HER2 Breast Cancer

In the phase III APHINITY trial, pertuzumab with trastuzumab plus chemotherapy demonstrated a 0.9% improvement in overall survival and continued to reduce the risk of disease recurrence in patients with HER2-positive early breast cancer in the adjuvant setting, according to a 6-year analysis of the phase III APHINITY trial presented at the 2019 San Antonio Breast Cancer Symposium.

Triple-negative breast cancer — defined as tumors that lack expression of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 amplification— is a heterogenous disease and clinically represents a major unmet need in the field of oncology. TNBC is associated with aggressive tumor biology and higher risk of recurrence and visceral metastasis, including brain metastasis.

In an interview with Targeted Oncology, Charles Geyer, MD, discussed the potential role of neratinib as well as other new agents that are coming down the pipeline for the treatment of patients with metastatic HER2-positive breast cancer. He also addressed the biggest challenges oncologists face in managing this disease.

Debu Tripathy, MD, of the Department of Breast Medical Oncology, Division of Cancer Medicine, MD Anderson Cancer Center, was an investigator in the phase III MONALEESA-7 trial. The purpose of the study was to examine how endocrine therapy, in combination with a cyclin-dependent kinase inhibitor, affects progression-free survival and overall survival in premenopausal patients with HR-positive, HER2-negative advanced breast cancer.

The need for new therapies to treat metastatic triple-negative breast cancer is pressing, and the development of antibody-drug conjugates represents a promising new strategy for these patients, according to Aditya Bardia, MD, MPH.

Joseph F. Stilwill, MD, shares insight on the benefit seen with CDK4/6 inhibitors in patients with advanced HR-positive, HER2-negative breast cancer and highlighted ongoing research aimed at overcoming acquired resistance.

The immunotherapy agent balixafortide (POL6326) has been granted Fast Track designation by the FDA in combination with eribulin (Halaven) for the treatment of patients with HER2-negative metastatic breast cancer who have previously received at least 2 chemotherapeutic regimens in the metastatic setting, according to Polyphor, the manufacturer of the potent and highly selective CXCR4 antagonist.

Pembrolizumab produced a &ldquo;modest but durable&rdquo; response in heavily pretreated women with PD-L1&ndash;positive, estrogen receptor-positive, HER2-negative advanced breast cancer, according to results from the KEYNOTE-028 trial which were recently published in <em>Clinical Cancer Research</em>.

Updated results of the&nbsp;phase III randomized OlympiAD trial, presented at the 2018 AACR Annual Meeting, suggest women with HER2-negative metastatic breast cancer associated with a germline <em>BRCA</em> mutation may have a slight survival advantage with a poly polymerase inhibitor instead of chemotherapy.

A&nbsp;marketing authorization application for olaparib (Lynparza) for the&nbsp;treatment of women with <em>BRCA</em>-mutated, HER2-negative metastatic breast cancer who previously received chemotherapy in the neoadjuvant, adjuvant, or metastatic setting has been accepted by the&nbsp;European Medicines Agency.

Kornelia Polyak, MD, PhD,&nbsp;discusses several exciting advancements in the field of breast cancer, including immunotherapy, PARP inhibitors, and liquid biopsies.

Tumor reduction for patients with ER-positive breast cancer can be achieved with endocrine therapy and can&nbsp;possibly avoid the need for chemotherapy or even surgery in some patients. Hyman B. Muss, MD, who presented at the 2018 Miami Breast Cancer Conference, said that deciding how long to continue this therapy can be tricky, however.

Uttara Nayar, PhD, shares the findings of recent studies in patients with ER+ breast cancer. Findings&nbsp;have shown that acquired HER2 mutations lead to endocrine resistance, the most frequent cause of breast cancer mortality in the country.

HER2-positive breast cancer has gone from &quot;worst to first&quot; because of the success of the monoclonal antibody drug trastuzumab in combination with chemotherapy.&nbsp;

An axillary lymph node dissection can be avoided for patients with large, operable tumors in the breast, no clinical signs of cancer in the axillary nodes before being treated with neoadjuvant chemotherapy, and no signs of cancer following a sentinel lymph node biopsy during surgery.

Welela Tereffe, MD, discusses&nbsp;the current state of RT in breast cancer and emphasized the importance of a multidisciplinary approach.

According to the results of a study recently published in <em>JAMA Oncology,</em>&nbsp;high breast density surpasses other known risk factors for developing breast cancer, including family history of the disease, personal history of benign lesions, and later-in-life childbirth.

Melanie E. Royce, MD, PhD,&nbsp;discusses the recent progress in the landscape of HER2-positive breast cancer and what she envisions future treatment approaches will be for patients.&nbsp;

Joyce A. O&rsquo;Shaughnessy, MD, addresses some of the key issues in breast cancer and shared her expert insight on where TNBC treatment is headed based on recent findings.

A prospective study is looking at whether breast cancer surgery can be eliminated in patients who respond well to neoadjuvant systemic therapy.

Measuring molecular biomarkers after metastasis could inform treatment decisions for women with breast cancer that has spread to the brain.

A pre-planned subgroup analysis of data from the MONALEESA-2 trial demonstrated similar clinical benefit and safety profiles in elderly patients compared to younger patients with HR+/HER2-advanced breast cancer, supporting a paradigm shift in the future medical management of these patients from the current standard of letrozole to combined treatment of letrozole plus ribociclib.

Yu (Amy) Zong, Shanghai Jiaotong University School of Medicine, discusses a meta-analysis of nanoparticle albumin-bound paclitaxel as neoadjuvant chemotherapy of breast cancer.&nbsp;

Neoadjuvant chemotherapy with nanoparticle albumin-bound nab-paclitaxel has demonstrated substantial activity across major subgroups of breast cancer, a meta-analysis of clinical trials showed.

The results of a recent randomized study showed anti-HER2 DC1 vaccination to be a safe and immunogenic treatment to induce tumor-specific T-cell responses in patients with HER2-positive breast cancer.