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breast cancer

SABCS 2017: MONALEESA-7: Ribociclib Improved Progression-Free Survival for Pre- and Perimenopausal Women With HR-Positive Advanced Breast Cancer

Adding the cyclin-dependent kinase (CDK) 4/6 inhibitor ribociclib (Kisqali) to standard endocrine therapy with temporary ovarian suppression significantly improved progression-free survival for pre- and perimenopausal women with advanced hormone receptor–positive (HR-positive), HER2-negative...

breast cancer

SABCS 2017: Combination of Pembrolizumab and Trastuzumab Shows Early Promise for Patients With Trastuzumab-Resistant Breast Cancer

A combination of pembrolizumab (Keytruda) and trastuzumab (Herceptin) tested in patients with trastuzumab-resistant advanced HER2-positive breast cancer was well tolerated and had clinical benefit in patients whose tumors were positive for a biomarker for pembrolizumab, according to data presented...

breast cancer

Richard G. Gray, MSc, on Adjusting Adjuvant Chemotherapy Dosing: Results From an EBCTCG Analysis

Richard G. Gray, MSc, of the University of Oxford, discusses an Early Breast Cancer Trialists’ Collaborative Group meta-analysis of 21,000 women in 16 randomized trials, which showed that increasing the dose density of adjuvant chemotherapy by shortening intervals between courses or sequentially administering treatment significantly reduces disease recurrence and breast cancer mortality (Abstract GS1-01).

breast cancer

Louis Fehrenbacher, MD, on Invasive Breast Cancer: Results From the NSABP B-47 Trial

Louis Fehrenbacher, MD, of Kaiser Permanente, discusses study findings comparing adjuvant chemotherapy with doxorubicin and cyclophosphamide followed by weekly paclitaxel—or docetaxel and cyclophosphamide—with or without a year of trastuzumab in women with node-positive or high-risk node-negative disease (Abstract GS1-02).

breast cancer

Debu Tripathy, MD, on HR+, HER2– Breast Cancer: Results From the MONALEESA-7 Trial

Debu Tripathy, MD, of The University of Texas MD Anderson Cancer Center, discusses phase III study findings on first-line ribociclib vs placebo with goserelin and tamoxifen or a nonsteroidal aromatase inhibitor in premenopausal women with hormone receptor–positive, HER2-negative advanced breast cancer (Abstract GS2-05).

breast cancer

Wolfgang Janni, MD, PhD, on Early Breast Cancer and Bisphosphonate Treatment: Results From the SUCCESS A Trial

Wolfgang Janni, MD, PhD, of Ulm University, discusses study findings that showed extended adjuvant bisphosphonate treatment over 5 years in early breast cancer does not improve disease-free and overall survival when compared with 2 years of treatment (Abstract GS1-06).

breast cancer

Keynote Lecture: Silvia C. Formenti, MD, on Converting Tumors Into in Situ Vaccines With Radiation Therapy

Silvia C. Formenti, MD, of Weill Cornell Medicine, discusses the high therapeutic potential of combining radiotherapy with immunotherapy and findings that show radiation dose and fractionation seem particularly relevant to the success of abscopal responses. The science has now matured to clinical translation.

breast cancer

SABCS 2017: Increasing the Dose Intensity of Chemotherapy May Lower the Risk of Breast Cancer Recurrence and Death

Increasing the dose intensity of chemotherapy—by either shortening the intervals between the cycles or by sequential administration instead of concurrent administration of the drugs—reduced the risk of early-stage breast cancer recurrence and death compared with standard chemotherapy...

breast cancer

SABCS 2017: Adjuvant Trastuzumab Did Not Improve Outcomes for Patients With HER2-Low Breast Cancer

Adding trastuzumab (Herceptin) to standard adjuvant chemotherapy did not improve invasive disease–free survival for patients with early-stage breast cancer found to have low levels of HER2, defined as immunohistochemistry (IHC) 1–positive or IHC 2-positive and/or in situ hybridization...

breast cancer

Neoadjuvant Regimens Compared in HER2-Positive Breast Cancer

The phase III KRISTINE trial has shown that neoadjuvant therapy with docetaxel, carboplatin, and trastuzumab (Herceptin) plus pertuzumab (Perjeta) resulted in a higher pathologic complete response rate vs ado-trastuzumab emtansine (Kadcyla) plus pertuzumab, as well as a higher incidence of severe...

breast cancer

Extended Intermittent vs Continuous Adjuvant Therapy for Postmenopausal Women With Breast Cancer

The phase III SOLE trial has shown no disease-free survival benefit with extended intermittent vs continuous adjuvant letrozole in postmenopausal women with breast cancer. These findings were reported by Colleoni et al in The Lancet Oncology. As noted by the investigators, the findings suggest an...

breast cancer
prostate cancer
issues in oncology

Urban American Indian and Alaskan Natives May Have Lower Survival Rates Following Invasive Prostate and Breast Cancers

Compared with the non-Hispanic white (NHW) population, the urban American Indian and Alaskan Native (AIAN) community was more likely to have lower survival rates following invasive prostate and breast cancer, according to a new study by Emerson et al in Cancer Research. “It’s been...

breast cancer
cost of care

Climbing Costs for Treating Breast Cancer Poised to Strain Medicare in the Near Future

With cancer care costs projected to increase 32% from 2010 to 2020, researchers are working to determine the main drivers of costs for treating breast cancer. In a study led by Ami Vyas, PhD, MS, MBA, of the University of Rhode Island, published in the November issue of JNCCN–Journal of the...

Hematologic Malignancies
Breast Cancer
Lung Cancer
Lymphoma

FDA Approvals in November 2017: Novel Drugs, New Indications

THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) approved a number of novel drugs and new indications in November 2017. Several of them are listed here.  Fulvestrant/Abemaciclib Combination in Breast Cancer  ON NOVEMBER 15 , the FDA approved fulvestrant (Faslodex) in combination with abemaciclib...

Solid Tumors
Breast Cancer
Issues in Oncology
Health-Care Policy

Health-Care Access Unlikely to Explain Racial/Ethnic Disparities in Breast Cancer Outcomes

Even with equivalent access to care, black patients with breast cancer may fare worse than white patients with breast cancer, according to Lawrence H. Kushi, ScD, Director of Scientific Policy at the Kaiser Permanente Northern California Division of Research in Oakland. “Accounting for...

Solid Tumors
Breast Cancer

Gene-Expression Assays in Early-Stage Breast Cancer: Who Should Order Them and When?

A deeper understanding of biology has allowed significant advances in the treatment of breast cancer. In the early-stage setting, standard pathology measures can help identify which subset of patients with hormone receptor–positive breast cancers are more likely to experience benefit from...

Solid Tumors
Breast Cancer

Genomic Profiling With Multidisciplinary Collaboration: Improving Breast Cancer Outcomes Through Timely Chemotherapy Initiation

As reviewed in this issue of The ASCO Post, Losk and colleagues from Dana-Farber/Brigham and Women’s Cancer Center report their institution’s implementation of a protocol of surgeon-initiated genomic profiling of estrogen receptor–positive tumors in women with early breast cancer that resulted in ...

Solid Tumors
Breast Cancer

Surgeon-Initiated Gene-Expression Profile Testing in Early-Stage Breast Cancer Reduces Time to Start of Chemotherapy

In a single-center study reported in the Journal of Oncology Practice, Katya Losk, MPH, of Dana-Farber Cancer Institute, and colleagues found that an intervention including surgeon initiation of gene-expression profile testing with Oncotype DX significantly reduced the time to testing, receipt of...

breast cancer

Long-Term Risk of Breast Cancer Recurrence After 5 Years of Endocrine Therapy

In a meta-analysis reported in The New England Journal of Medicine by Pan et al for the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), it was found that breast cancer recurs at a steady incidence following cessation of adjuvant endocrine therapy after 5 years, with the risk...

Solid Tumors
Breast Cancer

About One in Four Women With Small Breast Tumors May Benefit From Chemotherapy

A large subset analysis of the MINDACT trial suggests that oncologists may be undertreating women with small (< 1 cm) node-negative breast tumors, which are clinically considered to be low risk but can be genomically high risk. About one in four women with small node-negative breast tumors <...

breast cancer

Antidepressant for Aromatase Inhibitor–Associated Arthralgia in Early-Stage Breast Cancer

The phase III SWOG S1202 trial has shown benefit of the antidepressant agent duloxetine in reducing aromatase inhibitor–associated joint pain in women with early-stage breast cancer. These results were reported in the Journal of Clinical Oncology by Henry et al. Study Details In the...

Solid Tumors
Breast Cancer

Pathologic Complete Response Rates Not Improved With Neoadjuvant Letrozole/Palbociclib

As neoadjuvant treatment of women with high-risk luminal breast cancer, the combination of letrozole and palbociclib (Ibrance) did not reduce the residual cancer burden or improve the rates of breast-conserving surgery, in the phase II UNICANCER- NeoPAL study presented at the 2017 European Society ...

Solid Tumors
Breast Cancer

Neratinib for Extended Adjuvant Treatment of Early-Stage HER2-Positive Breast Cancer

On July 17, 2017, neratinib (Nerlynx) a dual inhibitor of HER2 and epidermal growth factor receptor (EGFR), was approved for extended adjuvant treatment of adults with early-stage HER2-overexpressed/amplified breast cancer following adjuvant trastuzumab (Herceptin)-based therapy.1,2 Supporting...

Solid Tumors
Breast Cancer

Abemaciclib in Hormone Receptor–Positive, HER2-Negative Breast Cancer

On September 28, 2017, the cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitor abemaciclib (Verzenio) was approved for use in combination with fulvestrant (Faslodex) for women with hormone receptor–positive, HER2-negative advanced or metastatic breast cancer with disease progression following...

Breast Cancer

Computer-Based Support May Allow Physicians to Spend More Time on ‘Human Aspects of Cancer Care’

As computer-based physician support systems for decision-making in cancer management continue to evolve, “we will come to embrace this as something that liberates us to spend more time on the human aspects of cancer care,” Andrew D. Seidman, MD, told participants at the 2017 Lynn Sage Breast Cancer ...

Breast Cancer

What Can We Do Differently for Premenopausal Patients With Breast Cancer?

While age remains a major risk factor for breast cancer, with nearly 80% of new cases occurring in women aged 50 years and older, women diagnosed at a younger age generally have poorer outcomes. This is partly because premenopausal women are more likely to have triple-negative breast cancer, which ...

Solid Tumors
Breast Cancer

Where Are We Now in Triple-Negative Breast Cancer?

The treatment of triple-negative breast cancer is rapidly evolving, as clinical trials continue to test chemotherapy agents and combinations and immunotherapy studies promise potentially “game-changing” interventions early in the course of disease, Joyce O’Shaughnessy, MD, reported at the 19th...

Solid Tumors
Breast Cancer

Gauging the Impact of Weight Loss Intervention on Breast Cancer Outcomes

“Growing research suggests that body weight is not only related to the risk of developing malignancy, but also prognosis after diagnosis, especially in breast cancer,” said Jennifer A. Ligibel, MD, of Dana-Farber Cancer Institute and Harvard Medical School, at the 19th Annual Lynn Sage Breast...

breast cancer

5-Year Outcomes With Extended Adjuvant Therapy in HER2-Positive Breast Cancer

The 5-year analysis of the phase III ExteNET trial has shown that 1 year of neratinib (Nerlynx) after trastuzumab (Herceptin)-based adjuvant therapy significantly improved invasive disease–free survival vs placebo in HER2-positive breast cancer. These findings were reported in The Lancet...

breast cancer

Are African American Women With Type 2 Diabetes at Increased Risk for ER-Negative Breast Cancer?

A prospective study by Palmer et al assessing the relationship of type 2 diabetes and the incidence of estrogen receptor–negative and estrogen receptor–positive breast cancer among African American women has found statistically significant evidence of an increased risk of estrogen...

breast cancer

FDA Approves Fulvestrant in Combination With Abemaciclib in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

Today, the U.S. Food and Drug Administration (FDA) approved a new indication for fulvestrant (Faslodex), expanding the drug's approved use to include combined therapy with abemaciclib (Verzenio), a cyclin-dependent kinase (CDK) 4/6 inhibitor, for the treatment of hormone receptor–positive,...

Breast Cancer

Predisposition to Breast Cancer due to Mutations Other Than BRCA1/BRCA2 in Ashkenazi Jewish Women

A cohort study in Ashkenazi Jewish women with breast cancer identified mutations other than BRCA1 and BRCA2 founder alleles that were associated with cancer risk. These results were reported by Walsh et al in JAMA Oncology. Among Ashkenazi Jewish women, three mutations in BRCA1 and BRCA2...

Breast Cancer

Ovarian Function Recovery During Anastrozole Therapy in Postmenopausal Patients With Breast Cancer

In the phase III DATA trial reported in the Journal of the National Cancer Institute by Vivianne C.G. Tjan-Heijnen, MD, PhD, of the Maastricht University Medical Centre, the Netherlands, and colleagues, 12% of women with breast cancer who had chemotherapy-induced ovarian function failure...

Breast Cancer

10-Year Follow-up on Adjuvant Therapy in Postmenopausal Early Breast Cancer

The 10-year follow-up of the phase III TEAM trial has shown that exemestane alone and sequential tamoxifen/exemestane provide similar outcomes as adjuvant endocrine therapy in postmenopausal women with hormone receptor–positive early breast cancer. The findings were reported in The Lancet Oncology ...

Breast Cancer

BRCA1/2 Status in Response to Therapy in Triple-Negative Breast Cancer

An analysis of the GeparSixto trial in triple-negative breast cancer showed that adding carboplatin to neoadjuvant therapy improved pathologic complete response rate in patients without BRCA1/2 mutation and that response rates were higher overall in those with mutations, without additive effects...

breast cancer

Higher Risk of Breast Cancer Does Not Motivate Cancer Screening in Many Women

Some women, because of genetic predisposition, personal, or family history, have a higher-than-average lifetime risk of developing breast cancer. For those women, earlier magnetic resonance imaging (MRI) is recommended for cancer screening. But according to new findings presented at the American...

breast cancer

Long-Term Follow-up of Cardiac Function After Adjuvant Therapy With Trastuzumab in Early Breast Cancer

As reported by Ganz et al in the Journal of Clinical Oncology, long-term follow-up of patients in the National Surgical Adjuvant Breast and Bowel Project (NSABP) Protocol B-31/NRG Oncology trial showed no worsening of cardiac function or quality of life with the addition of adjuvant trastuzumab...

Solid Tumors
Breast Cancer

Twisted Pink Joins Forces With the Conquer Cancer Foundation to Support Metastatic Breast Cancer Research

As one of the few organizations exclusively focused on funding research for metastatic breast cancer, Twisted Pink has a unique story to tell. Based in Louisville, Kentucky, the organization was founded in 2014 by breast cancer survivor Caroline Johnson. While Ms. Johnson fully recovered from her...

Breast Cancer
Gynecologic Cancers

More Data From ESMO 2017

In GEICAM 2006-10, the addition of fulvestrant at 250 mg/d to anastrozole did not improve 5-year disease-free survival over anastrozole alone (91.0% vs 90.8%).  “Immune induction” with chemotherapy or radiotherapy appeared to enhance response to nivolumab in women with metastatic triple-negative...

Breast Cancer
Gynecologic Cancers

International Trials Reveal New Findings in the Management of Breast and Ovarian Cancers

The European Society for Medical Oncology (ESMO) 2017 Congress, held in Madrid, featured important news including at least seven practice-changing or potentially practice-changing trials, which are covered in recent issues of The ASCO Post. Here we present additional highlights of studies in breast ...

Breast Cancer

Model Emphasizes Long-Term Risks of Ovarian Ablation Plus Aromatase Inhibitor

“At Microphone 1” is an occasional column written by Steven E. Vogl, MD, of Bronx, New York. When he’s not in his clinic, Dr. Vogl can generally be found at major oncology meetings and often at the microphone, where he stands ready with critical questions for presenters of new data. Here Dr. Vogl...

breast cancer

Complications and Patient Satisfaction After Breast Reconstruction in Women Receiving Radiotherapy

In a prospective cohort study reported by Jagsi et al in the Journal of the National Cancer Institute, autologous reconstruction was associated with fewer complications and greater patient satisfaction vs implant approaches in women receiving postmastectomy radiotherapy. Study Details The...

breast cancer

ASCO/CCO Focused Guideline Update on Role of Bone-Modifying Agents in Metastatic Breast Cancer

As reported by Catherine Van Poznak, MD, 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 agents in...

breast cancer

ASHG 2017: Quantifying Breast Cancer Risk Based on Rare Variants and Background Risk

Rare variants combined with background genetic risk factors may account for many unexplained cases of familial breast cancer, and knowing the specific genes involved could inform choice of prevention and treatment strategies, according to findings presented in a plenary session at the American...

breast cancer

Potential Risk Activities and Breast Cancer–Related Lymphedema in Patients Undergoing Bilateral Surgery

In a study reported in the Journal of Clinical Oncology, Asdourian et al found that several factors considered to pose an increased risk of lymphedema were not significantly associated with the occurrence of lymphedema among women undergoing bilateral breast cancer surgery. Study Details In the...

breast cancer

Extended Aromatase Inhibitor Therapy After Sequential Endocrine Therapy

In the Dutch phase III DATA trial reported in The Lancet Oncology by Tjan-Heinjen et al, a nonsignificant disease-free survival advantage was found for 6 vs 3 years of adjuvant aromatase inhibitor therapy after 2 to 3 years of tamoxifen in hormone receptor–positive early breast cancer....

breast cancer

FDA Grants Priority Review for Olaparib in Metastatic Breast Cancer

On October 18, AstraZeneca and Merck & Co announced that the U.S. Food and Drug Administration (FDA) has accepted and granted Priority Review to a supplemental New Drug Application (sNDA) for the use of olaparib (Lynparza) tablets in patients with germline BRCA-mutated, HER2-negative...

breast cancer

MAF Amplification and Outcomes With Adjuvant Zoledronic Acid in Early Breast Cancer

An analysis from the phase III AZURE trial has shown that MAF-negative status was associated with a benefit and MAF-positive status, with a detriment of adjuvant zoledronic acid in early breast cancer. The analysis was reported by Coleman et al in The Lancet Oncology. Study Details The current...

Solid Tumors
Breast Cancer

Breast Cancer Has Changed Me, But the Change Has Been Positive

I’ve always had dense breasts and avoided doing breast self-exams because I couldn’t tell if the lumpiness I was feeling was something serious or merely normal fibrous tissue. Instead I relied on my yearly mammogram to spot any early signs of cancer. Four years ago, I was once again relieved to...

Solid Tumors
Breast Cancer

Stalked by BRCA1: A Women Struggles to Survive the Same Disease That Killed Her Mother

No matter what a person does in life, for good and bad, his or her inherited genetic makeup follows along the way. Such was the case with British journalist Sarah Gabriel, who inherited the BRCA1 mutation from her mother, who died of ovarian cancer when Ms. Gabriel was in college. Much of her...

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