Key clinical point: The peripheral blood parameters of total white blood cell (WBC) count at least 20×10⁹/L, basophilia, and granulocytic left shift could help identify the need for BCR-ABL1 testing for chronic myeloid leukemia (CML) diagnosis, thereby reducing unnecessary testing, health care costs, and risk of clinically false-positive results.

Major finding: Overall, 92% of patients with newly diagnosed CML had a WBC count of at least 20×10⁹/L, whereas 92% of non-CML patients had a WBC count less than 20×10⁹/L. A positive BCR-ABL1 p210 result was associated with the presence of basophilia (86% sensitivity; 96% specificity), granulocytic left shift with circulating myelocytes and metamyelocytes (95% sensitivity; 94% specificity), and WBC of at least 20×10⁹/L (92% sensitivity; 92% specificity).

Study details: Findings are from a retrospective analysis of 495 patients undergoing first-time testing for p210 BCR-ABL1 on peripheral blood by real-time polymerase chain reaction.

Disclosures: No source of funding was identified. The authors declared no conflicts of interest.

Source: Fenu E et al. Int J Lan Hematol. 2021 Jun 29. doi: 10.1111/ijlh.13635.

Key clinical point: The peripheral blood parameters of total white blood cell (WBC) count at least 20×10⁹/L, basophilia, and granulocytic left shift could help identify the need for BCR-ABL1 testing for chronic myeloid leukemia (CML) diagnosis, thereby reducing unnecessary testing, health care costs, and risk of clinically false-positive results.

Major finding: Overall, 92% of patients with newly diagnosed CML had a WBC count of at least 20×10⁹/L, whereas 92% of non-CML patients had a WBC count less than 20×10⁹/L. A positive BCR-ABL1 p210 result was associated with the presence of basophilia (86% sensitivity; 96% specificity), granulocytic left shift with circulating myelocytes and metamyelocytes (95% sensitivity; 94% specificity), and WBC of at least 20×10⁹/L (92% sensitivity; 92% specificity).

Study details: Findings are from a retrospective analysis of 495 patients undergoing first-time testing for p210 BCR-ABL1 on peripheral blood by real-time polymerase chain reaction.

Disclosures: No source of funding was identified. The authors declared no conflicts of interest.

Source: Fenu E et al. Int J Lan Hematol. 2021 Jun 29. doi: 10.1111/ijlh.13635.

Key clinical point: The peripheral blood parameters of total white blood cell (WBC) count at least 20×10⁹/L, basophilia, and granulocytic left shift could help identify the need for BCR-ABL1 testing for chronic myeloid leukemia (CML) diagnosis, thereby reducing unnecessary testing, health care costs, and risk of clinically false-positive results.

Major finding: Overall, 92% of patients with newly diagnosed CML had a WBC count of at least 20×10⁹/L, whereas 92% of non-CML patients had a WBC count less than 20×10⁹/L. A positive BCR-ABL1 p210 result was associated with the presence of basophilia (86% sensitivity; 96% specificity), granulocytic left shift with circulating myelocytes and metamyelocytes (95% sensitivity; 94% specificity), and WBC of at least 20×10⁹/L (92% sensitivity; 92% specificity).

Study details: Findings are from a retrospective analysis of 495 patients undergoing first-time testing for p210 BCR-ABL1 on peripheral blood by real-time polymerase chain reaction.

Disclosures: No source of funding was identified. The authors declared no conflicts of interest.

Source: Fenu E et al. Int J Lan Hematol. 2021 Jun 29. doi: 10.1111/ijlh.13635.

Key clinical point: Blood cell counts collected up to 5 years before chronic myeloid leukemia (CML) diagnosis could predict BCR-ABL1 test using machine learning methods. Such predictive models may enable early diagnosis of CML, and subsequently, earlier treatment initiation, leading to a better prognosis.

Major finding: The BCR-ABL1 positivity rate was 6.2%. The ability of machine learning models to predict CML diagnosis improved with the usage of blood cell counts closer to the time of diagnosis (at diagnosis: area under the curve [AUC], 0.87-0.96; 6 months to 1-year prediagnosis: AUC, 0.75-0.80; 2-5 years prediagnosis: AUC, 0.59-0.67).

Study details: This study included 1,623 patients with a BCR-ABL1 test and at least 6 consecutive prior years of differential blood cell counts between October 1999 and April 2020 from the Veterans Health Administration database.

Disclosures: No source of funding or author disclosures were reported.

Source: Hauser RG et al. Am J Clin Pathol. 2021 Jun 29. doi: 10.1093/ajcp/aqab086.

Key clinical point: Blood cell counts collected up to 5 years before chronic myeloid leukemia (CML) diagnosis could predict BCR-ABL1 test using machine learning methods. Such predictive models may enable early diagnosis of CML, and subsequently, earlier treatment initiation, leading to a better prognosis.

Major finding: The BCR-ABL1 positivity rate was 6.2%. The ability of machine learning models to predict CML diagnosis improved with the usage of blood cell counts closer to the time of diagnosis (at diagnosis: area under the curve [AUC], 0.87-0.96; 6 months to 1-year prediagnosis: AUC, 0.75-0.80; 2-5 years prediagnosis: AUC, 0.59-0.67).

Study details: This study included 1,623 patients with a BCR-ABL1 test and at least 6 consecutive prior years of differential blood cell counts between October 1999 and April 2020 from the Veterans Health Administration database.

Disclosures: No source of funding or author disclosures were reported.

Source: Hauser RG et al. Am J Clin Pathol. 2021 Jun 29. doi: 10.1093/ajcp/aqab086.

Key clinical point: Blood cell counts collected up to 5 years before chronic myeloid leukemia (CML) diagnosis could predict BCR-ABL1 test using machine learning methods. Such predictive models may enable early diagnosis of CML, and subsequently, earlier treatment initiation, leading to a better prognosis.

Major finding: The BCR-ABL1 positivity rate was 6.2%. The ability of machine learning models to predict CML diagnosis improved with the usage of blood cell counts closer to the time of diagnosis (at diagnosis: area under the curve [AUC], 0.87-0.96; 6 months to 1-year prediagnosis: AUC, 0.75-0.80; 2-5 years prediagnosis: AUC, 0.59-0.67).

Study details: This study included 1,623 patients with a BCR-ABL1 test and at least 6 consecutive prior years of differential blood cell counts between October 1999 and April 2020 from the Veterans Health Administration database.

Disclosures: No source of funding or author disclosures were reported.

Source: Hauser RG et al. Am J Clin Pathol. 2021 Jun 29. doi: 10.1093/ajcp/aqab086.

Key clinical point: Among patients with myeloid blast phase chronic myeloid leukemia (CML-MBP), combination therapy of tyrosine kinase inhibitor (TKI) with intensive chemotherapy (IC) or hypomethylating agent (HMA) resulted in better clinical outcomes vs TKI alone.

Major finding: IC/HMA+TKI vs TKI alone resulted in higher rates of complete remission (CR) or CR with incomplete count recovery (57.5% vs 33.9%), complete cytogenic response (45.0% vs 10.7%), major/deep molecular response (24.2% vs 4.3%;), and more patients proceeding to allogeneic stem cell transplant (32.5% vs 10.7%). In patients receiving the second/third generation TKIs, IC/HMA+TKI led to superior 5-year event-free survival (28% vs 0%) and reduced relapse (44% vs 86%) vs TKI alone (all P less than .05).

Study details: Findings are from a retrospective analysis of 104 patients with CML-MBP receiving frontline treatment based on 4 different approaches, i.e., IC+TKI (n=20), HMA+TKI (n=20), TKI alone (n=56), or IC alone (n=8), between 2000 and 2019.

Disclosures: This study was supported by MD Anderson Cancer Center Support Grant and SPORE. NJ Short reported ties with various pharmaceutical companies. Other authors declared no competing interests.

Source: Saxena K et al. J Hematol Oncol. 2021 Jun 15. doi: 10.1186/s13045-021-01106-1.

Key clinical point: Among patients with myeloid blast phase chronic myeloid leukemia (CML-MBP), combination therapy of tyrosine kinase inhibitor (TKI) with intensive chemotherapy (IC) or hypomethylating agent (HMA) resulted in better clinical outcomes vs TKI alone.

Major finding: IC/HMA+TKI vs TKI alone resulted in higher rates of complete remission (CR) or CR with incomplete count recovery (57.5% vs 33.9%), complete cytogenic response (45.0% vs 10.7%), major/deep molecular response (24.2% vs 4.3%;), and more patients proceeding to allogeneic stem cell transplant (32.5% vs 10.7%). In patients receiving the second/third generation TKIs, IC/HMA+TKI led to superior 5-year event-free survival (28% vs 0%) and reduced relapse (44% vs 86%) vs TKI alone (all P less than .05).

Study details: Findings are from a retrospective analysis of 104 patients with CML-MBP receiving frontline treatment based on 4 different approaches, i.e., IC+TKI (n=20), HMA+TKI (n=20), TKI alone (n=56), or IC alone (n=8), between 2000 and 2019.

Disclosures: This study was supported by MD Anderson Cancer Center Support Grant and SPORE. NJ Short reported ties with various pharmaceutical companies. Other authors declared no competing interests.

Source: Saxena K et al. J Hematol Oncol. 2021 Jun 15. doi: 10.1186/s13045-021-01106-1.

Key clinical point: Among patients with myeloid blast phase chronic myeloid leukemia (CML-MBP), combination therapy of tyrosine kinase inhibitor (TKI) with intensive chemotherapy (IC) or hypomethylating agent (HMA) resulted in better clinical outcomes vs TKI alone.

Major finding: IC/HMA+TKI vs TKI alone resulted in higher rates of complete remission (CR) or CR with incomplete count recovery (57.5% vs 33.9%), complete cytogenic response (45.0% vs 10.7%), major/deep molecular response (24.2% vs 4.3%;), and more patients proceeding to allogeneic stem cell transplant (32.5% vs 10.7%). In patients receiving the second/third generation TKIs, IC/HMA+TKI led to superior 5-year event-free survival (28% vs 0%) and reduced relapse (44% vs 86%) vs TKI alone (all P less than .05).

Study details: Findings are from a retrospective analysis of 104 patients with CML-MBP receiving frontline treatment based on 4 different approaches, i.e., IC+TKI (n=20), HMA+TKI (n=20), TKI alone (n=56), or IC alone (n=8), between 2000 and 2019.

Disclosures: This study was supported by MD Anderson Cancer Center Support Grant and SPORE. NJ Short reported ties with various pharmaceutical companies. Other authors declared no competing interests.

Source: Saxena K et al. J Hematol Oncol. 2021 Jun 15. doi: 10.1186/s13045-021-01106-1.

Key clinical point: Presence of non-breakpoint cluster region-Abelson murine leukemia viral oncogene homolog 1 (BCR-ABL1) mutations in patients with chronic myeloid leukemia (CML) was not associated with clinical outcomes.

Major finding: Non-BCR-ABL1 mutations were observed in 18% of patients with CML at diagnosis and were mostly cleared with TKI therapy, indicating an origin in the Philadelphia chromosome-positive clone. However, no difference was observed in overall survival, progression-free survival, failure-free survival, and adverse events between patients with vs without non-BCR-ABL1 mutations.

Study details: Findings are from next-generation sequencing analysis of BCR-ABL1 kinase domain and 18 myeloid neoplasm-associated genes in 49 patients with de novo chronic phase-CML and 6 healthy controls.

Disclosures: This study was supported by grants from the Ministry of Health of the Czech Republic, the Ministry of Education, and Bristol-Myers Squibb. D Zackova and J Mayer reported ties with various pharmaceutical companies including Bristol-Myers Squibb. Other authors declared no competing interests.

Source: Romzova M et al. Br J Haematol. 2021 Jul 1. doi: 10.1111/bjh.17659.

Key clinical point: Presence of non-breakpoint cluster region-Abelson murine leukemia viral oncogene homolog 1 (BCR-ABL1) mutations in patients with chronic myeloid leukemia (CML) was not associated with clinical outcomes.

Major finding: Non-BCR-ABL1 mutations were observed in 18% of patients with CML at diagnosis and were mostly cleared with TKI therapy, indicating an origin in the Philadelphia chromosome-positive clone. However, no difference was observed in overall survival, progression-free survival, failure-free survival, and adverse events between patients with vs without non-BCR-ABL1 mutations.

Study details: Findings are from next-generation sequencing analysis of BCR-ABL1 kinase domain and 18 myeloid neoplasm-associated genes in 49 patients with de novo chronic phase-CML and 6 healthy controls.

Disclosures: This study was supported by grants from the Ministry of Health of the Czech Republic, the Ministry of Education, and Bristol-Myers Squibb. D Zackova and J Mayer reported ties with various pharmaceutical companies including Bristol-Myers Squibb. Other authors declared no competing interests.

Source: Romzova M et al. Br J Haematol. 2021 Jul 1. doi: 10.1111/bjh.17659.

Key clinical point: Presence of non-breakpoint cluster region-Abelson murine leukemia viral oncogene homolog 1 (BCR-ABL1) mutations in patients with chronic myeloid leukemia (CML) was not associated with clinical outcomes.

Major finding: Non-BCR-ABL1 mutations were observed in 18% of patients with CML at diagnosis and were mostly cleared with TKI therapy, indicating an origin in the Philadelphia chromosome-positive clone. However, no difference was observed in overall survival, progression-free survival, failure-free survival, and adverse events between patients with vs without non-BCR-ABL1 mutations.

Study details: Findings are from next-generation sequencing analysis of BCR-ABL1 kinase domain and 18 myeloid neoplasm-associated genes in 49 patients with de novo chronic phase-CML and 6 healthy controls.

Disclosures: This study was supported by grants from the Ministry of Health of the Czech Republic, the Ministry of Education, and Bristol-Myers Squibb. D Zackova and J Mayer reported ties with various pharmaceutical companies including Bristol-Myers Squibb. Other authors declared no competing interests.

Source: Romzova M et al. Br J Haematol. 2021 Jul 1. doi: 10.1111/bjh.17659.

Key clinical point: Nilotinib treatment resulted in an early and stable clearance of CD34+/lin-Ph+ cells from the bone marrow of patients with newly diagnosed chronic-phase chronic myeloid leukemia (CML-CP).

Major finding: At 3, 6, and 12 months, only 12.3% (95% confidence interval [CI], 5.5%-22.8%), 7% (95% CI, 2.3%-15.7%), and 0% (95% CI, 0.0%-5.0%) samples, respectively, showed residual CD34+/lin-Ph+ cells, indicating rapid and sustained clearance of these cells from the bone marrow of treated patients.

Study details: Findings are from a prospective, single-arm, PhilosoPhi34 study including 87 adult patients with newly diagnosed Philadelphia chromosome-positive CML-CP treated with nilotinib 300 mg twice daily.

Disclosures: This study was partly supported by Novartis. The authors declared no conflicts of interest.

Source: Pungolino E et al. Eur J Haematol. 2021 Jun 17. doi: 10.1111/ejh.13680.

Key clinical point: Nilotinib treatment resulted in an early and stable clearance of CD34+/lin-Ph+ cells from the bone marrow of patients with newly diagnosed chronic-phase chronic myeloid leukemia (CML-CP).

Major finding: At 3, 6, and 12 months, only 12.3% (95% confidence interval [CI], 5.5%-22.8%), 7% (95% CI, 2.3%-15.7%), and 0% (95% CI, 0.0%-5.0%) samples, respectively, showed residual CD34+/lin-Ph+ cells, indicating rapid and sustained clearance of these cells from the bone marrow of treated patients.

Study details: Findings are from a prospective, single-arm, PhilosoPhi34 study including 87 adult patients with newly diagnosed Philadelphia chromosome-positive CML-CP treated with nilotinib 300 mg twice daily.

Disclosures: This study was partly supported by Novartis. The authors declared no conflicts of interest.

Source: Pungolino E et al. Eur J Haematol. 2021 Jun 17. doi: 10.1111/ejh.13680.

Key clinical point: Nilotinib treatment resulted in an early and stable clearance of CD34+/lin-Ph+ cells from the bone marrow of patients with newly diagnosed chronic-phase chronic myeloid leukemia (CML-CP).

Major finding: At 3, 6, and 12 months, only 12.3% (95% confidence interval [CI], 5.5%-22.8%), 7% (95% CI, 2.3%-15.7%), and 0% (95% CI, 0.0%-5.0%) samples, respectively, showed residual CD34+/lin-Ph+ cells, indicating rapid and sustained clearance of these cells from the bone marrow of treated patients.

Study details: Findings are from a prospective, single-arm, PhilosoPhi34 study including 87 adult patients with newly diagnosed Philadelphia chromosome-positive CML-CP treated with nilotinib 300 mg twice daily.

Disclosures: This study was partly supported by Novartis. The authors declared no conflicts of interest.

Source: Pungolino E et al. Eur J Haematol. 2021 Jun 17. doi: 10.1111/ejh.13680.

Key clinical point: Dasatinib dose optimization by therapeutic drug monitoring (TDM) during treatment initiation in patients with newly diagnosed chronic myeloid leukemia (CML) was feasible and led to a significant reduction in pleural effusion (PIEff) without affecting molecular responses.

Major finding: Reduced incidence of all-grade PlEff was observed in patients with high trough concentration [(C)min] who underwent dasatinib dose optimization by TDM (TDM arm; 13.2%) vs those who continued with standard dose (control arm; 42.8%) and those with low (C)min assigned to observation (observation arm; 17.4%; P = .006), with no major effect on major molecular response (P = .978) across the 3 arms.

Study details: Findings are from the phase 2 OPTIM-dasatinib study including 287 patients with newly diagnosed, previously untreated (except with hydroxycarbamide) CML. Patients were initially started on dasatinib 100 mg/day. After 7-10 days, patients with low (C)min were assigned to the observation arm (n=207) and those with high (C)min (3 nmol/L or higher) were randomly assigned to either TDM (n=38) or control (n=42) arms.

Disclosures: This study was funded by Bristol-Myers Squibb. The lead author reported research funding from Bristol-Myers Squibb, Pfizer, and Incyte.

Source: Rousselot P et al. Br J Haematol. 2021 Jun 30. doi: 10.1111/bjh.17654.

Key clinical point: Dasatinib dose optimization by therapeutic drug monitoring (TDM) during treatment initiation in patients with newly diagnosed chronic myeloid leukemia (CML) was feasible and led to a significant reduction in pleural effusion (PIEff) without affecting molecular responses.

Major finding: Reduced incidence of all-grade PlEff was observed in patients with high trough concentration [(C)min] who underwent dasatinib dose optimization by TDM (TDM arm; 13.2%) vs those who continued with standard dose (control arm; 42.8%) and those with low (C)min assigned to observation (observation arm; 17.4%; P = .006), with no major effect on major molecular response (P = .978) across the 3 arms.

Study details: Findings are from the phase 2 OPTIM-dasatinib study including 287 patients with newly diagnosed, previously untreated (except with hydroxycarbamide) CML. Patients were initially started on dasatinib 100 mg/day. After 7-10 days, patients with low (C)min were assigned to the observation arm (n=207) and those with high (C)min (3 nmol/L or higher) were randomly assigned to either TDM (n=38) or control (n=42) arms.

Disclosures: This study was funded by Bristol-Myers Squibb. The lead author reported research funding from Bristol-Myers Squibb, Pfizer, and Incyte.

Source: Rousselot P et al. Br J Haematol. 2021 Jun 30. doi: 10.1111/bjh.17654.

Key clinical point: Dasatinib dose optimization by therapeutic drug monitoring (TDM) during treatment initiation in patients with newly diagnosed chronic myeloid leukemia (CML) was feasible and led to a significant reduction in pleural effusion (PIEff) without affecting molecular responses.

Major finding: Reduced incidence of all-grade PlEff was observed in patients with high trough concentration [(C)min] who underwent dasatinib dose optimization by TDM (TDM arm; 13.2%) vs those who continued with standard dose (control arm; 42.8%) and those with low (C)min assigned to observation (observation arm; 17.4%; P = .006), with no major effect on major molecular response (P = .978) across the 3 arms.

Study details: Findings are from the phase 2 OPTIM-dasatinib study including 287 patients with newly diagnosed, previously untreated (except with hydroxycarbamide) CML. Patients were initially started on dasatinib 100 mg/day. After 7-10 days, patients with low (C)min were assigned to the observation arm (n=207) and those with high (C)min (3 nmol/L or higher) were randomly assigned to either TDM (n=38) or control (n=42) arms.

Disclosures: This study was funded by Bristol-Myers Squibb. The lead author reported research funding from Bristol-Myers Squibb, Pfizer, and Incyte.

Source: Rousselot P et al. Br J Haematol. 2021 Jun 30. doi: 10.1111/bjh.17654.

Key clinical point: Suboptimal responses to a single dose of Pfizer-BioNTech BNT162b2 or AstraZeneca ChAdOx1 nCoV-19 vaccines in patients with chronic myeloid neoplasms including chronic myeloid leukemia (CML) highlight a potentially important immunocompromise in this patient population.

Major finding: At 14 days after single vaccination dose, patients with chronic myeloid blood cancers vs health care workers above 60 years of age had significantly lower seroconversion (58% vs 97%) and median anti-S antibody titer (75 vs 630; both P less than .0001). Among disease subgroups, seroconversion was highest in patients with CML (75%) and observed in 83% of patients with CML receiving imatinib.

Study details: Findings are from a real-world analysis of 60 patients with myeloid cancers, including 12 patients with CML and no evidence of prior COVID-19 infection, who received a single dose of either BNT162b2 or ChAdOx1 nCoV-19 vaccines.

Disclosures: This study was funded by the National Institute of Health Research Oxford Biomedical Research Centre. The authors declared no conflicts of interest.

Source: Chowdhury O et al. Br J Haematol. 2021 Jun 16. doi: 10.1111/bjh.17644.

Key clinical point: Suboptimal responses to a single dose of Pfizer-BioNTech BNT162b2 or AstraZeneca ChAdOx1 nCoV-19 vaccines in patients with chronic myeloid neoplasms including chronic myeloid leukemia (CML) highlight a potentially important immunocompromise in this patient population.

Major finding: At 14 days after single vaccination dose, patients with chronic myeloid blood cancers vs health care workers above 60 years of age had significantly lower seroconversion (58% vs 97%) and median anti-S antibody titer (75 vs 630; both P less than .0001). Among disease subgroups, seroconversion was highest in patients with CML (75%) and observed in 83% of patients with CML receiving imatinib.

Study details: Findings are from a real-world analysis of 60 patients with myeloid cancers, including 12 patients with CML and no evidence of prior COVID-19 infection, who received a single dose of either BNT162b2 or ChAdOx1 nCoV-19 vaccines.

Disclosures: This study was funded by the National Institute of Health Research Oxford Biomedical Research Centre. The authors declared no conflicts of interest.

Source: Chowdhury O et al. Br J Haematol. 2021 Jun 16. doi: 10.1111/bjh.17644.

Key clinical point: Suboptimal responses to a single dose of Pfizer-BioNTech BNT162b2 or AstraZeneca ChAdOx1 nCoV-19 vaccines in patients with chronic myeloid neoplasms including chronic myeloid leukemia (CML) highlight a potentially important immunocompromise in this patient population.

Major finding: At 14 days after single vaccination dose, patients with chronic myeloid blood cancers vs health care workers above 60 years of age had significantly lower seroconversion (58% vs 97%) and median anti-S antibody titer (75 vs 630; both P less than .0001). Among disease subgroups, seroconversion was highest in patients with CML (75%) and observed in 83% of patients with CML receiving imatinib.

Study details: Findings are from a real-world analysis of 60 patients with myeloid cancers, including 12 patients with CML and no evidence of prior COVID-19 infection, who received a single dose of either BNT162b2 or ChAdOx1 nCoV-19 vaccines.

Disclosures: This study was funded by the National Institute of Health Research Oxford Biomedical Research Centre. The authors declared no conflicts of interest.

Source: Chowdhury O et al. Br J Haematol. 2021 Jun 16. doi: 10.1111/bjh.17644.

Key clinical point: Chemotherapy is not associated with postmastectomy breast reconstruction surgical complications or with most surgery-related patient-reported outcomes.

Major finding: Compared with no chemotherapy, no difference was observed in the risk for any/major complication with either neoadjuvant (P = .68 and .46, respectively) or adjuvant (P = .15 and .053, respectively) chemotherapy in patients who received implant-based procedures. In patients who received autologous reconstruction, the risk for 2-year postoperative any/major complication was similar with neoadjuvant (P = .25 and .11, respectively) and adjuvant (P = .44 and .40, respectively) chemotherapy vs no chemotherapy. There were no differences across the chemotherapy groups for most BREAST-Q subscales.

Study details: A multicenter cohort study of 1,881 women who underwent postmastectomy breast reconstruction and were followed up for 2 years.

Disclosures: This study was supported by the National Cancer Institute. The authors did not report any conflicts of interest.

Source: Hart SE et al. JAMA Surg. 2021 Jun 23. doi: 10.1001/jamasurg.2021.2239.

Key clinical point: Chemotherapy is not associated with postmastectomy breast reconstruction surgical complications or with most surgery-related patient-reported outcomes.

Major finding: Compared with no chemotherapy, no difference was observed in the risk for any/major complication with either neoadjuvant (P = .68 and .46, respectively) or adjuvant (P = .15 and .053, respectively) chemotherapy in patients who received implant-based procedures. In patients who received autologous reconstruction, the risk for 2-year postoperative any/major complication was similar with neoadjuvant (P = .25 and .11, respectively) and adjuvant (P = .44 and .40, respectively) chemotherapy vs no chemotherapy. There were no differences across the chemotherapy groups for most BREAST-Q subscales.

Study details: A multicenter cohort study of 1,881 women who underwent postmastectomy breast reconstruction and were followed up for 2 years.

Disclosures: This study was supported by the National Cancer Institute. The authors did not report any conflicts of interest.

Source: Hart SE et al. JAMA Surg. 2021 Jun 23. doi: 10.1001/jamasurg.2021.2239.

Key clinical point: Chemotherapy is not associated with postmastectomy breast reconstruction surgical complications or with most surgery-related patient-reported outcomes.

Major finding: Compared with no chemotherapy, no difference was observed in the risk for any/major complication with either neoadjuvant (P = .68 and .46, respectively) or adjuvant (P = .15 and .053, respectively) chemotherapy in patients who received implant-based procedures. In patients who received autologous reconstruction, the risk for 2-year postoperative any/major complication was similar with neoadjuvant (P = .25 and .11, respectively) and adjuvant (P = .44 and .40, respectively) chemotherapy vs no chemotherapy. There were no differences across the chemotherapy groups for most BREAST-Q subscales.

Study details: A multicenter cohort study of 1,881 women who underwent postmastectomy breast reconstruction and were followed up for 2 years.

Disclosures: This study was supported by the National Cancer Institute. The authors did not report any conflicts of interest.

Source: Hart SE et al. JAMA Surg. 2021 Jun 23. doi: 10.1001/jamasurg.2021.2239.

Key clinical point: In the real-world setting, the overall survival (OS) with pertuzumab and trastuzumab emtansine (T-DM1) in patients with human epidermal growth factor hormone receptor 2 (HER2)-positive metastatic breast cancer is inferior to results from pivotal clinical trials.

Major finding: The OS with pertuzumab and T-DM1 was shorter than that reported in the pivotal clinical trials. In the pertuzumab cohort, OS was 43 months and time on treatment was 14 months. In the T-DM1 cohort, median OS and time on treatment were 15 months and 4 months, respectively.

Study details: A population-based retrospective cohort study of patients with ERBB2-positive metastatic breast cancer treated with first-line pertuzumab (n=795) or second-line T-DM1 (n=506).

Disclosures: This study was supported by the Canadian Institutes of Health Research. The authors received personal fees from various sources outside this work. Dr. CM Booth was supported as a Canada Research Chair in Population Cancer Care.

Source: Ethier JL et al. JAMA Oncol. 2021 Jul 8. doi: 10.1001/jamaoncol.2021.2140.

Key clinical point: In the real-world setting, the overall survival (OS) with pertuzumab and trastuzumab emtansine (T-DM1) in patients with human epidermal growth factor hormone receptor 2 (HER2)-positive metastatic breast cancer is inferior to results from pivotal clinical trials.

Major finding: The OS with pertuzumab and T-DM1 was shorter than that reported in the pivotal clinical trials. In the pertuzumab cohort, OS was 43 months and time on treatment was 14 months. In the T-DM1 cohort, median OS and time on treatment were 15 months and 4 months, respectively.

Study details: A population-based retrospective cohort study of patients with ERBB2-positive metastatic breast cancer treated with first-line pertuzumab (n=795) or second-line T-DM1 (n=506).

Disclosures: This study was supported by the Canadian Institutes of Health Research. The authors received personal fees from various sources outside this work. Dr. CM Booth was supported as a Canada Research Chair in Population Cancer Care.

Source: Ethier JL et al. JAMA Oncol. 2021 Jul 8. doi: 10.1001/jamaoncol.2021.2140.

Key clinical point: In the real-world setting, the overall survival (OS) with pertuzumab and trastuzumab emtansine (T-DM1) in patients with human epidermal growth factor hormone receptor 2 (HER2)-positive metastatic breast cancer is inferior to results from pivotal clinical trials.

Major finding: The OS with pertuzumab and T-DM1 was shorter than that reported in the pivotal clinical trials. In the pertuzumab cohort, OS was 43 months and time on treatment was 14 months. In the T-DM1 cohort, median OS and time on treatment were 15 months and 4 months, respectively.

Study details: A population-based retrospective cohort study of patients with ERBB2-positive metastatic breast cancer treated with first-line pertuzumab (n=795) or second-line T-DM1 (n=506).

Disclosures: This study was supported by the Canadian Institutes of Health Research. The authors received personal fees from various sources outside this work. Dr. CM Booth was supported as a Canada Research Chair in Population Cancer Care.

Source: Ethier JL et al. JAMA Oncol. 2021 Jul 8. doi: 10.1001/jamaoncol.2021.2140.

Key clinical point: Stereotactic ablative body radiotherapy (SABR) leads to long-term systemic disease control and survival in patients with oligometastatic breast cancer.

Major finding: The median follow-up was 50 months. Of the patients who progressed, 82% had new metastases and 18% experienced local failure. Median overall survival (OS) was 86 months, and progression-free survival (PFS) was 33 months. The receipt of SABR within 5 years of diagnosis (P = .004) and presence of triple-negative breast cancer (TNBC; P = .013) were associated with worse OS. Advanced T stage (P = .062) and TNBC (P = .013) were associated with worse PFS.

Study details: A retrospective study of patients with metastatic breast cancer who received SABR between 2008 and 2018.

Disclosures: This study was supported by the National Institutes of Health/National Cancer Institute. The authors declared no conflicts of interest.

Source: Wijetunga NA et al. Cancer Med. 2021 Jun 22. doi: 10.1002/cam4.4068.

Key clinical point: Stereotactic ablative body radiotherapy (SABR) leads to long-term systemic disease control and survival in patients with oligometastatic breast cancer.

Major finding: The median follow-up was 50 months. Of the patients who progressed, 82% had new metastases and 18% experienced local failure. Median overall survival (OS) was 86 months, and progression-free survival (PFS) was 33 months. The receipt of SABR within 5 years of diagnosis (P = .004) and presence of triple-negative breast cancer (TNBC; P = .013) were associated with worse OS. Advanced T stage (P = .062) and TNBC (P = .013) were associated with worse PFS.

Study details: A retrospective study of patients with metastatic breast cancer who received SABR between 2008 and 2018.

Disclosures: This study was supported by the National Institutes of Health/National Cancer Institute. The authors declared no conflicts of interest.

Source: Wijetunga NA et al. Cancer Med. 2021 Jun 22. doi: 10.1002/cam4.4068.

Key clinical point: Stereotactic ablative body radiotherapy (SABR) leads to long-term systemic disease control and survival in patients with oligometastatic breast cancer.

Major finding: The median follow-up was 50 months. Of the patients who progressed, 82% had new metastases and 18% experienced local failure. Median overall survival (OS) was 86 months, and progression-free survival (PFS) was 33 months. The receipt of SABR within 5 years of diagnosis (P = .004) and presence of triple-negative breast cancer (TNBC; P = .013) were associated with worse OS. Advanced T stage (P = .062) and TNBC (P = .013) were associated with worse PFS.

Study details: A retrospective study of patients with metastatic breast cancer who received SABR between 2008 and 2018.

Disclosures: This study was supported by the National Institutes of Health/National Cancer Institute. The authors declared no conflicts of interest.

Source: Wijetunga NA et al. Cancer Med. 2021 Jun 22. doi: 10.1002/cam4.4068.