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Breast Cancer

ESMO Asia 2020: Baseline Characteristics of Asian Patients Enrolled in the monarchE Trial

A comparison of baseline characteristics in patients with hormone receptor (HR)-positive, HER2-negative early breast cancer revealed that a higher proportion of patients enrolled from Asia had risk factors for disease recurrence than those enrolled from non-Asian countries, reported Jiang et al at...

Breast Cancer
Immunotherapy

Guideline Update Offers New Directions About Trastuzumab Emtansine for HER2-Positive Breast Cancer

About 10% to 20% of newly diagnosed breast cancers demonstrate overexpression of the HER2 protein.1 Since the introduction of trastuzumab, several new HER2-targeted therapies have been approved for use in the adjuvant and metastatic settings (eg, pertuzumab, lapatinib, and neratinib). However, for...

Breast Cancer
Legislation

Study Finds Medicaid Expansion in Louisiana Increased Early-Stage Breast Cancer Diagnosis and Access to Treatment

A study by Quyen D. Chu, MD, MBA, FACS, and colleagues published in the journal Cancer investigated how expansion of the Medicaid provision in the the Patient Protection and Affordable Care Act (ACA) affected breast cancer care in Louisiana. The state is the third poorest in the country and has one ...

Breast Cancer
Gynecologic Cancers
Genomics/Genetics

Screening Younger Women for Variants Linked to Breast and Ovarian Cancers May Be Cost-Effective

Population-wide screening for genetic variants linked to hereditary breast and ovarian cancers may be cost-effective in women between the ages of 20 and 35, according to a study published by Guzauskas et al in JAMA Network Open. However, screening for older women was not cost-effective, the...

Breast Cancer

Researchers Develop Prognostic Model to Guide Systemic Therapy for Early-Stage HER2-Positive Breast Cancer

As reported in The Lancet Oncology, Prat et al have developed a prognostic risk score model—HER2DX—that can be used to identify patients with early-stage HER2-positive breast cancer who might be candidates for escalated or de-escalated systemic treatment. As stated by the investigators, “In...

Breast Cancer
Genomics/Genetics

Paclitaxel Plus Trastuzumab With or Without Lapatinib in HER2-Positive Breast Cancer: Long-Term Follow-up and Genomic Analysis

In a 7-year follow-up of the phase III CALGB 40601/Alliance neoadjuvant trial reported in the Journal of Clinical Oncology, Fernandez-Martinez et al found that paclitaxel combined with trastuzumab/lapatinib was associated with improved survival outcomes vs paclitaxel/trastuzumab in women with...

Breast Cancer

Can Circulating Tumor Cell Count Guide First-Line Chemotherapy or Endocrine Therapy for HR-Positive, HER2-Negative Metastatic Breast Cancer?

In the French phase III STIC CTC trial reported in JAMA Oncology, François-Clément Bidard, MD, PhD, and colleagues found that choice of first-line chemotherapy vs endocrine therapy in hormone receptor (HR)-positive, HER2-negative metastatic breast cancer based on circulating tumor cell count...

Breast Cancer

Addition of Indoximod to Taxane Chemotherapy in First-Line Treatment of HER2-Negative Metastatic Breast Cancer

In a phase II trial reported in JAMA Oncology, Mariotti et al found that the addition of the indoleamine 2,3-dioxygenase 1 (IDO1) pathway inhibitor indoximod to a taxane did not improve progression-free survival in first-line treatment of patients with metastatic HER2-negative breast cancer. As...

Legislation
Breast Cancer
Colorectal Cancer
Lung Cancer

Medicaid Expansion Associated With Decreased Mortality in Patients With Newly Diagnosed Breast, Colorectal, and Lung Cancers

In states that have expanded Medicaid availability as part of the Affordable Care Act (ACA), mortality rates for three major types of cancer are significantly lower than in states that have not expanded their Medicaid, according to findings from a new study published by Miranda B. Lam, MD, MBA, and ...

Breast Cancer

Reduced Breast Cancer Mortality and Risk of Recurrence With Internal Mammary and Medial Supraclavicular Nodal Irradiation in Stage I to III Breast Cancer

As reported in The Lancet Oncology by Philip M. Poortmans, PhD, and colleagues, 15-year outcomes of the phase III EORTC 22922/10925 trial show continued reductions in both breast cancer mortality and recurrence with postsurgery internal mammary and medial supraclavicular (IM-MS) lymph node chain...

Breast Cancer

Beyond BROCADE3: Just the Beginning for Veliparib-Based Therapy in Advanced BRCA-Mutated Breast Cancer

As recently reported in The Lancet Oncology and reviewed in the October 10, 2020, issue of The ASCO Post, the phase III BROCADE3 trial has shown that the addition of veliparib to carboplatin and paclitaxel improved progression-free survival in previously treated BRCA-mutated advanced breast...

Breast Cancer

Predicting Cardiovascular Disease Risk Via Routine CT Scans in Women With Breast Cancer

Coronary artery calcification scores based on routine computed tomography (CT) scans used for planning radiotherapy therapy may be able to predict which women with breast cancer have a high probability of developing cardiovascular disease. The promise of this research is that once high-risk...

Breast Cancer

Expert Point of View: Charles L. Shapiro, MD

The ASCO Post asked Charles L. Shapiro, MD, Professor of Medicine, Director of Translational Breast Cancer Research, and Director of Cancer Survivorship at Icahn School of Medicine at Mount Sinai, New York, for his thoughts on the exploratory analysis of PALOMA-3. He first pointed out that the...

Breast Cancer

PALOMA-3 Exploratory Analysis: Who Benefits Most From Palbociclib?

The phase III PALOMA-3 trial significantly reduced the risk of disease progression by 50% in patients with hormone receptor–positive/HER2-negative advanced breast cancer, but the improvement in overall survival did not reach statistical significance.1 An exploratory subgroup analysis has now shown...

Breast Cancer
Geriatric Oncology

Surgery Improves Survival in Older Women With Early Estrogen Receptor–Positive Breast Cancer

Older women with estrogen receptor–positive breast cancer have poorer survival than younger women, but this gap might be closed by offering surgery to women over age 70 who are fit and have resectable tumors. According to a study presented at the 12th European Breast Cancer Conference (EBCC 12),...

Breast Cancer
Immunotherapy

First-Line Pembrolizumab Delays Disease Progression in PD-L1–Expressing Metastatic Triple-Negative Breast Cancer

In the phase III KEYNOTE-355 trial, pembrolizumab combined with several chemotherapy partners yielded a statistically significant and clinically meaningful improvement in progression-free survival vs chemotherapy alone in patients with previously untreated locally advanced or metastatic...

Breast Cancer

Recently Approved and Emerging Therapies for Triple-Negative Breast Cancer

“Triple-negative breast cancer has multiple different subtypes, and there are targeted therapies that can be used based on the biomarkers that we identify for each patient,” Kari B. Wisinski, MD, noted in a review of recently approved and emerging therapies at the 2020 Lynn Sage Breast Cancer...

Breast Cancer
Lung Cancer
Gynecologic Cancers

FDA Approves Companion Diagnostic for Three Targeted Therapies for Advanced Ovarian, Breast, and Non–Small Cell Lung Cancers

On October 27, 2020, the U.S. Food and Drug Administration (FDA) approved the FoundationOne Liquid CDx test for three new companion diagnostic indications to help match patients who may benefit from treatment with specific FDA-approved targeted therapies. The new indications are for alpelisib...

Breast Cancer
Genomics/Genetics

Olaparib for Patients With Metastatic Breast Cancer and Mutations in Homologous Recombination–Related Genes

In a phase II Translational Breast Cancer Research Consortium (TBCRC) study (TBCRC 048; Olaparib Expanded) reported in the Journal of Clinical Oncology, Nadine M. Tung, MD, and colleagues found that olaparib produced high response rates in patients with metastatic breast cancer and germline PALB2...

Breast Cancer

Potential Factors in Prognostic Discrepancies Among Tests for Recurrence Risk in Patients With Breast Cancer Receiving Endocrine Therapy

The TransATAC study reported by Buus et al in the Journal of Clinical Oncology sought to identify causes of discrepancies among tests for determining the risk of breast cancer recurrence in patients with estrogen receptor–positive, HER2-negative disease receiving endocrine therapy. The...

Breast Cancer

Immediate Breast Reconstruction vs Conventional Mastectomy After Neoadjuvant Chemotherapy: Long-Term Outcomes

In a Korean single-institution study reported in JAMA Surgery, Wu et al found no differences in long-term breast cancer outcomes between women who underwent immediate breast reconstruction with nipple-sparing or skin-sparing mastectomy vs those who underwent conventional mastectomy alone after...

Breast Cancer
Genomics/Genetics

Breast Cancer Risk and Disease-Causing Genetic Mutations in Women Older Than 65

Women with breast cancer onset after age 65 often do not qualify for genetic testing, yet little is known about the frequency of disease-causing mutations in breast cancer predisposition genes in this population. In a new study, researchers investigated the prevalence of disease-causing variants in ...

Breast Cancer
Immunotherapy

Effect of Early Trastuzumab Interruption on Recurrence-Free Survival in HER2-Positive Breast Cancer

In a single-center analysis reported in a research letter in JAMA Oncology, Copeland-Halperin et al found that early trastuzumab interruption and interruption resulting in a cumulative trastuzumab dose ≤ 56 mg/kg were associated with significantly poorer recurrence-free survival in patients with...

breast cancer

Alphonse G. Taghian, MD, PhD, on Irradiation for Breast Cancer: Defining the Optimal Dose

Alphonse G. Taghian, MD, PhD, of Massachusetts General Hospital, reviews the 10-year follow-up of a dose-escalation trial studying accelerated partial-breast irradiation and discusses the optimal dose, adverse effects, and cosmetic outcomes (Abstract 25).

breast cancer

Youssef Zeidan, MD, PhD, on HER2-Positive Breast Cancer: Deintensifying Radiation Therapy

Youssef Zeidan, MD, PhD, of the American University of Beirut Medical Center, discusses study findings showing that breast-conserving surgery, whole-breast irradiation, and trastuzumab offer effective local tumor control for patients with HER2-positive breast cancer. An additional radiation boost does not seem to further improve outcomes (Abstract 52).

breast cancer

Juliane Hörner-Rieber, MD, on Breast Cancer: Boosting Intensity-Modulated and Conventional Radiotherapies

Juliane Hörner-Rieber, MD, of Heidelberg University Hospital, discusses phase III results of the MINT trial, which showed that conventionally fractionated intensity-modulated radiotherapy with a simultaneous integrated boost was noninferior to three-dimensional conformal radiotherapy followed by a sequential boost for both local control and cosmesis in patients with breast cancer (Abstract 19).

Breast Cancer
Gynecologic Cancers
Prostate Cancer
Genomics/Genetics

FDA Approves Companion Diagnostic for Three Targeted Therapies for Advanced Ovarian, Breast, and Non–Small Cell Lung Cancers

On October 27, the U.S. Food and Drug Administration (FDA) approved the FoundationOne Liquid CDx test for three new companion diagnostic indications to help match patients who may benefit from treatment with specific FDA-approved targeted therapies. The new indications are for alpelisib (Piqray) in ...

Breast Cancer
Issues in Oncology

Trends and Outcomes Among Hispanic Women of Different Races With Breast Cancer

In a National Cancer Database analysis reported in JCO Oncology Practice, Champion et al identified patterns in disease characteristics, time to surgery, and overall survival among Hispanic patients of different races and among Hispanic and non-Hispanic women of the same race. Study Details The...

Breast Cancer

Expect Questions About Increased Cancer Mortality Risk Among Patients Diagnosed With DCIS

A large cohort study1 finding that the risk of dying of breast cancer was increased threefold after a DCIS diagnosis may cause patients diagnosed with DCIS to ask what they can do to reduce that risk. Currently, there is little that most patients can do. “The lifetime risk of death following DCIS...

Breast Cancer

Focus on Preventing Invasive Recurrence in Women With DCIS Does Not Sufficiently Address Breast Cancer Mortality

A study published recently by Giannakeas et al looked at the risk of death from breast cancer for women diagnosed with ductal carcinoma in situ (DCIS).1 The investigators anticipated that treatment would eliminate the risk of invasive ipsilateral recurrence and prevent subsequent mortality from...

Breast Cancer
Immunotherapy

Sacituzumab Govitecan Yields Survival Benefit as Third-Line Treatment in Triple-Negative Breast Cancer: ASCENT Trial

Based on results from a phase I/II clinical trial, the antibody drug conjugate sacituzumab govitecan was recently granted accelerated approval in the treatment of patients with advanced triple-negative breast cancer, contingent on a larger study confirming its benefit. The confirmatory phase III...

Breast Cancer

Should Body Mass Index Guide the Choice of Chemotherapy in Patients With Breast Cancer?

The rate of obesity is rising dramatically in the United States and Europe, with more than 60% of women in the United States1,2 and 50% of women in Europe3 classified as overweight or obese based on their body mass index (BMI). Obesity is associated with an increased risk of hormone...

Breast Cancer

Effect of Virtual Tumor Board Implementation on Use of Whole-Breast Hypofractionated Radiation Therapy

In an observational cohort study reported in JCO Oncology Practice, Powell et al found that the use of whole-breast hypofractionated radiotherapy increased among patients with breast cancer with health insurance plans from one national health-care organization after the implementation of a virtual...

Breast Cancer

Are Delays in Breast Cancer Treatment as Harmful as Commonly Thought?

Delays in the treatment of breast cancer matter, but not as much “as we and our patients typically assume,” Richard J. Bleicher, MD, FACS, informed participants at the 22nd Annual Lynn Sage Breast Cancer Symposium.1 Some of these delays are unavoidable and others are tradeoffs that must be made to...

Breast Cancer

Final Efficacy Results From the ExteNET Trial: Neratinib in Pretreated Patients With HR-Positive, HER2-Positive Early Breast Cancer

In an analysis from the phase III ExteNET trial reported in Clinical Breast Cancer, Arlene Chan, MD, and colleagues found significant improvements in efficacy outcomes with the administration of neratinib vs placebo starting at 1 year or sooner after neoadjuvant/adjuvant trastuzumab-based therapy...

Breast Cancer
Issues in Oncology

Limited English-Language Proficiency May Affect Frequency of Screening Mammograms

Limited English-language proficiency may be a risk factor for receiving screening mammograms less often, according to new study results using national data. These findings, concerning women age 40 and older living in the United States, were presented at the American College of Surgeons Clinical...

Breast Cancer
Immunotherapy

Addition of Atezolizumab to T-DM1 in Previously Treated Patients With HER2-Positive Advanced Breast Cancer

In the phase II KATE2 trial reported in The Lancet Oncology, Leisha A. Emens, MD, and colleagues found that the addition of atezolizumab to ado-trastuzumab emtansine (T-DM1) did not improve progression-free survival in patients with advanced HER2-positive breast cancer progressing after previous...

breast cancer
covid-19

Melissa K. Accordino, MD, on Breast Cancer Care Delivery: Impact of the COVID-19 Pandemic

Melissa K. Accordino, MD, of Columbia University Medical Center, discusses findings showing nearly half of the patients with breast cancer treated at an academic center in New York City experienced a change or delay in their workup or treatment during the COVID-19 pandemic. Race and socioeconomic factors played a significant role (Abstract 88).

Breast Cancer

Clinical Challenges of Managing Breast Cancer Brain Metastases

“Breast cancer brain metastases are a clinical challenge that are only increasing in incidence and are a consequence of advanced breast cancers, largely HER2-positive and triple-negative,” according to Carey K. Anders, MD, Professor of Medicine and Medical Director of the Duke Brain and Spine...

Issues in Oncology
Breast Cancer

Do Hospitals That Primarily Serve Minority Patients Offer Standard Surgical Care for Patients With Breast Cancer?

Among accredited cancer centers in the United States, hospitals serving primarily minority patients are as likely as other hospitals to offer the standard of surgical care for early-stage breast cancer, according to results presented at the virtual American College of Surgeons Clinical Congress...

Breast Cancer
Symptom Management

Can Routine Scans Help Predict Which Patients With Breast Cancer May Be at Risk for Heart Disease?

Automated analysis of the routine scans of patients with breast cancer may help to predict which women have a greater risk of developing cardiovascular disease, according to research presented by Gal et al at the 12th European Breast Cancer Conference (Abstract 7). Women who have been treated for...

Breast Cancer
Immunotherapy

NeoALTTO Trial: Final Analysis Examines Neoadjuvant Lapatinib/Trastuzumab in HER2-Positive Breast Cancer

Final analysis of results from a randomized clinical trial of lapatinib and trastuzumab given before surgery in patients with early HER2-positive breast cancer has found that women who had a pathologic complete response survived longer without cancer recurrence than patients who did not. This was...

Breast Cancer

Addition of Veliparib to Carboplatin/Paclitaxel in BRCA-Mutated Advanced Breast Cancer

As reported in The Lancet Oncology by Véronique Diéras, MD, of the Institut Curie, Paris, and Centre Eugène Marquis, Rennes, and colleagues, the phase III BROCADE3 trial has shown a significant improvement in progression-free survival with the addition of the poly (ADP-ribose) polymerase (PARP)...

Issues in Oncology
Breast Cancer
Colorectal Cancer
Lung Cancer
Genomics/Genetics
Multiple Myeloma
Pancreatic Cancer

Trends to Watch in Early-Onset Cancer Among Young Adults

Although cancer incidence and mortality rates for all cancers combined are considerably lower in younger adults than older adults, a disturbing pattern is beginning to emerge in the development of early-onset cancers, typically diagnosed in older patients, occurring in younger adults. The rising...

Breast Cancer
Pain Management

Eliminating Routine Opioids While Maintaining Pain Control for Women Undergoing Lumpectomy or Excisional Biopsy

Changing from routinely prescribing opioids for patients who were having a lumpectomy or excisional biopsy to instead routinely prescribing nonsteroidal anti-inflammatory drugs [NSAIDs] resulted in a sharply decreased opioid prescription rate with “no difference in the proportion of patients...

Breast Cancer

Expert Point of View: George W. Sledge, Jr, MD

The results of monarchE were discussed by George W. Sledge, Jr, MD, Professor of Medicine and Chief of Oncology at Stanford University Medical Center, who offered some possibilities as to why its results were positive and those for palbociclib, in the phase III PALLAS trial, were “resoundingly...

Breast Cancer

Addition of Abemaciclib to Endocrine Therapy Reduces Recurrence in Early Breast Cancer

For the first time, an inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6) has reduced the risk of invasive disease recurrence in patients with early breast cancer when combined with standard endocrine therapy, investigators reported at the European Society for Medical Oncology (ESMO) Virtual...

Breast Cancer

Phase III NALA Trial Meets Primary Endpoint in Previously Treated HER2-Positive Breast Cancer

As reported in the Journal of Clinical Oncology by Cristina Saura, MD, of Vall d’Hebron University Hospital, Barcelona, and colleagues, the phase III NALA trial has shown significantly prolonged progression-free survival with the irreversible pan-HER tyrosine kinase inhibitor neratinib plus...

Breast Cancer

Tucatinib Combination Extends Survival in HER2-Positive Metastatic Breast Cancer, Including Patients With Brain Metastases

For patients with progressing HER2-positive metastatic breast cancer previously treated with trastuzumab, pertuzumab, and ado-trastuzumab emtansine (T-DM1), no single regimen is an established standard of care. More than 50% of these patients will develop brain metastasis, and thus far, treatments...

Breast Cancer

Managing Breast Cancer in a Pregnant Patient

“One of the most challenging oncologic situations is the diagnosis of breast cancer in a young pregnant patient,” Jacqueline Jeruss, MD, PhD, Associate Dean, Regulatory Affairs; Director of the Breast Care Center; and Professor of Surgery, Pathology, and Biomedical Engineering at the University of...

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