Breast Cancer

Targeted treatments, including antibody-drug conjugates and immunotherapy agents, are now standard of care for breast cancer, but there are limited data on the safety of combining these newer agents alongside radiotherapy.

One reason is studies of new drugs typically exclude concurrent radiotherapy, said Kathy Miller, MD, a contributor to this news organization and professor of oncology and medicine at the Indiana University School of Medicine, Indianapolis, Indiana.

If trials evaluating new targeted therapies included concurrent radiotherapy, it would be challenging to identify whether toxicities came from the drug itself, the radiation, or the combination, Dr. Miller explained.

Given the limited evidence, “we tend to be cautious and conservative” and not combine therapies that “we don’t know are safe or appropriate for patients,” said Chirag Shah, MD, director of breast radiology at the Cleveland Clinic, Cleveland, Ohio.

Below is a guide to what we do and don’t know about combining radiotherapy and systemic treatments in breast cancer.

1. Immunotherapy plus radiotherapy likely safe but evidence is limited

Safety data on combining immune checkpoint inhibitors and radiotherapy in breast cancer are limited because concurrent radiotherapy has typically been excluded in pivotal trials.

The 2020 KEYNOTE-522 trial did provide a rare look at concurrent radiotherapy and immunotherapy in early triple-negative breast cancer. The analysis found “no safety concerns” with concurrent radiotherapy and pembrolizumab, lead investigator Peter Schmid, MD, of Queen Mary University of London, England, told this news organization.

Research on other solid tumor types also suggests that radiotherapy “can be considered safe” alongside immunotherapy, the authors of a recent ESTRO consensus said.

Despite evidence indicating radiotherapy alongside immunotherapy can be safe in patients with breast cancer, “certain aspects, such as patient selection, total dose, and dose per fraction, remain open for debate to achieve the best therapeutic outcomes,” the ESTRO experts cautioned.

2. CDK4/6 inhibitors may be offered with radiotherapy in some settings, not others

CDK4/6 inhibitors are now standard of care for first- or second-line treatment in patients with advanced or metastatic hormone receptor–positive, human epidermal growth factor receptor 2 (HER2)–negative breast cancer.

“Unfortunately, we found no information regarding concurrent radiotherapy in the adjuvant setting” in pivotal trials for palbociclib, abemaciclib, and ribociclib, the ESTRO authors said. In the pivotal trials for palbociclib and abemaciclib, patients had to discontinue immunotherapy before initiating radiotherapy, and in the trial for ribociclib, palliative radiotherapy was allowed for relieving bone pain only.

However, in 2023, a team of experts from 12 countries attempted to piece together the available evidence, publishing a meta-analysis of 11 retrospective studies on the safety of CDK4/6 inhibitors given concurrently with radiotherapy in patients with metastatic disease.

Although most of these studies had small patient populations, the analysis revealed that CDK4/6 inhibitors given concurrently with radiotherapy in patients with metastatic breast cancer led to a similar side-effect profile to that observed in trials of the inhibitors given sequentially with adjuvant radiotherapy.

“These findings suggest that the simultaneous administration of CDK4/6 inhibitors and radiotherapy is generally well tolerated,” the ESTRO authors concluded but added that CDK4/6 inhibitors and concomitant radiotherapy should be investigated more in the adjuvant locoregional, whole brain, and intracranial stereotactic radiotherapy settings.

The expert panel did note, however, that CDK4/6 inhibitors and concomitant radiotherapy “could be offered” during palliative and ablative extracranial radiotherapy.

3. Only offer poly (ADP-ribose) polymerase (PARP) inhibitors plus radiotherapy in clinical trial setting

PARP inhibitors olaparib (Lynparza) and talazoprib (Talzenna) are standard of care in patients with metastatic breast cancer who have BRCA1/2 gene mutations. Olaparib is also indicated for high-risk early breast cancer following neoadjuvant or adjuvant chemotherapy.

But data on combining PARP inhibitors with radiotherapy in breast cancer also remain limited.

One ongoing phase 2 trial, comparing olaparib plus radiotherapy to radiotherapy alone in 300 people with inflammatory breast cancer, is aiming to tease out the safety of the combination and whether it improves local control in patients with aggressive disease.

“The desire is to explore the exciting possibility that low doses of PARP inhibition may radiosensitize tumor cells more than normal tissues,” Reshma Jagsi, MD, chair of the Department of Radiation Oncology at Emory University School of Medicine in Atlanta, Georgia, who is leading the study.

Because of potential good or bad interactions between new systemic therapies and radiotherapy, “intentional trial design” is important, Dr. Jagsi said, so we “know the best way to combine treatments in practice to optimize outcomes.”

But given the evidence to date, the ESTRO experts advised waiting until “further research provides more comprehensive safety and efficacy data” in the primary, adjuvant, and metastatic settings. The experts also advised not offering PARP inhibitors and concomitant radiotherapy to treat advanced breast cancer outside of clinical trials.

4. Phosphoinositide 3-kinase inhibitors (PI3K) inhibitors, mammalian target of rapamycin (mTOR) inhibitors, and newer targeted agents should not be offered concurrently with radiotherapy

Clinical trial data on the safety of combining PI3K and mTOR inhibitors with radiation are thin, especially in advanced breast cancer. Typically, radiotherapy within 4 weeks before randomization, or 2 weeks for palliative radiation, was excluded in pivotal trials.

For this reason, the ESTRO team recommended that concurrent radiation with either PI3K inhibitors or mTOR inhibitors “should not be offered.”

ESTRO also cautioned against providing radiation concurrently with newer anti-HER2 tyrosine-kinase drugs, such as neratinib or tucatinib, or newer antibody-drug conjugates such as trastuzumab deruxtecan, until more data emerge on the safety of these combinations.

5. Combining older HER2-targeted drugs and radiotherapy generally safe

The ESTRO authors agreed that older anti-HER2 drugs trastuzumab (Herceptin), pertuzumab (Perjeta), and lapatinib (Tykerb) can be safely used concurrently with locoregional radiotherapy as well.

One of the biggest concerns in the field is how to combine radiation with systemic therapies in the setting of brain metastases, and the data on these older anti-HER2 drugs are relatively clear that it’s safe, Dr. Miller said.

For instance, in a 2019 study of 84 patients with 487 brain metastases, stereotactic radiosurgery given alongside lapatinib led to significantly higher rates of complete responses than stereotactic radiosurgery alone (35% vs 11%) with no increased risk for radiation necrosis.

The ESTRO team agreed, noting that the latest evidence supports the use of trastuzumab, pertuzumab, or lapatinib alongside radiotherapy for whole brain and ablative intracranial stereotactic radiotherapy.

As for older antibody-drug conjugates, trastuzumab emtansine (T-DM1) plus radiotherapy “might be considered” during adjuvant locoregional radiotherapy for breast cancer but should not be offered for whole brain and ablative intracranial stereotactic radiotherapy, the ESTRO team said.

Dr. Jagsi declared the following conflicts in a recent 2024 publication: Stock options for advisory board role in Equity Quotient; grants or contracts from Genentech; and expert witness for Kleinbard, LLC, and Hawks Quindel Law. In the Keynote-522 trial publication Dr. Schmid declared relationships with AstraZeneca, Bayer, Boehringer Ingelheim, Celgene, Eisai, Hoffmann-La Roche, Genetech, Merck, Novartis, and Pfizer. Dr. Shah reported consulting for Impedimed, Videra Surgical, and PreludeDX.

A version of this article appeared on Medscape.com.

Targeted treatments, including antibody-drug conjugates and immunotherapy agents, are now standard of care for breast cancer, but there are limited data on the safety of combining these newer agents alongside radiotherapy.

One reason is studies of new drugs typically exclude concurrent radiotherapy, said Kathy Miller, MD, a contributor to this news organization and professor of oncology and medicine at the Indiana University School of Medicine, Indianapolis, Indiana.

If trials evaluating new targeted therapies included concurrent radiotherapy, it would be challenging to identify whether toxicities came from the drug itself, the radiation, or the combination, Dr. Miller explained.

Given the limited evidence, “we tend to be cautious and conservative” and not combine therapies that “we don’t know are safe or appropriate for patients,” said Chirag Shah, MD, director of breast radiology at the Cleveland Clinic, Cleveland, Ohio.

Below is a guide to what we do and don’t know about combining radiotherapy and systemic treatments in breast cancer.

1. Immunotherapy plus radiotherapy likely safe but evidence is limited

Safety data on combining immune checkpoint inhibitors and radiotherapy in breast cancer are limited because concurrent radiotherapy has typically been excluded in pivotal trials.

The 2020 KEYNOTE-522 trial did provide a rare look at concurrent radiotherapy and immunotherapy in early triple-negative breast cancer. The analysis found “no safety concerns” with concurrent radiotherapy and pembrolizumab, lead investigator Peter Schmid, MD, of Queen Mary University of London, England, told this news organization.

Research on other solid tumor types also suggests that radiotherapy “can be considered safe” alongside immunotherapy, the authors of a recent ESTRO consensus said.

Despite evidence indicating radiotherapy alongside immunotherapy can be safe in patients with breast cancer, “certain aspects, such as patient selection, total dose, and dose per fraction, remain open for debate to achieve the best therapeutic outcomes,” the ESTRO experts cautioned.

2. CDK4/6 inhibitors may be offered with radiotherapy in some settings, not others

CDK4/6 inhibitors are now standard of care for first- or second-line treatment in patients with advanced or metastatic hormone receptor–positive, human epidermal growth factor receptor 2 (HER2)–negative breast cancer.

“Unfortunately, we found no information regarding concurrent radiotherapy in the adjuvant setting” in pivotal trials for palbociclib, abemaciclib, and ribociclib, the ESTRO authors said. In the pivotal trials for palbociclib and abemaciclib, patients had to discontinue immunotherapy before initiating radiotherapy, and in the trial for ribociclib, palliative radiotherapy was allowed for relieving bone pain only.

However, in 2023, a team of experts from 12 countries attempted to piece together the available evidence, publishing a meta-analysis of 11 retrospective studies on the safety of CDK4/6 inhibitors given concurrently with radiotherapy in patients with metastatic disease.

Although most of these studies had small patient populations, the analysis revealed that CDK4/6 inhibitors given concurrently with radiotherapy in patients with metastatic breast cancer led to a similar side-effect profile to that observed in trials of the inhibitors given sequentially with adjuvant radiotherapy.

“These findings suggest that the simultaneous administration of CDK4/6 inhibitors and radiotherapy is generally well tolerated,” the ESTRO authors concluded but added that CDK4/6 inhibitors and concomitant radiotherapy should be investigated more in the adjuvant locoregional, whole brain, and intracranial stereotactic radiotherapy settings.

The expert panel did note, however, that CDK4/6 inhibitors and concomitant radiotherapy “could be offered” during palliative and ablative extracranial radiotherapy.

3. Only offer poly (ADP-ribose) polymerase (PARP) inhibitors plus radiotherapy in clinical trial setting

PARP inhibitors olaparib (Lynparza) and talazoprib (Talzenna) are standard of care in patients with metastatic breast cancer who have BRCA1/2 gene mutations. Olaparib is also indicated for high-risk early breast cancer following neoadjuvant or adjuvant chemotherapy.

But data on combining PARP inhibitors with radiotherapy in breast cancer also remain limited.

One ongoing phase 2 trial, comparing olaparib plus radiotherapy to radiotherapy alone in 300 people with inflammatory breast cancer, is aiming to tease out the safety of the combination and whether it improves local control in patients with aggressive disease.

“The desire is to explore the exciting possibility that low doses of PARP inhibition may radiosensitize tumor cells more than normal tissues,” Reshma Jagsi, MD, chair of the Department of Radiation Oncology at Emory University School of Medicine in Atlanta, Georgia, who is leading the study.

Because of potential good or bad interactions between new systemic therapies and radiotherapy, “intentional trial design” is important, Dr. Jagsi said, so we “know the best way to combine treatments in practice to optimize outcomes.”

But given the evidence to date, the ESTRO experts advised waiting until “further research provides more comprehensive safety and efficacy data” in the primary, adjuvant, and metastatic settings. The experts also advised not offering PARP inhibitors and concomitant radiotherapy to treat advanced breast cancer outside of clinical trials.

4. Phosphoinositide 3-kinase inhibitors (PI3K) inhibitors, mammalian target of rapamycin (mTOR) inhibitors, and newer targeted agents should not be offered concurrently with radiotherapy

Clinical trial data on the safety of combining PI3K and mTOR inhibitors with radiation are thin, especially in advanced breast cancer. Typically, radiotherapy within 4 weeks before randomization, or 2 weeks for palliative radiation, was excluded in pivotal trials.

For this reason, the ESTRO team recommended that concurrent radiation with either PI3K inhibitors or mTOR inhibitors “should not be offered.”

ESTRO also cautioned against providing radiation concurrently with newer anti-HER2 tyrosine-kinase drugs, such as neratinib or tucatinib, or newer antibody-drug conjugates such as trastuzumab deruxtecan, until more data emerge on the safety of these combinations.

5. Combining older HER2-targeted drugs and radiotherapy generally safe

The ESTRO authors agreed that older anti-HER2 drugs trastuzumab (Herceptin), pertuzumab (Perjeta), and lapatinib (Tykerb) can be safely used concurrently with locoregional radiotherapy as well.

One of the biggest concerns in the field is how to combine radiation with systemic therapies in the setting of brain metastases, and the data on these older anti-HER2 drugs are relatively clear that it’s safe, Dr. Miller said.

For instance, in a 2019 study of 84 patients with 487 brain metastases, stereotactic radiosurgery given alongside lapatinib led to significantly higher rates of complete responses than stereotactic radiosurgery alone (35% vs 11%) with no increased risk for radiation necrosis.

The ESTRO team agreed, noting that the latest evidence supports the use of trastuzumab, pertuzumab, or lapatinib alongside radiotherapy for whole brain and ablative intracranial stereotactic radiotherapy.

As for older antibody-drug conjugates, trastuzumab emtansine (T-DM1) plus radiotherapy “might be considered” during adjuvant locoregional radiotherapy for breast cancer but should not be offered for whole brain and ablative intracranial stereotactic radiotherapy, the ESTRO team said.

Dr. Jagsi declared the following conflicts in a recent 2024 publication: Stock options for advisory board role in Equity Quotient; grants or contracts from Genentech; and expert witness for Kleinbard, LLC, and Hawks Quindel Law. In the Keynote-522 trial publication Dr. Schmid declared relationships with AstraZeneca, Bayer, Boehringer Ingelheim, Celgene, Eisai, Hoffmann-La Roche, Genetech, Merck, Novartis, and Pfizer. Dr. Shah reported consulting for Impedimed, Videra Surgical, and PreludeDX.

A version of this article appeared on Medscape.com.

Targeted treatments, including antibody-drug conjugates and immunotherapy agents, are now standard of care for breast cancer, but there are limited data on the safety of combining these newer agents alongside radiotherapy.

One reason is studies of new drugs typically exclude concurrent radiotherapy, said Kathy Miller, MD, a contributor to this news organization and professor of oncology and medicine at the Indiana University School of Medicine, Indianapolis, Indiana.

If trials evaluating new targeted therapies included concurrent radiotherapy, it would be challenging to identify whether toxicities came from the drug itself, the radiation, or the combination, Dr. Miller explained.

Given the limited evidence, “we tend to be cautious and conservative” and not combine therapies that “we don’t know are safe or appropriate for patients,” said Chirag Shah, MD, director of breast radiology at the Cleveland Clinic, Cleveland, Ohio.

Below is a guide to what we do and don’t know about combining radiotherapy and systemic treatments in breast cancer.

1. Immunotherapy plus radiotherapy likely safe but evidence is limited

Safety data on combining immune checkpoint inhibitors and radiotherapy in breast cancer are limited because concurrent radiotherapy has typically been excluded in pivotal trials.

The 2020 KEYNOTE-522 trial did provide a rare look at concurrent radiotherapy and immunotherapy in early triple-negative breast cancer. The analysis found “no safety concerns” with concurrent radiotherapy and pembrolizumab, lead investigator Peter Schmid, MD, of Queen Mary University of London, England, told this news organization.

Research on other solid tumor types also suggests that radiotherapy “can be considered safe” alongside immunotherapy, the authors of a recent ESTRO consensus said.

Despite evidence indicating radiotherapy alongside immunotherapy can be safe in patients with breast cancer, “certain aspects, such as patient selection, total dose, and dose per fraction, remain open for debate to achieve the best therapeutic outcomes,” the ESTRO experts cautioned.

2. CDK4/6 inhibitors may be offered with radiotherapy in some settings, not others

CDK4/6 inhibitors are now standard of care for first- or second-line treatment in patients with advanced or metastatic hormone receptor–positive, human epidermal growth factor receptor 2 (HER2)–negative breast cancer.

“Unfortunately, we found no information regarding concurrent radiotherapy in the adjuvant setting” in pivotal trials for palbociclib, abemaciclib, and ribociclib, the ESTRO authors said. In the pivotal trials for palbociclib and abemaciclib, patients had to discontinue immunotherapy before initiating radiotherapy, and in the trial for ribociclib, palliative radiotherapy was allowed for relieving bone pain only.

However, in 2023, a team of experts from 12 countries attempted to piece together the available evidence, publishing a meta-analysis of 11 retrospective studies on the safety of CDK4/6 inhibitors given concurrently with radiotherapy in patients with metastatic disease.

Although most of these studies had small patient populations, the analysis revealed that CDK4/6 inhibitors given concurrently with radiotherapy in patients with metastatic breast cancer led to a similar side-effect profile to that observed in trials of the inhibitors given sequentially with adjuvant radiotherapy.

“These findings suggest that the simultaneous administration of CDK4/6 inhibitors and radiotherapy is generally well tolerated,” the ESTRO authors concluded but added that CDK4/6 inhibitors and concomitant radiotherapy should be investigated more in the adjuvant locoregional, whole brain, and intracranial stereotactic radiotherapy settings.

The expert panel did note, however, that CDK4/6 inhibitors and concomitant radiotherapy “could be offered” during palliative and ablative extracranial radiotherapy.

3. Only offer poly (ADP-ribose) polymerase (PARP) inhibitors plus radiotherapy in clinical trial setting

PARP inhibitors olaparib (Lynparza) and talazoprib (Talzenna) are standard of care in patients with metastatic breast cancer who have BRCA1/2 gene mutations. Olaparib is also indicated for high-risk early breast cancer following neoadjuvant or adjuvant chemotherapy.

But data on combining PARP inhibitors with radiotherapy in breast cancer also remain limited.

One ongoing phase 2 trial, comparing olaparib plus radiotherapy to radiotherapy alone in 300 people with inflammatory breast cancer, is aiming to tease out the safety of the combination and whether it improves local control in patients with aggressive disease.

“The desire is to explore the exciting possibility that low doses of PARP inhibition may radiosensitize tumor cells more than normal tissues,” Reshma Jagsi, MD, chair of the Department of Radiation Oncology at Emory University School of Medicine in Atlanta, Georgia, who is leading the study.

Because of potential good or bad interactions between new systemic therapies and radiotherapy, “intentional trial design” is important, Dr. Jagsi said, so we “know the best way to combine treatments in practice to optimize outcomes.”

But given the evidence to date, the ESTRO experts advised waiting until “further research provides more comprehensive safety and efficacy data” in the primary, adjuvant, and metastatic settings. The experts also advised not offering PARP inhibitors and concomitant radiotherapy to treat advanced breast cancer outside of clinical trials.

4. Phosphoinositide 3-kinase inhibitors (PI3K) inhibitors, mammalian target of rapamycin (mTOR) inhibitors, and newer targeted agents should not be offered concurrently with radiotherapy

Clinical trial data on the safety of combining PI3K and mTOR inhibitors with radiation are thin, especially in advanced breast cancer. Typically, radiotherapy within 4 weeks before randomization, or 2 weeks for palliative radiation, was excluded in pivotal trials.

For this reason, the ESTRO team recommended that concurrent radiation with either PI3K inhibitors or mTOR inhibitors “should not be offered.”

ESTRO also cautioned against providing radiation concurrently with newer anti-HER2 tyrosine-kinase drugs, such as neratinib or tucatinib, or newer antibody-drug conjugates such as trastuzumab deruxtecan, until more data emerge on the safety of these combinations.

5. Combining older HER2-targeted drugs and radiotherapy generally safe

The ESTRO authors agreed that older anti-HER2 drugs trastuzumab (Herceptin), pertuzumab (Perjeta), and lapatinib (Tykerb) can be safely used concurrently with locoregional radiotherapy as well.

One of the biggest concerns in the field is how to combine radiation with systemic therapies in the setting of brain metastases, and the data on these older anti-HER2 drugs are relatively clear that it’s safe, Dr. Miller said.

For instance, in a 2019 study of 84 patients with 487 brain metastases, stereotactic radiosurgery given alongside lapatinib led to significantly higher rates of complete responses than stereotactic radiosurgery alone (35% vs 11%) with no increased risk for radiation necrosis.

The ESTRO team agreed, noting that the latest evidence supports the use of trastuzumab, pertuzumab, or lapatinib alongside radiotherapy for whole brain and ablative intracranial stereotactic radiotherapy.

As for older antibody-drug conjugates, trastuzumab emtansine (T-DM1) plus radiotherapy “might be considered” during adjuvant locoregional radiotherapy for breast cancer but should not be offered for whole brain and ablative intracranial stereotactic radiotherapy, the ESTRO team said.

Dr. Jagsi declared the following conflicts in a recent 2024 publication: Stock options for advisory board role in Equity Quotient; grants or contracts from Genentech; and expert witness for Kleinbard, LLC, and Hawks Quindel Law. In the Keynote-522 trial publication Dr. Schmid declared relationships with AstraZeneca, Bayer, Boehringer Ingelheim, Celgene, Eisai, Hoffmann-La Roche, Genetech, Merck, Novartis, and Pfizer. Dr. Shah reported consulting for Impedimed, Videra Surgical, and PreludeDX.

A version of this article appeared on Medscape.com.

Click to view the Digital Edition.

In this issue: 

Hepatocellular Carcinoma
Special care for veterans, changes in staging, and biomarkers for early diagnosis

Lung Cancer
Guideline updates and racial disparities in veterans

Multiple Myeloma
Improving survival in the VA

Colorectal Cancer
Barriers to follow-up colonoscopies after FIT testing 

B-Cell Lymphomas
Findings from the VA's National TeleOncology Program and recent therapy updates

Breast Cancer
A look at the VA's Risk Assessment Pipeline and incidence among veterans vs the general population

Genitourinary Cancers
Molecular testing in prostate cancer, improving survival for metastatic RCC, and links between bladder cancer and Agent Orange exposure

Click to view the Digital Edition.

In this issue: 

Hepatocellular Carcinoma
Special care for veterans, changes in staging, and biomarkers for early diagnosis

Lung Cancer
Guideline updates and racial disparities in veterans

Multiple Myeloma
Improving survival in the VA

Colorectal Cancer
Barriers to follow-up colonoscopies after FIT testing 

B-Cell Lymphomas
Findings from the VA's National TeleOncology Program and recent therapy updates

Breast Cancer
A look at the VA's Risk Assessment Pipeline and incidence among veterans vs the general population

Genitourinary Cancers
Molecular testing in prostate cancer, improving survival for metastatic RCC, and links between bladder cancer and Agent Orange exposure

Click to view the Digital Edition.

In this issue: 

Hepatocellular Carcinoma
Special care for veterans, changes in staging, and biomarkers for early diagnosis

Lung Cancer
Guideline updates and racial disparities in veterans

Multiple Myeloma
Improving survival in the VA

Colorectal Cancer
Barriers to follow-up colonoscopies after FIT testing 

B-Cell Lymphomas
Findings from the VA's National TeleOncology Program and recent therapy updates

Breast Cancer
A look at the VA's Risk Assessment Pipeline and incidence among veterans vs the general population

Genitourinary Cancers
Molecular testing in prostate cancer, improving survival for metastatic RCC, and links between bladder cancer and Agent Orange exposure

TOPLINE:

When considering a job offer at an academic radiation oncology practice, the prospective employee should focus on three key factors — compensation, daily duties, and location — and accept an offer if the practice is “great” in at least two of those areas and “good” in the third, experts say in a recent editorial.

METHODOLOGY:

• Many physicians choose to go into academic medicine because they want to stay involved in research and education while still treating patients.
• However, graduating radiation oncology residents often lack or have limited guidance on what to look for in a prospective job and how to assess their contract.
• This recent editorial provides guidance to radiation oncologists seeking academic positions. The authors advise prospective employees to evaluate three main factors — compensation, daily duties, and location — as well as provide tips for identifying red flags in each category.

TAKEAWAY:

• Compensation: Prospective faculty should assess both direct compensation, that is, salary, and indirect compensation, which typically includes retirement contributions and other perks. For direct compensation, what is the base salary? Is extra work compensated? How does the salary offer measure up to salary data reported by national agencies? Also: Don’t overlook uncompensated duties, such as time in tumor boards or in meetings, which may be time-consuming, and make sure compensation terms are clearly delineated in a contract and equitable among physicians in a specific rank.
• Daily duties: When it comes to daily life on the job, a prospective employee should consider many factors, including the cancer center’s excitement to hire you, the reputation of the faculty and leaders at the organization, employee turnover rates, diversity among faculty, and the time line of career advancement.
• Location: The location of the job encompasses the geography — such as distance from home to work, the number of practices covered, cost of living, and the area itself — as well as the atmosphere for conducting research and publishing.
• Finally, carefully review the job contract. All the key aspects of the job, including compensation and benefits, should be clearly stated in the contract to “improve communication of expectations.”

IN PRACTICE:

“A prospective faculty member can ask 100 questions, but they can’t make 100 demands; consideration of the three domains can help to focus negotiation efforts where the efforts are needed,” the authors noted.

SOURCE:

This editorial, led by Nicholas G. Zaorsky from the Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, Ohio, was published online in Practical Radiation Oncology

DISCLOSURES:

The lead author declared being supported by the American Cancer Society and National Institutes of Health. He also reported having ties with many other sources.

A version of this article appeared on Medscape.com.

TOPLINE:

When considering a job offer at an academic radiation oncology practice, the prospective employee should focus on three key factors — compensation, daily duties, and location — and accept an offer if the practice is “great” in at least two of those areas and “good” in the third, experts say in a recent editorial.

METHODOLOGY:

• Many physicians choose to go into academic medicine because they want to stay involved in research and education while still treating patients.
• However, graduating radiation oncology residents often lack or have limited guidance on what to look for in a prospective job and how to assess their contract.
• This recent editorial provides guidance to radiation oncologists seeking academic positions. The authors advise prospective employees to evaluate three main factors — compensation, daily duties, and location — as well as provide tips for identifying red flags in each category.

TAKEAWAY:

• Compensation: Prospective faculty should assess both direct compensation, that is, salary, and indirect compensation, which typically includes retirement contributions and other perks. For direct compensation, what is the base salary? Is extra work compensated? How does the salary offer measure up to salary data reported by national agencies? Also: Don’t overlook uncompensated duties, such as time in tumor boards or in meetings, which may be time-consuming, and make sure compensation terms are clearly delineated in a contract and equitable among physicians in a specific rank.
• Daily duties: When it comes to daily life on the job, a prospective employee should consider many factors, including the cancer center’s excitement to hire you, the reputation of the faculty and leaders at the organization, employee turnover rates, diversity among faculty, and the time line of career advancement.
• Location: The location of the job encompasses the geography — such as distance from home to work, the number of practices covered, cost of living, and the area itself — as well as the atmosphere for conducting research and publishing.
• Finally, carefully review the job contract. All the key aspects of the job, including compensation and benefits, should be clearly stated in the contract to “improve communication of expectations.”

IN PRACTICE:

“A prospective faculty member can ask 100 questions, but they can’t make 100 demands; consideration of the three domains can help to focus negotiation efforts where the efforts are needed,” the authors noted.

SOURCE:

This editorial, led by Nicholas G. Zaorsky from the Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, Ohio, was published online in Practical Radiation Oncology

DISCLOSURES:

The lead author declared being supported by the American Cancer Society and National Institutes of Health. He also reported having ties with many other sources.

A version of this article appeared on Medscape.com.

TOPLINE:

When considering a job offer at an academic radiation oncology practice, the prospective employee should focus on three key factors — compensation, daily duties, and location — and accept an offer if the practice is “great” in at least two of those areas and “good” in the third, experts say in a recent editorial.

METHODOLOGY:

• Many physicians choose to go into academic medicine because they want to stay involved in research and education while still treating patients.
• However, graduating radiation oncology residents often lack or have limited guidance on what to look for in a prospective job and how to assess their contract.
• This recent editorial provides guidance to radiation oncologists seeking academic positions. The authors advise prospective employees to evaluate three main factors — compensation, daily duties, and location — as well as provide tips for identifying red flags in each category.

TAKEAWAY:

• Compensation: Prospective faculty should assess both direct compensation, that is, salary, and indirect compensation, which typically includes retirement contributions and other perks. For direct compensation, what is the base salary? Is extra work compensated? How does the salary offer measure up to salary data reported by national agencies? Also: Don’t overlook uncompensated duties, such as time in tumor boards or in meetings, which may be time-consuming, and make sure compensation terms are clearly delineated in a contract and equitable among physicians in a specific rank.
• Daily duties: When it comes to daily life on the job, a prospective employee should consider many factors, including the cancer center’s excitement to hire you, the reputation of the faculty and leaders at the organization, employee turnover rates, diversity among faculty, and the time line of career advancement.
• Location: The location of the job encompasses the geography — such as distance from home to work, the number of practices covered, cost of living, and the area itself — as well as the atmosphere for conducting research and publishing.
• Finally, carefully review the job contract. All the key aspects of the job, including compensation and benefits, should be clearly stated in the contract to “improve communication of expectations.”

IN PRACTICE:

“A prospective faculty member can ask 100 questions, but they can’t make 100 demands; consideration of the three domains can help to focus negotiation efforts where the efforts are needed,” the authors noted.

SOURCE:

This editorial, led by Nicholas G. Zaorsky from the Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, Ohio, was published online in Practical Radiation Oncology

DISCLOSURES:

The lead author declared being supported by the American Cancer Society and National Institutes of Health. He also reported having ties with many other sources.

A version of this article appeared on Medscape.com.

Key clinical point: The risk factors for overall breast cancer (such as parity, menopausal hormone therapy use, and alcohol consumption) did not increase the risk for triple-negative breast cancer (TNBC), which had a distinct risk factor profile.

Major finding: Parity, menopausal hormone therapy use, alcohol consumption, smoking, and higher body mass index were not significantly associated with TNBC risk (all P > .05); instead, family history (odds ratio [OR] 1.55; P < .001), longer duration of oral contraceptive use (OR 1.29; P < .001), and higher breast density (OR 2.19; P < .001) were significantly associated with an increased risk for TNBC.

Study details: This meta-analysis evaluated the association between TNBC incidence and established BC risk factors using data from 33 studies.

Disclosures: This study was supported by grants from the American Cancer Society and Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB Bahrain). The authors declared no conflicts of interest.

Source: Kumar N, Ehsan S, Banerjee S, et al. The unique risk factor profile of triple negative breast cancer: A comprehensive meta-analysis. J Natl Cancer Inst. 2024 (Mar 5). Doi: 10.1093/jnci/djae056 Source

Key clinical point: The risk factors for overall breast cancer (such as parity, menopausal hormone therapy use, and alcohol consumption) did not increase the risk for triple-negative breast cancer (TNBC), which had a distinct risk factor profile.

Major finding: Parity, menopausal hormone therapy use, alcohol consumption, smoking, and higher body mass index were not significantly associated with TNBC risk (all P > .05); instead, family history (odds ratio [OR] 1.55; P < .001), longer duration of oral contraceptive use (OR 1.29; P < .001), and higher breast density (OR 2.19; P < .001) were significantly associated with an increased risk for TNBC.

Study details: This meta-analysis evaluated the association between TNBC incidence and established BC risk factors using data from 33 studies.

Disclosures: This study was supported by grants from the American Cancer Society and Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB Bahrain). The authors declared no conflicts of interest.

Source: Kumar N, Ehsan S, Banerjee S, et al. The unique risk factor profile of triple negative breast cancer: A comprehensive meta-analysis. J Natl Cancer Inst. 2024 (Mar 5). Doi: 10.1093/jnci/djae056 Source

Key clinical point: The risk factors for overall breast cancer (such as parity, menopausal hormone therapy use, and alcohol consumption) did not increase the risk for triple-negative breast cancer (TNBC), which had a distinct risk factor profile.

Major finding: Parity, menopausal hormone therapy use, alcohol consumption, smoking, and higher body mass index were not significantly associated with TNBC risk (all P > .05); instead, family history (odds ratio [OR] 1.55; P < .001), longer duration of oral contraceptive use (OR 1.29; P < .001), and higher breast density (OR 2.19; P < .001) were significantly associated with an increased risk for TNBC.

Study details: This meta-analysis evaluated the association between TNBC incidence and established BC risk factors using data from 33 studies.

Disclosures: This study was supported by grants from the American Cancer Society and Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB Bahrain). The authors declared no conflicts of interest.

Source: Kumar N, Ehsan S, Banerjee S, et al. The unique risk factor profile of triple negative breast cancer: A comprehensive meta-analysis. J Natl Cancer Inst. 2024 (Mar 5). Doi: 10.1093/jnci/djae056 Source

Key clinical point: The pro-vegetarian dietary pattern (PDP) was associated with a significantly lower risk for breast cancer (BC) in women, particularly postmenopausal women.

Major finding: Compared with women who had low adherence to PDP (score ≤ 33), the risk for BC was significantly lower among women with moderate adherence to PDP (score 34-38; adjusted odds ratio [aOR] 0.42; P = .003) and in those with high adherence to PDP (score ≥ 39; aOR 0.49; P = .017), with outcomes being similar in the subgroup of postmenopausal women.

Study details: Findings are from a case-control study including women with BC (n = 134) and those without cancer (n = 265).

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

Source: Hosseini Y, Hadi Sichani P, Moslemi E, et al. Pro-vegetarian dietary pattern and risk of breast cancer: A case-control study. Breast Cancer Res Treat. 2024 (Feb 28). doi: 10.1007/s10549-024-07243-8 Source

Key clinical point: The pro-vegetarian dietary pattern (PDP) was associated with a significantly lower risk for breast cancer (BC) in women, particularly postmenopausal women.

Major finding: Compared with women who had low adherence to PDP (score ≤ 33), the risk for BC was significantly lower among women with moderate adherence to PDP (score 34-38; adjusted odds ratio [aOR] 0.42; P = .003) and in those with high adherence to PDP (score ≥ 39; aOR 0.49; P = .017), with outcomes being similar in the subgroup of postmenopausal women.

Study details: Findings are from a case-control study including women with BC (n = 134) and those without cancer (n = 265).

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

Source: Hosseini Y, Hadi Sichani P, Moslemi E, et al. Pro-vegetarian dietary pattern and risk of breast cancer: A case-control study. Breast Cancer Res Treat. 2024 (Feb 28). doi: 10.1007/s10549-024-07243-8 Source

Key clinical point: The pro-vegetarian dietary pattern (PDP) was associated with a significantly lower risk for breast cancer (BC) in women, particularly postmenopausal women.

Major finding: Compared with women who had low adherence to PDP (score ≤ 33), the risk for BC was significantly lower among women with moderate adherence to PDP (score 34-38; adjusted odds ratio [aOR] 0.42; P = .003) and in those with high adherence to PDP (score ≥ 39; aOR 0.49; P = .017), with outcomes being similar in the subgroup of postmenopausal women.

Study details: Findings are from a case-control study including women with BC (n = 134) and those without cancer (n = 265).

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

Source: Hosseini Y, Hadi Sichani P, Moslemi E, et al. Pro-vegetarian dietary pattern and risk of breast cancer: A case-control study. Breast Cancer Res Treat. 2024 (Feb 28). doi: 10.1007/s10549-024-07243-8 Source

Key clinical point: Everolimus + exemestane demonstrated good efficacy and had a manageable safety profile in postmenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC).

Major finding: Everolimus + exemestane led to a median progression-free survival (PFS) of 6.6 months (95% CI 6.3-7.0 months). PFS was more favorable among patients with a greater vs lower body mass index (≥25 vs 20 to <25 kg/m²; P < .0001); however, the survival outcomes were worse among patients with vs without visceral metastases (hazard ratio 1.417; P < .0001). Stomatitis (42.6%) and fatigue (19.8%) were the most frequent adverse events.

Study details: Findings are from a prospective, non-interventional study including 2074 postmenopausal women with HR+/HER2− advanced BC who received everolimus + exemestane.

Disclosures: This study was funded by Novartis Deutschland GmbH, Germany. Two authors declared being employees of or holding stocks in Novartis. Some authors declared receiving honoraria or personal fees or having other ties with Novartis and various other sources. Eight authors declared no conflicts of interest.

Source: Lüftner D, Schuetz F, Schneeweiss A, et al. Efficacy and safety of everolimus plus exemestane in patients with hormone receptor-positive, HER-2-negative advanced breast cancer: Results from the open-label, multicentre, non-interventional BRAWO study. Int J Cancer. 2024 (Mar 6). doi: 10.1002/ijc.34912 Source

Key clinical point: Everolimus + exemestane demonstrated good efficacy and had a manageable safety profile in postmenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC).

Major finding: Everolimus + exemestane led to a median progression-free survival (PFS) of 6.6 months (95% CI 6.3-7.0 months). PFS was more favorable among patients with a greater vs lower body mass index (≥25 vs 20 to <25 kg/m²; P < .0001); however, the survival outcomes were worse among patients with vs without visceral metastases (hazard ratio 1.417; P < .0001). Stomatitis (42.6%) and fatigue (19.8%) were the most frequent adverse events.

Study details: Findings are from a prospective, non-interventional study including 2074 postmenopausal women with HR+/HER2− advanced BC who received everolimus + exemestane.

Disclosures: This study was funded by Novartis Deutschland GmbH, Germany. Two authors declared being employees of or holding stocks in Novartis. Some authors declared receiving honoraria or personal fees or having other ties with Novartis and various other sources. Eight authors declared no conflicts of interest.

Source: Lüftner D, Schuetz F, Schneeweiss A, et al. Efficacy and safety of everolimus plus exemestane in patients with hormone receptor-positive, HER-2-negative advanced breast cancer: Results from the open-label, multicentre, non-interventional BRAWO study. Int J Cancer. 2024 (Mar 6). doi: 10.1002/ijc.34912 Source

Key clinical point: Everolimus + exemestane demonstrated good efficacy and had a manageable safety profile in postmenopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) breast cancer (BC).

Major finding: Everolimus + exemestane led to a median progression-free survival (PFS) of 6.6 months (95% CI 6.3-7.0 months). PFS was more favorable among patients with a greater vs lower body mass index (≥25 vs 20 to <25 kg/m²; P < .0001); however, the survival outcomes were worse among patients with vs without visceral metastases (hazard ratio 1.417; P < .0001). Stomatitis (42.6%) and fatigue (19.8%) were the most frequent adverse events.

Study details: Findings are from a prospective, non-interventional study including 2074 postmenopausal women with HR+/HER2− advanced BC who received everolimus + exemestane.

Disclosures: This study was funded by Novartis Deutschland GmbH, Germany. Two authors declared being employees of or holding stocks in Novartis. Some authors declared receiving honoraria or personal fees or having other ties with Novartis and various other sources. Eight authors declared no conflicts of interest.

Source: Lüftner D, Schuetz F, Schneeweiss A, et al. Efficacy and safety of everolimus plus exemestane in patients with hormone receptor-positive, HER-2-negative advanced breast cancer: Results from the open-label, multicentre, non-interventional BRAWO study. Int J Cancer. 2024 (Mar 6). doi: 10.1002/ijc.34912 Source

Key clinical point: Sentinel lymph node biopsy (SLNB), a less invasive strategy, resulted in comparable survival and regional disease control as axillary lymph node dissection (ALND) in patients with sentinel node-positive early breast cancer (BC) who underwent total mastectomy (TM).

Major finding: There were no significant differences in 5-year ipsilateral locoregional recurrence-free survival (LRRFS; P = .21), 5-year distant metastasis-free survival (P = .96), and disease-free survival (P > .05) between the SLNB-alone and ALND groups. However, receipt vs no receipt of radiation therapy improved local disease control in the SLNB group (5-year LRRFS; 100.0% vs 92.9%; P = .02).

Study details: Findings are from a retrospective study including 643 patients with early BC with 1-3 metastatic sentinel lymph nodes who underwent total mastectomy, of which 237 and 406 patients underwent SLNB alone and completion ALND, respectively.

Disclosures: The open access funding for this study was enabled and organized by Seoul National University. The authors declared no conflicts of interest.

Source: Chun JW, Kang E, Kim H-K, et al. Oncological safety of skipping axillary lymph node dissection in patients with clinical N0, sentinel node-positive breast cancer undergoing total mastectomy. Ann Surg Oncol. 2024 (Feb 17). doi: 10.1245/s10434-024-15049-7 Source

Key clinical point: Sentinel lymph node biopsy (SLNB), a less invasive strategy, resulted in comparable survival and regional disease control as axillary lymph node dissection (ALND) in patients with sentinel node-positive early breast cancer (BC) who underwent total mastectomy (TM).

Major finding: There were no significant differences in 5-year ipsilateral locoregional recurrence-free survival (LRRFS; P = .21), 5-year distant metastasis-free survival (P = .96), and disease-free survival (P > .05) between the SLNB-alone and ALND groups. However, receipt vs no receipt of radiation therapy improved local disease control in the SLNB group (5-year LRRFS; 100.0% vs 92.9%; P = .02).

Study details: Findings are from a retrospective study including 643 patients with early BC with 1-3 metastatic sentinel lymph nodes who underwent total mastectomy, of which 237 and 406 patients underwent SLNB alone and completion ALND, respectively.

Disclosures: The open access funding for this study was enabled and organized by Seoul National University. The authors declared no conflicts of interest.

Source: Chun JW, Kang E, Kim H-K, et al. Oncological safety of skipping axillary lymph node dissection in patients with clinical N0, sentinel node-positive breast cancer undergoing total mastectomy. Ann Surg Oncol. 2024 (Feb 17). doi: 10.1245/s10434-024-15049-7 Source

Key clinical point: Sentinel lymph node biopsy (SLNB), a less invasive strategy, resulted in comparable survival and regional disease control as axillary lymph node dissection (ALND) in patients with sentinel node-positive early breast cancer (BC) who underwent total mastectomy (TM).

Major finding: There were no significant differences in 5-year ipsilateral locoregional recurrence-free survival (LRRFS; P = .21), 5-year distant metastasis-free survival (P = .96), and disease-free survival (P > .05) between the SLNB-alone and ALND groups. However, receipt vs no receipt of radiation therapy improved local disease control in the SLNB group (5-year LRRFS; 100.0% vs 92.9%; P = .02).

Study details: Findings are from a retrospective study including 643 patients with early BC with 1-3 metastatic sentinel lymph nodes who underwent total mastectomy, of which 237 and 406 patients underwent SLNB alone and completion ALND, respectively.

Disclosures: The open access funding for this study was enabled and organized by Seoul National University. The authors declared no conflicts of interest.

Source: Chun JW, Kang E, Kim H-K, et al. Oncological safety of skipping axillary lymph node dissection in patients with clinical N0, sentinel node-positive breast cancer undergoing total mastectomy. Ann Surg Oncol. 2024 (Feb 17). doi: 10.1245/s10434-024-15049-7 Source

Key clinical point: The coexistence of obesity and family history of cancer significantly increased the risk for breast cancer (BC) in women, suggesting that weight management is important in women with a family history of cancer.

Major finding: The risk for BC was significantly higher in women with vs without a family history of BC (adjusted hazard ratio [aHR] 1.63; 95% CI 1.22-2.49). The risk was further elevated in women with a body mass index (BMI) ≥ 24 kg/m² and a family history of cancer vs women with BMI < 24 kg/m² and no family history of cancer (adjusted hazard ratio 2.06; 95% CI 1.39-3.06).

Study details: Findings are from a population-based prospective cohort study that included 15,055 women, of which 4210 women had a family history of cancer.

Disclosures: This study was supported by the Nature Science Foundation of Minhang district, Shanghai, China. The authors declared no conflicts of interest.

Source: Cao J, Li J, Zhang Z, et al. Interaction between body mass index and family history of cancer on the risk of female breast cancer. Sci Rep. 2024;14:4927 (Feb 28). doi: 10.1038/s41598-024-54762-x Source

Key clinical point: The coexistence of obesity and family history of cancer significantly increased the risk for breast cancer (BC) in women, suggesting that weight management is important in women with a family history of cancer.

Major finding: The risk for BC was significantly higher in women with vs without a family history of BC (adjusted hazard ratio [aHR] 1.63; 95% CI 1.22-2.49). The risk was further elevated in women with a body mass index (BMI) ≥ 24 kg/m² and a family history of cancer vs women with BMI < 24 kg/m² and no family history of cancer (adjusted hazard ratio 2.06; 95% CI 1.39-3.06).

Study details: Findings are from a population-based prospective cohort study that included 15,055 women, of which 4210 women had a family history of cancer.

Disclosures: This study was supported by the Nature Science Foundation of Minhang district, Shanghai, China. The authors declared no conflicts of interest.

Source: Cao J, Li J, Zhang Z, et al. Interaction between body mass index and family history of cancer on the risk of female breast cancer. Sci Rep. 2024;14:4927 (Feb 28). doi: 10.1038/s41598-024-54762-x Source

Key clinical point: The coexistence of obesity and family history of cancer significantly increased the risk for breast cancer (BC) in women, suggesting that weight management is important in women with a family history of cancer.

Major finding: The risk for BC was significantly higher in women with vs without a family history of BC (adjusted hazard ratio [aHR] 1.63; 95% CI 1.22-2.49). The risk was further elevated in women with a body mass index (BMI) ≥ 24 kg/m² and a family history of cancer vs women with BMI < 24 kg/m² and no family history of cancer (adjusted hazard ratio 2.06; 95% CI 1.39-3.06).

Study details: Findings are from a population-based prospective cohort study that included 15,055 women, of which 4210 women had a family history of cancer.

Disclosures: This study was supported by the Nature Science Foundation of Minhang district, Shanghai, China. The authors declared no conflicts of interest.

Source: Cao J, Li J, Zhang Z, et al. Interaction between body mass index and family history of cancer on the risk of female breast cancer. Sci Rep. 2024;14:4927 (Feb 28). doi: 10.1038/s41598-024-54762-x Source

Key clinical point: Compared with mastectomy, breast-conserving surgery (BCS) led to comparable locoregional recurrence (LRR; the first relapse site) events along with improved survival outcomes in patients with early-stage node-negative triple-negative breast cancer (TNBC) treated with neoadjuvant chemotherapy.

Major finding: BCS vs mastectomy following neoadjuvant chemotherapy did not increase LRR (P = .5209) and was significantly associated with improved disease-free survival (adjusted hazard ratio [aHR] 0.51; P < .001) and overall survival (aHR 0.43; P < .001). Absence of pathologic complete response was the only determinant for worsened LRR risk (HR 2.22; P = .001).

Study details: This retrospective analysis of eight prospective trials included 1074 neoadjuvant chemotherapy-treated patients with early-stage node-negative TNBC and available surgery data.

Disclosures: This study received financial support from Deutschen Forschungsgemeinschaft (DFG) within the funding program Open Access Publikationskosten. Three authors declared being employees of GBG Forschungs GmbH. Ninel authors declared receiving honoraria, grants, consulting fees, or personal fees or having other ties with various sources. The other authors had no conflicts to declare.

Source: Krug D, Vladimirova V, Untch M, et al. Breast-conserving surgery is not associated with increased local recurrence in patients with early-stage node-negative triple-negative breast cancer treated with neoadjuvant chemotherapy. Breast. 2024;74:103701 (Feb 24). doi: 10.1016/j.breast.2024.103701 Source

Key clinical point: Compared with mastectomy, breast-conserving surgery (BCS) led to comparable locoregional recurrence (LRR; the first relapse site) events along with improved survival outcomes in patients with early-stage node-negative triple-negative breast cancer (TNBC) treated with neoadjuvant chemotherapy.

Major finding: BCS vs mastectomy following neoadjuvant chemotherapy did not increase LRR (P = .5209) and was significantly associated with improved disease-free survival (adjusted hazard ratio [aHR] 0.51; P < .001) and overall survival (aHR 0.43; P < .001). Absence of pathologic complete response was the only determinant for worsened LRR risk (HR 2.22; P = .001).

Study details: This retrospective analysis of eight prospective trials included 1074 neoadjuvant chemotherapy-treated patients with early-stage node-negative TNBC and available surgery data.

Disclosures: This study received financial support from Deutschen Forschungsgemeinschaft (DFG) within the funding program Open Access Publikationskosten. Three authors declared being employees of GBG Forschungs GmbH. Ninel authors declared receiving honoraria, grants, consulting fees, or personal fees or having other ties with various sources. The other authors had no conflicts to declare.

Source: Krug D, Vladimirova V, Untch M, et al. Breast-conserving surgery is not associated with increased local recurrence in patients with early-stage node-negative triple-negative breast cancer treated with neoadjuvant chemotherapy. Breast. 2024;74:103701 (Feb 24). doi: 10.1016/j.breast.2024.103701 Source

Key clinical point: Compared with mastectomy, breast-conserving surgery (BCS) led to comparable locoregional recurrence (LRR; the first relapse site) events along with improved survival outcomes in patients with early-stage node-negative triple-negative breast cancer (TNBC) treated with neoadjuvant chemotherapy.

Major finding: BCS vs mastectomy following neoadjuvant chemotherapy did not increase LRR (P = .5209) and was significantly associated with improved disease-free survival (adjusted hazard ratio [aHR] 0.51; P < .001) and overall survival (aHR 0.43; P < .001). Absence of pathologic complete response was the only determinant for worsened LRR risk (HR 2.22; P = .001).

Study details: This retrospective analysis of eight prospective trials included 1074 neoadjuvant chemotherapy-treated patients with early-stage node-negative TNBC and available surgery data.

Disclosures: This study received financial support from Deutschen Forschungsgemeinschaft (DFG) within the funding program Open Access Publikationskosten. Three authors declared being employees of GBG Forschungs GmbH. Ninel authors declared receiving honoraria, grants, consulting fees, or personal fees or having other ties with various sources. The other authors had no conflicts to declare.

Source: Krug D, Vladimirova V, Untch M, et al. Breast-conserving surgery is not associated with increased local recurrence in patients with early-stage node-negative triple-negative breast cancer treated with neoadjuvant chemotherapy. Breast. 2024;74:103701 (Feb 24). doi: 10.1016/j.breast.2024.103701 Source