Long-Term Results of Adjuvant Endocrine Therapy in Premenopausal Breast Cancer

Excerpt:

“In an analysis of long-term outcomes in the SOFT and TEXT trials reported at the 2018 ASCO Annual Meeting and in The New England Journal of Medicine, Francis et al found that the addition of ovarian suppression to adjuvant tamoxifen significantly improved 8-year rates of disease-free and overall survival vs tamoxifen alone among premenopausal women with breast cancer; risk of recurrence was further reduced with exemestane plus ovarian suppression.

“Initial reports showed that 5-year rates of recurrence were significantly lower among premenopausal women who received the aromatase inhibitor exemestane plus ovarian suppression vs tamoxifen plus ovarian suppression, with the addition of ovarian suppression to tamoxifen not significantly improving recurrence risk vs tamoxifen alone.”

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Neratinib/T-DM1 Combo Shows Promise in HER2-Positive Breast Cancer

Excerpt:

“The combination of neratinib (Nerlynx) and T-DM1 (ado-trastuzumab emtansine; Kadcyla) induced an overall response rate of 60% in previously-treated women with HER2-positive metastatic breast cancer, according to results from the phase Ib NSABP FB-10 study presented at the 2018 ASCO Annual Meeting.

“Among 12 of 20 evaluable patients with objective responses, 3 had a complete response and 9 had a partial response. An additional 2 patients had stable disease, and 6 patients had progressive disease.”

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Tucatinib Active in Heavily Pretreated HER2+ Breast Cancer

Excerpt:

“Tucatinib used in combination with capecitabine, trastuzumab (Herceptin), or both agents showed promising antitumor activity in heavily pretreated women with HER2-positive breast cancer with or without brain metastases, according to findings published in The Lancet Oncology.

“In phase Ib results from a nonrandomized, open-label study, 83% (5/6) of patients with measurable disease treated with tucatinib/capecitabine had an objective response, as did 40% (6/15) of patients receiving tucatinib/trastuzumab. Sixty-one percent (14/23) of patients treated with the combination of all 3 drugs had an objective response.”

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Early Detection and Intervention Reduce Breast Cancer–Related Lymphedema

Excerpt:

“A new study has found that early detection along with a simple intervention can be highly effective in preventing breast cancer–related lymphedema for at-risk women. According to data presented at the 2018 Annual Meeting of the American Society of Breast Surgeons, 82% of women identified at an early stage of lymphatic impairment returned to their normal pretreatment measurements following patient-administered therapies that combined compression sleeve garments and self-directed massage. The researchers, who used bioimpedance spectroscopy to measure extracellular fluid, emphasized that early screening of lymphatic function is crucial to address subtle lymphatic changes before they become permanent. ”

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Talazoparib Granted Priority Review by FDA for BRCA+ Metastatic Breast Cancer

Excerpt:

“A new drug application (NDA) for the PARP inhibitor talazoparib has been granted a priority review by the FDA for the treatment of patients with germline BRCA mutation–positive, HER2-negative locally advanced or metastatic breast cancer, according to Pfizer, the manufacturer of the agent.

“In results from the phase III EMBRACA trial, on which the application is based, talazoparib reduced risk of disease progression or death by 46% compared with chemotherapy in patients with BRCA-positive advanced breast cancer. At a median follow-up of 11.2 months, the Median progression-free survival (PFS) at the median follow-up of 11.2 months was 8.6 months (95% CI, 7.2-9.3) with talazoparib versus 5.6 months (95% CI, 4.2-6.7) with physician’s choice of therapy (HR, 0.54; 95% CI, 0.41-0.71; P <.0001). The objective response rate (ORR) was 62.6% (95% CI, 55.8-69.0) compared with 27.2% (95% CI, 19.3-36.3), respectively (odds ratio, 4.99; 95% CI, 2.9-8.8; 2-sided P value <.0001).”

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Niraparib/Pembrolizumab Combo Active in Relapsed, Progressive TNBC

Excerpt:

“Half of patients with metastatic triple-negative breast cancer (TNBC) achieved disease control when treated with the combination of a poly (ADP-ribose) polymerase (PARP) inhibitor and an anti–PD-1 agent, a preliminary prospective study showed.

“Overall, 13 of 46 evaluable patients had objective responses to treatment with niraparib (Zejula) and pembrolizumab (Keytruda). An additional 10 patients had stable disease. Clinical activity was observed in patients beyond those with germline BRCA mutations.”

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Adding Abemaciclib Offers Good Outcomes in Pre-/Perimenopausal Breast Cancer

Excerpt:

“The addition of the CDK4/6 inhibitor abemaciclib to fulvestrant significantly improved progression-free survival (PFS) and time to subsequent chemotherapy in pre- and perimenopausal women with hormone receptor–positive/HER2-negative advanced breast cancer, according to results from an analysis of the phase III MONARCH-2 trial (abstract 1002) presented at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting, held June 1–5 in Chicago.”

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First Study of Neoadjuvant Use of PARP Inhibitor Shows Promise for Early-Stage, BRCA+ Breast Cancer Patients

Excerpt:

In a small Phase II study of early-stage breast cancer patients with BRCA1/2 mutations, researchers at The University of Texas MD Anderson Cancer Center found that more than half of the women who took the PARP inhibitor talazoparib once daily prior to surgery had no evidence of disease at the time of surgery. If further validated in larger, confirmatory trials, the oral medication could replace chemotherapy for these patients.

“The trial, which expands upon a feasibility study published in npj Breast Cancer, was presented today as an oral presentation at the 2018 American Society of Clinical Oncology Annual Meeting by Jennifer Litton, M.D., associate professor of Breast Medical Oncology.”

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New Approach to Immunotherapy Leads to Complete Response in Breast Cancer Patient

Excerpt:

A novel approach to immunotherapy developed by researchers at the National Cancer Institute (NCI) has led to the complete regression of breast cancer in a patient who was unresponsive to all other treatments. This patient received the treatment in a clinical trial led by Steven A. Rosenberg, M.D., Ph.D., chief of the Surgery Branch at NCI’s Center for Cancer Research (CCR), and the findings were published June 4, 2018 in Nature Medicine. NCI is part of the National Institutes of Health.

” ‘We’ve developed a high-throughput method to identify  present in a cancer that are recognized by the immune system,’ Dr. Rosenberg said. ‘This research is experimental right now. But because this new approach to immunotherapy is dependent on mutations, not on cancer type, it is in a sense a blueprint we can use for the  of many types of cancer.’ ”

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