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In a single-institution retrospective analysis reported in the Journal of Clinical Oncology, Naoum et al found that pathologic exploration of axillary soft tissue in patients with lymph node–positive breast cancer is a critical element in predicting disease outcome and in determining axillary...
In a major development in the treatment of breast cancer, short-course, or hypofractionated, radiation therapy has demonstrated comparable outcomes to conventional postmastectomy radiation therapy while reducing treatment breaks and financial toxicity, according to data presented at the 2023...
As reported in The Lancet by the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), an individual patient meta-analysis has shown that more recent—but not older—trials of regional lymph node radiotherapy vs no radiotherapy in patients with early breast cancer showed benefits of...
As reported in the Journal of Clinical Oncology by François-Clément Bidard, MD, PhD, and colleagues, the French phase III STIC CTC trial showed a nonsignificant overall survival benefit with a circulating tumor cell (CTC) count–driven approach to therapy vs physician’s choice in the first-line...
The American Society for Radiation Oncology (ASTRO) issued recommendations for patient-centered strategies for performing partial-breast irradiation in patients with early-stage invasive breast cancer or ductal carcinoma in situ (DCIS). The new clinical guidelines were published by Shaitelman et al ...
On November 16, 2023, the U.S. Food and Drug Administration (FDA) approved capivasertib (Truqap) with fulvestrant for adult patients with hormone receptor–positive, HER2-negative locally advanced or metastatic breast cancer with one or more PIK3CA/AKT1/PTEN alterations, as detected by an...
The TROP-2–directed antibody-drug conjugate datopotamab deruxtecan (Dato-DXd) significantly improved progression-free survival over standard chemotherapy in the TROPION-Breast01 trial involving patients with previously treated, hormone receptor–positive, HER2-negative, unresectable and/or...
Investigators have found that patients with breast cancer who have insufficient levels of vitamin D prior to initiating treatment with paclitaxel may be more likely to experience peripheral neuropathy, according to a recent study published by Chen et al in JNCCN–Journal of the National...
Nadia Harbeck, MD, PhD, of Munich’s LMU University Hospital and the Ludwig Maximilian University, discusses an interim analysis of the monarchE trial on adjuvant abemaciclib plus endocrine therapy for patients with hormone receptor–positive, HER2-negative, high-risk early breast cancer. The data showed this regimen continued to reduce the risk of developing invasive and distant disease recurrence well beyond the completion of treatment. The improvement at 5 years is consistent with a carryover effect and further supports the use of the CDK4/6 inhibitor abemaciclib in this population (Abstract LBA17).
Peter Schmid, MD, PhD, of Queen Mary University of London, discusses phase III findings from the KEYNOTE-522 study, which showed neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab continues to improve event-free survival compared with neoadjuvant chemotherapy alone in patients with early-stage triple-negative breast cancer, regardless of pathologic complete response (Abstract LBA18).
Researchers have discovered that resistance to PI3K-alpha inhibitors and reduced drug binding in patients with breast cancer may be driven by secondary PIK3CA mutations and so may be effectively treated with a novel class of PI3K-alpha inhibitors designed to bind to different parts of the target,...
Investigators have found that U.S. adult patients with prior insurance coverage disruptions may be less likely to receive guideline-concordant and past-year cancer screenings compared with those with continuous coverage, according to new findings presented by Shi et al at the 2023 ASCO Quality Care ...
This is Part 3 of Updates in Early-Stage Breast Cancer,, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Erika Hamilton, Michael Danso, and Komal Jhaveri discuss the management of early triple-negative breast cancer. The patient is a 54-year-old Black female who notices nipple retraction in the left breast. Ultrasound reveals a 3.8-cm mass, and biopsy confirms estrogen receptor 0, progesterone receptor 0, HER2 1+ by IHC, FISH nonamplified, grade 3 disease, with a high Ki-67 of 60%. She undergoes lymph node sampling, which is also positive for invasive ductal carcinoma. The faculty review neoadjuvant chemotherapy options for patients with node-positive, triple-negative breast cancer, whether PD-L1 status has any impact in the early-stage setting, the importance of genetic testing, and the clinical implications of the KEYNOTE-522 and OlympiA trials.
This is Part 2 of Updates in Early-Stage Breast Cancer,, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Erika Hamilton, Michael Danso, and Komal Jhaveri discuss the management of early node-negative HER2-positive breast cancer. The patient is a 53-year-old White female with a right breast abnormality noted on screening mammogram. The mass is biopsied, revealing a 1.1-cm lesion that is estrogen receptor positive, progesterone receptor negative, HER2 amplified. Due to the small size, she undergoes lumpectomy and is found to have 1.2-cm invasive ductal carcinoma that is HER2-amplified with zero out of two lymph nodes involved. In the conversation that follows, the faculty discuss the impact of tumor size on adjuvant treatment selection for patients with node-negative HER2-positive breast cancer, which patients are candidates for neoadjuvant HER2-directed therapy, and the clinical implications of the APT and KATHERINE trials.
This is Part 1 of Updates in Early-Stage Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Erika Hamilton, Michael Danso, and Komal Jhaveri discuss the management of early hormone receptor–positive/HER2-negative breast cancer. The patient is a 42-year-old female who presents with a right breast lump that has been palpable for 2 months. Mammogram reveals a 3-cm abnormality that upon biopsy was determined to be estrogen receptor 100%, progesterone receptor 90%, HER2 0, grade 3 invasive ductal carcinoma. She has no abnormal lymph nodes and an Oncotype recurrence score of 21. Following initial treatment with chemotherapy, she undergoes lumpectomy and is found to have 1.5 cm of high-grade residual carcinoma, one out of three positive lymph nodes, and a 5-mm cancer deposit. In the conversation that follows, the faculty discuss initial treatment options for this patient, whether recommendations for chemotherapy would change depending on menopausal status, the role of endocrine therapy, and the clinical implications of the monarchE and NATALEE trials.
Investigators have discovered that reliable educational materials about breast cancer surgery may be difficult to access and are often presented at much higher reading levels than recommended, according to the findings of two new studies presented by Brennan et al and Satarasinghe et al at the...
Researchers have developed a novel artificial intelligence (AI)-based Cancer Survival Calculator for estimating long-term survival in patients with newly diagnosed cancer, according to new findings presented by Janczewski et al at the American College of Surgeons (ACS) Clinical Congress 2023....
Researchers have discovered that it may be possible to detect and treat dormant tumor cells in breast cancer survivors, according to new findings presented by DeMichele et al at the European Society for Medical Oncology (ESMO) Congress 2023 (Abstract 244MO). The results may have offered a...
Women living and working in places with higher levels of fine particle air pollution are more likely to get breast cancer than those living and working in less polluted areas. Results of a study looking at the effects of both residential and workplace exposure to air pollution on breast cancer risk ...
The past year has been an exciting time for breast oncologists and patients with all stages of breast cancer, with new agents approved and long-term results from pivotal trials showing improved survival for patients with metastatic disease. Let’s take a look at some of the highlights in early-stage ...
Over the past year, the U.S. Food and Drug Administration (FDA) granted approval to several novel drugs and expanded indications for older therapeutic agents used in breast cancer. Abemaciclib Plus Endocrine Therapy On March 3, 2023, the FDA expanded the indication for abemaciclib with endocrine...
The MONARCH 3 study’s invited discussant, Meritxell Bellet Ezquerra, MD, PhD, a senior researcher at the Vall d’Hebron Institute of Oncology in Barcelona, commented: “The second interim analysis for overall survival in MONARCH 31 indicates a positive trend, which was also observed for the subgroup...
Overall survival results from two trials of abemaciclib in advanced breast cancer were reported at the European Society for Medical Oncology (ESMO) Congress 2022. Both MONARCH 3 and monarcHER previously met their primary endpoints of progression-free survival. The current results for overall...
Preserving fertility is a driving concern for many young women with breast cancer. Many of these women have hormone receptor–positive breast cancer and are treated with adjuvant endocrine therapy for 5 to 10 years, which is known to compromise fertility. Younger women who may want to take a break...
In an analysis of the SOFT trial, the Breast Cancer Index accurately identified premenopausal women with hormone receptor–positive early breast cancer who may benefit from ovarian function suppression in addition to adjuvant endocrine therapy. The findings were reported by Ruth O’Regan, MD, Chair...
The combination of capivasertib, an AKT pathway inhibitor, plus fulvestrant, an estrogen receptor antagonist, significantly improved progression-free survival compared with fulvestrant alone in patients with hormone receptor–positive, HER2-negative advanced breast cancer, according to results of...
The combination of palbociclib and fulvestrant did not prolong progression-free survival compared to fulvestrant alone in patients with hormone receptor–positive/HER2-negative metastatic breast cancer who had disease progression on prior treatment with a CDK4/6 inhibitor and endocrine therapy,...
Commenting on the DESTINY-Breast03 presentation at the 2022 San Antonio Breast Cancer Symposium, Neelima Vidula, MD, a medical oncologist at Mass General Cancer Center, said: “The results highlight the important survival differences of T-DXd [fam-trastuzumab deruxtecan-nxki] compared to T-DM1...
The antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) proved to be superior to the antibody-drug conjugate ado-trastuzumab emtansine (T-DM1), significantly improving progression-free survival and overall survival, in women with unresectable or metastatic HER2-positive breast cancer as ...
Elacestrant—an investigational oral selective estrogen receptor degrader (SERD)—achieved longer progression-free survival vs standard-of-care endocrine monotherapy as second- or third-line therapy in patients with estrogen receptor–positive, HER2-negative advanced or metastatic breast cancer in the ...
Nancy Chan, MD, Director of Breast Cancer Clinical Research at NYU Langone’s Perlmutter Cancer Center, New York, commented on the monarchE analysis for The ASCO Post. She noted that the study investigated the addition of adjuvant abemaciclib (an oral CDK4/6 inhibitor) to endocrine therapy in a...
Results of a planned interim overall survival analysis of the phase III monarchE trial offered further support for the addition of abemaciclib to adjuvant endocrine therapy for patients with hormone receptor–positive, HER2-negative, node-positive, high-risk disease, according to Stephen R.D....
The invited discussant of the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) meta-analysis, Ines Vaz-Luis, MD, PhD, of the Breast Cancer Survivorship Group, Gustave Roussy, Villejuif, France, pointed out that the benefit of ovarian suppression or ablation in reducing breast cancer...
A meta-analysis of randomized trials has revealed a benefit to ovarian ablation or suppression in preventing breast cancer recurrence in premenopausal women with estrogen receptor–positive tumors.1 The findings, based on almost 15,000 women in studies spanning several decades, were presented at the ...
An analysis of patient-reported outcomes in the adjuvant phase III NATALEE trial of ribociclib plus endocrine therapy in early-stage breast cancer showed maintenance of health-related quality of life (QOL), as determined by a number of factors. For patients receiving the inhibitor of...
In an Italian single-institution retrospective study reported in JAMA Surgery, Martelli et al found that prophylactic salpingo-oophorectomy was associated with improved overall survival in patients who had undergone resection of germline BRCA1/2-mutant breast cancer. Study Details The study...
Jame Abraham, MD, FACP, has been in the field of oncology for more than 2 decades, he and says this is both one of the most exhilarating and challenging times in cancer care. “What excites me the most are the innovations in treatment that are literally transforming the lives of our patients and...
In a Japanese-U.S. phase I/II trial (U31402-A-J101) reported in the Journal of Clinical Oncology, Ian E. Krop, MD, PhD, and colleagues found that the HER3-targeted antibody-drug conjugate patritumab deruxtecan (HER3-DXd) produced durable responses in previously treated patients with HER3-expressing ...
In a noninferiority phase III trial (SOUND) reported in JAMA Oncology, Gentilini et al found that no axillary surgery was noninferior to sentinel lymph node biopsy (SLNB) in terms of distant disease–free survival among patients with small breast cancer and negative findings on preoperative...
Residing in more walkable neighborhoods could protect against the risk of overall obesity-related cancers in female patients, according to a recent study published by India-Aldana et al in Environmental Health Perspectives. Background Obesity has previously been linked to an increased risk of...
Breast milk from women with breast cancer who were diagnosed during pregnancy or postpartum contains circulating tumor DNA (ctDNA), according to researchers at the Vall d’Hebron Institute of Oncology (VHIO) in Barcelona. The investigators noted that ctDNA can be detected through liquid biopsy in...
As reported in the Journal of Clinical Oncology by PierFranco Conte, MD, PhD, and colleagues, the final analysis of the Italian phase III noninferiority ShortHER trial showed little difference in 10-year disease-free survival and overall survival with 9 weeks vs 1 year of adjuvant trastuzumab in...
Despite a steady increase in palliative care utilization from 2004 to 2020, racial and ethnic minority patients with metastatic breast cancer may be less likely to receive palliative care compared with non-Hispanic White patients with the disease, according to new findings presented by Freeman et...
In a first-of-its-kind study, patients with breast cancer who underwent implant-based breast reconstruction immediately following a mastectomy reported that getting fewer, higher doses of radiation was just as effective as standard radiation, did not increase side effects, and saved them time and...
Neoadjuvant immunotherapy may be effective prior to surgery in multiple types of cancers, according to a recent study published by Topalian et al in Cancer Cell. Background Neoadjuvant immune checkpoint blockades have been a rapidly growing area of research and are currently being tested across...
The novel imaging agent gallium (Ga)-68–ABY-025 may help to predict early metabolic response to HER2-targeted treatment in patients with HER2-positive metastatic breast cancer, according to a recent study published by Alhuseinalkhudhur et al in The Journal of Nuclear Medicine. These findings...
Researchers have uncovered elevated rates of hyperglycemia among patients who have breast cancer receiving treatment with alpelisib, according to a recent study published by Shen et al in Cancer. Background Alpelisib is designed to target the phosphoinositide 3-kinase (PI3K) protein, which is...
This is Part 3 of Ovarian Function Suppression in Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Jame Abraham, Erin Roesch, and Azka Ali discuss the management of a patient with de novo metastatic estrogen receptor–positive breast cancer. The patient is a 35-year-old premenopausal female with a patient-detected right breast mass; on imaging, the mass is 6 cm with suspicious lymph nodes. Biopsy confirms invasive carcinoma, grade 2, and her biomarkers are ER > 95%, PR 5%, and HER2 IHC 0. Breast MRI reveals nonmass enhancement in the right mass and at least seven abnormal axillary lymph nodes. She presents to the ER with back pain 4 days later and is found to have multiple lytic lesions on PET body imaging. In the conversation that follows, the faculty discuss the importance of staging scans in patients with larger tumors and lymph node involvement, choosing the most appropriate endocrine therapy and CDK4/6 inhibitor for first-line therapy, and monthly vs every-3-month dosing of GnRH analogs.
This is Part 2 of Ovarian Function Suppression in Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Jame Abraham, Erin Roesch, and Azka Ali discuss the management of a patient with recurrent estrogen receptor–positive breast cancer. The patient is a 39-year-old premenopausal female with a small T1aN0M0 estrogen receptor–positive, progesterone receptor–positive, HER2-negative left breast cancer. She opts for a mastectomy but declines adjuvant tamoxifen due to fertility concerns. She agrees to annual MRIs, and she presents to the clinic 10 years later at age 49 years with a palpable abnormality on the left side. Core-needle biopsy confirms the recurrence of breast cancer, and she undergoes left breast wide local excision, revealing multifocal invasive mammary carcinoma with mixed ductal and lobular features, grade 2 (10 mm). In the conversation that follows, the faculty discuss the use of adjuvant endocrine therapy in treating patients with breast cancer recurrences, the clinical implications of the CALOR trial, and the potential role of genomic assays in chemotherapy decision-making.
This is Part 1 of Ovarian Function Suppression in Breast Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Jame Abraham, Erin Roesch, and Azka Ali discuss the management of stage I breast cancer. The patient is a 46-year-old female with a history of hysterectomy (with intact ovaries) and venous thromboembolism who was diagnosed with stage I cT1N0M0 estrogen receptor–positive, progesterone receptor–positive, HER2-negative breast cancer after a screening mammography. She has a right breast partial mastectomy with sentinel lymph node biopsy, which showed multifocal invasive tubular carcinoma (5 mm), grade 1, with ER > 90%, PR of 10%, and HER2-negative per IHC, as well as atypical ductal hyperplasia, and no nodal involvement. In the conversation that follows, the faculty discuss how to choose the most appropriate endocrine therapy for patients, understanding the side effects of ovarian function suppression vs tamoxifen, the optimal duration of ovarian suppression in patients, and the recent 13-year follow-up data from the SOFT/TEXT trials.