Adam Brufsky, MD, PhD: Expectations of Therapy in Breast Cancer
What are the expectations of therapy in this setting?
Of the many choices that we have, one of the choices that I really like is a combination of an anti-hormonal agent and a targeted therapy, and we have a lot of really good data for exemestane and everolimus in this setting. I think that the expectation is that there will be at least a fairly substantial benefit in progression-free survival, almost doubling from about 4 months, which is the standard in this setting, to about 9 to 10 months when exemestane and everolimus are given.
ER+/HER2-Breast Cancer: Case 2
Mary is a 62-year-old woman, who in mid-2014 complained of rib pain. Rib plain films revealed a lytic lesion of the left 5th rib. Bone scan revealed multiple areas of uptake in the lumbosacral spine and ribs.
PET-CT revealed lytic lesions in the lumbosacral spine and ribs, and a 3 cm right upper lobe lesion in the lung with a PET SUV value of 6, indicating malignancy
A mammogram and ultrasound of the left breast revealed a 2 cm speculated mass in the upper outer quadrant of the left breast
Core needle biopsy of this lesion revealed infiltrating ductal carcinoma, ER 80%, Her2 negative
She was placed on denosumab 120 mg SQ monthly, and anastrozole 1 mg orally daily. Her pain resolved within 1 month, and on follow-up CT at 4 months her bone lesions appeared sclerotic and her lung lesion had reduced to 2 cm. Her anastrozole and denosumab were continued
In mid-2015 she again complained of worsening low back pain and left hip pain. Repeat PET-CT demonstrated new lytic lesions in the left iliac crest as well as an enlargement of the lung lesion to 4 cm.
She was placed on fulvestrant 500 mg IM monthly and denosumab was continued. Within 2 months her pain improved, and a repeat CT of the chest in late 2015 demonstrated reduction of the lung lesion to 2 cm
In March 2016 she complained of new right scapular pain. A PET-CT revealed new lytic lesions of the left scapula and right ribs, and a new lung nodule in the left upper lobe 1 cm in diameter with an increase in the right upper lobe lesion to 3 cm
Therapy Type and Site of Metastases Factor into HR+, HER2+ mBC Treatment
December 20th 2024During a Case-Based Roundtable® event, Ian Krop, MD, and participants discussed considerations affecting first- and second-line treatment of metastatic HER2-positive breast cancer in the first article of a 2-part series.
Read More
Imlunestrant Improves PFS in ESR1-Mutant Advanced Breast Cancer
December 13th 2024The phase 3 EMBER-3 trial showed imlunestrant improved PFS over SOC endocrine therapy in ER-positive, HER2-negative advanced breast cancer with ESR1 mutations, though not significantly in the overall population.
Read More
Breast Cancer Leans into the Decade of Antibody-Drug Conjugates, Experts Discuss
September 25th 2020In season 1, episode 3 of Targeted Talks, the importance of precision medicine in breast cancer, and how that vitally differs in community oncology compared with academic settings, is the topic of discussion.
Listen
Postoperative Radiation Improves HRQOL Over Endocrine Therapy in Breast Cancer
December 13th 2024In the phase 3 EUROPA trial, exclusive postoperative radiation therapy led to better health-related quality of life and fewer treatment-related adverse events in older patients with stage I luminal-like breast cancer at 24 months.
Read More
