San Antonio Breast Cancer Symposium

According to a pooled analysis of neoadjuvant trials presented at the San Antonio Breast Cancer Symposium, a pathologic complete response to HER2-directed neoadjuvant therapy reduced the risk of recurrence in patients with early HER2-positive breast cancer but did not eliminate it, supporting the common practice of continued anti-HER2 therapy.

In patients with triple-negative breast cancer or those with PD-L1–positive breast cancer across several subtypes, durvalumab as maintenance therapy, may improve outcomes compared with chemotherapy, according to an exploratory analyses from the phase II randomized SAFIR02-IMMUNO trial presented at the 2019 San Antonio Breast Cancer Symposium.

The addition of pembrolizumab to standard-of-care chemotherapy for neoadjuvant and adjuvant treatment of early triple-negative breast cancer lead to higher rates of pathologic complete responses in the KEYNOTE-522 trial, especially in those patients with stage III and/or node-positive disease.

Frontline treatment with palbociclib demonstrated positive progression-free survival n real-world patients with HR-positive/HER2-negative metastatic breast cancer and may lead to an overall survival benefit , according to data from the pivotal PALOMA-2 trial.

High rates of disease control were reported in the first set of results from a randomized trial in which adjuvant T-DM1 was compared to  trastuzumab and paclitaxel for the treatment of patients with early HER2-positive breast cancer.

Rita Nanda, MD, discusses the IMpower130 trial in patients with metastatic triple-negative breast cancer who express PD-L1.

Patients with HER2-positive metastatic breast cancer who had received prior anti-HER2 therapies continued to experience a progression-free survival benefit with margetuximab and a trend toward overall survival compared with trastuzumab when either agent was combined with chemotherapy, according to updated findings from the phase III SOPHIA trial. 

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.

In the phase II HER2CLIMB trial, a 34% reduction in the risk of death was observed with the addition of tucatinib to the combination of trastuzumab and capecitabine in patients with heavily pretreated unresectable locally advanced or metastatic HER2-positive breast cancer compared to the combination alone, according to results from the phase II HER2CLIMB trial presented at the 2019 San Antonio Breast Cancer Symposium.

Japanese patients with HR-positive, HER2-negative breast cancer had a significant improvement in invasive disease-free survival with the addition of the novel oral fluoropyrimidine derivative S-1, according to findings from the phase III POTENT trial presented at the 2019 San Antonio Breast Cancer Symposium.

In heavily pretreated patients with advanced HER2-positive breast cancer, trastuzumab deruxtecan induced a confirmed objective response rate of almost 61% and a durable benefit, according to results from the phase II DESTINY-Breast01 trial presented at the 2019 San Antonio Breast Cancer Symposium.

Based on data from the phase III TAM-01 trial presented at the 41st Annual San Antonio Breast Cancer Symposium, investigators concluded that giving women diagnosed with breast intraepithelial neoplasia a lower dose of tamoxifen following surgery could be as effective and less toxic than the current standard dose.

Charles E. Geyer, Jr, MD, professor of medicine at Virginia Commonwealth University School of Medicine, associate director for clinical research and Harrigan, Haw, Luck Families Chair in Cancer Research at Massey Cancer Center, discusses the impact of pertuzumab (Perjeta) in the treatment of patients with HER2-positive breast cancer at the 2018 San Antonio Breast Cancer Symposium.

At the 2018 San Antonio Breast Cancer Symposium, data demonstrated that use of circulating tumor-cell counts had strong value for selecting endocrine therapy compared to chemotherapy in patients with estrogen receptor–positive, HER2-negative metastatic breast cancer.

Sara A. Hurvitz, MD, director of the Breast Oncology Program, medical director of the Clinical Research Unit, University of California, Los Angeles Jonsson Comprehensive Cancer Center, discusses response to abemaciclib (Verzenio) in the neoMONARCH trial at the 2018 San Antonio Breast Cancer Symposium.

A biomarker subgroup analysis of the phase III IMpassion130 study in patients with metastatic triple negative breast cancer or inoperable locally advanced TNBC found that progression-free survival and overall survival improvements with the addition of first-line atezolizumab  to nab-paclitaxel were exclusive to patients with PD-L1 expression ≥1% in immune cells.

Patients with triple-negative breast cancer who received chemotherapy treatment more than 30 days after surgery had worse survival rates and outcomes than patients who received adjuvant chemotherapy within 30 days of surgery, according to findings from a retrospective study presented at the 2018 San Antonio Breast Cancer Symposium.

Roberto A. Leon Ferre, MD, oncologist, Mayo Clinic, discusses the identification of patients with luminal androgen receptor (LAR) triple-negative breast cancer (TNBC) during the 2018 San Antonio Breast Cancer Symposium.

Adding adjuvant capecitabine to the standard treatment for patients with early-stage triple-negative breast cancer did not lead to a significant improvement in disease-free or overall survival compared with observation, according to findings presented during the 2018 San Antonio Breast Cancer Symposium

Patients with breast cancer who achieved pathologic complete response following neoadjuvant chemotherapy were more likely to have improved survival outcomes, according to findings of a meta-analyses data presented at the 2018 San Antonio Breast Cancer Symposium.

Findings from the phase III KATHERINE study showed adjuvant treatment with ado-trastuzumab emtansine (T-DM1; Kadcyla) reduced the risk of invasive disease recurrence or death by 50% compared with trastuzumab (Herceptin) in patients with HER2-positive early breast cancer who had residual invasive disease following neoadjuvant therapy.

Updated results of the phase Ib/II ENHANCE1/KEYNOTE-150 study presented at the 2017 San Antonio Breast Cancer Symposium found that the combination of pembrolizumab (Keytruda) and eribulin (Halaven) was associated with a 26.4% objective response rate for patients with metastatic triple-negative breast cancer.

Results of a 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 associated with an increased risk for late recurrence.

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

Treatment with a 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. 

Disease-free survival  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. 

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–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.