Olaparib in Breast Cancer: PFS Is Significant but OS Is Not

Excerpt:

“A few months ago, olaparib (Lynparza, AstraZeneca) was the first drug approved to treat women with advanced breast cancer with germline mutations in BRCA.

“That approval was based on a significant improvement in progression-free survival (PFS) compared with standard chemotherapy shown in the OlympiAD trial. The results led to quite some excitement among breast cancer researchers, as for example in the Medscape Oncology commentary ‘OlympiAD: Olaparib Captures Gold for BRCA-Mutated Breast Cancer Patients.’

“Now, however, a final analysis of OlympiAD results shows that overall survival (OS) did not significantly improve.”

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First Trial of Three Aromatase Inhibitors: Similar Efficacy, Safety

Excerpt:

“The first-ever direct comparison of three adjuvant aromatase inhibitors for the treatment of postmenopausal hormone receptor–positive early breast cancer shows no significant differences in clinical efficacy or safety, according to an Italian research team.

“In the randomized, open-label phase 3 FATA-GIM3 trial of almost 3700 women, the 5-year disease-free survival for patients treated with anastrozole (Arimidex, Novartis), exemestane (Aromasin, Pfizer), or letrozole (Femara, Novartis) was 90.0%, 88.0% and 89.4%, respectively.”

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Breast Cancer Therapy: All Clear for the Heart

Excerpt:

“Many breast cancer therapies cause damage to the heart. However, in the largest study of its kind so far, scientists from the German Cancer Research Center (DKFZ) in Heidelberg have now shown that the risk of death from heart disease in breast cancer patients following radiotherapy or chemotherapy is no higher than it is among the average population. Good risk management in the hospitals as well as control screenings at short intervals seem to make up for elevated risks.”

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Massive Bio Aims to Improve Clinical Trial Enrollment Rates With Oncology Registry, Matching Tool

Excerpt:

“Healthcare informatics firm Massive Bio has enrolled its first patient in a global registry it launched as part of a new clinical trial matching system that seeks to connect patients to appropriate biomarker-based clinical trials using information such as clinical history and genomic testing results.

“Previously, Massive Bio offered its clinical trial matching capability as part of a broader oncology clinical decision support system through which it provides treatment guidance and expert recommendations primarily to oncologists working in community practices. By separating the clinical trial matching component, the company hopes to broaden its market reach, said Massive Bio CEO and Cofounder Selin Kurnaz. The company also hopes the new tool will appeal to contract research organizations, molecular diagnostics companies, and patients themselves.”

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Why Can’t Dying Patients Get the Drugs They Want?

Excerpt:

“At first glance, a bill passed by the House of Representatives this week seems like the kind of thing anyone could get behind.

“Known as the “Right to Try” legislation, it would allow terminally ill patients access to experimental drugs without the approval of the Food and Drug Administration.

“But the bill and a similar one passed last summer by the Senate do little to address the main barrier that patients face in getting unapproved treatments: permission from the drug companies themselves.”

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Double Mastectomy to Prevent Breast Cancer Reduces Risk of Dying from the Disease in BRCA1 Mutation Carriers – but Does Not Reduce Further the Already Low Risk in BRCA2 Carriers

Excerpt:

“Healthy women who carry a breast cancer-­causing mutation in the BRCA1 gene, not only reduce their risk of developing the disease but also their chances of dying from it if they have both breasts removed, according to new research presented today (Wednesday) at the 11th European Breast Cancer Conference.

“However, the study also found that for women with a mutation in the BRCA2 gene, there was no difference in their chances of dying from the disease whether they opted to have their breasts removed (bilateral risk-­reducing mastectomy or BRRM) or chose to have closer surveillance instead.”

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New ASTRO Guidelines Recommend Hypofractionated Breast Irradiation

Excerpt:

“An expert panel convened by the American Society for Radiation Oncology (ASTRO) released a set of recommendations regarding fractionation for whole-breast irradiation (WBI) in women with breast cancer. The guideline includes recommendations for standard practice, factors that should influence fractionation decision making, and issues surrounding tumor bed boost, among other issues.

” ‘Breast cancer is the most common malignancy treated with radiation therapy in the United States, and WBI is the most common radiotherapeutic approach for breast cancer,’ wrote authors led by Benjamin D. Smith, MD, of MD Anderson Cancer Center in Houston. The standard of care for WBI has involved conventional fractionation (CF), with daily doses of 180 to 200 cGy up to approximately 4,500 to 5,000 cGy; research in the 1990s and 2000s looked into whether moderate hypofractionation (HF) with daily doses of 265 to 330 cGy could offer similar outcomes.”

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CMS Starts to Cover Broad Cancer DNA Tests, Boosting Foundation, Thermo

Excerpt:

“The Centers for Medicare & Medicaid Services, which administers the federal Medicare insurance program, will begin covering FDA-approved diagnostic tests that scan tumors for a range of genetic mutations. The news is a boost for companies like Foundation Medicine and Thermo Fisher Scientific, who are among the few firms with such tests on the market.

“Late Friday, the CMS said that, going forward, it will start to reimburse for tests that use DNA sequencing technology to map the tumors of patients with advanced cancers once approved by the FDA. Two of the already-approved tests fitting this description are FoundationOne CDx, from Cambridge, MA-based Foundation, and Oncomine Dx Target Test, from Waltham, MA-based Thermo Fisher Scientific (NYSE: TMO). FoundationOne CDx looks for 324 cancer-related alterations in patients’ DNA. Foundation amasses a report based on the results and sends it to doctors, who use the data to suggest possible treatments. Oncomine detects 23 genetic alterations associated with non-small cell lung cancer.”

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Accelerated WBI Should be the Norm for Most Breast Cancers

Excerpt:

“Most women with breast cancer should receive accelerated whole-breast irradiation (WBI) as the standard of care, according to a new guideline from the American Society for Radiation Oncology (ASTRO).

“Accelerated, or hypofractionated, WBI is the preferred form of radiotherapy for breast cancer, regardless of a patient’s age, tumor stage, or whether the patient has received chemotherapy. The guideline replaces an ASTRO guideline published in 2011, which recommended hypofractionated WBI for selected patients: primarily older patients and those with less advanced disease.”

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