Breast Cancer

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Clarissa Ghazi gets lye relaxers, which contain the chemical sodium hydroxide, applied to her hair two to three times a year.

A recent study that made headlines over a potential link between hair straighteners and uterine cancer is not going to make her stop.

“This study is not enough to cause me to say I’ll stay away from this because [the researchers] don’t prove that using relaxers causes cancer,” Ms. Ghazi said.

Indeed, primary care doctors are unlikely to address the increased risk of uterine cancer in women who frequently use hair straighteners that the study reported.

Among frequent users of hair straighteners – meaning those who used them more than four times a year – the researchers found that women were 2.55 times more likely to be diagnosed with uterine cancer than those who never used these products.

In the recently published paper on this research, the authors said that they found an 80% higher adjusted risk of uterine cancer among women who had ever “straightened,” “relaxed,” or used “hair pressing products” in the 12 months before enrolling in their study.

This finding is “real, but small,” says internist Douglas S. Paauw, MD, professor of medicine at the University of Washington in Seattle.

Dr. Paauw is among several primary care doctors interviewed for this story who expressed little concern about the implications of this research for their patients.

“Since we have hundreds of things we are supposed to discuss at our 20-minute clinic visits, this would not make the cut,” Dr. Paauw said.

While it’s good to be able to answer questions a patient might ask about this new research, the study does not prove anything, he said.

Alan Nelson, MD, an internist-endocrinologist and former special adviser to the CEO of the American College of Physicians, said while the study is well done, the number of actual cases of uterine cancer found was small.

One of the reasons he would not recommend discussing the study with patients is that the brands of hair products used to straighten hair in the study were not identified.

Alexandra White, PhD, lead author of the study, said participants were simply asked, “In the past 12 months, how frequently have you or someone else straightened or relaxed your hair, or used hair pressing products?”

The terms “straightened,” “relaxed,” and “hair pressing products” were not defined, and “some women may have interpreted the term ‘pressing products’ to mean nonchemical products” such as flat irons, Dr. White, head of the National Institute of Environmental Health Sciences’ Environment and Cancer Epidemiology group, said in an email.

Dermatologist Crystal Aguh, MD, associate professor of dermatology at Johns Hopkins University, Baltimore, tweeted the following advice in light of the new findings: “The overall risk of uterine cancer is quite low so it’s important to remember that. For now, if you want to change your routine, there’s no downside to decreasing your frequency of hair straightening to every 12 weeks or more, as that may lessen your risk.”

She also noted that “styles like relaxer, silk pressing, and keratin treatments should only be done by a professional, as this will decrease the likelihood of hair damage and scalp irritation.

“I also encourage women to look for hair products free of parabens and phthalates (which are generically listed as “fragrance”) on products to minimize exposure to hormone disrupting chemicals.”
 

Not ready to go curly

Ms. Ghazi said she decided to stop using keratin straighteners years ago after she learned they are made with several added ingredients. That includes the chemical formaldehyde, a known carcinogen, according to the American Cancer Society.

“People have been relaxing their hair for a very long time, and I feel more comfortable using [a relaxer] to straighten my hair than any of the others out there,” Ms. Ghazi said.

Janaki Ram, who has had her hair chemically straightened several times, said the findings have not made her worried that straightening will cause her to get uterine cancer specifically, but that they are a reminder that the chemicals in these products could harm her in some other way.

She said the new study findings, her knowledge of the damage straightening causes to hair, and the lengthy amount of time receiving a keratin treatment takes will lead her to reduce the frequency with which she gets her hair straightened.

“Going forward, I will have this done once a year instead of twice a year,” she said.

Dr. White, the author of the paper, said in an interview that the takeaway for consumers is that women who reported frequent use of hair straighteners/relaxers and pressing products were more than twice as likely to go on to develop uterine cancer compared to women who reported no use of these products in the previous year.

“However, uterine cancer is relatively rare, so these increases in risks are small,” she said. “Less frequent use of these products was not as strongly associated with risk, suggesting that decreasing use may be an option to reduce harmful exposure. Black women were the most frequent users of these products and therefore these findings are more relevant for Black women.”

In a statement, Dr. White noted, “We estimated that 1.64% of women who never used hair straighteners would go on to develop uterine cancer by the age of 70; but for frequent users, that risk goes up to 4.05%.”

The findings were based on the Sister Study, which enrolled women living in the United States, including Puerto Rico, between 2003 and 2009. Participants needed to have at least one sister who had been diagnosed with breast cancer, been breast cancer-free themselves, and aged 35-74 years. Women who reported a diagnosis of uterine cancer before enrollment, had an uncertain uterine cancer history, or had a hysterectomy were excluded from the study.

The researchers examined hair product usage and uterine cancer incidence during an 11-year period among 33 ,947 women. The analysis controlled for variables such as age, race, and risk factors. At baseline, participants were asked to complete a questionnaire on hair products use in the previous 12 months.

“One of the original aims of the study was to better understand the environmental and genetic causes of breast cancer, but we are also interested in studying ovarian cancer, uterine cancer, and many other cancers and chronic diseases,” Dr. White said.

A version of this article first appeared on WebMD.com.

Clarissa Ghazi gets lye relaxers, which contain the chemical sodium hydroxide, applied to her hair two to three times a year.

A recent study that made headlines over a potential link between hair straighteners and uterine cancer is not going to make her stop.

“This study is not enough to cause me to say I’ll stay away from this because [the researchers] don’t prove that using relaxers causes cancer,” Ms. Ghazi said.

Indeed, primary care doctors are unlikely to address the increased risk of uterine cancer in women who frequently use hair straighteners that the study reported.

Among frequent users of hair straighteners – meaning those who used them more than four times a year – the researchers found that women were 2.55 times more likely to be diagnosed with uterine cancer than those who never used these products.

In the recently published paper on this research, the authors said that they found an 80% higher adjusted risk of uterine cancer among women who had ever “straightened,” “relaxed,” or used “hair pressing products” in the 12 months before enrolling in their study.

This finding is “real, but small,” says internist Douglas S. Paauw, MD, professor of medicine at the University of Washington in Seattle.

Dr. Paauw is among several primary care doctors interviewed for this story who expressed little concern about the implications of this research for their patients.

“Since we have hundreds of things we are supposed to discuss at our 20-minute clinic visits, this would not make the cut,” Dr. Paauw said.

While it’s good to be able to answer questions a patient might ask about this new research, the study does not prove anything, he said.

Alan Nelson, MD, an internist-endocrinologist and former special adviser to the CEO of the American College of Physicians, said while the study is well done, the number of actual cases of uterine cancer found was small.

One of the reasons he would not recommend discussing the study with patients is that the brands of hair products used to straighten hair in the study were not identified.

Alexandra White, PhD, lead author of the study, said participants were simply asked, “In the past 12 months, how frequently have you or someone else straightened or relaxed your hair, or used hair pressing products?”

The terms “straightened,” “relaxed,” and “hair pressing products” were not defined, and “some women may have interpreted the term ‘pressing products’ to mean nonchemical products” such as flat irons, Dr. White, head of the National Institute of Environmental Health Sciences’ Environment and Cancer Epidemiology group, said in an email.

Dermatologist Crystal Aguh, MD, associate professor of dermatology at Johns Hopkins University, Baltimore, tweeted the following advice in light of the new findings: “The overall risk of uterine cancer is quite low so it’s important to remember that. For now, if you want to change your routine, there’s no downside to decreasing your frequency of hair straightening to every 12 weeks or more, as that may lessen your risk.”

She also noted that “styles like relaxer, silk pressing, and keratin treatments should only be done by a professional, as this will decrease the likelihood of hair damage and scalp irritation.

“I also encourage women to look for hair products free of parabens and phthalates (which are generically listed as “fragrance”) on products to minimize exposure to hormone disrupting chemicals.”
 

Not ready to go curly

Ms. Ghazi said she decided to stop using keratin straighteners years ago after she learned they are made with several added ingredients. That includes the chemical formaldehyde, a known carcinogen, according to the American Cancer Society.

“People have been relaxing their hair for a very long time, and I feel more comfortable using [a relaxer] to straighten my hair than any of the others out there,” Ms. Ghazi said.

Janaki Ram, who has had her hair chemically straightened several times, said the findings have not made her worried that straightening will cause her to get uterine cancer specifically, but that they are a reminder that the chemicals in these products could harm her in some other way.

She said the new study findings, her knowledge of the damage straightening causes to hair, and the lengthy amount of time receiving a keratin treatment takes will lead her to reduce the frequency with which she gets her hair straightened.

“Going forward, I will have this done once a year instead of twice a year,” she said.

Dr. White, the author of the paper, said in an interview that the takeaway for consumers is that women who reported frequent use of hair straighteners/relaxers and pressing products were more than twice as likely to go on to develop uterine cancer compared to women who reported no use of these products in the previous year.

“However, uterine cancer is relatively rare, so these increases in risks are small,” she said. “Less frequent use of these products was not as strongly associated with risk, suggesting that decreasing use may be an option to reduce harmful exposure. Black women were the most frequent users of these products and therefore these findings are more relevant for Black women.”

In a statement, Dr. White noted, “We estimated that 1.64% of women who never used hair straighteners would go on to develop uterine cancer by the age of 70; but for frequent users, that risk goes up to 4.05%.”

The findings were based on the Sister Study, which enrolled women living in the United States, including Puerto Rico, between 2003 and 2009. Participants needed to have at least one sister who had been diagnosed with breast cancer, been breast cancer-free themselves, and aged 35-74 years. Women who reported a diagnosis of uterine cancer before enrollment, had an uncertain uterine cancer history, or had a hysterectomy were excluded from the study.

The researchers examined hair product usage and uterine cancer incidence during an 11-year period among 33 ,947 women. The analysis controlled for variables such as age, race, and risk factors. At baseline, participants were asked to complete a questionnaire on hair products use in the previous 12 months.

“One of the original aims of the study was to better understand the environmental and genetic causes of breast cancer, but we are also interested in studying ovarian cancer, uterine cancer, and many other cancers and chronic diseases,” Dr. White said.

A version of this article first appeared on WebMD.com.

Clarissa Ghazi gets lye relaxers, which contain the chemical sodium hydroxide, applied to her hair two to three times a year.

A recent study that made headlines over a potential link between hair straighteners and uterine cancer is not going to make her stop.

“This study is not enough to cause me to say I’ll stay away from this because [the researchers] don’t prove that using relaxers causes cancer,” Ms. Ghazi said.

Indeed, primary care doctors are unlikely to address the increased risk of uterine cancer in women who frequently use hair straighteners that the study reported.

Among frequent users of hair straighteners – meaning those who used them more than four times a year – the researchers found that women were 2.55 times more likely to be diagnosed with uterine cancer than those who never used these products.

In the recently published paper on this research, the authors said that they found an 80% higher adjusted risk of uterine cancer among women who had ever “straightened,” “relaxed,” or used “hair pressing products” in the 12 months before enrolling in their study.

This finding is “real, but small,” says internist Douglas S. Paauw, MD, professor of medicine at the University of Washington in Seattle.

Dr. Paauw is among several primary care doctors interviewed for this story who expressed little concern about the implications of this research for their patients.

“Since we have hundreds of things we are supposed to discuss at our 20-minute clinic visits, this would not make the cut,” Dr. Paauw said.

While it’s good to be able to answer questions a patient might ask about this new research, the study does not prove anything, he said.

Alan Nelson, MD, an internist-endocrinologist and former special adviser to the CEO of the American College of Physicians, said while the study is well done, the number of actual cases of uterine cancer found was small.

One of the reasons he would not recommend discussing the study with patients is that the brands of hair products used to straighten hair in the study were not identified.

Alexandra White, PhD, lead author of the study, said participants were simply asked, “In the past 12 months, how frequently have you or someone else straightened or relaxed your hair, or used hair pressing products?”

The terms “straightened,” “relaxed,” and “hair pressing products” were not defined, and “some women may have interpreted the term ‘pressing products’ to mean nonchemical products” such as flat irons, Dr. White, head of the National Institute of Environmental Health Sciences’ Environment and Cancer Epidemiology group, said in an email.

Dermatologist Crystal Aguh, MD, associate professor of dermatology at Johns Hopkins University, Baltimore, tweeted the following advice in light of the new findings: “The overall risk of uterine cancer is quite low so it’s important to remember that. For now, if you want to change your routine, there’s no downside to decreasing your frequency of hair straightening to every 12 weeks or more, as that may lessen your risk.”

She also noted that “styles like relaxer, silk pressing, and keratin treatments should only be done by a professional, as this will decrease the likelihood of hair damage and scalp irritation.

“I also encourage women to look for hair products free of parabens and phthalates (which are generically listed as “fragrance”) on products to minimize exposure to hormone disrupting chemicals.”
 

Not ready to go curly

Ms. Ghazi said she decided to stop using keratin straighteners years ago after she learned they are made with several added ingredients. That includes the chemical formaldehyde, a known carcinogen, according to the American Cancer Society.

“People have been relaxing their hair for a very long time, and I feel more comfortable using [a relaxer] to straighten my hair than any of the others out there,” Ms. Ghazi said.

Janaki Ram, who has had her hair chemically straightened several times, said the findings have not made her worried that straightening will cause her to get uterine cancer specifically, but that they are a reminder that the chemicals in these products could harm her in some other way.

She said the new study findings, her knowledge of the damage straightening causes to hair, and the lengthy amount of time receiving a keratin treatment takes will lead her to reduce the frequency with which she gets her hair straightened.

“Going forward, I will have this done once a year instead of twice a year,” she said.

Dr. White, the author of the paper, said in an interview that the takeaway for consumers is that women who reported frequent use of hair straighteners/relaxers and pressing products were more than twice as likely to go on to develop uterine cancer compared to women who reported no use of these products in the previous year.

“However, uterine cancer is relatively rare, so these increases in risks are small,” she said. “Less frequent use of these products was not as strongly associated with risk, suggesting that decreasing use may be an option to reduce harmful exposure. Black women were the most frequent users of these products and therefore these findings are more relevant for Black women.”

In a statement, Dr. White noted, “We estimated that 1.64% of women who never used hair straighteners would go on to develop uterine cancer by the age of 70; but for frequent users, that risk goes up to 4.05%.”

The findings were based on the Sister Study, which enrolled women living in the United States, including Puerto Rico, between 2003 and 2009. Participants needed to have at least one sister who had been diagnosed with breast cancer, been breast cancer-free themselves, and aged 35-74 years. Women who reported a diagnosis of uterine cancer before enrollment, had an uncertain uterine cancer history, or had a hysterectomy were excluded from the study.

The researchers examined hair product usage and uterine cancer incidence during an 11-year period among 33 ,947 women. The analysis controlled for variables such as age, race, and risk factors. At baseline, participants were asked to complete a questionnaire on hair products use in the previous 12 months.

“One of the original aims of the study was to better understand the environmental and genetic causes of breast cancer, but we are also interested in studying ovarian cancer, uterine cancer, and many other cancers and chronic diseases,” Dr. White said.

A version of this article first appeared on WebMD.com.