cancer Symposium (SABCS) brought together researchers, clinicians, industry experts, patients, and advocates from across the globe to present and grapple with new data and important topics in breast ...

Breast Cancer

Prediction Model for BRCA Mutation–Carrying Status in Asian Patients With Breast Cancer

In a study reported in the Journal of Clinical Oncology, Ang et al developed a model for predicting carrier status of pathogenic variants in BRCA1 or BRCA2 among Asian women with breast cancer. As stated by the investigators: “With the development of poly (ADP-ribose) polymerase [PARP] inhibitors...

Breast Cancer

Study Investigates the Risk of Breast Cancer Mortality After Late Breast Cancer Recurrence

In a Danish study reported in the Journal of Clinical Oncology, Pedersen et al identified risk of breast cancer mortality among women with breast cancer recurrence at ≥ 10 years after primary diagnosis and found that mortality risk was reduced after late vs early recurrence. Study Details The study ...

Breast Cancer
Immunotherapy

KEYNOTE-522: Event-Free Survival With Neoadjuvant and Adjuvant Pembrolizumab in Triple-Negative Breast Cancer

As reported in The New England Journal of Medicine by Peter Schmid, MD, PhD, and colleagues, a preplanned interim analysis of the phase III KEYNOTE-522 trial has shown improved event-free survival with the addition of pembrolizumab to neoadjuvant chemotherapy, followed by adjuvant pembrolizumab, in ...

Breast Cancer

As a Black Woman, I Knew I Had to Advocate for the Best Breast Cancer Care

When I got the call from the radiology department telling me I had to come back for a follow-up mammogram right before Christmas of 2020, I wasn’t surprised or initially concerned. I have dense breasts, and my first mammogram 2 years earlier had also detected suspicious areas in one of my breasts...

Breast Cancer

ASCO Updates Guidance on Use of Abemaciclib and Endocrine Therapy in Patients With High-Risk Early Breast Cancer

A rapid update to the ASCO guideline on optimal adjuvant chemotherapy and targeted therapy for early breast cancer provides guidance on the use of the oral cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitor abemaciclib with endocrine therapy in patients with high-risk early breast cancer.1 The...

Breast Cancer

Single-Cell Spatial Connectivity Analysis Offers ‘Unprecedented’ Information in Breast Cancer

A next-generation technology that focuses on protein expression at the single-cell level has yielded a wealth of information about “spatial connectivity” between cancer cells and their microenvironment. It also provided information on the benefit of adding the immune checkpoint inhibitor...

Breast Cancer

Meta-Analysis of Aromatase Inhibitors vs Tamoxifen in Premenopausal Women With ER-Positive Early-Stage Breast Cancer Receiving Ovarian Suppression

In a patient-level meta-analysis reported in The Lancet Oncology, researchers from the Early Breast Cancer Trialists’ Collaborative Group found that use of an aromatase inhibitor vs tamoxifen reduced the risk of recurrence in premenopausal women with estrogen receptor (ER)-positive early breast...

Breast Cancer

Does Daily Aspirin Help Prevent Breast Cancer Recurrence?

Taking aspirin daily does not prevent breast cancer recurrence, according to research presented by Wendy Y. Chen, MD, MPH, a medical oncologist at Dana-Farber Cancer Institute, during the February 2022 ASCO Plenary Series session (Abstract 360922). Results of a double-blind phase III study of more...

breast cancer
immunotherapy

Sara A. Hurvitz, MD, on HER2-Positive Metastatic Breast Cancer: T-DXd vs T-DM1

Sara A. Hurvitz, MD, of the University of California, Los Angeles Jonsson Comprehensive Cancer Center, discusses phase III findings from the DESTINY-Breast03 trial, which compared ado-trastuzumab deruxtecan (T-DXd) with standard-of-care trastuzumab emtansine (T-DM1) in patients with HER2-positive metastatic breast cancer. T-DXd showed superior progression-free survival across subgroups of patients previously treated with trastuzumab and a taxane, including those with brain metastases (Abstract GS3-01).

Breast Cancer

Study Identifies Factors Impacting Adherence to Oral Medications for Metastatic Breast Cancer

A recent study published by Conley et al in Breast Cancer Research and Treatment aimed to evaluate factors that influence the ability of people with metastatic breast cancer to adhere to their prescribed regimen of oral anticancer medication. Researchers found that multiple factors affected...

Breast Cancer
Immunotherapy

Concordance for Low HER2 Protein Expression in Breast Cancer Tissue Using Standard Immunohistochemistry Assays

In a study reported in JAMA Oncology, Fernandez et al found that scoring accuracy for low HER2 protein expression (0 or 1+) in breast cancer tissue on standard immunohistochemistry (IHC) assays was poor. As observed by the investigators, the findings pose issues for investigation of fam-trastuzumab ...

Breast Cancer

RxPONDER Trial: Another Step in Defining Which Patients With Breast Cancer May Be Spared Adjuvant Cytotoxic Chemotherapy

As reported by Kalinsky et al and summarized in this issue of The ASCO Post, an interim analysis of the phase III RxPONDER trial showed that the addition of adjuvant chemotherapy to endocrine therapy improved invasive disease–free survival among premenopausal—but not postmenopausal—women with...

Breast Cancer

Improved Outcomes With Adjuvant Chemoendocrine vs Endocrine Therapy in Premenopausal Women With Node-Positive Breast Cancer and Recurrence Score ≤ 25

In an interim analysis of a phase III trial (RxPONDER) reported in The New England Journal of Medicine, Kevin Kalinsky, MD, MS, of Winship Cancer Institute, and colleagues found that the addition of adjuvant chemotherapy to endocrine therapy improved invasive disease–free survival among...

Breast Cancer

Expert Point of View: Charles Shapiro, MD

Charles Shapiro, MD, Professor of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, commented on the study findings. “MA.32 is a large, randomized placebo-controlled trial of metformin in over 3,600 women with invasive breast cancer. The rationale for...

Breast Cancer

Metformin Added to Standard Adjuvant Chemotherapy Fails to Improve Outcomes in Early Breast Cancer

The addition of metformin, a drug commonly used to treat type 2 diabetes, to standard adjuvant treatment failed to improve invasive disease–free survival or overall survival for hormone receptor–positive or –negative breast cancer, according to the results of a large landmark trial led by the...

Breast Cancer
Genomics/Genetics
Immunotherapy

Expert Point of View: Angela DeMichele, MD, MSCE

Angela DeMichele, MD, MSCE, the Alan and Jill Miller Professor in Breast Cancer Excellence at the Perelman School of Medicine of the University of Pennsylvania in Philadelphia, commented on NIMBUS1 for The ASCO Post. She said obtaining information on tumor mutational burden is simple, as it is part ...

Breast Cancer
Genomics/Genetics
Immunotherapy

Dual Checkpoint Inhibitor Therapy Elicits Responses in Highly Mutated Breast Cancer

Patients with advanced HER2-negative metastatic breast cancer and high tumor mutational burden achieved responses—often durable—from treatment with the immunotherapy doublet of nivolumab and ipilimumab, according to results of the phase II NIMBUS trial reported at the 2021 San Antonio Breast Cancer ...

Breast Cancer
Immunotherapy

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

The ASCO Post asked Debu Tripathy, MD, Professor and Chair of Medical Breast Oncology at The University of Texas MD Anderson Cancer Center, Houston, and Hope S. Rugo, MD, FASCO, Professor of Medicine, Director of Breast Oncology and Clinical Trials Education at the University of California San...

Breast Cancer
Immunotherapy

Datopotamab Deruxtecan Shows Activity in Advanced Triple-Negative Breast Cancer

Datopotamab deruxtecan, an antibody-drug conjugate directed against trophoblast cell surface antigen-2 (Trop-2), is showing promise as a treatment for relapsed or refractory advanced triple-negative breast cancer, according to early findings from the phase I TROPION-PanTumor01 trial presented...

Breast Cancer

Expert Point of View: Anne Blaes, MD

Invited discussant Anne Blaes, MD, of the University of Minnesota, Minneapolis, emphasized the main takeaway finding of the combined updated analysis of the SOFT and TEXT trials. “In early-stage estrogen receptor–positive breast cancer, premenopausal women who don’t require chemotherapy do very...

Breast Cancer

Evidence Supports Ovarian Function Suppression Plus Aromatase Inhibitor in Premenopausal Women With Early Breast Cancer

The benefits of ovarian function suppression were sustained long term for premenopausal women with hormone receptor–positive breast cancer, according to updates from SOFT and TEXT, two randomized, controlled trials, presented at the 2021 San Antonio Breast Cancer Symposium.1 A separate large...

Breast Cancer
Immunotherapy

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

The discussant of KEYNOTE-522 at the 2021 San Antonio Breast Cancer Symposium, Hope S. Rugo, MD, FASCO, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education at the University of California San Francisco Comprehensive Cancer Center, commented: “We are clearly making...

Breast Cancer
Immunotherapy

KEYNOTE-522: Sensitivity Analyses Confirm Value of Neoadjuvant Pembrolizumab in Triple-Negative Breast Cancer

Updated results from the pivotal KEYNOTE-522 trial have confirmed the benefit of neoadjuvant therapy with pembrolizumab plus chemotherapy in patients with early triple-negative breast cancer.1 The results were presented at the 2021 San Antonio Breast Cancer Symposium by Peter Schmid, MD, PhD,...

Breast Cancer

PALLAS Trial in Hormone Receptor–Positive, HER2-Negative Breast Cancer: Defining the Role of Adjuvant CDK4/6 Inhibition

Over the past 7 years, the introduction of combined endocrine therapy with cyclin-dependent kinase (CDK) 4/6 inhibitors resulted in a dramatic improvement in outcomes for patients with metastatic, hormone receptor–positive, HER2-negative breast cancer. Early attempts to modulate the cell cycle with ...

Breast Cancer

PALLAS Trial: No Invasive Disease–Free Survival Benefit With Addition of Adjuvant Palbociclib to Endocrine Therapy in Early Breast Cancer

As reported in the Journal of Clinical Oncology by Michael Gnant, MD, of the Comprehensive Cancer Center, Medical University of Vienna, and colleagues, the final analysis of the phase III PALLAS trial has shown no invasive disease–free survival benefit with the addition of adjuvant palbociclib to...

Breast Cancer
Supportive Care

Compression Sleeves to Reduce Risk of Arm Swelling in Women Undergoing Surgery for Breast Cancer

In an Indian single-center study reported in the Journal of Clinical Oncology, Paramanandam et al found that the prophylactic use of compression sleeves reduced the risk of arm swelling in women with breast cancer undergoing axillary lymph node dissection. Study Details In the study, 301 evaluable...

Breast Cancer

Can An Intelligent Vacuum-Assisted Biopsy Algorithm Reliably Identify Patients With Breast Cancer Who Have a Pathologic Complete Response to Neoadjuvant Therapy?

In a study reported in the Journal of Clinical Oncology, Pfob et al developed a machine learning algorithm–based (intelligent) vacuum-assisted biopsy model that could identify patients with pathologic complete response (ypT0 and ypN0) to neoadjuvant therapy for breast cancer who may be able to...

Breast Cancer
Genomics/Genetics

Association of Breast Cancer Subtypes With Pathogenic Germline Variants in Nine Breast Cancer Susceptibility Genes

In a study reported in JAMA Oncology, researchers from the Breast Cancer Association Consortium found that pathogenic germline variants in nine breast cancer susceptibility genes were associated with different breast cancer subtypes, although most were also associated with triple-negative disease....

Breast Cancer
Supportive Care

Predictive Model for Severe Fatigue After Breast Cancer Diagnosis

In a study reported in the Journal of Clinical Oncology, Di Meglio et al developed a predictive model for severe fatigue after a diagnosis of breast cancer. Study Details The study involved data on patients with stage I to III breast cancer included in the prospective multicenter CANcer TOxicity...

Breast Cancer
Genomics/Genetics

Role of CECR2 Gene in Advanced Triple-Negative Breast Cancer

A new study published by Zhang et al in Science Translational Medicine shows inhibition of the CECR2 gene may prevent triple-negative breast cancer from advancing or metastasizing. The discovery is an early step in finding new therapeutics for triple-negative breast cancer, one of the most...

Breast Cancer

Pyrotinib and Capecitabine in HER2-Positive Breast Cancer With Brain Metastases

In the Chinese phase II PERMEATE trial reported in The Lancet Oncology, Yan et al found that the combination of the pan-HER receptor tyrosine kinase inhibitor pyrotinib plus capecitabine produced high intracranial response rates in women with HER2-positive breast cancer and brain metastases,...

Breast Cancer
Immunotherapy

Use of Autologous Metastasis Mutation–Reactive TILs in Metastatic Breast Cancer

In a National Institutes of Health study reported in the Journal of Clinical Oncology, Zacharakis et al found that treatment with autologous tumor-infiltrating lymphocytes (TILs) reactive to mutations in metastatic lesions produced responses in patients with metastatic breast cancer. Study Details...

Breast Cancer

Can Postsurgical Monoclonal Antibody Treatment Reduce HER2-Positive Early-Stage Breast Cancer Recurrence?

Treating women diagnosed with a certain type of early-stage breast cancer with the monoclonal antibody trastuzumab after surgery may reduce the risk of the cancer returning, according to a report published by Ali et al in Scientific Reports. The research team from the University of Saskatchewan...

Breast Cancer

Outcomes in a Large Cohort of Patients With Ultra-Low–Risk Breast Cancer: Analysis From the MINDACT Trial

As reported in the Journal of Clinical Oncology by Josephine M.N. Lopes Cardozo, MD, and colleagues, long-term follow-up in the phase III MINDACT trial has shown excellent outcomes among a large group of patients with ultra-low­–risk breast cancer as classified by the 70-gene signature assay, with...

Breast Cancer

Palbociclib Exposure and Discontinuation and Potential Impact on Outcome in the PALLAS Trial

In an analysis reported in the Journal of Clinical Oncology, Erica L. Mayer, MD, MPH, and colleagues found that early discontinuation and lower exposure intensity of oral palbociclib did not appear to account for the lack of invasive disease–free survival benefit observed with the addition of...

Breast Cancer

David Cescon, MD, PhD, Comments on the MONALEESA Analyses

David Cescon, MD, PhD, Clinician Scientist at the Princess Margaret Cancer Centre in Toronto, Canada, was the invited discussant of the two MONALEESA analyses.1,2 He noted that the most recent overall survival analysis, presented at the European Society for Medical Oncology (ESMO) Congress 2021,...

Breast Cancer

MONALEESA Analyses Show Widespread Benefit for Ribociclib in Hormone Receptor–Positive, HER2-Negative Breast Cancer

Further analyses of the ­MONALEESA metastatic breast cancer trials have shown that the benefit of ribociclib plus endocrine therapy in the first-line setting extends to most intrinsic molecular subtypes and is consistent across multiple subgroups. The studies were presented at the 2021 San Antonio...

Breast Cancer
Issues in Oncology

Study Identifies Black Race as Risk Factor for Lymphedema After Axillary Dissection in Women With Breast Cancer

Black women with breast cancer had significantly higher rates of lymphedema after axillary lymph node dissection compared with Hispanic, White, and Asian women in a prospective study of breast cancer–related lymphedema presented at the 2021 San Antonio Breast Cancer Symposium (SABCS). In fact,...

Breast Cancer
Survivorship

Cardiometabolic Risk Factors in Breast Cancer Survivors

In the case-control Pathways Heart Study reported in the Journal of Clinical Oncology, Kwan et al found that breast cancer survivors had an elevated risk for incident diabetes overall and according to treatment as well as an elevated risk of incident hypertension according to treatment vs controls...

Breast Cancer

PADA-1 Trial: With Early Identification of ESR1 Mutation, Switch to Fulvestrant in Metastatic Breast Cancer

Switching from an aromatase inhibitor to fulvestrant upon early identification of the ESR1 mutation in plasma—before disease progression—doubled progression-free survival in the phase III PADA-1 trial, presented at the 2021 San Antonio Breast Cancer Symposium.1 “PADA-1 is the first trial to...

Breast Cancer
Immunotherapy

Long-Term Outcomes After Neoadjuvant Chemotherapy With or Without Carboplatin and Bevacizumab for Triple-Negative Breast Cancer

In an analysis from the phase II CALGB 40603/Alliance trial reported in the Journal of Clinical Oncology, Shepherd et al found that the addition of carboplatin or bevacizumab to neoadjuvant chemotherapy was not associated with improved long-term outcomes in patients with stage II or III...

Breast Cancer

Does Early Locoregional Therapy for the Primary Site Improve Survival in Newly Diagnosed Metastatic Breast Cancer?

In the phase III ECOG-ACRIN E2108 trial reported in the Journal of Clinical Oncology, Seema A. Khan, MD, MPH, and colleagues found no difference in overall survival with early locoregional therapy vs continued systemic therapy among women with newly diagnosed stage IV breast cancer and an intact...

Breast Cancer

Expert Point of View: Anne Blaes, MD

Invited discussant Anne Blaes, MD, Associate Professor of Medicine at the University of Minnesota, Minneapolis, commented on Dr. Braybrooke’s study. “In 18,000 patients in randomized trials initiated before 2012, there was a 15% improvement in recurrence with the use of anthracyclines plus taxanes...

Breast Cancer

Anthracycline Plus Taxane Reduces Risk of Breast Cancer Recurrence at 10 Years

In a large patient-level meta-analysis of 16 trials, presented at the 2021 San Antonio Breast Cancer Symposium (SABCS),1 the combination of an anthracycline plus a taxane achieved a substantial 15% reduction in breast cancer recurrence at 10 years vs taxane chemotherapy alone, representing an...

Breast Cancer
Gynecologic Cancers

Expert Point of View: Steven J. Isakoff, MD, PhD

Steven J. Isakoff, MD, PhD, Director of Breast Cancer Clinical Research at Massachusetts General Hospital, Boston, found the TAMARISK study “interesting.” “Looking at genomic profiles of uterine cancer in both tamoxifen-associated uterine cancer, the researchers found a lower frequency of PIK3...

Breast Cancer
Gynecologic Cancers

PI3K Pathway Activation May Underlie Tamoxifen-Associated Uterine Cancer

Even though it is infrequent, uterine cancer can develop in patients treated with tamoxifen. A study presented at the 2021 San Antonio Breast Cancer Symposium (SABCS) suggests that the mechanism by which uterine cancers develop is tamoxifen-induced PI3K pathway activation.1 Patients treated with...

Breast Cancer
Supportive Care

Depression Screening and Behavioral Health Referrals for Patients With Newly Diagnosed Breast Cancer in the Community Oncology Setting

In a study reported in JAMA, Hahn et al found that a depression screening and intervention program resulted in a higher rate of referral to behavioral health services vs education alone among patients with newly diagnosed breast cancer at community oncology centers located in Southern California....

Breast Cancer

Addition of Capecitabine to Taxane/Anthracycline Adjuvant Chemotherapy for Early Breast Cancer: 15-Year Overall Survival Results of the FinXX Trial

As reported in the Journal of Clinical Oncology by Heikki Joensuu, MD, and colleagues, 15-year overall survival results from the Finland Capecitabine Trial (FinXX) showed that the addition of capecitabine to taxane/anthracycline adjuvant chemotherapy was associated with improved overall survival...

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