Biomarker Selects TNBC Patients for Targeted Therapy

Excerpt:

“A tumor necrosis-based gene expression signature (GS) successfully identified patients with triple-negative breast cancer (TNBC) responsive to neoadjuvant therapy with the novel targeted agent LCL161, according to researchers.

“The international, randomized phase II trial of 207 patients with localized TNBC showed that of the 30.1% with GS-positive disease, a significantly higher pathologic complete response (pCR) was seen in those treated with paclitaxel plus the inhibitor of apoptosis antagonist LCL161 compared with those treated with paclitaxel alone (38.2% versus 17.2%).”

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Can Trastuzumab Duration Be Shortened in HER2-Positive Breast Cancer?

Excerpt:

“Adding to a growing list of similar results, the Short-HER study was unable to show noninferiority of 9 weeks of trastuzumab compared with the standard 1 year when given along with chemotherapy in women with HER2-positive breast cancer. Shorter administration does, however, reduce the risk of cardiotoxicity.

” ‘Adjuvant pivotal trials with 1-year trastuzumab have significantly improved the prognosis of HER2-positive early breast cancer,’ wrote study authors led by Pierfranco Conte, MD, of the Istituto Oncologico Veneto in Italy. Several studies have attempted to reduce the duration of trastuzumab, though most have failed to show noninferiority.”

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Tool Predicts Risk for Late Breast Cancer Recurrence

Excerpt:

“An online prognostic tool accurately determined the risk for late distant recurrence among women with ER-positive breast cancer, according to a single-arm, prospective study.

“The Clinical Treatment Score post-5 years (CTS5) tool could be used to determine whether patients should continue endocrine therapy 5 years after initial treatment.”

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MONALEESA-3 Data Highlight Ribociclib as Standard in HR+ Breast Cancer

Excerpt:

“Findings from the MONALEESA-3 trial dispelled the theory that a CDK4/6 inhibitor had to be reserved following recurrence on hormone therapy in postmenopausal patients with hormone receptor (HR)-positive, HER2-negative breast cancer, explained Dennis J. Slamon, MD, PhD.

“In the phase III trial, postmenopausal patients with HR-positive, HER2-negative advanced disease who received up to 1 prior line of therapy were randomized 2:1 to ribociclib (Kisqali) plus fulvestrant (Faslodex) or placebo.”

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Novel Agents are Changing the Face of Metastatic TNBC

Excerpt:

“Only 1 treatment option is currently available for treating patients with metastatic germline BRCA-mutated triple-negative breast cancer (TNBC), but research into novel therapies, including PI3K/conjugates (ADCs) could soon result in a host of new therapies for this hard-to-treat disease.

” ‘Right now, for TNBC, chemotherapy is our only option,’ said Joyce A. O’Shaughnessy, MD, co-chair of Breast Cancer Research and the chair of Breast Cancer Prevention Research at Baylor-Sammons Cancer Center and for The US Oncology Network. ‘That’s about to change very soon with the likely availability of atezolizumab [Tecentriq].’ ”

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Does Sequential vs Concurrent Treatment Change Outcomes in HER2+ Breast Cancer?

Excerpt:

“Outcomes for patients with HER2-positive breast cancer did not differ when treated with sequential chemotherapy plus trastuzumab compared with a concurrent approach, according to a new phase III trial.

” ‘The effectiveness of trastuzumab with chemotherapy in the neoadjuvant setting is evident; however, the cardiac safety of trastuzumab combined with anthracyclines has been questioned,’ wrote study authors led by Kelly K. Hunt, MD, of the University of Texas MD Anderson Cancer Center in Houston.”

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Biomarkers, PARP Inhibitors Vital for Personalized Treatment in Breast Cancer Subtypes

Excerpt:

“Developing predictive biomarkers will be key to treating patients with triple-negative breast cancer (TNBC), especially when choosing a targeted therapy, said Banu K. Arun, MD.

“In a presentation during the 2018 OncLive® State of the Science Summit™ on Breast Cancer, Arun said there is evidence that PARP inhibitors as well as immunotherapy in combination with various agents may be effective in women with TNBC and BRCA1-related breast cancers, but the science isn’t there yet.”

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Alpelisib Improves PFS for Advanced PIK3CA-Mutated Breast Cancer

Excerpt:

“A trial assessing the alpha-specific PI3K inhibitor alpelisib with fulvestrant met its primary endpoint of PFS among patients with hormone receptor-positive, HER-2-negative advanced breast cancer with a PIK3CA mutation, according to the agent’s manufacturer.

“Alpelisib (BYL719, Novartis) is an inhibitor of the PI3K pathway. About 40% of patients with hormone receptor-positive breast cancer harbor PIK3CA mutations.

“The phase 3 global, double-blind SOLAR-1 study included 572 women and men with PIK3CA-mutated hormone receptor-positive, HER-2-negative advanced or metastatic breast cancer that progressed on or following prior aromatase inhibitor treatment with or without a CDK4/6 inhibitor.”

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PARP Inhibitor Talazoparib Benefit in BCRA+ Breast Cancer

Excerpt:

“The now-published results from the EMBRACA study confirm that  talazoparib (Pfizer), a poly-adenosine diphosphate-ribose polymerase (PARP) inhibitor,  prolongs progression-free survival (PFS) in patients with advanced BCRA-positive breast cancer compared with single-agent chemotherapy alone, and that it also significantly improves quality of life.

” ‘This is the largest randomized trial in BRCA mutation carriers [ever undertaken] and demonstrates PARP efficacy,’ Jennifer Litton, MD, associate professor in the Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, told Medscape Medical News in an email.”

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