San Antonio Breast Cancer Symposium

Subgroup analyses of a phase 3 randomized trial continue to support a role for the addition of pembrolizumab to chemotherapy in the frontline setting for patients with advanced triple-negative breast cancer, with the greatest benefit derived by those with higher PD-L1 expression by combined positive score.

Compared with women in the general population, those who survive breast cancer experience more difficulty in becoming pregnant and have a risk of preterm labor, although a systematic review and meta-analysis demonstrated that most deliver healthy babies with no detrimental effects on their long-term survival.

Improved survival was observed among women with stage I-III breast cancer who adhered to a diabetes risk reduction diet compared with those who did not.

Patients with radiation-associated breast angiosarcoma may have an effective treatment option with the combination of oral paclitaxel with encequidar.

Alpelisib in combination with letrozole demonstrated sustained efficacy and no new safety signals as treatment of patients with PIK3CA-mutant HR–positive, HER2-negative advanced breast cancer who received prior treatment with the combination of a CDK4/6 inhibitor and fulvestrant.

Adjuvant treatment with pertuzumab demonstrated a trend for greater benefit in patients with early breast cancer with a HER2 single-activated pathway determined by molecular subtyping using BluePrint assay.

The cumulative incidence of central nervous system recurrences was improved, and fewer deaths were observed with adjuvant neratinib as treatment of patients with early-stage HER2-positive breast cancer after trastuzumab-based therapy compared with placebo at 8 years of follow-up.

Favorable outcomes after treatment with the HER2-directed lapatinib were indicated by early declines in circulating tumor cell counts in patients with metastatic breast cancer who initially had HER2-negative primary tumors but positive HER2 CTCs, suggesting this could serve as a clinical biomarker.

Sara M. Tolaney, MD, MPH, discusses where she sees the treatment landscape evolving in the future for the treatment of patients with hormone receptor-positive metastatic breast cancer.

The addition of trilaciclib prior to gemcitabine and carboplatin chemotherapy significantly improved overall survival in patients with previously treated metastatic triple-negative breast cancer.

In patients with hormone receptor–positive, HER2-negative, node-positive, early breast cancer whose tumors have high clinicopathological risk factors, treatment with abemaciclib in combination with endocrine therapy educed the risk of invasive disease recurrence or death, independent of Ki-67 level, according to results from a subanalysis of the phase 3 monarchE clinical trial.

Patients with HER2-positive metastatic breast cancer treated with fam-trastuzumab deruxtecan-nxki had continued to experience extended durable responses and overall survival rates, along with tolerable toxicity in the phase 2 DESTINY-Breast01 study for which data were presented during the 2020 San Antonio Breast Cancer Symposium.

In the phase 3 MONALEESA-7 trial, patients with hormone receptor–positive, HER2-negative breast cancer had a significant improvement in overall survival and chemotherapy delay when treated with ribociclib plus endocrine therapy compared with placebo.

No significant differences in recurrence were observed between treatment with tamoxifen or anastrozole in postmenopausal women with locally excised ductal carcinoma in situ.

The use of whole breast irradiation can be omitted in patients 65 years and older with pT1-2 tumors on local control at 10 years after breast-conserving surgery and adjuvant endocrine therapy in low risk, older patients.

Patients with Oncotype Dx low-risk recurrence scores were classifed with high accuracy by PreciseDx by using only hematoxylin and eosin stain images and limited clinical data.

In the phase 3 KX-ORAX-001 clinical trial, treatment with paclitaxel in combination with encequidar achieved a 26.5% reduction in the risk of death compared with paclitaxel by intravenous injection in patients with metastatic breast cancer.

A retrospective exploratory analysis of 3 trials of ribociclib in patients with hormone receptor–positive, HER2-negative advanced breast cancer confirmed the prognostic value of intrinsic tumor subtype for efficacy outcomes with CDK4/6 inhibition.

A higher risk of new chronic controlled substance use was observed among women who underwent both a mastectomy and reconstructive surgery, those who received a breast cancer diagnosis, received chemotherapy and were younger.

Serial circulating tumor cell enumeration in patients with metastatic breast cancer has been shown to strongly predict overall survival outcomes. The prediction is possible when CTC assessments are performed at a median of 29 days following treatment initiation.

Data from a 29-practice consortium shows that oncologists tend to under-recognize substantial symptoms among patients with breast cancer receiving radiotherapy after they have undergone a lumpectomy, according to a presentation during the 2020 San Antonio Breast Cancer Symposium. The data underscore a need for improvement in symptom detection.

Invasive disease-free survival was prolonged in patients with high-risk, early hormone receptor–positive, HER2-negative breast cancer treated with abemaciclib in combination with standard endocrine therapy in the phase 3 monarchE trial, according to a presentation at the 2020 San Antonio Breast Cancer Symposium.

Five-year invasive disease-free survival and overall survival were improved with the addition of chemotherapy to endocrine therapy as treatment of premenopausal, but not postmenopausal, women with hormone receptor–positive, HER2-negative, lymph node–positive breast cancer and a recurrence score between 0 and 25.

Adam M. Brufsky, MD, PhD, FACP, discusses the TBCRC049 trial, which looks at the safety and efficacy of the tucatinib/trastuzumab/capecitabine combination to treat leptomeningeal metastases in HER2-positive breast cancer.

In a 500-patient randomized trial, the pharmacokinetics, clinical activity, and safety of pertuzumab and trastuzumab administered as a subcutaneous fixed-dose combination were found to be noninferior to the intravenous versions of the drugs.

A pathologic complete response rate of 44% was observed with a neoadjuvant durvalumab (Imfinzi)-based regimen administered to patients with triple-negative breast cancer, according to results of a phase I/II study presented in a poster at the 2019 San Antonio Breast Cancer Symposium.

Sara M. Tolaney, MD, MPH, discusses the results of the monarcHER trial, which examined adding the CDK4/6 inhibitor abemaciclib and endocrine therapy to trastuzumab versus trastuzumab plus chemotherapy in advanced hormone receptor-positive, HER2-positive breast cancer.

Nearly 12 years after discontinuing treatment, anastrozole, an aromatase inhibitor, maintained a preventive effect for postmenopausal women at high risk for breast cancer. Women assigned to anastrozole were 49% less likely to have developed breast cancer compared with women assigned to placebom according to data presented at the 2019 San Antonio Breast Cancer Symposium.

Preliminary results from the phase III NeoTRIPaPDL1 Michelangelo study showed that the addition of atezolizumab to combination carboplatin plus nab-paclitaxel did not result in a statistically significant increase in the pathologic complete response rate compared with the combination alone in patients with early high-risk and locally advanced triple-negative breast cancer.

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.