Key clinical point: Cabozantinib plus atezolizumab significantly improved progression-free survival (PFS) but not overall survival (OS) in systemic therapy-naive patients with advanced hepatocellular carcinoma (HCC) unresponsive to curative or locoregional therapy.

Major finding: Patients receiving cabozantinib plus atezolizumab vs sorafenib had a significantly longer median PFS (6.8 vs 4.2 months; hazard ratio [HR] 0.63; P  =  .001) but a comparable median OS (15.4 vs 15.5 months; HR 0.90; P  =  .44).

Study details: Findings are from a multicenter, phase 3 trial, COSMIC-312, that included 837 systemic therapy-naive adult patients with HCC unresponsive to curative or locoregional therapy who were randomly assigned 2:1:1 to receive cabozantinib plus atezolizumab (n = 432), sorafenib (n = 217), or single-agent cabozantinib (n = 188).

Disclosures: This study was funded by Exelixis, USA, and Ipsen, France. Some authors reported being consultants, advisors, or speakers for or receiving research funding, personal fees, travel and accommodations, or other expenses from various sources, including Exelixis and Ipsen. Four authors reported employment (current or former), stock, and other ownership interests in Exelixis or Ipsen.

Source: Kelley RK et al. Cabozantinib plus atezolizumab versus sorafenib for advanced hepatocellular carcinoma (COSMIC-312): A multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2022 (Jul 4). Doi: 10.1016/S1470-2045(22)00326-6

Key clinical point: Cabozantinib plus atezolizumab significantly improved progression-free survival (PFS) but not overall survival (OS) in systemic therapy-naive patients with advanced hepatocellular carcinoma (HCC) unresponsive to curative or locoregional therapy.

Major finding: Patients receiving cabozantinib plus atezolizumab vs sorafenib had a significantly longer median PFS (6.8 vs 4.2 months; hazard ratio [HR] 0.63; P  =  .001) but a comparable median OS (15.4 vs 15.5 months; HR 0.90; P  =  .44).

Study details: Findings are from a multicenter, phase 3 trial, COSMIC-312, that included 837 systemic therapy-naive adult patients with HCC unresponsive to curative or locoregional therapy who were randomly assigned 2:1:1 to receive cabozantinib plus atezolizumab (n = 432), sorafenib (n = 217), or single-agent cabozantinib (n = 188).

Disclosures: This study was funded by Exelixis, USA, and Ipsen, France. Some authors reported being consultants, advisors, or speakers for or receiving research funding, personal fees, travel and accommodations, or other expenses from various sources, including Exelixis and Ipsen. Four authors reported employment (current or former), stock, and other ownership interests in Exelixis or Ipsen.

Source: Kelley RK et al. Cabozantinib plus atezolizumab versus sorafenib for advanced hepatocellular carcinoma (COSMIC-312): A multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2022 (Jul 4). Doi: 10.1016/S1470-2045(22)00326-6

Key clinical point: Cabozantinib plus atezolizumab significantly improved progression-free survival (PFS) but not overall survival (OS) in systemic therapy-naive patients with advanced hepatocellular carcinoma (HCC) unresponsive to curative or locoregional therapy.

Major finding: Patients receiving cabozantinib plus atezolizumab vs sorafenib had a significantly longer median PFS (6.8 vs 4.2 months; hazard ratio [HR] 0.63; P  =  .001) but a comparable median OS (15.4 vs 15.5 months; HR 0.90; P  =  .44).

Study details: Findings are from a multicenter, phase 3 trial, COSMIC-312, that included 837 systemic therapy-naive adult patients with HCC unresponsive to curative or locoregional therapy who were randomly assigned 2:1:1 to receive cabozantinib plus atezolizumab (n = 432), sorafenib (n = 217), or single-agent cabozantinib (n = 188).

Disclosures: This study was funded by Exelixis, USA, and Ipsen, France. Some authors reported being consultants, advisors, or speakers for or receiving research funding, personal fees, travel and accommodations, or other expenses from various sources, including Exelixis and Ipsen. Four authors reported employment (current or former), stock, and other ownership interests in Exelixis or Ipsen.

Source: Kelley RK et al. Cabozantinib plus atezolizumab versus sorafenib for advanced hepatocellular carcinoma (COSMIC-312): A multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2022 (Jul 4). Doi: 10.1016/S1470-2045(22)00326-6

The pelvic autonomic nerves are responsible for the neurogenic control of the rectum and bladder and for sexual arousal. Over the past 30 years, different nerve-sparing techniques have been recommended and adopted to minimize risk of urinary or rectal dysfunction and incontinence, as well as sexual dysfunction, in radical surgery for rectal and early cervical cancer without compromising surgical outcome.

As the treatment of deep infiltrative endometriosis has become more aggressive and radical, it is certainly feasible to consider nerve-sparing techniques at the time of dissection and endometriosis excision to minimize the known risk of urinary, rectal, and sexual dysfunction. Interestingly, because endometriosis generally follows an asymmetric distribution, effect on bladder function is not as problematic as it is in the case of cancer surgery.

Early innovators include Dr. Marc Possover from Switzerland and Dr. Marcello Ceccaroni from Italy. Both physicians are superior pelvic neuroanatomists. Both describe meticulous and extensive dissection of the nerves of the pelvis at the time of excision of deep infiltrative endometriosis. Unfortunately, their techniques would appear to be beyond the scope of even the most experienced excisional surgeons.

A simplified approach to nerve sparing at the time of excision of deep infiltrative endometriosis has been developed by our guest author, Dr. Nucelio Lemos, in collaboration with physicians at the University of Bologna and the University of Cambridge. By using the hypogastric nerves as the landmark, they have developed a more surgeon friendly and less radical approach to nerve sparing at the time of deep infiltrative endometriosis surgery.

For this edition of the Master Class in Gynecologic Surgery, I have enlisted the assistance of both Dr. Lemos and his fellow in advanced gynecologic surgery, Dr. Meghan McGrattan, from Mount Sinai and Women’s College Hospital in Toronto. Dr. McGrattan drew the anatomic illustrations that accompany Dr. Lemos’ description of the new technique.

Dr. Lemos is associate professor in the department of obstetrics and gynecology at the University of Toronto. He specializes in pelvic pain, pelvic floor dysfunction, pelvic organ prolapse, endometriosis, and neuropelveology. Dr. Lemos is a founding member and second vice president of the International Society of Neuropelveology. In addition, Dr. Lemos started the Pelvic Functional Surgery and Neuropelveology Clinic in the department of obstetrics and gynecology of Mount Sinai and Women’s College Hospitals, Toronto.

It is a pleasure and honor to welcome Dr. Lemos and Dr. McGrattan to this addition of the Master Class in Gynecologic Surgery.
 

Dr. Miller is a professor of obstetrics and gynecology, department of clinical sciences, Rosalind Franklin University of Medicine and Science, North Chicago, Ill. He has no conflicts of interest to report.

The pelvic autonomic nerves are responsible for the neurogenic control of the rectum and bladder and for sexual arousal. Over the past 30 years, different nerve-sparing techniques have been recommended and adopted to minimize risk of urinary or rectal dysfunction and incontinence, as well as sexual dysfunction, in radical surgery for rectal and early cervical cancer without compromising surgical outcome.

As the treatment of deep infiltrative endometriosis has become more aggressive and radical, it is certainly feasible to consider nerve-sparing techniques at the time of dissection and endometriosis excision to minimize the known risk of urinary, rectal, and sexual dysfunction. Interestingly, because endometriosis generally follows an asymmetric distribution, effect on bladder function is not as problematic as it is in the case of cancer surgery.

Early innovators include Dr. Marc Possover from Switzerland and Dr. Marcello Ceccaroni from Italy. Both physicians are superior pelvic neuroanatomists. Both describe meticulous and extensive dissection of the nerves of the pelvis at the time of excision of deep infiltrative endometriosis. Unfortunately, their techniques would appear to be beyond the scope of even the most experienced excisional surgeons.

A simplified approach to nerve sparing at the time of excision of deep infiltrative endometriosis has been developed by our guest author, Dr. Nucelio Lemos, in collaboration with physicians at the University of Bologna and the University of Cambridge. By using the hypogastric nerves as the landmark, they have developed a more surgeon friendly and less radical approach to nerve sparing at the time of deep infiltrative endometriosis surgery.

For this edition of the Master Class in Gynecologic Surgery, I have enlisted the assistance of both Dr. Lemos and his fellow in advanced gynecologic surgery, Dr. Meghan McGrattan, from Mount Sinai and Women’s College Hospital in Toronto. Dr. McGrattan drew the anatomic illustrations that accompany Dr. Lemos’ description of the new technique.

Dr. Lemos is associate professor in the department of obstetrics and gynecology at the University of Toronto. He specializes in pelvic pain, pelvic floor dysfunction, pelvic organ prolapse, endometriosis, and neuropelveology. Dr. Lemos is a founding member and second vice president of the International Society of Neuropelveology. In addition, Dr. Lemos started the Pelvic Functional Surgery and Neuropelveology Clinic in the department of obstetrics and gynecology of Mount Sinai and Women’s College Hospitals, Toronto.

It is a pleasure and honor to welcome Dr. Lemos and Dr. McGrattan to this addition of the Master Class in Gynecologic Surgery.
 

Dr. Miller is a professor of obstetrics and gynecology, department of clinical sciences, Rosalind Franklin University of Medicine and Science, North Chicago, Ill. He has no conflicts of interest to report.

The pelvic autonomic nerves are responsible for the neurogenic control of the rectum and bladder and for sexual arousal. Over the past 30 years, different nerve-sparing techniques have been recommended and adopted to minimize risk of urinary or rectal dysfunction and incontinence, as well as sexual dysfunction, in radical surgery for rectal and early cervical cancer without compromising surgical outcome.

As the treatment of deep infiltrative endometriosis has become more aggressive and radical, it is certainly feasible to consider nerve-sparing techniques at the time of dissection and endometriosis excision to minimize the known risk of urinary, rectal, and sexual dysfunction. Interestingly, because endometriosis generally follows an asymmetric distribution, effect on bladder function is not as problematic as it is in the case of cancer surgery.

Early innovators include Dr. Marc Possover from Switzerland and Dr. Marcello Ceccaroni from Italy. Both physicians are superior pelvic neuroanatomists. Both describe meticulous and extensive dissection of the nerves of the pelvis at the time of excision of deep infiltrative endometriosis. Unfortunately, their techniques would appear to be beyond the scope of even the most experienced excisional surgeons.

A simplified approach to nerve sparing at the time of excision of deep infiltrative endometriosis has been developed by our guest author, Dr. Nucelio Lemos, in collaboration with physicians at the University of Bologna and the University of Cambridge. By using the hypogastric nerves as the landmark, they have developed a more surgeon friendly and less radical approach to nerve sparing at the time of deep infiltrative endometriosis surgery.

For this edition of the Master Class in Gynecologic Surgery, I have enlisted the assistance of both Dr. Lemos and his fellow in advanced gynecologic surgery, Dr. Meghan McGrattan, from Mount Sinai and Women’s College Hospital in Toronto. Dr. McGrattan drew the anatomic illustrations that accompany Dr. Lemos’ description of the new technique.

Dr. Lemos is associate professor in the department of obstetrics and gynecology at the University of Toronto. He specializes in pelvic pain, pelvic floor dysfunction, pelvic organ prolapse, endometriosis, and neuropelveology. Dr. Lemos is a founding member and second vice president of the International Society of Neuropelveology. In addition, Dr. Lemos started the Pelvic Functional Surgery and Neuropelveology Clinic in the department of obstetrics and gynecology of Mount Sinai and Women’s College Hospitals, Toronto.

It is a pleasure and honor to welcome Dr. Lemos and Dr. McGrattan to this addition of the Master Class in Gynecologic Surgery.
 

Dr. Miller is a professor of obstetrics and gynecology, department of clinical sciences, Rosalind Franklin University of Medicine and Science, North Chicago, Ill. He has no conflicts of interest to report.

Key clinical point: Human epidermal growth factor receptor 2 (ERBB2)-low breast cancer (BC) cannot be considered a distinct biologic subtype of BC because most of its clinicopathologic and prognostic differences are associated with hormone receptor (HR) expression.

Major finding: HR expression was a significant factor associated with the ERBB2 status (adjusted odds ratio for HR-positive vs HR-negative tumors 2.1; P < .001). The pathologic complete response rate was similar in ERBB2-low and ERBB2-0 tumors among patients with HR-positive (P  =  .08) or triple-negative (P  =  .40) BC.

Study details: Findings are from a large cohort study including 5235 patients with ERBB2-negative invasive, stage I-III BC, of which 55.7% and 44.3% of patients had ERBB2-low and ERBB2-0 tumors, respectively.

Disclosures: Dr. Tarantino was supported by an American-Italian Cancer Foundation postdoctoral research fellowship. The authors declared serving on advisory boards of or receiving personal fees, research grants, consulting fees, or honoraria from several sources.

Source: Tarantino P et al. Prognostic and biologic significance of ERBB2-low expression in early-stage breast cancer. JAMA Oncol. 2022 (Jun 23). Doi: 10.1001/jamaoncol.2022.2286

Key clinical point: Human epidermal growth factor receptor 2 (ERBB2)-low breast cancer (BC) cannot be considered a distinct biologic subtype of BC because most of its clinicopathologic and prognostic differences are associated with hormone receptor (HR) expression.

Major finding: HR expression was a significant factor associated with the ERBB2 status (adjusted odds ratio for HR-positive vs HR-negative tumors 2.1; P < .001). The pathologic complete response rate was similar in ERBB2-low and ERBB2-0 tumors among patients with HR-positive (P  =  .08) or triple-negative (P  =  .40) BC.

Study details: Findings are from a large cohort study including 5235 patients with ERBB2-negative invasive, stage I-III BC, of which 55.7% and 44.3% of patients had ERBB2-low and ERBB2-0 tumors, respectively.

Disclosures: Dr. Tarantino was supported by an American-Italian Cancer Foundation postdoctoral research fellowship. The authors declared serving on advisory boards of or receiving personal fees, research grants, consulting fees, or honoraria from several sources.

Source: Tarantino P et al. Prognostic and biologic significance of ERBB2-low expression in early-stage breast cancer. JAMA Oncol. 2022 (Jun 23). Doi: 10.1001/jamaoncol.2022.2286

Key clinical point: Human epidermal growth factor receptor 2 (ERBB2)-low breast cancer (BC) cannot be considered a distinct biologic subtype of BC because most of its clinicopathologic and prognostic differences are associated with hormone receptor (HR) expression.

Major finding: HR expression was a significant factor associated with the ERBB2 status (adjusted odds ratio for HR-positive vs HR-negative tumors 2.1; P < .001). The pathologic complete response rate was similar in ERBB2-low and ERBB2-0 tumors among patients with HR-positive (P  =  .08) or triple-negative (P  =  .40) BC.

Study details: Findings are from a large cohort study including 5235 patients with ERBB2-negative invasive, stage I-III BC, of which 55.7% and 44.3% of patients had ERBB2-low and ERBB2-0 tumors, respectively.

Disclosures: Dr. Tarantino was supported by an American-Italian Cancer Foundation postdoctoral research fellowship. The authors declared serving on advisory boards of or receiving personal fees, research grants, consulting fees, or honoraria from several sources.

Source: Tarantino P et al. Prognostic and biologic significance of ERBB2-low expression in early-stage breast cancer. JAMA Oncol. 2022 (Jun 23). Doi: 10.1001/jamaoncol.2022.2286

Key clinical point: The use of β-blocker at the time of breast cancer (BC) diagnosis reduced mortality in patients with triple-negative BC (TNBC).

Major finding: Although β-blocker use vs no use was not associated with BC-specific survival in the overall population, β-blockers reduced BC mortality by 34% in patients with TNBC (hazard ratio [HR] 0.66; 95% CI 0.47-0.91). The meta-analysis further confirmed that β-blocker use was associated with progression/recurrence-free survival (HR 0.58; 95% CI 0.38-0.89) in the TNBC population.

Study details: Findings are from a large population-based cohort study including 30,060 women aged ≥ 50 years with primary invasive BC, of which 15% used β-blockers at the time of BC diagnosis, and from a meta-analysis of 8 observational studies.

Disclosures: This study was funded by the Norwegian Research Council and other sources. EK Sloan declared serving as a scientific advisory board member for Cygnal Therapeutics.

Source: Løfling LL et al. β-blockers and breast cancer survival by molecular subtypes: A population-based cohort study and meta-analysis. Br J Cancer. 2022 (Jun 20). Doi: 10.1038/s41416-022-01891-7

Key clinical point: The use of β-blocker at the time of breast cancer (BC) diagnosis reduced mortality in patients with triple-negative BC (TNBC).

Major finding: Although β-blocker use vs no use was not associated with BC-specific survival in the overall population, β-blockers reduced BC mortality by 34% in patients with TNBC (hazard ratio [HR] 0.66; 95% CI 0.47-0.91). The meta-analysis further confirmed that β-blocker use was associated with progression/recurrence-free survival (HR 0.58; 95% CI 0.38-0.89) in the TNBC population.

Study details: Findings are from a large population-based cohort study including 30,060 women aged ≥ 50 years with primary invasive BC, of which 15% used β-blockers at the time of BC diagnosis, and from a meta-analysis of 8 observational studies.

Disclosures: This study was funded by the Norwegian Research Council and other sources. EK Sloan declared serving as a scientific advisory board member for Cygnal Therapeutics.

Source: Løfling LL et al. β-blockers and breast cancer survival by molecular subtypes: A population-based cohort study and meta-analysis. Br J Cancer. 2022 (Jun 20). Doi: 10.1038/s41416-022-01891-7

Key clinical point: The use of β-blocker at the time of breast cancer (BC) diagnosis reduced mortality in patients with triple-negative BC (TNBC).

Major finding: Although β-blocker use vs no use was not associated with BC-specific survival in the overall population, β-blockers reduced BC mortality by 34% in patients with TNBC (hazard ratio [HR] 0.66; 95% CI 0.47-0.91). The meta-analysis further confirmed that β-blocker use was associated with progression/recurrence-free survival (HR 0.58; 95% CI 0.38-0.89) in the TNBC population.

Study details: Findings are from a large population-based cohort study including 30,060 women aged ≥ 50 years with primary invasive BC, of which 15% used β-blockers at the time of BC diagnosis, and from a meta-analysis of 8 observational studies.

Disclosures: This study was funded by the Norwegian Research Council and other sources. EK Sloan declared serving as a scientific advisory board member for Cygnal Therapeutics.

Source: Løfling LL et al. β-blockers and breast cancer survival by molecular subtypes: A population-based cohort study and meta-analysis. Br J Cancer. 2022 (Jun 20). Doi: 10.1038/s41416-022-01891-7

Key clinical point: In patients with early-stage triple-negative breast cancer (TNBC), capecitabine improved survival and demonstrated a tolerable safety profile, with lower dosage, higher frequency, and adjuvant setting being related with better survival outcomes.

Major finding: Capecitabine vs chemotherapy without capecitabine improved disease-free survival (DFS; hazard ratio [HR] 0.77; P < .001) and overall survival (HR 0.73; P < .0001). A lower dose (<1000 mg; HR 0.69; P  =  .002), a higher dosage frequency (≥6 cycles; HR 0.72; P < .0001) and an adjuvant setting (HR 0.74; P < .0001) were associated with a higher DFS. Capecitabine was associated with higher risk for diarrhea (P < .0001), hand-foot syndrome (P < .0001), and leukopenia (P < .01).

Study details: Findings are from a meta-analysis of 11 phase 3 randomized controlled trials including 5175 female patients with early-stage TNBC who received neoadjuvant or adjuvant chemotherapy with or without capecitabine.

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

Source: Xun X et al. Efficacy and safety of capecitabine for triple-negative breast cancer: A meta-analysis. Front Oncol. 2022;12:899423 (Jul 7). Doi: 10.3389/fonc.2022.899423

Key clinical point: In patients with early-stage triple-negative breast cancer (TNBC), capecitabine improved survival and demonstrated a tolerable safety profile, with lower dosage, higher frequency, and adjuvant setting being related with better survival outcomes.

Major finding: Capecitabine vs chemotherapy without capecitabine improved disease-free survival (DFS; hazard ratio [HR] 0.77; P < .001) and overall survival (HR 0.73; P < .0001). A lower dose (<1000 mg; HR 0.69; P  =  .002), a higher dosage frequency (≥6 cycles; HR 0.72; P < .0001) and an adjuvant setting (HR 0.74; P < .0001) were associated with a higher DFS. Capecitabine was associated with higher risk for diarrhea (P < .0001), hand-foot syndrome (P < .0001), and leukopenia (P < .01).

Study details: Findings are from a meta-analysis of 11 phase 3 randomized controlled trials including 5175 female patients with early-stage TNBC who received neoadjuvant or adjuvant chemotherapy with or without capecitabine.

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

Source: Xun X et al. Efficacy and safety of capecitabine for triple-negative breast cancer: A meta-analysis. Front Oncol. 2022;12:899423 (Jul 7). Doi: 10.3389/fonc.2022.899423

Key clinical point: In patients with early-stage triple-negative breast cancer (TNBC), capecitabine improved survival and demonstrated a tolerable safety profile, with lower dosage, higher frequency, and adjuvant setting being related with better survival outcomes.

Major finding: Capecitabine vs chemotherapy without capecitabine improved disease-free survival (DFS; hazard ratio [HR] 0.77; P < .001) and overall survival (HR 0.73; P < .0001). A lower dose (<1000 mg; HR 0.69; P  =  .002), a higher dosage frequency (≥6 cycles; HR 0.72; P < .0001) and an adjuvant setting (HR 0.74; P < .0001) were associated with a higher DFS. Capecitabine was associated with higher risk for diarrhea (P < .0001), hand-foot syndrome (P < .0001), and leukopenia (P < .01).

Study details: Findings are from a meta-analysis of 11 phase 3 randomized controlled trials including 5175 female patients with early-stage TNBC who received neoadjuvant or adjuvant chemotherapy with or without capecitabine.

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

Source: Xun X et al. Efficacy and safety of capecitabine for triple-negative breast cancer: A meta-analysis. Front Oncol. 2022;12:899423 (Jul 7). Doi: 10.3389/fonc.2022.899423

Key clinical point: Postmastectomy radiotherapy (PMRT) did not influence locoregional recurrence (LRR) in patients with pT1-2 and 1-3 node-positive breast cancer (BC).

Major finding: Rate of LRR at 5 years was similar in patients receiving PMRT and no PMRT (P  =  .61), and PMRT was not significantly associated with LRR in the overall population (P  =  .305).

Study details: Findings are from a retrospective, cohort study including 8914 patients with pT1-2 BC tumors and 1-3 lymph node metastases who received PMRT (n = 492) or no PMRT (n = 8422) after undergoing mastectomy and axillary lymph node dissection.

Disclosures: This study was supported by the Japanese Breast Cancer Society. Some authors declared receiving speaker’s fees, consulting fees, research funds, or honoraria from several sources.

Source: Yamada A et al. Prognostic impact of postoperative radiotherapy in patients with breast cancer and with pT1-2 and 1–3 lymph node metastases: A retrospective cohort study based on the Japanese Breast Cancer Registry. Eur J Cancer. 2022;172:32-40 (Jun 22). Doi: 10.1016/j.ejca.2022.05.017

Key clinical point: Postmastectomy radiotherapy (PMRT) did not influence locoregional recurrence (LRR) in patients with pT1-2 and 1-3 node-positive breast cancer (BC).

Major finding: Rate of LRR at 5 years was similar in patients receiving PMRT and no PMRT (P  =  .61), and PMRT was not significantly associated with LRR in the overall population (P  =  .305).

Study details: Findings are from a retrospective, cohort study including 8914 patients with pT1-2 BC tumors and 1-3 lymph node metastases who received PMRT (n = 492) or no PMRT (n = 8422) after undergoing mastectomy and axillary lymph node dissection.

Disclosures: This study was supported by the Japanese Breast Cancer Society. Some authors declared receiving speaker’s fees, consulting fees, research funds, or honoraria from several sources.

Source: Yamada A et al. Prognostic impact of postoperative radiotherapy in patients with breast cancer and with pT1-2 and 1–3 lymph node metastases: A retrospective cohort study based on the Japanese Breast Cancer Registry. Eur J Cancer. 2022;172:32-40 (Jun 22). Doi: 10.1016/j.ejca.2022.05.017

Key clinical point: Postmastectomy radiotherapy (PMRT) did not influence locoregional recurrence (LRR) in patients with pT1-2 and 1-3 node-positive breast cancer (BC).

Major finding: Rate of LRR at 5 years was similar in patients receiving PMRT and no PMRT (P  =  .61), and PMRT was not significantly associated with LRR in the overall population (P  =  .305).

Study details: Findings are from a retrospective, cohort study including 8914 patients with pT1-2 BC tumors and 1-3 lymph node metastases who received PMRT (n = 492) or no PMRT (n = 8422) after undergoing mastectomy and axillary lymph node dissection.

Disclosures: This study was supported by the Japanese Breast Cancer Society. Some authors declared receiving speaker’s fees, consulting fees, research funds, or honoraria from several sources.

Source: Yamada A et al. Prognostic impact of postoperative radiotherapy in patients with breast cancer and with pT1-2 and 1–3 lymph node metastases: A retrospective cohort study based on the Japanese Breast Cancer Registry. Eur J Cancer. 2022;172:32-40 (Jun 22). Doi: 10.1016/j.ejca.2022.05.017

Key clinical point: Addition of atezolizumab vs placebo to pertuzumab-trastuzumab (PH)+chemotherapy did not improve pathological complete response (pCR) rates in patients with high-risk, human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (BC).

Major finding: The rate of pCR was similar with atezolizumab and placebo in the intention-to-treat (62.4% and 62.7%, respectively; P  =  .9551) and programmed cell death-ligand 1-positive (64.2% and 72.5%, respectively; P  =  .1846) populations. The atezolizumab vs placebo group reported 5 vs 0 grade 5 adverse events, respectively.

Study details: Findings are from the phase 3 IMpassion050 study including 454 patients with high-risk, HER2+ early BC who were randomly assigned to receive atezolizumab or placebo with PH+chemotherapy in the neoadjuvant setting and continued atezolizumab or placebo with PH in the adjuvant phase.

Disclosures: This study was sponsored by F. Hoffmann-La Roche Ltd. Six authors declared being employees or stockowners at Roche, and the other authors reported ties with various sources, including Roche.

Source: Huober J et al. Atezolizumab With Neoadjuvant anti–human epidermal growth factor receptor 2 therapy and chemotherapy in human epidermal growth factor receptor 2–positive early breast cancer: Primary results of the randomized phase III IMpassion050 trial. J Clin Oncol. 2022 (Jun 28). Doi:  10.1200/JCO.21.02772

Key clinical point: Addition of atezolizumab vs placebo to pertuzumab-trastuzumab (PH)+chemotherapy did not improve pathological complete response (pCR) rates in patients with high-risk, human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (BC).

Major finding: The rate of pCR was similar with atezolizumab and placebo in the intention-to-treat (62.4% and 62.7%, respectively; P  =  .9551) and programmed cell death-ligand 1-positive (64.2% and 72.5%, respectively; P  =  .1846) populations. The atezolizumab vs placebo group reported 5 vs 0 grade 5 adverse events, respectively.

Study details: Findings are from the phase 3 IMpassion050 study including 454 patients with high-risk, HER2+ early BC who were randomly assigned to receive atezolizumab or placebo with PH+chemotherapy in the neoadjuvant setting and continued atezolizumab or placebo with PH in the adjuvant phase.

Disclosures: This study was sponsored by F. Hoffmann-La Roche Ltd. Six authors declared being employees or stockowners at Roche, and the other authors reported ties with various sources, including Roche.

Source: Huober J et al. Atezolizumab With Neoadjuvant anti–human epidermal growth factor receptor 2 therapy and chemotherapy in human epidermal growth factor receptor 2–positive early breast cancer: Primary results of the randomized phase III IMpassion050 trial. J Clin Oncol. 2022 (Jun 28). Doi:  10.1200/JCO.21.02772

Key clinical point: Addition of atezolizumab vs placebo to pertuzumab-trastuzumab (PH)+chemotherapy did not improve pathological complete response (pCR) rates in patients with high-risk, human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (BC).

Major finding: The rate of pCR was similar with atezolizumab and placebo in the intention-to-treat (62.4% and 62.7%, respectively; P  =  .9551) and programmed cell death-ligand 1-positive (64.2% and 72.5%, respectively; P  =  .1846) populations. The atezolizumab vs placebo group reported 5 vs 0 grade 5 adverse events, respectively.

Study details: Findings are from the phase 3 IMpassion050 study including 454 patients with high-risk, HER2+ early BC who were randomly assigned to receive atezolizumab or placebo with PH+chemotherapy in the neoadjuvant setting and continued atezolizumab or placebo with PH in the adjuvant phase.

Disclosures: This study was sponsored by F. Hoffmann-La Roche Ltd. Six authors declared being employees or stockowners at Roche, and the other authors reported ties with various sources, including Roche.

Source: Huober J et al. Atezolizumab With Neoadjuvant anti–human epidermal growth factor receptor 2 therapy and chemotherapy in human epidermal growth factor receptor 2–positive early breast cancer: Primary results of the randomized phase III IMpassion050 trial. J Clin Oncol. 2022 (Jun 28). Doi:  10.1200/JCO.21.02772

Key clinical point: The prophylactic use of etoricoxib reduced the incidence and severity of taxane-associated acute pain syndrome (T-APS) and potentially attenuated docetaxel-induced peripheral neuropathy in patients receiving docetaxel-based chemotherapy for breast cancer (BC).

Major finding: Incidence rates of all T-APS (57.1% vs 91.5%) and severe T-APS (11.4% vs 54.9%; both P < .001) were significantly lower in the etoricoxib vs no treatment group. At 3 months follow-up after 4 cycles of docetaxel chemotherapy, the etoricoxib vs no treatment group showed a significantly higher mean Functional Assessment of Cancer Treatment Neurotoxicity subscale score (38.46 vs 34.59; P < .001).

Study details: Findings are from a phase 2 study including 144 adult women with stage I-III BC who received 4 cycles of docetaxel-based chemotherapy and were randomly assigned to receive prophylactic etoricoxib or no treatment.

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

Source: Zhang J et al. Prevention of taxane-associated acute pain syndrome with etoricoxib for patients with breast cancer: A phase II randomised trial. Eur J Cancer. 2022;171:150-160 (Jun 17). Doi: 10.1016/j.ejca.2022.05.019

Key clinical point: The prophylactic use of etoricoxib reduced the incidence and severity of taxane-associated acute pain syndrome (T-APS) and potentially attenuated docetaxel-induced peripheral neuropathy in patients receiving docetaxel-based chemotherapy for breast cancer (BC).

Major finding: Incidence rates of all T-APS (57.1% vs 91.5%) and severe T-APS (11.4% vs 54.9%; both P < .001) were significantly lower in the etoricoxib vs no treatment group. At 3 months follow-up after 4 cycles of docetaxel chemotherapy, the etoricoxib vs no treatment group showed a significantly higher mean Functional Assessment of Cancer Treatment Neurotoxicity subscale score (38.46 vs 34.59; P < .001).

Study details: Findings are from a phase 2 study including 144 adult women with stage I-III BC who received 4 cycles of docetaxel-based chemotherapy and were randomly assigned to receive prophylactic etoricoxib or no treatment.

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

Source: Zhang J et al. Prevention of taxane-associated acute pain syndrome with etoricoxib for patients with breast cancer: A phase II randomised trial. Eur J Cancer. 2022;171:150-160 (Jun 17). Doi: 10.1016/j.ejca.2022.05.019

Key clinical point: The prophylactic use of etoricoxib reduced the incidence and severity of taxane-associated acute pain syndrome (T-APS) and potentially attenuated docetaxel-induced peripheral neuropathy in patients receiving docetaxel-based chemotherapy for breast cancer (BC).

Major finding: Incidence rates of all T-APS (57.1% vs 91.5%) and severe T-APS (11.4% vs 54.9%; both P < .001) were significantly lower in the etoricoxib vs no treatment group. At 3 months follow-up after 4 cycles of docetaxel chemotherapy, the etoricoxib vs no treatment group showed a significantly higher mean Functional Assessment of Cancer Treatment Neurotoxicity subscale score (38.46 vs 34.59; P < .001).

Study details: Findings are from a phase 2 study including 144 adult women with stage I-III BC who received 4 cycles of docetaxel-based chemotherapy and were randomly assigned to receive prophylactic etoricoxib or no treatment.

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

Source: Zhang J et al. Prevention of taxane-associated acute pain syndrome with etoricoxib for patients with breast cancer: A phase II randomised trial. Eur J Cancer. 2022;171:150-160 (Jun 17). Doi: 10.1016/j.ejca.2022.05.019

Key clinical point: First-line treatment with nivolumab, bevacizumab, and paclitaxel showed promising efficacy with a tolerable safety profile in patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (BC).

Major finding: The objective response rate was 70% (95% CI 55.9%-81.2%) in the overall cohort of patients with HER2-negative metastatic BC, 74% in patients with hormone receptor-positive BC, and 59% in patients with triple-negative BC. Grade 3/4 adverse drug reactions were reported by 58% of patients.

Study details: Findings are primary results from the phase 2 NEWBEAT study including 57 women with invasive, metastatic, or inoperable HER2-negative BC who received the first-line triple therapy with nivolumab, bevacizumab, and paclitaxel.

Disclosures: This study was supported by Ono Pharmaceutical Company. The authors declared receiving research funds, grants, personal fees, lecture fees, honoraria, or consulting fees from several sources, including Ono Pharmaceuticals.

Source: Ozaki Y et al. Safety and efficacy of nivolumab plus bevacizumab, paclitaxel for HER2-negative metastatic breast cancer: Primary results and biomarker data from a phase 2 trial (WJOG9917B). Eur J Cancer. 2022;171:193-202 (Jun 18). Doi: 10.1016/j.ejca.2022.05.014

Key clinical point: First-line treatment with nivolumab, bevacizumab, and paclitaxel showed promising efficacy with a tolerable safety profile in patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (BC).

Major finding: The objective response rate was 70% (95% CI 55.9%-81.2%) in the overall cohort of patients with HER2-negative metastatic BC, 74% in patients with hormone receptor-positive BC, and 59% in patients with triple-negative BC. Grade 3/4 adverse drug reactions were reported by 58% of patients.

Study details: Findings are primary results from the phase 2 NEWBEAT study including 57 women with invasive, metastatic, or inoperable HER2-negative BC who received the first-line triple therapy with nivolumab, bevacizumab, and paclitaxel.

Disclosures: This study was supported by Ono Pharmaceutical Company. The authors declared receiving research funds, grants, personal fees, lecture fees, honoraria, or consulting fees from several sources, including Ono Pharmaceuticals.

Source: Ozaki Y et al. Safety and efficacy of nivolumab plus bevacizumab, paclitaxel for HER2-negative metastatic breast cancer: Primary results and biomarker data from a phase 2 trial (WJOG9917B). Eur J Cancer. 2022;171:193-202 (Jun 18). Doi: 10.1016/j.ejca.2022.05.014

Key clinical point: First-line treatment with nivolumab, bevacizumab, and paclitaxel showed promising efficacy with a tolerable safety profile in patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (BC).

Major finding: The objective response rate was 70% (95% CI 55.9%-81.2%) in the overall cohort of patients with HER2-negative metastatic BC, 74% in patients with hormone receptor-positive BC, and 59% in patients with triple-negative BC. Grade 3/4 adverse drug reactions were reported by 58% of patients.

Study details: Findings are primary results from the phase 2 NEWBEAT study including 57 women with invasive, metastatic, or inoperable HER2-negative BC who received the first-line triple therapy with nivolumab, bevacizumab, and paclitaxel.

Disclosures: This study was supported by Ono Pharmaceutical Company. The authors declared receiving research funds, grants, personal fees, lecture fees, honoraria, or consulting fees from several sources, including Ono Pharmaceuticals.

Source: Ozaki Y et al. Safety and efficacy of nivolumab plus bevacizumab, paclitaxel for HER2-negative metastatic breast cancer: Primary results and biomarker data from a phase 2 trial (WJOG9917B). Eur J Cancer. 2022;171:193-202 (Jun 18). Doi: 10.1016/j.ejca.2022.05.014

Key clinical point: The risk for hemorrhage was not significantly different in patients with breast cancer (BC) aged ≥ 66 years who received direct oral anticoagulants (DOAC) concurrently with tamoxifen vs aromatase inhibitors (AI).

Major finding: During a median follow-up of 166 days, the risk for major hemorrhage requiring an emergency department visit or hospitalization (2.5% vs 3.3%; weighted hazard ratio [HR] 0.68; 95% CI 0.44-1.06) or any hemorrhage (4.9% vs 4.6%; weighted HR 1.04; 95% CI 0.75-1.43) was not higher with tamoxifen+DOAC compared with AI+DOAC.

Study details: Findings are from a population-based, retrospective cohort study including 4753 patients aged ≥ 66 years with BC who were prescribed tamoxifen or AI concurrently with a DOAC.

Disclosures: This study was supported by Canadian Institutes of Health Research and ICES. Some authors declared serving on advisory boards of or receiving grants, personal fees, or travel expenses from several sources.

Source: Wang T-F et al. Hemorrhage risk among patients with breast cancer receiving concurrent direct oral anticoagulants with tamoxifen vs aromatase inhibitors. JAMA Netw Open. 2022;5(6):e2219128 (Jun 28). Doi: 10.1001/jamanetworkopen.2022.19128

Key clinical point: The risk for hemorrhage was not significantly different in patients with breast cancer (BC) aged ≥ 66 years who received direct oral anticoagulants (DOAC) concurrently with tamoxifen vs aromatase inhibitors (AI).

Major finding: During a median follow-up of 166 days, the risk for major hemorrhage requiring an emergency department visit or hospitalization (2.5% vs 3.3%; weighted hazard ratio [HR] 0.68; 95% CI 0.44-1.06) or any hemorrhage (4.9% vs 4.6%; weighted HR 1.04; 95% CI 0.75-1.43) was not higher with tamoxifen+DOAC compared with AI+DOAC.

Study details: Findings are from a population-based, retrospective cohort study including 4753 patients aged ≥ 66 years with BC who were prescribed tamoxifen or AI concurrently with a DOAC.

Disclosures: This study was supported by Canadian Institutes of Health Research and ICES. Some authors declared serving on advisory boards of or receiving grants, personal fees, or travel expenses from several sources.

Source: Wang T-F et al. Hemorrhage risk among patients with breast cancer receiving concurrent direct oral anticoagulants with tamoxifen vs aromatase inhibitors. JAMA Netw Open. 2022;5(6):e2219128 (Jun 28). Doi: 10.1001/jamanetworkopen.2022.19128

Key clinical point: The risk for hemorrhage was not significantly different in patients with breast cancer (BC) aged ≥ 66 years who received direct oral anticoagulants (DOAC) concurrently with tamoxifen vs aromatase inhibitors (AI).

Major finding: During a median follow-up of 166 days, the risk for major hemorrhage requiring an emergency department visit or hospitalization (2.5% vs 3.3%; weighted hazard ratio [HR] 0.68; 95% CI 0.44-1.06) or any hemorrhage (4.9% vs 4.6%; weighted HR 1.04; 95% CI 0.75-1.43) was not higher with tamoxifen+DOAC compared with AI+DOAC.

Study details: Findings are from a population-based, retrospective cohort study including 4753 patients aged ≥ 66 years with BC who were prescribed tamoxifen or AI concurrently with a DOAC.

Disclosures: This study was supported by Canadian Institutes of Health Research and ICES. Some authors declared serving on advisory boards of or receiving grants, personal fees, or travel expenses from several sources.

Source: Wang T-F et al. Hemorrhage risk among patients with breast cancer receiving concurrent direct oral anticoagulants with tamoxifen vs aromatase inhibitors. JAMA Netw Open. 2022;5(6):e2219128 (Jun 28). Doi: 10.1001/jamanetworkopen.2022.19128