BREAST CANCER

Angela M. DeMichele, MD, professor of Medicine and Epidemiology, University of Pennsylvania, discusses the biology of triple negative breast cancer and the significant role of DNA repair.

Phase III results of the KRISTINE trial demonstrated that patients with HER2-positive early breast cancer had a significantly higher pathological complete response (pCR) rate when they received the neoadjuvant regimen of docetaxel, carboplatin, and trastuzumab plus pertuzumab (TCH+P) versus trastuzumab emtansine (T-DM1) plus pertuzumab (T-DM1+P).  

As I write this, the 2016 ASCO conference has just concluded in Chicago. And, as is typical with this event, the amount and level of groundbreaking research and information presented at this year's conference is nothing less than staggering in its scope, innovation, and promise.

Breast cancer has traditionally not been viewed as immunogenic. There is now a growing body of evidence that immune infiltration has a prognostic role in al breast cancer subtypes, and predicts improved clinical outcome in triple-negative and human epidermal growth factor receptor 2-positive tumors.

For patients with early-stage invasive breast cancer and known estrogen receptor, progesterone receptor, and HER2 status, ASCO's February 2016 release of their evidence-based recommendations helped define appropriate use of biomarker assay results in guiding adjuvant treatment decisions.

A number of small changes that were specific to neoadjuvant and adjuvant therapies were made to the NCCN breast cancer guidelines, additionally, the recommended treatments for patients with ER-positive disease were also modified.

Allison W. Kurian, MD, MSc, associate professor of Medicine and of Health Research and Policy, Stanford University School of Medicine, discusses two ongoing trials utilizing multi-gene panels to uncover previously undetected risks in patients with breast and ovarian cancer.

Preliminary data shows an anthracycline/taxane-based chemotherapy regimen (TaxAC) could be superior to docetaxal plus cyclophosphamide in patients with breast cancer.

Multigene panel testing may uncover new risks in breast cancer and ovarian cancer.

The combination of T-DM1 and pertuzumab was superior to the combination of paclitaxel and trastuzumab as neoadjuvant treatment for women with HER2-positive breast cancer.

TNFSF11, also known as RANKL, shows potential as a genetic pathway in the prevention of breast cancer for women carrying BRCA1 mutations. Early study findings, published in Nature Medicine, show that a drug currently used in the treatment of osteoporosis, denosumab (Xgeva)-an inhibitor of RANKL-could also be used for the prevention and delay of tumor growth for BRCA1-mutation carriers.

Single-agent abemaciclib as well as taselisib in combination with fulvestrant (Faslodex) could both play a substantial role in breast cancer in the near future, says Maura Dickler, MD.

Joanne Blum, MD, PhD, FACP, physician, Texas Oncology, discusses the combination of fulvestrant and palbociclib (Ibrance) in patients with breast cancer, as well as the synergy fulvestrant has with other CDK4/6 inhibitors.

A new nationwide research project is encouraging patients to share tumor samples and clinical information with researchers in the hope that it will lead to discoveries for new and improved treatment options and, ultimately, a cure, for metastatic breast cancer.

Extending aromatase inhibitor (AI) treatment to 10 years post-treatment reduced the risk of recurrence in women with early-stage HR-positive breast cancer by more than a third. Findings of the MA.17R trial also showed that adjuvant therapy extension did not create any new toxicities or quality of life complications for patients.

Palbociclib (Ibrance), when added to letrozole, increased the median progression-free survival (PFS) rate in patients with ER-positive, HER2-negative advanced or metastatic breast cancer by >10 months, according to results from the phase III PALOMA-2 trial presented at the 2016 ASCO Annual Meeting.

Maura N. Dickler, MD, Memorial Sloan Kettering Cancer Center, discusses next steps with abemaciclib following the results of the single-arm MONARCH 1 trial.

In patients with HER2-positive early breast cancer, data from a phase III trial has shown a significantly higher pathological complete response (pCR) rate with neoadjuvant docetaxel plus carboplatin plus trastuzumab plus pertuzumab versus trastuzumab emtansine plus pertuzumab.

Durvalumab, an investigational PD-L1 targeting drug, is the subject of a unique ongoing basket trial being conducted by the National Institutes of Health, and was part of a single arm phase I combination therapy study of the drug in 19 patients with cervical cancer, triple negative breast cancer (TNBC), ovarian cancer, or uterine leiomyosarcoma.

Findings from a population-based study reported at the 2016 ASCO Annual Meeting revealed that young black women with breast cancer are much less likely to undergo testing for the BRCA gene or to get risk reducing prophylactic mastectomy or salpingo-oophorectomy than other women.

Herceptin, a biosimilar version of trastuzumab, produced comparable efficacy rates and safety profile as trastuzumab in patients with HER2-positive metastatic breast cancer, according to research presented at the 2016 ASCO Annual Meeting.

Neratinib, an experimental TKI being developed for breast cancer, achieved a 36% clinical benefit rate in a phase II trial, according to a poster presented June 5, 2016 at the ASCO Annual Meeting in Chicago.

When tested in heavily pretreated patients with refractory, hormone-receptor (HR)-positive, HER2-negative advanced breast cancer, abemaciclib, a CDK4/6 inhibitor, produced a positive response rate of approximately 20%.

An ongoing phase IIa basket study is evaluating treating patients who have molecular abnormalities with agents that target the HER2, BRAF, Hedgehog, or EGFR pathways, regardless of the patient's tumor type and the drug's original indication.

A joint analysis of the "ABC" trials comparing anthracycline versus non-anthracycline treatment in patients with high-risk, HER2-negative breast cancer has failed to demonstrate non-inferiority of the non-anthracycline regimen.

Gastric cancers with high-level clonal FGFR2 gene amplification responded to AZD4547, a selective FGFR inhibitor, in a phase II open label trial of previously treated, advanced FGFR amplified cancer. Yet tumors with multiple FGFR1 genes, low level or subclonal amplification of FGFR2 did not respond similarly to the drug.

Significant strides have been made in developing cyclin-dependent kinase 4 (CDK4) and CDK6 inhibitors to treat estrogen receptor (ER)‒positive breast cancer.

Cyclin-dependent kinase 4 (CDK4) and CDK6 inhibitors are a promising class of anticancer agents that may present effective alternatives to standard therapy for women with advanced, refractory, or relapsed hormone receptor (HR)‒positive breast cancer.

A number of highly effective cyclin-dependent kinase 4 (CDK4) and CDK6 inhibitors are currently in development as treatments for patients with metastatic breast cancer.

Inhibition of cyclin-dependent kinase 4 (CDK4) and CDK6 has been extensively studied in estrogen receptor (ER)‒driven breast cancer.