Terry P. Mamounas, MD, MPH, on Extending Letrozole Treatment in Hormone Receptor–Positive Breast Cancer
2019 San Antonio Breast Cancer Symposium
Terry P. Mamounas, MD, MPH, of Orlando Health UF Health Cancer Center, discusses 10-year results from NRG Oncology/NSABP B-42, which showed that, for postmenopausal women with hormone receptor–positive breast cancer who have completed previous adjuvant therapy with an aromatase inhibitor or with tamoxifen followed by an aromatase inhibitor, extended treatment with letrozole improved disease-free survival (Abstract GS4-01).
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?
Hongchao Pan, PhD, of the University of Oxford, discusses an analysis of 86,000 women in the Early Breast Cancer Trialists’ Collaborative Group database, which showed that the risk of distant recurrence 20 years after a diagnosis of node-negative, estrogen receptor–negative early-stage breast cancer in women who discontinued endocrine therapy at 5 years is likely to be about a third lower now than in his group’s previous report (Abstract GS2-04).
Marie-Jeanne T.F.D. Vrancken Peeters, MD, PhD, of the Netherlands Cancer Institute, discusses an interim study analysis showing that ultrasound-guided core biopsies of the breast in patients with excellent response on MRI after neoadjuvant systemic therapy may not be accurate enough to safely select patients with pathologic complete response for omission of surgery (Abstract GS5-06).
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).
Jack Cuzick, PhD, of Queen Mary University of London, discusses the substantially greater benefits of anastrozole as compared with tamoxifen in terms of preventing breast cancer, with no increase in fractures or other reported serious side effects (Abstract GS4-04).