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Breast Cancer
Genomics/Genetics

Use of ctDNA to Direct Therapy in Advanced Breast Cancer

In the phase IIa plasmaMATCH platform trial reported in The Lancet Oncology, Nicholas C. Turner, MD, and colleagues found that circulating tumor DNA (ctDNA) provided accurate genotyping that permitted selection of directed therapies in patients with advanced breast cancer. Study Details The...

Breast Cancer

Abbreviated Breast MRI as Supplementary Screening Method in Women With Dense Breasts

In a single-institution retrospective analysis reported in the Journal of Clinical Oncology, Weinstein et al identified the prevalent cancer detection rate associated with supplemental abbreviated breast magnetic resonance imaging (MRI) screening among average-risk women with dense breasts who had...

Breast Cancer

Impact of Neoadjuvant Endocrine Therapy and Neoadjuvant Chemotherapy on Rates of Breast‑Conserving Surgery

“Studies that have compared neoadjuvant endocrine therapy with neoadjuvant chemotherapy have shown low pathologic complete response rates with both approaches. However, the rates of breast-conserving surgery have been shown to be slightly higher with neoadjuvant endocrine therapy,” Kelly Hunt, MD,...

breast cancer

Stephen R.D. Johnston, MD, PhD, on Early Breast Cancer: Abemaciclib in High-Risk Disease

Stephen R.D. Johnston, MD, PhD, of The Royal Marsden NHS Foundation Trust, discusses phase III study findings from the global monarchE trial, which showed that when added to standard adjuvant endocrine therapy, abemaciclib is the first CDK4/6 inhibitor to improve invasive disease–free survival in hormone receptor–positive high-risk early breast cancer (Abstract LBA5_PR). Read more on the monarchE trial in the Journal of Clinical Oncology.

breast cancer

Erika P. Hamilton, MD, on Breast Cancer: Abemaciclib With or Without Tamoxifen in HR-Positive, HER2-Negative Metastatic Disease

Erika P. Hamilton, MD, of Sarah Cannon Research Institute, discusses results of the nextMONARCH study, which indicated that combining abemaciclib with tamoxifen improved overall survival. Dr. Hamilton also details adverse events in different arms of the study (Abstract 273O).

breast cancer

Andreas Schneeweiss, MD, on Breast Cancer: Comparing Neoadjuvant Chemotherapy With Paclitaxel, Doxorubicin, and Carboplatin

Andreas Schneeweiss, MD, of the Heidelberg University Hospital and German Cancer Research Center, discusses phase III survival data from the GeparOcto trial, which compared the neoadjuvant chemotherapy intense dose-dense EPC (epirubicin, paclitaxel, and cyclophosphamide) with weekly paclitaxel and liposomal doxorubicin (with or without carboplatin in triple-negative breast cancer) for patients with high-risk early breast cancer (Abstract 160O).

Breast Cancer

Abemaciclib Plus Endocrine Therapy May Reduce Recurrence in Early Breast Cancer: monarchE Trial

For the first time, an inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6) has improved outcomes in patients with early breast cancer when combined with standard endocrine therapy, Stephen Johnston, MD, PhD, and colleagues reported at the ESMO Virtual Congress 2020 (Abstract LBA5_PR)....

Breast Cancer
Immunotherapy

Addition of Pembrolizumab to Eribulin in HR-Positive, HER2-Negative Metastatic Breast Cancer

In a phase II trial reported in JAMA Oncology, Sara M. Tolaney, MD, MPH, and colleagues found that the addition of pembrolizumab to eribulin did not improve progression-free survival in women with hormone receptor (HR)-positive, HER2-negative metastatic breast cancer. As stated by the...

Breast Cancer
Immunotherapy

Meta-analysis of Duration of Adjuvant Trastuzumab in Early Breast Cancer

In individual participant data and trial-level meta-analyses reported in JAMA Network Open, Gulia et al found that disease-free survival with adjuvant trastuzumab given for less than 1 year was noninferior to 1 year of trastuzumab therapy in patients with early breast cancer. In addition, the...

Breast Cancer

High-Risk, HER2-Positive Breast Cancer: Neoadjuvant and Adjuvant Treatment Options

Although most patients with breast cancer are considered to have an overall excellent prognosis, 600,000 people still die annually of the disease around the world. Even in HER2-positive breast cancer, a subtype that has seen a transformation of outcomes in the past 2 decades, there’s still room for ...

Breast Cancer

Local Recurrence With Radiation Boost in HER2-Positive Breast Cancer: HERA Trial Analysis

In a retrospective analysis reported in the International Journal of Radiation Oncology • Biology • Physics, Jaoude et al found that a radiation boost did not reduce the risk of local recurrence among women with HER2-positive breast cancer receiving breast-conserving surgery, whole-breast...

Breast Cancer
Immunotherapy

FDA Issues Alert About Efficacy and Potential Safety Concerns Regarding Atezolizumab Plus Paclitaxel in Metastatic Triple-Negative Breast Cancer

On September 8, the U.S. Food and Drug Administration (FDA) alerted health-care professionals, oncology clinical investigators, and patients that a clinical trial studying the use of atezolizumab and paclitaxel in patients with previously untreated, inoperable, locally advanced or metastatic...

Multiple Myeloma
Breast Cancer
Lung Cancer
Solid Tumors
Lymphoma
Leukemia
Skin Cancer

FDA Pipeline: Priority Reviews in Multiple Myeloma, Metastatic Breast Cancer, and NSCLC

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to agents for the treatment of refractory multiple myeloma, metastatic breast cancer, and metastatic non–small cell lung cancer (NSCLC); gave Fast Track designation to treatments for NTRK mutation­–positive solid tumors...

Symptom Management
Breast Cancer

Strategies for Early Detection and Management of Lymphedema

The standard of care since 2003, sentinel lymph node biopsy has dramatically reduced the risk of lymphedema in early breast cancer, but more than 6% of patients still develop the condition. At the ASCO20 Virtual Education Program, Nicole L. Stout, DPT, CLT-LANA, FAPTA, Research Assistant Professor...

Breast Cancer

Long-Term Outcomes With Accelerated Partial-Breast vs Whole-Breast Irradiation in Patients With Early Breast Cancer

As reported in the Journal of Clinical Oncology by Icro Meattini, MD, and colleagues, 10-year follow-up of the Italian single-center APBI-IMRT-Florence trial showed no differences in ipsilateral recurrence or survival with accelerated partial-breast irradiation vs whole-breast irradiation after...

Breast Cancer

Updated Results of the ALTERNATIVE Trial of Lapatinib/Trastuzumab Plus AI in HER2-Positive, HR-Positive Metastatic Breast Cancer

Updated results of the phase III ALTERNATIVE trial of dual HER2 inhibition with lapatinib/trastuzumab plus aromatase inhibitor (AI) therapy in HER2-positive, hormone receptor (HR)-positive metastatic breast cancer were reported in the Journal of Clinical Oncology by Johnston et al. The previously...

Breast Cancer

Addition of Veliparib to Carboplatin/Paclitaxel in Previously Treated Patients With BRCA-Mutated Advanced Breast Cancer: BROCADE3 Trial

As reported in The Lancet Oncology by Véronique Diéras, MD, and colleagues, the phase III BROCADE3 trial showed a significant improvement in progression-free survival with the addition of the poly (ADP-ribose) polymerase (PARP) inhibitor veliparib to carboplatin and paclitaxel in patients with...

Breast Cancer

Association of Adjuvant Endocrine Therapy With Overall Survival in Small HR-Positive, HER2-Negative Breast Cancer

In a National Cancer Database cohort study reported in a research letter in JAMA Network Open, Ma et al found that receipt vs no receipt of adjuvant endocrine therapy was associated with improved overall survival in women with small hormone receptor (HR)-positive, HER2-negative breast cancers. As...

Breast Cancer

Changes in Reoperation Rates After Publication of SSO/ASTRO Guideline on Margins for Breast-Conserving Surgery

In a meta-analysis reported in JAMA Surgery, Marinovich et al found that reoperation rates after breast-conserving surgery in women with breast cancer declined after the publication of the Society of Surgical Oncology/American Society for Radiation Oncology (SSO/ASTRO) Consensus Guideline on...

Breast Cancer
Survivorship

Breast Cancer Survival Is Significantly Decreased Among Premenopausal Women Previously Treated With Radiation for Childhood or AYA Cancer

Although radiotherapy is integral to the multidisciplinary therapy used in the treatment of common childhood and adolescent and young adult (AYA) cancers, including Hodgkin lymphomas, sarcomas, and breast cancer, the treatment is a strong risk factor for a secondary breast malignancy, especially...

Breast Cancer

One in Six Premenopausal Women With Invasive Breast Cancer Is Nonadherent to Tamoxifen Therapy

Measuring serum levels of tamoxifen among premenopausal women being treated for invasive breast cancer identified a “worryingly high proportion of patients, one in six, who were nonadherent to therapy at only 1 year after treatment prescription,” researchers reported in the Journal of Clinical...

Breast Cancer

Effect of Mammography Screening From Age 40 on Breast Cancer Mortality: Final Results of the UK Age Trial

As reported in The Lancet Oncology by Duffy et al, final results of the UK Age Trial show that initiation of annual mammography screening for breast cancer at age 40 was associated with a significant reduction in breast cancer mortality at 10 years compared with screening beginning at age 50 years, ...

Breast Cancer
COVID-19

Study Finds Treatment Delays for Patients With Breast Cancer Early in the COVID-19 Pandemic

The results of an online questionnaire of 609 breast cancer survivors in the United States suggest that nearly half of patients experienced delays in care during the early weeks of the COVID-19 pandemic. The study was published by Papautsky et al in the journal Breast Cancer Research and ...

Breast Cancer

Hypofractionated vs Conventionally Fractionated Radiotherapy After Breast-Conserving Surgery in Women With Breast Cancer

In a Chinese phase III trial reported in the Journal of Clinical Oncology, Wang et al found that hypofractionated radiotherapy (HFRT) and conventionally fractionated radiotherapy (CFRT) following breast-conserving surgery were associated with similar low 5-year local recurrence rates in women with...

Breast Cancer
Genomics/Genetics

Three Novel Genetic Variants Linked to Male Breast Cancer Discovered

Scientists have newly discovered three genetic changes that increase the risk of breast cancer in men. These findings were published by Maguire et al in the Journal of the National Cancer Institute. The researchers identified three common variations in DNA that predispose men to developing breast...

Breast Cancer
Immunotherapy

Activity of Olaparib and Durvalumab in Germline BRCA-Mutated Metastatic Breast Cancer

As reported in The Lancet Oncology by Susan M. Domchek, MD, and colleagues, the combination of olaparib and durvalumab showed activity in a cohort of patients with germline BRCA-mutated, HER2-negative metastatic breast cancer enrolled in a phase I/II basket study (MEDIOLA). Study Details In the...

Breast Cancer
Immunotherapy

Balancing Efficacy and Safety of Targeted Therapy in Breast Cancer Care

Novel targeted therapies have increased the likelihood of cure and prolonged survival in many patients with advanced breast cancer (Table 1), but these new agents also carry toxicity profiles that vary greatly from those of traditional chemotherapy. During the ASCO20 Virtual Education Program,...

Breast Cancer
Symptom Management

Effect of Axillary Surgery Approach and Nodal Irradiation on Risk of Lymphedema in Patients With Breast Cancer

In a prospective lymphedema screening trial reported in the Journal of Clinical Oncology, Naoum et al found that although regional lymph node radiation increased the incidence of breast cancer–related lymphedema, the primary driver of risk was the type of axillary surgery used. Study Details The...

Breast Cancer

Fixed-Dose Subcutaneous Combination of Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf in HER2-Positive Breast Cancer

On June 29, 2020, a new fixed-dose combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf (PHESGO) for subcutaneous injection was approved for the following indications1,2: Use in combination with chemotherapy as neoadjuvant treatment of patients with HER2-positive, locally advanced,...

Breast Cancer

Multiple Lesions Not a Contraindication for Cosmetically Acceptable Lumpectomy

More than 70% of women with multiple tumors in a single breast reported good or excellent satisfaction with the cosmetic results of breast-conserving therapy, Alliance (ACOSOG) Z11102 investigators reported at the 2020 American Society of Breast Surgeons (ASBrS) Virtual Scientific Session.1 In...

Breast Cancer
COVID-19

Increased Time to Breast Cancer Surgery May Not Impact Overall Survival for Patients With Early-Stage Disease

A new study published by Minami et al in the Journal of the American College of Surgeons found that longer time from diagnosis to surgical treatment did not lower overall survival in women with early-stage breast cancer. These findings may be reassuring for women with early-stage breast cancer who...

Breast Cancer

Association of Pathologic Complete Response With 3-Year Outcomes in I-SPY 2 Trial of Neoadjuvant Therapy for Stage II or III Breast Cancer

In a 3-year follow-up analysis of the phase II I-SPY 2 trial reported in JAMA Oncology, researchers in the I-SPY 2 Trial Consortium found that pathologic complete response was associated with improved event-free and distant recurrence–free survival—irrespective of molecular subtype or neoadjuvant...

Kidney Cancer
Lung Cancer
Myelodysplastic Syndromes
Solid Tumors
Skin Cancer
Lymphoma
Pancreatic Cancer
Breast Cancer
Immunotherapy

FDA Pipeline: Designations in Kidney and Lung Cancers, Myelodysplastic Syndromes, and More

Over the past few weeks, the U.S. Food and Drug Administration (FDA) has issued designations and accepted applications for novel agents, as well as approved companion diagnostics. We summarize these regulatory movements below. Breakthrough Therapy Designation for MK-6482 in von Hippel-Lindau...

Hematologic Malignancies
Breast Cancer

Risk of Breast Cancer After Total-Body Irradiation and Blood or Marrow Transplantation for Hematologic Malignancies

In an analysis from the Blood or Marrow Transplantation Survivor Study reported in the Journal of Clinical Oncology, McDonald et al found that total-body irradiation in women undergoing autologous or allogeneic blood or marrow transplantation for hematologic malignancies was associated with an...

Breast Cancer

NALA Trial: Neratinib/Capecitabine vs Lapatinib/Capecitabine for Pretreated Patients With HER2-Positive Metastatic Breast Cancer

As reported in the Journal of Clinical Oncology by Cristina Saura, MD, and colleagues, the phase III NALA trial has shown significantly prolonged progression-free survival with neratinib/capecitabine vs lapatinib/capecitabine in patients with HER2-positive metastatic breast cancer who had received...

COVID-19
Breast Cancer
Colorectal Cancer
Gastroesophageal Cancer
Lung Cancer

Modeling Study Aims to Estimate the Effect of the COVID-19 Pandemic on Cancer Deaths in England

In a population-based modeling study reported in The Lancet Oncology, Maringe et al estimated that delays in diagnosis due to the COVID-19 pandemic could result in 3,291 to 3,621 additional deaths from breast, colorectal, esophageal, and lung cancers within 5 years. As stated by the investigators,...

Breast Cancer
Genomics/Genetics
Survivorship

Impact of Pregnancy After Breast Cancer in Women With Deleterious Germline BRCA Mutations

In a retrospective cohort study reported in the Journal of Clinical Oncology, Matteo Lambertini, MD, PhD, and colleagues found that pregnancy after breast cancer in women harboring deleterious germline BRCA mutations did not appear to be associated with worsened maternal prognosis or fetal...

Breast Cancer

Does Adjuvant Chemotherapy Improve Survival Among Older Patients With ER-Positive, Node-Positive Breast Cancer and Multiple Comorbidities?

In a retrospective cohort study reported in JAMA Oncology, Tamirisa et al found evidence that adjuvant chemotherapy was associated with improved survival among patients age ≥ 70 years with estrogen receptor (ER)-positive, HER2-negative, node-positive breast cancer and multiple comorbidities. Study...

Breast Cancer

Phase III PADA-1 Trial Examines the Impact of ESR1 Mutations in Metastatic Breast Cancer

ESR1 mutations are known to confer resistance to endocrine therapy in the metastatic breast cancer setting. These mutations herald a poor prognosis, so their clearance early in the treatment course may greatly reduce the risk of recurrence, according to the early results of the prospective phase...

Breast Cancer

When Paired With Palbociclib, Fulvestrant and Letrozole Yield Comparable Results in PARSIFAL Trial

When paired with palbociclib in the first-line treatment of metastatic breast cancer, fulvestrant and letrozole performed comparably, with no statistical superiority in progression-free or overall survival shown for either endocrine agent, in the phase II PARSIFAL study presented during the ASCO20...

Breast Cancer

Double PIK3CA Mutations and Response Benefit in Breast Cancer

Patients who have breast cancers with double PIK3CA mutations seem to have a more robust response to PI3Kα inhibitors than those with a single PIK3CA mutation, based on an analysis of the phase III SANDPIPER trial, which tested taselisib plus fulvestrant, according to a presentation during the 2020 ...

Breast Cancer
Immunotherapy

T-DM1 in Patients With HER2-Positive Breast Cancer and Brain Metastases: KAMILLA Trial

An exploratory subgroup analysis of the KAMILLA trial represents the largest reported cohort of patients with HER2-positive breast cancer and brain metastases treated with the anti-HER2 antibody-drug conjugate ado-trastuzumab emtansine, or T-DM1, in a prospective setting. Researchers observed...

Breast Cancer
Genomics/Genetics

Effect of Breast Cancer Pathway Implementation on Rate of Referrals for Genetic Counseling and Testing

In a study reported in JCO Oncology Practice, Stephanie L. Graff, MD, and colleagues found that patients with breast cancer seen by a physician with training in using an established pathway for genetic counseling and testing referral were more frequently referred for such services vs patients seen...

Breast Cancer

Long-Term Normal Tissue Effects With Five-Fraction Whole-Breast Radiotherapy for Early Breast Cancer

As reported in the Journal of Clinical Oncology by Brunt et al, 10-year follow-up in the FAST trial of women with early breast cancer showed greater risk for photographic- and physician-assessed normal tissue effects with an adjuvant radiotherapy regimen of 30 Gy in 5 once-weekly fractions—but not...

Breast Cancer

Outcomes According to BMI in Women Receiving Adjuvant Docetaxel-Based Chemotherapy for Early Breast Cancer

A retrospective analysis from the BIG 2-98 trial reported in the Journal of Clinical Oncology by Desmedt et al showed poorer disease-free and overall survival with increasing baseline body mass index (BMI) in women receiving adjuvant docetaxel-based chemotherapy but not among those receiving...

Breast Cancer
Genomics/Genetics

Presence of ctDNA and CTCs and Prediction of Disease Recurrence in Patients With Triple-Negative Breast Cancer

In a preplanned secondary analysis of the BRE12-158 trial published in JAMA Oncology, Milan Radovich, PhD, and colleagues found that the presence of circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) in the plasma of women who have received neoadjuvant treatment for stage I, II, or...

Breast Cancer
Health-Care Policy

Effect of Medicaid Expansion on Breast Cancer Stage at Diagnosis

In a study reported in JAMA Surgery, Le Blanc et al found that Medicaid expansion under the Affordable Care Act was associated with increased insurance coverage and reduction in rates of diagnosis of breast cancer at later stages. Study Details The study involved data from the National Cancer...

Breast Cancer

Addition of Capecitabine to T-DM1 in Previously Treated Patients With HER2-Positive Metastatic Breast Cancer

In the phase I/II TRAXHER2 trial reported in JAMA Oncology, Cortés et al found that the combination of capecitabine and ado-trastuzumab emtansine (T-DM1) did not improve overall response rate vs T-DM1 alone in previously treated patients with HER2-positive metastatic breast cancer. Study Details In ...

Breast Cancer
Immunotherapy

Roundup of High-Impact Studies in Early Breast Cancer

Clinicians interested in breast cancer who logged into the ASCO20 Virtual Scientific Program were greeted with an abundance of high-impact presentations. The ASCO Post has reported on several studies in depth elsewhere, but here we offer our readers a roundup of several important studies in early...

Breast Cancer
Survivorship

Early Screening With MRI May Reduce Breast Cancer Mortality in Survivors of Childhood Cancer Treated With Chest Radiation

The early initiation—at age 25 to 30—of annual breast cancer screening with magnetic resonance imaging (MRI) with or without mammography may reduce breast cancer mortality by more than half in survivors of childhood cancer who had been previously exposed to chest radiation, according to a study by...

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