Breast Cancer

Key clinical point: The combination of apatinib and etoposide proved to be a feasible treatment option for patients with triple-negative breast cancer (TNBC) who had failed ≥1 line of chemotherapy in the advanced setting.

Major finding: The median progression-free survival and overall survival were 6.0 and 24.5 months, respectively, with an objective response rate of 10.0% and a disease control rate of 62.5%. Overall, 95.0% of patients experienced adverse events (AE) of any grade, mostly grade 1 and 2. Hypertension (65.0%), nausea (47.5%), vomiting (42.5%), and hand-foot syndrome (32.5%) were the most common AE.

Study details: Findings are from a single-arm phase 2 study including 40 patients with advanced TNBC who had failed ≥1 line of chemotherapy and received oral apatinib plus oral etoposide.

Disclosures: This study was funded by National Cancer Fund Climbing Fund. The authors declared no conflicts of interest.

Source: Cao M et al. Apatinib plus etoposide in pretreated patients with advanced triple-negative breast cancer: A phase II trial. BMC Cancer. 2023;23:463 (May 19). doi: 10.1186/s12885-023-10768-8

Key clinical point: The combination of apatinib and etoposide proved to be a feasible treatment option for patients with triple-negative breast cancer (TNBC) who had failed ≥1 line of chemotherapy in the advanced setting.

Major finding: The median progression-free survival and overall survival were 6.0 and 24.5 months, respectively, with an objective response rate of 10.0% and a disease control rate of 62.5%. Overall, 95.0% of patients experienced adverse events (AE) of any grade, mostly grade 1 and 2. Hypertension (65.0%), nausea (47.5%), vomiting (42.5%), and hand-foot syndrome (32.5%) were the most common AE.

Study details: Findings are from a single-arm phase 2 study including 40 patients with advanced TNBC who had failed ≥1 line of chemotherapy and received oral apatinib plus oral etoposide.

Disclosures: This study was funded by National Cancer Fund Climbing Fund. The authors declared no conflicts of interest.

Source: Cao M et al. Apatinib plus etoposide in pretreated patients with advanced triple-negative breast cancer: A phase II trial. BMC Cancer. 2023;23:463 (May 19). doi: 10.1186/s12885-023-10768-8

Key clinical point: The combination of apatinib and etoposide proved to be a feasible treatment option for patients with triple-negative breast cancer (TNBC) who had failed ≥1 line of chemotherapy in the advanced setting.

Major finding: The median progression-free survival and overall survival were 6.0 and 24.5 months, respectively, with an objective response rate of 10.0% and a disease control rate of 62.5%. Overall, 95.0% of patients experienced adverse events (AE) of any grade, mostly grade 1 and 2. Hypertension (65.0%), nausea (47.5%), vomiting (42.5%), and hand-foot syndrome (32.5%) were the most common AE.

Study details: Findings are from a single-arm phase 2 study including 40 patients with advanced TNBC who had failed ≥1 line of chemotherapy and received oral apatinib plus oral etoposide.

Disclosures: This study was funded by National Cancer Fund Climbing Fund. The authors declared no conflicts of interest.

Source: Cao M et al. Apatinib plus etoposide in pretreated patients with advanced triple-negative breast cancer: A phase II trial. BMC Cancer. 2023;23:463 (May 19). doi: 10.1186/s12885-023-10768-8

Key clinical point: Atypical hyperplasia (AH) at the surgical margins of breast-conserving surgery (BCS) did not increase the risk for ipsilateral breast cancer (BC) recurrence, distant metastasis, or mortality in patients with BC who had received neoadjuvant chemotherapy (NAC).

Major finding: The 5-year ipsilateral breast tumor recurrence (IBTR) rate was 4.6% (95% CI 3.2%-6.0%) in patients with AH and 6.2% (95% CI 4.6%-7.8%) in patients without AH, with no significant differences observed between both groups in terms of IBTR (P = .448), distant metastasis-free survival (P = .506), and overall survival (P = .432).

Study details: Findings are from a retrospective analysis including 598 patients with BC who received NAC and BCS, of which 301 patients had AH at the margins of BCS and 297 patients did not have AH at the margins of BCS.

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

Source: Su A et al. Impact of atypical hyperplasia at surgical margins on breast cancer outcomes in patients treated with neoadjuvant chemotherapy. Front Oncol. 2023;13:1202689 (May 19). Doi: 10.3389/fonc.2023.1202689

Key clinical point: Atypical hyperplasia (AH) at the surgical margins of breast-conserving surgery (BCS) did not increase the risk for ipsilateral breast cancer (BC) recurrence, distant metastasis, or mortality in patients with BC who had received neoadjuvant chemotherapy (NAC).

Major finding: The 5-year ipsilateral breast tumor recurrence (IBTR) rate was 4.6% (95% CI 3.2%-6.0%) in patients with AH and 6.2% (95% CI 4.6%-7.8%) in patients without AH, with no significant differences observed between both groups in terms of IBTR (P = .448), distant metastasis-free survival (P = .506), and overall survival (P = .432).

Study details: Findings are from a retrospective analysis including 598 patients with BC who received NAC and BCS, of which 301 patients had AH at the margins of BCS and 297 patients did not have AH at the margins of BCS.

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

Source: Su A et al. Impact of atypical hyperplasia at surgical margins on breast cancer outcomes in patients treated with neoadjuvant chemotherapy. Front Oncol. 2023;13:1202689 (May 19). Doi: 10.3389/fonc.2023.1202689

Key clinical point: Atypical hyperplasia (AH) at the surgical margins of breast-conserving surgery (BCS) did not increase the risk for ipsilateral breast cancer (BC) recurrence, distant metastasis, or mortality in patients with BC who had received neoadjuvant chemotherapy (NAC).

Major finding: The 5-year ipsilateral breast tumor recurrence (IBTR) rate was 4.6% (95% CI 3.2%-6.0%) in patients with AH and 6.2% (95% CI 4.6%-7.8%) in patients without AH, with no significant differences observed between both groups in terms of IBTR (P = .448), distant metastasis-free survival (P = .506), and overall survival (P = .432).

Study details: Findings are from a retrospective analysis including 598 patients with BC who received NAC and BCS, of which 301 patients had AH at the margins of BCS and 297 patients did not have AH at the margins of BCS.

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

Source: Su A et al. Impact of atypical hyperplasia at surgical margins on breast cancer outcomes in patients treated with neoadjuvant chemotherapy. Front Oncol. 2023;13:1202689 (May 19). Doi: 10.3389/fonc.2023.1202689

Key clinical point: Aspirin intake may be associated with a reduced risk for incident breast cancer (BC) in adults.

Major finding: Aspirin users vs nonusers had a significantly reduced risk for BC (hazard ratio [HR] 0.91; P =  .002), especially estrogen receptor-positive BC (HR 0.90; P = .0004).

Study details: Findings are from a meta-analysis of 28 cohort studies including adults who received aspirin.

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

Source: Bakierzynska M et al. Prophylactic aspirin intake and breast cancer risk: A systematic review and meta-analysis of observational cohort studies. Eur J Surg Oncol. 2023 (Jun 6). doi: 10.1016/j.ejso.2023.05.015

Key clinical point: Aspirin intake may be associated with a reduced risk for incident breast cancer (BC) in adults.

Major finding: Aspirin users vs nonusers had a significantly reduced risk for BC (hazard ratio [HR] 0.91; P =  .002), especially estrogen receptor-positive BC (HR 0.90; P = .0004).

Study details: Findings are from a meta-analysis of 28 cohort studies including adults who received aspirin.

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

Source: Bakierzynska M et al. Prophylactic aspirin intake and breast cancer risk: A systematic review and meta-analysis of observational cohort studies. Eur J Surg Oncol. 2023 (Jun 6). doi: 10.1016/j.ejso.2023.05.015

Key clinical point: Aspirin intake may be associated with a reduced risk for incident breast cancer (BC) in adults.

Major finding: Aspirin users vs nonusers had a significantly reduced risk for BC (hazard ratio [HR] 0.91; P =  .002), especially estrogen receptor-positive BC (HR 0.90; P = .0004).

Study details: Findings are from a meta-analysis of 28 cohort studies including adults who received aspirin.

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

Source: Bakierzynska M et al. Prophylactic aspirin intake and breast cancer risk: A systematic review and meta-analysis of observational cohort studies. Eur J Surg Oncol. 2023 (Jun 6). doi: 10.1016/j.ejso.2023.05.015

Key clinical point: Adjuvant capecitabine was extremely well tolerated in a real-world population of patients with early triple-negative breast cancer (TNBC) who had invasive residual disease at surgery after receiving neoadjuvant chemotherapy.

Major finding: The rate of treatment discontinuation due to adjuvant capecitabine-related toxicity was very low (10.4%). After a median follow-up of 15 months, the 2-year disease-free survival rate was 62.0%, and the 2- and 3-year overall survival rates were 84.0% and 76.2%, respectively.

Study details: Findings are from an observational, retrospective study including 270 patients with TNBC who had residual disease even after receiving neoadjuvant chemotherapy and were treated with adjuvant capecitabine.

Disclosures: This research was supported by Funds Ricerca Corrente 2023 from the Italian Ministry of Health. Some authors declared receiving research grants, personal fees, speaker fees, honoraria, or travel grants or having other ties with several sources.

Source: Di Lisa FS et al. Adjuvant capecitabine in triple negative breast cancer patients with residual disease after neoadjuvant treatment: Real-world evidence from CaRe, a multicentric, observational study. Front Oncol. 2023;13:1152123 (May 16). doi: 10.3389/fonc.2023.1152123

Key clinical point: Adjuvant capecitabine was extremely well tolerated in a real-world population of patients with early triple-negative breast cancer (TNBC) who had invasive residual disease at surgery after receiving neoadjuvant chemotherapy.

Major finding: The rate of treatment discontinuation due to adjuvant capecitabine-related toxicity was very low (10.4%). After a median follow-up of 15 months, the 2-year disease-free survival rate was 62.0%, and the 2- and 3-year overall survival rates were 84.0% and 76.2%, respectively.

Study details: Findings are from an observational, retrospective study including 270 patients with TNBC who had residual disease even after receiving neoadjuvant chemotherapy and were treated with adjuvant capecitabine.

Disclosures: This research was supported by Funds Ricerca Corrente 2023 from the Italian Ministry of Health. Some authors declared receiving research grants, personal fees, speaker fees, honoraria, or travel grants or having other ties with several sources.

Source: Di Lisa FS et al. Adjuvant capecitabine in triple negative breast cancer patients with residual disease after neoadjuvant treatment: Real-world evidence from CaRe, a multicentric, observational study. Front Oncol. 2023;13:1152123 (May 16). doi: 10.3389/fonc.2023.1152123

Key clinical point: Adjuvant capecitabine was extremely well tolerated in a real-world population of patients with early triple-negative breast cancer (TNBC) who had invasive residual disease at surgery after receiving neoadjuvant chemotherapy.

Major finding: The rate of treatment discontinuation due to adjuvant capecitabine-related toxicity was very low (10.4%). After a median follow-up of 15 months, the 2-year disease-free survival rate was 62.0%, and the 2- and 3-year overall survival rates were 84.0% and 76.2%, respectively.

Study details: Findings are from an observational, retrospective study including 270 patients with TNBC who had residual disease even after receiving neoadjuvant chemotherapy and were treated with adjuvant capecitabine.

Disclosures: This research was supported by Funds Ricerca Corrente 2023 from the Italian Ministry of Health. Some authors declared receiving research grants, personal fees, speaker fees, honoraria, or travel grants or having other ties with several sources.

Source: Di Lisa FS et al. Adjuvant capecitabine in triple negative breast cancer patients with residual disease after neoadjuvant treatment: Real-world evidence from CaRe, a multicentric, observational study. Front Oncol. 2023;13:1152123 (May 16). doi: 10.3389/fonc.2023.1152123

Key clinical point: Surgery improved locoregional progression or recurrence rate in patients with de novo human epidermal growth factor receptor 2-positive (HER2+) metastatic inflammatory breast cancer (BC) who received first-line systemic therapy.

Major finding: Patients who underwent mastectomy had a median overall survival of 5.2 years from the date of surgery. Only one incidence of a locoregional progression or recurrence was reported 7.8 years after surgery, and pathological complete response was achieved by 10 patients, all of whom were alive at last follow-up.

Study details: Findings are from a retrospective study including 78 patients with de novo HER2+ metastatic inflammatory BC who received first-line systemic therapy, of which 41 patients underwent mastectomy with (n = 33) or without (n = 8) subsequent radiation therapy.

Disclosures: This study was funded by the Dana-Farber Cancer Institute IBC Research Fund and Reardon Family Fund. The authors declared serving as consultants or advisors or receiving speaker honorarium or travel support from, or holding stocks in several sources.

Source: Garrido-Castro AC et al. Clinical outcomes of de novo metastatic HER2-positive inflammatory breast cancer. NPJ Breast Cancer. 2023;9:50 (Jun 2). doi: 10.1038/s41523-023-00555-w

Key clinical point: Surgery improved locoregional progression or recurrence rate in patients with de novo human epidermal growth factor receptor 2-positive (HER2+) metastatic inflammatory breast cancer (BC) who received first-line systemic therapy.

Major finding: Patients who underwent mastectomy had a median overall survival of 5.2 years from the date of surgery. Only one incidence of a locoregional progression or recurrence was reported 7.8 years after surgery, and pathological complete response was achieved by 10 patients, all of whom were alive at last follow-up.

Study details: Findings are from a retrospective study including 78 patients with de novo HER2+ metastatic inflammatory BC who received first-line systemic therapy, of which 41 patients underwent mastectomy with (n = 33) or without (n = 8) subsequent radiation therapy.

Disclosures: This study was funded by the Dana-Farber Cancer Institute IBC Research Fund and Reardon Family Fund. The authors declared serving as consultants or advisors or receiving speaker honorarium or travel support from, or holding stocks in several sources.

Source: Garrido-Castro AC et al. Clinical outcomes of de novo metastatic HER2-positive inflammatory breast cancer. NPJ Breast Cancer. 2023;9:50 (Jun 2). doi: 10.1038/s41523-023-00555-w

Key clinical point: Surgery improved locoregional progression or recurrence rate in patients with de novo human epidermal growth factor receptor 2-positive (HER2+) metastatic inflammatory breast cancer (BC) who received first-line systemic therapy.

Major finding: Patients who underwent mastectomy had a median overall survival of 5.2 years from the date of surgery. Only one incidence of a locoregional progression or recurrence was reported 7.8 years after surgery, and pathological complete response was achieved by 10 patients, all of whom were alive at last follow-up.

Study details: Findings are from a retrospective study including 78 patients with de novo HER2+ metastatic inflammatory BC who received first-line systemic therapy, of which 41 patients underwent mastectomy with (n = 33) or without (n = 8) subsequent radiation therapy.

Disclosures: This study was funded by the Dana-Farber Cancer Institute IBC Research Fund and Reardon Family Fund. The authors declared serving as consultants or advisors or receiving speaker honorarium or travel support from, or holding stocks in several sources.

Source: Garrido-Castro AC et al. Clinical outcomes of de novo metastatic HER2-positive inflammatory breast cancer. NPJ Breast Cancer. 2023;9:50 (Jun 2). doi: 10.1038/s41523-023-00555-w

Key clinical point: A family history of estrogen receptor (ER)-positive (+) and negative (−) breast cancer (BC) as well as other cancers among first-degree relatives is associated with an increased risk for ER-subtypes of BC.

Major finding: Women with familial ER+ and ER− BC had ~2 times increased risk for ER+ (hazard ratio [HR] 1.96; 95% CI 1.84-2.09) and ER− (HR 2.67; 95% CI 2.10-3.40) BC, respectively. A family history of liver (odds ratio [OR] 1.33; 95% CI 1.05-1.67), ovarian (OR 1.28; 95% CI 1.01-1.61), and testicular (OR 1.78; 95% CI 1.01-3.14) cancers was associated with a higher risk for ER− vs ER+ BC.

Study details: Findings are from a population-based cohort study including 464,707 female participants, of which 25,273 were diagnosed with BC (including 16,286 and 3613 patients with ER+ and ER− BC, respectively).

Disclosures: This study was supported by the Swedish Research Council and other sources. The authors declared no conflicts of interest.

Source: Wang Q et al. Risk of ER-specific breast cancer by family history of ER subtypes and other cancers. J Natl Cancer Inst. 2023 (May 27). doi: 10.1093/jnci/djad104

Key clinical point: A family history of estrogen receptor (ER)-positive (+) and negative (−) breast cancer (BC) as well as other cancers among first-degree relatives is associated with an increased risk for ER-subtypes of BC.

Major finding: Women with familial ER+ and ER− BC had ~2 times increased risk for ER+ (hazard ratio [HR] 1.96; 95% CI 1.84-2.09) and ER− (HR 2.67; 95% CI 2.10-3.40) BC, respectively. A family history of liver (odds ratio [OR] 1.33; 95% CI 1.05-1.67), ovarian (OR 1.28; 95% CI 1.01-1.61), and testicular (OR 1.78; 95% CI 1.01-3.14) cancers was associated with a higher risk for ER− vs ER+ BC.

Study details: Findings are from a population-based cohort study including 464,707 female participants, of which 25,273 were diagnosed with BC (including 16,286 and 3613 patients with ER+ and ER− BC, respectively).

Disclosures: This study was supported by the Swedish Research Council and other sources. The authors declared no conflicts of interest.

Source: Wang Q et al. Risk of ER-specific breast cancer by family history of ER subtypes and other cancers. J Natl Cancer Inst. 2023 (May 27). doi: 10.1093/jnci/djad104

Key clinical point: A family history of estrogen receptor (ER)-positive (+) and negative (−) breast cancer (BC) as well as other cancers among first-degree relatives is associated with an increased risk for ER-subtypes of BC.

Major finding: Women with familial ER+ and ER− BC had ~2 times increased risk for ER+ (hazard ratio [HR] 1.96; 95% CI 1.84-2.09) and ER− (HR 2.67; 95% CI 2.10-3.40) BC, respectively. A family history of liver (odds ratio [OR] 1.33; 95% CI 1.05-1.67), ovarian (OR 1.28; 95% CI 1.01-1.61), and testicular (OR 1.78; 95% CI 1.01-3.14) cancers was associated with a higher risk for ER− vs ER+ BC.

Study details: Findings are from a population-based cohort study including 464,707 female participants, of which 25,273 were diagnosed with BC (including 16,286 and 3613 patients with ER+ and ER− BC, respectively).

Disclosures: This study was supported by the Swedish Research Council and other sources. The authors declared no conflicts of interest.

Source: Wang Q et al. Risk of ER-specific breast cancer by family history of ER subtypes and other cancers. J Natl Cancer Inst. 2023 (May 27). doi: 10.1093/jnci/djad104

Key clinical point: In patients with locally advanced breast cancer (BC), staging with ¹⁸F-labeled fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) was more effective than conventional staging for detecting asymptomatic distant metastases.

Major finding: More than twice the number of patients undergoing PET-CT vs conventional staging were upstaged to stage IV BC (relative risk 2.4; P = .002), with combined modality treatment being received by fewer patients in the PET-CT vs conventional staging group (81% vs 89%; P = .03).

Study details: Findings are from the PET ABC study including 369 patients with invasive ductal carcinoma of the breast and TNM stage III or IIb BC who were randomly assigned to undergo ¹⁸F-labeled fluorodeoxyglucose PET-CT (whole body) or conventional staging (bone scan and CT of the chest/abdomen and pelvis).

Disclosures: This study did not report the source of funding. Some authors declared receiving honoraria from or serving as employees, consultants, or advisors for different sources.

Source: Dayes IS et al. Impact of ¹⁸F-labeled fluorodeoxyglucose positron emission tomography-computed tomography versus conventional staging in patients with locally advanced breast cancer. J Clin Oncol. 2023 (May 26). doi: 10.1200/JCO.23.00249

Key clinical point: In patients with locally advanced breast cancer (BC), staging with ¹⁸F-labeled fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) was more effective than conventional staging for detecting asymptomatic distant metastases.

Major finding: More than twice the number of patients undergoing PET-CT vs conventional staging were upstaged to stage IV BC (relative risk 2.4; P = .002), with combined modality treatment being received by fewer patients in the PET-CT vs conventional staging group (81% vs 89%; P = .03).

Study details: Findings are from the PET ABC study including 369 patients with invasive ductal carcinoma of the breast and TNM stage III or IIb BC who were randomly assigned to undergo ¹⁸F-labeled fluorodeoxyglucose PET-CT (whole body) or conventional staging (bone scan and CT of the chest/abdomen and pelvis).

Disclosures: This study did not report the source of funding. Some authors declared receiving honoraria from or serving as employees, consultants, or advisors for different sources.

Source: Dayes IS et al. Impact of ¹⁸F-labeled fluorodeoxyglucose positron emission tomography-computed tomography versus conventional staging in patients with locally advanced breast cancer. J Clin Oncol. 2023 (May 26). doi: 10.1200/JCO.23.00249

Key clinical point: In patients with locally advanced breast cancer (BC), staging with ¹⁸F-labeled fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) was more effective than conventional staging for detecting asymptomatic distant metastases.

Major finding: More than twice the number of patients undergoing PET-CT vs conventional staging were upstaged to stage IV BC (relative risk 2.4; P = .002), with combined modality treatment being received by fewer patients in the PET-CT vs conventional staging group (81% vs 89%; P = .03).

Study details: Findings are from the PET ABC study including 369 patients with invasive ductal carcinoma of the breast and TNM stage III or IIb BC who were randomly assigned to undergo ¹⁸F-labeled fluorodeoxyglucose PET-CT (whole body) or conventional staging (bone scan and CT of the chest/abdomen and pelvis).

Disclosures: This study did not report the source of funding. Some authors declared receiving honoraria from or serving as employees, consultants, or advisors for different sources.

Source: Dayes IS et al. Impact of ¹⁸F-labeled fluorodeoxyglucose positron emission tomography-computed tomography versus conventional staging in patients with locally advanced breast cancer. J Clin Oncol. 2023 (May 26). doi: 10.1200/JCO.23.00249

Key clinical point: Simultaneous integrated boost (SIB) radiotherapy was safe and demonstrated noninferior clinical outcomes compared with sequential photon tumor-bed boost in patients with early breast cancer (BC) who underwent breast-conserving surgery (BCS).

Major finding: SIB with 48 Gy in 15 fractions to the tumor-bed volume vs sequential photon tumor-bed boost resulted in comparable rates of ipsilateral breast tumor relapse (hazard ratio [HR] 1.04; P = .91), whereas dose-escalated SIB (53 Gy) proved disadvantageous (HR 1.76; P = .041). There was no increase in toxicity outcomes with 48 Gy SIB vs sequential photon tumor-bed boost.

Study details: Findings are from the phase 3 IMPORT HIGH study including 2617 patients with early BC who underwent BCS and were randomly assigned to receive sequential photon tumor-bed boost or SIB with 48 or 53 Gy in 15 fractions to the tumor-bed volume.

Disclosures: This study was supported by Cancer Research U.K. Some authors declared receiving grants or funding from various sources, including Cancer Research U.K.

Source: Coles CE et al. Dose-escalated simultaneous integrated boost radiotherapy in early breast cancer (IMPORT HIGH): A multicentre, phase 3, non-inferiority, open-label, randomised controlled trial. Lancet. 2023 (Jun 8). doi: 10.1016/S0140-6736(23)00619-0

Key clinical point: Simultaneous integrated boost (SIB) radiotherapy was safe and demonstrated noninferior clinical outcomes compared with sequential photon tumor-bed boost in patients with early breast cancer (BC) who underwent breast-conserving surgery (BCS).

Major finding: SIB with 48 Gy in 15 fractions to the tumor-bed volume vs sequential photon tumor-bed boost resulted in comparable rates of ipsilateral breast tumor relapse (hazard ratio [HR] 1.04; P = .91), whereas dose-escalated SIB (53 Gy) proved disadvantageous (HR 1.76; P = .041). There was no increase in toxicity outcomes with 48 Gy SIB vs sequential photon tumor-bed boost.

Study details: Findings are from the phase 3 IMPORT HIGH study including 2617 patients with early BC who underwent BCS and were randomly assigned to receive sequential photon tumor-bed boost or SIB with 48 or 53 Gy in 15 fractions to the tumor-bed volume.

Disclosures: This study was supported by Cancer Research U.K. Some authors declared receiving grants or funding from various sources, including Cancer Research U.K.

Source: Coles CE et al. Dose-escalated simultaneous integrated boost radiotherapy in early breast cancer (IMPORT HIGH): A multicentre, phase 3, non-inferiority, open-label, randomised controlled trial. Lancet. 2023 (Jun 8). doi: 10.1016/S0140-6736(23)00619-0

Key clinical point: Simultaneous integrated boost (SIB) radiotherapy was safe and demonstrated noninferior clinical outcomes compared with sequential photon tumor-bed boost in patients with early breast cancer (BC) who underwent breast-conserving surgery (BCS).

Major finding: SIB with 48 Gy in 15 fractions to the tumor-bed volume vs sequential photon tumor-bed boost resulted in comparable rates of ipsilateral breast tumor relapse (hazard ratio [HR] 1.04; P = .91), whereas dose-escalated SIB (53 Gy) proved disadvantageous (HR 1.76; P = .041). There was no increase in toxicity outcomes with 48 Gy SIB vs sequential photon tumor-bed boost.

Study details: Findings are from the phase 3 IMPORT HIGH study including 2617 patients with early BC who underwent BCS and were randomly assigned to receive sequential photon tumor-bed boost or SIB with 48 or 53 Gy in 15 fractions to the tumor-bed volume.

Disclosures: This study was supported by Cancer Research U.K. Some authors declared receiving grants or funding from various sources, including Cancer Research U.K.

Source: Coles CE et al. Dose-escalated simultaneous integrated boost radiotherapy in early breast cancer (IMPORT HIGH): A multicentre, phase 3, non-inferiority, open-label, randomised controlled trial. Lancet. 2023 (Jun 8). doi: 10.1016/S0140-6736(23)00619-0

Key clinical point: In patients with hormone receptor-positive (HR+) human epidermal growth factor receptor 2-positive (ERBB2+, aka HER2+) breast cancer (BC), de-escalated neoadjuvant chemotherapy with paclitaxel plus trastuzumab and pertuzumab resulted in excellent pathological complete response (pCR) rates, which were superior to those achieved with endocrine therapy plus pertuzumab and trastuzumab.

Major finding: At 12 weeks, endocrine therapy+trastuzumab+pertuzumab led to a significantly inferior pCR rate compared with paclitaxel+trastuzumab+pertuzumab (23.7% vs 56.4%; odds ratio 0.24; P < .001). Both the types of treatment were well tolerated.

Study details: Findings are from the prospective, phase 2 WSG-TP-II trial including 207 patients with HR+/ERBB2+ early BC who were randomly assigned to receive trastuzumab+pertuzumab with paclitaxel or standard endocrine therapy for 12 weeks in the neoadjuvant setting.

Disclosures: This study was supported by Roche Pharma AG. The authors declared receiving personal fees, consulting fees, payments, grants, or travel support or having other ties with Roche and other sources.

Source: Gluz O et al. Efficacy of endocrine therapy plus trastuzumab and pertuzumab vs de-escalated chemotherapy in patients with hormone receptor-positive/ERBB2-positive early breast cancer: The neoadjuvant WSG-TP-II randomized clinical trial. JAMA Oncol. 2023 (May 11). doi: 10.1001/jamaoncol.2023.0646

Key clinical point: In patients with hormone receptor-positive (HR+) human epidermal growth factor receptor 2-positive (ERBB2+, aka HER2+) breast cancer (BC), de-escalated neoadjuvant chemotherapy with paclitaxel plus trastuzumab and pertuzumab resulted in excellent pathological complete response (pCR) rates, which were superior to those achieved with endocrine therapy plus pertuzumab and trastuzumab.

Major finding: At 12 weeks, endocrine therapy+trastuzumab+pertuzumab led to a significantly inferior pCR rate compared with paclitaxel+trastuzumab+pertuzumab (23.7% vs 56.4%; odds ratio 0.24; P < .001). Both the types of treatment were well tolerated.

Study details: Findings are from the prospective, phase 2 WSG-TP-II trial including 207 patients with HR+/ERBB2+ early BC who were randomly assigned to receive trastuzumab+pertuzumab with paclitaxel or standard endocrine therapy for 12 weeks in the neoadjuvant setting.

Disclosures: This study was supported by Roche Pharma AG. The authors declared receiving personal fees, consulting fees, payments, grants, or travel support or having other ties with Roche and other sources.

Source: Gluz O et al. Efficacy of endocrine therapy plus trastuzumab and pertuzumab vs de-escalated chemotherapy in patients with hormone receptor-positive/ERBB2-positive early breast cancer: The neoadjuvant WSG-TP-II randomized clinical trial. JAMA Oncol. 2023 (May 11). doi: 10.1001/jamaoncol.2023.0646

Key clinical point: In patients with hormone receptor-positive (HR+) human epidermal growth factor receptor 2-positive (ERBB2+, aka HER2+) breast cancer (BC), de-escalated neoadjuvant chemotherapy with paclitaxel plus trastuzumab and pertuzumab resulted in excellent pathological complete response (pCR) rates, which were superior to those achieved with endocrine therapy plus pertuzumab and trastuzumab.

Major finding: At 12 weeks, endocrine therapy+trastuzumab+pertuzumab led to a significantly inferior pCR rate compared with paclitaxel+trastuzumab+pertuzumab (23.7% vs 56.4%; odds ratio 0.24; P < .001). Both the types of treatment were well tolerated.

Study details: Findings are from the prospective, phase 2 WSG-TP-II trial including 207 patients with HR+/ERBB2+ early BC who were randomly assigned to receive trastuzumab+pertuzumab with paclitaxel or standard endocrine therapy for 12 weeks in the neoadjuvant setting.

Disclosures: This study was supported by Roche Pharma AG. The authors declared receiving personal fees, consulting fees, payments, grants, or travel support or having other ties with Roche and other sources.

Source: Gluz O et al. Efficacy of endocrine therapy plus trastuzumab and pertuzumab vs de-escalated chemotherapy in patients with hormone receptor-positive/ERBB2-positive early breast cancer: The neoadjuvant WSG-TP-II randomized clinical trial. JAMA Oncol. 2023 (May 11). doi: 10.1001/jamaoncol.2023.0646

Key clinical point: Capivasertib-fulvestrant therapy demonstrated significant progression-free survival (PFS) benefit and a manageable safety profile in patients with endocrine therapy-resistant hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) advanced breast cancer (BC).

Major finding: Significant PFS benefits were observed with capivasertib+fulvestrant vs placebo+fulvestrant in the overall population (hazard ratio for progression or death 0.60; P < .001) and in patients with AKT pathway-altered (PIK3CA, AKT1, or PTEN) tumors (hazard ratio 0.50; P < .001). Diarrhea and rash were the most common adverse events in the capivasertib+fulvestrant group.

Study details: Findings are from a primary analysis of the phase 3 CAPItello-291 study including 708 patients with HR+/HER2− advanced BC who had progressed on an aromatase inhibitor with or without cyclin-dependent kinase 4 and 6 inhibitor and were randomly assigned to receive fulvestrant with capivasertib or placebo.

Disclosures: This study was supported by AstraZeneca and other sources. Four authors declared being employees and stockholders in AstraZeneca. Some authors declared having ties with several sources.

Source: Turner NC et al for the CAPItello-291 Study Group. Capivasertib in hormone receptor-positive advanced breast cancer. N Engl J Med. 2023;388(22):2058-2070 (Jun 1). doi: 10.1056/NEJMoa2214131

Key clinical point: Capivasertib-fulvestrant therapy demonstrated significant progression-free survival (PFS) benefit and a manageable safety profile in patients with endocrine therapy-resistant hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) advanced breast cancer (BC).

Major finding: Significant PFS benefits were observed with capivasertib+fulvestrant vs placebo+fulvestrant in the overall population (hazard ratio for progression or death 0.60; P < .001) and in patients with AKT pathway-altered (PIK3CA, AKT1, or PTEN) tumors (hazard ratio 0.50; P < .001). Diarrhea and rash were the most common adverse events in the capivasertib+fulvestrant group.

Study details: Findings are from a primary analysis of the phase 3 CAPItello-291 study including 708 patients with HR+/HER2− advanced BC who had progressed on an aromatase inhibitor with or without cyclin-dependent kinase 4 and 6 inhibitor and were randomly assigned to receive fulvestrant with capivasertib or placebo.

Disclosures: This study was supported by AstraZeneca and other sources. Four authors declared being employees and stockholders in AstraZeneca. Some authors declared having ties with several sources.

Source: Turner NC et al for the CAPItello-291 Study Group. Capivasertib in hormone receptor-positive advanced breast cancer. N Engl J Med. 2023;388(22):2058-2070 (Jun 1). doi: 10.1056/NEJMoa2214131

Key clinical point: Capivasertib-fulvestrant therapy demonstrated significant progression-free survival (PFS) benefit and a manageable safety profile in patients with endocrine therapy-resistant hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) advanced breast cancer (BC).

Major finding: Significant PFS benefits were observed with capivasertib+fulvestrant vs placebo+fulvestrant in the overall population (hazard ratio for progression or death 0.60; P < .001) and in patients with AKT pathway-altered (PIK3CA, AKT1, or PTEN) tumors (hazard ratio 0.50; P < .001). Diarrhea and rash were the most common adverse events in the capivasertib+fulvestrant group.

Study details: Findings are from a primary analysis of the phase 3 CAPItello-291 study including 708 patients with HR+/HER2− advanced BC who had progressed on an aromatase inhibitor with or without cyclin-dependent kinase 4 and 6 inhibitor and were randomly assigned to receive fulvestrant with capivasertib or placebo.

Disclosures: This study was supported by AstraZeneca and other sources. Four authors declared being employees and stockholders in AstraZeneca. Some authors declared having ties with several sources.

Source: Turner NC et al for the CAPItello-291 Study Group. Capivasertib in hormone receptor-positive advanced breast cancer. N Engl J Med. 2023;388(22):2058-2070 (Jun 1). doi: 10.1056/NEJMoa2214131