BREAST CANCER

A Case of Estrogen-Driven Metastatic Breast Cancer

A supplemental biologics license application for the frontline combination of atezolizumab plus nab-paclitaxel has been granted a priority review by the FDA for the treatment of patients with unresectable locally advanced or metastatic PD-L1–positive triple-negative breast cancer, based on data from the phase III IMpassion130 trial.

According to findings of a systematic literature review presented at the 2018 ESMO Congress, the neoadjuvant and metastatic breast cancer settings are appropriate areas to evaluate the equivalence of biosimilars and originator products.

Joseph A. Sparano, MD, the current role of liquid biopsy and the ongoing challenge of improving survival for patients with metastatic disease.

Steven J. Katz, MD, MPH, discusses the benefits and challenges with genetic testing in patients with breast cancer.

James L. Wade III, MD, FACP, FASCO, discusses the importance of clinical trials in the community.

Sherene Loi, MBBS, FRACP, PhD, FAHMS, discusses the current status of immunotherapy research in HER2-positive breast cancer.

I think one of the most important advancements in biomedical technology that has improved our understanding of the complexities of cancer is the ability to sequence the cancer genome for any individual patient, in a rapid and cost-effective manner, to help us make treatment decisions in the clinic.

Groundbreaking developments in cancer therapies can change lives, extending survival and sending patients who previously thought their chances were slim into remission. But these therapies come at a cost, and many patients reel at the prospect of heavy financial burdens. To help patients and programs meet the challenges of affording cancer treatments, community cancer centers are expanding the role of financial advocates in their organizations.

Thomas A. Gallo, MS, MDA, president of the Association of Community Cancer Centers, discusses his mission as president to “reflect, renew, and reignite” in order to create a more resilient oncology team for the community.

Among patients with advanced solid tumors associated with <em>NTRK</em> gene fusions, more than half had responses to&nbsp;the small-molecule inhibitor entrectinib, according to an integrated analysis of 3 clinical trials presented at the 2018 ESMO Annual Congress.

Larotrectinib induced an objective response rate of 80% in patients with advanced solid tumors who harbored&nbsp;<em>NTRK&nbsp;</em>gene fusions, according to results pooled from 3 small trials of the TRK inhibitor. Results were presented during the 2018 ESMO Congress.

Lead investigator Fabrice Andr&eacute;, MD, PhD, said findings from the SOLAR-1 trial are the first to show benefit in a genomic subgroup of patients with breast cancer and could open the door for genomic testing in breast cancer.

In results from an analysis of the phase III&nbsp;PALOMA-3 trial, patients&nbsp;with hormone receptor-positive, HER2-negative advanced breast cancer who had progressed or relapsed on prior endocrine therapy achieved a clinically meaningful benefit in overall survival from&nbsp;the combination of palbociclib plus fulvestrant.&nbsp;

The combination of atezolizumab and nab-paclitaxel demonstrated a 2.5-month benefit in progression-free survival over nab-paclitaxel alone in&nbsp;patients with PD-L1&ndash;positive metastatic triple-negative breast cancer, according to findings of the phase III IMpassion130 trial presented at the 2018 ESMO Congress.

Rising prescription drug prices continue to add to the burden of paying for quality healthcare. In an effort to confront such costs, the Centers for Medicare &amp; Medicaid Services has rescinded a prohibition on step therapy for Medicare Advantage plans. But some contend such a policy will reduce patient access to optimal medication.

In results presented at the European Society for Medical&nbsp;Oncology&rsquo;s 2018 Molecular Analysis for Personalised Therapy Congress, Marlene Kok, MD, PhD, said results from the phase II TONIC study showed that induction therapy with doxorubicin turned &ldquo;cold&rdquo; tumor cells &ldquo;hot,&rdquo; resulting in an objective response rate of 20% following treatment with nivolumab.

Genomic assays and signatures are increasingly being used as a prognostic indicator for guiding treatment decisions, according to Harold J. Burstein, MD, PhD. During a presentation at the 2018 Lynn Sage Breast Cancer Symposium in Chicago, he explained that many of these tests can also be used as predictive indicators.

Talazoparib has been approved by the FDA for treatment of patients with deleterious or suspected deleterious germline <em>BRCA</em>-mutated, HER2-negative locally advanced or metastatic breast cancer, according to Pfizer, the manufacturer of the PARP inhibitor.

Although, it is challenging to determine the optimal&nbsp;adjuvant therapy for&nbsp;younger patients with breast cancer, Mark Robson, MD, encouraged that the addition of adjuvant chemotherapy does show a benefit in this patient population.&nbsp;

The role of&nbsp;tumor-infiltrating lymphocytes (TILs) is expanding in cancer care, necessitating a more involved role for pathologists to quantify immune infiltrates,&nbsp;K.P. Siziopikou, MD, PhD, suggested during a presentation at&nbsp;the 2018 Lynn Sage Breast Cancer Symposium.

Patients with HER2-positive, microsatellite instability-high (MSI-H), and <em>NTRK</em> gene fusion-positive breast cancer likely benefit more than others from molecular profiling. In a presentation at the 2018 Lynn Sage Breast Cancer Symposium in Chicago, Illinois,&nbsp;Sledge discussed the growing use of molecular profiling, especially for metastatic cancers, as well said the decreasing cost of sequencing.

Following recent FDA clearances, using scalp cooling to&nbsp;limit alopecia in patients receiving chemotherapy is closer to becoming a more common practice,&nbsp;according to a presentation at the 2018 Lynn Sage Breast Cancer Symposium.