Breast Cancer

Lisocabtagene maraleucel (liso-cel), an investigational CD19-directed chimeric antigen receptor (CAR) T-cell therapy, has induced durable responses in high-risk patients with ag­gressive relapsed or refractory non-Hodg­kin lymphoma (NHL), according to data presented at ASCO 2018.
One of the most important stud­­­ies presented at ASCO 2018 showed that endocrine therapy alone was noninferior to endocrine therapy plus chemotherapy in women with estrogen receptor (ER)-positive, HER2-­negative, node-negative early-stage breast cancer and an intermediate risk score (score, 11-25) on the Oncotype DX gene-expression assay for breast cancer.
A novel drug is showing significant promise in metastatic breast cancers, offering renewed hope to patients with late-stage, difficult-to-treat solid tumors. According to data presented at ASCO 2018, sacituzumab govitecan demonstrated significant clinical activity as a single agent in heavily pretreated patients with hormone receptor (HR)-positive, HER2-negative metastatic breast cancer.
The current standard of care for women with early, HER2-positive breast cancer is 12 months of trastuzumab (Herceptin). Analysis of the phase 3 randomized clinical trial PERSEPHONE showed that 6 months of treatment with trastuzumab was noninferior to 12 months in terms of disease-free survival. Furthermore, a shorter course of trastuzumab was associated with a 50% reduction in cardiotoxicity leading to cessation of therapy.
When breast cancer recurs or is diagnosed at an advanced stage, treatment is complicated by the diverse nature of the disease, with several molecular subgroups with distinct tumor biology responding differently to different therapies.
Chicago, IL—The PARP inhibitor olaparib (Lynparza) significantly improved progression-free survival (PFS) compared with standard chemotherapy in women with HER2-negative metastatic breast cancer with a germline BRCA mutation. Disease progression was delayed by approximately 3 months with olaparib in the multinational, randomized, open-label, phase 3 OlympiAD clinical trial, reported Mark E. Robson, MD, Clinic Director, Clinical Genetics Service, Memorial Sloan Kettering Cancer Center, New York City, at the 2017 ASCO annual meeting.
Chicago, IL—The addition of the investigational CDK4/CDK6 inhibitor abemaciclib to fulvestrant (Faslodex) extended progression-free survival (PFS) by 7 months in women with hormone receptor (HR)-positive, HER2-negative advanced breast cancer, reported George W. Sledge, Jr, MD, Professor, Medical Oncology, Stanford University Medical Center, Palo Alto, CA, who presented the results of a large study at the 2017 ASCO annual meeting.
The FDA approved ribociclib, in combination with an aromatase inhibitor, for the treatment of postmenopausal women with hormone receptor (HR)-positive, HER2-negative advanced or metastatic breast cancer.

Extending aromatase inhibitor therapy with letrozole for an additional 5 years beyond standard treatment with letrozole improved disease-free survival (DFS) and reduced the rate of new contralateral breast cancer in postmenopausal women with estrogen receptor (ER)-positive breast cancer. Prolonged letrozole did not improve overall survival. These were the main findings of the large MA.17R trial, which were presented at the plenary session at ASCO 2016.

The addition of lapatinib (Tykerb) to trastuzumab (Herceptin) to create dual HER2 blockade was no better than trastuzumab alone in the adjuvant treatment of patients with HER2 breast cancer in the global phase 3 ALTTO (Adjuvant Lapatinib and/or Trastuzumab Treatment Optimisation) trial, reported Martine J. Piccart-Gebhart, MD, PhD, Chair, Breast International Group, Brussels, Belgium, at a plenary session at ASCO 2014.
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