Startseite Kongressberichte & Archiv 2021 ASCO Annual Meeting Breast Cancer Breast Cancer—Local/Regional/Adjuvant
Discovery and validation of a genomic signature to identify women with early-stage invasive breast cancer who may safely omit adjuvant radiotherapy after breast-conserving surgery.
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.
A novel biosignature identifies DCIS patients with a poor biologic subtype with an unacceptably high rate of local recurrence after breast conserving surgery and radiotherapy.
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.
Lisinopril or carvedilol in prevention of trastuzumab-induced cardiotoxicity in patients with HER2-positive early stage breast cancer: Longitudinal changes of left ventricular ejection fraction below normal levels (LVEF <50%).
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
Cardiac safety of dual anti-HER2 blockade with pertuzumab plus trastuzumab (P+T) in the APHINITY trial.
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
Outcome of breast cancer patients treated with chemotherapy during pregnancy compared with non-pregnant controls.
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.
Final analysis of the PROMISE-GIM6 phase III trial assessing GnRH agonist use during chemotherapy as a strategy to preserve ovarian function in premenopausal patients with early breast cancer.
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
Abemaciclib combined with adjuvant endocrine therapy in patients with high risk early breast cancer who received neoadjuvant chemotherapy (NAC).
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
Subgroup of post-neoadjuvant luminal-B tumors assessed by HTG in PENELOPE-B investigating palbociclib in high risk HER2-/HR+ breast cancer with residual disease.
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).
Inflammatory cytokines and distant recurrence in HER2-negative early breast cancer in the ECOG-ACRIN 5103 trial.
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
Usefulness of assessment of circulating tumor DNA(ctDNA) of cerebrospinal fluid(CSF) samples for early detection of brain metastasis (BrM) in patients with triple-negative breast cancer (TNBC).
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.