Neoadjuvant HER2+ Breast Cancer Options Need Refinement, Expert Says

Excerpt:

“While recent findings from the I-SPY 2 trial have shown potential with the combination of ado-trastuzumab emtansine (T-DM1; Kadcyla) and pertuzumab (Perjeta) for patients with HER2-positive breast cancer, the neoadjuvant space still has a lot of work ahead, according to Lisa A. Carey, MD.

“Results presented at the 2016 AACR Annual Meeting1 showed that, out of the 249 patients enrolled on the I-SPY 2 study, 54% of those who received T-DM1/pertuzumab experienced a pathological complete response (pCR) rate compared with 22% of those who received the combination of paclitaxel (Abraxane) plus trastuzumab (Herceptin).

“This suggests that T-DM1 could increase overall survival (OS) in this patient population, but Carey adds more research with the regimen needs to be conducted.”

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Delays in Radiation Therapy Increase Chance of Breast Tumor Development in Women Treated for Ductal Carcinoma in Situ

Excerpt:

“Women who underwent treatment for ductal carcinoma in situ (DCIS), a noninvasive breast abnormality, were at higher risk of developing malignant breast tumors if they did not receive timely radiation therapy as part of their treatment, according to a study presented here at the AACR Annual Meeting 2016, April 16-20.

“DCIS is the most common premalignant breast lesion, with over 60,000 women diagnosed each year. Not all DCIS will develop into invasive cancer, but because it is difficult to predict which cases will become cancerous, most women diagnosed with DCIS undergo treatment for it.

“ ‘According to the National Comprehensive Cancer Network guidelines, primary treatment options for DCIS include breast-conserving surgery plus radiation, total mastectomy, and breast-conserving surgery alone,’ said the study’s lead author, Ying Liu, MD, PhD, instructor of surgery at Washington University School of Medicine and a research member at Siteman Cancer Center in St. Louis, Missouri. ‘This study shows that it is important for women to understand the benefits of timely receipt of radiation therapy after breast-conserving surgery.’ ”

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MammaPrint Genetic Test Can Reduce Use of Post-surgery Chemotherapy Among Early-stage Breast Cancer Patients

Excerpt:

“Among patients with early-stage breast cancer who were considered at high risk for disease recurrence based on clinical and biological criteria, the MammaPrint genetic test identified a large group of patients for whom five-year distant metastasis–free survival was equally good whether or not they received adjuvant chemotherapy (chemotherapy given post-surgery), according to results from the randomized, phase III microarray in node negative disease may avoid chemotherapy (MINDACT) clinical trial to be presented here at the AACR Annual Meeting 2016, April 16-20.”

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Palbociclib Showed Antiproliferative Activity in Early-stage Breast Cancer

Excerpt:

“The molecularly targeted therapeutic palbociclib (Ibrance), which is used to treat advanced breast cancer, was effective in slowing the multiplication of cancer cells in patients diagnosed with early-stage breast cancer who received no prior therapy, according to data from a phase II clinical trial presented here at the AACR Annual Meeting 2016, April 16-20.

” ‘The use of targeted therapies has been increasing in the last few years. It is crucial to determine that these drugs do hold activity against tumor cells,’ said the study’s lead author, Monica Arnedos, MD, an assistant professor at Gustave Roussy Cancer Campus in Villejuif, France. ‘In the case of palbociclib, no predictive biomarkers have been identified to date, and there are still no data about its potential efficacy in the early setting.’ ”

“Palbociclib, an inhibitor of cyclin-dependent kinases (CDK) 4 and 6, was approved by the U.S. Food and Drug Administration (FDA) in February 2015 for use in combination with the anti-estrogen therapeutic letrozole for treating postmenopausal women with a specific subtype of breast cancer: estrogen receptor-positive, HER2-negative, metastatic breast cancer.”

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Ignyta Announces Updated Data from Entrectinib Phase 1 Clinical Trials at the 2016 AACR Annual Meeting

Excerpt:

“Ignyta, Inc. (RXDX),a precision oncology biotechnology company, today announced that updated results of its Phase 1 clinical trials of entrectinib, the company’s proprietary oral tyrosine kinase inhibitor targeting solid tumors harboring activating alterations to NTRK1, NTRK2, NTRK3, ROS1 or ALK, were presented in an oral plenary session at the 2016 Annual Meeting of the American Association for Cancer Research (AACR) in New Orleans, Louisiana.

“ ‘We continue to be excited by entrectinib’s ability to help patients with advanced cancer,’ said Jonathan Lim, M.D., Chairman and CEO of Ignyta. ‘With respect to efficacy, in the 25 patients in the Phase 1 trials who would meet the eligibility criteria for our Phase 2 clinical trial, we saw tumor regression in 20 patients, or 80%. Nineteen out of 24 patients with extracranial solid tumors had a confirmed RECIST response, representing a 79% overall response rate; and one patient with an astrocytoma had evidence of substantial tumor regression by volumetric measurement. These responses were observed in patients with each of NTRK, ROS1 and ALK rearrangements, and across six tumor histologies, including complete and/or durable responses in both primary and metastatic tumors of the central nervous system.’ ”

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