The most recent update of the National Comprehensive Cancer Network (NCCN) guideline on breast cancer has undergone a number of “tweaks” with few major changes. The revisions include new recommendations for preoperative endocrine therapy, optimization of adjuvant endocrine therapy in premenopausal and postmenopausal women, an update on HER2-directed therapy for patients with operable breast cancer, and guidance on new agents for endocrine therapy in metastatic disease.
Immunotherapy is a hot topic in cancer right now, with approved checkpoint inhibitors for melanoma and non–small-cell lung cancer. Checkpoint inhibitors are also making inroads in other solid tumors.
An ongoing clinical trial of a novel strategy to evaluate new chemotherapy regimens for patients with early-stage breast cancer has identified another neoadjuvant combination therapy worthy of a phase 3 clinical trial involving patients with HER2-positive breast cancer.
It is not clear how to treat residual disease after neoadjuvant therapy in patients with early HER2-negative breast cancer. Additional chemotherapy with capecitabine improved survival in this group of patients, according to a large Japanese study presented by lead investigator Masakazu Toi, MD, PhD, Professor, Breast Surgery, Kyoto Hospital, Japan, at the 2015 San Antonio Breast Cancer Symposium.
Younger patients with luminal A subtype breast cancer may not need chemotherapy, according to a Danish trial presented by lead investigator Torsten O. Nielsen, MD, PhD, Professor, University of British Columbia, Vancouver, Canada, at the 2015 San Antonio Breast Cancer Symposium. Patients with luminal A biological subtype breast cancer have an excellent prognosis, even high-risk patients, the study suggests.
The antibody-drug conjugate trastuzumab emtansine (T-DM1) improved overall survival (OS) compared with physician’s choice of therapy in patients with pretreated HER2-positive metastatic breast cancer, according to the final results of the phase 3 TH3RESA trial, which were presented at the 2015 San Antonio Breast Cancer Symposium.
Anastrozole and tamoxifen are similarly effective in preventing breast cancer recurrence in postmenopausal women with ductal carcinoma in situ (DCIS). The choice should depend on patient preferences, side-effect profiles, age, and other patient factors, according to 2 studies presented at the 2015 San Antonio Breast Cancer Symposium.
Patients with early breast cancer and a low Oncotype DX recurrence score can safely receive treatment with hormone therapy alone and avoid chemotherapy, according to results of the TAILORx trial, which was sponsored by the National Cancer Institute.
Boston, MA—Fertility preservation by controlled ovarian hyperstimulation with concurrent letrozole (Femara) is safe in women with breast cancer, according to a single-center, prospective study on the long-term safety of fertility preservation by the use of ovarian stimulation and concurrent aromatase inhibitors in women with breast cancer, presented at the 2015 Best of ASCO meeting in Boston. Controlled ovarian hyperstimulation had no impact on relapse-free survival and enabled live births in a substantial proportion of women who later chose to retrieve their frozen embryos or oocytes.
San Antonio, TX—Adding an erythropoiesis-stimulating agent (ESA) to best supportive care failed to demonstrate noninferiority for progression-free survival (PFS) compared with best supportive care alone in patients with metastatic breast cancer, in a clinical trial known as EPO-ANE-3010 that was requested by the FDA.
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