Articles related to BREAST CANCER

According to the final results from the phase 3 PALLAS trial, palbociclib offers no benefit over endocrine therapy alone in women with early HR+ HER2- breast cancer. The primary endpoint — 4-year invasive DFS — was nearly equivalent in the test and control arms of the study. None of the secondary endpoints showed a significant difference either. There was a high rate of palbociclib discontinuation (42%), mostly due to grade 3 or 4 neutropenia. But even in those who completed the two-year planned course showed no benefit over endocrine therapy alone. The results were not just disappointing, but surprising given that CDK 4/6 inhibitors plus endocrine therapy is the standard of care for advanced breast cancer.

Of the nearly 83,000 mammograms taken among nearly 36,000 women screened, 1 in 7 cases was determined to be overdiagnosed. The information revealed in this Annals of Internal Medicine study clarifies the risk for breast cancer overdiagnosis in contemporary screening practice and should facilitate shared and informed decision making about mammography screening.

Recent studies identify DNA damage repair (DDR) genes as a new class of endocrine therapy resistance driver that contributes to poor survival among ER+ breast cancer patients. This study reveals differences in DDR regulation in Black women that may in part contribute to the higher breast cancer mortality in Black women vs. other populations. Based on their findings, the authors recommend more effort to refine biomarker profiles to ensure precision medicine for underserved populations.

Joyce A. O’Shaughnessy, MD provides updates on several key presentations from SABCS, touching on SERD therapy, ribociclib combinations, the datopotamab deruxtecan antibody-drug conjugate targeting overexpression of the calcium signal transducer TROP2, trastuzumab deruxtecan, and more. The MONALEESA phase 3 trial is looking at letrozole + ribociclib vs letrozole + placebo in postmenopausal women with ER+ HER2- advanced breast cancer. The trial arm outperformed the control arm with a median OS of 63.9 months vs 51.4 months respectively at a median follow up of just over 6.5 years. That median OS is the longest reported for any phase 3 trial in advanced breast cancer.

This study reports long term outcomes on CALGB 40603 at a median follow-up of 7.9 years. Event-free survival and other LTOs were not significantly improved with either study drug overall or in studied sub-populations. Results showed that patients with any residual disease had significantly worse outcomes. This finding supports considering adjuvant therapy even in the setting of minimal residual disease.

Presented at SABCS 2021, the EMERALD Study of elacastrant and the PHOEBE Trial of pyrotinib showed a better than doubling of 12-month PFS with the first agent, and an improvement in both OS and PFT with the second agent. And the results of the DESTINY-Breast03 study have been called “practice changing.”