Breast Cancer—Local/Regional/Adjuvant

Martin Sjöström, S. Laura Chang, Linda Hartman, et al.
The study authors conclude that their data suggest that the novel Profile for the Omission of Local Adjuvant Radiation (POLAR) genomic signature based on locoregional recurrence biology can not only identify patients who have a low risk of locoregional recurrence without adjuvant radiotherapy after (RT) breast-conserving surgery but who also would not benefit from RT, thus being prime candidates for RT omission.
Frank Vicini, Chirag Shah, Pat W. Whitworth, et al.
The study authors conclude that biosignatures identified a Low-risk patient group with low 10-year recurrence rates with or without RT who may be candidates for omitting adjuvant radiotherapy. Also identified was an elevated risk group receiving breast-conserving surgery plus radiotherapy with a poor response subtype that had unacceptably high recurrence rates, warranting potential intensified or alternate therapy.
Pamela N. Munster, Roy Tamura, Jeffrey Krischer, et al.
The study authors conclude that the impact of trastuzumab on left ventricular ejection fraction (LVEF) is small and infrequent In patients treated with trastuzumab without anthracyclines. Treatment with anthracyclines prior to trastuzumab demonstrated a decrease in LVEF to below normal levels in a larger than previously reported number of women in this community-based setting. This decline in LVEF could be prevented with concurrent treatment with lisinopril, which was tolerable even in patients without hypertension. Clinical trial information: NCT01009918
Evandro de Azambuja, Daniel Eiger, Marion Jennifer Procter, et al.
The study authors conclude that dual blockade with pertuzumab plus trastuzumab does not increase the risk of cardiac events compared to placebo plus trastuzumab alone. Anthracycline-based chemotherapy increases the risk of cardiac events. Non-anthracycline chemotherapy may be considered particularly in patients with other cardiovascular risk factors. Clinical trial information: NCT01358877
Frederic Amant, Valentina Nekljudova, Charlotte Maggen, et al.
The study authors conclude that pregnancy-induced alternations in chemotherapy concentration do not affect maternal prognosis in breast cancer patients. They suggest the initiation of chemotherapy for breast cancer during pregnancy when indicated for oncological reasons.
Matteo Lambertini, Luca Boni, Andrea Michelotti, et al.
The study authors conclude that PROMISE-GIM6 (at a median follow-up of 12.4 years) provides reassuring evidence on the safety of GnRHa use during chemotherapy as a strategy to preserve ovarian function in premenopausal patients with hormone receptor-positive early breast cancer. Clinical trial information: NCT00311636
Miguel Martin, Roberto Hegg, Sung-Bae Kim, et al.
The study authors conclude that Patients with HR+, HER2- early breast cancer who received neoadjuvant chemotherapy were noted to be at a higher risk of recurrence. In this subgroup, abemaciclib combined with endocrine therapy demonstrated a clinically meaningful treatment benefit in invasive disease-free survival and distant relapse-free survival. This was numerically greater than in the intent-to-treat population. Safety data were reported as consistent with the abemaciclib safety profile. Clinical trial information: NCT03155997
Frederik Marmé, Miguel Martin, Michael Untch, et al.
The study authors conclude that the addition of palbociclib to endocrine therapy did not improve invasive disease-free survival in premenopausal women. The analysis showed also that the addition of palbociclib to tamoxifen +/-GnRH in premenopausal women did not increase side effects compared to AI+GnRH. It seems to be an alternative to AI+GnRH. Clinical trial information: NCT01864746
Carsten Denkert, Frederik Marmé, Miguel Martin, et al.
The study authors conclude that PENELOPE-B did not show a benefit from the addition of 1 year palbociclib to endocrine therapy compared to placebo in the total enrolled high-risk primary breast cancer population. Interestingly, the small group of luminal-B tumors (n = 64) derived benefit from palbociclib (without statistically significant interaction).
Joseph A. Sparano, Anne M. O'Neill, Noah Graham, et al.
The study authors conclude that the analysis provides level 1B evidence. It indicates that despite optimal adjuvant systemic therapy higher levels of the cytokine IL-6 at diagnosis are associated with significantly higher distant recurrence risk in high-risk stage II-III breast cancer.
According to the study authors, this provides a foundation for confirmatory validation of IL-6 as a prognostic biomarker, and potentially as a predictive biomarker for testing therapeutic interventions targeting the IL-6/JAK/STAT3 pathway. Clinical trial information: NCT00433511
Lucrezia Raimondi, Giuseppe Naso, Rachele Lazzeroni, et al.
The study authors conclude that after neoadjuvant therapy+surgery, detectable CSF-ctDNA significantly associates with progression-free and overall survival, identifying early at-risk patients to develop BrM in triple-negative breast cancer.