Abemaciclib/Pembrolizumab Combo Shows Early Promise for HR+/HER2- Breast Cancer


“The combination of abemaciclib (Verzenio) and pembrolizumab (Keytruda) showed preliminary signs of activity without additive toxicity for patients with pretreated HR-positive, HER2-negative metastatic breast cancer, according to early results from a pilot trial presented in a poster at the 2017 San Antonio Breast Cancer Symposium (SABCS).

“At a 16-week analysis, the objective response rate (ORR) with the combination was 14.3%, which was less than the response rate seen with single-agent abemaciclib in the MONARCH-1 trial (19.7%). However, the trial investigators noted that the median time to response for abemaciclib has historically been 3.7 months, suggesting the efficacy is likely to improve with longer follow-up. At 16 weeks, the ORR in the MONARCH-1 trial was 6.8%.”

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Nab-Paclitaxel Shows Greatest Utility for TNBC


“Treatment with nab-paclitaxel (Abraxane) showed promising improvements in overall survival (OS) and progression-free survival (PFS) compared with standard paclitaxel for patients with metastatic triple-negative breast cancer (TNBC), according to post-hoc findings from the CALGB 40502/NCCTG N063H trial presented at the 2017 San Antonio Breast Cancer Symposium (SABCS).

“For those with TNBC in the phase III trial (n = 201), the median OS with nab-paclitaxel was 21.0 months compared with 15.3 months with standard paclitaxel, representing a 26% reduction in the risk of death. Given the limitations of the post-hoc assessment, these findings were not powered for statistical significance, explained lead investigator Hope S. Rugo, MD. The hazard ratio for the comparison was 0.74 (95% CI, 0.51-1.07).”

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In Young Women With Metastatic Breast Cancer, Kisqali Delays Tumor Growth And Relieves Symptoms


“At this year’s San Antonio Breast Cancer Symposium, several reports on new treatments for advanced breast cancer caught my attention. In an impressive analysis presented by Dr. Debu Tripathy, ribociclib (Kisqali, Novartis) extended progression-free survival (PFS) and improved the quality of life in young women with metastatic hormone receptor (HR) positive, HER2 negative tumors.

“Ribociclib meets ‘a clear and unmet need for premenopausal patients with HR positive, HER2 negative advanced breast cancer,’ Tripathy said at the press meeting in San Antonio. Novartis sponsored the MONALEESA-7 trial in which 672 eligible women with metastatic disease were randomized to receive hormone-blocking agents with either ribociclib or a placebo. The study registered women between age 25 and 58; the median age was around 44 years; the groups were divided evenly. The international study includes metastatic breast cancer patients in North and South America, Europe, Asia and Australia.”

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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.’ “