“From 1973 to 2010 in the U.S., large reductions in breast cancer-specific death hazards were experienced in women diagnosed with invasive breast cancer, a comprehensive analysis of breast cancer survival data now shows.
“Although overall age-adjusted breast cancer mortality rates were stable initially, they decreased by almost one-third, from 33.5% in 1988 to 23.5% in 2010, reported Mitchell Gail, MD, PhD, senior investigator, biostatistics branch, division of cancer epidemiology and genetics, National Cancer Institute, Rockville, Md., and colleagues online in the Journal of Clinical Oncology.
“Improvements were evident in women younger than age 70 years with distant stage at time of diagnosis, as well as in those with local and regional disease. Tumor size usually accounted for more of the improvement in the first 5 years after diagnosis rather than later on, the researchers said.
” ‘Breast cancer mortality rates following diagnosis have been decreasing over four decades, not only in the first five years after diagnosis but thereafter,’ Gail told MedPage Today. ‘Little of the improvement could be explained by changes in tumor size or estrogen-receptor (ER) status over time in women under age 70. This suggests a major contribution from treatment for these women.’ “
Earlier this year, a new treatment option was added to the arsenal for ER-positive breast cancer in postmenopausal women when the U.S. Food and Drug Administration (FDA) approved the combination of letrozole (Femara) and palbociclib (Ibrance). Continue reading…
“The new investigational estrogen receptor (ER) degrader GDC-0810 was safe and tolerable in postmenopausal women with advanced ER-positive breast cancer, and a subset of the women, all of whom were previously treated with standard endocrine therapy, gained clinical benefit from the drug, according to data from a first-in-human phase I/IIa clinical trial presented here at the AACR Annual Meeting 2015, April 18-22.
” ‘Most breast cancers diagnosed in the United States are ER-positive, and their growth is fueled by the hormone estrogen,’ said Maura N. Dickler, MD, associate member of the Breast Medicine Service at Memorial Sloan Kettering Cancer Center and Weill Medical College of Cornell University in New York. ‘Resistance to currently available therapies targeting estrogen and the estrogen receptor causes morbidity and mortality for women with metastatic ER-positive breast cancer and new therapies that have activity against tumors resistant to currently available treatments are urgently needed.
” ‘The phase I dose-escalation portion of the study enrolled heavily pretreated patients, and the observed antitumor activity is promising for GDC-0810, which is demonstrating clinical benefit in these patients who have developed resistance to other endocrine therapies for ER-positive breast cancer patients,’ continued Dickler. ‘The phase IIa dose-expansion portion of the study is ongoing. It is evaluating GDC-0810 efficacy in more defined patient subpopulations and will provide more information about how effective this estrogen receptor degrader is.’ “
The gist: A recent study showed that a test called Prosigna affects whether oncologists recommend chemotherapy to women with estrogen receptor (ER)-positive, node-negative breast cancer.
“NanoString Technologies, Inc. (NASDAQ:NSTG), a provider of life science tools for translational research and molecular diagnostic products, today announced that the results of the first Prosigna® Assay decision impact study presented at the 37th Annual CTRC-AACR San Antonio Breast Cancer Symposium (SABCS) showed that the use of the test significantly changed oncologists’ treatment recommendations. Conducted in collaboration with Grupo Español de Investigación del Cáncer de Mama (GEICAM), a Spanish breast cancer research group, this prospective study of the Prosigna Assay and its impact on the treatment of women with Estrogen Receptor-Positive (ER+), HER2-negative, node-negative breast cancer showed that the use of the test informed the oncologists’ recommendation whether or not to treat with adjuvant chemotherapy in addition to adjuvant endocrine therapy.
“ ‘We are very pleased to see that in this study, Prosigna was used by oncologists to make more informed decisions regarding the administration of adjuvant chemotherapy for early-stage breast cancer patients,’ stated Brad Gray, President and Chief Executive Officer of NanoString. ‘Also, we were pleased to recapitulate the results of our earlier analytical validation study, which showed that Prosigna can be run at multiple sites and generate high-quality, consistent results…’ ”
“Overall, the investigators concluded that Prosigna can be reliably performed in hospital laboratories to provide useful information beyond standard clinicopathological variables that oncologists can use to inform adjuvant treatment recommendations in clinical practice, and that this study provides additional evidence that Prosigna has analytical validity and clinical utility in real-world settings.”
The gist: A different treatment schedule after surgery might increase survival and time without cancer worsening for women with axillary node-negative or high-risk node-negative breast cancer. A clinical trial found that these women might benefit from taking the drug paclitaxel once per week or docetaxel once every three weeks, instead of paclitaxel once every three weeks. The same trial found that women with triple negative breast cancer (TNBC) also benefit from weekly paclitaxel. But docetaxel once every three weeks showed better results for women with ER-positive, HER2–negative breast cancer.
“Women with axillary node-negative or high-risk node-negative breast cancer achieved prolonged DFS and marginally improved OS when they received adjuvant paclitaxel every week or docetaxel every 3 weeks compared with paclitaxel every 3 weeks, according to phase 3 study results presented at the San Antonio Breast Cancer Symposium.
“Further, weekly paclitaxel extended DFS and OS in women with triple-negative breast cancer, whereas docetaxel administered every 3 weeks improved DFS in women with ER-positive, HER-2–negative disease.
“Joseph A. Sparano, MD, professor of medicine and women’s health at Albert Einstein College of Medicine, and colleagues evaluated various regimens in 4,954 women with axillary node-positive or high-risk node-negative breast cancer. Previously released results, based on a median 5.3 years of follow-up, showed those who received adjuvant weekly paclitaxel (HR=0.73; P=.0006) or docetaxel every 3 weeks (HR=0.77; P=.02) demonstrated longer DFS than women who received paclitaxel every 3 weeks.
“The current analysis occurred after a median 12.1 years of follow-up. The numbers of DFS events (1639 vs. 1048) and deaths (1283 vs. 686) in the current analysis vs. the previous report were substantially higher.”
“Women who have had children (parous women) appear to have an increased risk of developing estrogen receptor-negative breast cancer, the subtype that carries a higher mortality rate and is more common in women of African ancestry. A similar relationship was found for triple-negative breast cancer. However, the association between childbearing and increased risk of estrogen receptor-negative and triple-negative breast cancer was largely confined to the women who had never breastfed. These findings, published in the Journal of the National Cancer Institute, suggest that low rates of breastfeeding in African American women may contribute to their higher incidence of the more aggressive and difficult-to-treat subtypes of breast cancer.
“Researchers from Boston University’s Slone Epidemiology Center (SEC) collaborated with the Roswell Park Cancer Institute of Buffalo, NY and the University of North Carolina Lineberger Cancer Center to form a consortium to study the determinants of breast cancer subtypes in African American women. They combined data on breast cancer cases and controls from four large studies, including the Boston University Black Women’s Health Study. The combined analyses included 3,698 African American women with breast cancer, including 1,252 with the estrogen receptor-negative subtype.
“They found that parous women had a 33 percent higher chance of developing estrogen receptor negative breast cancer than women who had never given birth. Women who had four or more births and had never breastfed any of their babies had a 68 percent higher chance of developing this type of cancer compared with women who had only one birth and had breastfed that baby. By contrast, parous women who had four or more births had a slightly decreased risk of estrogen receptor-positive breast cancer, regardless of whether or not they had breastfed.”