31 mei 2019:

Komende week is er weer ASCO 2019. Hier een aantal aanbevolen abstracten over borstkanker door artsen die zelf voor ASCO werken. Klik op de nummers voor de abstracten. Het zijn veel absrtacten want door maar liefst vier verschillende oncologen / artsen zijn lijsten gemaakt.

Published in Oncology

Expert Opinion / Conference Coverage · May 29, 2019

ASCO 2019: Abstract Recommendations From Dr. Ben Anderson for Breast Cancer

Breast Cancer Locoregional Management

Session: Breast Cancer—Local/Regional/Adjuvant
Sunday June 2, 2019; 8:00 AM–11:00 AM

520 Low-fat dietary pattern and long-term breast cancer incidence and mortality: The Women’s Health Initiative randomized clinical trial. RT Chlebowski, AK Aragaki, GL Anderson, et al

Session: Breast Cancer—Local/Regional/Adjuvant
Monday June 3, 2019; 9:45 AM–12:45 PM

508 Patient-reported outcomes (PROs) in NRG oncology/NSABP B-39/RTOG 0413: A randomized phase III study of conventional whole breast irradiation (WBI) versus partial breast irradiation (PBI) in stage 0, I, or II breast cancer. PA Ganz, RS Cecchini, JR White, et al

Care Delivery / Models of Care

Session: Health Services Research, Clinical Informatics, and Quality of Care
Saturday June 1, 2019; 1:15 PM–4:15 PM

6524 Effect of exercise during adjuvant chemotherapy for breast cancer. BK Haas, CRC Osborne, SJ Vukelja, et al

Disparities/Access to Care

Session: Health Services Research, Clinical Informatics, and Quality of Care
Friday May 31, 2019; 2:45 PM–5:45 PM

6508 Impact of a same-day breast biopsy program on disparities in time to biopsy. M Seidler, BN Dontchos, S Mercaldo, et al

Session: Health Services Research, Clinical Informatics, and Quality of Care
Saturday June 1, 2019; 1:15 PM–4:15 PM

6562 Access to care and financial burden for patients with breast cancer in Ghana, Kenya, and Nigeria. M Twahir, RA Oyesegun, J Yarney, et al

6563 Racial comparisons in receipt of timely guideline-based colon cancer treatment in an equal-access health system. YL Eaglehouse, MW Georg, CD Shriver, et al

6569 Clinical impact of the Mexican healthcare system "Seguro Popular" on breast cancer survival. LA Cancel, CE Salazar-Mejía, FEV Badillo, et al

6575 Diagnostic and treatment delays in young women with breast cancer. PD Poorvu, Y Zheng, T Sella, et al

Session: Plenary Session
Sunday June 2, 2019; 1:00 PM–4:00 PM

LBA1 Affordable Care Act (ACA) Medicaid expansion impact on racial disparities in time to cancer treatment. BJS Adamson, AB Cohen, M Estevez, et al

ASCO 2019: Abstract Recommendations From Dr. Reshma Mahtani for Breast Cancer

Local/Regional/Adjuvant

Session: Breast Cancer—Local/Regional/Adjuvant
Monday June 3, 2019; 9:45 AM–12:45 PM

500 Neoadjuvant trastuzumab (H), pertuzumab (P), and chemotherapy versus trastuzumab emtansine (T-DM1) and P in human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC): Final outcome results from the phase III KRISTINE study. SA Hurvitz, M Martin, KH Jung, et al

501 Docetaxel, trastuzumab, pertuzumab versus trastuzumab emtansine as neoadjuvant treatment of HER2-positive breast cancer: Results from the Swedish PREDIX HER2 trial identifying a new potential de-escalation standard? JCS Bergh, A Andersson, J Bjohle, et al

506 GeparOLA: A randomized phase II trial to assess the efficacy of paclitaxel and olaparib in comparison to paclitaxel/carboplatin followed by epirubicin/cyclophosphamide as neoadjuvant chemotherapy in patients (pts) with HER2-negative early breast cancer (BC) and homologous recombination deficiency (HRD). PA Fasching, C Jackisch, K Rhiem, et al

Metastatic Breast Cancer

Session: Breast Cancer—Metastatic
Tuesday June 4, 2019; 9:45 AM–12:45 PM

1000 SOPHIA primary analysis: A phase 3 (P3) study of margetuximab (M) + chemotherapy (C) versus trastuzumab (T) + C in patients (pts) with HER2+ metastatic (met) breast cancer (MBC) after prior anti-HER2 therapies (Tx). HS Rugo, S-AhIm, GLS Wright, et al

1001 Pyrotinib combined with capecitabine in women with HER2+ metastatic breast cancer previously treated with trastuzumab and taxanes: A randomized phase III study. Z Jiang, M Yan, X Hu, et al

1002 Neratinib + capecitabine versus lapatinib + capecitabine in patients with HER2+ metastatic breast cancer previously treated with ≥ 2 HER2-directed regimens: Findings from the multinational, randomized, phase III NALA trial. C Saura, M Oliveira, Y-H Feng, et al

1003 IMpassion130: updated overall survival (OS) from a global, randomized, double-blind, placebo-controlled, Phase III study of atezolizumab (atezo) + nab-paclitaxel (nP) in previously untreated locally advanced or metastatic triple-negative breast cancer (mTNBC). P Schmid, S Adams, HS Rugo, et al

1005 Capivasertib (AZD5363) plus fulvestrant versus placebo plus fulvestrant after relapse or progression on an aromatase inhibitor in metastatic ER-positive breast cancer (FAKTION): A randomized, double-blind, placebo-controlled, phase II trial. RH Jones, M Carucci, AC Casbard, et al

1007 A randomized phase II study of palbociclib plus exemestane with GNRH agonist versus capecitabine in premenopausal women with hormone receptor-positive metastatic breast cancer (KCSG-BR 15-10, NCT02592746). YH Park, TY Kim, GM Kim, et al

ASCO 2019: Abstract Recommendations From Dr. Lee Schwartzberg for Breast Cancer

Neoadjuvant/Adjuvant

Session: Breast Cancer—Local/Regional/Adjuvant
Monday June 3, 2019; 9:45 AM–12:45 PM

Take-Home Message

Event-free survival favors TCHP at 3 years’ follow-up, mainly due to more local regional events with T-DM1+P for neoadjuvant chemotherapy. pCR in either arm was associated with >95% disease-free survival.
More local regional failures in the T-DM1 arm raises the question of primary tumor heterogeneity (see also Abstract 502 HER2 heterogeneity as a predictor of response to neoadjuvant T-DM1 plus pertuzumab: Results from a prospective clinical trial).

Take-Home Message

pCR rates were similar between DHP and T-DM1 in a small randomized trial, with less toxicity from T-DM1.
pCR rates in ER−/HER2+ disease were numerically lower in the T-DM1 arm, although not statistically significant. This is possibly suggestive of using a nonchemotherapy regimen in biologically lower-risk patients. Other studies show that HER2-enriched genomic subtypes derive the most benefit from chemotherapy-free regimens.

503 Impact of clinical risk category on prognosis and prediction of chemotherapy benefit in early breast cancer (EBC) by age and the 21-gene recurrence score (RS) in TAILORx. JA Sparano, RJ Gray, DF Makower, et al

Take-Home Message

Tumor size and grade are additional prognostic, but not predictive, factors of chemotherapy in patients with low (0–10), intermediate (11–25), and high (26–100) recurrence scores. For women younger than 50, more benefit from chemotherapy in reduction of distant relapse was gained in the 16–20 recurrence score group with high clinical risk, but no difference was gained in the 21–25 group.
Higher clinical risk confers a higher relapse rate at all genomic levels of risk. Clinical factors can help make the chemotherapy decision for women younger than 50 with a recurrence score of 16–20.505 Trans-aTTom: Breast Cancer Index for prediction of endocrine benefit and late distant recurrence (DR) in patients with HR+ breast cancer treated in the adjuvant tamoxifen—To offer more? (aTTom) trial. J Bartlett, D Sgroi, K Treuner, et al

Take-Home Message

The Breast Cancer Index HoxB13/IL17BR status predicted benefit to extended adjuvant therapy with tamoxifen in lymph node–positive women with high scores.
These results provide increased evidence across studies to utilize this genomic expression profile to guide an extended adjuvant therapy decision. It will be interesting to see the variation in predictive value between lymph node–positive and lymph node–negative patients whose tissue was analyzed.

Take-Home Message

Adding olaparib, a PARP inhibitor, to paclitaxel in neoadjuvant chemotherapy increased the pCR rate in patients with homologous recombination deficiency (HRD)–positive breast cancer compared with carboplatin plus paclitaxel. In the HRD-negative patients (which included those with BRCA mutations), pCR rates were higher and essentially equal in both groups.
Olaparib may be of benefit in patients with non–BRCA HRD breast cancer, with equal efficacy to carboplatin and potentially less toxicity in BRCA-mutated disease.

Metastatic Breast Cancer

HER2+ Metastatic Breast Cancer

Session: Breast Cancer—Metastatic
Tuesday June 4, 2019; 9:45 AM–12:45 PM

Take-Home Message

Margetuximab led to superior progression-free survival of 5.8 versus 4.9 months in heavily pretreated patients with HER2+ metastatic breast cancer. Genotyping of patients further discriminated those who could derive benefit from margetuximab compared with trastuzumab.
This antibody may be an additional alternative to trastuzumab in the metastatic setting. It will be interesting to see its activity in earlier-line disease and selecting for the genotype CD16A (the majority of patients) to improve efficacy.

1001 Pyrotinib combined with capecitabine in women with HER2+ metastatic breast cancer previously treated with trastuzumab and taxanes: A randomized phase III study. Z Jiang, M Yan, X Hu, et al

Take-Home Message

Pyrotinib, an irreversible pan-ERBB inhibitor, was associated with superior progression-free survival and response rates compared with capecitabine alone, and, in crossover, had substantial single-agent activity after capecitabine single-agent.
A better comparison would be small-molecule anti-HER2 therapy or trastuzumab plus capecitabine as anti-HER2 therapy is generally given through all lines of therapy in HER2+ metastatic breast cancer. Nonetheless, this is a promising agent to add to the HER2 armamentarium.

Take-Home Message

Neratinib plus capecitabine (N+C) was superior to lapatinib plus capecitabine (L+C) for the primary endpoint of progression-free/overall survival (HR, 0.76). For all other endpoints, including overall response rate, clinical benefit rate, length of response, and time to symptomatic CNS events, N+C was numerically superior (and, in some cases, statistically superior) to L+C. No new safety signals were identified.
This study establishes N+C as the new standard of care over L+C in HER2+ metastatic breast cancer when an anti-HER2–TKI combination with capecitabine is warranted.

ER+ Metastatic Breast Cancer

Session: Breast Cancer—Metastatic
Tuesday June 4, 2019; 9:45 AM–12:45 PM

Take-Home Message

Capivasertib, an AKT inhibitor, showed doubling of progression-free survival to 10.3 months from 4.8 months (HR, 0.57), meeting its endpoint, and a trend towards better survival.
It will be interesting to see efficacy breakdown by alteration in the PI3K/AKT pathway. A phase III trial is in progress.

Take-Home Message

Palbociclib plus exemestane plus GNRH had superior progression-free survival of 19.0 months compared with 11.3 months for capecitabine (HR, 0.643) in patients with either no or one prior line of chemotherapy in the metastatic setting.
Despite evidence for a superior response rate and progression-free survival, chemotherapy is still used as first-line therapy in a substantial minority of patients with HR+ metastatic breast cancer. This study should help convince clinicians that CDK 4/6 plus endocrine therapy is a better choice. It will be interesting to see subgroup analysis by prior chemotherapy and prior endocrine therapy.

Triple-Negative Breast Cancer

Session: Breast Cancer—Metastatic
Tuesday June 4, 2019; 9:45 AM–12:45 PM

Take-Home Message

At 2 years of follow-up, the second interim overall survival analysis of this study shows a 7-month overall survival benefit in the PD-L1 population with the addition of atezolizumab to nab-paclitaxel (HR, 0.71; statistically significant). No new long-term safety signals were identified.
While the numerical difference in overall survival has narrowed somewhat, it is now statistically significant and supports the use of atezolizumab plus nab-paclitaxel in the PD-L1+ triple-negative subgroup.

ASCO 2019: Abstract Recommendations From Professor Lillie Shockney for Metastatic Breast Cancer

Session: Health Services Research, Clinical Informatics, and Quality of Care
Saturday June 1, 2019; 1:15 PM–4:15 PM

6640 Desire to address costs at time of treatment decisions among patients with metastatic breast cancer. YY Lei, KM Quain, DS Dizon, et al

Session: Breast Cancer—Metastatic
Sunday June 2, 2019; 8:00 AM–11:00 AM

1032 Disparities in treatment patterns and overall survival (OS) in hormone receptor-positive HER2+ metastatic breast cancer (MBC): A National Cancer Database Analysis. A Statler, A Gupta, CN Blake, et al

1034 Clinical characteristics of patients with no evidence of disease (NED) versus residual disease (RES) to anti-HER2 therapy in metastatic breast cancer (MBC): A multi-institutional analysis. ZWN Veitch, PL Bedard, PA Tang, et al

1046 Endocrine-based targeted combination versus endocrine therapy alone as first-line treatment in elderly patients with hormone receptor-positive advanced breastcancer: Meta-analysis of phase II and III randomized clinical trials. C Omarini, F Piacentini, I Sperduti, et al

1090 Gaps in metastatic breast cancer patient knowledge and understanding in Mexico. C Villarreal-Garza, A Fonseca, C Pineda, et al

Session: Symptoms and Survivorship
Monday June 3, 2019; 1:15 PM–4:15 PM

11622 The individualized Goals of Care Discussion Guide: A simple tool to empower patients with metastatic breast cancer. JM Peppercorn, YY Lei, N Horick, et al

Publication Only

e12512 HER2 testing: Insights from pathologists' perspective on challenging HER2 cases. EV Grimm, KK Swenson, J Krueger, et al

e12515 Impact of mastectomy in women with stage IV HER2+ breast cancer. A Babar, F Covut, TZ Kewan, et al

e12529 Different maintenance strategies versus observation in patients with hormone receptor-positive metastatic breast cancer after first-line chemotherapy: A real-world study and meta-analysis. H Hong, Y Wang, Y Yu, et al

e12537 CDK4/6 plus aromatase inhibitor-induced alopecia in breast cancer patients. D Chan, ADF Martinez, SB Goldfarb, et al

e12554 Learning from every patient: Real-world clinical outcomes of patients with metastatic triple-negative breast cancer treated in the community oncology setting. A Khanna, E Bowers, A Haiderali, et al

e12568 Asymptomatic versus symptomatic metastatic breast cancer: Potential effects on prognosis and treatment strategies. S Kuba, K Yamanouchi, S Maeda, et al

e12583 The landscape of palliative systemic therapy and overall survival of 2,063 advanced breast cancer patients in the China National Cancer Center. X Guan, B Xu, F Ma, et al

e20717 Treatment and outcomes for patients (pts) with selected advanced/metastatic cancers by place of care. Y Xu, LM Hess, C Molife, et al

aanbevolen abstracten voor borstkanker van ASCO 2019