For Adjuvant Trastuzumab, 6 Months Is Noninferior to 12 Months
The noninferiority phase III Persephone trial could shake up the standard of care for adjuvant trastuzumab (Herceptin), showing that patients with early-stage HER2-positive breast cancer derived as much benefit from 6 months of trastuzumab as 12 months, according to research from the United Kingdom ...
2018 ASCO: Shortening Adjuvant Trastuzumab to 6 Months in Patients With HER2-Positive Early Breast Cancer Is Effective and Reduces Cardiac Toxicities
Persephone, a large phase III randomized noninferiority study conducted in the United Kingdom comparing 6 months to 12 months of trastuzumab (Herceptin) in patients with HER2-positive early breast cancer has found 6 months of trastuzumab to be noninferior to 12 months of the therapy. In addition,...
Can Some Patients With Early Breast Cancer Avoid Surgery?
RESEARCHERS AT The University of Texas MD Anderson Cancer Center are testing the possibility of safely eliminating surgery in patients with breast cancer who are “exceptional responders” to neoadjuvant therapy, according to Henry M. Kuerer, MD, PhD, a breast cancer surgeon who described this...
Dispel Fears About Breast Cancer Radiotherapy With ‘Real Truth’ About Modern Techniques and Side Effects
Nearly 85% of patients surveyed 6 or more months after completing radiotherapy as part of their treatment for breast cancer reported the side effects were not as bad as they had feared or expected. Approximately 92% of the 269 patients treated with breast conservation and 81% of the 58 patients...
Hormone Therapy and Diabetes Risk in Survivors of Breast Cancer
In an Israeli case-cohort study reported in the Journal of Clinical Oncology, Hamood et al found that hormone therapy in breast cancer survivors was associated with an increased risk of developing diabetes. The study involved a cohort of 2,246 women from the Leumit health-care fund diagnosed with...
Modest Weight Loss Reduces Breast Cancer Risk
Evidence of the numerous health benefits of weight loss continues to mount, and the hope is that doctors and patients are listening. A large observational study presented at the 2017 San Antonio Breast Cancer Symposium showed that weight loss of more than 5% is associated with a significantly lower ...
Talazoparib Reduces Risk of Disease Progression in BRCA-Mutated Breast Cancer
In patients with BRCA-positive advanced breast cancer, talazoparib reduced the risk of disease progression or death by 46% vs chemotherapy, according to the phase III EMBRACA trial presented at the 2017 San Antonio Breast Cancer Symposium.1 “We are very pleased that the EMBRACA trial—the largest...
Education Plus Exercise Improves Arm Mobility After Lymph Node Dissection in Women With Breast Cancer
In breast cancer survivors after lymph node dissection, a combined education and exercise intervention resulted in patients regaining full range of motion in both arms sooner than those who received education alone, according to follow-up from a phase III clinical trial reported by Electra D....
2018 Treatment Algorithm for Metastatic HER2-Positive Breast Cancer
How should clinicians position anti-HER2 agents and also incorporate endocrine therapies in the treatment of metastatic HER2-positive breast cancer? At the 2018 Miami Breast Cancer Conference, this question was explored by Sunil Verma, MD, Medical Director of the Tom Baker Cancer Center and...
Expert Point of View: Timothy Gilligan, MD, MSc
“IN THE PAST, patients were often told to rest and reduce their physical activity during treatment, but we now know that exercise is both safe and beneficial,” said Timothy Gilligan, MD, MSc, moderator of a presscast where these results were presented prior to the Cancer Survivorship Symposium....
Four Years Posttreatment, Exercise Improves Physical Activity Levels, Reduces Fatigue in Patients With Breast and Colon Cancers
IN PATIENTS WITH breast and colon cancers, a physical exercise intervention conducted during adjuvant chemotherapy improved total physical activity levels 4 years after treatment, with a trend toward less fatigue, according to a follow-up study from the randomized multicenter PACT study, presented...
How Will ctDNA Assays Aid in Managing Breast Cancer?
CIRCULATING TUMOR DNA (ctDNA) assays are now commercially available for use in lung cancer and melanoma, where they can identify the presence of specific mutations that drive treatment selection. In breast cancer, ctDNA remains more of a research tool, but this is poised to change. At the 2018...
Potent Anti-HER2 Agents on the Horizon
THANKS TO the efficacy of five approved anti-HER2 agents, patients with HER2-positive breast cancer have overall survival numbers that are as good as, or better than, their HER2-negative counterparts. With the next generation of anti-HER2 therapies in clinical trials, these outcomes may become even ...
Extended Duration of Aromatase Inhibitors Need Not Be Very Long
At the 2017 San Antonio Breast Cancer Symposium (SABCS), Michael Gnant, MD, FACS, of the Medical University of Vienna presented the 9-year median follow-up of a trial looking at the length of extended aromatase inhibitor therapy. At least four other recently presented or published trials have...
Acupuncture for Joint Pain Associated With Aromatase Inhibition
Although aromatase inhibitors are highly effective as adjuvant therapy in metastatic breast cancer and for prevention of breast cancer, the side effects can be difficult to tolerate and often lead to discontinuation of therapy. A phase III randomized trial has found that acupuncture may relieve...
Anthony D. Elias, MD, on Triple-Negative Breast Cancer: Treatment Update
Anthony D. Elias, MD, of the University of Colorado Cancer Center, reviews promising experimental treatments, as well as PARP inhibitor therapy in TNBC, including the implications of newly approved olaparib for gBRCA-mutant breast cancer.
William J. Gradishar, MD, on Hormone-Sensitive Breast Cancer: Treatment Update
William J. Gradishar, MD, of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, discusses recent evidence on the efficacy, safety, and utility of HER2-targeted treatments in the adjuvant setting for early-stage and advanced breast cancers.
When Is Active Surveillance Appropriate in the Treatment of DCIS?
In 2017, more than 63,000 women in the United States were diagnosed with in situ breast cancer. The overwhelming majority of those women, about 83%, were diagnosed with ductal carcinoma in situ (DCIS), a condition characterized by the presence of abnormal cells confined to the breast milk ducts;...
Breast Cancer Care in U.S. Territories Seems to Lag Behind Care in Continental United States
OLDER WOMEN residing in U.S. territories are less likely to receive recommended or timely care for breast cancer compared with similar women residing in the continental United States, according to Yale researchers, whose findings were published in Health Affairs.1 “Inferior breast cancer care in...
FDA Approves Abemaciclib as Initial Therapy for Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer
On February 26, the U.S. Food and Drug Administration (FDA) approved abemaciclib (Verzenio) in combination with an aromatase inhibitor as initial endocrine-based therapy for postmenopausal women with hormone receptor–positive, HER2-negative advanced or metastatic breast cancer. MONARCH 3 Approval...
Mentorship From a Past ASCO President and Others Steers a Career to Academic Research
Breast cancer specialist Stacy L. Moulder, MD, was born and reared in Brookhaven, Mississippi, a small town southwest of the state capital of Jackson. “I was always interested in math and science, and I had a wonderful biology teacher in high school. It was when the advanced placement courses...
Breast Cancer Screening Guidelines May Lead to Delayed Diagnosis in Nonwhite Women
The current guidelines for mammographic breast cancer screening, which are based on data from primarily white populations, may lead to delayed diagnosis in nonwhite women, according to a report published by Stapleton et al in JAMA Surgery. A team of Massachusetts General Hospital (MGH)...
EXPERT POINT OF VIEW: Aditya Bardia, MD
ADITYA BARDIA, MD, Director of Precision Medicine at the Center for Breast Cancer, Massachusetts General Hospital, Harvard Medical School, Boston, said: “This large, well-powered trial that included 181 centers and more than 2,600 patients unfortunately failed to show that celecoxib improved...
No Evidence of Celecoxib Benefit Reported in Patients With Early Breast Cancer
TWO YEARS of treatment with celecoxib had no observed effect on 5-year outcomes of patients with early breast cancer in the large REACT trial presented at the 2017 San Antonio Breast Cancer Symposium.1 “There was no overall benefit observed in disease-free survival or overall survival for...
Selected Abstracts From the San Antonio Breast Cancer Symposium
EACH YEAR, The ASCO Post asks Jame Abraham, MD, FACP, Director of the Breast Oncology Program at Taussig Cancer Institute and Co-Director of the Cleveland Clinic Comprehensive Breast Cancer Program, to give his picks for the most important research presented at the San Antonio Breast Cancer...
Internet-Delivered Cognitive-Behavioral Therapy for Insomnia in Breast Cancer Survivors
In a Danish study reported in the Journal of the National Cancer Institute, Zachariae et al found that an Internet-delivered cognitive-behavioral therapy intervention improved insomnia among breast cancer survivors. Study Details In the study, 255 patients from a national sample of Danish breast...
Conqueror in Action: Katherine Reeder-Hayes, MD, Takes on Breast Cancer
When a cutting-edge cancer tool becomes available, marginalized populations such as African Americans and older patients often have less access to it than other populations. This is problematic, especially when those with limited access are those who could benefit the most. As a result, public...
Electra D. Paskett, PhD, on Breast Cancer and Arm Mobility: Clinical Trial Results
Electra D. Paskett, PhD, of The Ohio State University Comprehensive Cancer Center, discusses study findings on whether exercise helps women with breast cancer regain arm mobility after lymph node surgery (Abstract 123).
Huntsman Cancer Institute to Use National Cancer Institute Grant for Breast Cancer Trial Center
Huntsman Cancer Institute at the University of Utah has been awarded a $2.4 million 2-year grant from the National Cancer Institute to help continue its research in breast cancer. Alana Welm, PhD, and Bryan Welm, PhD, investigators at Huntsman Cancer Institute, along with Michael Lewis, PhD, a...
Ovarian Function Suppression During and After Chemotherapy Valid for Some Patients With Early Breast Cancer
Temporary ovarian suppression during chemotherapy as a means of preserving ovarian function and fertility in young women with early breast cancer is controversial. An eagerly awaited meta-analysis including individual patient data from five randomized controlled trials found that the use of...
Perioperative Aromatase Inhibitors: No Effect on Recurrence, but Ki67 Level Important
Updated analysis from the United Kingdom’s POETIC trial found no evidence that perioperative aromatase inhibitor therapy slows or prevents time to recurrence of breast cancer. However, the study did show that tumor Ki67 levels after 2 weeks of perioperative aromatase inhibitor therapy are...
SABCS Highlights Focus on Predicting Residual Tumor Burden, Therapy-Related Arm Morbidity, Lifestyle and Cancer Risk
We have covered many of the important presentations from the 2017 San Antonio Breast Cancer Symposium in the pages of The ASCO Post and in our online Evening News. Here are summaries of additional noteworthy studies presented at the meeting. We hope you will find them of interest. Predicting...
Neoadjuvant Trastuzumab Biosimilar vs Trastuzumab in HER2-Positive Early Breast Cancer
In a phase III trial reported in the Journal of Clinical Oncology, Pivot et al found equivalence of the trastuzumab biosimilar SB3 and the reference trastuzumab (Herceptin) in producing breast pathologic complete response in the neoadjuvant treatment of patients with HER2-positive early breast...
2018 SURVIVORSHIP: Exercise Speeds Improvement in Arm Mobility After Surgery for Breast Cancer
New findings from a clinical trial of women with breast cancer suggest that guided exercise with a physical therapist after lymph node dissection helps women regain their range of arm motion more quickly. These findings will be presented by Paskett et al at the upcoming 2018 Cancer Survivorship...
2018 SURVIVORSHIP: Exercising During Chemotherapy for Breast or Colon Cancer Has Long-Term Benefits
A follow-up study to a randomized clinical trial reveals that exercising during adjuvant chemotherapy helps people engage in more physical activity years later. Four years later, people with breast or colon cancer who had participated in an 18-week exercise program while receiving chemotherapy...
ASCO/CCO Focused Guideline Update on Role of Bone-Modifying Agents in Metastatic Breast Cancer
AS REPORTED BY Catherine Van Poznak, MD, FASCO, of the University of Michigan, Ann Arbor, and colleagues in the Journal of Clinical Oncology, ASCO and Cancer Care Ontario (CCO) have collaborated in providing a focused update for the ASCO clinical practice guideline on the role of bone-modifying...
EXPERT POINT OF VIEW: Eric P. Winer, MD, FASCO; Heikki Joensuu, MD; and Julie Gralow, MD, FASCO
IN INTERVIEWS with The ASCO Post and in discussions held during the meeting, several breast cancer experts weighed in on the findings of GeparSepto and CALGB 40502. Eric P. Winer, MD, FASCO, Chief of the Division of Women’s Cancers and the Thompson Senior Investigator in Breast Cancer Research at ...
Updates of Key Studies Differ on Relative Benefit of Nab-Paclitaxel in Breast Cancer
TWO IMPORTANT STUDIES, both updates of earlier findings and presented at the 2017 San Antonio Breast Cancer Symposium, provided different findings as to the relative benefit of nanoparticle albumin-bound (nab)-paclitaxel (Abraxane), vs solvent-based paclitaxel in breast cancer. “The two studies...
EXPERT POINT OF VIEW: Julie Gralow, MD, FASCO
JULIE GRALOW, MD, FASCO, Director of Breast Medical Oncology for the Seattle Cancer Care Alliance and Professor of Medical Oncology at the University of Washington School of Medicine, commented on the findings of the SUCCESS A trial in an interview with The ASCO Post. The Oxford meta-analysis...
Adjuvant Zoledronic Acid in Early Breast Cancer: Is 5 Years Better?
THE PHASE III SUCCESS A trial, presented at the 2017 San Antonio Breast Cancer Symposium, found no benefit for extending the use of intravenous zoledronic acid from 2 years to 5 years.1 “At this time point, our study showed no difference in disease-free survival or overall survival between 5 years ...
EXPERT POINT OF VIEW: C. Kent Osborne, MD, and Joseph Sparano, MD
“ONCOLOGISTS WANT to find drugs that will delay the use of chemotherapy, and cyclin-dependent kinase (CDK) 4/6 inhibitors provide that. These agents work better than chemotherapy and with less toxicity,” said press conference moderator C. Kent Osborne, MD, Director of the Duncan Cancer Center at...
CDK 4/6 Inhibitors May Be Effective but More Toxic in Older Women
OLDER WOMEN with breast cancer derive benefit from treatment with cyclin-dependent kinase (CDK) 4/6 inhibitors as part of initial endocrine-based therapy for hormone receptor–positive, HER2-negative, metastatic breast cancer, according to a retrospective pooled subgroup analysis of women aged 70 or ...
EXPERT POINT OF VIEW: William Sikov, MD, and Carlos L. Arteaga, MD
BREAST CANCER EXPERTS found the small differences in benefit for 1 year vs 9 weeks of adjuvant trastuzumab (Herceptin) in the SOLD trial to be provocative. William Sikov, MD, of Women and Infants Hospital of Rhode Island’s Breast Health Center and the Warren Alpert Medical School of Brown...
Trastuzumab for 9 Weeks Fails to Show Noninferiority in HER2-Positive Breast Cancer
ANOTHER TRIAL has validated that 1 year of adjuvant trastuzumab (Herceptin) remains the standard in HER2-positive breast cancer, but the margin of difference, compared with just 9 weeks of the drug, was slim, based on the findings of the phase III SOLD trial reported at the 2017 San Antonio Breast...
Precision Medicine: Hope or Hype?
ALTHOUGH PRECISION medicine may be a recent discovery in some fields, it is an old story in the field of breast cancer, and one that has been exceptionally important in terms of managing the disease, according to George Sledge, MD, FASCO, Professor of Medicine and Medical Oncologist at the...
Bone-Modifying Agents in Metastatic Breast Cancer: Time to De-escalate Dosing Intervals
AS REVIEWED in this issue of The ASCO Post, ASCO and Cancer Care Ontario (CCO) have issued an updated guideline on the role of bone-modifying agents in metastatic breast cancer.1 The updated guideline supports a change in clinical practice for our patients with breast cancer and bone metastasis....
Steep Decline in Chemotherapy Use for Early-Stage Breast Cancer
The use of chemotherapy to treat women with early-stage breast cancer “declined markedly over time,” according to analysis of data from 2,926 women between the ages of 20 and 79. The trends documented “are remarkable for their steepness of decline, independent of clinical factors and despite no...
I’m Not a Victim of Cancer
What I thought after feeling a large, hard lump—similar to the feel of a granola bar—in my left breast was that I probably pulled a muscle while playing with my two young children, ages 7 and 5. Cancer never entered my mind until I asked my husband to feel the lump, and he immediately said, with...
Effects of Group Psychosocial Intervention on Body Image and Quality of Life in Breast Cancer Survivors
In a study reported in the Journal of Clinical Oncology, Esplen et al found that a group psychosocial intervention was effective in improving body image concerns and breast cancer–related quality of life among breast cancer survivors. Study Details In the study, 194 breast cancer survivors...
Two Genetic Mutations Implicated in Breast Cancer Emerge From Study of Lynch Syndrome
Researchers at Columbia University Irving Medical Center (CUIMC) and GeneDx, a genetic testing company, have identified two new genetic mutations associated with breast cancer: MSH6 and PMS2. The researchers’ study—published by Roberts et al in Genetics in Medicine—suggests that...
