Breast Cancer ICYMI

Key clinical point: In clinically fit older women with breast cancer (BC), high interleukin-6 (IL-6) and C-reactive protein (CRP) levels before chemotherapy treatment may predict chemotherapy-induced deterioration in frailty status.

Major finding: Overall, 25.8% of patients experienced a decline in frailty status due to chemotherapy. Higher vs lower prechemotherapy levels of both IL-6 and CRP were associated with increased odds of decline in frailty status (odds ratio 3.52; P = .003).

Study details: Findings are from a prospective study, The Hurria Older Patients with BC Study, including 295 robust women with stage I-III BC who received chemotherapy.

Disclosures: This study was supported by the National Institute on Aging and other sources. Three authors declared receiving research funding or royalties, owning patents, or holding stock options in pharmaceutical companies. The other authors declared no conflicts of interest.

Source: Ji J, Sun C-L, et al. Inflammation and clinical decline after adjuvant chemotherapy in older adults with breast cancer: Results from The Hurria Older Patients prospective study. J Clin Oncol. 2022 (Sep 20). Doi: 10.1200/JCO.22.01217

Key clinical point: In clinically fit older women with breast cancer (BC), high interleukin-6 (IL-6) and C-reactive protein (CRP) levels before chemotherapy treatment may predict chemotherapy-induced deterioration in frailty status.

Major finding: Overall, 25.8% of patients experienced a decline in frailty status due to chemotherapy. Higher vs lower prechemotherapy levels of both IL-6 and CRP were associated with increased odds of decline in frailty status (odds ratio 3.52; P = .003).

Study details: Findings are from a prospective study, The Hurria Older Patients with BC Study, including 295 robust women with stage I-III BC who received chemotherapy.

Disclosures: This study was supported by the National Institute on Aging and other sources. Three authors declared receiving research funding or royalties, owning patents, or holding stock options in pharmaceutical companies. The other authors declared no conflicts of interest.

Source: Ji J, Sun C-L, et al. Inflammation and clinical decline after adjuvant chemotherapy in older adults with breast cancer: Results from The Hurria Older Patients prospective study. J Clin Oncol. 2022 (Sep 20). Doi: 10.1200/JCO.22.01217

Key clinical point: In clinically fit older women with breast cancer (BC), high interleukin-6 (IL-6) and C-reactive protein (CRP) levels before chemotherapy treatment may predict chemotherapy-induced deterioration in frailty status.

Major finding: Overall, 25.8% of patients experienced a decline in frailty status due to chemotherapy. Higher vs lower prechemotherapy levels of both IL-6 and CRP were associated with increased odds of decline in frailty status (odds ratio 3.52; P = .003).

Study details: Findings are from a prospective study, The Hurria Older Patients with BC Study, including 295 robust women with stage I-III BC who received chemotherapy.

Disclosures: This study was supported by the National Institute on Aging and other sources. Three authors declared receiving research funding or royalties, owning patents, or holding stock options in pharmaceutical companies. The other authors declared no conflicts of interest.

Source: Ji J, Sun C-L, et al. Inflammation and clinical decline after adjuvant chemotherapy in older adults with breast cancer: Results from The Hurria Older Patients prospective study. J Clin Oncol. 2022 (Sep 20). Doi: 10.1200/JCO.22.01217

Key clinical point: A considerable number of patients with breast cancer (BC) who received sedative-hypnotic medications during adjuvant chemotherapy turned into new, persistent users of those medications even after chemotherapy.

Major finding: Overall, a substantial proportion of benzodiazepine-naive (15.6%)/Z-drug (zolpidem, zaleplon, and eszopiclone, the active stereoisomer of zopiclone)-naive (27.3%) patients who filled ≥1 prescription of benzodiazepine/Z-drug became persistent users. A shorter duration (<4 months) of chemotherapy and receipt of opioid prescriptions during chemotherapy were associated with new persistent sedative-hypnotic use in both benzodiazepine-naive and Z-drug-naive patients (both P ≤ .01).

Study details: Findings are from a study including patients with BC who were naive to benzodiazepine (n = 22,039) or Z-drug (n = 23,816) and received adjuvant chemotherapy.

Disclosures: This work was supported by the Breast Cancer Research Foundation and American Cancer Society. JD Wright declared receiving research support and royalties from some sources.

Source: Cogan JC et al. New and persistent sedative-hypnotic use after adjuvant chemotherapy for breast cancer. J Natl Cancer Inst. 2022 (Sep 20). Doi: 10.1093/jnci/djac170

Key clinical point: A considerable number of patients with breast cancer (BC) who received sedative-hypnotic medications during adjuvant chemotherapy turned into new, persistent users of those medications even after chemotherapy.

Major finding: Overall, a substantial proportion of benzodiazepine-naive (15.6%)/Z-drug (zolpidem, zaleplon, and eszopiclone, the active stereoisomer of zopiclone)-naive (27.3%) patients who filled ≥1 prescription of benzodiazepine/Z-drug became persistent users. A shorter duration (<4 months) of chemotherapy and receipt of opioid prescriptions during chemotherapy were associated with new persistent sedative-hypnotic use in both benzodiazepine-naive and Z-drug-naive patients (both P ≤ .01).

Study details: Findings are from a study including patients with BC who were naive to benzodiazepine (n = 22,039) or Z-drug (n = 23,816) and received adjuvant chemotherapy.

Disclosures: This work was supported by the Breast Cancer Research Foundation and American Cancer Society. JD Wright declared receiving research support and royalties from some sources.

Source: Cogan JC et al. New and persistent sedative-hypnotic use after adjuvant chemotherapy for breast cancer. J Natl Cancer Inst. 2022 (Sep 20). Doi: 10.1093/jnci/djac170

Key clinical point: A considerable number of patients with breast cancer (BC) who received sedative-hypnotic medications during adjuvant chemotherapy turned into new, persistent users of those medications even after chemotherapy.

Major finding: Overall, a substantial proportion of benzodiazepine-naive (15.6%)/Z-drug (zolpidem, zaleplon, and eszopiclone, the active stereoisomer of zopiclone)-naive (27.3%) patients who filled ≥1 prescription of benzodiazepine/Z-drug became persistent users. A shorter duration (<4 months) of chemotherapy and receipt of opioid prescriptions during chemotherapy were associated with new persistent sedative-hypnotic use in both benzodiazepine-naive and Z-drug-naive patients (both P ≤ .01).

Study details: Findings are from a study including patients with BC who were naive to benzodiazepine (n = 22,039) or Z-drug (n = 23,816) and received adjuvant chemotherapy.

Disclosures: This work was supported by the Breast Cancer Research Foundation and American Cancer Society. JD Wright declared receiving research support and royalties from some sources.

Source: Cogan JC et al. New and persistent sedative-hypnotic use after adjuvant chemotherapy for breast cancer. J Natl Cancer Inst. 2022 (Sep 20). Doi: 10.1093/jnci/djac170

Key clinical point: One of the key factors influencing contraceptive use in premenopausal women with early breast cancer (BC) is the use of contraception at the time of diagnosis.

Major finding: At diagnosis, 54.2% of patients reported using contraceptives, mostly hormonal (62.7%); however, the use of contraception decreased significantly to 38.9% and 41.2% at the first and second year, respectively (P < .001). The use of contraception at diagnosis was associated with higher odds of contraceptive use at years 1 (adjusted odds ratio [aOR] 4.02; 95% CI 3.15-5.14) and 2 (aOR 3.12; 95% CI 2.36-4.14) after diagnosis.

Study details: Findings are from an analysis of the prospective, Cancer Toxicity (CANTO) study including 2900 premenopausal women with early BC.

Disclosures: The CANTO study is supported by the Investment for the Future program of the National Research Agency of France. The authors declared serving as advisors, owning stocks, or receiving grants, personal fees, or royalties from several sources.

Source: Lambertini M et al. Contraceptive use in premenopausal women with early breast cancer. JAMA Netw Open. 2022;5(9):e2233137 (Sep 23). Doi: 10.1001/jamanetworkopen.2022.33137

Key clinical point: One of the key factors influencing contraceptive use in premenopausal women with early breast cancer (BC) is the use of contraception at the time of diagnosis.

Major finding: At diagnosis, 54.2% of patients reported using contraceptives, mostly hormonal (62.7%); however, the use of contraception decreased significantly to 38.9% and 41.2% at the first and second year, respectively (P < .001). The use of contraception at diagnosis was associated with higher odds of contraceptive use at years 1 (adjusted odds ratio [aOR] 4.02; 95% CI 3.15-5.14) and 2 (aOR 3.12; 95% CI 2.36-4.14) after diagnosis.

Study details: Findings are from an analysis of the prospective, Cancer Toxicity (CANTO) study including 2900 premenopausal women with early BC.

Disclosures: The CANTO study is supported by the Investment for the Future program of the National Research Agency of France. The authors declared serving as advisors, owning stocks, or receiving grants, personal fees, or royalties from several sources.

Source: Lambertini M et al. Contraceptive use in premenopausal women with early breast cancer. JAMA Netw Open. 2022;5(9):e2233137 (Sep 23). Doi: 10.1001/jamanetworkopen.2022.33137

Key clinical point: One of the key factors influencing contraceptive use in premenopausal women with early breast cancer (BC) is the use of contraception at the time of diagnosis.

Major finding: At diagnosis, 54.2% of patients reported using contraceptives, mostly hormonal (62.7%); however, the use of contraception decreased significantly to 38.9% and 41.2% at the first and second year, respectively (P < .001). The use of contraception at diagnosis was associated with higher odds of contraceptive use at years 1 (adjusted odds ratio [aOR] 4.02; 95% CI 3.15-5.14) and 2 (aOR 3.12; 95% CI 2.36-4.14) after diagnosis.

Study details: Findings are from an analysis of the prospective, Cancer Toxicity (CANTO) study including 2900 premenopausal women with early BC.

Disclosures: The CANTO study is supported by the Investment for the Future program of the National Research Agency of France. The authors declared serving as advisors, owning stocks, or receiving grants, personal fees, or royalties from several sources.

Source: Lambertini M et al. Contraceptive use in premenopausal women with early breast cancer. JAMA Netw Open. 2022;5(9):e2233137 (Sep 23). Doi: 10.1001/jamanetworkopen.2022.33137

Key clinical point: Male patients who survived breast cancer (BC) were more likely to develop second primary cancers (SPC), such as colorectal, pancreatic, and thyroid cancers.

Major finding: Standardized incidence ratio (SIR) of any SPC was estimated to be 1.27 (95% CI 1.03-1.56), with the risk being elevated in the case of a second primary colorectal cancer (SIR 1.29; 95% CI 1.03-1.61), pancreatic cancer (SIR 1.64; 95% CI 1.05-2.55), and thyroid cancer (SIR 5.58; 95% CI 1.04-30.05).

Study details: Findings are from a meta-analysis of eight retrospective cohort studies including male BC survivors.

Disclosures: This study was funded by the Cancer Research UK Catalyst Award CanGene-CanVar. The authors declared no conflicts of interest.

Source: Allen I et al. Risk of developing a second primary cancer in male breast cancer survivors: A systematic review and meta-analysis. Br J Cancer. 2022;127:1660–1669 (Sep 17). Doi: 10.1038/s41416-022-01940-1

Key clinical point: Male patients who survived breast cancer (BC) were more likely to develop second primary cancers (SPC), such as colorectal, pancreatic, and thyroid cancers.

Major finding: Standardized incidence ratio (SIR) of any SPC was estimated to be 1.27 (95% CI 1.03-1.56), with the risk being elevated in the case of a second primary colorectal cancer (SIR 1.29; 95% CI 1.03-1.61), pancreatic cancer (SIR 1.64; 95% CI 1.05-2.55), and thyroid cancer (SIR 5.58; 95% CI 1.04-30.05).

Study details: Findings are from a meta-analysis of eight retrospective cohort studies including male BC survivors.

Disclosures: This study was funded by the Cancer Research UK Catalyst Award CanGene-CanVar. The authors declared no conflicts of interest.

Source: Allen I et al. Risk of developing a second primary cancer in male breast cancer survivors: A systematic review and meta-analysis. Br J Cancer. 2022;127:1660–1669 (Sep 17). Doi: 10.1038/s41416-022-01940-1

Key clinical point: Male patients who survived breast cancer (BC) were more likely to develop second primary cancers (SPC), such as colorectal, pancreatic, and thyroid cancers.

Major finding: Standardized incidence ratio (SIR) of any SPC was estimated to be 1.27 (95% CI 1.03-1.56), with the risk being elevated in the case of a second primary colorectal cancer (SIR 1.29; 95% CI 1.03-1.61), pancreatic cancer (SIR 1.64; 95% CI 1.05-2.55), and thyroid cancer (SIR 5.58; 95% CI 1.04-30.05).

Study details: Findings are from a meta-analysis of eight retrospective cohort studies including male BC survivors.

Disclosures: This study was funded by the Cancer Research UK Catalyst Award CanGene-CanVar. The authors declared no conflicts of interest.

Source: Allen I et al. Risk of developing a second primary cancer in male breast cancer survivors: A systematic review and meta-analysis. Br J Cancer. 2022;127:1660–1669 (Sep 17). Doi: 10.1038/s41416-022-01940-1

Key clinical point: Endocrine therapy (ET) improved survival outcomes in all patients with small pT1a-b, estrogen receptor-positive (ER+) breast cancer (BC), especially in patients with grade 2-3 tumors.

Major finding: No adjuvant ET vs adjuvant ET was associated with decreased disease-free survival (DFS) in the overall cohort of patients with pT1a-bN0 ER+ BC (hazard ratio [HR] 1.275; P = .047) and in those with grade 2-3 tumors (HR 1.502; P = .049); however, ET did not affect DFS outcomes in grade 1 pT1a-bN0 ER+ BC.

Study details: Findings are from a retrospective, observational study including 5545 patients with pT1a-b ER+ BC, of which the majority (80.3%) received adjuvant ET.

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

Source: Houvenaeghel G et al. Contribution of endocrine therapy in oestrogen receptor-positive pT1a-b breast cancer: Results of a retrospective study. Eur J Cancer. 2022;176:58-69 (Oct 1). Doi: 10.1016/j.ejca.2022.08.027

Key clinical point: Endocrine therapy (ET) improved survival outcomes in all patients with small pT1a-b, estrogen receptor-positive (ER+) breast cancer (BC), especially in patients with grade 2-3 tumors.

Major finding: No adjuvant ET vs adjuvant ET was associated with decreased disease-free survival (DFS) in the overall cohort of patients with pT1a-bN0 ER+ BC (hazard ratio [HR] 1.275; P = .047) and in those with grade 2-3 tumors (HR 1.502; P = .049); however, ET did not affect DFS outcomes in grade 1 pT1a-bN0 ER+ BC.

Study details: Findings are from a retrospective, observational study including 5545 patients with pT1a-b ER+ BC, of which the majority (80.3%) received adjuvant ET.

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

Source: Houvenaeghel G et al. Contribution of endocrine therapy in oestrogen receptor-positive pT1a-b breast cancer: Results of a retrospective study. Eur J Cancer. 2022;176:58-69 (Oct 1). Doi: 10.1016/j.ejca.2022.08.027

Key clinical point: Endocrine therapy (ET) improved survival outcomes in all patients with small pT1a-b, estrogen receptor-positive (ER+) breast cancer (BC), especially in patients with grade 2-3 tumors.

Major finding: No adjuvant ET vs adjuvant ET was associated with decreased disease-free survival (DFS) in the overall cohort of patients with pT1a-bN0 ER+ BC (hazard ratio [HR] 1.275; P = .047) and in those with grade 2-3 tumors (HR 1.502; P = .049); however, ET did not affect DFS outcomes in grade 1 pT1a-bN0 ER+ BC.

Study details: Findings are from a retrospective, observational study including 5545 patients with pT1a-b ER+ BC, of which the majority (80.3%) received adjuvant ET.

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

Source: Houvenaeghel G et al. Contribution of endocrine therapy in oestrogen receptor-positive pT1a-b breast cancer: Results of a retrospective study. Eur J Cancer. 2022;176:58-69 (Oct 1). Doi: 10.1016/j.ejca.2022.08.027

Key clinical point: Repeat breast-conserving surgery (re-BCS) worsened survival outcomes in patients with small ipsilateral breast tumor recurrence (IBTR), especially in those with estrogen receptor-negative (ER−) IBTR and those who omitted radiation after re-BCS.

Major finding: Compared with mastectomy, re-BCS was associated with worse overall survival (OS; hazard ratio [HR] 1.342; 95% CI 1.084-1.663) and breast cancer-specific survival (BCSS; HR 1.454; 95% CI 1.004-2.105). After re-BCS, the omission of radiation worsened OS (overall re-BCS without radiation: HR 1.384; 95% CI 1.110-1.724; and negative IBTR ER re-BCS without radiation: HR 1.972; 95% CI 1.191-3.265, respectively) and BCSS (overall re-BCS without radiation: HR 1.577; 95% CI 1.075-2.314; and negative IBTR ER re-BCS without radiation: HR 2.097; 95% CI 1.053-4.178, respectively).

Study details: Findings are from a population-based cohort study including 3648 patients with small IBTR, of which 22.4% of patients underwent re-BCS and the remaining patients underwent mastectomy.

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

Source: Li Y et al. Is repeat breast conservation possible for small ipsilateral breast cancer recurrence? Cancer. 2022 (Sep 20). Doi: 10.1002/cncr.34468

Key clinical point: Repeat breast-conserving surgery (re-BCS) worsened survival outcomes in patients with small ipsilateral breast tumor recurrence (IBTR), especially in those with estrogen receptor-negative (ER−) IBTR and those who omitted radiation after re-BCS.

Major finding: Compared with mastectomy, re-BCS was associated with worse overall survival (OS; hazard ratio [HR] 1.342; 95% CI 1.084-1.663) and breast cancer-specific survival (BCSS; HR 1.454; 95% CI 1.004-2.105). After re-BCS, the omission of radiation worsened OS (overall re-BCS without radiation: HR 1.384; 95% CI 1.110-1.724; and negative IBTR ER re-BCS without radiation: HR 1.972; 95% CI 1.191-3.265, respectively) and BCSS (overall re-BCS without radiation: HR 1.577; 95% CI 1.075-2.314; and negative IBTR ER re-BCS without radiation: HR 2.097; 95% CI 1.053-4.178, respectively).

Study details: Findings are from a population-based cohort study including 3648 patients with small IBTR, of which 22.4% of patients underwent re-BCS and the remaining patients underwent mastectomy.

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

Source: Li Y et al. Is repeat breast conservation possible for small ipsilateral breast cancer recurrence? Cancer. 2022 (Sep 20). Doi: 10.1002/cncr.34468

Key clinical point: Repeat breast-conserving surgery (re-BCS) worsened survival outcomes in patients with small ipsilateral breast tumor recurrence (IBTR), especially in those with estrogen receptor-negative (ER−) IBTR and those who omitted radiation after re-BCS.

Major finding: Compared with mastectomy, re-BCS was associated with worse overall survival (OS; hazard ratio [HR] 1.342; 95% CI 1.084-1.663) and breast cancer-specific survival (BCSS; HR 1.454; 95% CI 1.004-2.105). After re-BCS, the omission of radiation worsened OS (overall re-BCS without radiation: HR 1.384; 95% CI 1.110-1.724; and negative IBTR ER re-BCS without radiation: HR 1.972; 95% CI 1.191-3.265, respectively) and BCSS (overall re-BCS without radiation: HR 1.577; 95% CI 1.075-2.314; and negative IBTR ER re-BCS without radiation: HR 2.097; 95% CI 1.053-4.178, respectively).

Study details: Findings are from a population-based cohort study including 3648 patients with small IBTR, of which 22.4% of patients underwent re-BCS and the remaining patients underwent mastectomy.

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

Source: Li Y et al. Is repeat breast conservation possible for small ipsilateral breast cancer recurrence? Cancer. 2022 (Sep 20). Doi: 10.1002/cncr.34468

Key clinical point: In patients with metastatic breast cancer (BC), germline BRCA1/2 mutation (gBRCAm) had a differential prognostic impact for triple-negative BC (TNBC) or hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) BC.

Major finding: Compared with gBRCA wild-type (WT) BC, gBRCAm BC showed comparable overall survival (OS) and first-line progression-free survival (PFS1) outcomes in the overall cohort of patients with metastatic BC (both P > .05), better OS (hazard ratio [HR] 0.76; P = .027) and PFS1 (HR 0.69; P = .001) in the TNBC subgroup, and worse PFS1 (HR 1.23; P = .024) in the HR+/HER2− BC subgroup.

Study details: Findings are from a retrospective cohort including 20,624 patients with newly diagnosed metastatic BC, of which 325 had gBRCAm, 1138 had gBRCA WT, and 19,161 had not tested for gBRCA.

Disclosures: This study was funded by an industrial consortium. Several authors declared receiving personal fees, grants, nonfinancial support, or travel support from several sources, including some of the companies in the consortium. Seventeen authors declared no conflicts of interest.

Source: Mailliez A et al. Survival outcomes of metastatic breast cancer patients by germline BRCA1/2 status in a large multicenter real-world database. Int J Cancer. 2022 (Sep 26). Doi: 10.1002/ijc.34304

Key clinical point: In patients with metastatic breast cancer (BC), germline BRCA1/2 mutation (gBRCAm) had a differential prognostic impact for triple-negative BC (TNBC) or hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) BC.

Major finding: Compared with gBRCA wild-type (WT) BC, gBRCAm BC showed comparable overall survival (OS) and first-line progression-free survival (PFS1) outcomes in the overall cohort of patients with metastatic BC (both P > .05), better OS (hazard ratio [HR] 0.76; P = .027) and PFS1 (HR 0.69; P = .001) in the TNBC subgroup, and worse PFS1 (HR 1.23; P = .024) in the HR+/HER2− BC subgroup.

Study details: Findings are from a retrospective cohort including 20,624 patients with newly diagnosed metastatic BC, of which 325 had gBRCAm, 1138 had gBRCA WT, and 19,161 had not tested for gBRCA.

Disclosures: This study was funded by an industrial consortium. Several authors declared receiving personal fees, grants, nonfinancial support, or travel support from several sources, including some of the companies in the consortium. Seventeen authors declared no conflicts of interest.

Source: Mailliez A et al. Survival outcomes of metastatic breast cancer patients by germline BRCA1/2 status in a large multicenter real-world database. Int J Cancer. 2022 (Sep 26). Doi: 10.1002/ijc.34304

Key clinical point: In patients with metastatic breast cancer (BC), germline BRCA1/2 mutation (gBRCAm) had a differential prognostic impact for triple-negative BC (TNBC) or hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) BC.

Major finding: Compared with gBRCA wild-type (WT) BC, gBRCAm BC showed comparable overall survival (OS) and first-line progression-free survival (PFS1) outcomes in the overall cohort of patients with metastatic BC (both P > .05), better OS (hazard ratio [HR] 0.76; P = .027) and PFS1 (HR 0.69; P = .001) in the TNBC subgroup, and worse PFS1 (HR 1.23; P = .024) in the HR+/HER2− BC subgroup.

Study details: Findings are from a retrospective cohort including 20,624 patients with newly diagnosed metastatic BC, of which 325 had gBRCAm, 1138 had gBRCA WT, and 19,161 had not tested for gBRCA.

Disclosures: This study was funded by an industrial consortium. Several authors declared receiving personal fees, grants, nonfinancial support, or travel support from several sources, including some of the companies in the consortium. Seventeen authors declared no conflicts of interest.

Source: Mailliez A et al. Survival outcomes of metastatic breast cancer patients by germline BRCA1/2 status in a large multicenter real-world database. Int J Cancer. 2022 (Sep 26). Doi: 10.1002/ijc.34304

Key clinical point: Patients with human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (BC) who relapsed after prior (neo)adjuvant trastuzumab (T) treatment benefitted from dual blockade with pertuzumab + trastuzumab (P + T) in routine clinical practice.

Major finding: The median progression-free survival was 18.8 months, with comparable outcomes observed in patients with hormone receptor (HR)-positive vs HR-negative BC (18.2 vs 19.4 months) and with visceral vs non-visceral metastasis (18.0 vs 20.5 months). No new safety signals were reported, and 6.1% of patients reported fatal serious adverse events.

Study details: Findings are from the observational, noninterventional, HELENA study including 126 patients with HER2+ metastatic BC who relapsed after prior (neo)adjuvant T treatment and received first-line P + T + chemotherapy.

Disclosures: This study was funded by Roche Pharma AG. Some authors declared receiving personal fees, grants, honoraria, or consulting fees from several sources, and one author declared being an employee and holding stocks in Roche Pharma.

Source: Thill M et al. Dual HER2 blockade with pertuzumab (P) and trastuzumab (T) in patients with HER2-positive metastatic breast cancer (mBC) relapsing after adjuvant treatment with T: Results from a German non-interventional study (NIS) HELENA (NCT01777958). Breast Cancer Res Treat. 2022 (Sep 12). Doi: 10.1007/s10549-022-06710-4

Key clinical point: Patients with human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (BC) who relapsed after prior (neo)adjuvant trastuzumab (T) treatment benefitted from dual blockade with pertuzumab + trastuzumab (P + T) in routine clinical practice.

Major finding: The median progression-free survival was 18.8 months, with comparable outcomes observed in patients with hormone receptor (HR)-positive vs HR-negative BC (18.2 vs 19.4 months) and with visceral vs non-visceral metastasis (18.0 vs 20.5 months). No new safety signals were reported, and 6.1% of patients reported fatal serious adverse events.

Study details: Findings are from the observational, noninterventional, HELENA study including 126 patients with HER2+ metastatic BC who relapsed after prior (neo)adjuvant T treatment and received first-line P + T + chemotherapy.

Disclosures: This study was funded by Roche Pharma AG. Some authors declared receiving personal fees, grants, honoraria, or consulting fees from several sources, and one author declared being an employee and holding stocks in Roche Pharma.

Source: Thill M et al. Dual HER2 blockade with pertuzumab (P) and trastuzumab (T) in patients with HER2-positive metastatic breast cancer (mBC) relapsing after adjuvant treatment with T: Results from a German non-interventional study (NIS) HELENA (NCT01777958). Breast Cancer Res Treat. 2022 (Sep 12). Doi: 10.1007/s10549-022-06710-4

Key clinical point: Patients with human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (BC) who relapsed after prior (neo)adjuvant trastuzumab (T) treatment benefitted from dual blockade with pertuzumab + trastuzumab (P + T) in routine clinical practice.

Major finding: The median progression-free survival was 18.8 months, with comparable outcomes observed in patients with hormone receptor (HR)-positive vs HR-negative BC (18.2 vs 19.4 months) and with visceral vs non-visceral metastasis (18.0 vs 20.5 months). No new safety signals were reported, and 6.1% of patients reported fatal serious adverse events.

Study details: Findings are from the observational, noninterventional, HELENA study including 126 patients with HER2+ metastatic BC who relapsed after prior (neo)adjuvant T treatment and received first-line P + T + chemotherapy.

Disclosures: This study was funded by Roche Pharma AG. Some authors declared receiving personal fees, grants, honoraria, or consulting fees from several sources, and one author declared being an employee and holding stocks in Roche Pharma.

Source: Thill M et al. Dual HER2 blockade with pertuzumab (P) and trastuzumab (T) in patients with HER2-positive metastatic breast cancer (mBC) relapsing after adjuvant treatment with T: Results from a German non-interventional study (NIS) HELENA (NCT01777958). Breast Cancer Res Treat. 2022 (Sep 12). Doi: 10.1007/s10549-022-06710-4

Key clinical point: The combination of apatinib and vinorelbine lowered the risk for disease progression and was well tolerated in patients with metastatic triple-negative breast cancer (TNBC) who had failed first or second-line treatment.

Major finding: There was a significant improvement in progression-free survival with apatinib + vinorelbine vs only vinorelbine (hazard ratio 1.82; P = .026). Leukopenia (42.4% vs 40.6%) and granulocytopenia (57.6% vs 31.3%) were the most frequent grade 3-4 hematologic adverse events in the apatinib + vinorelbine vs vinorelbine group.

Study details: Findings are from the phase 2, NAN study including 66 patients with recurrent or metastatic TNBC who had failed first or second-line treatment and were randomly assigned to receive apatinib + vinorelbine or vinorelbine.

Disclosures: This study was supported by the National Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.

Source: Li DD et al. Apatinib plus vinorelbine versus vinorelbine for metastatic triple-negative breast cancer who failed first/second-line treatment: The NAN trial. NPJ Breast Cancer. 2022;8:110 (Sep 20). Doi: 10.1038/s41523-022-00462-6

Key clinical point: The combination of apatinib and vinorelbine lowered the risk for disease progression and was well tolerated in patients with metastatic triple-negative breast cancer (TNBC) who had failed first or second-line treatment.

Major finding: There was a significant improvement in progression-free survival with apatinib + vinorelbine vs only vinorelbine (hazard ratio 1.82; P = .026). Leukopenia (42.4% vs 40.6%) and granulocytopenia (57.6% vs 31.3%) were the most frequent grade 3-4 hematologic adverse events in the apatinib + vinorelbine vs vinorelbine group.

Study details: Findings are from the phase 2, NAN study including 66 patients with recurrent or metastatic TNBC who had failed first or second-line treatment and were randomly assigned to receive apatinib + vinorelbine or vinorelbine.

Disclosures: This study was supported by the National Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.

Source: Li DD et al. Apatinib plus vinorelbine versus vinorelbine for metastatic triple-negative breast cancer who failed first/second-line treatment: The NAN trial. NPJ Breast Cancer. 2022;8:110 (Sep 20). Doi: 10.1038/s41523-022-00462-6

Key clinical point: The combination of apatinib and vinorelbine lowered the risk for disease progression and was well tolerated in patients with metastatic triple-negative breast cancer (TNBC) who had failed first or second-line treatment.

Major finding: There was a significant improvement in progression-free survival with apatinib + vinorelbine vs only vinorelbine (hazard ratio 1.82; P = .026). Leukopenia (42.4% vs 40.6%) and granulocytopenia (57.6% vs 31.3%) were the most frequent grade 3-4 hematologic adverse events in the apatinib + vinorelbine vs vinorelbine group.

Study details: Findings are from the phase 2, NAN study including 66 patients with recurrent or metastatic TNBC who had failed first or second-line treatment and were randomly assigned to receive apatinib + vinorelbine or vinorelbine.

Disclosures: This study was supported by the National Natural Science Foundation of China and other sources. The authors declared no conflicts of interest.

Source: Li DD et al. Apatinib plus vinorelbine versus vinorelbine for metastatic triple-negative breast cancer who failed first/second-line treatment: The NAN trial. NPJ Breast Cancer. 2022;8:110 (Sep 20). Doi: 10.1038/s41523-022-00462-6

Key clinical point: Switch to fulvestrant + palbociclib from aromatase inhibitor (AI) + palbociclib improved progression-free survival (PFS) without increasing toxicity in patients with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC) and high levels of ESR1 mutation in the blood (bESR1^mut).

Major finding: Median PFS improved significantly in the fulvestrant + palbociclib vs AI + palbociclib group (stratified hazard ratio 0.61; 2-sided P = .0040). The rates of most common grade ≥3 adverse events, such as neutropenia (44.3% and 41.7%, respectively) and lymphopenia (4.5% and 3.6%, respectively), were similar in the fulvestrant + palbociclib and AI + palbociclib groups.

Study details: Findings are from the phase 3, PADA-1 trial including 172 patients with ER+HER2− advanced BC, rising bESR1^mut, and no synchronous disease progression with first-line AI + palbociclib who were randomly assigned to continue AI + palbociclib or switch to fulvestrant + palbociclib.

Disclosures: This study was funded by Pfizer. Some authors declared receiving grants, honoraria, consulting fees, or travel support, or having other ties with several sources, including Pfizer.

Source: Bidard FC et al. Switch to fulvestrant and palbociclib versus no switch in advanced breast cancer with rising ESR1 mutation during aromatase inhibitor and palbociclib therapy (PADA-1): A randomised, open-label, multicentre, phase 3 trial. Lancet Oncol. 2022 (Sep 29). Doi: 10.1016/S1470-2045(22)00555-1

Key clinical point: Switch to fulvestrant + palbociclib from aromatase inhibitor (AI) + palbociclib improved progression-free survival (PFS) without increasing toxicity in patients with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC) and high levels of ESR1 mutation in the blood (bESR1^mut).

Major finding: Median PFS improved significantly in the fulvestrant + palbociclib vs AI + palbociclib group (stratified hazard ratio 0.61; 2-sided P = .0040). The rates of most common grade ≥3 adverse events, such as neutropenia (44.3% and 41.7%, respectively) and lymphopenia (4.5% and 3.6%, respectively), were similar in the fulvestrant + palbociclib and AI + palbociclib groups.

Study details: Findings are from the phase 3, PADA-1 trial including 172 patients with ER+HER2− advanced BC, rising bESR1^mut, and no synchronous disease progression with first-line AI + palbociclib who were randomly assigned to continue AI + palbociclib or switch to fulvestrant + palbociclib.

Disclosures: This study was funded by Pfizer. Some authors declared receiving grants, honoraria, consulting fees, or travel support, or having other ties with several sources, including Pfizer.

Source: Bidard FC et al. Switch to fulvestrant and palbociclib versus no switch in advanced breast cancer with rising ESR1 mutation during aromatase inhibitor and palbociclib therapy (PADA-1): A randomised, open-label, multicentre, phase 3 trial. Lancet Oncol. 2022 (Sep 29). Doi: 10.1016/S1470-2045(22)00555-1

Key clinical point: Switch to fulvestrant + palbociclib from aromatase inhibitor (AI) + palbociclib improved progression-free survival (PFS) without increasing toxicity in patients with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC) and high levels of ESR1 mutation in the blood (bESR1^mut).

Major finding: Median PFS improved significantly in the fulvestrant + palbociclib vs AI + palbociclib group (stratified hazard ratio 0.61; 2-sided P = .0040). The rates of most common grade ≥3 adverse events, such as neutropenia (44.3% and 41.7%, respectively) and lymphopenia (4.5% and 3.6%, respectively), were similar in the fulvestrant + palbociclib and AI + palbociclib groups.

Study details: Findings are from the phase 3, PADA-1 trial including 172 patients with ER+HER2− advanced BC, rising bESR1^mut, and no synchronous disease progression with first-line AI + palbociclib who were randomly assigned to continue AI + palbociclib or switch to fulvestrant + palbociclib.

Disclosures: This study was funded by Pfizer. Some authors declared receiving grants, honoraria, consulting fees, or travel support, or having other ties with several sources, including Pfizer.

Source: Bidard FC et al. Switch to fulvestrant and palbociclib versus no switch in advanced breast cancer with rising ESR1 mutation during aromatase inhibitor and palbociclib therapy (PADA-1): A randomised, open-label, multicentre, phase 3 trial. Lancet Oncol. 2022 (Sep 29). Doi: 10.1016/S1470-2045(22)00555-1