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Mixed results have occured in recent trials testing immuotherapy in patients with breast cancer. Checkpoint inhibitors have been used as monotherapy in a pair of trials, reporting lackluster overall response rates. When immunotherapy was paired with chemotherapy, on the other hand, it usually showed better results, and gave signals that immunotherapies combined with targeted agents could work better than immunotherapy alone.

Elizabeth Mittendorf, MD, PhD, director of the Breast Oncology Program at the Susan F. Smith Center for Women’s Cancers at Dana-Farber Cancer Institute, discusses the importance of identifying biomarkers in patients with breast cancer. Current studies are looking at PD-L1 as a possible biomarker, but Mittendorf believes there may be other biomarkers that will prove to be more reliable. 

Tumor reduction for patients with ER-positive breast cancer can be achieved with endocrine therapy and can 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.

Abemaciclib, the only CDK4/6 inhibitor approved as a single-agent, has amassed several clinical indications for patients with metastatic breast cancer. The findings from the phase III MONARCH2 and 3 trials, as well as the phase II MONARCH1 study led to these approvals. Each trial showed improvements in progression-free survival, especially in patients with visceral disease and endocrine therapy resistance.

Presented at the 2018 Miami Breast Cancer Conference, results from the phase III OlympiAD trial demonstrated improvements in progression-free survival with olaparib over treatment of physician&#39;s choice. These results were consistent regardless of the baseline tumor burden for patients with HER2-negative breast cancer with a germline <em>BRCA</em>1/2 mutation.