BREAST CANCER

Based on findings from the APHINITY trial, pertuzumab (Perjeta) has been approved by the FDA in combination with trastuzumab (Herceptin) and chemotherapy for the adjuvant treatment of patients with HER2-positive early breast cancer at high risk for recurrence.

Denise A. Yardley, MD, discusses the promise of CDK4&6 inhibitors in estrogen receptor (ER)-positive breast cancer, as well as the potential with immunotherapy agents. 

Richard S. Finn, MD, covers the evolution of CDK4&6 inhibition in the field of breast cancer and appropriately selecting patients for this type of therapy.

Prospects for patients with breast cancer have improved with the use of CDK4&6 inhibitors, including palbociclib, ribociclib, and abemaciclib; however, the effects of these inhibitors in many subsets of patients have not been investigated.

The development of CDK4&6 inhibitors has provided promising data regarding this new therapeutic option for patients with cancer, particularly for patients with breast cancer. Currently, there are 3 FDA-approved CDK4&6 inhibitors for the treatment of patients with breast cancer.

The second most common cancer worldwide, breast cancer remains a significant global burden despite decreased incidence in Western countries. Breast cancer is the fifth leading cause of cancer death in the United States, with more than 40,000 estimated deaths in 2017.

According to phase II findings from the MEDIOLA trial presented at the 2017 San Antonio Breast Cancer Symposium,&nbsp;the combination of olaparib and durvalumab demonstrated a disease control rate of 80% for pretreated patients with germline <em>BRCA-</em>mutated, HER2-negative metastatic breast cancer, according to phase II findings from the MEDIOLA trial.

According to early results from a pilot trial presented in a poster at the 2017 San Antonio Breast Cancer Symposium,&nbsp;the combination of abemaciclib and pembrolizumab showed preliminary signs of activity without additive toxicity for patients with pretreated HR-positive, HER2-negative metastatic breast cancer.

Denise Yardley, MD, Senior Investigator, Sarah Cannon Research Institute, discusses the role of enzalutamide in hormone-receptor positive (HR+) advanced breast cancer.

Promising clinical trial results have been seen with the exploration of new and existing treatment approaches for patients with triple-negative breast cancer (TNBC) on several fronts, including chemotherapy,&nbsp;immunotherapy, novel antibodies, and agents targeting the PI3K/mTOR/AKT pathway, according to David W. Miles,&nbsp;MB BS, BSc, MD. During a presentation at the <em>1st Annual </em>Paris Breast Cancer Conference hosted by the Physicians Education Resource&reg;, LLC, Miles, a consultant medical oncologist at West Hertfordshire Hospitals in England, provided his perspective on potential new treatment options for patients with TNBC.

Eli Lilly and Company has announced that Kimberly L. Blackwell, MD, a pioneer in breast cancer research, will serve as its vice president of early phase development and immuno-oncology. She will begin her new role on March 12, 2018.<br /> &nbsp;

Lori Goldstein, MD, FASCO, is among 27 breast oncologists across the country to be recognized by <em>Forbes&rsquo; </em>&ldquo;Physician Honor Role&rdquo;<em> </em>as an extraordinary physician in the field of oncology.

Treatment with&nbsp;ladiratuzumab vedotin demonstrated an estimated median progression-free survival (PFS) of 11.6 weeks for patients with heavily pretreated metastatic triple-negative breast cancer (TNBC) treated&nbsp; with the recommended phase II dose of the antibody&ndash;drug conjugate, according to results of a phase I study presented during the 2017 San Antonio Breast Cancer Symposium.&nbsp;

Hope S. Rugo, MD, professor of medicine and director of the Breast Oncology Clinical Trials Program at the UCSF Helen Diller Family Comprehensive Cancer Center, discusses the 5-year follow-up of the CALGB 40502 study for patients with triple-negative breast cancer (TNBC).

Treatment discontinuation due to toxicity was less frequent with olaparib (Lynparza) monotherapy compared with chemotherapy in patients with HER2-negative metastatic breast cancer and a germline <em>BRCA</em> mutation in the phase III OlympiAD study.

In findings from the phase III GeparSepto trial presented during the 2017 San Antonio Breast Cancer Symposium, long-term disease-free survival rates were improved with neoadjuvant nab-paclitaxel (Abraxane) compared with standard paclitaxel in patients with high-risk early breast cancer.

Survival rates improved with nab-paclitaxel (Abraxane) therapy compared with paclitaxel in patients with triple-negative breast cancer (TNBC) more than in other patient subsets, according to findings from a post-hoc analysis from the CALGB 40502/NCCTG N063H clinical trial.&nbsp;

Results of a&nbsp;prospective clinical trial demonstrated that the detection of positive circulating tumor cells in the blood 5 years after hormone receptor-positive, HER2-negative breast cancer diagnosis was&nbsp;associated with an increased risk for late recurrence.

Tari King, MD, chief of Breast Surgery, Dana-Farber/Brigham and Women&#39;s Cancer Center, discusses a &quot;less is more&quot; approach when it comes to lymph node surgery in patients with breast cancer.

Treatment with a&nbsp;gonadotropin-releasing hormone analog could potentially preserve fertility and protect ovarian function in premenopausal woman being treated with chemotherapy for early-stage breast cancer, according to the results of a meta-analysis presented at the 2017 San Antonio Breast Cancer Symposium.

Results of the phase III SOLD trial maintained the benefit of 12 months of adjuvant treatment with trastuzumab (Herceptin) for patients with early stage HER2-positive breast cancer, as the trial failed to demonstrate noninferiority for 9 weeks of trastuzumab versus the standard 1-year period, when added to chemotherapy.&nbsp;

Disease-free survival&nbsp; is maintained in women with postmenopausal hormone receptor-positive breast cancer treated with aromatase inhibitors, even when the treatment is only given for 2 years in comparison with the standard 5 years of additional aromatase inhibitor therapy, according to findings from the phase III ABCSG-16 trial presented at the 2017 San Antonio Breast Cancer Symposium.&nbsp;

Denise Yardley, MD, senior investigator, Sarah Cannon Research Institute, discusses the results from a recent phase II trial evaluating exemestane with or without enzalutamide in patients with hormone receptor&ndash;positive breast cancer.

Julie Nangia, MD, assistant professor of Medicine, Baylor College of Medicine, discusses getting genetic testing for patients. While the NCCN has guidelines of who should be tested, it may also be possible for physicians to write a letter of medical necessity for other people, such as Ashkenazi Jewish women, who have higher rates of BRCA mutations.