Neoadjuvant Veliparib/Carboplatin and Neratinib ‘Graduate’ From Adaptive Randomization I-SPY 2 Trial in Early Breast Cancer
As reported by Rugo et al and Park et al in The New England Journal of Medicine, the adaptive randomization phase II I-SPY 2 trial has shown that the addition of veliparib/carboplatin and the addition of neratinib to standard neoadjuvant therapy have met criteria predictive of success in a phase...
Insurance, Distance to Care Can Be Barriers to Breast Reconstruction
Women were less likely to have breast reconstruction surgery after mastectomy if they had Medicaid or Medicare rather than private insurance or if they lived 10 or more miles from a plastic surgeon’s office, a University of North Carolina (UNC) Lineberger Comprehensive Cancer Center study has ...
Sampling Method Used for New Breast Cancer Tests May Lead to Underestimation of Risk
Not only is breast cancer more than one disease, but a single breast cancer tumor can vary within itself, a finding that University of Pittsburgh Cancer Institute (UPCI) researchers discovered has the potential to lead to very different patient treatment plans depending on the tumor sample and...
In Vitro Fertilization Not Associated With Increased Risk of Breast Cancer in Dutch Study
Among women undergoing fertility treatment in the Netherlands between 1980 and 1995, the use of in vitro fertilization (IVF) compared with non-IVF treatment was not associated with increased risk of breast cancer after a median follow-up of 21 years, according to a study published by van den...
Mindfulness-Based Stress-Reduction Program May Reduce Psychological and Physical Symptoms in Breast Cancer Survivors
A mindfulness-based stress-reduction program for breast cancer survivors was associated with psychological and physical symptom benefits during and at 6 weeks after intervention, according to a randomized trial reported in the Journal of Clinical Oncology by Cecile A. Lengacher, RN, PhD, of the...
Meta-analysis Indicates Similar Outcomes With Neoadjuvant Endocrine vs Chemotherapy in Estrogen Receptor–Positive Breast Cancer
In a meta-analysis reported in JAMA Oncology, Spring et al found that neoadjuvant endocrine therapy was associated with outcomes similar to those with chemotherapy in women with estrogen receptor–positive breast cancer. Similar Outcomes The analysis included 3,490 patients from 20...
ASCO Guideline on Endocrine Therapy for Metastatic Breast Cancer: Reaffirming Principles for Making Treatment Decisions
The role of endocrine therapy for hormone receptor–positive metastatic breast cancer is well established, and clinicians are strongly encouraged to consider one of several therapeutic options for the majority of patients who present with metastatic disease. The recent ASCO guideline on this topic, ...
ASCO Guideline on Endocrine Therapy for Hormone Receptor–Positive Metastatic Breast Cancer
As reported by Hope S. Rugo, MD, of the University of California San Francisco Comprehensive Cancer Center, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on endocrine therapy for hormone receptor–positive metastatic breast cancer.1 The...
Can Self-Administered Acupressure Reduce Fatigue in Breast Cancer Survivors?
Self-administered relaxing acupressure and stimulating acupressure were both associated with reduced persistent fatigue vs usual care in breast cancer survivors, according to a randomized clinical trial reported by Zick et al in JAMA Oncology. However, only relaxing acupressure had significant...
Study Finds Wide Variation in Breast Density Assessments Among Radiologists
A large observational study examining the variation in breast density assessment among radiologists in clinical practice has found a wide variation—from 6.3% to 84.5%—in the percentage of mammograms rated as showing dense breasts, which persisted after adjusting for patient...
The Metastatic Breast Cancer Project: Direct-to-Patient Research Initiative
A nationwide project is enlisting patients with breast cancer to share their tumor samples and clinical information. Launched in October 2015, the Metastatic Breast Cancer (MBC) Project has enrolled more than 2,000 patients from all 50 states and is yielding information that will be shared with...
Using Social Media to Accelerate Genomic Research
The success of using social media to push forward causes for social good was a driving factor in the launch this past October of the Metastatic Breast Cancer Project (MBC project), which aims to accelerate the understanding of what makes patients with metastatic breast cancer genetically unique....
Quick Takes on Promising New Approaches to Treating Breast Cancer
At the 2016 ASCO Annual Meeting, researchers reported encouraging results for several new drugs and treatment strategies for breast cancer. The ASCO Post brings you brief summaries of a select few. Abemaciclib Trial The cyclin-dependent kinase 4/6 (CDK4/6) inhibitor abemaciclib produced responses...
PHEREXA: Benefit for Second-Line Pertuzumab Questionable
In the second-line metastatic breast cancer setting, the addition of pertuzumab (Perjeta) to trastuzumab (Herceptin)/capecitabine did not significantly improve progression-free survival, results of the phase III PHEREXA trial showed.1 This is the first randomized trial to evaluate the efficacy of ...
Results of Two Practice-Changing Breast Cancer Trials Upheld
Results of two pivotal breast cancer trials reported at the 2016 ASCO Annual Meeting confirmed the practice-changing findings that resulted from earlier findings. PALOMA-2 The phase III PALOMA-2 trial confirmed results from the smaller, open-label phase II PALOMA-1 trial that led to the U.S. Food...
Stress and Adverse Life Events Unlikely to Cause Breast Cancer
Day-to-day psychological stress and adverse life events are unlikely to increase a woman’s risk of developing breast cancer, according to a new prospective study published by Schoemaker et al in Breast Cancer Research. Women with breast cancer often consider stress as a likely cause of their ...
Preclinical Study Shows Target of Trastuzumab, Receptor Protein ErbB2, Needed for Coronary Vasculature Patterning
A receptor protein that is the target of the breast cancer drug trastuzumab (Herceptin) is needed for proper heart blood vessel development, reported researchers from the Perelman School of Medicine at the University of Pennsylvania, Philadelphia. They published their findings this month in a paper ...
Better 10-Year Survival Reported With Breast-Conserving Surgery and Radiotherapy vs Mastectomy in Early Breast Cancer
In a Dutch population-based study reported in The Lancet Oncology, van Maaren et al found that breast-conserving surgery plus radiotherapy was associated with improved 10-year survival vs mastectomy in women with early breast cancer. Study Details The study included data from 37,207 women from...
New Analysis Evaluates Predictors of Persistent Pain After Breast Cancer Surgery
An analysis led by McMaster University researchers has found that women who undergo armpit lymph node surgery for breast cancer are much more likely to develop chronic pain. Wang et al published their review of studies exploring risk factors for developing chronic pain after breast cancer...
Survey Asks Women Whom They Trust Most When Selecting Breast Cancer Surgery and Reviews Postsurgical Satisfaction
A research team led by Rebecca M. Kwait, MD, Breast Health Fellow at The Breast Health Center at Women & Infants Hospital of Rhode Island, recently presented research indicating that when faced with a decision on the type of surgery to have for breast cancer, more women trust their own judgment ...
Managing Upper Extremity Dysfunction in Breast Cancer Survivors
With an increased number of breast cancer survivors and patients with metastatic disease living longer, it is imperative for oncology care providers to manage issues of new and chronic upper extremity dysfunction as a result of the malignancy itself or its treatment. As one of my patients...
Detection of Breast Cancer With Ultrasound vs Tomosynthesis in Women With Mammography-Negative Dense Breasts
As reported in the Journal of Clinical Oncology by Alberto S. Tagliafico, MD, of the University of Genoa, and colleagues, interim findings in the Italian prospective ASTOUND study indicate that ultrasound is associated with improved incremental detection of breast cancer at screening compared with ...
Greatest Benefit of Adjuvant Exemestane in Premenopausal Women at Higher Risk of Breast Cancer Recurrence
In an analysis of the SOFT and TEXT trials reported in the Journal of Clinical Oncology, Meredith M. Regan, ScD, of Dana-Farber Cancer Institute, and colleagues found that the greatest benefit of adjuvant exemestane in reducing breast cancer recurrence was among women with the greatest risk of...
Mixed Results With Resection of Primary Tumor in Stage IV Breast Cancer
For de novo stage IV breast cancer, does resection of the primary tumor improve outcomes? Two studies presented at the 2016 ASCO Annual Meeting reached different conclusions. A prospective randomized study conducted in Turkey concluded there is a survival benefit at 5 years,1 whereas a U.S....
Pertuzumab-Containing Regimens Compared for Neoadjuvant Treatment in Early Breast Cancer
In patients with HER2-positive early breast cancer, pathologic complete response rates after neoadjuvant therapy were higher with docetaxel plus carboplatin plus trastuzumab (Herceptin) plus pertuzumab (Perjeta), or TCH+P, than with ado-trastuzumab emtansine (Kadcyla) plus pertuzumab, or T-DM1+P,...
EBCTCG Analysis Identifies Recurrence Risk by Tumor Subgroup in Estrogen Receptor–Positive Breast Cancer
The risk of recurrence in estrogen receptor–positive breast cancer is known to continue after 5 years, but just how much is that risk once endocrine therapy is stopped? The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) has concluded it is “appreciable,” with distant recurrences...
Approximately 20% of Older Women With Early Breast Cancer Experience Some Form of Functional Decline After Treatment
In a study of older women with newly diagnosed stage I to III breast cancer, approximately 1 in 5 lost the ability to complete some of the basic tasks necessary for independent living within 1 year of initiating treatment. The study also found that a simple survey can help identify which women are...
No Advantage With Cyclophosphamide/Methotrexate Maintenance in Hormone Receptor–Negative Early Breast Cancer, but Subgroup May Benefit
Low-dose oral cyclophosphamide plus methotrexate maintenance therapy yielded no disease-free survival benefit in women with hormone receptor–negative early breast cancer, according to the phase III International Breast Cancer Study Group (IBCSG) 22-00 trial. Some evidence of benefit was...
Influence of Microbiota of Breast Tissue on the Development of Cancers
Bacteria that have the potential to abet breast cancer are present in the breasts of cancer patients, while beneficial bacteria are more abundant in healthy breasts, where they may actually be protecting women from cancer, according to Gregor Reid, PhD, of the Lawson Health Research Institute, and...
Surgery and Radiation Therapy Remain Standard of Care for Managing Ductal Carcinoma in Situ
A review of more than 50 studies (many randomized controlled trials) concluded that surgery and radiation therapy “remain standard-of-care treatment options” in the management of ductal carcinoma in situ.1 The review continues the widely reported discussion on managing ductal carcinoma in situ,...
Pembrolizumab in Triple-Negative Breast Cancer: Emerging New Treatment Modality
Lajos Pusztai, MD, DPhil, Professor of Medicine, Chief of Breast Medical Oncology and Co-Director of Cancer Genetics Research Program at Yale Cancer Center, New Haven, Connecticut, commented on KEYNOTE-012. He remarked that the overall response rate of 18.5% to the single agent is similar to...
Hypofractionated Radiation Found Equivalent to Conventionally Fractionated Regimen in Early-Stage Breast Cancer
Early-stage breast cancer patients receiving a shorter course of whole-breast irradiation with higher radiation doses per fraction reported equivalent cosmetic, functional, and pain outcomes over time as those receiving a longer, lower-dose per fraction course of treatment, according to researchers ...
Pembrolizumab Active in PD-L1–Positive Advanced Gastric Cancer and Triple-Negative Breast Cancer
The KEYNOTE-012 phase Ib trial assessed single-agent pembrolizumab (Keytruda) in patients with advanced programmed cell death ligand 1 (PD-L1)–positive gastric cancer, triple-negative breast cancer, urothelial cancer, and head and neck cancer. The activity of pembrolizumab in study patients with...
Trastuzumab Biosimilar Shows Efficacy and Safety Comparable to Reference Product in Phase III HERITAGE Trial
A new biosimilar version of the monoclonal antibody trastuzumab (Herceptin) is getting close to the finish line in the race to develop biosimilars in oncology. The new antibody, MYL-1401O, demonstrated comparable efficacy and safety compared with trastuzumab as front-line treatment of women with...
Joint Analysis Confirms Benefit of Anthracyclines for High-Risk Early-Stage Breast Cancer
For the treatment of high-risk, HER2-negative early-stage breast cancer, anthracyclines were confirmed as beneficial in a joint analysis of the Anthracyclines in Early Breast Cancer (ABC) trials. Presented at the 2016 ASCO Annual Meeting, the joint analysis of the ABC trials validated taxane plus...
SNMMI 2016: VASH Collimator Allows Three-Dimensional Imaging of the Breast With Less Radiation
Preliminary tests have demonstrated that a new device may enable existing breast cancer imagers to provide up to six times better contrast of tumors in the breast, while maintaining the same or better image quality and halving the radiation dose to patients. The advance is made possible by a new...
Mindfulness-Based Stress-Reduction Program May Reduce Psychological and Physical Symptoms in Breast Cancer Survivors
A mindfulness-based stress-reduction program for breast cancer survivors was associated with psychological and physical symptom benefits during and at 6 weeks after intervention, according to a randomized trial reported in the Journal of Clinical Oncology by Lengacher et al. Study Details In the...
PALOMA-3 Trial in HER2-Negative Metastatic Breast Cancer: Challenge of Moving Beyond Estrogen Receptor Positivity
Hormone receptor–positive breast cancer represents the largest therapeutic subgroup of the disease. The development of endocrine therapies has shaped the treatment paradigm for both advanced- and early-stage disease for decades.1 Still, despite their significant impact, advanced breast cancer...
Prolonged Progression-Free Survival With Addition of Palbociclib to Fulvestrant in HER2-Negative Metastatic Breast Cancer
As reported in The Lancet Oncology by Massimo Cristofanilli, MD, of the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, and colleagues, the final results of the phase III PALOMA-3 trial showed that the addition of the CDK4/CDK6 inhibitor palbociclib (Ibrance) to fulvestrant...
Ovarian Suppression in Premenopausal Women With Estrogen Receptor–Positive Breast Cancer
Oophorectomy was the first proposed form of endocrine therapy for women with breast cancer. Over 100 years ago, Thomas Nunn reported a relationship between menopause and regression of breast cancer.1 This incited interest in the induction of menopause as an anticancer therapy, and in 1986, a...
ASCO Clinical Practice Guideline Update on Ovarian Suppression/Adjuvant Endocrine Therapy in Hormone Receptor–Positive Breast Cancer
As reported in the Journal of Clinical Oncology by Harold J. Burstein, MD, PhD, of Dana-Farber Cancer Institute, Boston, and colleagues, ASCO has released a clinical practice guideline update on ovarian suppression as part of the extant guideline on adjuvant endocrine therapy in hormone...
Lisa A. Carey, MD, and Nicholas C. Turner, MD, PhD, on PALOMA-2 and -3 Study Findings in Advanced Breast Cancer
Lisa A. Carey, MD, of the University of North Carolina, and Nicholas C. Turner, MD, PhD, of The Royal Marsden Hospital and Institute of Cancer Research, discuss the efficacy of palbociclib plus fulvestrant in patients with ESR1 mutations in circulating tumor DNA, and palbociclib and letrozole for postmenopausal women with ER+/HER2–advanced breast cancer (Abstracts 507, 524).
Rising Breast Cancer Incidence in Sub-Saharan Africa: Challenges and Opportunities
The incidence of new cases of breast cancer in low- and middle-income countries, particularly in sub-Saharan Africa, is rising, and it will take a concerted effort from the international cancer community to counteract this troubling upward trend. It has been estimated that of the 15 million cancer ...
Additional 5 Years of Letrozole May Benefit Some Postmenopausal Women With Early-Stage Breast Cancer
Five years of aromatase inhibitor as upfront therapy or after tamoxifen is the current standard of care for postmenopausal women with early hormone receptor–positive breast cancer. A new trial suggests that extending aromatase inhibitor therapy with letrozole for an additional 5 years may improve...
ASCO 2016: Significant Cost Differences Found Among Breast Cancer Chemotherapy Regimens
Costs associated with different breast cancer chemotherapy regimens can vary significantly, regardless of effectiveness, according to new research from The University of Texas MD Anderson Cancer Center. Understanding cost differences should help guide informed discussions between patients and...
Lisa A. Carey, MD, and Tuya Pal, MD, on BRCA Carriers: The Disparities in Management
Lisa A. Carey, MD, of the University of North Carolina, and Tuya Pal, MD, of H. Lee Moffitt Cancer Center & Research Institute, discuss the racial disparities in cancer risk management among BRCA carriers across a diverse sample of young black, Hispanic, and non-Hispanic white breast cancer survivors (Abstract LBA1504).
Lisa A. Carey, MD, and Julie Gralow, MD: Top Breast Cancer Papers Presented at the 2016 ASCO Annual Meeting
Lisa A. Carey, MD, of the University of North Carolina, and Julie Gralow, MD, of the University of Washington, discuss the most important data presented this year on treating breast malignancies (Abstracts LBA1, 500, and 507).
Exercise Associated With Reduced Risk of Cardiovascular Events in Women With Nonmetastatic Breast Cancer
Greater levels of leisure-time physical activity were associated with a reduced risk for cardiovascular disease events in women with nonmetastatic breast cancer, according to a study reported by Jones et al in the Journal of Clinical Oncology. Study Details The study involved 2,973 women (mean...
Prognostic Impact of Recurrence Score and Estrogen Receptor Expression in Breast Cancer After 5 Years of Tamoxifen
As reported in the Journal of Clinical Oncology by Wolmark et al, higher 21-gene recurrence score (RS) was strongly predictive of late disease recurrence among patients with high quantitative estrogen-receptor expression (ESR1) receiving tamoxifen for 5 years in two NRG Oncology/NSABP (National...
ASCO 2016: Minority BRCA-Positive Breast Cancer Survivors Appear Less Likely to Receive Preventive Surgery
For breast cancer survivors who carry mutations in BRCA genes, preventive surgery may substantially reduce the risk of future breast and ovarian cancers. However, it appears that black women are far less likely to receive these widely recommended procedures than white or Hispanic...
