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Poziotinib Shows Promising Antitumor Activity in Heavily Pretreated HER2+ BC in Phase 2
Key clinical point: Poziotinib demonstrated promising antitumor activity but high toxicity in patients with human epidermal growth factor receptor 2-positive (HER2+) advanced breast cancer (BC) who were heavily pretreated with HER2-directed therapy.
Major finding: Intermittent and continuous dosing schedules of poziotinib led to objective response rates of 30% each (P = .98) and disease control rates of 60% and 78% (P = .15), respectively. Grades 3-4 treatment-related adverse events were reported by 67% and 76% of patients receiving intermittent and continuous dosing schedules of poziotinib, respectively.
Study details: This phase 2 trial included 67 patients with HER2+ advanced BC who were previously treated with two or more HER2-directed regimens and who received 24 mg poziotinib once daily on an intermittent dosing schedule (n = 33) or 16 mg poziotinib once daily on a continuous dosing schedule (n = 34).
Disclosures: This study received financial support from Spectrum Pharmaceuticals. Gajanan Bhat and Szu-Yun Leu declared being employees of Spectrum Pharmaceuticals. Adam Brufsky declared serving as a consultant for and receiving research support from various sources. The other authors did not declare any conflicts of interest.
Source: Nasrazadani A, Marti JLG, Lathrop K, et al. Poziotinib treatment in patients with HER2-positive advanced breast cancer who have received prior anti-HER2 regimens. Breast Cancer Res Treat. 2024 (Jan 23). doi: 10.1007/s10549-023-07236-z Source
Key clinical point: Poziotinib demonstrated promising antitumor activity but high toxicity in patients with human epidermal growth factor receptor 2-positive (HER2+) advanced breast cancer (BC) who were heavily pretreated with HER2-directed therapy.
Major finding: Intermittent and continuous dosing schedules of poziotinib led to objective response rates of 30% each (P = .98) and disease control rates of 60% and 78% (P = .15), respectively. Grades 3-4 treatment-related adverse events were reported by 67% and 76% of patients receiving intermittent and continuous dosing schedules of poziotinib, respectively.
Study details: This phase 2 trial included 67 patients with HER2+ advanced BC who were previously treated with two or more HER2-directed regimens and who received 24 mg poziotinib once daily on an intermittent dosing schedule (n = 33) or 16 mg poziotinib once daily on a continuous dosing schedule (n = 34).
Disclosures: This study received financial support from Spectrum Pharmaceuticals. Gajanan Bhat and Szu-Yun Leu declared being employees of Spectrum Pharmaceuticals. Adam Brufsky declared serving as a consultant for and receiving research support from various sources. The other authors did not declare any conflicts of interest.
Source: Nasrazadani A, Marti JLG, Lathrop K, et al. Poziotinib treatment in patients with HER2-positive advanced breast cancer who have received prior anti-HER2 regimens. Breast Cancer Res Treat. 2024 (Jan 23). doi: 10.1007/s10549-023-07236-z Source
Key clinical point: Poziotinib demonstrated promising antitumor activity but high toxicity in patients with human epidermal growth factor receptor 2-positive (HER2+) advanced breast cancer (BC) who were heavily pretreated with HER2-directed therapy.
Major finding: Intermittent and continuous dosing schedules of poziotinib led to objective response rates of 30% each (P = .98) and disease control rates of 60% and 78% (P = .15), respectively. Grades 3-4 treatment-related adverse events were reported by 67% and 76% of patients receiving intermittent and continuous dosing schedules of poziotinib, respectively.
Study details: This phase 2 trial included 67 patients with HER2+ advanced BC who were previously treated with two or more HER2-directed regimens and who received 24 mg poziotinib once daily on an intermittent dosing schedule (n = 33) or 16 mg poziotinib once daily on a continuous dosing schedule (n = 34).
Disclosures: This study received financial support from Spectrum Pharmaceuticals. Gajanan Bhat and Szu-Yun Leu declared being employees of Spectrum Pharmaceuticals. Adam Brufsky declared serving as a consultant for and receiving research support from various sources. The other authors did not declare any conflicts of interest.
Source: Nasrazadani A, Marti JLG, Lathrop K, et al. Poziotinib treatment in patients with HER2-positive advanced breast cancer who have received prior anti-HER2 regimens. Breast Cancer Res Treat. 2024 (Jan 23). doi: 10.1007/s10549-023-07236-z Source
Hypofractionated and Conventional Radiotherapy Similarly Effective, Safe in Postoperative BC
Key clinical point: Both hypofractionated (HF) and conventional fractionated (CF) radiotherapy were comparably effective in patients who had undergone surgery for breast cancer (BC); however, the HF vs CF regimen was more effective in reducing skin toxicity and relieving fatigue.
Major finding: CF vs HF radiotherapy demonstrated no significant improvement in terms of local recurrence (odds ratio [OR] 0.91; P = .30) or overall survival (OR 1.08; P = .28) outcomes. Although safety outcomes like breast pain, breast atrophy, lymphedema, pneumonia, pulmonary fibrosis, telangiectasia, and cardiotoxicity were comparable in both groups, HF vs CF regimen led to lower skin toxicity (OR 0.43; P < .01) and improved patient fatigue outcomes (OR 0.73; P < .01).
Study details: This meta-analysis of 35 studies included 18,246 patients diagnosed with BC who underwent surgery and were treated with HF or CF radiotherapy.
Disclosures: This study was supported by the Key Research and Development Projects of Shaanxi Province, China, and other sources. The authors declared no conflicts of interest.
Source: Lu Y, Hui B, Yang D, et al. Efficacy and safety analysis of hypofractionated and conventional fractionated radiotherapy in postoperative breast cancer patients. BMC Cancer. 2024;24:181. doi: 10.1186/s12885-024-11918-2 Source
Key clinical point: Both hypofractionated (HF) and conventional fractionated (CF) radiotherapy were comparably effective in patients who had undergone surgery for breast cancer (BC); however, the HF vs CF regimen was more effective in reducing skin toxicity and relieving fatigue.
Major finding: CF vs HF radiotherapy demonstrated no significant improvement in terms of local recurrence (odds ratio [OR] 0.91; P = .30) or overall survival (OR 1.08; P = .28) outcomes. Although safety outcomes like breast pain, breast atrophy, lymphedema, pneumonia, pulmonary fibrosis, telangiectasia, and cardiotoxicity were comparable in both groups, HF vs CF regimen led to lower skin toxicity (OR 0.43; P < .01) and improved patient fatigue outcomes (OR 0.73; P < .01).
Study details: This meta-analysis of 35 studies included 18,246 patients diagnosed with BC who underwent surgery and were treated with HF or CF radiotherapy.
Disclosures: This study was supported by the Key Research and Development Projects of Shaanxi Province, China, and other sources. The authors declared no conflicts of interest.
Source: Lu Y, Hui B, Yang D, et al. Efficacy and safety analysis of hypofractionated and conventional fractionated radiotherapy in postoperative breast cancer patients. BMC Cancer. 2024;24:181. doi: 10.1186/s12885-024-11918-2 Source
Key clinical point: Both hypofractionated (HF) and conventional fractionated (CF) radiotherapy were comparably effective in patients who had undergone surgery for breast cancer (BC); however, the HF vs CF regimen was more effective in reducing skin toxicity and relieving fatigue.
Major finding: CF vs HF radiotherapy demonstrated no significant improvement in terms of local recurrence (odds ratio [OR] 0.91; P = .30) or overall survival (OR 1.08; P = .28) outcomes. Although safety outcomes like breast pain, breast atrophy, lymphedema, pneumonia, pulmonary fibrosis, telangiectasia, and cardiotoxicity were comparable in both groups, HF vs CF regimen led to lower skin toxicity (OR 0.43; P < .01) and improved patient fatigue outcomes (OR 0.73; P < .01).
Study details: This meta-analysis of 35 studies included 18,246 patients diagnosed with BC who underwent surgery and were treated with HF or CF radiotherapy.
Disclosures: This study was supported by the Key Research and Development Projects of Shaanxi Province, China, and other sources. The authors declared no conflicts of interest.
Source: Lu Y, Hui B, Yang D, et al. Efficacy and safety analysis of hypofractionated and conventional fractionated radiotherapy in postoperative breast cancer patients. BMC Cancer. 2024;24:181. doi: 10.1186/s12885-024-11918-2 Source
Chemotherapy Improves Survival Outcomes in Metaplastic Breast Cancer
Key clinical point: Compared with patients having metaplastic breast cancer (MpBC) who did not receive any chemotherapy, prognostic outcomes were significantly improved in those who received neoadjuvant chemotherapy (NAC) or adjuvant chemotherapy.
Major finding: Compared with patients who did not receive any chemotherapy, the overall survival (OS) improved significantly in those who received adjuvant chemotherapy (hazard ratio [HR] 0.451; P < .001) or responded to NAC (HR 0.479; P < .001). Breast cancer-specific survival also improved in patients who received and responded to NAC or received adjuvant chemotherapy.
Study details: This study analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database and included 1186 patients with MpBC who received NAC (n = 181), adjuvant chemotherapy (n = 647), or did not receive any chemotherapy (n = 358).
Disclosures: This study was supported by the Science and Technology Innovation Plan of Shanghai Science and Technology Commission and the Obstetrics and Gynecology Hospital of Fudan University. The authors declared no conflicts of interest.
Source: Zhang M, Yuan J, Wang M, Zhang M, Chen H. Chemotherapy is of prognostic significance to metaplastic breast cancer. Sci Rep. 2024;14:1210. doi: 10.1038/s41598-024-51627-1 Source
Key clinical point: Compared with patients having metaplastic breast cancer (MpBC) who did not receive any chemotherapy, prognostic outcomes were significantly improved in those who received neoadjuvant chemotherapy (NAC) or adjuvant chemotherapy.
Major finding: Compared with patients who did not receive any chemotherapy, the overall survival (OS) improved significantly in those who received adjuvant chemotherapy (hazard ratio [HR] 0.451; P < .001) or responded to NAC (HR 0.479; P < .001). Breast cancer-specific survival also improved in patients who received and responded to NAC or received adjuvant chemotherapy.
Study details: This study analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database and included 1186 patients with MpBC who received NAC (n = 181), adjuvant chemotherapy (n = 647), or did not receive any chemotherapy (n = 358).
Disclosures: This study was supported by the Science and Technology Innovation Plan of Shanghai Science and Technology Commission and the Obstetrics and Gynecology Hospital of Fudan University. The authors declared no conflicts of interest.
Source: Zhang M, Yuan J, Wang M, Zhang M, Chen H. Chemotherapy is of prognostic significance to metaplastic breast cancer. Sci Rep. 2024;14:1210. doi: 10.1038/s41598-024-51627-1 Source
Key clinical point: Compared with patients having metaplastic breast cancer (MpBC) who did not receive any chemotherapy, prognostic outcomes were significantly improved in those who received neoadjuvant chemotherapy (NAC) or adjuvant chemotherapy.
Major finding: Compared with patients who did not receive any chemotherapy, the overall survival (OS) improved significantly in those who received adjuvant chemotherapy (hazard ratio [HR] 0.451; P < .001) or responded to NAC (HR 0.479; P < .001). Breast cancer-specific survival also improved in patients who received and responded to NAC or received adjuvant chemotherapy.
Study details: This study analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database and included 1186 patients with MpBC who received NAC (n = 181), adjuvant chemotherapy (n = 647), or did not receive any chemotherapy (n = 358).
Disclosures: This study was supported by the Science and Technology Innovation Plan of Shanghai Science and Technology Commission and the Obstetrics and Gynecology Hospital of Fudan University. The authors declared no conflicts of interest.
Source: Zhang M, Yuan J, Wang M, Zhang M, Chen H. Chemotherapy is of prognostic significance to metaplastic breast cancer. Sci Rep. 2024;14:1210. doi: 10.1038/s41598-024-51627-1 Source
Delaying Adjuvant Chemotherapy Beyond 4-6 Weeks Worsens Prognosis in Early TNBC
Key clinical point: Patients with early-stage triple-negative breast cancer (TNBC) should receive adjuvant chemotherapy without unnecessary delays after primary surgery because prognosis may worsen if treatment is postponed beyond 6 weeks.
Major finding: Patients who received adjuvant systemic therapy within 22-28 days after surgery reported the most favorable overall survival (OS) outcomes (median OS 10.2 years), with the OS decreasing in the groups that received adjuvant systemic therapy during 29-35 days, 36-42 days, and >6 weeks after surgery (8.3 years, 7.8 years, and 6.9 years, respectively).
Study details: Findings are from a retrospective cohort study that included 245 patients with early TNBC who received adjuvant chemotherapy after primary surgery.
Disclosures: The open access funding for this study was enabled and organized by Projekt DEAL. Some authors declared receiving honoraria or travel reimbursements from or serving as consultants or board members for various sources.
Source: Hatzipanagiotou ME, Pigerl M, Gerken M, et al. Clinical impact of delaying initiation of adjuvant chemotherapy in patients with early triple negative breast cancer. Breast Cancer Res Treat. 2024 (Jan 19). doi: 10.1007/s10549-023-07207-4 Source
Key clinical point: Patients with early-stage triple-negative breast cancer (TNBC) should receive adjuvant chemotherapy without unnecessary delays after primary surgery because prognosis may worsen if treatment is postponed beyond 6 weeks.
Major finding: Patients who received adjuvant systemic therapy within 22-28 days after surgery reported the most favorable overall survival (OS) outcomes (median OS 10.2 years), with the OS decreasing in the groups that received adjuvant systemic therapy during 29-35 days, 36-42 days, and >6 weeks after surgery (8.3 years, 7.8 years, and 6.9 years, respectively).
Study details: Findings are from a retrospective cohort study that included 245 patients with early TNBC who received adjuvant chemotherapy after primary surgery.
Disclosures: The open access funding for this study was enabled and organized by Projekt DEAL. Some authors declared receiving honoraria or travel reimbursements from or serving as consultants or board members for various sources.
Source: Hatzipanagiotou ME, Pigerl M, Gerken M, et al. Clinical impact of delaying initiation of adjuvant chemotherapy in patients with early triple negative breast cancer. Breast Cancer Res Treat. 2024 (Jan 19). doi: 10.1007/s10549-023-07207-4 Source
Key clinical point: Patients with early-stage triple-negative breast cancer (TNBC) should receive adjuvant chemotherapy without unnecessary delays after primary surgery because prognosis may worsen if treatment is postponed beyond 6 weeks.
Major finding: Patients who received adjuvant systemic therapy within 22-28 days after surgery reported the most favorable overall survival (OS) outcomes (median OS 10.2 years), with the OS decreasing in the groups that received adjuvant systemic therapy during 29-35 days, 36-42 days, and >6 weeks after surgery (8.3 years, 7.8 years, and 6.9 years, respectively).
Study details: Findings are from a retrospective cohort study that included 245 patients with early TNBC who received adjuvant chemotherapy after primary surgery.
Disclosures: The open access funding for this study was enabled and organized by Projekt DEAL. Some authors declared receiving honoraria or travel reimbursements from or serving as consultants or board members for various sources.
Source: Hatzipanagiotou ME, Pigerl M, Gerken M, et al. Clinical impact of delaying initiation of adjuvant chemotherapy in patients with early triple negative breast cancer. Breast Cancer Res Treat. 2024 (Jan 19). doi: 10.1007/s10549-023-07207-4 Source
Veliparib Fails to Show OS Benefits in Advanced BRCA1/2-mutated HER2− BC
Key clinical point: Addition of veliparib vs placebo to carboplatin + paclitaxel did not significantly improve the overall survival (OS) outcomes in patients with BRCA1/2-mutated human epidermal growth factor receptor 2-negative (HER2−) advanced breast cancer (BC).
Major finding: A combination of veliparib and carboplatin + paclitaxel vs placebo + carboplatin + paclitaxel led to numerical but nonsignificant improvements in median OS (32.4 vs 28.2 months; hazard ratio 0.916; P = .434). The addition of veliparib was generally well-tolerated, consistent with previous findings.
Study details: Findings are from the phase 3 BROCADE3 trial which included 509 patients with BRCA1/2-mutated HER2− advanced BC who had received at least two prior lines of chemotherapy and were randomly assigned to receive carboplatin + paclitaxel with either veliparib or placebo.
Disclosures: This study was funded by AbbVie. No other disclosures were reported in this study.
Source: Diéras V, Han HS, Wildiers H, et al. Veliparib with carboplatin and paclitaxel in BRCA-mutated advanced breast cancer (BROCADE3): Final overall survival results from a randomized phase 3 trial. Eur J Cancer. 2024;200:113580. doi: 10.1016/j.ejca.2024.113580 Source
Key clinical point: Addition of veliparib vs placebo to carboplatin + paclitaxel did not significantly improve the overall survival (OS) outcomes in patients with BRCA1/2-mutated human epidermal growth factor receptor 2-negative (HER2−) advanced breast cancer (BC).
Major finding: A combination of veliparib and carboplatin + paclitaxel vs placebo + carboplatin + paclitaxel led to numerical but nonsignificant improvements in median OS (32.4 vs 28.2 months; hazard ratio 0.916; P = .434). The addition of veliparib was generally well-tolerated, consistent with previous findings.
Study details: Findings are from the phase 3 BROCADE3 trial which included 509 patients with BRCA1/2-mutated HER2− advanced BC who had received at least two prior lines of chemotherapy and were randomly assigned to receive carboplatin + paclitaxel with either veliparib or placebo.
Disclosures: This study was funded by AbbVie. No other disclosures were reported in this study.
Source: Diéras V, Han HS, Wildiers H, et al. Veliparib with carboplatin and paclitaxel in BRCA-mutated advanced breast cancer (BROCADE3): Final overall survival results from a randomized phase 3 trial. Eur J Cancer. 2024;200:113580. doi: 10.1016/j.ejca.2024.113580 Source
Key clinical point: Addition of veliparib vs placebo to carboplatin + paclitaxel did not significantly improve the overall survival (OS) outcomes in patients with BRCA1/2-mutated human epidermal growth factor receptor 2-negative (HER2−) advanced breast cancer (BC).
Major finding: A combination of veliparib and carboplatin + paclitaxel vs placebo + carboplatin + paclitaxel led to numerical but nonsignificant improvements in median OS (32.4 vs 28.2 months; hazard ratio 0.916; P = .434). The addition of veliparib was generally well-tolerated, consistent with previous findings.
Study details: Findings are from the phase 3 BROCADE3 trial which included 509 patients with BRCA1/2-mutated HER2− advanced BC who had received at least two prior lines of chemotherapy and were randomly assigned to receive carboplatin + paclitaxel with either veliparib or placebo.
Disclosures: This study was funded by AbbVie. No other disclosures were reported in this study.
Source: Diéras V, Han HS, Wildiers H, et al. Veliparib with carboplatin and paclitaxel in BRCA-mutated advanced breast cancer (BROCADE3): Final overall survival results from a randomized phase 3 trial. Eur J Cancer. 2024;200:113580. doi: 10.1016/j.ejca.2024.113580 Source
Toripalimab Bests Chemo in PD-L1 Positive TNBC in Phase 3
Key clinical point: Treatment with toripalimab + nab-paclitaxel vs placebo + nab-paclitaxel significantly improved progression-free survival (PFS) and showed an acceptable safety profile in patients with programmed death ligand-1 (PD-L1)-positive metastatic or recurrent triple-negative breast cancer (TNBC).
Major finding: Toripalimab + nab-paclitaxel vs placebo + nab-paclitaxel led to a significantly longer PFS (median 8.4 vs 5.6 months) in patients with PD-L1-positive TNBC (hazard ratio 0.65; P = .0102) and similar incidences of grade ≥3 treatment-emergent adverse events (56.4% vs 54.3%) and fatal adverse events (0.6% vs 3.4%).
Study details: Findings are from the phase 3 TORCHLIGHT trial which included 531 patients with metastatic or recurrent locally advanced TNBC who were previously untreated or treated with up to one systemic chemotherapy and were randomly assigned to receive toripalimab + nab-paclitaxel or placebo + nab-paclitaxel. Of these, 300 patients had PD-L1-positive TNBC.
Disclosures: This study was sponsored by Shanghai Junshi Biosciences and supported by other sources. Five authors declared being employees of Shanghai Junshi Biosciences or TopAlliance Biosciences. The other authors declared no competing interests.
Source: Jiang Z, Ouyang Q, Sun T, et al. Toripalimab plus nab-paclitaxel in metastatic or recurrent triple-negative breast cancer: A randomized phase 3 trial. Nat Med. 2024;30:249-256. doi: 10.1038/s41591-023-02677-x Source
Key clinical point: Treatment with toripalimab + nab-paclitaxel vs placebo + nab-paclitaxel significantly improved progression-free survival (PFS) and showed an acceptable safety profile in patients with programmed death ligand-1 (PD-L1)-positive metastatic or recurrent triple-negative breast cancer (TNBC).
Major finding: Toripalimab + nab-paclitaxel vs placebo + nab-paclitaxel led to a significantly longer PFS (median 8.4 vs 5.6 months) in patients with PD-L1-positive TNBC (hazard ratio 0.65; P = .0102) and similar incidences of grade ≥3 treatment-emergent adverse events (56.4% vs 54.3%) and fatal adverse events (0.6% vs 3.4%).
Study details: Findings are from the phase 3 TORCHLIGHT trial which included 531 patients with metastatic or recurrent locally advanced TNBC who were previously untreated or treated with up to one systemic chemotherapy and were randomly assigned to receive toripalimab + nab-paclitaxel or placebo + nab-paclitaxel. Of these, 300 patients had PD-L1-positive TNBC.
Disclosures: This study was sponsored by Shanghai Junshi Biosciences and supported by other sources. Five authors declared being employees of Shanghai Junshi Biosciences or TopAlliance Biosciences. The other authors declared no competing interests.
Source: Jiang Z, Ouyang Q, Sun T, et al. Toripalimab plus nab-paclitaxel in metastatic or recurrent triple-negative breast cancer: A randomized phase 3 trial. Nat Med. 2024;30:249-256. doi: 10.1038/s41591-023-02677-x Source
Key clinical point: Treatment with toripalimab + nab-paclitaxel vs placebo + nab-paclitaxel significantly improved progression-free survival (PFS) and showed an acceptable safety profile in patients with programmed death ligand-1 (PD-L1)-positive metastatic or recurrent triple-negative breast cancer (TNBC).
Major finding: Toripalimab + nab-paclitaxel vs placebo + nab-paclitaxel led to a significantly longer PFS (median 8.4 vs 5.6 months) in patients with PD-L1-positive TNBC (hazard ratio 0.65; P = .0102) and similar incidences of grade ≥3 treatment-emergent adverse events (56.4% vs 54.3%) and fatal adverse events (0.6% vs 3.4%).
Study details: Findings are from the phase 3 TORCHLIGHT trial which included 531 patients with metastatic or recurrent locally advanced TNBC who were previously untreated or treated with up to one systemic chemotherapy and were randomly assigned to receive toripalimab + nab-paclitaxel or placebo + nab-paclitaxel. Of these, 300 patients had PD-L1-positive TNBC.
Disclosures: This study was sponsored by Shanghai Junshi Biosciences and supported by other sources. Five authors declared being employees of Shanghai Junshi Biosciences or TopAlliance Biosciences. The other authors declared no competing interests.
Source: Jiang Z, Ouyang Q, Sun T, et al. Toripalimab plus nab-paclitaxel in metastatic or recurrent triple-negative breast cancer: A randomized phase 3 trial. Nat Med. 2024;30:249-256. doi: 10.1038/s41591-023-02677-x Source
Chemo-Free Olaparib with or Without Durvalumab Maintains Platinum Therapy’s Benefits in TNBC
Key clinical point: In patients with platinum-pretreated advanced triple-negative breast cancer (TNBC), a chemotherapy-free maintenance regimen containing olaparib with or without durvalumab vs continued platinum-based chemotherapy led to a greater improvement in progression-free survival (PFS) with no new safety signals.
Major finding: The median PFS was 4.0 months with olaparib and 6.1 months with olaparib + durvalumab, with both treatments providing greater PFS benefit than the historical control of continued platinum-based therapy (P = .0023 and P < .0001, respectively). No treatment-related deaths or new safety signals were reported.
Study details: Findings are from the phase 2 DORA trial which included 45 patients with advanced TNBC who had stable disease or complete or partial response after receiving platinum-based chemotherapy and were randomly assigned to receive olaparib or olaparib + durvalumab.
Disclosures: This study was supported by AstraZeneca Pharmaceuticals LP. Some authors declared receiving honoraria, research funding, or fees; owning stocks; or having other ties with AstraZeneca and various other sources.
Source: Tan TJ, Sammons S, Im YH, et al. Phase II DORA study of olaparib with or without durvalumab as a chemotherapy-free maintenance strategy in platinum-pretreated advanced triple-negative breast cancer. Clin Cancer Res. 2024 (Jan 18). doi: 10.1158/1078-0432.CCR-23-2513 Source
Key clinical point: In patients with platinum-pretreated advanced triple-negative breast cancer (TNBC), a chemotherapy-free maintenance regimen containing olaparib with or without durvalumab vs continued platinum-based chemotherapy led to a greater improvement in progression-free survival (PFS) with no new safety signals.
Major finding: The median PFS was 4.0 months with olaparib and 6.1 months with olaparib + durvalumab, with both treatments providing greater PFS benefit than the historical control of continued platinum-based therapy (P = .0023 and P < .0001, respectively). No treatment-related deaths or new safety signals were reported.
Study details: Findings are from the phase 2 DORA trial which included 45 patients with advanced TNBC who had stable disease or complete or partial response after receiving platinum-based chemotherapy and were randomly assigned to receive olaparib or olaparib + durvalumab.
Disclosures: This study was supported by AstraZeneca Pharmaceuticals LP. Some authors declared receiving honoraria, research funding, or fees; owning stocks; or having other ties with AstraZeneca and various other sources.
Source: Tan TJ, Sammons S, Im YH, et al. Phase II DORA study of olaparib with or without durvalumab as a chemotherapy-free maintenance strategy in platinum-pretreated advanced triple-negative breast cancer. Clin Cancer Res. 2024 (Jan 18). doi: 10.1158/1078-0432.CCR-23-2513 Source
Key clinical point: In patients with platinum-pretreated advanced triple-negative breast cancer (TNBC), a chemotherapy-free maintenance regimen containing olaparib with or without durvalumab vs continued platinum-based chemotherapy led to a greater improvement in progression-free survival (PFS) with no new safety signals.
Major finding: The median PFS was 4.0 months with olaparib and 6.1 months with olaparib + durvalumab, with both treatments providing greater PFS benefit than the historical control of continued platinum-based therapy (P = .0023 and P < .0001, respectively). No treatment-related deaths or new safety signals were reported.
Study details: Findings are from the phase 2 DORA trial which included 45 patients with advanced TNBC who had stable disease or complete or partial response after receiving platinum-based chemotherapy and were randomly assigned to receive olaparib or olaparib + durvalumab.
Disclosures: This study was supported by AstraZeneca Pharmaceuticals LP. Some authors declared receiving honoraria, research funding, or fees; owning stocks; or having other ties with AstraZeneca and various other sources.
Source: Tan TJ, Sammons S, Im YH, et al. Phase II DORA study of olaparib with or without durvalumab as a chemotherapy-free maintenance strategy in platinum-pretreated advanced triple-negative breast cancer. Clin Cancer Res. 2024 (Jan 18). doi: 10.1158/1078-0432.CCR-23-2513 Source
Fulvestrant-Containing Therapy Not Superior to Anastrozole in ER-Rich/ERBB2− BC
Key clinical point: Neoadjuvant endocrine therapy with fulvestrant or anastrozole + fulvestrant led to an endocrine-sensitive disease rate (ESDR) comparable to anastrozole alone in postmenopausal women with estrogen receptor (ER)-rich, human epidermal growth factor receptor 2-negative (ERBB2−) breast cancer (BC).
Major finding: Both fulvestrant and anastrozole + fulvestrant vs anastrozole alone demonstrated no significant improvement in the ESDR at 6 months (22.8% and 20.5% vs 18.7%, respectively; Wald test, P ≥ .98) and median percentage change in Ki67 at 4 weeks (−79.1% and −83.5% vs −80.6%, respectively; P ≥ .15).
Study details: Findings are from the phase 3 ALTERNATE trial, which included 1298 treatment-naive postmenopausal women with ER-rich/ERBB2− BC who were randomly assigned to receive anastrozole, fulvestrant, or anastrozole + fulvestrant for 6 months in a neoadjuvant setting.
Disclosures: This study was supported by the US National Institutes of Health (NIH)/National Cancer Institute (NCI) and other sources. Several authors declared receiving grants, personal fees, or research support or having other ties with various sources, including NIH/NCI.
Source: Ma CX, Suman VJ, Sanati S, et al. Endocrine-sensitive disease rate in postmenopausal patients with estrogen receptor-rich/ERBB2-negative breast cancer receiving neoadjuvant anastrozole, fulvestrant, or their combination: A phase 3 randomized clinical trial. JAMA Oncol. 2024 (Jan 18). doi: 10.1001/jamaoncol.2023.6038 Source
Key clinical point: Neoadjuvant endocrine therapy with fulvestrant or anastrozole + fulvestrant led to an endocrine-sensitive disease rate (ESDR) comparable to anastrozole alone in postmenopausal women with estrogen receptor (ER)-rich, human epidermal growth factor receptor 2-negative (ERBB2−) breast cancer (BC).
Major finding: Both fulvestrant and anastrozole + fulvestrant vs anastrozole alone demonstrated no significant improvement in the ESDR at 6 months (22.8% and 20.5% vs 18.7%, respectively; Wald test, P ≥ .98) and median percentage change in Ki67 at 4 weeks (−79.1% and −83.5% vs −80.6%, respectively; P ≥ .15).
Study details: Findings are from the phase 3 ALTERNATE trial, which included 1298 treatment-naive postmenopausal women with ER-rich/ERBB2− BC who were randomly assigned to receive anastrozole, fulvestrant, or anastrozole + fulvestrant for 6 months in a neoadjuvant setting.
Disclosures: This study was supported by the US National Institutes of Health (NIH)/National Cancer Institute (NCI) and other sources. Several authors declared receiving grants, personal fees, or research support or having other ties with various sources, including NIH/NCI.
Source: Ma CX, Suman VJ, Sanati S, et al. Endocrine-sensitive disease rate in postmenopausal patients with estrogen receptor-rich/ERBB2-negative breast cancer receiving neoadjuvant anastrozole, fulvestrant, or their combination: A phase 3 randomized clinical trial. JAMA Oncol. 2024 (Jan 18). doi: 10.1001/jamaoncol.2023.6038 Source
Key clinical point: Neoadjuvant endocrine therapy with fulvestrant or anastrozole + fulvestrant led to an endocrine-sensitive disease rate (ESDR) comparable to anastrozole alone in postmenopausal women with estrogen receptor (ER)-rich, human epidermal growth factor receptor 2-negative (ERBB2−) breast cancer (BC).
Major finding: Both fulvestrant and anastrozole + fulvestrant vs anastrozole alone demonstrated no significant improvement in the ESDR at 6 months (22.8% and 20.5% vs 18.7%, respectively; Wald test, P ≥ .98) and median percentage change in Ki67 at 4 weeks (−79.1% and −83.5% vs −80.6%, respectively; P ≥ .15).
Study details: Findings are from the phase 3 ALTERNATE trial, which included 1298 treatment-naive postmenopausal women with ER-rich/ERBB2− BC who were randomly assigned to receive anastrozole, fulvestrant, or anastrozole + fulvestrant for 6 months in a neoadjuvant setting.
Disclosures: This study was supported by the US National Institutes of Health (NIH)/National Cancer Institute (NCI) and other sources. Several authors declared receiving grants, personal fees, or research support or having other ties with various sources, including NIH/NCI.
Source: Ma CX, Suman VJ, Sanati S, et al. Endocrine-sensitive disease rate in postmenopausal patients with estrogen receptor-rich/ERBB2-negative breast cancer receiving neoadjuvant anastrozole, fulvestrant, or their combination: A phase 3 randomized clinical trial. JAMA Oncol. 2024 (Jan 18). doi: 10.1001/jamaoncol.2023.6038 Source
Body Fat Tied to Skeletal Fragility in Postmenopausal Women with AI-Treated Breast Cancer
Key clinical point: High initial fat body mass was associated with a risk for vertebral fracture (VF) progression in postmenopausal women with hormone receptor-positive (HR+) early breast cancer (BC) who received aromatase inhibitors (AI) plus denosumab.
Major finding: After 18 months of adjuvant therapy with AI and denosumab, 4.4% of patients had VF progression, with percentage of fat body mass (odds ratio [OR] 5.41; P = .01) and Fracture Risk Assessment Tool score (OR 3.95; P = .04) being independently associated with VF progression risk.
Study details: Findings are from a prospective cohort study including 237 postmenopausal women with HR+ early BC who received adjuvant therapy with AI and denosumab.
Disclosures: This study did not declare any specific funding. Three authors declared receiving personal fees or grants or having other ties with various sources.
Source: Cosentini D, Pedersini R, Mauro PD, et al. Fat body mass and vertebral fracture progression in women with breast cancer. JAMA Netw Open. 2024;7:e2350950. doi:10.1001/jamanetworkopen.2023.50950 Source
Key clinical point: High initial fat body mass was associated with a risk for vertebral fracture (VF) progression in postmenopausal women with hormone receptor-positive (HR+) early breast cancer (BC) who received aromatase inhibitors (AI) plus denosumab.
Major finding: After 18 months of adjuvant therapy with AI and denosumab, 4.4% of patients had VF progression, with percentage of fat body mass (odds ratio [OR] 5.41; P = .01) and Fracture Risk Assessment Tool score (OR 3.95; P = .04) being independently associated with VF progression risk.
Study details: Findings are from a prospective cohort study including 237 postmenopausal women with HR+ early BC who received adjuvant therapy with AI and denosumab.
Disclosures: This study did not declare any specific funding. Three authors declared receiving personal fees or grants or having other ties with various sources.
Source: Cosentini D, Pedersini R, Mauro PD, et al. Fat body mass and vertebral fracture progression in women with breast cancer. JAMA Netw Open. 2024;7:e2350950. doi:10.1001/jamanetworkopen.2023.50950 Source
Key clinical point: High initial fat body mass was associated with a risk for vertebral fracture (VF) progression in postmenopausal women with hormone receptor-positive (HR+) early breast cancer (BC) who received aromatase inhibitors (AI) plus denosumab.
Major finding: After 18 months of adjuvant therapy with AI and denosumab, 4.4% of patients had VF progression, with percentage of fat body mass (odds ratio [OR] 5.41; P = .01) and Fracture Risk Assessment Tool score (OR 3.95; P = .04) being independently associated with VF progression risk.
Study details: Findings are from a prospective cohort study including 237 postmenopausal women with HR+ early BC who received adjuvant therapy with AI and denosumab.
Disclosures: This study did not declare any specific funding. Three authors declared receiving personal fees or grants or having other ties with various sources.
Source: Cosentini D, Pedersini R, Mauro PD, et al. Fat body mass and vertebral fracture progression in women with breast cancer. JAMA Netw Open. 2024;7:e2350950. doi:10.1001/jamanetworkopen.2023.50950 Source
AHA: Urgent Need To Reduce Maternal Postpartum CVD Risk
Complications during pregnancy may be a wake-up call pointing to a higher risk for cardiovascular (CVD) and other diseases later in life. Therefore, the postpartum and interpregnancy periods are opportune windows for reducing CVD susceptibility and providing preventive care, especially for mothers with a history of adverse pregnancy outcomes (APOs). To that end, the American Heart Association recently released a scientific statement in Circulation outlining pregnancy-related CVD risks and reviewing evidence for preventive lifestyle strategies based on the AHA’s Life’s Essential 8 recommendations.
The Life’s Essential 8 encompass healthy eating, sleeping, and activity patterns; controlling weight, blood pressure, cholesterol, and blood sugar; and avoiding tobacco use.
“The motivation behind this statement was that complications in pregnancy are becoming more common and we now have more understanding that these serve as important risk factors for heart disease later in life,” said Jennifer Lewey, MD, MPH, director of the Penn Women’s Cardiovascular Health Program and an assistant professor of medicine at the University of Pennsylvania Perelman School of Medicine in Philadelphia.
“These risk factors are underrecognized and underappreciated. Clinicians don’t feel comfortable counseling their patients about how to reduce their cardiovascular disease risk,” Dr. Lewey, chair of the AHA writing group, said in an interview.
“So we thought this was the perfect time to highlight what we know and don’t know about how to care for this population,” she said.
APOs predispose mothers to heart disease and other long-term complications, including heart failure, stroke, chronic kidney disease, and vascular dementia. “Pregnancy is a significant stress on the body, and APOs such as preeclampsia can lead to vascular changes in the blood vessels and structural changes to the heart that can persist long term,” Dr. Lewey explained. Reduced maternal physical activity and unshed weight can compound the problem.
Varying by race and ethnicity, the proportion of mothers experiencing pregnancy complications, such as high blood pressure, gestational diabetes, and/or preterm birth is estimated at 10%-20%, the statement authors noted. These complications may serve as a wake-up call to young mothers.
The AHA panel believes that identifying at-risk women at younger ages will enable prevention through lifestyle changes and timely treatment. Little is known, however about what specific care may best reduce long-term CVD risk in women who had pregnancy complications, Dr. Lewey said. While randomized clinical trials have yet to evaluate the effects of postpartum interventions on CVD outcomes, the need for strategies supported by rigorous evidence is clear. “In particular, the fourth trimester, defined as the 12 weeks after delivery, is an optimal time to engage postpartum individuals in care to reduce maternal morbidity and improve care transitions,” the AHA group wrote.
An earlier AHA statement in 2021 recommended frequent cardiac risk factor screening in the first year postpartum at 6 and 12 weeks and again at 6 and 12 months, with appropriate transition from postpartum to longitudinal primary care around the 8- to 12-week mark.
Among the current statement’s findings: High blood pressure is the most prevalent cardiovascular condition during pregnancy, and the last two decades have seen a 25% increase in preeclampsia.
Hypertension during pregnancy carries a two- to fourfold higher risk of chronic hypertension within 2-7 years.
Women with one or more APOs experience heart attack and stroke at younger ages. Commenting on the statement but not involved in it, internist Natalie A. Cameron, MD, a primary and preventive care physician at Northwestern Medicine in Chicago, said, “This statement will be very helpful for physicians from a primary care perspective, especially since in internal medicine we don’t standardly receive education in cardiovascular health in the context of pregnancy and the first year postpartum.”
Dr. Cameron also noted that new research suggests the mother’s cardiovascular health during pregnancy can affect the child’s health through adolescence. “There’s a potential intergenerational effect and there may even be some programming and changes to the offspring in utero related to maternal lifestyle factors.”
While the postpartum period would seem like an opportune time to piggyback postpartum visits with infant wellness checkups, “the fact is that, in the U.S., many mothers are lost to care after delivery,” Dr. Lewey said. “But it’s essential to ensure transition to postpartum care.”
According to Dr. Cameron, physicians should be aware of the risk factor data and educate their pregnant and postpartum patients about reducing risk factors. “As I like to say, ‘If you’re going to take care of others, you need to take care of yourself first.’ ” While this statement may be a good starting point, future trials are needed to improve screening for subclinical CVD in individuals with APOs before symptom onset, the statement authors wrote.
This scientific statement was prepared on behalf of the American Heart Association. Dr. Lewey and several coauthors reported research funding from various agencies within the National Institutes of Health. Dr. Brown reported research funding from a cy-près court settlement with Wyeth. Dr. Cameron had no competing interests relevant to her comments.
Complications during pregnancy may be a wake-up call pointing to a higher risk for cardiovascular (CVD) and other diseases later in life. Therefore, the postpartum and interpregnancy periods are opportune windows for reducing CVD susceptibility and providing preventive care, especially for mothers with a history of adverse pregnancy outcomes (APOs). To that end, the American Heart Association recently released a scientific statement in Circulation outlining pregnancy-related CVD risks and reviewing evidence for preventive lifestyle strategies based on the AHA’s Life’s Essential 8 recommendations.
The Life’s Essential 8 encompass healthy eating, sleeping, and activity patterns; controlling weight, blood pressure, cholesterol, and blood sugar; and avoiding tobacco use.
“The motivation behind this statement was that complications in pregnancy are becoming more common and we now have more understanding that these serve as important risk factors for heart disease later in life,” said Jennifer Lewey, MD, MPH, director of the Penn Women’s Cardiovascular Health Program and an assistant professor of medicine at the University of Pennsylvania Perelman School of Medicine in Philadelphia.
“These risk factors are underrecognized and underappreciated. Clinicians don’t feel comfortable counseling their patients about how to reduce their cardiovascular disease risk,” Dr. Lewey, chair of the AHA writing group, said in an interview.
“So we thought this was the perfect time to highlight what we know and don’t know about how to care for this population,” she said.
APOs predispose mothers to heart disease and other long-term complications, including heart failure, stroke, chronic kidney disease, and vascular dementia. “Pregnancy is a significant stress on the body, and APOs such as preeclampsia can lead to vascular changes in the blood vessels and structural changes to the heart that can persist long term,” Dr. Lewey explained. Reduced maternal physical activity and unshed weight can compound the problem.
Varying by race and ethnicity, the proportion of mothers experiencing pregnancy complications, such as high blood pressure, gestational diabetes, and/or preterm birth is estimated at 10%-20%, the statement authors noted. These complications may serve as a wake-up call to young mothers.
The AHA panel believes that identifying at-risk women at younger ages will enable prevention through lifestyle changes and timely treatment. Little is known, however about what specific care may best reduce long-term CVD risk in women who had pregnancy complications, Dr. Lewey said. While randomized clinical trials have yet to evaluate the effects of postpartum interventions on CVD outcomes, the need for strategies supported by rigorous evidence is clear. “In particular, the fourth trimester, defined as the 12 weeks after delivery, is an optimal time to engage postpartum individuals in care to reduce maternal morbidity and improve care transitions,” the AHA group wrote.
An earlier AHA statement in 2021 recommended frequent cardiac risk factor screening in the first year postpartum at 6 and 12 weeks and again at 6 and 12 months, with appropriate transition from postpartum to longitudinal primary care around the 8- to 12-week mark.
Among the current statement’s findings: High blood pressure is the most prevalent cardiovascular condition during pregnancy, and the last two decades have seen a 25% increase in preeclampsia.
Hypertension during pregnancy carries a two- to fourfold higher risk of chronic hypertension within 2-7 years.
Women with one or more APOs experience heart attack and stroke at younger ages. Commenting on the statement but not involved in it, internist Natalie A. Cameron, MD, a primary and preventive care physician at Northwestern Medicine in Chicago, said, “This statement will be very helpful for physicians from a primary care perspective, especially since in internal medicine we don’t standardly receive education in cardiovascular health in the context of pregnancy and the first year postpartum.”
Dr. Cameron also noted that new research suggests the mother’s cardiovascular health during pregnancy can affect the child’s health through adolescence. “There’s a potential intergenerational effect and there may even be some programming and changes to the offspring in utero related to maternal lifestyle factors.”
While the postpartum period would seem like an opportune time to piggyback postpartum visits with infant wellness checkups, “the fact is that, in the U.S., many mothers are lost to care after delivery,” Dr. Lewey said. “But it’s essential to ensure transition to postpartum care.”
According to Dr. Cameron, physicians should be aware of the risk factor data and educate their pregnant and postpartum patients about reducing risk factors. “As I like to say, ‘If you’re going to take care of others, you need to take care of yourself first.’ ” While this statement may be a good starting point, future trials are needed to improve screening for subclinical CVD in individuals with APOs before symptom onset, the statement authors wrote.
This scientific statement was prepared on behalf of the American Heart Association. Dr. Lewey and several coauthors reported research funding from various agencies within the National Institutes of Health. Dr. Brown reported research funding from a cy-près court settlement with Wyeth. Dr. Cameron had no competing interests relevant to her comments.
Complications during pregnancy may be a wake-up call pointing to a higher risk for cardiovascular (CVD) and other diseases later in life. Therefore, the postpartum and interpregnancy periods are opportune windows for reducing CVD susceptibility and providing preventive care, especially for mothers with a history of adverse pregnancy outcomes (APOs). To that end, the American Heart Association recently released a scientific statement in Circulation outlining pregnancy-related CVD risks and reviewing evidence for preventive lifestyle strategies based on the AHA’s Life’s Essential 8 recommendations.
The Life’s Essential 8 encompass healthy eating, sleeping, and activity patterns; controlling weight, blood pressure, cholesterol, and blood sugar; and avoiding tobacco use.
“The motivation behind this statement was that complications in pregnancy are becoming more common and we now have more understanding that these serve as important risk factors for heart disease later in life,” said Jennifer Lewey, MD, MPH, director of the Penn Women’s Cardiovascular Health Program and an assistant professor of medicine at the University of Pennsylvania Perelman School of Medicine in Philadelphia.
“These risk factors are underrecognized and underappreciated. Clinicians don’t feel comfortable counseling their patients about how to reduce their cardiovascular disease risk,” Dr. Lewey, chair of the AHA writing group, said in an interview.
“So we thought this was the perfect time to highlight what we know and don’t know about how to care for this population,” she said.
APOs predispose mothers to heart disease and other long-term complications, including heart failure, stroke, chronic kidney disease, and vascular dementia. “Pregnancy is a significant stress on the body, and APOs such as preeclampsia can lead to vascular changes in the blood vessels and structural changes to the heart that can persist long term,” Dr. Lewey explained. Reduced maternal physical activity and unshed weight can compound the problem.
Varying by race and ethnicity, the proportion of mothers experiencing pregnancy complications, such as high blood pressure, gestational diabetes, and/or preterm birth is estimated at 10%-20%, the statement authors noted. These complications may serve as a wake-up call to young mothers.
The AHA panel believes that identifying at-risk women at younger ages will enable prevention through lifestyle changes and timely treatment. Little is known, however about what specific care may best reduce long-term CVD risk in women who had pregnancy complications, Dr. Lewey said. While randomized clinical trials have yet to evaluate the effects of postpartum interventions on CVD outcomes, the need for strategies supported by rigorous evidence is clear. “In particular, the fourth trimester, defined as the 12 weeks after delivery, is an optimal time to engage postpartum individuals in care to reduce maternal morbidity and improve care transitions,” the AHA group wrote.
An earlier AHA statement in 2021 recommended frequent cardiac risk factor screening in the first year postpartum at 6 and 12 weeks and again at 6 and 12 months, with appropriate transition from postpartum to longitudinal primary care around the 8- to 12-week mark.
Among the current statement’s findings: High blood pressure is the most prevalent cardiovascular condition during pregnancy, and the last two decades have seen a 25% increase in preeclampsia.
Hypertension during pregnancy carries a two- to fourfold higher risk of chronic hypertension within 2-7 years.
Women with one or more APOs experience heart attack and stroke at younger ages. Commenting on the statement but not involved in it, internist Natalie A. Cameron, MD, a primary and preventive care physician at Northwestern Medicine in Chicago, said, “This statement will be very helpful for physicians from a primary care perspective, especially since in internal medicine we don’t standardly receive education in cardiovascular health in the context of pregnancy and the first year postpartum.”
Dr. Cameron also noted that new research suggests the mother’s cardiovascular health during pregnancy can affect the child’s health through adolescence. “There’s a potential intergenerational effect and there may even be some programming and changes to the offspring in utero related to maternal lifestyle factors.”
While the postpartum period would seem like an opportune time to piggyback postpartum visits with infant wellness checkups, “the fact is that, in the U.S., many mothers are lost to care after delivery,” Dr. Lewey said. “But it’s essential to ensure transition to postpartum care.”
According to Dr. Cameron, physicians should be aware of the risk factor data and educate their pregnant and postpartum patients about reducing risk factors. “As I like to say, ‘If you’re going to take care of others, you need to take care of yourself first.’ ” While this statement may be a good starting point, future trials are needed to improve screening for subclinical CVD in individuals with APOs before symptom onset, the statement authors wrote.
This scientific statement was prepared on behalf of the American Heart Association. Dr. Lewey and several coauthors reported research funding from various agencies within the National Institutes of Health. Dr. Brown reported research funding from a cy-près court settlement with Wyeth. Dr. Cameron had no competing interests relevant to her comments.
FROM CIRCULATION