SABCS 2015

Dr Siesling talks to ecancertv at SABCS 2015, about the results of a large population-based study that compared the 10-year overall survival (OS) and disease-free survival (DFS) after breast-conserving therapy plus radiotherapy with mastectomy without radiation therapy in Dutch women with early stage breast cancer. The study considered data on 37,207 women diagnosed with primary invasive early (T1-2N0-1M0) breast cancer over a 4-year period staring in 2000. Of these 58% had received breast-conserving surgery with radiotherapy and 42% had undergone mastectomy. The respective 10-year OS were 76.8% and 59.7%. Although DFS was similar, patients who had breast-conserving treatment were less likely to experience distant metastases or regional recurrence. Dr Siesling observes that the additional radiotherapy may be responsible for the better OS seen in the breast-conserving arm, although residual factors could explain part of the difference in recurrences.

Dr Pagani (POSITIVE co-chair for International Breast Cancer Study Group, Bern, Switzerland) and Dr Partridge (POSITIVE co-chair for US through ALLIANCE, Rochester, Minnesota) talk to ecancertv at SABCS 2015 about the POSITIVE study. The study evaluates the pregnancy outcomes and safety of interrupting endocrine therapy for young women with endocrine responsive breast cancer who desire pregnancy.

Dr Sikov talks to ecancertv at SABCS 2015 about survival outcomes from the CALGB 40603 study involving women with stage II-III triple-negative breast cancer (TNBC) who were treated with carboplatin, bevacizumab, or both in addition to standard neo-adjuvant chemotherapy. The aim of the study was to assess the effects of adding carboplatin or bevacizumab on complete response (pCR) rates. Standard neo-adjuvant chemotherapy used in the trial was weekly paclitaxel then dose-dense doxorubicin plus cyclophosphamide. The effect on pCR have been reported (J Clin Oncol 2015;33:13–21) and showed improved pCR with the addition of both the chemotherapy and the anti-angiogenic agent. At SABCS 2015, the effects on the secondary endpoints of event-free (EFS) and overall survival (OS) were presented, with 3-year rates of 74.1% and 83.2%, respectively, although the study was not powered to assess the different treatment effects on either of these endpoints. What it shows is that patients with TNBC who achieved pCR with study treatment had significantly better EFS and OS than patients who did not.

Dr Kaklamani talks to ecancertv at SABCS 2015 about results from the ongoing, prospective Trial Assigning Individualized Options for Treatment (TAILORx) involving more than 10,000 women with estrogen receptor (ER)-positive, HER2-negative, axillary node-negative breast cancer. TAILORx has been designed to demonstrate whether the Oncotype DX can be used to correctly identify women who may not need chemotherapy and could safely be given endocrine treatment alone. In the study, patients with a low (25) RS assigned to chemoendocrine therapy. Women with an intermediate (11-25) RS were treated with chemoendocrine therapy or endocrine therapy alone and results of that study arm are expected in the future. Dr Kaklamani discusses the data from the low risk group who received endocrine treatment alone. Five-year rates for distant relapse-free interval, the relapse-free interval, invasive disease free survival, and overall survival were a respective 99.2%, 98.5%, 93.7%, and 98.2%. The findings show that despite meeting guidelines for recommending or at least considering adjuvant chemotherapy based on classical clinical and pathological features, the risk of recurrence was very low at 5 years. This population of women patients may be very effectively treated with endocrine therapy alone without chemotherapy.

Dr Kaklamani talks to ecancertv at SABCS 2015 about a pooled analysis of five phase II studies showing that homologous recombination deficiency predicts response to neo-adjuvant platinum-based therapy in patients with triple-negative breast cancer. Indeed, significantly higher pathologic complete response (pCR) rates were observed when women had TNBC tumours that were homologous recombination deficient than when tumours were not (44% vs. 8% (p < 0.01), even after adjusting for potential confounding factors. Prospective studies are needed before a test for homologous recombination deficiency is commercially available, Dr Kaklamani observes.

Prof Ganz talks to ecancertv at SABCS 2015 about secondary end point data from the phase III NSABP B-35 clinical trial that compared 5 years’ treatment with anastrozole or tamoxifen in postmenopausal women with ductal carcinoma in situ (DCIS). The primary end point results of the NSABP B-35 trial were reported at the American Society of Clinical Oncology 2015 annual meeting and showed that anastrozole was at least as effective and safe as tamoxifen. There was a slight advantage of anastrozole perhaps, Dr Ganz notes in the interview. Indeed women where more likely to remain breast-cancer free at 10 years if they had received the aromatase inhibitor. Patient reported outcomes such as quality of life were reported in a sub-study of the trial and Dr Ganz reported data on more than 1000 women who has participated and completed the Short-Form 12. There were no differences, however, between the women treated with anastrozole and those treated with tamoxifen when using the Physical Component Summary (p=0.16) or the Mental Component Summary (p=0.38) of this questionnaire. As expected there were differences in terms of the symptoms, with the typical tamoxifen side effects of hot flashes seen and more musculoskeletal pain and vaginal pain and discomfort during sex in those treated with anastrozole. What these data show is that there are choices, Dr Ganz says. Before tamoxifen was the only approved option in DCIS but the NSABP B-35 and other trial data now show that aromatase inhibitor therapy, specifically anastrozole, is also of benefit.

Prof Cuzick presents, at a press conference at SABCS 2015 about the results from the phase III IBIS-II DCIS clinical trial. The data showed postmenopausal women with ductal carcinoma in situ had similar outcomes with disease recurrence whether they took tamoxifen or the aromatase inhibitor anastrozole for five years after surgery, but women in the two groups had different side effects.

Prof Ganz presents, at a press conference at SABCS 2015, about the analysis of patient-reported outcomes and the secondary endpoint of the phase III, NSABP B-35 clinical trial. NSABP B-35 compares, anastrazole and tamoxifen in postmenopausal women with ductal carcinoma in-situ who underwent lumpectomy plus radiotherapy. The data showed that there were no differences in outcomes related to quality of life but some differences in outcomes related to symptoms in the two treatment groups.

Prof Wildiers presents, at a press conference at SABCS 2015 about final overall survival results from the phase 3 TH3RESA study. TDM1 (the immunoconjugate: trastuzumab emtanzine) improved overall survival in heavily pre-treated patients with HER2-positive breast cancer.

Dr Campone talks to ecancertv at SABCS 2015 about the first results from the randomised, phase III BELLE-2 trial that assessed the the efficacy and safety of combining the PI3K inhibitor buparlisib with the endocrine therapy fulvestrant in postmenopausal women with endocrine resistant, hormone receptor (HR)-positive, HER2-negative metastatic breast cancer. Activation of the PI3K pathway is a hallmark of resistance to endocrine therapy, Dr Campone explains. Early data suggest that using a PI3K inhibitor may be able to help reverse endocrine resistance and so the BELLE-2 trial was designed to look at this question further. More than 1,140 women who were refractory to aromatase inhibitor therapy were enrolled into the study and stratified based on their PI3K pathway status measured in archival tumor tissue. A 22% reduction in PFS was seen comparing buparlisib plus fulvestrant versus fulvestrant plus placebo in the full population, with respective median PFS of 6.9 and 5 months (p < .001). Pre-specified analyses showed that characterizing PIK3CA mutation in circulating tumour DNA at trial entry could identify patients that may benefit from the buparlisib/fulvestrant combination.

Prof Wildiers talks to ecancertv at SABCS 2015 about the final overall survival (OS) results from the a randomized, open-label phase III TH3RESA study in which treatment with the immunoconjugate trastuzumab emtansine (T-DM1) was compared against the treatment of physician's choice in roughly 600 women with previously treated HER2-positive metastatic breast cancer. The first results from the trial were published last year and showed significantly improved PFS with T-DM1 compared with the treatment of physician’s choice. There was also a trend for improved overall survival (OS). In the interview, Dr Wildiers notes that the final median overall survival increased from 15.8 months with physician’s choice to 22.7 months with T-DM1 (p = 0.0007). T-DM1 has a favourable safety profile that is consistent to prior studies, he observes. Overall the findings solidify the role of T-DM1 in the treatment of previously treated HER2-positive advanced breast cancer.

Prof Cuzick talks to ecancertv at SABCS 2015 about the results from the phase III IBIS-II DCIS clinical trial that compared the efficacy and safety of anastrozole versus tamoxifen in postmenopausal women with estrogen-receptor positive ductal carcinoma in situ (DCIS). Third generation aromatase inhibitors (AIs) such as anastrozole have been shown to be a more effective treatment option than tamoxifen for postmenopausal women with ER positive invasive breast cancer. However, it is not known whether AIs have the same benefit over tamoxifen in women with hormone-sensitive DCIS. The IBIS-II DCIS study therefore directly set out to compare the two hormonal therapies, which were given over a 5-year period to almost 3000 women with locally excised disease. Dr Cuzick discusses data from a first analysis, at a median of almost 7 years of follow, and noted that there was no significant different between the two study arms. While apparently as effective as each other in the DCIS setting, the two hormonal therapies had very different side effect profiles. The side effects seen were those commonly attributed to these drugs, with an increased risk of endometrial cancer and thrombotic disease with the use of tamoxifen and more musculoskeletal abnormalities and bone loss with anastrozole.

Dr Jacobs talks to ecancertv at SABCS 2015 about the phase II NSABP FB-7 trial that evaluated the efficacy and safety of neoadjuvant therapy with weekly paclitaxel plus neratinib, trastuzumab or both for 12 weeks followed by standard chemotherapy before surgery in women with locally advanced HER2-positive breast cancer. The underlying premise for the trial was that combining the investigational agent neratinib and trastuzumab may be better than trastuzumab alone as both agents target HER2 by different mechanisms. The trial involved 126 women and the primary endpoint of pathological complete response rate (pCR). Dr Jacobs reports that in women who were hormone-receptor (HR)-positive the pCR for the neratinib, trastuzumab or the combination were similar. However, in women who were HR-negative the pCR was higher when the combination was used. Dr Jacobs observes that intensive anti-diarrhoeal prophylaxis was able to negate the effects of neratinib on the gastrointestinal tract and that the side effect of diarrhea was most common in the first cycle of treatment but could be managed well thereafter.

Dr Chanderlapaty presents, at a press conference at SABCS 2015 about the latest data on oestrogen receptor-positive, metastatic breast cancer. The data shows that among patients with oestrogen receptor-positive, metastatic breast cancer, those who had a D538G and/or a Y537S mutation in the oestrogen receptor 1 gene, as detected in cell-free DNA obtained from patient blood samples, had significantly worse median overall survival.

Dr Siesling presents, at a press conference at SABCS 2015 about the latest data on breast-conserving therapy. The data showed that among patients with early-stage breast cancer, those who received breast-conserving surgery plus radiation therapy had improved overall survival after 10 years compared with those who received mastectomy without radiation therapy.

Dr Harris presents, at a press conference at SABCS 2015 discussing the latest data on APOBEC3B. The data shows responses to tamoxifen were significantly prolonged by reducing levels of the enzyme APOBEC3B in preclinical models of oestrogen receptor–positive breast cancer, additionally there were significantly shortened by increasing levels of APOBEC3B, suggesting that APOBEC3B drives resistance to tamoxifen.

Dr Smith presents, at a press conference at SABCS 2015 about the various guideline-concordant local therapy options available for women with early-stage breast cancer in the United States. The data shows mastectomy plus reconstruction had the highest complication rates and complication-related costs for both younger women with private insurance and older women on Medicare, and it was the most expensive option for younger women.

Dr Campone presents, at a press conference at SABCS 2015 about the first results from the randomised phase III BELLE-2 trial, treating women with endocrine-resistant HR /HER2 advanced breast cancer.

Prof Børresen-Dale, winner of the “AACR Distinguished Lectureship” award, talks to ecancertv at SABCS 2015 about the molecular evolution of breast cancer during neoadjuvant chemotherapy. In the interview she states that molecular evolution of breast cancer is important during all type of chemotherapy and there is some evidence that the various molecular subtypes of breast cancer respond differently. So research is looking at whether changing the chemotherapy throughout the course of breast cancer could help improve outcomes.

Dr Chandarlapaty talks to ecancertv at SABCS 2015 about the results of a study looking at two genetic mutations in the estrogen receptor 1 gene (ESR1) and how this affected the outcomes of women with estrogen receptor-positive metastatic breast cancer. The Y537S and D538G mutations in ESR1 are common alterations seen in metastatic breast cancer and result in making the receptor estrogen independent and can results in resistance to estrogen deprivation therapy such as an aromatase inhibitor. Using blood samples from the BOLERO-2 study, Dr Chandarlapaty and colleagues hypothesized that cell free DNA (cfDNA) analysis of a patient’s plasma could be used to detect the presence of the mutations. The mutations were found in about 30% of women and women with these mutations had a shorter OS than women who did not have these mutations. Dr Chandarlapaty says that one major implication of these data is that it shows a blood sample could be taken to test for these mutations and provide important prognostic information.

Dr Toi talks to ecancertv at SABCS 2015 about the results of the CREATE-X phase III clinical trial that have shown that capecitabine improves survival outcomes in women with HER2-negative breast cancer who have invasive disease after neoadjuvant chemotherapy. In the interview, Dr Toi explains that women who do not achieve a pathological complete response (pCR) after neoadjuvant chemotherapy with an anthracycline and a taxane have an intermediate or high-risk for relapse. The CREATE-X trial was designed to see if further systemic chemotherapy with capecitabine would be beneficial for these patients. Dr Toi and colleagues have previously reported data to show that adding capecitabine to standard adjuvant radiotherapy or hormone therapy was feasible and well tolerated. The findings presented at SABCS 2015 showed that the addition also improved the primary endpoint of 2-year disease-free survival by about 32% (87.3% vs 80.5%, p=0.001) and the secondary endpoint of overall survival (96.2% vs 93.9%, p=0.086) by about 35% versus standard adjuvant therapy alone. Tolerability was consistent with the established safety profile of capecitabine in metastatic breast cancer and the results suggest there may be a role for capecitabine in some women after neoadjuvant chemotherapy.

Prof Bundred talks to ecancertv at SABCS 2015 about a retrospective study comparing local recurrence rates after simple mastectomy or skin-sparing mastectomy for ductal carcinoma in situ (DCIS). Traditionally DCIS has been treated by simple mastectomy. This is associated with a low (

Prof Bundred talks to ecancertv at SABCS 2015 about early results from the UK EPHOS-B trial on the effect of peri-operative anti-HER2 therapy on cancer cell proliferation and cell survival. The UK EPHOS-B trial is an ongoing, multicentre, two-part randomised trial in patients with operable newly diagnosed HER2 primary breast cancer. The Independent Data Monitoring Committee for the trial has agreed partial release of the data from the first part of the study only in which women about to undergo surgery were randomised to receive peri-operative treatment with lapatinib or trastuzumab alone, or to no treatment. With approximately 11 days’ lapatinib treatment, decreased cell proliferation (defined as a ≥30% fall in Ki67, a marker of cell proliferation) was measured in 67% of women. An increase in cell death (≥30% rise in apoptosis) was measured in 30% of women. The key point is that you need to know the HER2 status of women before undergoing surgery, Dr Bunsen suggests. This is not always done but if it is and women are positive it shows that giving them lapatinib as early as possible could significantly improve their outcome.

Dr Cortes talks to ecancertv at SABCS 2015 about results from the phase II SOLTI1007 study, a prospective, open-label, single-arm, exploratory pharmacogenomic study of single agent eribulin as neoadjuvant treatment for stage I-II HER2-negative metastatic breast cancer. Eribulin approved for the treatment of patients with locally advanced or metastatic breast cancer and the aim of the study was to see if it was also effective in the treatment-naïve setting, Dr Cortes explains. The aim was also to look and see if there was a way to prospectively select patients who may benefit from neoadjuvant eribulin treatment. Two cohorts of women were studied, those with HER2-negative and hormone receptor-positive disease and those with triple negative disease. So far data from the HER2-negative/HR-positive cohort are available. Results have shown that almost 50% of women with the Luminal B subtype of breast cancer at baseline had a change in subtype at surgery, mostly (78.6% of cases) to the Luminal A subtype. This induction of the Luminal A subtype switch is important, Dr Cortes says, as it suggests that the aggressiveness of the tumours has been reduced and thus improved outcomes might follow. Results also suggest that strategies combining eribulin with endocrine therapy seem warranted in Luminal B breast cancer and that eribulin may be beneficial given earlier in the treatment of metastatic breast cancer.

Dr Formisano talks to ecancertv at SABCS 2015 about the critical interaction between the estrogen receptor (ER) and amplification of the fibroblast growth factor receptor 1 (FGFR1) gene in endocrine resistant breast cancer. In the interview, Dr Formisano explains how targeting the FGFR1 gene in combination with anti-estrogen therapy may abrogate resistance and is worthy of further clinical investigation. Specifically he describes the findings of a study in which whole exome sequencing was used to evaluate tumour biopsies taken from 130 women with an operable ER-positive/HER2-negative breast cancer who had received endocrine treatment with an aromatase inhibitor for 10 to 21 days before surgery.

Prof Minckwitz talks to ecancertv at SABCS 2015 about his research into adding carboplatin to presurgery chemotherapy. According to results from the randomised phase II GeparSixto clinical trial there was improved disease-free survival for patients with triple-negative breast cancer.

Prof Los Santos talks to ecancertv at SABCS 2015 about updated results of a study looking at the treatment outcomes of women with invasive breast cancer who had been treated with neoadjuvant therapy and then underwent lumpectomy or mastectomy. The trial included more than 1000 women aged a median of 50 years from nine institutions in the USA who were retrospectively identified as having undergone neoadjuvant chemotherapy and who had magnetic resonance imaging (MRI) data available both before and after systemic treatment. After a median follow-up of 4.2 years, the rate of loco-regional recurrence among women who achieved a pathological or a radiological complete response was similar among women regardless of the surgical procedure used. There were also no differences in terms of survival (disease-free or overall), or time to progression. A subset analysis showed that there may be an advantage for some women with triple negative breast cancer to undergo neoadjuvant chemotherapy then breast conservation, but this did not lead to an improved disease-free survival rate. Dr De Los Santos observes in the interview that these results confirm the “outstanding outcomes” that can be achieved with neo-adjuvant chemotherapy and that for some women mastectomy may not be necessary as great results can be achieved with breast conservation approaches.

Dr Bartlett talks to ecancertv at SABCS 2015 about using HER2 status as a predictive marker for benefiting from treatment with an aromatase inhibitor (AI) versus tamoxifen based on data from a meta-analysis of more than 12,000 patients who participated in three landmark AI trials: ATAC (Arimidex, Tamoxifen, Alone or in Combination), BIG (Breast International Group) 1-98 and the TEAM (Tamoxifen Exemestane Adjuvant Multinational) studies. HER2 has been long proposed as a marker of endocrine resistance and data from the three landmark AI trials have suggested it might have a potential role in deciding if patients should be treated ‘upfront’ with an AI rather than tamoxifen. Alone, data from the trials were insufficient to determine if this was the case so a meta-analysis was performed. While improved outcomes were seen in women with HER2-negative tumours if they were treated with AIs rather than tamoxifen, the situation was less clear for women with HER2-positive tumours. The latter fared no better, or slightly worse, during AI treatment than those who received tamoxifen. Dr Bartlett explains what these findings might mean for clinical practice.

Dr Raj talks to ecancertv at SABCS 2015 about a novel agent that targets the estrogen receptor 1 (ESR1) and that could help overcome resistance to hormonal therapy in women with metastatic breast cancer. The central role of estrogen in the progression of breast cancer has been long known and current therapies involve either anti-estrogens or aromatase inhibitors that target ESR1. Most women treated with these drugs eventually develop resistance, so there is a need for other approaches. In the interview, Dr Raj explains how the ESR1 coregulator binding inhibitor (ECBI) is able to disrupt ESR1 signalling by blocking ESR1 interactions with its critical coregulators. The molecule is in the early phases of development but has been tested on several breast cancer and therapy-resistant model cells and on primary human breast tissue.

Dr Smith presents, talks to ecancertv at SABCS 2015 about the various guideline-concordant local therapy options available for women with early-stage breast cancer in the United States. The data shows mastectomy plus reconstruction had the highest complication rates and complication-related costs for both younger women with private insurance and older women on Medicare, and it was the most expensive option for younger women.

Prof Gnant presents, at a press conference at SABCS 2015, results from the phase III ABCSG-18 clinical trial. The results showed that adding denosumab to adjuvant aromatase inhibitor therapy improved disease-free survival for postmenopausal patients with early-stage, hormone receptor-positive breast cancer.

Prof Gnant talks to ecancertv at SABCS 2015 about results from the phase III Austrian Breast & Colorectal Cancer Study Group (ABCSG)-18 clinical trial in which denosumab was added to adjuvant aromatase inhibitor (AI) therapy. Denosumab is a monoclonal antibody licensed for the treatment of osteoporosis, drug-induced bone loss and bone metastases. Long-term AI therapy is associated with bone loss so the rationale was to see if denosumab could prevent this. The trial included more than 3000 for postmenopausal women with early-stage, hormone receptor- positive breast cancer who were treated with AI therapy alone or with additional denosumab given as subcutaneously injected dose of 60 mg every 6 months. Data on the primary bone end points were recently published in The Lancet and showed that denosumab could halve the risk of clinical bone fractures. The disease-free survival data presented by Prof Gnant at SABCS 2015 showed that, at a median follow-up of 4 years, that this secondary end point was also substantially improved.

Prof El Saghir talks to ecancertv at SABCS 2015 about the development of resource-based guidelines for the management of advanced breast cancer in low- and middle-income countries. While advanced disease accounts for relatively few cases of breast cancer in high-income countries, it represents around 45% of cancers in low- and middle-income countries, he explains. Even with improved awareness and screening in some countries the rate is still around 35%. Guidelines issued by major international bodies provide recommendations on the best possible practice, but the treatment options suggested may not be always be available in lower income countries. Dr El Saghir discusses the development of resource-stratified guidelines that take this into account and that aim to provide the best possible care based on available resources while these resources are also being improved, he says. Specifically, he outlines the Breast Health Global Initiative and ABC Consensus Guidelines that categorise countries according to their level or resources rather than income.

Dr Nielsen presents, at a press conference at SABCS 2015 about the data from the phase III DBCG77B clinical trial. The data showed that premenopausal women whose invasive breast cancers were of the luminal A subtype had comparable 10-year disease-free survival rates regardless of whether or not they received adjuvant chemotherapy.

Dr Sikov presents, at a press conference at SABCS 2015 about the results from the randomised phase II CALGB/Alliance 40603 clinical trial. The results showed that patients with stage 2 or stage 3 triple-negative breast cancer who had a pathologic complete response after presurgery chemotherapy had increased event- free and overall survival compared with those who had more than minimal residual invasive disease at surgery following presurgery chemotherapy.

Dr Gluz talks to ecancertv at SABCS 2015 about biomarker driven clinical trials and the WSG-ADAPT TN randomised phase II trial. WSG-ADAPT TN is an adjuvant dynamic marker-adjusted personalised therapy trial, optimising risk assessment and therapy response prediction in early breast cancer.

Dr Toi talks to ecancertv at SABCS 2015 about the results of the CREATE-X phase III clinical trial that have shown that capecitabine improves survival outcomes in women with HER2-negative breast cancer who have invasive disease after neoadjuvant chemotherapy. In the interview, Dr Toi explains that women who do not achieve a pathological complete response (pCR) after neoadjuvant chemotherapy with an anthracycline and a taxane have an intermediate or high-risk for relapse. The CREATE-X trial was designed to see if further systemic chemotherapy with capecitabine would be beneficial for these patients. Dr Toi and colleagues have previously reported data to show that adding capecitabine to standard adjuvant radiotherapy or hormone therapy was feasible and well tolerated. The findings presented at SABCS 2015 showed that the addition also improved the primary endpoint of 2-year disease-free survival by about 32% (87.3% vs 80.5%, p=0.001) and the secondary endpoint of overall survival (96.2% vs 93.9%, p=0.086) by about 35% versus standard adjuvant therapy alone. Tolerability was consistent with the established safety profile of capecitabine in metastatic breast cancer and the results suggest there may be a role for capecitabine in some women after neoadjuvant chemotherapy.

Dr Lancaster talks to ecancertv at SABCS 2015 about the myRisk® Hereditary Cancer test. This test consists of a 25-gene panel that identifies an elevated risk for eight important hereditary cancers: breast, ovarian, endometrial, prostate, gastric, colorectal, pancreatic and melanoma. Dr Lancaster notes that one of the potential barriers to testing for hereditary cancer is that it may cause distress to the individual being tested and so some patients and clinicians may be wary. Interim data on several hundred patients suggests, however, that this does not appear to be a significant problem with the use of the myRisk® test and patients noted that they were quite pleased that they agreed to being tested and had no regrets. He also discusses the advantages of testing for multiple rather than single genes for identifying different risk categories of patients, and how 40% of mutated genes in breast cancer appear over the age of 45 years so using that age as a cut off would mean missing a lot of women who may go on to develop the disease or secondary cancers.

Prof Nielsen talks to ecancertv at SABCS 2015 about data showing that premenopausal women with invasive breast cancers of the luminal A subtype had comparable 10-year disease-free survival rates regardless of whether or not they received adjuvant chemotherapy. In a prospectively performed retrospective analysis of the Danish Breast Cancer Cooperative Group (DBCG) 77B study, the aim was determine the predictive value of intrinsic breast cancer subtypes for response to adjuvant chemotherapy. Using tumour specimens from this randomised clinical trial, Prof Nielsen explains how data on the immunohistochemistry of the samples was used to identify the subtype of breast cancer and then assess the effect of adjuvant cyclophosphamide-based chemotherapy. Patients with luminal A breast tumours did not benefit from chemotherapy whereas patients with non-luminal A subtypes did. Prospective trial data are needed to confirm the findings.

Dr Harris talks to ecancertv at SABCS 2015, about his research on APOBEC3B and its correlation to drug resistance in breast cancer. APOBEC, particularly APOBEC3B is a brand new source of mutation in cancer, he observes. Infection with the human papillomavirus (HPV) has been shown to account for upregulation of APOBEC3B in cervical and head/ and neck cancers but it is not clear how it becomes changed in on-viral malignancies such as breast cancer. Dr Harris discusses data that show that upregulation in breast cancer may occur via the PKC-NFκB pathway. These data establish the first mechanistic link between APOBEC3B and a common signal transduction pathway, he says, suggesting that using inhibitors that target this pathway may be of benefit.