Startseite Kongressberichte & Archiv 2021 ASCO Annual Meeting Breast Cancer Breast Cancer—Local/Regional/Adjuvant
Josephine Lopes Cardozo, Caroline Drukker, Marjanka Schmidt, et al.
This prospective study demonstrates, that patients with an ultralow risk 70-gene signature have an excellent prognosis with 8-year BCSS above 99%. This is regardless of their clinical risk status. The 8-year distant metastasis-free interval is 95-98%.
Breast Cancer Index (BCI) and prediction of benefit from extended aromatase inhibitor (AI) therapy (tx) in HR+ breast cancer: NRG oncology/NSABP B-42.
Eleftherios P. Mamounas, Hanna Bandos, Priya Rastogi, et al.
BCI HOXB13/IL17BR (BCI-H/I) ratio prediction of extended letrozole therapy (ELT) benefit on recurrence-free interval was not confirmed in this study. In time-dependent distant recurrence analyses, BCI-H/I-High patients benefitted statistically significantly from ELT after four years, while BCI-H/I-Low patients did not. Observed ELT benefit on breast cancer-free interval in BCI-H/I-Low patients was primarily driven by second primary breast cancers. The study authors favor additional follow-ups to further characterize the BCI-H/I predictive ability in this study. Clinical trial information: NCT00382070
Utility of the 70-gene MammaPrint assay for prediction of benefit from extended letrozole therapy (ELT) in the NRG Oncology/NSABP B-42 trial.
Priya Rastogi, Hanna Bandos, Peter C. Lucas, et al.
Statistically significant extended letrozole therapy benefit was observed for The 70-gene MammaPrint (MP)-Low-Risk (MP score > 0.000), but not MP-High Risk (MP score ≤0.000). The treatment by risk group interaction was not statistically significant for distant recurrence, but it was for disease-free survival and breast cancer-free interval. The benefit appears to be stronger in MP-L but not MP-UL (MP-LNUL) (MP score > 0.000, ≤0.355) than in MP Ultralow Risk (MP-UL) (MP score > 0.355). NCT: 00382070.
De-escalated neoadjuvant pertuzumab+trastuzumab with or without paclitaxel weekly in HR-/HER2+ early breast cancer: ADAPT-HR-/HER2+ biomarker and survival results.
Nadia Harbeck, Oleg Gluz, Matthias Christgen, et al.
The study authors demonstrated for the first time both excellent pathological complete response (pCR) and survival in patients treated by de-escalated neoadjuvant CT+P+T irrespective of further CT use in a prospective multicenter study. CT-free therapies may only need to be evaluated and administered in selected patients (e.g. with high HER2 expression / non-basal-like tumors). The authors mention, that In ADAPT HR-/HER2+, early pCR after only 12 weeks of neoadjuvant P+T+pac was strongly associated with improved outcome and may thus serve as a predictive clinical marker for further treatment (de)-escalation. Clinical trial information: NCT01779206
Prognostic impact of recurrence score, endocrine response and clinical-pathological factors in high-risk luminal breast cancer: Results from the WSG-ADAPT HR+/HER2- chemotherapy trial.
Oleg Gluz, Ulrike Nitz, Matthias Christgen, et al.
First results from a phase III ADAPT trial with a prospective high-risk cohort show evidence for good prognosis in some patients with over 4 positive lymph nodes and e.g. low RS. The authors conclude, that the combination of lower post-endocrine Ki-67 and limited tumor burden may be a promising criterion for CT de-escalation strategies even in patients with high RS. Clinical trial information: NCT01779206
Neoadjuvant talazoparib in patients with germline BRCA1/2 (gBRCA1/2) mutation-positive, early HER2-negative breast cancer (BC): Results of a phase 2 study.
Jennifer Keating Litton, Joseph Thaddeus Beck, Jason M. Jones, et al.
According to the authors, monotherapy with the poly(ADP-ribose) polymerase inhibitor talazoparib in the neoadjuvant setting was active and showed pathologic complete response rates comparable to those observed with combination anthracycline and taxane-based CT-regimens.The treatment was generally well tolerated. Clinical trial information: NCT03499353
Durvalumab improves long-term outcome in TNBC: results from the phase II randomized GeparNUEVO study investigating neodjuvant durvalumab in addition to an anthracycline/taxane based neoadjuvant chemotherapy in early triple-negative breast cancer (TNBC).
Sibylle Loibl, Andreas Schneeweiss, Jens Bodo Huober, et al.
The study shows, that the anti-PD-L1 checkpoint inhibitor Durvalumab added to neoadjuvant chemotherapy in triple-negative breast cancer improved long-term outcome significantly despite a small increase of pathologic complete response and no continuation after surgery. The authors ask whether adjuvant therapy with a checkpoint inhibitor is needed at all. Clinical trial information: NCT02685059
Evaluation of intra-tumoral (IT) SD-101 and pembrolizumab (Pb) in combination with paclitaxel (P) followed by AC in high-risk HER2-negative (HER2-) stage II/III breast cancer: Results from the I-SPY 2 trial.
Amy Jo Chien, Hatem Hussein Soliman, Cheryl Ann Ewing, et al.
SD-101 is an investigational Toll-like receptor 9 (TLR9) agonist CpG-C class oligodeoxynucleotide. The study demonstrates that the SD-101+Pembrolizumab 4 regimen was active but the pre-specified threshold for graduation in I-SPY 2 was not met. Pathologic complete response/Residual Cancer Burden analysis suggests improved response in the HR+/HER-negative signature vs. control. The clinical relevance of these results must be weighed against the potential immune-mediated toxicity risk. Clinical trial information: NCT01042379
A randomized phase III post-operative trial of platinum-based chemotherapy (P) versus capecitabine (C) in patients (pts) with residual triple-negative breast cancer (TNBC) following neoadjuvant chemotherapy (NAC): ECOG-ACRIN EA1131
Ingrid A. Mayer, Fengmin Zhao, Carlos L. Arteaga, et al.
The study demonstrates, that Patients with residual triple-negative breast cancer after neoadjuvant chemotherapy (NAC) had a lower than expected 3-year invasive disease-free survival regardless of study treatment. According to the available data, it seems very unlikely that the study would be able to establish non-inferiority of platinum-based chemotherapy (P) to capecitabine (C). Severe toxicities were more commonly seen with P. In patients with triple-negative breast cancer, particularly basal subtype, with at least 1 cm residual disease after NAC and high recurrence risk, adjuvant P use does not improve outcomes. Clinical trial information: NCT02445391