Breast Cancer

Key clinical point: Pyrotinib led to promising long-term outcomes and was well-tolerated in patients with human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (BC) and brain metastases (BM).

Major finding: In patients with BM, the overall median progression-free survival (PFS), considering both intracranial and extracranial lesions, was 7.50 months (95% CI 5.84-9.16) and median overall survival was 21.27 months (95% CI 20.10-22.44), with the median PFS not improving in patients who received vs did not receive radiotherapy (P  =  .319). Diarrhea (any grade) was the most common adverse event.

Study details: This real-world study included 239 patients with HER2+ metastatic BC who received pyrotinib-based therapy, of whom 61 patients had BM.

Disclosures: This study was supported by the keyAtlas precision medicine and clinical research project of Shanghai Science & Technology Development Foundation, China. The authors declared no conflicts of interest.

Source: Liang X et al. Long-term outcome analysis of pyrotinib in patients with HER2-Positive metastatic breast cancer and brain metastasis: A real-world study. Oncologist. 2023 (Aug 17). doi: 10.1093/oncolo/oyad228

Key clinical point: Pyrotinib led to promising long-term outcomes and was well-tolerated in patients with human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (BC) and brain metastases (BM).

Major finding: In patients with BM, the overall median progression-free survival (PFS), considering both intracranial and extracranial lesions, was 7.50 months (95% CI 5.84-9.16) and median overall survival was 21.27 months (95% CI 20.10-22.44), with the median PFS not improving in patients who received vs did not receive radiotherapy (P  =  .319). Diarrhea (any grade) was the most common adverse event.

Study details: This real-world study included 239 patients with HER2+ metastatic BC who received pyrotinib-based therapy, of whom 61 patients had BM.

Disclosures: This study was supported by the keyAtlas precision medicine and clinical research project of Shanghai Science & Technology Development Foundation, China. The authors declared no conflicts of interest.

Source: Liang X et al. Long-term outcome analysis of pyrotinib in patients with HER2-Positive metastatic breast cancer and brain metastasis: A real-world study. Oncologist. 2023 (Aug 17). doi: 10.1093/oncolo/oyad228

Key clinical point: Pyrotinib led to promising long-term outcomes and was well-tolerated in patients with human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (BC) and brain metastases (BM).

Major finding: In patients with BM, the overall median progression-free survival (PFS), considering both intracranial and extracranial lesions, was 7.50 months (95% CI 5.84-9.16) and median overall survival was 21.27 months (95% CI 20.10-22.44), with the median PFS not improving in patients who received vs did not receive radiotherapy (P  =  .319). Diarrhea (any grade) was the most common adverse event.

Study details: This real-world study included 239 patients with HER2+ metastatic BC who received pyrotinib-based therapy, of whom 61 patients had BM.

Disclosures: This study was supported by the keyAtlas precision medicine and clinical research project of Shanghai Science & Technology Development Foundation, China. The authors declared no conflicts of interest.

Source: Liang X et al. Long-term outcome analysis of pyrotinib in patients with HER2-Positive metastatic breast cancer and brain metastasis: A real-world study. Oncologist. 2023 (Aug 17). doi: 10.1093/oncolo/oyad228

Key clinical point: Adjuvant capecitabine plus ibandronate failed to show improved survival outcomes compared with ibandronate alone in older patients with node-positive/high-risk node-negative breast cancer (BC).

Major finding: At a median follow-up of 61 months, the 5-year invasive disease-free survival rates were comparable between the adjuvant ibandronate + capecitabine and ibandronate arms (hazard ratio 0.96; 95% CI 0.78-1.19). The incidences of high-grade gastrointestinal disorders (6.7% vs 1.0%; P < .001) and skin toxicity (14.6% vs 0.6%; P < .01) were significantly higher in the ibandronate + capecitabine vs ibandronate arm.

Study details: Findings are from a phase 3 study including 1358 patients age ≥ 65 years with early BC who were randomly assigned to receive ibandronate with or without capecitabine.

Disclosures: This study was sponsored by the German Breast Group. Some authors declared receiving personal fees, grants, contracts, consulting fees, payment, honoraria, support for attending meetings, or travel support from or having other ties with various sources.

Source: Schmidt M et al. Adjuvant capecitabine versus nihil in older patients with node-positive/high-risk node-negative early breast cancer receiving ibandronate - The ICE Randomized Clinical Trial. Eur J Cancer. 2023;113324 (Sep 6). doi: 10.1016/j.ejca.2023.113324

Key clinical point: Adjuvant capecitabine plus ibandronate failed to show improved survival outcomes compared with ibandronate alone in older patients with node-positive/high-risk node-negative breast cancer (BC).

Major finding: At a median follow-up of 61 months, the 5-year invasive disease-free survival rates were comparable between the adjuvant ibandronate + capecitabine and ibandronate arms (hazard ratio 0.96; 95% CI 0.78-1.19). The incidences of high-grade gastrointestinal disorders (6.7% vs 1.0%; P < .001) and skin toxicity (14.6% vs 0.6%; P < .01) were significantly higher in the ibandronate + capecitabine vs ibandronate arm.

Study details: Findings are from a phase 3 study including 1358 patients age ≥ 65 years with early BC who were randomly assigned to receive ibandronate with or without capecitabine.

Disclosures: This study was sponsored by the German Breast Group. Some authors declared receiving personal fees, grants, contracts, consulting fees, payment, honoraria, support for attending meetings, or travel support from or having other ties with various sources.

Source: Schmidt M et al. Adjuvant capecitabine versus nihil in older patients with node-positive/high-risk node-negative early breast cancer receiving ibandronate - The ICE Randomized Clinical Trial. Eur J Cancer. 2023;113324 (Sep 6). doi: 10.1016/j.ejca.2023.113324

Key clinical point: Adjuvant capecitabine plus ibandronate failed to show improved survival outcomes compared with ibandronate alone in older patients with node-positive/high-risk node-negative breast cancer (BC).

Major finding: At a median follow-up of 61 months, the 5-year invasive disease-free survival rates were comparable between the adjuvant ibandronate + capecitabine and ibandronate arms (hazard ratio 0.96; 95% CI 0.78-1.19). The incidences of high-grade gastrointestinal disorders (6.7% vs 1.0%; P < .001) and skin toxicity (14.6% vs 0.6%; P < .01) were significantly higher in the ibandronate + capecitabine vs ibandronate arm.

Study details: Findings are from a phase 3 study including 1358 patients age ≥ 65 years with early BC who were randomly assigned to receive ibandronate with or without capecitabine.

Disclosures: This study was sponsored by the German Breast Group. Some authors declared receiving personal fees, grants, contracts, consulting fees, payment, honoraria, support for attending meetings, or travel support from or having other ties with various sources.

Source: Schmidt M et al. Adjuvant capecitabine versus nihil in older patients with node-positive/high-risk node-negative early breast cancer receiving ibandronate - The ICE Randomized Clinical Trial. Eur J Cancer. 2023;113324 (Sep 6). doi: 10.1016/j.ejca.2023.113324

Key clinical point: Adding ovarian function suppression (OFS) to adjuvant tamoxifen for 2 years demonstrated consistent improvement in disease-free survival (DFS) outcomes and high overall survival (OS) rates in women with estrogen receptor-positive (ER+) breast cancer (BC) who remained premenopausal or regained ovarian function after chemotherapy.

Major finding: The 8-year DFS rates improved consistently in women who received tamoxifen + OFS vs tamoxifen only (85.4% vs 80.2%; hazard ratio 0.67; P  =  .003). Although the 8-year OS rates were comparable between both treatment groups (P  =  .305), they were considerably high (>95%).

Study details: Findings are from an 8-year follow-up of the phase 3 ASTRRA trial including 1282 premenopausal women with ER+ BC, who remained premenopausal or regained ovarian function after chemotherapy and were randomly assigned to receive tamoxifen with or without OFS.

Disclosures: This study was supported by the Korea Health Industry Development Institute, Republic of Korea. Some authors declared receiving honoraria or research funding from or serving in consulting or advisory roles with various sources.

Source: Baek SY et al. Adding ovarian suppression to tamoxifen for premenopausal women with hormone receptor-positive breast cancer after chemotherapy: An 8-year follow-up of the ASTRRA trial. J Clin Oncol. 2023 (Aug 22). doi: 10.1200/JCO.23.00557

Key clinical point: Adding ovarian function suppression (OFS) to adjuvant tamoxifen for 2 years demonstrated consistent improvement in disease-free survival (DFS) outcomes and high overall survival (OS) rates in women with estrogen receptor-positive (ER+) breast cancer (BC) who remained premenopausal or regained ovarian function after chemotherapy.

Major finding: The 8-year DFS rates improved consistently in women who received tamoxifen + OFS vs tamoxifen only (85.4% vs 80.2%; hazard ratio 0.67; P  =  .003). Although the 8-year OS rates were comparable between both treatment groups (P  =  .305), they were considerably high (>95%).

Study details: Findings are from an 8-year follow-up of the phase 3 ASTRRA trial including 1282 premenopausal women with ER+ BC, who remained premenopausal or regained ovarian function after chemotherapy and were randomly assigned to receive tamoxifen with or without OFS.

Disclosures: This study was supported by the Korea Health Industry Development Institute, Republic of Korea. Some authors declared receiving honoraria or research funding from or serving in consulting or advisory roles with various sources.

Source: Baek SY et al. Adding ovarian suppression to tamoxifen for premenopausal women with hormone receptor-positive breast cancer after chemotherapy: An 8-year follow-up of the ASTRRA trial. J Clin Oncol. 2023 (Aug 22). doi: 10.1200/JCO.23.00557

Key clinical point: Adding ovarian function suppression (OFS) to adjuvant tamoxifen for 2 years demonstrated consistent improvement in disease-free survival (DFS) outcomes and high overall survival (OS) rates in women with estrogen receptor-positive (ER+) breast cancer (BC) who remained premenopausal or regained ovarian function after chemotherapy.

Major finding: The 8-year DFS rates improved consistently in women who received tamoxifen + OFS vs tamoxifen only (85.4% vs 80.2%; hazard ratio 0.67; P  =  .003). Although the 8-year OS rates were comparable between both treatment groups (P  =  .305), they were considerably high (>95%).

Study details: Findings are from an 8-year follow-up of the phase 3 ASTRRA trial including 1282 premenopausal women with ER+ BC, who remained premenopausal or regained ovarian function after chemotherapy and were randomly assigned to receive tamoxifen with or without OFS.

Disclosures: This study was supported by the Korea Health Industry Development Institute, Republic of Korea. Some authors declared receiving honoraria or research funding from or serving in consulting or advisory roles with various sources.

Source: Baek SY et al. Adding ovarian suppression to tamoxifen for premenopausal women with hormone receptor-positive breast cancer after chemotherapy: An 8-year follow-up of the ASTRRA trial. J Clin Oncol. 2023 (Aug 22). doi: 10.1200/JCO.23.00557

Key clinical point: In patients with human epidermal growth factor receptor 2-positive (ERBB2+, aka HER2+) metastatic breast cancer (BC), anti-ERBB2 treatment without vs with chemotherapy worsened the progression-free survival (PFS) rate but did not yield detrimental overall survival (OS) outcomes.

Major finding: Patients who did not receive vs received chemotherapy showed comparable OS rates at 2 years (79.0%; 90% CI 71.4%-85.4% vs 78.1%; 90% CI 70.4%-84.5%) but had shorter median PFS (8.4 months; 95% CI 7.9-12.0 vs 23.3 months; 95% CI 18.9-33.1).

Study details: This secondary analysis of a phase 2 trial included 210 patients with ERBB2+ metastatic BC who were randomly assigned to receive pertuzumab + trastuzumab with or without chemotherapy followed by trastuzumab-emtansine as the second-line therapy in both groups.

Disclosures: This study was supported by F. Hoffmann-La Roche AG and other sources. B Thürlimann declared owning stocks from F. Hoffmann-La Roche AG and some other authors declared ties with various sources, including F. Hoffmann-La Roche AG.

Source: Huober J et al for the Swiss Group for Clinical Cancer Research, Unicancer Breast Group, and Dutch Breast Cancer Research Group. Pertuzumab plus trastuzumab with or without chemotherapy followed by emtansine in ERBB2-positive metastatic breast cancer: A secondary analysis of a randomized clinical trial. JAMA Oncol. 2023 (Aug 10). doi: 10.1001/jamaoncol.2023.2909

Key clinical point: In patients with human epidermal growth factor receptor 2-positive (ERBB2+, aka HER2+) metastatic breast cancer (BC), anti-ERBB2 treatment without vs with chemotherapy worsened the progression-free survival (PFS) rate but did not yield detrimental overall survival (OS) outcomes.

Major finding: Patients who did not receive vs received chemotherapy showed comparable OS rates at 2 years (79.0%; 90% CI 71.4%-85.4% vs 78.1%; 90% CI 70.4%-84.5%) but had shorter median PFS (8.4 months; 95% CI 7.9-12.0 vs 23.3 months; 95% CI 18.9-33.1).

Study details: This secondary analysis of a phase 2 trial included 210 patients with ERBB2+ metastatic BC who were randomly assigned to receive pertuzumab + trastuzumab with or without chemotherapy followed by trastuzumab-emtansine as the second-line therapy in both groups.

Disclosures: This study was supported by F. Hoffmann-La Roche AG and other sources. B Thürlimann declared owning stocks from F. Hoffmann-La Roche AG and some other authors declared ties with various sources, including F. Hoffmann-La Roche AG.

Source: Huober J et al for the Swiss Group for Clinical Cancer Research, Unicancer Breast Group, and Dutch Breast Cancer Research Group. Pertuzumab plus trastuzumab with or without chemotherapy followed by emtansine in ERBB2-positive metastatic breast cancer: A secondary analysis of a randomized clinical trial. JAMA Oncol. 2023 (Aug 10). doi: 10.1001/jamaoncol.2023.2909

Key clinical point: In patients with human epidermal growth factor receptor 2-positive (ERBB2+, aka HER2+) metastatic breast cancer (BC), anti-ERBB2 treatment without vs with chemotherapy worsened the progression-free survival (PFS) rate but did not yield detrimental overall survival (OS) outcomes.

Major finding: Patients who did not receive vs received chemotherapy showed comparable OS rates at 2 years (79.0%; 90% CI 71.4%-85.4% vs 78.1%; 90% CI 70.4%-84.5%) but had shorter median PFS (8.4 months; 95% CI 7.9-12.0 vs 23.3 months; 95% CI 18.9-33.1).

Study details: This secondary analysis of a phase 2 trial included 210 patients with ERBB2+ metastatic BC who were randomly assigned to receive pertuzumab + trastuzumab with or without chemotherapy followed by trastuzumab-emtansine as the second-line therapy in both groups.

Disclosures: This study was supported by F. Hoffmann-La Roche AG and other sources. B Thürlimann declared owning stocks from F. Hoffmann-La Roche AG and some other authors declared ties with various sources, including F. Hoffmann-La Roche AG.

Source: Huober J et al for the Swiss Group for Clinical Cancer Research, Unicancer Breast Group, and Dutch Breast Cancer Research Group. Pertuzumab plus trastuzumab with or without chemotherapy followed by emtansine in ERBB2-positive metastatic breast cancer: A secondary analysis of a randomized clinical trial. JAMA Oncol. 2023 (Aug 10). doi: 10.1001/jamaoncol.2023.2909

Key clinical point: Sacituzumab govitecan outperformed chemotherapy in terms of overall survival outcomes and showed a manageable safety profile in patients with pretreated, endocrine-resistant hormone receptor-positive (HR+) human epidermal growth factor receptor 2-negative (HER2–) metastatic breast cancer (BC) who had limited treatment options.

Major finding: Sacituzumab govitecan vs chemotherapy improved overall survival by 3.2 months (hazard ratio 0.79; P  =  .020). No new adverse events (AE) were reported; however, 1 fatal AE (septic shock caused by neutropenic colitis) was determined to be related to sacituzumab govitecan treatment.

Study details: Findings are from the phase 3 TROPiCS-02 study including 543 patients with pretreated, endocrine-resistant HR+/HER2− metastatic BC who were randomly assigned to receive either sacituzumab govitecan or single-agent chemotherapy of physician’s choice.

Disclosures: This study was funded by Gilead Sciences. Six authors declared being current or former employees of and owning stocks in Gilead Sciences, and several other authors declared ties with various sources, including Gilead Sciences.

Source: Rugo HS et al. Overall survival with sacituzumab govitecan in hormone receptor-positive and human epidermal growth factor receptor 2-negative metastatic breast cancer (TROPiCS-02): A randomised, open-label, multicentre, phase 3 trial. Lancet. 2023 (Aug 23). doi: 10.1016/S0140-6736(23)01245-X

Key clinical point: Sacituzumab govitecan outperformed chemotherapy in terms of overall survival outcomes and showed a manageable safety profile in patients with pretreated, endocrine-resistant hormone receptor-positive (HR+) human epidermal growth factor receptor 2-negative (HER2–) metastatic breast cancer (BC) who had limited treatment options.

Major finding: Sacituzumab govitecan vs chemotherapy improved overall survival by 3.2 months (hazard ratio 0.79; P  =  .020). No new adverse events (AE) were reported; however, 1 fatal AE (septic shock caused by neutropenic colitis) was determined to be related to sacituzumab govitecan treatment.

Study details: Findings are from the phase 3 TROPiCS-02 study including 543 patients with pretreated, endocrine-resistant HR+/HER2− metastatic BC who were randomly assigned to receive either sacituzumab govitecan or single-agent chemotherapy of physician’s choice.

Disclosures: This study was funded by Gilead Sciences. Six authors declared being current or former employees of and owning stocks in Gilead Sciences, and several other authors declared ties with various sources, including Gilead Sciences.

Source: Rugo HS et al. Overall survival with sacituzumab govitecan in hormone receptor-positive and human epidermal growth factor receptor 2-negative metastatic breast cancer (TROPiCS-02): A randomised, open-label, multicentre, phase 3 trial. Lancet. 2023 (Aug 23). doi: 10.1016/S0140-6736(23)01245-X

Key clinical point: Sacituzumab govitecan outperformed chemotherapy in terms of overall survival outcomes and showed a manageable safety profile in patients with pretreated, endocrine-resistant hormone receptor-positive (HR+) human epidermal growth factor receptor 2-negative (HER2–) metastatic breast cancer (BC) who had limited treatment options.

Major finding: Sacituzumab govitecan vs chemotherapy improved overall survival by 3.2 months (hazard ratio 0.79; P  =  .020). No new adverse events (AE) were reported; however, 1 fatal AE (septic shock caused by neutropenic colitis) was determined to be related to sacituzumab govitecan treatment.

Study details: Findings are from the phase 3 TROPiCS-02 study including 543 patients with pretreated, endocrine-resistant HR+/HER2− metastatic BC who were randomly assigned to receive either sacituzumab govitecan or single-agent chemotherapy of physician’s choice.

Disclosures: This study was funded by Gilead Sciences. Six authors declared being current or former employees of and owning stocks in Gilead Sciences, and several other authors declared ties with various sources, including Gilead Sciences.

Source: Rugo HS et al. Overall survival with sacituzumab govitecan in hormone receptor-positive and human epidermal growth factor receptor 2-negative metastatic breast cancer (TROPiCS-02): A randomised, open-label, multicentre, phase 3 trial. Lancet. 2023 (Aug 23). doi: 10.1016/S0140-6736(23)01245-X

Key clinical point: This case-control study indicated that high dietary phosphorus intake (>1800 mg/day) almost doubled the risk for breast cancer (BC), thus warranting the evaluation of a low-phosphate diet in patients with BC.

Major finding: A high dietary phosphorus intake >1800 mg per day vs a low intake of 800-1000 mg per day was associated with an increased risk of developing BC (relative risk 2.30; P = .07).

Study details: This nested case-control study analyzed the data of 74 women with BC and 296 age-matched control individuals from the Study of Women’s Health Across the Nation, USA.

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

Source: Brown RB et al. High dietary phosphorus is associated with increased breast cancer risk in a U.S. cohort of middle-age women. Nutrients. 2023;15(17):3735 (Aug 25). doi: 10.3390/nu15173735

Key clinical point: This case-control study indicated that high dietary phosphorus intake (>1800 mg/day) almost doubled the risk for breast cancer (BC), thus warranting the evaluation of a low-phosphate diet in patients with BC.

Major finding: A high dietary phosphorus intake >1800 mg per day vs a low intake of 800-1000 mg per day was associated with an increased risk of developing BC (relative risk 2.30; P = .07).

Study details: This nested case-control study analyzed the data of 74 women with BC and 296 age-matched control individuals from the Study of Women’s Health Across the Nation, USA.

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

Source: Brown RB et al. High dietary phosphorus is associated with increased breast cancer risk in a U.S. cohort of middle-age women. Nutrients. 2023;15(17):3735 (Aug 25). doi: 10.3390/nu15173735

Key clinical point: This case-control study indicated that high dietary phosphorus intake (>1800 mg/day) almost doubled the risk for breast cancer (BC), thus warranting the evaluation of a low-phosphate diet in patients with BC.

Major finding: A high dietary phosphorus intake >1800 mg per day vs a low intake of 800-1000 mg per day was associated with an increased risk of developing BC (relative risk 2.30; P = .07).

Study details: This nested case-control study analyzed the data of 74 women with BC and 296 age-matched control individuals from the Study of Women’s Health Across the Nation, USA.

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

Source: Brown RB et al. High dietary phosphorus is associated with increased breast cancer risk in a U.S. cohort of middle-age women. Nutrients. 2023;15(17):3735 (Aug 25). doi: 10.3390/nu15173735

Key clinical point: The post-diagnostic use of statins and metformin substantially reduced the risk for breast cancer (BC)-specific deaths in patients age ≥ 50 years with primary invasive BC.

Major finding: At a median follow-up of 6.1 years, 2169 BC-specific deaths were reported. Patients who did vs did not use statins (hazard ratio [HR] 0.84; 95% CI 0.75-0.94) and those who used metformin vs other non-metformin antidiabetics (HR 0.70; 95% CI 0.51-0.96) showed 16% and 30% improvement in BC-specific survival rates, respectively.

Study details: Findings are from a nationwide population-based cohort study including 26,190 women with BC, of whom 20%, 29%, and 6% were post-diagnostic users of low-dose aspirin, statins, and metformin, respectively.

Disclosures: This study was funded by the Research Council of Norway. The authors declared no conflicts of interest.

Source: Löfling LL et al. Low-dose aspirin, statins, and metformin and survival in patients with breast cancers: A Norwegian population-based cohort study. Breast Cancer Res. 2023;25:101 (Aug 30). doi: 10.1186/s13058-023-01697-2

Key clinical point: The post-diagnostic use of statins and metformin substantially reduced the risk for breast cancer (BC)-specific deaths in patients age ≥ 50 years with primary invasive BC.

Major finding: At a median follow-up of 6.1 years, 2169 BC-specific deaths were reported. Patients who did vs did not use statins (hazard ratio [HR] 0.84; 95% CI 0.75-0.94) and those who used metformin vs other non-metformin antidiabetics (HR 0.70; 95% CI 0.51-0.96) showed 16% and 30% improvement in BC-specific survival rates, respectively.

Study details: Findings are from a nationwide population-based cohort study including 26,190 women with BC, of whom 20%, 29%, and 6% were post-diagnostic users of low-dose aspirin, statins, and metformin, respectively.

Disclosures: This study was funded by the Research Council of Norway. The authors declared no conflicts of interest.

Source: Löfling LL et al. Low-dose aspirin, statins, and metformin and survival in patients with breast cancers: A Norwegian population-based cohort study. Breast Cancer Res. 2023;25:101 (Aug 30). doi: 10.1186/s13058-023-01697-2

Key clinical point: The post-diagnostic use of statins and metformin substantially reduced the risk for breast cancer (BC)-specific deaths in patients age ≥ 50 years with primary invasive BC.

Major finding: At a median follow-up of 6.1 years, 2169 BC-specific deaths were reported. Patients who did vs did not use statins (hazard ratio [HR] 0.84; 95% CI 0.75-0.94) and those who used metformin vs other non-metformin antidiabetics (HR 0.70; 95% CI 0.51-0.96) showed 16% and 30% improvement in BC-specific survival rates, respectively.

Study details: Findings are from a nationwide population-based cohort study including 26,190 women with BC, of whom 20%, 29%, and 6% were post-diagnostic users of low-dose aspirin, statins, and metformin, respectively.

Disclosures: This study was funded by the Research Council of Norway. The authors declared no conflicts of interest.

Source: Löfling LL et al. Low-dose aspirin, statins, and metformin and survival in patients with breast cancers: A Norwegian population-based cohort study. Breast Cancer Res. 2023;25:101 (Aug 30). doi: 10.1186/s13058-023-01697-2

Key clinical point: Patients with breast cancer (BC), particularly those with left-sided BC who underwent radiotherapy, faced the risk of developing major ischemic events.

Major finding: At a median follow-up of 7.9 years, the incidence of a major ischemic event was reported in 4.1% of patients, with the incidence rate being significantly higher in patients with left-sided vs right-sided BC (P = .044). The risk for major ischemic events increased by 6.2% per Gy increase in the mean heart dose (hazard ratio 1.062; P = .012).

Study details: This retrospective study included 2158 women with BC who received adjuvant radiotherapy.

Disclosures: This study was supported by the Taipei Veterans General Hospital, Taiwan, and other sources. The authors declared no conflicts of interest.

Source: Lai TY et al. Association of radiation dose to cardiac substructures with major ischaemic events following breast cancer radiotherapy. Eur Heart J. 2023 (Aug 16). doi: 10.1093/eurheartj/ehad462

Key clinical point: Patients with breast cancer (BC), particularly those with left-sided BC who underwent radiotherapy, faced the risk of developing major ischemic events.

Major finding: At a median follow-up of 7.9 years, the incidence of a major ischemic event was reported in 4.1% of patients, with the incidence rate being significantly higher in patients with left-sided vs right-sided BC (P = .044). The risk for major ischemic events increased by 6.2% per Gy increase in the mean heart dose (hazard ratio 1.062; P = .012).

Study details: This retrospective study included 2158 women with BC who received adjuvant radiotherapy.

Disclosures: This study was supported by the Taipei Veterans General Hospital, Taiwan, and other sources. The authors declared no conflicts of interest.

Source: Lai TY et al. Association of radiation dose to cardiac substructures with major ischaemic events following breast cancer radiotherapy. Eur Heart J. 2023 (Aug 16). doi: 10.1093/eurheartj/ehad462

Key clinical point: Patients with breast cancer (BC), particularly those with left-sided BC who underwent radiotherapy, faced the risk of developing major ischemic events.

Major finding: At a median follow-up of 7.9 years, the incidence of a major ischemic event was reported in 4.1% of patients, with the incidence rate being significantly higher in patients with left-sided vs right-sided BC (P = .044). The risk for major ischemic events increased by 6.2% per Gy increase in the mean heart dose (hazard ratio 1.062; P = .012).

Study details: This retrospective study included 2158 women with BC who received adjuvant radiotherapy.

Disclosures: This study was supported by the Taipei Veterans General Hospital, Taiwan, and other sources. The authors declared no conflicts of interest.

Source: Lai TY et al. Association of radiation dose to cardiac substructures with major ischaemic events following breast cancer radiotherapy. Eur Heart J. 2023 (Aug 16). doi: 10.1093/eurheartj/ehad462

Key clinical point: Adjuvant endocrine therapy (ET) significantly reduces the incidence of distant metastasis in patients with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) T1a/bN0M0 breast cancer (BC).

Major finding: The 9-year cumulative incidence of distant metastasis was significantly lower in patients who did vs did not receive adjuvant ET (1.5% vs 2.6%; adjusted subdistribution hazard ratio 0.54; P = .027), with the risk factors for distant metastasis being mastectomy (P = .022), no prior receipt of ET (P = .027), lymphatic invasion (P = .004), and higher nuclear grade (P = .047).

Study details: Findings are from a multicenter cohort study including 4758 patients with ER+ /HER2− T1a/bN0M0 BC who underwent surgery, of whom 3991 patients were administered adjuvant ET.

Disclosures: This study was partly supported by the National Cancer Center Research and Development Fund and the Practical Research for Innovative Cancer Control, Japan. The authors declared no conflicts of interest.

Source: Sasada S et al. Prognostic impact of adjuvant endocrine therapy for estrogen receptor-positive and HER2-negative T1a/bN0M0 breast cancer. Breast Cancer Res Treat. 2023 (Sep 9). doi: 10.1007/s10549-023-07097-6

Key clinical point: Adjuvant endocrine therapy (ET) significantly reduces the incidence of distant metastasis in patients with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) T1a/bN0M0 breast cancer (BC).

Major finding: The 9-year cumulative incidence of distant metastasis was significantly lower in patients who did vs did not receive adjuvant ET (1.5% vs 2.6%; adjusted subdistribution hazard ratio 0.54; P = .027), with the risk factors for distant metastasis being mastectomy (P = .022), no prior receipt of ET (P = .027), lymphatic invasion (P = .004), and higher nuclear grade (P = .047).

Study details: Findings are from a multicenter cohort study including 4758 patients with ER+ /HER2− T1a/bN0M0 BC who underwent surgery, of whom 3991 patients were administered adjuvant ET.

Disclosures: This study was partly supported by the National Cancer Center Research and Development Fund and the Practical Research for Innovative Cancer Control, Japan. The authors declared no conflicts of interest.

Source: Sasada S et al. Prognostic impact of adjuvant endocrine therapy for estrogen receptor-positive and HER2-negative T1a/bN0M0 breast cancer. Breast Cancer Res Treat. 2023 (Sep 9). doi: 10.1007/s10549-023-07097-6

Key clinical point: Adjuvant endocrine therapy (ET) significantly reduces the incidence of distant metastasis in patients with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2−) T1a/bN0M0 breast cancer (BC).

Major finding: The 9-year cumulative incidence of distant metastasis was significantly lower in patients who did vs did not receive adjuvant ET (1.5% vs 2.6%; adjusted subdistribution hazard ratio 0.54; P = .027), with the risk factors for distant metastasis being mastectomy (P = .022), no prior receipt of ET (P = .027), lymphatic invasion (P = .004), and higher nuclear grade (P = .047).

Study details: Findings are from a multicenter cohort study including 4758 patients with ER+ /HER2− T1a/bN0M0 BC who underwent surgery, of whom 3991 patients were administered adjuvant ET.

Disclosures: This study was partly supported by the National Cancer Center Research and Development Fund and the Practical Research for Innovative Cancer Control, Japan. The authors declared no conflicts of interest.

Source: Sasada S et al. Prognostic impact of adjuvant endocrine therapy for estrogen receptor-positive and HER2-negative T1a/bN0M0 breast cancer. Breast Cancer Res Treat. 2023 (Sep 9). doi: 10.1007/s10549-023-07097-6

Key clinical point: Neoadjuvant high-dose alkylating chemotherapy did not improve the Neoadjuvant Response Index (NRI) scores in patients with BRCA1- or BRCA2-pathway-altered (BRCA-altered) triple-negative breast cancer (TNBC).

Major finding: The NRI scores were comparable between the conventional and high-dose chemotherapy treatment groups (0.72 vs 0.78; P = .41). Adverse events, such as fatigue, infections, nausea, oral mucositis, and diarrhea, were more prevalent in the high-dose vs conventional chemotherapy group, although no treatment-related deaths occurred in either group.

Study details: Findings are from the phase 3 neo-TN study that included 122 patients with BRCA-altered TNBC who were randomly assigned to receive either conventional or high-dose chemotherapy.

Disclosures: This study was supported by The Dutch Cancer Foundation and the Schumacher Kramer Foundation, Amsterdam. The authors declared no conflicts of interest.

Source: Vliek S et al. High-dose alkylating chemotherapy in BRCA-altered triple-negative breast cancer: The randomized phase III NeoTN trial. NPJ Breast Cancer. 2023;9:75 (Sep 9). doi: 10.1038/s41523-023-00580-9

Key clinical point: Neoadjuvant high-dose alkylating chemotherapy did not improve the Neoadjuvant Response Index (NRI) scores in patients with BRCA1- or BRCA2-pathway-altered (BRCA-altered) triple-negative breast cancer (TNBC).

Major finding: The NRI scores were comparable between the conventional and high-dose chemotherapy treatment groups (0.72 vs 0.78; P = .41). Adverse events, such as fatigue, infections, nausea, oral mucositis, and diarrhea, were more prevalent in the high-dose vs conventional chemotherapy group, although no treatment-related deaths occurred in either group.

Study details: Findings are from the phase 3 neo-TN study that included 122 patients with BRCA-altered TNBC who were randomly assigned to receive either conventional or high-dose chemotherapy.

Disclosures: This study was supported by The Dutch Cancer Foundation and the Schumacher Kramer Foundation, Amsterdam. The authors declared no conflicts of interest.

Source: Vliek S et al. High-dose alkylating chemotherapy in BRCA-altered triple-negative breast cancer: The randomized phase III NeoTN trial. NPJ Breast Cancer. 2023;9:75 (Sep 9). doi: 10.1038/s41523-023-00580-9

Key clinical point: Neoadjuvant high-dose alkylating chemotherapy did not improve the Neoadjuvant Response Index (NRI) scores in patients with BRCA1- or BRCA2-pathway-altered (BRCA-altered) triple-negative breast cancer (TNBC).

Major finding: The NRI scores were comparable between the conventional and high-dose chemotherapy treatment groups (0.72 vs 0.78; P = .41). Adverse events, such as fatigue, infections, nausea, oral mucositis, and diarrhea, were more prevalent in the high-dose vs conventional chemotherapy group, although no treatment-related deaths occurred in either group.

Study details: Findings are from the phase 3 neo-TN study that included 122 patients with BRCA-altered TNBC who were randomly assigned to receive either conventional or high-dose chemotherapy.

Disclosures: This study was supported by The Dutch Cancer Foundation and the Schumacher Kramer Foundation, Amsterdam. The authors declared no conflicts of interest.

Source: Vliek S et al. High-dose alkylating chemotherapy in BRCA-altered triple-negative breast cancer: The randomized phase III NeoTN trial. NPJ Breast Cancer. 2023;9:75 (Sep 9). doi: 10.1038/s41523-023-00580-9