Harold J. Burstein, MD, PhD

Dr Harold J. Burstein, of the Dana-Farber Cancer Institute in Boston, Massachusetts, highlights key abstracts on early breast cancer from the 2023 American Society of Clinical Oncology (ASCO) annual meeting. 

Dr Burstein first reports on exciting results from the phase 3 NATALEE trial, which compared adjuvant use of CDK4/6 inhibitor ribociclib plus endocrine therapy (ET) vs ET alone in patients with HR+/HER2- early breast cancer and found that the combination lowered risk for recurrence.  

The results of NATALEE, together with the recent findings of the monarchE trial, provide strong evidence that the addition of a CDK4/6 inhibitor to ET is useful in the adjuvant setting. Dr Burstein suggests that these findings may point to an emerging treatment paradigm in HR+/HER2- patients, particularly those with higher-risk breast cancers. 

Dr Burstein next discusses important data from the Early Breast Cancer Trialists Collaborative Group (EBCTCG). Their meta-analysis of 25 randomized trials on ovarian ablation in premenopausal women showed that ovarian ablation provided a substantial reduction in 15-year risk for recurrence and death. 

Finally, Dr Burstein reports on data from an analysis of patients enrolled in the PENELOPE-B trial to assess the value of circulating tumor DNA (ctDNA) in predicting clinical relapse. Dr Burstein reports that the results indicated that ctDNA was a strong prognostic factor for disease recurrence. 

--

Harold J. Burstein, MD, PhD, Professor, Department of Medicine, Harvard Medical School; Institute Physician, Dana-Farber Cancer Institute, Boston, Massachusetts 

Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships. 

Dr Harold J. Burstein, of the Dana-Farber Cancer Institute in Boston, Massachusetts, highlights key abstracts on early breast cancer from the 2023 American Society of Clinical Oncology (ASCO) annual meeting. 

Dr Burstein first reports on exciting results from the phase 3 NATALEE trial, which compared adjuvant use of CDK4/6 inhibitor ribociclib plus endocrine therapy (ET) vs ET alone in patients with HR+/HER2- early breast cancer and found that the combination lowered risk for recurrence.  

The results of NATALEE, together with the recent findings of the monarchE trial, provide strong evidence that the addition of a CDK4/6 inhibitor to ET is useful in the adjuvant setting. Dr Burstein suggests that these findings may point to an emerging treatment paradigm in HR+/HER2- patients, particularly those with higher-risk breast cancers. 

Dr Burstein next discusses important data from the Early Breast Cancer Trialists Collaborative Group (EBCTCG). Their meta-analysis of 25 randomized trials on ovarian ablation in premenopausal women showed that ovarian ablation provided a substantial reduction in 15-year risk for recurrence and death. 

Finally, Dr Burstein reports on data from an analysis of patients enrolled in the PENELOPE-B trial to assess the value of circulating tumor DNA (ctDNA) in predicting clinical relapse. Dr Burstein reports that the results indicated that ctDNA was a strong prognostic factor for disease recurrence. 

--

Harold J. Burstein, MD, PhD, Professor, Department of Medicine, Harvard Medical School; Institute Physician, Dana-Farber Cancer Institute, Boston, Massachusetts 

Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships. 

Dr Harold J. Burstein, of the Dana-Farber Cancer Institute in Boston, Massachusetts, highlights key abstracts on early breast cancer from the 2023 American Society of Clinical Oncology (ASCO) annual meeting. 

Dr Burstein first reports on exciting results from the phase 3 NATALEE trial, which compared adjuvant use of CDK4/6 inhibitor ribociclib plus endocrine therapy (ET) vs ET alone in patients with HR+/HER2- early breast cancer and found that the combination lowered risk for recurrence.  

The results of NATALEE, together with the recent findings of the monarchE trial, provide strong evidence that the addition of a CDK4/6 inhibitor to ET is useful in the adjuvant setting. Dr Burstein suggests that these findings may point to an emerging treatment paradigm in HR+/HER2- patients, particularly those with higher-risk breast cancers. 

Dr Burstein next discusses important data from the Early Breast Cancer Trialists Collaborative Group (EBCTCG). Their meta-analysis of 25 randomized trials on ovarian ablation in premenopausal women showed that ovarian ablation provided a substantial reduction in 15-year risk for recurrence and death. 

Finally, Dr Burstein reports on data from an analysis of patients enrolled in the PENELOPE-B trial to assess the value of circulating tumor DNA (ctDNA) in predicting clinical relapse. Dr Burstein reports that the results indicated that ctDNA was a strong prognostic factor for disease recurrence. 

--

Harold J. Burstein, MD, PhD, Professor, Department of Medicine, Harvard Medical School; Institute Physician, Dana-Farber Cancer Institute, Boston, Massachusetts 

Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships. 

Dr Harold Burstein, of the Dana-Farber Cancer Institute in Boston, Massachusetts, reports on studies in HR+/HER2- breast cancer presented at the 2022 San Antonio Breast Cancer Symposium. 

Dr Burstein reports on the phase 2 RIGHT Choice study, which is the first head-to-head comparison of endocrine therapy plus a CDK4/6 inhibitor vs chemotherapy for stage IV breast cancer. The results indicate that frontline therapy using the combination is superior to chemotherapy.  

Dr Burstein next comments on the phase 3 CAPItello-291 trial, which looked at a new AKT inhibitor, capivasertib. The study compared capivasertib plus fulvestrant vs fulvestrant alone and found that the combination provided meaningful improvements in progression-free survival. He then reports on the phase 2 SERENA-2 trial, which compared fulvestrant with camizestrant, an oral selective estrogen receptor degrader, in the second-line setting. The study showed that camizestrant was superior to fulvestrant.  

An update of the phase 3 monarchE trial showed an increasing benefit from adding abemaciclib to endocrine therapy in the adjuvant setting, regardless of the Ki-67 index. 

In closing, Dr Burstein discusses the POSITIVE trial, which indicated that endocrine therapy can be safely interrupted in women whose breast cancer is in remission and who are pursuing pregnancy.  

--

Harold J. Burstein, MD, PhD, Professor, Department of Medicine, Harvard Medical School; Medical Oncologist, Dana-Farber Cancer Institute, Boston, Massachusetts 

Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships. 

Dr Harold Burstein, of the Dana-Farber Cancer Institute in Boston, Massachusetts, reports on studies in HR+/HER2- breast cancer presented at the 2022 San Antonio Breast Cancer Symposium. 

Dr Burstein reports on the phase 2 RIGHT Choice study, which is the first head-to-head comparison of endocrine therapy plus a CDK4/6 inhibitor vs chemotherapy for stage IV breast cancer. The results indicate that frontline therapy using the combination is superior to chemotherapy.  

Dr Burstein next comments on the phase 3 CAPItello-291 trial, which looked at a new AKT inhibitor, capivasertib. The study compared capivasertib plus fulvestrant vs fulvestrant alone and found that the combination provided meaningful improvements in progression-free survival. He then reports on the phase 2 SERENA-2 trial, which compared fulvestrant with camizestrant, an oral selective estrogen receptor degrader, in the second-line setting. The study showed that camizestrant was superior to fulvestrant.  

An update of the phase 3 monarchE trial showed an increasing benefit from adding abemaciclib to endocrine therapy in the adjuvant setting, regardless of the Ki-67 index. 

In closing, Dr Burstein discusses the POSITIVE trial, which indicated that endocrine therapy can be safely interrupted in women whose breast cancer is in remission and who are pursuing pregnancy.  

--

Harold J. Burstein, MD, PhD, Professor, Department of Medicine, Harvard Medical School; Medical Oncologist, Dana-Farber Cancer Institute, Boston, Massachusetts 

Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships. 

Dr Harold Burstein, of the Dana-Farber Cancer Institute in Boston, Massachusetts, reports on studies in HR+/HER2- breast cancer presented at the 2022 San Antonio Breast Cancer Symposium. 

Dr Burstein reports on the phase 2 RIGHT Choice study, which is the first head-to-head comparison of endocrine therapy plus a CDK4/6 inhibitor vs chemotherapy for stage IV breast cancer. The results indicate that frontline therapy using the combination is superior to chemotherapy.  

Dr Burstein next comments on the phase 3 CAPItello-291 trial, which looked at a new AKT inhibitor, capivasertib. The study compared capivasertib plus fulvestrant vs fulvestrant alone and found that the combination provided meaningful improvements in progression-free survival. He then reports on the phase 2 SERENA-2 trial, which compared fulvestrant with camizestrant, an oral selective estrogen receptor degrader, in the second-line setting. The study showed that camizestrant was superior to fulvestrant.  

An update of the phase 3 monarchE trial showed an increasing benefit from adding abemaciclib to endocrine therapy in the adjuvant setting, regardless of the Ki-67 index. 

In closing, Dr Burstein discusses the POSITIVE trial, which indicated that endocrine therapy can be safely interrupted in women whose breast cancer is in remission and who are pursuing pregnancy.  

--

Harold J. Burstein, MD, PhD, Professor, Department of Medicine, Harvard Medical School; Medical Oncologist, Dana-Farber Cancer Institute, Boston, Massachusetts 

Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships. 

Dr Harold J. Burstein, from the Dana-Farber Cancer Institute in Boston, Massachusetts, reports on important abstracts in the management of metastatic breast cancer from the 2022 American Society of Clinical Oncology (ASCO) annual meeting. 

Dr Burstein first highlights results from the NRG-BR002 trial, a randomized phase 2 study comparing standard therapy vs standard therapy in combination with focal stereotactic radiation treatment for oligometastatic disease in up to four sites. Investigators reported no impact on progression-free or overall survival.  

Exciting results from the DESTINY-Breast04 trial were a "showstopper," according to Dr Burstein. Investigators reported prolonged progression-free survival and overall survival in patients with HER2-low unresectable and/or metastatic disease with the use of the antibody-drug conjugate trastuzumab deruxtecan compared with physicians' choice of standard single-agent chemotherapy, advancing a new treatment option for the large subset of patients with HER2-low disease. 

Next, Dr Burstein discusses results from the TROPiCS-02 trial, which compared another antibody-drug conjugate, sacituzumab govitecan, with standard chemotherapy in patients with ER+/HER- breast cancer. A statistically significant benefit was reported, although the progression-free survival at just 6 weeks was relatively modest. 

Finally, Dr Burstein reports on interesting data from the MAINTAIN study, a phase 2 randomized trial looking at maintenance CDK4/6 inhibition after progression on initial treatment. Results suggest that switching endocrine therapy and continuing treatment with CDK4/6 inhibitor ribociclib beyond progression may be of clinical value to patients.

--

Harold J. Burstein, MD, PhD, Professor, Department of Medicine, Harvard Medical School; Medical Oncologist, Dana-Farber Cancer Institute, Brigham & Women's Hospital, Boston, Massachusetts 

Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships. 

Dr Harold J. Burstein, from the Dana-Farber Cancer Institute in Boston, Massachusetts, reports on important abstracts in the management of metastatic breast cancer from the 2022 American Society of Clinical Oncology (ASCO) annual meeting. 

Dr Burstein first highlights results from the NRG-BR002 trial, a randomized phase 2 study comparing standard therapy vs standard therapy in combination with focal stereotactic radiation treatment for oligometastatic disease in up to four sites. Investigators reported no impact on progression-free or overall survival.  

Exciting results from the DESTINY-Breast04 trial were a "showstopper," according to Dr Burstein. Investigators reported prolonged progression-free survival and overall survival in patients with HER2-low unresectable and/or metastatic disease with the use of the antibody-drug conjugate trastuzumab deruxtecan compared with physicians' choice of standard single-agent chemotherapy, advancing a new treatment option for the large subset of patients with HER2-low disease. 

Next, Dr Burstein discusses results from the TROPiCS-02 trial, which compared another antibody-drug conjugate, sacituzumab govitecan, with standard chemotherapy in patients with ER+/HER- breast cancer. A statistically significant benefit was reported, although the progression-free survival at just 6 weeks was relatively modest. 

Finally, Dr Burstein reports on interesting data from the MAINTAIN study, a phase 2 randomized trial looking at maintenance CDK4/6 inhibition after progression on initial treatment. Results suggest that switching endocrine therapy and continuing treatment with CDK4/6 inhibitor ribociclib beyond progression may be of clinical value to patients.

--

Harold J. Burstein, MD, PhD, Professor, Department of Medicine, Harvard Medical School; Medical Oncologist, Dana-Farber Cancer Institute, Brigham & Women's Hospital, Boston, Massachusetts 

Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships. 

Dr Harold J. Burstein, from the Dana-Farber Cancer Institute in Boston, Massachusetts, reports on important abstracts in the management of metastatic breast cancer from the 2022 American Society of Clinical Oncology (ASCO) annual meeting. 

Dr Burstein first highlights results from the NRG-BR002 trial, a randomized phase 2 study comparing standard therapy vs standard therapy in combination with focal stereotactic radiation treatment for oligometastatic disease in up to four sites. Investigators reported no impact on progression-free or overall survival.  

Exciting results from the DESTINY-Breast04 trial were a "showstopper," according to Dr Burstein. Investigators reported prolonged progression-free survival and overall survival in patients with HER2-low unresectable and/or metastatic disease with the use of the antibody-drug conjugate trastuzumab deruxtecan compared with physicians' choice of standard single-agent chemotherapy, advancing a new treatment option for the large subset of patients with HER2-low disease. 

Next, Dr Burstein discusses results from the TROPiCS-02 trial, which compared another antibody-drug conjugate, sacituzumab govitecan, with standard chemotherapy in patients with ER+/HER- breast cancer. A statistically significant benefit was reported, although the progression-free survival at just 6 weeks was relatively modest. 

Finally, Dr Burstein reports on interesting data from the MAINTAIN study, a phase 2 randomized trial looking at maintenance CDK4/6 inhibition after progression on initial treatment. Results suggest that switching endocrine therapy and continuing treatment with CDK4/6 inhibitor ribociclib beyond progression may be of clinical value to patients.

--

Harold J. Burstein, MD, PhD, Professor, Department of Medicine, Harvard Medical School; Medical Oncologist, Dana-Farber Cancer Institute, Brigham & Women's Hospital, Boston, Massachusetts 

Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships. 

Dr. Harold Burstein, breast cancer specialist from Dana-Farber Cancer Institute, discusses practice-changing research and advances in early-stage breast cancer from the 2021 American Society of Clinical Oncology Annual Meeting.

He first reports on OlympiA, a phase 3 trial of adjuvant olaparib after neoadjuvant chemotherapy in patients with BRCA1/2 mutations and high-risk HR+/HER2- disease. The results showed a substantial invasive and distant disease-free survival benefit and underscored the need for genetic testing for BRCA mutations in patients with early-stage disease.

Next, he discusses two studies in triple-negative breast cancer. EA1131 was a phase 3 postoperative trial of platinum-based chemotherapy vs capecitabine in patients with residual disease after neoadjuvant chemotherapy. The negative results suggested that additional chemotherapy does not improve outcomes.

In contrast, adding durvalumab to neoadjuvant chemotherapy significantly improved outcomes in GeparNuevo, calling into question whether the drug is needed in the later adjuvant setting.

Next, Dr. Burstein looks at the ADAPT-HR-/HER2+ trial of de-escalated neoadjuvant pertuzumab plus trastuzumab, which suggested that patients with early pathologic complete responses may be suitable for further de-escalation.

Finally, he reports on a retrospective analysis of more than 330,000 US individuals that puts the well-known financial toxicity associated with cancer care into numbers and shows the impact on people’s lives beyond their diagnosis.

--

Professor, Department of Medicine, Harvard Medical School

Institute Physician, Dana-Farber Cancer Institute, Boston, Massachusetts

Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships.

Dr. Harold Burstein, breast cancer specialist from Dana-Farber Cancer Institute, discusses practice-changing research and advances in early-stage breast cancer from the 2021 American Society of Clinical Oncology Annual Meeting.

He first reports on OlympiA, a phase 3 trial of adjuvant olaparib after neoadjuvant chemotherapy in patients with BRCA1/2 mutations and high-risk HR+/HER2- disease. The results showed a substantial invasive and distant disease-free survival benefit and underscored the need for genetic testing for BRCA mutations in patients with early-stage disease.

Next, he discusses two studies in triple-negative breast cancer. EA1131 was a phase 3 postoperative trial of platinum-based chemotherapy vs capecitabine in patients with residual disease after neoadjuvant chemotherapy. The negative results suggested that additional chemotherapy does not improve outcomes.

In contrast, adding durvalumab to neoadjuvant chemotherapy significantly improved outcomes in GeparNuevo, calling into question whether the drug is needed in the later adjuvant setting.

Next, Dr. Burstein looks at the ADAPT-HR-/HER2+ trial of de-escalated neoadjuvant pertuzumab plus trastuzumab, which suggested that patients with early pathologic complete responses may be suitable for further de-escalation.

Finally, he reports on a retrospective analysis of more than 330,000 US individuals that puts the well-known financial toxicity associated with cancer care into numbers and shows the impact on people’s lives beyond their diagnosis.

--

Professor, Department of Medicine, Harvard Medical School

Institute Physician, Dana-Farber Cancer Institute, Boston, Massachusetts

Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships.

Dr. Harold Burstein, breast cancer specialist from Dana-Farber Cancer Institute, discusses practice-changing research and advances in early-stage breast cancer from the 2021 American Society of Clinical Oncology Annual Meeting.

He first reports on OlympiA, a phase 3 trial of adjuvant olaparib after neoadjuvant chemotherapy in patients with BRCA1/2 mutations and high-risk HR+/HER2- disease. The results showed a substantial invasive and distant disease-free survival benefit and underscored the need for genetic testing for BRCA mutations in patients with early-stage disease.

Next, he discusses two studies in triple-negative breast cancer. EA1131 was a phase 3 postoperative trial of platinum-based chemotherapy vs capecitabine in patients with residual disease after neoadjuvant chemotherapy. The negative results suggested that additional chemotherapy does not improve outcomes.

In contrast, adding durvalumab to neoadjuvant chemotherapy significantly improved outcomes in GeparNuevo, calling into question whether the drug is needed in the later adjuvant setting.

Next, Dr. Burstein looks at the ADAPT-HR-/HER2+ trial of de-escalated neoadjuvant pertuzumab plus trastuzumab, which suggested that patients with early pathologic complete responses may be suitable for further de-escalation.

Finally, he reports on a retrospective analysis of more than 330,000 US individuals that puts the well-known financial toxicity associated with cancer care into numbers and shows the impact on people’s lives beyond their diagnosis.

--

Professor, Department of Medicine, Harvard Medical School

Institute Physician, Dana-Farber Cancer Institute, Boston, Massachusetts

Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships.