No Home Runs, But Some Solid Base Hits at SABCS

“University of Michigan oncologist Daniel F. Hayes, MD, told MedPage Today that, even though the San Antonio Breast Cancer Symposium he attended here wouldn’t change his treatment practices when he returns to Ann Arbor, what had been presented was still significant.

“A number of studies reaffirmed that certain treatments were appropriate and reinforced their continued use, said Hayes, as did several other prominent oncologists interviewed by MedPage Today.

“Hayes, clinical director of breast oncology in the University of Michigan Comprehensive Cancer Center, and president-elect of the American Society of Clinical Oncology, said that much of the progress reported at the symposium was incremental.”


Why Prolia May Be The Better Drug For Reducing Bone Breaks And Recurrence After Breast Cancer

“As people age, the risk of fracturing a bone – whether it’s a hip, a wrist, vertebrae, an ankle or toe, climbs steadily. For women and men who live after a cancer diagnosis, the risk of breaking bone is greater.

“At this year’s San Antonio Breast Cancer Symposium, Dr. Michael Gnant of Vienna gave an update on a major trial of denosumab in its capacity to reduce fractures and possibly stave off metastases. This drug is manufactured and sold by Amgen in a low-dose form as Prolia. Prolia is a monoclonal antibody that doesn’t require intravenous administration; it’s injected under the skin, just twice each year.

“The ongoing trial, by the Austrian Breast and Colorectal Cancer Study Group (ABCSG), includes over 3,400 postmenopausal women with non-metastatic, hormone receptor positive breast cancer. All participants took an aromatase inhibitor, a standard treatment given to lower hormone levels, and were randomized to receive either low-dose (60 milligrams) denosumab or a placebo injection under the skin, twice yearly.”


Resistance Mutations: Next in ER+ Metastatic Breast Cancer?

“Estrogen receptor (ER) mutations can be easily detected in the plasma of patients with metastatic breast cancer and may hold the key to targeted treatments for women with endocrine-resistant disease, according to new analysis of patients in the BOLERO-2 trial.

” ‘Patients who had mutations had a shorter median survival than those who did not…and patients with different mutations might have different responses to therapies,’ Sarat Chandarlapaty, MD, PhD, a breast medical oncologist from Memorial Sloan Kettering Cancer Center in New York reported at the San Antonio Breast Cancer Symposium.

“BOLERO-2 enrolled postmenopausal women with metastatic, endocrine-resistant, ER-positive breast cancer and changed the standard of care in this setting, as reported by Medscape Medical News.”


Breast Cancer Drugs Battle Disease's Return

“A pair of drugs already on the market appear to reduce the recurrence of breast cancer in women who’ve already undergone treatment, two new clinical trials show.

“The chemotherapy drug capecitabine (Xeloda) seems to reduce by nearly a third the risk of breast cancer recurrence if women receive the drug following surgery to remove their cancer, researchers were to report Wednesday at the 2015 San Antonio Breast Cancer Symposium.

“In addition, an osteoporosis medication called denosumab appears to reduce recurrence risk by 18 percent in women who have HR-positive breast cancer, a second study reports.”


Aspirin Doesn't Help Breast Cancer Outcomes, May Aid Detection

“Researchers found no link between taking aspirin and improved breast cancer outcomes, however the drug’s effect on breast density may help with earlier diagnosis, according to two new studies presented at a conference on breast cancer.

“Several studies have shown aspirin to cut the risk of colorectalbreast and other cancers.

“Researchers from the University of Pennsylvania presented the new studies at the San Antonio Breast Cancer Symposium.

” ‘Past studies have found that aspirin may hold anti-cancer benefits. However, many of them were preliminary, preclinical, and didn’t support a clear mortality benefit. They also didn’t look at prior use of aspirin,’ said Dr. Julia Tchou, an associate professor of surgery at the University of Pennsylvania, in a press release. ‘Our data did not support the notion that this century-old pill has protective qualities and down-the-road benefits for breast cancer patients. However, larger patient cohort studies are needed to confirm our results.’ “


Older Breast Cancer Patients Defy Survival Models

“Older women with early-stage, invasive breast cancer had better survival rates than what was estimated by a popular online tool for predicting survival, according to researchers at the Duke Cancer Institute.

“The finding provides a stronger rationale for women over the age of 70 — even those who have additional minor health concerns — to undergo aggressive treatments such as chemotherapy to prevent their cancer from returning.

“ ‘When making decisions about whether or not to use potentially toxic preventive chemotherapy for breast cancer in older women, patients and doctors debate what they should do,’ said Gretchen Kimmick, M.D., M.S., an associate professor of medicine at Duke who is presenting the study findings at the San Antonio Breast Cancer Symposium. ‘This predictive model can help us show patients that they are going to survive long enough to see the benefit of treatment.’ “


One-Two Punch of Palbociclib, Paclitaxel Shows Promise against Advanced Breast Cancer

“Combining the new breast cancer drug palbociclib with paclitaxel (Taxol) shrank tumors in nearly half of patient with estrogen-receptor (ER) positive breast cancer, according to new research from the Perelman School of Medicine at the University of Pennsylvania. The results will be presented Saturday at the 2015 San Antonio Breast Cancer Symposium. A second study provides new clues to how breast cancer develops resistance to the palbociclib, a common occurrence among many patients who take the drug.

” ‘Results of the first study found that palbociclib and paclitaxel can be safely combined on an alternating dosing schedule,’ said Angela DeMichele, MD, MSCE, the Alan and Jill Miller Associate Professor in Breast Cancer Excellence in Penn’s Abramson Cancer Center, and senior author on the study. ‘The high response rate we saw suggests this combination may hold benefits for patients over paclitaxel alone. Based on these results, a larger clinical trial to determine the benefits is warranted.’ “


Denosumab Benefits Postmenopausal Breast Cancer Patients

“The addition of the bone-targeting drug denosumab to adjuvant hormonal therapy in postmenopausal breast cancer patients improves disease-free survival (DFS), reducing the risk of disease recurrence by 18% compared with placebo, according to the results of the Austrian Breast and Colorectal Cancer Study Group (ABCSG)-18 trial.

“The results (abstract S2-02) were presented at the 2015 San Antonio Breast Cancer Symposium (SABCS), held December 8–12 in San Antonio, Texas.

“ ‘This is a very safe treatment and my clinical conclusion is that denosumab reduces the risk of disease recurrence or death, and this benefit is similar to what bisphosphonates can do and comes in addition to highly significantly reducing clinical fractures,’ said study author and presenter Michael Gnant, MD, professor of surgery at the Medical University of Vienna in Austria, during a press conference. ‘I believe that we should offer this treatment to postmenopausal breast cancer patients on adjuvant aromatase inhibitors.’ “


Capecitabine Improved Outcomes for Breast Cancer Patients with Disease after Presurgery Chemo

“Treatment with the chemotherapy agent capecitabine increased disease-free survival for women with HER2-negative breast cancer that was not eliminated by presurgery chemotherapy, according to results from the phase III CREATE-X clinical trial presented at the 2015 San Antonio Breast Cancer Symposium, held Dec. 8-12.

“Treatment given to shrink or eliminate a tumor before surgery is called neoadjuvant therapy. In some patients with breast cancer treated with neoadjuvant chemotherapy, residual invasive cancer can be detected in breast tissue samples and lymph nodes removed during surgery. These patients tend to have worse long-term outcomes compared with women who respond completely to neoadjuvant therapy.

” ‘It has been suggested that patients with residual invasive disease after neoadjuvant chemotherapy have chemoresistant breast cancer, but there have been no large-scale clinical trials to test whether adjuvant systemic chemotherapy is beneficial for these patients,’ said Masakazu Toi, MD, PhD, a professor at Kyoto University Hospital in Japan, and founder and senior director of the Japan Breast Cancer Research Group (JBCRG). ‘CREATE-X was designed to evaluate this clinical question by testing whether capecitabine could improve disease-free survival for patients with residual invasive disease after neoadjuvant chemotherapy.’ “