Breast Cancer

Adjuvant endocrine therapy (ET) has been shown to reduce risk of recurrence and improve survival in HR+ early breast cancer (EBC). A retrospective matched cohort analysis of 1,972 patients ≥70 years of age with HR+/HER2-negative, node-negative EBC and multiple medical co-morbidities, demonstrated higher median overall survival (OS) in patients who received ET versus those who did not (79.2 months compared to 67.7 months, p<0.0001). Older women with multiple medical co-morbidities may be at greater risk of toxicities related to ET, which can impact quality of life and adherence. The probability of initiating ET has been shown to be greater among patients who underwent radiation, thus highlighting the need to identify those who will adhere to ET when making decisions regarding radiation therapy to optimize care. ET should be discussed with all women who are candidates for this therapy, with a focus on individualized benefit and risk of these agents.

Studies of immunotherapy in metastatic triple-negative breast cancer have shown promising results, notably in patients with PD-L1 enriched tumors (IMpassion 130 and KEYNOTE-355). KEYNOTE-119 was a phase 3 study including 1,098 patients with metastatic TNBC who had received one or two previous systemic therapies for metastatic disease and progressed on most recent treatment, with randomization to pembrolizumab or physician’s choice chemotherapy . Median OS for pembrolizumab compared to chemotherapy was similar in the overall population (9.9 months versus 10.8 months, HR 0.97) and in patients with PD-L1 CPS score of ≥10 (12.7 months versus 11.6 months, HR 0.78, p=0.057). Although not statistically significant, greater PD-L1 expression was associated with longer median OS with pembrolizumab. Responses to immunotherapy may be durable in select patients, and these agents have an overall favorable toxicity profile. Novel immunotherapy combinations as well as biomarkers to predict response are certainly desired in this space.

Combination endocrine therapy plus a CDK 4/6 inhibitor is standard first-line treatment for metastatic HR+/HER2-negative breast cancer. Neutropenia is a common adverse event (AE) seen with the CDK 4/6 inhibitor palbociclib, and dosing guidelines provide a clear algorithm for drug monitoring and adjustment for cytopenias. Cutaneous toxicities, although not commonly seen, have been reported in the literature. Chawla and colleagues performed a retrospective analysis including 324 patients with advanced HR+/HER2-negative breast cancer who received palbociclib plus endocrine therapy. Cutaneous AEs were seen in 14.2%, with a significant proportion occurring early (41% occurred during or after the first cycle) and 50% resolved within 14 days (average 43 days). Of those who developed cutaneous AEs (n=46), only 15% and 4% required temporary hold and permanent cessation of therapy, respectively. These findings indicate a low overall incidence of cutaneous AEs associated with palbociclib, however highlight the importance of prompt recognition, management, and dermatology referral as appropriate, to help maintain patients on effective cancer-directed therapy.

References:

Yau C, van der Noordaa M, Wei J, et al. Residual cancer burden after neoadjuvant therapy and long-term survival outcomes in breast cancer: a multi-center pooled analysis. Presented at: 2019 San Antonio Breast Cancer Symposium; December 10-14, 2019; San Antonio, TX. Abstract GS5-01.

Wei M, Wang X, Zimmerman DN, Burt LM, Haaland B, Henry NL. Endocrine therapy and radiotherapy use among older women with hormone receptor-positive, clinically node-negative breast cancer. Breast Cancer Res Treat. 2021 Jan 9. doi: 10.1007/s10549-020-06071-w.Epub ahead of print.

Emens LA, Adams S, Barrios CH, et al. IMpassion130: Final OS analysis from the pivotal phase III study of atezolizumab plus nabpaclitaxel versus placebo plus nabpaclitaxel in previously untreated locally advanced or metastatic triple-negative breast cancer. Presented at: ESMO Virtual Congress 2020, Ann Oncol. 2020;31S:ESMO #LBA16.

Khan NAJ, Alsharedi M. Bullous Skin Rash: A Rare Case of Palbociclib-Induced Dermatological Toxicity. Cureus. 2020 Sep 3;12(9):e10229. doi: 10.7759/cureus.10229.

Adjuvant endocrine therapy (ET) has been shown to reduce risk of recurrence and improve survival in HR+ early breast cancer (EBC). A retrospective matched cohort analysis of 1,972 patients ≥70 years of age with HR+/HER2-negative, node-negative EBC and multiple medical co-morbidities, demonstrated higher median overall survival (OS) in patients who received ET versus those who did not (79.2 months compared to 67.7 months, p<0.0001). Older women with multiple medical co-morbidities may be at greater risk of toxicities related to ET, which can impact quality of life and adherence. The probability of initiating ET has been shown to be greater among patients who underwent radiation, thus highlighting the need to identify those who will adhere to ET when making decisions regarding radiation therapy to optimize care. ET should be discussed with all women who are candidates for this therapy, with a focus on individualized benefit and risk of these agents.

Studies of immunotherapy in metastatic triple-negative breast cancer have shown promising results, notably in patients with PD-L1 enriched tumors (IMpassion 130 and KEYNOTE-355). KEYNOTE-119 was a phase 3 study including 1,098 patients with metastatic TNBC who had received one or two previous systemic therapies for metastatic disease and progressed on most recent treatment, with randomization to pembrolizumab or physician’s choice chemotherapy . Median OS for pembrolizumab compared to chemotherapy was similar in the overall population (9.9 months versus 10.8 months, HR 0.97) and in patients with PD-L1 CPS score of ≥10 (12.7 months versus 11.6 months, HR 0.78, p=0.057). Although not statistically significant, greater PD-L1 expression was associated with longer median OS with pembrolizumab. Responses to immunotherapy may be durable in select patients, and these agents have an overall favorable toxicity profile. Novel immunotherapy combinations as well as biomarkers to predict response are certainly desired in this space.

Combination endocrine therapy plus a CDK 4/6 inhibitor is standard first-line treatment for metastatic HR+/HER2-negative breast cancer. Neutropenia is a common adverse event (AE) seen with the CDK 4/6 inhibitor palbociclib, and dosing guidelines provide a clear algorithm for drug monitoring and adjustment for cytopenias. Cutaneous toxicities, although not commonly seen, have been reported in the literature. Chawla and colleagues performed a retrospective analysis including 324 patients with advanced HR+/HER2-negative breast cancer who received palbociclib plus endocrine therapy. Cutaneous AEs were seen in 14.2%, with a significant proportion occurring early (41% occurred during or after the first cycle) and 50% resolved within 14 days (average 43 days). Of those who developed cutaneous AEs (n=46), only 15% and 4% required temporary hold and permanent cessation of therapy, respectively. These findings indicate a low overall incidence of cutaneous AEs associated with palbociclib, however highlight the importance of prompt recognition, management, and dermatology referral as appropriate, to help maintain patients on effective cancer-directed therapy.

References:

Yau C, van der Noordaa M, Wei J, et al. Residual cancer burden after neoadjuvant therapy and long-term survival outcomes in breast cancer: a multi-center pooled analysis. Presented at: 2019 San Antonio Breast Cancer Symposium; December 10-14, 2019; San Antonio, TX. Abstract GS5-01.

Wei M, Wang X, Zimmerman DN, Burt LM, Haaland B, Henry NL. Endocrine therapy and radiotherapy use among older women with hormone receptor-positive, clinically node-negative breast cancer. Breast Cancer Res Treat. 2021 Jan 9. doi: 10.1007/s10549-020-06071-w.Epub ahead of print.

Emens LA, Adams S, Barrios CH, et al. IMpassion130: Final OS analysis from the pivotal phase III study of atezolizumab plus nabpaclitaxel versus placebo plus nabpaclitaxel in previously untreated locally advanced or metastatic triple-negative breast cancer. Presented at: ESMO Virtual Congress 2020, Ann Oncol. 2020;31S:ESMO #LBA16.

Khan NAJ, Alsharedi M. Bullous Skin Rash: A Rare Case of Palbociclib-Induced Dermatological Toxicity. Cureus. 2020 Sep 3;12(9):e10229. doi: 10.7759/cureus.10229.

Adjuvant endocrine therapy (ET) has been shown to reduce risk of recurrence and improve survival in HR+ early breast cancer (EBC). A retrospective matched cohort analysis of 1,972 patients ≥70 years of age with HR+/HER2-negative, node-negative EBC and multiple medical co-morbidities, demonstrated higher median overall survival (OS) in patients who received ET versus those who did not (79.2 months compared to 67.7 months, p<0.0001). Older women with multiple medical co-morbidities may be at greater risk of toxicities related to ET, which can impact quality of life and adherence. The probability of initiating ET has been shown to be greater among patients who underwent radiation, thus highlighting the need to identify those who will adhere to ET when making decisions regarding radiation therapy to optimize care. ET should be discussed with all women who are candidates for this therapy, with a focus on individualized benefit and risk of these agents.

Studies of immunotherapy in metastatic triple-negative breast cancer have shown promising results, notably in patients with PD-L1 enriched tumors (IMpassion 130 and KEYNOTE-355). KEYNOTE-119 was a phase 3 study including 1,098 patients with metastatic TNBC who had received one or two previous systemic therapies for metastatic disease and progressed on most recent treatment, with randomization to pembrolizumab or physician’s choice chemotherapy . Median OS for pembrolizumab compared to chemotherapy was similar in the overall population (9.9 months versus 10.8 months, HR 0.97) and in patients with PD-L1 CPS score of ≥10 (12.7 months versus 11.6 months, HR 0.78, p=0.057). Although not statistically significant, greater PD-L1 expression was associated with longer median OS with pembrolizumab. Responses to immunotherapy may be durable in select patients, and these agents have an overall favorable toxicity profile. Novel immunotherapy combinations as well as biomarkers to predict response are certainly desired in this space.

Combination endocrine therapy plus a CDK 4/6 inhibitor is standard first-line treatment for metastatic HR+/HER2-negative breast cancer. Neutropenia is a common adverse event (AE) seen with the CDK 4/6 inhibitor palbociclib, and dosing guidelines provide a clear algorithm for drug monitoring and adjustment for cytopenias. Cutaneous toxicities, although not commonly seen, have been reported in the literature. Chawla and colleagues performed a retrospective analysis including 324 patients with advanced HR+/HER2-negative breast cancer who received palbociclib plus endocrine therapy. Cutaneous AEs were seen in 14.2%, with a significant proportion occurring early (41% occurred during or after the first cycle) and 50% resolved within 14 days (average 43 days). Of those who developed cutaneous AEs (n=46), only 15% and 4% required temporary hold and permanent cessation of therapy, respectively. These findings indicate a low overall incidence of cutaneous AEs associated with palbociclib, however highlight the importance of prompt recognition, management, and dermatology referral as appropriate, to help maintain patients on effective cancer-directed therapy.

References:

Yau C, van der Noordaa M, Wei J, et al. Residual cancer burden after neoadjuvant therapy and long-term survival outcomes in breast cancer: a multi-center pooled analysis. Presented at: 2019 San Antonio Breast Cancer Symposium; December 10-14, 2019; San Antonio, TX. Abstract GS5-01.

Wei M, Wang X, Zimmerman DN, Burt LM, Haaland B, Henry NL. Endocrine therapy and radiotherapy use among older women with hormone receptor-positive, clinically node-negative breast cancer. Breast Cancer Res Treat. 2021 Jan 9. doi: 10.1007/s10549-020-06071-w.Epub ahead of print.

Emens LA, Adams S, Barrios CH, et al. IMpassion130: Final OS analysis from the pivotal phase III study of atezolizumab plus nabpaclitaxel versus placebo plus nabpaclitaxel in previously untreated locally advanced or metastatic triple-negative breast cancer. Presented at: ESMO Virtual Congress 2020, Ann Oncol. 2020;31S:ESMO #LBA16.

Khan NAJ, Alsharedi M. Bullous Skin Rash: A Rare Case of Palbociclib-Induced Dermatological Toxicity. Cureus. 2020 Sep 3;12(9):e10229. doi: 10.7759/cureus.10229.

Key clinical point: Patients with human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (BC) who achieved a pathologic complete response (pCR) with neoadjuvant pertuzumab, trastuzumab, and chemotherapy (nPTC) and then received adjuvant trastuzumab remained at risk for recurrence, indicating the need for alternative therapies.

Major finding: At 4 years, the invasive disease-free survival rates for the overall, node-positive, and node-negative cohorts were 90.0% (95% confidence interval [CI], 84.6%-93.6%), 86.2% (95% CI, 78.1%-91.4%), and 96.0% (95% CI, 88.0%-98.7%), respectively.

Study details: Findings are from a real-world, retrospective analysis of 217 patients with HER2+ locally advanced, high-risk early-stage BC, including 135 patients with node-positive and 77 with node-negative disease. Patients received nPTC, had pCR, and then received adjuvant trastuzumab.

Disclosures: This study was funded by Genentech, Inc. Some investigators including the lead author reported ties with various pharmaceutical companies, including Genentech. J Sussell, A Cheng, and A Fung declared being employees of Genentech, Inc.

Source: O’Shaughnessy J et al. Breast Cancer Res Treat. 2021 Mar 1. doi: 10.1007/s10549-021-06137-3.

Key clinical point: Patients with human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (BC) who achieved a pathologic complete response (pCR) with neoadjuvant pertuzumab, trastuzumab, and chemotherapy (nPTC) and then received adjuvant trastuzumab remained at risk for recurrence, indicating the need for alternative therapies.

Major finding: At 4 years, the invasive disease-free survival rates for the overall, node-positive, and node-negative cohorts were 90.0% (95% confidence interval [CI], 84.6%-93.6%), 86.2% (95% CI, 78.1%-91.4%), and 96.0% (95% CI, 88.0%-98.7%), respectively.

Study details: Findings are from a real-world, retrospective analysis of 217 patients with HER2+ locally advanced, high-risk early-stage BC, including 135 patients with node-positive and 77 with node-negative disease. Patients received nPTC, had pCR, and then received adjuvant trastuzumab.

Disclosures: This study was funded by Genentech, Inc. Some investigators including the lead author reported ties with various pharmaceutical companies, including Genentech. J Sussell, A Cheng, and A Fung declared being employees of Genentech, Inc.

Source: O’Shaughnessy J et al. Breast Cancer Res Treat. 2021 Mar 1. doi: 10.1007/s10549-021-06137-3.

Key clinical point: Patients with human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (BC) who achieved a pathologic complete response (pCR) with neoadjuvant pertuzumab, trastuzumab, and chemotherapy (nPTC) and then received adjuvant trastuzumab remained at risk for recurrence, indicating the need for alternative therapies.

Major finding: At 4 years, the invasive disease-free survival rates for the overall, node-positive, and node-negative cohorts were 90.0% (95% confidence interval [CI], 84.6%-93.6%), 86.2% (95% CI, 78.1%-91.4%), and 96.0% (95% CI, 88.0%-98.7%), respectively.

Study details: Findings are from a real-world, retrospective analysis of 217 patients with HER2+ locally advanced, high-risk early-stage BC, including 135 patients with node-positive and 77 with node-negative disease. Patients received nPTC, had pCR, and then received adjuvant trastuzumab.

Disclosures: This study was funded by Genentech, Inc. Some investigators including the lead author reported ties with various pharmaceutical companies, including Genentech. J Sussell, A Cheng, and A Fung declared being employees of Genentech, Inc.

Source: O’Shaughnessy J et al. Breast Cancer Res Treat. 2021 Mar 1. doi: 10.1007/s10549-021-06137-3.

Key clinical point: In patients with newly diagnosed breast cancer (BC), the risk of local recurrence (LR) as a first event within 5 years of diagnosis was low and declined further with the number of event-free years.

Major finding: Overall, the incidence of LR as a first event within 5 years of diagnosis was 3.0%, which decreased to 2.4%, 1.6%, 1.0%, and 0.6% after 1, 2, 3, and 4 event-free years, respectively.

Study details: Findings are from the nationwide Netherlands Cancer Registry database, including 34,453 patients with newly diagnosed breast cancer between 2005 and 2008.

Disclosures: This study was supported by CZ fonds 201400316. ML Smidt reported receiving grant from Servier Pharma. Other authors had no disclosures.

Source: Moossdorff M et al. Breast Cancer Res Treat. 2021 Mar 10. doi: 10.1007/s10549-020-06040-3.

Key clinical point: In patients with newly diagnosed breast cancer (BC), the risk of local recurrence (LR) as a first event within 5 years of diagnosis was low and declined further with the number of event-free years.

Major finding: Overall, the incidence of LR as a first event within 5 years of diagnosis was 3.0%, which decreased to 2.4%, 1.6%, 1.0%, and 0.6% after 1, 2, 3, and 4 event-free years, respectively.

Study details: Findings are from the nationwide Netherlands Cancer Registry database, including 34,453 patients with newly diagnosed breast cancer between 2005 and 2008.

Disclosures: This study was supported by CZ fonds 201400316. ML Smidt reported receiving grant from Servier Pharma. Other authors had no disclosures.

Source: Moossdorff M et al. Breast Cancer Res Treat. 2021 Mar 10. doi: 10.1007/s10549-020-06040-3.

Key clinical point: In patients with newly diagnosed breast cancer (BC), the risk of local recurrence (LR) as a first event within 5 years of diagnosis was low and declined further with the number of event-free years.

Major finding: Overall, the incidence of LR as a first event within 5 years of diagnosis was 3.0%, which decreased to 2.4%, 1.6%, 1.0%, and 0.6% after 1, 2, 3, and 4 event-free years, respectively.

Study details: Findings are from the nationwide Netherlands Cancer Registry database, including 34,453 patients with newly diagnosed breast cancer between 2005 and 2008.

Disclosures: This study was supported by CZ fonds 201400316. ML Smidt reported receiving grant from Servier Pharma. Other authors had no disclosures.

Source: Moossdorff M et al. Breast Cancer Res Treat. 2021 Mar 10. doi: 10.1007/s10549-020-06040-3.

Key clinical point: Use of female hormones was associated with an increased incidence of breast cancer (BC) in premenopausal women. Among postmenopausal women, older age at first birth increased the incidence of BC, whereas more births decreased it.

Major finding: Use of female hormones significantly increased the incidence of premenopausal breast cancer (adjusted hazard ratio [aHR], 1.53; P = .03). Incidence of postmenopausal breast cancer was higher in women aged 26 years or more vs. 21-25 years at first birth (aHR, 1.34, 1.47, and 1.68 for ages 26-30, 31-35, and 36 years and older, respectively; P less than .001) and lower in women giving more vs. no births (aHR, 0.85, 0.65, and 0.52 for 1, 2, and 3 and more births, respectively; P = .02).

Study details: Findings are from a pooled analysis of 9 population-based cohort studies conducted in Japan including 187,999 women (premenopausal, n=61,113; postmenopausal, n=126,886).

Disclosures: This study was supported by the National Cancer Center Research and Development Fund and the Health and Labour Sciences Research Grants for the Third Term Comprehensive Control Research for Cancer. The authors had no disclosures.

Source: Takeuchi T et al. Cancer Med. 2021 Mar 1. doi: 10.1002/cam4.3752.

Key clinical point: Use of female hormones was associated with an increased incidence of breast cancer (BC) in premenopausal women. Among postmenopausal women, older age at first birth increased the incidence of BC, whereas more births decreased it.

Major finding: Use of female hormones significantly increased the incidence of premenopausal breast cancer (adjusted hazard ratio [aHR], 1.53; P = .03). Incidence of postmenopausal breast cancer was higher in women aged 26 years or more vs. 21-25 years at first birth (aHR, 1.34, 1.47, and 1.68 for ages 26-30, 31-35, and 36 years and older, respectively; P less than .001) and lower in women giving more vs. no births (aHR, 0.85, 0.65, and 0.52 for 1, 2, and 3 and more births, respectively; P = .02).

Study details: Findings are from a pooled analysis of 9 population-based cohort studies conducted in Japan including 187,999 women (premenopausal, n=61,113; postmenopausal, n=126,886).

Disclosures: This study was supported by the National Cancer Center Research and Development Fund and the Health and Labour Sciences Research Grants for the Third Term Comprehensive Control Research for Cancer. The authors had no disclosures.

Source: Takeuchi T et al. Cancer Med. 2021 Mar 1. doi: 10.1002/cam4.3752.

Key clinical point: Use of female hormones was associated with an increased incidence of breast cancer (BC) in premenopausal women. Among postmenopausal women, older age at first birth increased the incidence of BC, whereas more births decreased it.

Major finding: Use of female hormones significantly increased the incidence of premenopausal breast cancer (adjusted hazard ratio [aHR], 1.53; P = .03). Incidence of postmenopausal breast cancer was higher in women aged 26 years or more vs. 21-25 years at first birth (aHR, 1.34, 1.47, and 1.68 for ages 26-30, 31-35, and 36 years and older, respectively; P less than .001) and lower in women giving more vs. no births (aHR, 0.85, 0.65, and 0.52 for 1, 2, and 3 and more births, respectively; P = .02).

Study details: Findings are from a pooled analysis of 9 population-based cohort studies conducted in Japan including 187,999 women (premenopausal, n=61,113; postmenopausal, n=126,886).

Disclosures: This study was supported by the National Cancer Center Research and Development Fund and the Health and Labour Sciences Research Grants for the Third Term Comprehensive Control Research for Cancer. The authors had no disclosures.

Source: Takeuchi T et al. Cancer Med. 2021 Mar 1. doi: 10.1002/cam4.3752.

Key clinical point: Preoperative breast magnetic resonance imaging (MRI) has low accuracy in predicting nodal status after neoadjuvant therapy in patients with invasive lobular carcinoma (ILC), suggesting that axillary findings on posttreatment breast MRI should not be used to plan surgical approach to the axilla.

Major finding: Overall, the accuracy of posttreatment breast MRI in predicting axillary nodal status ranged from 45.5% to 66.7%. The overall accuracy of MRI for predicting nodal status was similar among patients treated with neoadjuvant endocrine therapy (ET) vs. chemotherapy (66.7% vs. 50%; P = .1393).

Study details: Findings are from a retrospective analysis of 79 women with stage I-III ILC who underwent preoperative breast MRI after either neoadjuvant chemotherapy (n=46) or ET (n=33).

Disclosures: This publication was supported by the National Center for Advancing Translational Sciences, National Institute of Health. The authors declared no conflicts of interest.

Source: Abel MK et al. NPJ Breast Cancer. 2021 Mar 5. doi: 10.1038/s41523-021-00233-9.

Key clinical point: Preoperative breast magnetic resonance imaging (MRI) has low accuracy in predicting nodal status after neoadjuvant therapy in patients with invasive lobular carcinoma (ILC), suggesting that axillary findings on posttreatment breast MRI should not be used to plan surgical approach to the axilla.

Major finding: Overall, the accuracy of posttreatment breast MRI in predicting axillary nodal status ranged from 45.5% to 66.7%. The overall accuracy of MRI for predicting nodal status was similar among patients treated with neoadjuvant endocrine therapy (ET) vs. chemotherapy (66.7% vs. 50%; P = .1393).

Study details: Findings are from a retrospective analysis of 79 women with stage I-III ILC who underwent preoperative breast MRI after either neoadjuvant chemotherapy (n=46) or ET (n=33).

Disclosures: This publication was supported by the National Center for Advancing Translational Sciences, National Institute of Health. The authors declared no conflicts of interest.

Source: Abel MK et al. NPJ Breast Cancer. 2021 Mar 5. doi: 10.1038/s41523-021-00233-9.

Key clinical point: Preoperative breast magnetic resonance imaging (MRI) has low accuracy in predicting nodal status after neoadjuvant therapy in patients with invasive lobular carcinoma (ILC), suggesting that axillary findings on posttreatment breast MRI should not be used to plan surgical approach to the axilla.

Major finding: Overall, the accuracy of posttreatment breast MRI in predicting axillary nodal status ranged from 45.5% to 66.7%. The overall accuracy of MRI for predicting nodal status was similar among patients treated with neoadjuvant endocrine therapy (ET) vs. chemotherapy (66.7% vs. 50%; P = .1393).

Study details: Findings are from a retrospective analysis of 79 women with stage I-III ILC who underwent preoperative breast MRI after either neoadjuvant chemotherapy (n=46) or ET (n=33).

Disclosures: This publication was supported by the National Center for Advancing Translational Sciences, National Institute of Health. The authors declared no conflicts of interest.

Source: Abel MK et al. NPJ Breast Cancer. 2021 Mar 5. doi: 10.1038/s41523-021-00233-9.

Key clinical point: The overall incidence of cutaneous adverse events (AEs) was low and manageable, rarely needing treatment cessation, in patients with advanced hormone receptor-positive, human epidermal growth receptor 2-negative breast cancer (HR+HER2−BC) receiving palbociclib and endocrine therapy (ET).

Major finding: The incidence of treatment-related cutaneous AEs was 14.2%, of which only 15.0% and 4.0% required temporary treatment suspension and discontinuation, respectively. The mean time to AE onset was 168 days (6 cycles) of treatment.

Study details: Findings are from a retrospective analysis of 324 adult patients with advanced HR+HER2−BC who received oral palbociclib (mean treatment cycles, 9) and ET.

Disclosures: This study did not declare any specific funding. The authors declared no conflicts of interest.

Source: Chawla S et al. Breast Cancer Res Treat. 2021 Mar 8. doi: 10.1007/s10549-021-06169-9.

Key clinical point: The overall incidence of cutaneous adverse events (AEs) was low and manageable, rarely needing treatment cessation, in patients with advanced hormone receptor-positive, human epidermal growth receptor 2-negative breast cancer (HR+HER2−BC) receiving palbociclib and endocrine therapy (ET).

Major finding: The incidence of treatment-related cutaneous AEs was 14.2%, of which only 15.0% and 4.0% required temporary treatment suspension and discontinuation, respectively. The mean time to AE onset was 168 days (6 cycles) of treatment.

Study details: Findings are from a retrospective analysis of 324 adult patients with advanced HR+HER2−BC who received oral palbociclib (mean treatment cycles, 9) and ET.

Disclosures: This study did not declare any specific funding. The authors declared no conflicts of interest.

Source: Chawla S et al. Breast Cancer Res Treat. 2021 Mar 8. doi: 10.1007/s10549-021-06169-9.

Key clinical point: The overall incidence of cutaneous adverse events (AEs) was low and manageable, rarely needing treatment cessation, in patients with advanced hormone receptor-positive, human epidermal growth receptor 2-negative breast cancer (HR+HER2−BC) receiving palbociclib and endocrine therapy (ET).

Major finding: The incidence of treatment-related cutaneous AEs was 14.2%, of which only 15.0% and 4.0% required temporary treatment suspension and discontinuation, respectively. The mean time to AE onset was 168 days (6 cycles) of treatment.

Study details: Findings are from a retrospective analysis of 324 adult patients with advanced HR+HER2−BC who received oral palbociclib (mean treatment cycles, 9) and ET.

Disclosures: This study did not declare any specific funding. The authors declared no conflicts of interest.

Source: Chawla S et al. Breast Cancer Res Treat. 2021 Mar 8. doi: 10.1007/s10549-021-06169-9.

Key clinical point: Adjuvant endocrine therapy (ET) was associated with improved overall survival (OS) in older patients with node-negative, estrogen receptor-positive/human epidermal growth factor receptor 2-negative (ER+/HER2−) invasive breast cancer with multiple comorbidities.

Major finding: During median follow-up of 43.6 months, median OS was higher in patients who received ET vs. those who did not (79.2 months vs. 67.7 months; P less than .0001).

Study details: Findings are from a retrospective, matched cohort analysis of 1,972 older patients (age, 70 years or more) with Charlson/Deyo comorbidity scores of 2 or 3 who received breast and axillary surgery for ER+/HER2−, pathologic node-negative breast cancer.

Disclosures: This work was partly supported by the National Cancer Institute. MS Karuturi reported support from Pfizer. The remaining authors had no disclosures.

Source: Tamirisa N et al. Cancer. 2021 Mar 18. doi: 10.1002/cncr.33489.

Key clinical point: Adjuvant endocrine therapy (ET) was associated with improved overall survival (OS) in older patients with node-negative, estrogen receptor-positive/human epidermal growth factor receptor 2-negative (ER+/HER2−) invasive breast cancer with multiple comorbidities.

Major finding: During median follow-up of 43.6 months, median OS was higher in patients who received ET vs. those who did not (79.2 months vs. 67.7 months; P less than .0001).

Study details: Findings are from a retrospective, matched cohort analysis of 1,972 older patients (age, 70 years or more) with Charlson/Deyo comorbidity scores of 2 or 3 who received breast and axillary surgery for ER+/HER2−, pathologic node-negative breast cancer.

Disclosures: This work was partly supported by the National Cancer Institute. MS Karuturi reported support from Pfizer. The remaining authors had no disclosures.

Source: Tamirisa N et al. Cancer. 2021 Mar 18. doi: 10.1002/cncr.33489.

Key clinical point: Adjuvant endocrine therapy (ET) was associated with improved overall survival (OS) in older patients with node-negative, estrogen receptor-positive/human epidermal growth factor receptor 2-negative (ER+/HER2−) invasive breast cancer with multiple comorbidities.

Major finding: During median follow-up of 43.6 months, median OS was higher in patients who received ET vs. those who did not (79.2 months vs. 67.7 months; P less than .0001).

Study details: Findings are from a retrospective, matched cohort analysis of 1,972 older patients (age, 70 years or more) with Charlson/Deyo comorbidity scores of 2 or 3 who received breast and axillary surgery for ER+/HER2−, pathologic node-negative breast cancer.

Disclosures: This work was partly supported by the National Cancer Institute. MS Karuturi reported support from Pfizer. The remaining authors had no disclosures.

Source: Tamirisa N et al. Cancer. 2021 Mar 18. doi: 10.1002/cncr.33489.

Key clinical point: Pembrolizumab monotherapy as second- or third-line treatment did not improve overall survival (OS) in patients with previously treated metastatic triple-negative breast cancer (TNBC) compared with chemotherapy.

Major finding: Median OS was similar with pembrolizumab vs. chemotherapy in patients with programmed death-ligand 1 combined positive score of 1 or more (10.7 months vs. 10.2 months; P = .073) or 10 or more (12.7 months vs. 11.6 months; P = .057). Dose modification, reduction, interruption, or withdrawal because of adverse events was lower in pembrolizumab (21%) vs. chemotherapy (45%) groups.

Study details: Findings are from phase 3 KEYNOTE-119 trial including 622 patients with metastatic TNBC who underwent 1 or 2 previous treatments, experienced progression on most recent therapy, and received previous treatment with an anthracycline or taxane. Patients were randomly allocated to receive either intravenous pembrolizumab (n=312) or investigator-choice chemotherapy (n=310).

Disclosures: This study was funded by Merck Sharp and Dohme. Some investigators, including the lead author, reported ties with various pharmaceutical companies including Merck Sharp and Dohme.

Source: Winer EP et al. Lancet Oncol. 2021 Mar 4. doi: 10.1016/S1470-2045(20)30754-3.

Key clinical point: Pembrolizumab monotherapy as second- or third-line treatment did not improve overall survival (OS) in patients with previously treated metastatic triple-negative breast cancer (TNBC) compared with chemotherapy.

Major finding: Median OS was similar with pembrolizumab vs. chemotherapy in patients with programmed death-ligand 1 combined positive score of 1 or more (10.7 months vs. 10.2 months; P = .073) or 10 or more (12.7 months vs. 11.6 months; P = .057). Dose modification, reduction, interruption, or withdrawal because of adverse events was lower in pembrolizumab (21%) vs. chemotherapy (45%) groups.

Study details: Findings are from phase 3 KEYNOTE-119 trial including 622 patients with metastatic TNBC who underwent 1 or 2 previous treatments, experienced progression on most recent therapy, and received previous treatment with an anthracycline or taxane. Patients were randomly allocated to receive either intravenous pembrolizumab (n=312) or investigator-choice chemotherapy (n=310).

Disclosures: This study was funded by Merck Sharp and Dohme. Some investigators, including the lead author, reported ties with various pharmaceutical companies including Merck Sharp and Dohme.

Source: Winer EP et al. Lancet Oncol. 2021 Mar 4. doi: 10.1016/S1470-2045(20)30754-3.

Key clinical point: Pembrolizumab monotherapy as second- or third-line treatment did not improve overall survival (OS) in patients with previously treated metastatic triple-negative breast cancer (TNBC) compared with chemotherapy.

Major finding: Median OS was similar with pembrolizumab vs. chemotherapy in patients with programmed death-ligand 1 combined positive score of 1 or more (10.7 months vs. 10.2 months; P = .073) or 10 or more (12.7 months vs. 11.6 months; P = .057). Dose modification, reduction, interruption, or withdrawal because of adverse events was lower in pembrolizumab (21%) vs. chemotherapy (45%) groups.

Study details: Findings are from phase 3 KEYNOTE-119 trial including 622 patients with metastatic TNBC who underwent 1 or 2 previous treatments, experienced progression on most recent therapy, and received previous treatment with an anthracycline or taxane. Patients were randomly allocated to receive either intravenous pembrolizumab (n=312) or investigator-choice chemotherapy (n=310).

Disclosures: This study was funded by Merck Sharp and Dohme. Some investigators, including the lead author, reported ties with various pharmaceutical companies including Merck Sharp and Dohme.

Source: Winer EP et al. Lancet Oncol. 2021 Mar 4. doi: 10.1016/S1470-2045(20)30754-3.

Key clinical point: Among women with breast cancer and high clinical risk, a subgroup of patients with low genomic risk identified by the 70-gene signature showed excellent distant metastasis-free survival (DMFS) even without chemotherapy. No benefits of chemotherapy were observed in women older than 50 years.

Major finding: Eight-year DMFS in patients with high clinical but low genomic risk with vs. without chemotherapy was 92.0% vs. 89.4%, with the benefit of adding chemotherapy to endocrine therapy remaining small (absolute difference, 2·6 percentage points). Chemotherapy showed no benefits in older women aged more than 50 years (absolute difference, 0.2 percentage points).

Study details: Findings are from the 8-year analysis of phase 3 MINDACT trial, including women with primary nonmetastatic invasive breast cancer with up to 3 positive lymph nodes. The 70-gene signature (MammaPrint) identified women with high clinical but low genomic risk who were randomly assigned to chemotherapy (n=749) vs. no chemotherapy (n=748).

Disclosures: This study was funded by European Commission Sixth Framework Programme (ECSFP). Some investigators including the lead author reported ties with various pharmaceutical companies and funding agencies including the ECSFP.

Source: Piccart M et al. Lancet Oncol. 2021 Mar 12. doi: 10.1016/S1470-2045(21)00007-3.

Key clinical point: Among women with breast cancer and high clinical risk, a subgroup of patients with low genomic risk identified by the 70-gene signature showed excellent distant metastasis-free survival (DMFS) even without chemotherapy. No benefits of chemotherapy were observed in women older than 50 years.

Major finding: Eight-year DMFS in patients with high clinical but low genomic risk with vs. without chemotherapy was 92.0% vs. 89.4%, with the benefit of adding chemotherapy to endocrine therapy remaining small (absolute difference, 2·6 percentage points). Chemotherapy showed no benefits in older women aged more than 50 years (absolute difference, 0.2 percentage points).

Study details: Findings are from the 8-year analysis of phase 3 MINDACT trial, including women with primary nonmetastatic invasive breast cancer with up to 3 positive lymph nodes. The 70-gene signature (MammaPrint) identified women with high clinical but low genomic risk who were randomly assigned to chemotherapy (n=749) vs. no chemotherapy (n=748).

Disclosures: This study was funded by European Commission Sixth Framework Programme (ECSFP). Some investigators including the lead author reported ties with various pharmaceutical companies and funding agencies including the ECSFP.

Source: Piccart M et al. Lancet Oncol. 2021 Mar 12. doi: 10.1016/S1470-2045(21)00007-3.

Key clinical point: Among women with breast cancer and high clinical risk, a subgroup of patients with low genomic risk identified by the 70-gene signature showed excellent distant metastasis-free survival (DMFS) even without chemotherapy. No benefits of chemotherapy were observed in women older than 50 years.

Major finding: Eight-year DMFS in patients with high clinical but low genomic risk with vs. without chemotherapy was 92.0% vs. 89.4%, with the benefit of adding chemotherapy to endocrine therapy remaining small (absolute difference, 2·6 percentage points). Chemotherapy showed no benefits in older women aged more than 50 years (absolute difference, 0.2 percentage points).

Study details: Findings are from the 8-year analysis of phase 3 MINDACT trial, including women with primary nonmetastatic invasive breast cancer with up to 3 positive lymph nodes. The 70-gene signature (MammaPrint) identified women with high clinical but low genomic risk who were randomly assigned to chemotherapy (n=749) vs. no chemotherapy (n=748).

Disclosures: This study was funded by European Commission Sixth Framework Programme (ECSFP). Some investigators including the lead author reported ties with various pharmaceutical companies and funding agencies including the ECSFP.

Source: Piccart M et al. Lancet Oncol. 2021 Mar 12. doi: 10.1016/S1470-2045(21)00007-3.

Key clinical point: Among women with breast cancer and high clinical risk, a subgroup of patients with low genomic risk identified by the 70-gene signature showed excellent distant metastasis-free survival (DMFS) even without chemotherapy. No benefits of chemotherapy were observed in women older than 50 years.

Major finding: Eight-year DMFS in patients with high clinical but low genomic risk with vs. without chemotherapy was 92.0% vs. 89.4%, with the benefit of adding chemotherapy to endocrine therapy remaining small (absolute difference, 2·6 percentage points). Chemotherapy showed no benefits in older women aged more than 50 years (absolute difference, 0.2 percentage points).

Study details: Findings are from the 8-year analysis of phase 3 MINDACT trial, including women with primary nonmetastatic invasive breast cancer with up to 3 positive lymph nodes. The 70-gene signature (MammaPrint) identified women with high clinical but low genomic risk who were randomly assigned to chemotherapy (n=749) vs. no chemotherapy (n=748).

Disclosures: This study was funded by European Commission Sixth Framework Programme (ECSFP). Some investigators including the lead author reported ties with various pharmaceutical companies and funding agencies including the ECSFP.

Source: Piccart M et al. Lancet Oncol. 2021 Mar 12. doi: 10.1016/S1470-2045(21)00007-3.

Key clinical point: Among women with breast cancer and high clinical risk, a subgroup of patients with low genomic risk identified by the 70-gene signature showed excellent distant metastasis-free survival (DMFS) even without chemotherapy. No benefits of chemotherapy were observed in women older than 50 years.

Major finding: Eight-year DMFS in patients with high clinical but low genomic risk with vs. without chemotherapy was 92.0% vs. 89.4%, with the benefit of adding chemotherapy to endocrine therapy remaining small (absolute difference, 2·6 percentage points). Chemotherapy showed no benefits in older women aged more than 50 years (absolute difference, 0.2 percentage points).

Study details: Findings are from the 8-year analysis of phase 3 MINDACT trial, including women with primary nonmetastatic invasive breast cancer with up to 3 positive lymph nodes. The 70-gene signature (MammaPrint) identified women with high clinical but low genomic risk who were randomly assigned to chemotherapy (n=749) vs. no chemotherapy (n=748).

Disclosures: This study was funded by European Commission Sixth Framework Programme (ECSFP). Some investigators including the lead author reported ties with various pharmaceutical companies and funding agencies including the ECSFP.

Source: Piccart M et al. Lancet Oncol. 2021 Mar 12. doi: 10.1016/S1470-2045(21)00007-3.

Key clinical point: Among women with breast cancer and high clinical risk, a subgroup of patients with low genomic risk identified by the 70-gene signature showed excellent distant metastasis-free survival (DMFS) even without chemotherapy. No benefits of chemotherapy were observed in women older than 50 years.

Major finding: Eight-year DMFS in patients with high clinical but low genomic risk with vs. without chemotherapy was 92.0% vs. 89.4%, with the benefit of adding chemotherapy to endocrine therapy remaining small (absolute difference, 2·6 percentage points). Chemotherapy showed no benefits in older women aged more than 50 years (absolute difference, 0.2 percentage points).

Study details: Findings are from the 8-year analysis of phase 3 MINDACT trial, including women with primary nonmetastatic invasive breast cancer with up to 3 positive lymph nodes. The 70-gene signature (MammaPrint) identified women with high clinical but low genomic risk who were randomly assigned to chemotherapy (n=749) vs. no chemotherapy (n=748).

Disclosures: This study was funded by European Commission Sixth Framework Programme (ECSFP). Some investigators including the lead author reported ties with various pharmaceutical companies and funding agencies including the ECSFP.

Source: Piccart M et al. Lancet Oncol. 2021 Mar 12. doi: 10.1016/S1470-2045(21)00007-3.