Madeleine M.A. Tilanus-Linthorst, MD, PhD, on MRI vs Mammography: Comparing Cost and Effectiveness
2019 San Antonio Breast Cancer Symposium
Madeleine M.A. Tilanus-Linthorst, MD, PhD, of Erasmus University, reports data from the first randomized trial comparing MRI breast cancer screening with mammography in women with a familial risk. Because MRI screening detected cancer at an earlier stage, it might reduce the use of adjuvant chemotherapy and decrease breast cancer–related mortality (Abstract GS4-07).
Gerardo Antonio Umanzor Funez, MD, of Liga Contra El Cáncer, discusses phase III findings on intravenous (IV) paclitaxel and oral paclitaxel plus encequidar (a novel P-gp inhibitor), the first orally administered taxane regimen shown to be superior to the IV formulation in terms of response and survival with less neuropathy (Abstract GS6-01).
Javier Cortes, MD, PhD, of the IOB Institute of Oncology, discusses study findings that suggested pembrolizumab offered a prolonged survival benefit compared to chemotherapy for a subset of patients with previously treated metastatic triple-negative breast cancer. In the trial, high tumor-infiltrating lymphocytes were significantly associated with better clinical outcomes with the checkpoint inhibitor.
Joseph Sparano, MD, of the Montefiore Medical Center, discusses three challenges:
- How can gene-expression profiles and other diagnostic tests be used to guide the use of adjuvant systemic therapy?
- Is it time to reappraise active surveillance?
- Are there diagnostic and therapeutic strategies that can identify tumors at highest risk of metastasis, and novel therapies that can block the spread of disease?
Nadine M. Tung, MD, of Beth Israel Deaconess Medical Center, discusses cisplatin vs doxorubicin/cyclophosphamide (AC) as neoadjuvant treatment in BRCA-mutation carriers with HER2-negative breast cancer. Although cisplatin as a single agent shows activity in this setting, the pathologic complete response with this agent alone is not higher than that with standard AC chemotherapy (Abstract GS6-03).
Ivana Sestak, PhD, of Queen Mary University of London and the Centre for Cancer Prevention, discusses study findings that confirm the prognostic ability of the Clinical Treatment Score at 5 years (CTS5) for late distant recurrence, specifically for patients older than 50 years and/or for those deemed to have intermediate- or high-risk hormone receptor–positive, HER2-negative, node-negative breast cancer. The CTS5 is less prognostic in women younger than 50 who received 5 years of endocrine therapy alone (Abstract GS4-03).
