Podcasts about san antonio breast cancer symposium

Featuring an interview with Dr Rinath M Jesselsohn, including the following topics: Evaluating first-line treatment of metastatic ER-positive, HER2-positive breast cancer: heredERA Breast Cancer study (0:00) Kuemmel S et al. heredERA Breast Cancer: A phase III, randomized, open-label study evaluating the efficacy and safety of giredestrant plus the fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection in patients with previously untreated HER2-positive, estrogen receptor-positive locally advanced or metastatic breast cancer. BMC Cancer 2024;24(1):641. Abstract  Treatment outcomes with CDK4/6 inhibitors and with elacestrant in real-world studies (4:13) Lloyd MR et al. CDK4/6 inhibitor efficacy in ESR1-mutant metastatic breast cancer. NEJM Evid 2024;3(5). Abstract  Lloyd M et al. Impact of prior treatment, ESR1 mutational (ESR1m) landscape, and co-occurring PI3K pathway status on real-world (RW) elacestrant outcomes in patients (pts) with hormone receptor-positive (HR+)/HER2-negative advanced breast cancer (aBC). San Antonio Breast Cancer Symposium 2024;Abstract PS7-05.  Evaluating the CNS activity of imlunestrant, an oral selective estrogen receptor degrader (SERD) (8:06) VandeKopple M et al. Preclinical characterization of imlunestrant, an oral brain-penetrant selective estrogen receptor degrader with activity in a brain metastasis (BM) model. ESMO Breast 2023;Abstract 41P.  Selective review of trials of oral SERDs in the adjuvant setting (11:27) A study of imlunestrant versus standard endocrine therapy in participants with early breast cancer (EMBER-4). NCT05514054 CME information and select publications

Featuring an interview with Dr Rinath M Jesselsohn, including the following topics: Imlunestrant with or without abemaciclib in advanced breast cancer: Results of the Phase III EMBER-3 trial (0:00) Jhaveri KL et al. Imlunestrant with or without abemaciclib in advanced breast cancer. N Engl J Med 2025;392(12):1189-202. Abstract  Jhaveri KL et al. Imlunestrant, an oral selective estrogen receptor degrader (SERD), as monotherapy & combined with abemaciclib, for patients with ER+, HER2- advanced breast cancer (ABC), pretreated with endocrine therapy (ET): Results of the Phase 3 EMBER-3 trial. San Antonio Breast Cancer Symposium 2024;Abstract GS1-01. Comprehensive genomic profiling of ESR1, PIK3CA, AKT1 and PTEN in HR-positive, HER2-negative metastatic breast cancer: Prevalence along treatment course and predictive value for endocrine therapy resistance in real-world practice (7:00) Bhave MA et al. Comprehensive genomic profiling of ESR1, PIK3CA, AKT1, and PTEN in HR(+)HER2(-) metastatic breast cancer: Prevalence along treatment course and predictive value for endocrine therapy resistance in real-world practice. Breast Cancer Res Treat 2024;207(3):599-609. Abstract Camizestrant, a next-generation oral selective estrogen receptor degrader (SERD), versus fulvestrant for postmenopausal women with estrogen receptor-positive, HER2-negative advanced breast cancer (SERENA-2): A multi-dose, open-label, randomized, Phase II trial (10:25) Oliveira M et al. Camizestrant, a next-generation oral SERD, versus fulvestrant in post-menopausal women with oestrogen receptor-positive, HER2-negative advanced breast cancer (SERENA-2): A multi-dose, open-label, randomised, phase 2 trial. Lancet Oncol 2024;25(11):1424-39. Abstract Latest on SERDs: An education session at San Antonio Breast Cancer Symposium 2024 (13:57) Jeselsohn RM. Latest on selective estrogen receptor degraders (SERDs). San Antonio Breast Cancer Symposium 2024;Education Session 5. CME information and select publications

Dr Sara A Hurvitz from the Fred Hutchinson Cancer Center in Seattle, Washington, summarizes data presented at the recent 2024 San Antonio Breast Cancer Symposium applicable to the management of HR-positive breast cancer. CME information and select publications here.

Featuring an interview with Dr Komal Jhaveri, including the following topics: Emerging treatment options for advanced ER-positive breast cancer (0:00) Burstein H. Emerging treatment options for advanced ER+ breast cancer. San Antonio Breast Cancer Symposium 2024;Abstract GS1-01 Discussant. Elacestrant real-world progression-free survival for adult patients with ER-positive, HER2-negative advanced breast cancer: A retrospective analysis using insurance claims in the United States (7:28) Swallow E et al. Elacestrant real-world progression-free survival (rwPFS) of adult patients with ER+/HER2-, advanced breast cancer: A retrospective analysis using insurance claims in the United States. San Antonio Breast Cancer Symposium 2024;Abstract P3-10-08. Ongoing clinical trials involving oral SERDs (9:03) Kaklamani V et al. ELCIN: Elacestrant in women and men with CDK4/6 inhibitor (CDK4/6i)-naïve estrogen receptor-positive (ER+), HER2-negative (HER2-) metastatic breast cancer (mBC): An open-label multicenter phase 2 study. San Antonio Breast Cancer Symposium 2024;Abstract P2-08-20. An adjuvant endocrine-based therapy study of camizestrant (AZD9833) in ER+/HER2- early breast cancer (CAMBRIA-2). NCT05952557 Bardia A et al. ELEGANT: Elacestrant versus standard endocrine therapy in women & men with node-positive, estrogen receptor-positive, HER2-negative, early breast cancer with high risk of recurrence in a global, multicenter, randomized, open-label phase 3 study. San Antonio Breast Cancer Symposium 2024;Abstract P2-08-21. Precision therapeutics and emerging strategies for HR-positive metastatic breast cancer (13:48) Lloyd MR et al. Precision therapeutics and emerging strategies for HR-positive metastatic breast cancer. Nat Rev Clin Oncol 2024;21(10):743-61. Abstract CME information and select publications

Dr. Jasmine Sukumar and Dr. Dionisia Quiroga discuss advances in adjuvant therapy for patients with early breast cancer and BRCA1/2 mutations, including how to identify patients who should receive genetic testing and the significant survival benefits of olaparib that emerged from the OlympiA trial. TRANSCRIPT Dr. Jasmine Sukumar: Hello, I'm Dr. Jasmine Sukumar, your guest host of the ASCO Daily News Podcast today. I'm an assistant professor and breast medical oncologist at the University of Texas MD Anderson Cancer Center. On today's episode, we'll be exploring advances in adjuvant therapy for high-risk early breast cancer in people with BRCA1/2 germline mutations. Joining me for this discussion is Dr. Dionisa Quiroga, an assistant professor and breast medical oncologist at the Ohio State University Comprehensive Cancer Center.  Our full disclosures are available in the transcript of this episode.  Dr. Quiroga, it's great to have you on the podcast. Thanks for being here. Dr. Dionisia Quiroga: Thank you. Looking forward to discussing this important topic. Dr. Jasmine Sukumar: Let's start by going over who should be tested for BRCA1/2 genetic mutations. How do you identify patients with breast cancer in your clinic who should be offered BRCA1/2 genetic testing? Dr. Dionisia Quiroga: So, guidelines on who to offer testing to somewhat differ between organizations at this point. I would say, generally, I do follow our current ASCO-Society of Surgical Oncology (SSO) Guidelines, though. Those guidelines recommend that BRCA1/2 mutation testing be offered to all patients who are diagnosed with breast cancer and are 65 years old or younger. For those that are older than 65 years old, there are additional factors to really take into account to decide on who to recommend testing for. Some of this has to do with personal and family history as well as ancestry. The NCCN also has their own specific guidelines for who to offer testing to. For example, people assigned male at birth; those who are found to have a second breast primary; those who are diagnosed at a young age; and those with significant family history should also be offered BRCA1/2 testing.  I think, very important for our discussion today, ASCO and SSO also made a very important point that all patients who may be eligible for PARP inhibitor therapy should be offered testing. So clearly this includes a large amount of our patient population. In my practice, we often refer to our Cancer Genetics Program. We're fortunate to have many experienced genetic counselors who can complete pre-test and post-test counseling with our patients. However, in settings where this may not be accessible to patients, it can also be appropriate for oncology providers to order the testing and ideally perform some of this counseling as well. Dr. Jasmine Sukumar: Thank you Dr. Quiroga. Let's next review where we are in current clinical practice guidelines. What current options do we have for adjuvant therapy specific to people with high-risk early breast cancer and BRCA1/2 genetic mutations? Dr. Dionisia Quiroga: Our current guidelines recommend adjuvant olaparib for one year for individuals with HER2-negative high risk breast cancer. This approval largely came from the data and the results of the OlympiA trial. This was a prospective phase 3, double blind, randomized clinical trial. It enrolled patients who had been diagnosed with HER2-negative early-stage breast cancer who also carried germline pathogenic or likely pathogenic variants of either the BRCA1 and/or BRCA2 genes. The disease also had to be considered high-risk and there were several criteria that had to be evaluated to deem whether or not these patients were high-risk. For example, those who are treated with neoadjuvant chemotherapy, if they had disease that was triple-negative, they needed to have some level of invasive residual disease at time of surgery. Alternatively, if the disease was hormone receptor-positive, they needed to have residual disease and a calculated CPS + EG score of 3 or higher. This scoring system is something that estimates relapse probability on the basis of clinical and pathologic stage, ER status, and histologic grade, and this will give you a score ranging from 0 to 6. In general, the higher the score, the worse the prognosis. This calculator though is available to the public online to allow providers to calculate this risk.  For the subset of patients who received adjuvant chemotherapy, for them to qualify for the OlympiA trial, if they had triple-negative disease, they needed to have a tumor of at least 2 cm or greater and/or have positive lymph nodes for disease. For hormone receptor-positive disease that was treated with adjuvant chemotherapy, they were required to have four or more pathologically confirmed positive lymph nodes at time of surgery. From this specified pool, patients were then randomized 1:1 to get either adjuvant olaparib starting at 300 mg twice a day or a matching placebo twice a day after they had completed surgery, chemotherapy and radiation treatment if needed. Dr. Jasmine Sukumar: And what were the outcomes of this study? Dr. Dionisia Quiroga: The study ended up enrolling over 1,800 patients and from these 1,800 patients, 70% had a BRCA1 mutation while 30% had a BRCA2 mutation. About 80% of the patients had triple-negative disease compared to hormone receptor-positive disease. Interestingly, about half of all patients enrolled had received neoadjuvant chemotherapy while the other half received adjuvant chemotherapy.  Looking at the outcomes, this was overall a very positive study. We actually now have outcomes data from a median of about 6 years out. This was just reported in December at the 2024 San Antonio Breast Cancer Symposium. There was found to be a 9.4% absolute difference in six-year invasive disease-free survival favoring the olaparib arm over the placebo arm. What was also interesting is that this was consistent across multiple subgroups of patients and the benefit was really seen whether or not they had hormone receptor-positive or triple-negative disease. The absolute difference in distant disease-free survival was also high at 7.8% and additionally favored olaparib. Most importantly, there was found to be a significant overall survival benefit. The six-year overall survival was 87.5% in the olaparib group compared to 83.2% in the placebo group. This translates to about a 4.4% difference and a relative 28% overall survival benefit in using olaparib.  Now, future follow up is going to be very important. Follow up for this study is actually planned to continue out until June 2029 so we can continue to observe if these survival curves will continue to branch apart as they have so far at each follow up. And I think this is especially important for those patients diagnosed with hormone receptor-positive cancers because we know those patients are at particular risk for later recurrences.  As an additional side note, the researchers also noted that there were fewer primary malignancies in the olaparib group, not just of the breast but also primary ovarian or fallopian tube cancers as well, which is not completely surprising knowing that this drug is also heavily used and beneficial in different types of gynecologic cancers. Ultimately, the amount of adverse events reported have been low with only about 9.9% of patients receiving olaparib needing to discontinue drug due to adverse events, and this is compared to 4.2% reported in the placebo group. Dr. Jasmine Sukumar: You mentioned that the OlympiA trial showed an overall survival benefit, but interestingly the OlympiAD trial looking at olaparib versus chemotherapy in patients with advanced metastatic HER2-negative breast cancer did not show a significant overall survival benefit. Could you discuss those differences? Dr. Dionisia Quiroga: I agree, that's a very good point. So OlympiA's comparator arm was, of course, a placebo. So while this isn't the same as comparing to chemotherapy, it does still potentially suggest that there is a degree of benefit that olaparib can provide when it's introduced in the early local disease setting compared to advanced metastatic disease. I think we need more future trials looking at potential other combinations to see if we can improve the efficacy of PARP inhibitors in the metastatic setting. Dr. Jasmine Sukumar: For patients who do choose to proceed with use of adjuvant olaparib due to the promising efficacy, what side effects should oncologists counsel their patients about? Dr. Dionisia Quiroga: The most common notable side effects, I would say with olaparib and other PARP inhibitors are really cytopenias. Gastrointestinal side effects such as nausea and vomiting can occur as well as fatigue. There are some less common but potentially more serious side effects that we should counsel our patients on. This includes pneumonitis. So counseling patients on if they're short of breath or experiencing cough to let their provider know. Venous thromboembolism can also be increased rates of occurrence. And then of course myelodysplastic syndromes or acute myeloid leukemia is something that we often are concerned about. That being said, I think it should be noted that interestingly in the OlympiA trial so far, there have been less new cases of MDS and AML in the olaparib group than actually what's been reported in the placebo group at this median follow up of over six years out. So we'll need to continue to monitor this endpoint over time, but I do think this provides some reassurance. Dr. Jasmine Sukumar: Since the initiation of the OlympiA trial, other adjuvant treatments have also been studied and FDA approved for non-metastatic HER2-negative breast cancer. So for example, the CREATE-X trial established adjuvant capecitabine as an FDA approved treatment option in patients with triple-negative breast cancer who had residual disease following neoadjuvant chemotherapy. So if a patient with triple-negative breast cancer with residual disease is eligible for both adjuvant olaparib and adjuvant capecitabine treatments, how do you decide amongst the two? Dr. Dionisia Quiroga: If a patient's eligible for both, I honestly often favor olaparib, and I do this because I find the data for adjuvant olaparib a little bit more compelling. There are also differences in toxicity profile and treatment duration between the two that I think we should discuss with patients. For example, olaparib is supposed to be taken for a year total, whereas with capecitabine we typically treat for six to eight cycles with each cycle taking three weeks. There are some who may also sequence the two drugs in very high-risk disease. However, this is very much a data free zone. We don't have any current clinical trials really comparing these two or if sequencing of these agents is appropriate. So I don't currently do this in my own clinical practice. Dr. Jasmine Sukumar: Nowadays, almost all patients with stage 2 to 3 triple-negative breast cancer will be offered neoadjuvant chemotherapy plus immune checkpoint inhibitor therapy pembrolizumab per our KEYNOTE-522 trial data. With our current approach, pembrolizumab is continued into the adjuvant setting regardless of surgical outcome, so that patients receive a year total of immunotherapy. So in patients with residual disease and a BRCA germline mutation, do you suggest using adjuvant olaparib concurrently with pembrolizumab? Do we have any data to support that approach? Dr. Dionisia Quiroga: I do. I do use them concurrently. If a patient is eligible for adjuvant olaparib, I would use it the same way as if they were not on pembrolizumab. That being said, there are no large studies currently that have shown what the benefit or the toxicity of pembrolizumab plus olaparib are for early-stage disease. However, we do have some safety data of this combinatorial approach from other studies. For example, the phase 2/3 KEYLYNK-009 study showed that patients with advanced metastatic triple-negative breast cancer who were receiving concurrent pembrolizumab and olaparib had a manageable safety profile, particularly as the toxicities of these drugs alone don't tend to overlap. Dr. Jasmine Sukumar: And what about endocrine therapy for those that also have hormone receptor-positive disease? Dr. Dionisia Quiroga: Adjuvant endocrine therapy should definitely be continued while patients are on olaparib if they're hormone receptor-positive. An important component of this will also likely be ovarian suppression, which should include recommendation of risk reducing bilateral salpingo oophorectomy due to the risk of ovarian cancer development in patients who carry BRCA1/2 gene mutations. In most cases, this should happen at age 40 or before for those that carry a BRCA1 mutation, and at age 45 or prior for those with BRCA2 mutations. Dr. Jasmine Sukumar: And do you also consider adjuvant bisphosphonates in this context? Dr. Dionisia Quiroga: Yes. Like adjuvant endocrine therapy, adjuvant bisphosphonates were also instructed to be given according to standard guidelines in the OlympiA trial, so I would recommend use of bisphosphonates when indicated. You can refer to the ASCO Ontario Health Guidelines on Adjuvant Bone-Modifying Therapy Breast Cancer to guide that decision in order to utilize this due to multiple clinical benefits. It doesn't just help in terms of adjuvant breast cancer treatment but also reduction of fracture rate and down the line, improved breast cancer mortality.  Dr. Jasmine Sukumar: Particularly in hormone receptor-positive breast cancer, another adjuvant therapy option that was not available when the OlympiA trial started are the CDK4/6 inhibitors, ribociclib and abemaciclib, based on the NATALEE and monarchE studies. So how do you consider the use of these adjuvant therapy drugs in the context of olaparib and BRCA mutations? Dr. Dionisia Quiroga: Yeah, so we are definitely in a data-free zone here. And that's in part because the NATALEE and the monarchE studies are still ongoing and reporting data out at the same time that we're getting updated OlympiA data. So unlike some of our other adjuvant treatments that we discussed, where olaparib could be safely given concurrently, the risk of myelosuppression and using both a CDK4/6 inhibitor and a PARP inhibitor at the same time would be too high. In some cases, even if a patient has a BRCA1/2 mutation, they may not meet that specified inclusion criteria that OlympiA set for what they consider to be high-risk disease. And we know from the NATALEE and the monarchE trial there are also different markers that they use to denote high-risk disease. So it's possible, for example, in the NATALEE trial that looks specifically at adjuvant ribociclib, they included a much larger pool of hormone receptor-positive early-stage breast cancers, including a subset that did not have positive axillary lymph nodes.  In cases where patients would qualify for both olaparib and a CDK4/6 inhibitor, I think this is worth a nuanced discussion with our patients about the potential benefits, risks and administration of these drugs. I think another point to bring up is the cost associated with these drugs and the length of time patients will be on for, because financial toxicity is always something that we should bring up with patients as well. When sequencing these in high-risk disease, my practice is to generally favor olaparib first due to the overall survival data. There is also some data to support that patients with BRCA1/2 germline mutations may not respond quite as well to CDK4/6 inhibitors compared to those without. But again, this is still outside of the purview of current guidelines. Fortunately, we have more potential choices for patients, and that's a good thing, but shared decision making also needs to be key. Dr. Jasmine Sukumar: And while our focus today is on adjuvant treatment for people who carry germline BRCA mutations, what about other related gene mutations such as PALB2 pathogenic variant? Dr. Dionisia Quiroga: That's a great question. Clinical trials in the advanced metastatic setting have shown that there is efficacy of olaparib in the setting for PALB2 mutations. This is largely based on the TBCRC 048 phase 2 trial and that provided a Category 2B NCCN recommendation for patients with these PALB2 gene mutations. However, we're really still lacking enough clinical data for use in early-stage disease, so I don't currently use adjuvant olaparib in this case. I am definitely eager for more data in this area as the efficacy of PARP inhibitors in PALB2 gene mutations is very compelling. I think also, in the same line, there's been some data for somatic BRCA1/2 mutations in the metastatic setting, but we still have a lack of data for the early stage setting here as well. Dr. Jasmine Sukumar: Thank you Dr. Quiroga, for sharing your valuable insights with us today on the ASCO Daily News Podcast. Dr. Dionisia Quiroga: Thank you, Dr. Sukumar. Dr. Jasmine Sukumar: And thank you to our listeners for your time today. You'll find links to the studies discussed today in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review and subscribe wherever you get your podcasts. Thank you. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:   Dr. Dionisa Quiroga @quirogad @quirogad.bsky.social Dr. Jasmine Sukumar @JasmineSukumar  @jasmine.sukumar.bsky.social Follow ASCO on social media:  @ASCO on X   @ASCO on Bluesky    ASCO on Facebook    ASCO on LinkedIn    Disclosures: Dr. Dionisia Quiroga:  No relationships to disclose Dr. Jasmine Sukumar: Honoraria: Sanofi (Immediate Family Member)  

In this episode of SurgOnc Today®, Dr. Olga Kantor discusses with Dr. Chandler Cortina and Dr. Puneet Singh the locoregional highlights of the 2024 San Antonio Breast Cancer Symposium, including the COMET, INSEMA, EUROPA and Alliance 11202 trials.

Join us for another insightful episode of the Oncology Brothers podcast as we dive into the latest breakthroughs in breast cancer research from the San Antonio Breast Cancer Symposium 2024. In this episode, hosts Drs. Rahul and Rohit Gosain are joined by Dr. Sara Tolaney from Dana-Farber Cancer Institute to discuss three pivotal studies: 1.⁠ ⁠DESTINY-Breast06 - An update on the efficacy of T-DXd in HER2 low and ultra-low breast cancer patients, highlighting its potential to change treatment paradigms for endocrine refractory disease. 2.⁠ ⁠DESTINY-Breast12 - Exploring the robust intracranial activity of T-DXd in patients with brain metastases and its impact on quality of life. 3.⁠ ⁠PATINA Trial - A groundbreaking study on the use of CDK4-6 inhibitors in combination with trastuzumab and pertuzumab for ER-positive, HER2-positive breast cancer, showcasing impressive progression-free survival rates. Tune in as we unpack the implications of these studies for clinical practice and discuss the future of breast cancer treatment. Don't forget to like, subscribe, and hit the notification bell for more updates on oncology research and treatment strategies! Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers For more information, visit our website: OncologyBrothers.com #OncologyBrothers #BreastCancer #SABCS2024 #TDXD #PATINA #CancerResearch #Podcast

Welcome to another episode of the Oncology Brothers podcast! In this episode, hosts Rahul and Rohit Gosain are joined by Dr. Jame Abraham from the Cleveland Clinic to discuss key abstracts in the hormone receptor-positive breast cancer space from the San Antonio Breast Cancer Symposium 2024. Episode Highlights: •⁠  ⁠EUROPA Trial: A phase 3 study comparing endocrine therapy versus radiation therapy in early-stage breast cancer patients over 70. Discover how the results may impact clinical practice and patient decision-making. •⁠  ⁠TAILORx Study: Updates on the benefits of anthracycline-based chemotherapy for patients with a recurrence score of 31 and above. Learn how this data influences treatment options for younger patients. •⁠  ⁠PADMA Study: Insights into the role of CDK4/6 inhibitors combined with endocrine therapy versus chemotherapy in aggressive disease settings. Understand why this combination remains the standard of care. •⁠  ⁠EMBER-3 Study: An exploration of the new oral selective estrogen receptor degrader, imlunestrant, and its promising results in combination with abemaciclib for patients with hormone receptor-positive, HER2-negative metastatic breast cancer. Join us as we delve into these important studies and their implications for the future of breast cancer treatment. Don't forget to check out our other conference highlights from ASH 2024 and SABCS 2024! Subscribe for more insights and updates in oncology! Website: http://www.oncbrothers.com/ X/Twitter: https://twitter.com/oncbrothers Contact us at info@oncbrothers.com

Claudine Isaacs, MD and Tiffany A. Traina, MD, FASCO share their insights from the 2024 San Antonio Breast Cancer Symposium on the TOUCH trial, DTP trial, and data on SHR-A1811 in HER2+ early breast cancer.

Welcome to another episode of the Oncology Brothers podcast! In this episode, hosts Drs. Rahul & Rohit Gosain are joined by Dr. Laura Huppert from UCSF to discuss key highlights from the San Antonio Breast Cancer Symposium 2024. We dive into three crucial studies: 1.⁠ ⁠INSEMA Study: Explore the findings on the potential omission of axillary surgery in early-stage hormone receptor-positive breast cancer and its implications for patient quality of life. 2.⁠ ⁠KEYNOTE-522 Update: Learn about the latest insights on the use of Pembrolizumab in triple-negative breast cancer, including the search for predictive biomarkers and the impact of achieving pathological complete response (PCR). 3.⁠ ⁠OlympiA Study Update: Discover the updated results on the use of Olaparib in BRCA-positive patients, highlighting its significant benefits in invasive disease-free survival and overall survival. Join us as we unpack these important studies and their implications for clinical practice. Don't forget to like, subscribe, and hit the notification bell for more updates from the Oncology Brothers! Website: http://www.oncbrothers.com/ X/Twitter: https://twitter.com/oncbrothers Contact us at info@oncbrothers.com

In this episode, listen to Virginia Kaklamani, MD, DSc; Erica L. Mayer, MD, MPH; and Laura M. Spring, MD, share their clinical insights and takeaways from a live symposium, including from key abstracts presented at the 2024 San Antonio Breast Cancer Symposium:Estrogen Receptor Mutations in Patients With HR-Positive/HER2-Negative Advanced Breast CancerCurrent Guideline Recommendations for When to Pursue ESR1 Mutation Testing Mutations in Patients With HR-Positive/HER2-Negative Advanced Breast CancerChoice and Sequencing of Next Line of Systemic Therapy for ESR1-Mutated Advanced Breast Cancer Based on Tumor Molecular AlterationsOverview of Class-Related and Unique Adverse Events With Approved and Emerging Oral SERDSExpert Recommendations for the Management of Oral SERDs-Related Adverse EventsProgram faculty:Virginia Kaklamani, MD, DScProfessor of MedicineRuth McLean Bowman Bowers Chair in Breast Cancer Research and TreatmentA.B. Alexander Distinguished Chair in Oncology LeaderBreast Oncology ProgramUT Health San AntonioMD Anderson Cancer CenterSan Antonio, TexasErica L. Mayer, MD, MPHDirector of Breast Cancer Clinical ResearchDana-Farber Cancer InstituteAssociate Professor in MedicineHarvard Medical SchoolBoston, MassachusettsLaura M. Spring, MDBreast Medical OncologistMass General Hospital Cancer CenterHarvard Medical SchoolBoston, Massachusetts Resources:To download the slides associated with this podcast discussion, please visit the program page.

Enjoy Living Our Breast Lives' last podcast episode of the year! Join Wren Morrobel, founder of the Living Our Breast Lives podcast, and Caroline Johnson, the founder of Twisted Pink, a nonprofit dedicated to funding critical research for Metastatic Breast Cancer! Together, they delve into the nonprofit's framework, the impact of allyship in advocating for the MBC community as an early-stage survivor, and their shared takeaways from the 2024 San Antonio Breast Cancer Symposium!Caroline Johnson—a patient advocate, wife, mom of three, and an 11-year stage three breast cancer survivor—shares her inspiring mission to direct critical funding toward Stage IV Metastatic Breast Cancer research. Her passion for advocacy stems from years of championing her son, born with a rare genetic deletion called BBSOAS. These profound medical and healthcare experiences not only shaped her advocacy journey but also empowered her to navigate her own breast cancer diagnosis with strength and determination.Caroline's unwavering dedication to supporting the MBC community shines through every time she speaks. She remains a passionate advocate for improved healthcare systems and policies benefiting individuals with rare diseases and cancer. As an early-stage survivor, she feels grateful to continue preventative treatment to this day, stay informed about clinical trials, and emphasize the vital role research plays in advancing cancer care.Living Our Breast Lives Information:Email: livingourbreastlives@gmail.comInstagram: @livingourbreastlivesFounder: Wren MorrobelPersonal Instagram: @wren_morrCaroline Johnson's Contact Information:Email: cvanjohnson73@twistedpink.orgWebsite: twistedpink.orgInstagram: @twistedpinkorgFacebook: Twisted PinkLinkedin: linkedin.com/company/twisted-pink-incYoutube: youtube.com/@TwistedPink

In deze podcast u aangeboden door oncologie.nu bespreken Sabine Linn en Agnes Jager laatste ontwikkelingen op het gebied van triple-negatieve borstkanker die werden gepresenteerd tijdens het San Antonio Breast Cancer Symposium 2024.

This episode of Pharmacy Focus, Oncology Edition highlights key insights from the 2024 San Antonio Breast Cancer Symposium, covering new FDA-approved therapies, dose optimization strategies, and innovative prevention approaches in breast cancer care.

In deze podcast bespreken Vivianne Tjan-Heijnen, Maastricht UMC+, en Sabine Linn, Antoni van Leeuwenhoek te Amsterdam en UMC Utrecht, laatste ontwikkelingen op het gebied van HER2+ borstkanker die werden gepresenteerd tijdens het San Antonio Breast Cancer Symposium 2024. Aan bod komen onder andere de TRAIN3-*, TOUCH-, PATINA-, DTP-, Neo-HIP- en de NRG-BR004-studie.*Bij de bespreking van de TRAIN-3 studie werd in de podcast gezegd dat 235 patiënten waren geïncludeerd, dat had moeten zijn 235 HR-negatieve patiënten. Bij de genoemde percentages patiënten ten aanzien van het aantal ontvangen kuren werden alleen aan die van de HR-negatieve patiënten gerefereerd.

In deze podcast bespreken Vivianne Tjan-Heijnen, Maastricht UMC+, en Agnes Jager, Erasmus MC te Rotterdam, laatste ontwikkelingen op het gebied van ER+ borstkanker die werden gepresenteerd tijdens het San Antonio Breast Cancer Symposium 2024. Aan bod komen onder andere de PADMA-, EMBER3-, APOBEC3-, DESTINY-Breast06- en GS309- studie.

The 2024 San Antonio Breast Cancer Symposium featured five days of research presentations, educational sessions, and advocacy meetings. Dr. Marisa Weiss, founder and chief medical officer of Breastcancer.org, breaks down the research that will have the most immediate impact for people diagnosed with breast cancer. Listen to the episode to hear Dr. Weiss discuss: results from the PATINA study showing that adding Ibrance (chemical name: palbociclib) to first treatments for metastatic, hormone receptor-positive, HER2-positive breast cancer improved outcomes research on the benefits of risk-reducing surgery for young women with a BRCA mutation and a history of breast cancer the importance of moving away from a “one-size-fits-all” approach to treating breast cancer and personalizing treatments for each unique person Scroll down to below the “About the guest” information to read a transcript of this podcast.

Five patient advocates share what they like and what they're excited about at the 2024 San Antonio Breast Cancer Symposium. The advocates are: Antoinette Greer, of My Sister My Friend Breast Cancer Support Gitte Joergensen, of the Lobular Breast Cancer Alliance Joan Mancuso, of Theresa's Research Foundation Barbara Bigelow, of Metavivor and the MBC Alliance Christine Hodgdon, of GRASP Listen to the episode to hear the advocates: explain the research they're most interested in, including circulating tumor DNA research what they like most about the San Antonio Breast Cancer Symposium what the symposium has inspired them to do Scroll down to below the “About the guest” information to read a transcript of this podcast.

Cases of breast cancer in young women have been increasing dramatically in the last eight years. Dr. Matteo Lambertini, whose research focuses on breast cancer in young, especially fertility and pregnancy after a breast cancer diagnosis, chaired a session on breast cancer in the young at the 2024 San Antonio Breast Cancer Symposium. He also presented the results of a study that found young women with a BRCA mutation and a history of breast cancer had better survival and a lower risk of recurrence – the cancer coming back – if they had risk-reducing surgery to remove their healthy ovaries and fallopian tubes, as well as the remaining healthy breast, and any breast tissue left if they had had lumpectomy. Listen to the episode to hear Dr. Lambertini explain: possible reasons why breast cancer rates are rising in young women, even though researchers aren't exactly sure yet some of the most troublesome issues young women with breast cancer face how he plans to use the results of his study with his patients

At the 2024 San Antonio Breast Cancer Symposium, Dr. Aditya Bardia, director of the Breast Oncology Program and Translational Research Integration at the UCLA Health Jonsson Comprehensive Cancer Center, presented results from the DESTINY-Breast06 study, showing that Enhertu (chemical name: fam-trastuzumab deruxtecan-nxki), also called T-DXd, was better than chemotherapy for metastatic, hormone receptor-positive, HER2-low or -ultralow breast cancer that grew after one or more hormonal therapy medicines. Listen to the episode to hear Dr. Bardia explain: results of the study what HER2-low and -ultralow breast cancer is whether people diagnosed with metastatic hormone receptor-positive, HER2-negative breast cancer should have additional HER2 testing

Andrea Hans was diagnosed with stage II triple-negative breast cancer when she was 28. With expertise in public health and health policy, she began working as an advocate to empower young women to understand their breast cancer risk factors. Andrea received an Alamo Breast Cancer Foundation Advocate Scholarship to attend the 2024 San Antonio Breast Cancer Symposium. Listen to the episode to hear Andrea explain: how she transitioned from patient to advocate the scholarship application process what being a scholar entails

Megan-Claire Chase, aka Warrior Megsie, is a patient advocate and breast cancer survivor from Atlanta, Georgia. Her blog, Life on the Cancer Train, is famous for being authentic, raw, and informative, with a twist of humor, where she shares her experiences of being a young adult cancer survivor while advocating for better treatments and resources. The blog is syndicated on Cancer Health Magazine's website. Megan-Claire is a highly sought-after blogger and influencer in the cancer community nationally and internationally. In 2023, Megan-Claire was featured in Stories from the Stage episode "Beyond Cancer," which aired on PBS and World Channel. Currently serves on Bayer Oncology's Digital Patient Council, and the Oncology Data Advisory Editorial Board, and is a Board Member for the LYTE Foundation. She hosts two podcasts, The Other Side of Cancer and Our BC Life, and ongoing collaborations with Teen Cancer America to create inclusive content for social media and patient-facing collateral. Megan-Claire co-authored abstracts and presented posters, including Genetic Testing in Metastatic Breast Cancer in the USA: A Podcast | Oncology and Therapy (springer.com), and The Impact of Triple-Negative Breast Cancer in Black Women at the San Antonio Breast Cancer Symposium in 2023, and "You don't really have a say in anything...like you don't have any options": AYA Cancer Survivors' Perspectives on Fertility Preservation Conversations with Healthcare Providers presented at the 16th Annual American Psychosocial Oncology Society (APOS) in 2019 and accepted for a Poster Symposia II: Sexual and Reproductive Health oral presentation at the annual meeting of the Society for Adolescent Health and Medicine and published in the medical journal Psycho-Oncology. Megan-Claire's work is featured in several publications, including Cancer Health, Cancer Today, CURE Magazine, Count Me In, Everyday Health, Elephants and Tea, Dating Roo (UK), Voyage ATL, Humor Beats Cancer, IHadCancer.com, RETHINK Cancer, Pharmaphorum (UK), and WebMD. Blog: Life on the Cancer Train at www.warriormegsie.com Social Media Links: Instagram - https://www.instagram.com/warriormegsie/ Twitter - https://twitter.com/warriormegsie LinkedIn - https://www.linkedin.com/in/megan-claire-chase/ Other Links to Projects/Articles: Stories from the Stage on PBS and World Channel episode: Beyond Cancer Watch here. Cancer Health magazine: You Can't Escape Race in Cancer Read here. Oncology Data Advisor: AYA Cancer Awareness Week: Creating Welcoming Spaces for Support and Advocacy With Dr. Lauren Ghazal, Megan-Claire Chase, and Allison Rosen Listen here. The Patient Story: Megan-Claire's Breast Cancer Story: My Symptoms Were VERY Different Watch here Pfizer: Genetic Testing in Metastatic Breast Cancer in the USA: A Podcast | Oncology and Therapy (springer.com)

Dr. Allison Zibelli and Dr. Megan Kruse discuss the potential benefit of endocrine therapy in ER-low breast cancer; the efficacy and tolerability of triplet therapy in PIK3CA-mutated, HER2-negative locally advanced or metastatic breast cancer; and more key research that will be featured at the 2024 ASCO Annual Meeting.  TRANSCRIPT Dr. Allison Zibelli: Hello, I'm Dr. Allison Zibelli, your guest host of the ASCO Daily News Podcast today. I am an associate professor of medicine and a breast medical oncologist at the Sidney Kimmel Cancer Center of Jefferson Health in Philadelphia. My guest today is Dr. Megan Kruse, a breast medical oncologist and director of breast cancer research at the Cleveland Clinic Taussig Cancer Institute. We'll be discussing key abstracts in breast cancer that will be featured at the 2024 ASCO Annual Meeting.  Our full disclosures are available in the transcript of this episode, and disclosures related to all episodes of the podcast are available at asco.org/DNpod.  Megan, it's great to have you back on the podcast. Dr. Megan Kruse: Thanks, Alison. Happy to be here. Dr. Allison Zibelli: So, let's begin with Abstract 505. This was another analysis of the SWOG S1007 (RxPONDER) trial, which was the trial that was looking at premenopausal women with intermediate risk oncotype scores. And do they benefit from chemotherapy? If you analyze the whole group, they do benefit from chemotherapy, but what this study questions is whether we can pull out the subset of these patients that actually benefit from chemotherapy? And what they tried doing was measuring various endocrine reproductive hormones and found that anti-mullerian hormone over 10 was the only one that predicted for chemotherapy benefit. What are your key takeaways from this study? Will it help us figure out who is truly postmenopausal biochemically? Dr. Megan Kruse: I think this is really promising. This is one of the toughest situations in clinic, honestly, when you have a premenopausal woman who has an intermediate oncotype risk. We know that chemotherapy is not going to make a huge difference potentially in their breast cancer outcomes, but it may add to some small differential benefit. I think that many of our patients are really afraid about leaving any impactful therapy on the table. And so, it'd be nice to have another marker to help sort out who in this group will really benefit. And the AMH levels, I think, are something that are very accessible for most practices, easily orderable. And it seems like this cutoff of 10 is a very well-known cut point in the AMH interpretation, and a pretty clear-cut point. So, I think it gives a little bit more objective view of who may actually benefit or not.  When you look at the results shown in this abstract, for the women in the recurrence score less than 25 receiving chemotherapy followed by endocrine therapy, they had a benefit in five-year invasive disease-free survival of 7.8%. When you look at those oncotype reports and they suggest how much benefit you might get, that's right around the same number you see. So, I think that's supporting that this is the subgroup that's benefiting.  When you look at those patients with AMH less than 10, they actually had a negative 1.7% difference in overall survival. So, you wonder, are we harming these patients by giving them chemotherapy? I think that's too far of a stretch to say. I wouldn't be worried about harm. But hopefully, we can stop giving chemotherapy to patients who truly are not going to benefit if we have an additional biomarker of response. That's what the promise is for this.  So again, another potentially actionable abstract that we can put into practice pretty quickly. It's going to be hard to know how to use this, also in the context of the upcoming OFSET study or BR009, which is of course the study in the same group of premenopausal patients with node-negative or 1-3 lymph nodes involved, and intermediate oncotype scores, randomizing them to endocrine therapy with ovarian suppression versus chemoendocrine therapy. It would be kind of nice to see the AMH levels incorporated into that model to see if the same trend holds true. But I think we go back to the TAILORx and RxPONDER studies many times as good quality data, and the trend here is really striking.  Dr. Allison Zibelli: I really like this study because one of the things I often struggle with in the clinic as a practicing breast oncologist is who's really in menopause. And we end up having these fights with the gynecologists where sometimes our opinions differ. And it would be really nice to have something this clear cut to say, “You're in biochemical menopause or you're not.” So, I look forward to seeing this used in a lot of different ways in the future.  Dr. Megan Kruse: Yeah, I agree. And I think it's based on the other markers we have with estrogen levels, with FSH levels. If you're checking those sequentially in patients, we know they go up and down, and it's really hard to tell what we are capturing at this single point in time. And maybe that's what we're seeing in this analysis is that the AMH is a little bit more stable and reliable marker. So, I really love that. And I don't know about you, but in clinical practice it can be really hard. A lot of our patients have had uterine ablations or hysterectomies but have intact ovaries. And so, figuring out ovarian function status is actually much, much harder than it may seem superficially.  Dr. Allison Zibelli: Okay, so let's focus on Abstract 513. I thought this was really interesting. It's a group of patients that we don't have much data for, and that's women that are ER-low, with an ER of 1% to 10% in early-stage breast cancer. Right now, national guidelines are sort of on the fence about whether these women benefit from endocrine therapy. So that's what this study tried to focus on. How will this study change how we approach this group of patients? Dr. Megan Kruse: This study really gave me pause and made me rethink what I'm doing on a day-to-day basis, because here, what the authors found in a very large NCDB analysis was that for women with ER-low status, so ER 1% to 10% positive, they actually did have benefit receiving endocrine therapy, it seems. What they found, after you adjust for many other confounding factors like age, comorbidity, and PR status, is that patients with ER-low breast cancer when they did not receive endocrine therapy actually had worse overall survival outcomes with a hazard ratio of around 1.2 to 1.3.  This is a group where I have typically not pushed endocrine therapy very strongly. I think the patients, especially now, are receiving such intense therapy with chemoimmunotherapy in the preoperative setting, by the time they reach their adjuvant phase with immunotherapy, maybe with capecitabine, maybe with a PARP inhibitor, endocrine therapy seems, “Oh, why bother after we've done all of this?” And we know that the toxicities of endocrine therapy are real and can be very problematic. And so, I have often felt like it's the least important part of therapy and questioned whether we should even bother. But I think this analysis really challenges that and makes us think twice. And I think it speaks to a theme that we're seeing more and more about the heterogeneity of these breast cancer subtypes. And again, talking about clear-cut points in analysis, nothing is truly black and white. So maybe that little bit of expression does mean something.   It does kind of stand in contrast to what we see in studies of ER-low behaving a bit more triple-negative like, but maybe they're their own category, and maybe it gives us a place to look for other therapy synergy in the future. But it certainly will make me stop and think again when I see a ER 4% patient. Should I talk to them about endocrine therapy?  Dr. Allison Zibelli: Yeah, I totally agree with everything you said there. And we know that this is a biologically different group of patients than the ER strongly positive group, but maybe not as different as we once thought. Dr. Megan Kruse: Yeah. And I think there's still a lot of unknowns here about what if they're ER truly negative and PR a little bit positive. So, these clinical situations don't come up that frequently, but when they do, they're humbling, because I think we really, as much data as we have in breast cancer, it's pretty limited for these types of patients.  Dr. Allison Zibelli: So, let's move on to Abstract 1003, which was a new combination in the INAVO120 trial. It was palbociclib plus fulvestrant with either inavolisib or placebo in patients with PIK3CA-mutated hormone receptor-positive, HER2-negative, locally advanced metastatic breast cancer in the second line, who relapsed within 12 months of adjuvant endocrine therapy completion. This is a big group of patients for us. Can you tell us about the study? And does this triple therapy, in your mind, represent a new standard of care? Dr. Megan Kruse: Yeah, this study was initially presented at our 2023 San Antonio Breast Cancer Symposium, and there I felt like it was a little bit of a surprise. There's been so much talk about PI3K-AKT-PTEN pathway impactful drugs and targetable mutations. We've heard a lot about alpelisib and capivasertib, and how these drugs are fitting into our practice. Then all of a sudden, we have this data with inavolisib that I wasn't really expecting to see. And perhaps I think one of the reasons that this study came about so suddenly, seemingly, and so quickly is because it looks at a really high-risk patient population. And so, these are those patients that are having relapses of their breast cancer within their initial, while on adjuvant AI therapy or within 12 months of stopping. And so, having a marker of this patient group that is developing, I think, early endocrine resistance and it's another space where it's kind of hard to identify who these patients are upfront. And so their response to therapy tends to be one of the best markers of risk moving forward.   So, when this trial was originally presented, what was quite striking is that the progression-free survival was more than doubled for the triplet combination compared to the control arm. And those numbers were PFS of 15 months versus 7.3 months for the triplet versus the control. The response rate was also significantly improved, with the triplet going above 50%, versus a response rate in the control of about 25%. So, the results were really striking. But they clearly come with some caveats, which are that this is a very defined patient population of risk. Of course, they have to have the biomarker of a PIK3CA mutation, and in the control arm here, there was no PIK3-targeted medication. And so you wonder, are we just getting better results by including that more specific targeted therapy earlier on? It's hard to know, but I think that could certainly be a big part of this.  And the other caveat, when I'm looking at the data, is how might we think about this in our real population? Because as we know, drugs that impact this pathway tend to have a lot of toxicity concerns, primarily hyperglycemia, diarrhea, and rash. And with this particular agent, there was also notable stomatitis, which is something we've seen with everolimus, of course, in this pathway, but not maybe as much with alpelisib and capivasertib. When you're thinking about all of those toxicities, keep in mind that this trial population included patients with a pretty tight fasting blood sugar requirement, A1c of less than 8, and not requiring insulin. So all of that being said, I think this combination seems really intriguing for efficacy. This is a patient population I'm worried about, because we know that these patients are likely not going to get the same upfront benefit of CDK4/6 inhibitor-based therapy, like maybe we see for a patient with long disease-free survival or de novo metastatic breast cancer. But I think it's going to have some meaningful issues in clinic regarding tolerability. And then, of course, the regimen is more complex. We're talking about two different oral agents and an intramuscular injection, which could be hard for some patients, and it's going to have some decent financial toxicity associated with it.  So, I think it's really, really exciting and has the potential to make an impact in first-line therapy. But I don't envision it being the standard of care first-line therapy for everyone, particularly in light of some of the other data we have in the first line questioning, like from the SONIA trial, how important is CDK for everyone? Again, this is I think where we're starting to get subsets within subsets of this first-line patient population of who needs escalation of therapy and who may benefit from more de-intensified therapy. Dr. Allison Zibelli: I agree, these agents have significant toxicity, and especially financial toxicity is something that we at the academic setting frequently forget about because a lot of our patients are on trials. So, it will be interesting to figure out how we're going to use these agents in real life.  So, for our final abstract, I wanted to discuss Abstract 10508, which was a prevention trial. I think pretty much everybody's patients are going to be asking them about this because it's about GLP-1 inhibitors. We know that bariatric surgery does prevent obesity-associated cancers. This study explored whether the GLP-1 agonists could offer a similar result to bariatric surgery in patients with BMIs over 35. What do you think about this study?  Dr. Megan Kruse: I thought this was such an interesting and timely study and question. These drugs are out there – Ozempic, Mounjaros, and Wegovy – and our patients ask about them. And I think there has been a lot of interest for years now about the impact of lifestyle factors on cancer incidence, particularly in breast cancer, where we know that obesity does seem to be related to cancer incidence. And with all of our concerns about hormonal exposure and extra weight, extra adipose tissue being a source of potential extra estrogen, this is a really key topic.   Talking about financial toxicity, again, I think that is honestly probably the bigger hurdle because this study does reinforce that patients who are receiving GLP-1 receptor antagonists and those who have had bariatric surgery do benefit in terms of cancer-related survival and all-cause related survival. So, I think the impact on metabolic factors is making a difference in cancer incidence and outcomes. But access and equity will be the big issue here, right? Dr. Allison Zibelli: Yes. Dr. Megan Kruse: Can we get patients on these drugs? I certainly have had patients with a history of breast cancer who have been on these medications, and they have done great with them in terms of weight loss. We know that our therapies, many times, do have the side effect of weight gain. So, I wonder if there is a part of weight management that maybe we haven't talked about so much as oncologists that we need to talk about moving forward and would be very welcome by our patients. But it'll have its own caveats, of course. Not only the financial issue but there's the durability issue. And I think when you look at the degree of impact of these medications versus bariatric surgery, you do see a greater impact from bariatric surgery, in not only the degree of weight loss but also the sustainability of that weight loss. So, I think for the right patient at the right time, bariatric surgery may still be the better option, but that's not going to be an option for a lot of patients. It is a huge shift in lifestyle and medications and many ways might be easier, so more to come.   I also wonder about looking at this data through the lens of different cancer types. What will we find out? Is the trend for colon cancer going to be different from the trend for breast cancer? Will the trend within breast cancer be different for breast cancer subtypes? I would very much welcome more data in this space, and it is nice to see a first step forward. Dr. Allison Zibelli: I thought the most interesting thing about this study was that while bariatric surgery patients lost more weight, GLP-1 patients had a higher decrease in obesity-related cancer risk. So, it shows to me that there is something beyond just weight. It is something in metabolism that is driving these cancers.  Dr. Megan Kruse: Yes, and I think that that goes back to some things we have thought about for a long time with insulin levels and insulin-like growth factor, and all of these things that I think when our patients look at more metabolic approaches to cancer control, this is probably what we are trying to get at. We have just never had great ways to measure it or influence it, and perhaps now we finally do. I would love to see some partnering work here in the future with oncologists and endocrinologists and digging into these patients who have great responses to see what we are actually seeing at the hormone level. Dr. Allison Zibelli: Well, thank you so much, Megan, for your great insights today on the ASCO Daily News Podcast. We really appreciate you coming to talk with us again. Dr. Megan Kruse: Thank you. It has been a great conversation. Thank you for opening my eyes to these abstracts, and I am happy to see what else ASCO brings. Dr. Allison Zibelli: And thank you to our listeners for joining us today. You will find links to all the abstracts we discussed today in the transcript of this episode. Finally, if you value the insights you hear on the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts. It really helps other people find us. Thank you for listening.   Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. The guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.   Follow today's speakers: Dr. Allison Zibelli Dr. Megan Kruse @MeganKruseMD   Follow ASCO on social media: @ASCO on Twitter ASCO on Facebook ASCO on LinkedIn   Disclosures: Dr. Allison Zibelli: None Disclosed   Dr. Megan Kruse: Consulting or Advisory Role: Novartis Oncology, Puma Biotechnology, Immunomedics, Eisai, Seattle Genetics, Lilly

Today we are bringing you a special episode that we created in partnership with SHARE Cancer Support. It's an audio version of a live webinar that was done this past February called Report back from San Antonio Breast Cancer Symposium 2023. SABCS is the world's leading breast cancer research meeting where scientists, patient advocates, and others dedicated to working in the field of cancer gather.In this podcast, Dr. Timothy Pluard, director of the Saint Luke's Koontz Center for Advanced Breast Cancer, breaks down the promising research, targeted therapy, the evolving treatment after CDK 4/6 inhibitors, liquid biopsy and more.

Dr. Shannon Westin and her guest, Dr. Reshma Jagsi, discuss the paper "Omission of Radiotherapy After Breast-Conserving Surgery for Women With Breast Cancer With Low Clinical and Genomic Risk: 5-Year Outcomes of IDEA" recently published in the JCO. TRANSCRIPT The guest on this podcast episode has no disclosures to declare. Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, the podcast where we get in depth with manuscripts that were published in the Journal of Clinical Oncology. I am your host, Shannon Westin, GYN Oncologist and Social Media Editor for the JCO. It is my pleasure to speak with Dr. Reshma Jagsi. Hello, Dr. Jagsi. Dr. Reshma Jagsi: Hello. Thanks for having me. Shannon Westin: I am so excited that you're here. Dr. Jagsi is the Lawrence W. Davis Professor and Chair of the Department of Radiation Oncology at Emory University School of Medicine, Winship Cancer Institute. She is going to be talking about her incredible work, "The Omission of Radiotherapy After Breast Conserving Surgery for Women with Breast Cancer with Low Clinical and Genomic Risk: Five-year Outcomes of IDEA," which was published in JCO in February 2024.  All right, let's get right to it. First, I want to levelset. Can you run us through some brief facts and figures about breast cancer just to make sure that all the listeners are on the same page?  Dr. Reshma Jagsi: Breast cancer is the most common cancer in the world. It's 12.5% of all new annual cancer cases worldwide and is the most commonly diagnosed cancer among US women. About a third of all newly diagnosed cancers in women are breast cancer, and about 13% of US women develop invasive breast cancer over their lifetime. In 2023, there were nearly 300,000 new cases of invasive breast cancer. The median age of breast cancer diagnosis is 62, meaning an awful lot of people are getting diagnosed with breast cancer in the population that we specifically chose to study.  Shannon Westin: Wow, you're really good at this. That's like the perfect transition to move to the next piece. So, first, I think I'd love to hear about the standard of care for the population that you were studying and how we got to this point.  Dr. Reshma Jagsi: We offer women who are diagnosed with early-stage invasive breast cancer the option of breast conservation, and we encourage breast conservation because, of course, it is a better-tolerated surgery than mastectomy. Many women are eligible for breast-conserving therapy. And years ago, we as radiation oncologists encouraged our surgical colleagues to refer to breast-conserving therapy as lumpectomy plus radiation, just as one set. Because the studies that have been done in the 1970s and 1980s to establish that breast conversation was equally safe and effective in treating breast cancer relied on radiation therapy to minimize in-breast tumor recurrence rate, which one of those trials independently showed that there was no difference in survival. But the ones that compared lumpectomy surgery alone to lumpectomy followed by radiation therapy did show a pretty substantial improvement in local control with the addition of radiation treatment. And so radiation treatment became a part of a parcel of breast conservation in the early 1990s when consensus statements came out favoring breast conservation as a treatment approach.  And so the net analysis has combined all of these studies together and showed that overall, without radiation treatment, a patient treatment with a lumpectomy had a 30% risk of in-breast tumor occurrence in those historical studies. And it was reduced by about two thirds to about 10% when that lumpectomy was followed by radiation in those historical randomized trials. But of course, we've made many advances in our understanding since that time, and so that's what this study is seeking to build on. Shannon Westin: It makes sense. We all know that radiotherapy can lead to other issues, acute and chronic morbidities, as well as cost and having to do the treatment itself. So we're all interested in de-escalation of therapy. Tell me, prior to your study, what data were out there potentially supporting the de-escalation and avoiding radiotherapy in that specific population? Dr. Reshma Jagsi: In the ‘90s, after those landmark foundational historical trials have been completed, there was a lot of interest in seeing if we could identify a population of patients in whom the risk of local recurrence was sufficiently low that they might safely choose to omit radiation therapy. All of these randomized trials have shown very consistently that there is a relative risk reduction. Whatever your risk is without radiation, radiation reduces that risk. The overall disease recurrence risk is cut in half with the addition of radiation treatment. But, if I told you that your overall risk was 1%, and I could cut that in half with radiation, you might say, “I might be willing to tolerate the 1%.” At least some women might be willing to tolerate that. So can we find a population in whom the risk is low enough that at least some of those women say, "Look, I want to go without radiation." And of course, the balance of where that number should be changes as we get better and better at delivering radiation. So you mentioned, radiation comes with toxicity, comes with burden and yet, there have been some tremendous advances, and particularly in recent years, to shorten the course of radiation. We have evidence that we can treat partial breast radiation safely in five treatment fractions. We have five-year data that we can treat the whole breast in five-treatment fraction. We certainly have long term evidence that we can the whole breast with 15 fractions from many patients diagnosed with breast cancer. So the burden has decreased. We've also found that with hypo fractionated shorter courses of radiation, the toxicities are much lower, patients tend to tolerate radiation treatment both in terms of acute side effects and long term side effects extremely well.  So that balance of what is low enough is changing with time.  But the trials that were started in the 1990s included the CALGB 9343 trial, a landmark trial published in the New England Journal of Medicine, with its five-year results showing only a 4% risk of recurrence at five years in patients who were 70 or older with clinical stage one disease that was hormone receptor-positive if they received a lumpectomy and tamoxifen alone, not receiving radiation - that risk, if we added radiation in this randomized trial, was only 1%. So there was still a substantial relative risk reduction with radiation treatment. This was published in 2004 in the New England Journal of Medicine.  At the same time, there was a Canadian trial that was published, and in that trial that included women who were 50 years of age and older, there were more concerning results with, even in a very favorable prespecified subgroup of patients who had node-negative breast cancer and T1 hormone receptor-positive tumors, the risk of ipsilateral breast tumor recurrence was 15% at eight years. So that started to feel excessive for women 50 and older.  Meanwhile, we went on to get the update of the CALGB trial, and the 10 -year results showed that the risk was, in the women 70 and older, was only about 10% without radiation. It was 2% with radiation. So again, there was a benefit from radiation, and it's up to each individual woman to decide whether they'd prefer to proceed and minimize their risk, or would be willing to tolerate something like a 10% risk. More recently, just this past year in the New England Journal, the PRIME 2 study from the United Kingdom, looking at women 65 and older, again, early-stage node-negative hormone receptor-positive tumors, and very similar results - 10% versus 1% local control at 10 years.   So you get an improvement with radiation. But there are some women who are 65 or 70 and older who say, I'm willing to tolerate the 10% risk. And so the question was, could we identify some patients who are younger than 65 to 70, but still postmenopausal, like in that Canadian trial, who might actually have similar outcomes - low risks at five and ten years - such that they might want to entertain the option of omitting radiation therapy, which right now is not standard or in any guidelines? So we have some promising information from some retrospective analysis of that Canadian trial that suggested that looking at biology might help. And in fact, the LUMINA trial, published just this year from Canada, did a prospective cohort study selecting patients based on immunohistochemistry, and suggested very low risks, five years in patients who were somewhat younger, although it ended up that the median age of the patients in that study was 67. So we still sort of had this question of what about the younger postmenopausal patients? And that's what took us to IDEA.  Shannon Westin: And just for my education and for the education of the listeners, when you have an in-breast recurrence, how likely are you to be able to cure that? Is that tough to cure, or can you usually get control again? Dr. Reshma Jagsi: It's an excellent question. And so often these recurrences are caught early and are still completely curable with additional intervention. Now, there can be an impact, of course. You can talk to any survivor about the devastating impact of being diagnosed with breast cancer recurrence, and no one wants to go through that. And so there are reasons that people will want to reduce that, and there are implications for breast conservation because it may be that the remaining breast tissue is insufficient to allow a second breast conserving surgical procedure. It may also be that when one experiences recurrence, one decides, "I'm done with this. I'm having a mastectomy at this point." So, in-breast recurrences are very meaningful to patients and something that we should not take lightly. Shannon Westin: It seems, though, the majority of the studies that you were talking about, aside from the LUMINA study, were predominantly based on those clinical features like stage and things like that. So, can you talk a little bit about the role of molecular features, genomic testing, things like that, to select patients?  Dr. Reshma Jagsi: Yeah. So, we have seen a tremendous change in the way we think about breast cancer in recent years, with a real focus on tumor biology, rather than classic clinical pathologic features alone to help us make decisions about systemic therapy. And so, there is a body of work that suggests that genomic assays, including the 21-gene recurrence score, that's commonly used for treatment decision making already ordered in many of these patients and available to us, that it may be useful in understanding patients' risk of local recurrence, both when they are treated with radiation and when they are treated without radiation. So, Terry Mamounas did some wonderful work looking at NSABP data where you know that the mastectomy patients at the time of the studies that were included were not receiving radiation treatment. And it did appear that the 21-gene recurrence score was helping to discriminate for local regional recurrence risk, suggesting it might be useful to use that to select patients who might be at lower risk.   Shannon Westin: All right, perfect. So, that leads us to your study. So, let's talk a little bit about the design and the population and kind of how you put it together.  Dr. Reshma Jagsi: This was really a true collaboration, a partnership across multiple 13 collaborating sites, where my colleagues, the lead investigators at each site, were extremely committed to this question. And we sought to do a preliminary cohort trial, really involving 200 patients. And over the course of three years, we enrolled those 200 patients who were aged 50 to 69 years old and had unicentric invasive breast cancer and lumpectomy surgery that led to negative margins of 2 mm or greater. And their disease needed to be PR positive, HER2 negative, it needed to be node negative, pathologically node negative, and the Oncotype DX 21-gene recurrence score needed to be less than or equal to 18. And then these patients were offered the opportunity to consent and register on a trial to receive five years of endocrine therapy as standard of care alone, and 10 years of surveillance on study, or to proceed with the standard of care treatment off trial, which would have been a recommendation to receive radiation treatment. And so, we ended up with patients with a mean age of 62 years, which, as I said, that's really more mapping the overall population of patients in the country. And we were able to report our results at the San Antonio Breast Cancer Symposium and with simultaneous publication in JCO, with a median follow up of 5.2 years. Shannon Westin: Okay, and let's talk about a little bit about your major findings. Tell us what your good work demonstrated. Dr. Reshma Jagsi: So, the overall and breast cancer-specific survival rates at five years were both 100%, and the five-year freedom from any recurrence was 99%, with a 95% confidence interval that went from 96% to 100%. But I want to emphasize that these are five-year data in a younger postmenopausal population, where five-year data are not typically sufficient to guide decision making. So, I really want to emphasize that these are very early results. But really, what happened here was we only had a couple of patients who had recurrences before five years, two patients, and that was one isolated ipsilateral axillary recurrence, and one ipsilateral breast event. But we also did see six additional patients who recurred later than five years after breast conserving surgery. And because we don't have much long-term follow-up, it makes it incredibly important for us to continue to follow this cohort over time before people make any Monday morning practice implications of offering this cohort of patients, or patients like this cohort of patients, omission off trial.  The good news is that there are ongoing trials that are building on this work, including NRG-BR007, the DEBRA ,that includes a population of patients really similar to those enrolled on IDEA and randomizes them to radiation or no radiation, which is actually incredibly important. Because what we want to understand is also the quality of life effects of omitting radiation therapy because what we don't want is to inadvertently cause an increase in worry about recurrence. Or, you could imagine that patients who omit radiation treatment then feel really stuck with their endocrine therapy. Now, endocrine therapy is the standard of care, but if they're experiencing terrible endocrine therapy side effects and they didn't get radiation treatment, are they more likely to persist with that endocrine therapy and to be miserable because they omitted a treatment that, as I mentioned earlier, can be administered now in five days or less?  And one of the questions that keeps coming up from older patients that I treat, where we already offer the option of omitting radiation, those CALGB and PRIME II patients, those patients will often say to me, "I've got to say, Doc, that whole experience of radiation that you described for five days, and the toxicity, and that doesn't sound so bad to me. What sounds bad to me is multiple years of endocrine therapy." And so, there are also ongoing trials in Europe, and I hope one day in the United States, also looking at older women and offering them a de-escalation of a different sort. Now that we have made so many advances in radiation treatment, maybe the optimal monotherapy for an older adult is actually, for many patients, given their values and preferences, going to involve omission of endocrine therapy. And we need to find out if that's safe. And again, Europa in Europe is investigating that question, and I hope that the American cooperative groups take up something similar. Shannon Westin: That's awesome! And what else is going on in this space? Any other trials? That was like, such a great review of ongoing trials, and I'm sure our listeners would love to have your expertise. Anything else that you're looking forward to that might impact the treatment landscape here? Dr. Reshma Jagsi: Absolutely, and if there are listeners in other parts of the world, there are trials going on also looking at this. There is PRIMETIME, which is a cohort study designed, but with a much larger cohort that's going on in the United Kingdom. There's the EXPERT trial that is randomizing patients to radiation treatment or not in Australia and New Zealand. So, there are many trials that are ongoing, again, looking at de-escalation of radiation therapy. And I want us all, regardless of our specialty, to think about ways that we can de-escalate and optimize the options that are offered to our patients. And I think there's a tendency for patients to be very scared of radiation, sometimes, for our colleagues to be very scared of radiation. I mean, we are the only specialty that has a special “danger radiation sign” that comes to mind when you hear the word radiation therapy. So, it can be this very frightening thing that we often leap to efforts to avoid.  And what I don't want to be the conclusion of this is, “Isn't it great? Radiation oncologists themselves recognize that radiation is terrible and that you should avoid it.” That's not the case. What I hope people will say is, “Isn't it great that radiation therapists are trying to offer as many options to patients as possible?” Because it means a lot to a patient who's had the sense of power and control and autonomy ripped away from them by a breast cancer diagnosis, to be given many options to articulate their values and their preferences and to decide what treatment makes most sense for them. I think, for a lot of patients, that involves radiation treatment. And I think what we need to do as physicians is think about what other things are our patients really concerned about.   Our medical oncology colleagues have done tremendous work to de-escalate systemic therapy in the form of chemotherapy. Our colleagues in surgery have, again, de-escalated mastectomies, axillary dissection. So, there are these ongoing efforts, and I do honestly believe that the next frontier is endocrine therapy and optimization of endocrine therapy. It is so powerful. It is why we have such wonderful outcomes. We know that we should have a healthy respect for ER-positive cancer, which can recur in the long term. We don't want to throw out the baby with the bathwater, but baby steps towards understanding what happens if we peel back our treatments is our obligation.  Shannon Westin: I think this is a perfect place to end/ I agree - less is more is really becoming a resonant statement across all of our different subtypes. We're certainly seeing it in GYN oncology, and just like you said, systemically or even surgically. So I agree. I think we have a call to action to really assess what we've always done and make sure that we're not over-treating patients for whom it's inappropriate.  So I think this is great. And I just want to commend you again on your work. These types of multicenter trials are really hard to do, and getting it done in such a short period of time and really getting the data out to patients is so important. And I appreciate what you're saying about needing more follow-up, but it is certainly very reassuring and very in line with what we've seen. So congratulations on your work. Dr. Reshma Jagsi: Thank you. And I just again want to thank all the patients who enrolled, the Coleman Foundation for their support, the University of Michigan for doing the multi-site coordination and the biostatistic support, and all of the collaborating investigators. I mean, this was a labor of love for everyone involved. Shannon Westin: Yeah, these types of trials definitely take a village. Well, great work. Thank you for taking the time. I know how busy you are. So again, we are so honored and so excited to talk about "The Omission of Radiotherapy After Breast Conserving Surgery for Women with Breast Cancer with Low Clinical and Genomic Risk: Five-year Outcomes of IDEA,” just published in print, February 2024 in the JCO. Definitely check it out. And please check out our other episodes of JCO After Hours. We'd love to have your feedback. Take care. The purpose of this podcast is to educate and inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.    Dr. Jagsi: Stock and Other Ownership Interests Company name: Equity Quotient Research Funding Company name: Genentech"

In this episode, we delve into the exciting developments in antibody drug conjugates (ADCs) presented at the 2023 San Antonio Breast Cancer Symposium.ADCs are a promising class of treatment that combines an antibody with a chemotherapy drug, aiming to target and kill cancer cells more effectively while reducing side effects. We discuss approved ADCs like Enhertu and Trodelvy, and highlight that there's an ADC available for every breast cancer subtype. With many more ADCs in clinical and preclinical trials, the future looks hopeful for breast cancer treatment.We explain the structure of ADCs, which includes the antibody that targets cancer cells, the cytotoxic drug that kills the cells, and the linker that holds them together. We also touch on the importance of choosing treatment types based on personal circumstances, such as age and family responsibilities, as different treatments come with varying side effects.During the episode, we cover two clinical trials in detail. The first is about Datopotamab Deruxtecan (DATO-DXD), which showed promising results in hormone receptor-positive, HER2-negative patients, offering increased progression-free survival and different side effect profiles compared to traditional chemotherapy. The second trial combined DATO-DXD with the immunotherapy drug Durvalumab for advanced and metastatic triple-negative breast cancer, showing a high response rate and manageable side effects.Our guest, Katie, shares her personal experiences with ADCs and provides insights into side effect management. She emphasizes the importance of dose adjustments and monitoring for specific side effects like nausea, vomiting, and interstitial lung disease. Katie also mentions the ongoing research to optimize dosing, detect side effects earlier, and engineer drugs with lower toxicity.As always, we remind our listeners that the information shared on our podcast is based on personal experiences and is not a substitute for professional medical advice. We encourage you to reach out to your medical care team with any questions or concerns.00:00:47 - Overview of Antibody Drug Conjugates (ADCs)00:03:37 - FDA-Approved ADC Examples00:04:49 - Datopotamab Deruxtecan (DATO-DXD) Clinical Trial Insights00:07:10 - Combining DATO-DXD with Immunotherapy00:08:23 - Managing ADC Side Effects00:09:53 - Specific Recommendations for Current ADCs00:11:09 - Future Directions in ADC Development+++++++++++++++++++++Attend a free virtual SurvivingBreastCancer.org event:https://www.survivingbreastcancer.org/eventsFollow us on InstagramLaura and Will: https://www.instagram.com/laura_and_will/SurvivingBreastCancer.org: https://www.survivingbreastcancer.org/Breast Cancer Conversations: https://www.instagram.com/breastcancerconversations/About SurvivingBreastCancer.org: SurvivingBreastCancer.org, Inc. (SBC) is a federally recognized 501(c)(3) non-profit virtual platform headquartered in Boston with a national and global reach. Through education, community, and resources, SurvivingBreastCancer.org supports women and men going through breast cancer. We provide a sanctuary of strength, compassion, and empowerment, where those diagnosed with cancer unite to share their stories, learn invaluable coping strategies to manage wellness and mental health, and find solace in the unbreakable bond that fuels hope, resilience, and the courage to conquer adversity.Support the show

On this month's episode, Pharmacy Times provides a recap of the latest advancements in hematology and breast cancer, shared at the 2023 American Society of Hematology conference and the San Antonio Breast Cancer Symposium conference.

Welcome back to another episode of Breast Cancer Conversations, where we continue to share valuable insights from the San Antonio Breast Cancer Symposium. As a breast cancer survivor and the founder of survivingbreastcancer.org, I'm thrilled to bring you key takeaways from one of the world's largest breast cancer conferences.In this episode, we focus on what to do when CDK4-6 inhibitors, such as Ibrance, Kisqali, and Verzenio, stop working.  Our guest, Amy Bremer, highlights the importance of getting a biopsy to check for mutations, which can be done through a liquid biopsy or a tissue biopsy. This step is crucial for determining the next course of action.We delve into the various treatment options available based on specific mutations. For instance, if your cancer has a PIK3CA mutation, a combination of PIQRAY and Faslodex might be recommended. Other drugs like Trucap, Orserdo, and LSS strontosome are also discussed as potential options for different mutations.For those without mutations, there are still choices available, such as Affinitor plus Faslodex, or considering a switch to a different CDK4-6 inhibitor. We also discuss the possibility of continuing treatment beyond progression or, in cases of aggressive progression, looking into chemotherapy or antibody drug conjugates (ADCs).Stay tuned for our next episode, "on SERDs, SERMs, CERANs, and PROTACs" and remember to subscribe to Breast Cancer Conversations. Please note that our podcast shares personal experiences and is not a substitute for professional medical advice. If you have specific topics in mind or want to be a guest, feel free to reach out to me.Thank you for listening, and let's continue to empower each other through community, education, and resources.00:02:44 - Topic: CDK4-6 Inhibitor Efficacy00:03:31 - Options After Endocrine Therapy and CDK4-6 Inhibitors00:04:35 - Treatment Options Based on Specific Mutations00:05:40 - Options Without Identified Mutations00:06:43 - Inherited Mutations and Treatment Choices00:07:09 - Expert Opinions on Treatment Complexity00:08:44 - Importance of Clinical Trials+++++++++++++++++++++Attend a free virtual SurvivingBreastCancer.org event:https://www.survivingbreastcancer.org/eventsFollow us on InstagramLaura and Will: https://www.instagram.com/laura_and_will/SurvivingBreastCancer.org: https://www.survivingbreastcancer.org/Breast Cancer Conversations: https://www.instagram.com/breastcancerconversations/About SurvivingBreastCancer.org: SurvivingBreastCancer.org, Inc. (SBC) is a federally recognized 501(c)(3) non-profit virtual platform headquartered in Boston with a national and global reach. Through education, community, and resources, SurvivingBreastCancer.org supports women and men going through breast cancer. We provide a sanctuary of strength, compassion, and empowerment, where those diagnosed with cancer unite to share their stories, learn invaluable coping strategies to manage wellness and mental health, and find solace in the unbreakable bond that fuels hope, resilience, and the courage to conquer adversity.Support the show

Dr. Monique Gary aka  “Dr. Mo” is a breast surgeon, educator, entrepreneur, media personality, farmer, and philanthropist. Dr. Mo currently serves as the Medical Director of the Grand View Health/Penn Cancer Network cancer program, where she also serves as director of the breast program. Tune in for this important conversation to learn about her career path, as well as the “golden nuggets” and most important takeaways from the San Antonio Breast Cancer Symposium, otherwise known as SABCS.

In discussion with Dr. Daniel G. Stover, covering the San Antonio Breast Cancer Symposium 2023 Highlights from Community Oncology perspective. We covered 3 important practice informing studies in HER2+ disease with Dr. Stover: - APHINITY Sub-analysis: Benefit of Adj Pertuzumab and Trastuzumab According to ER and HER2 Expression - KATHERINE Update: Phase III Study of Adjuvant TDM-1 vs Trastuzumab for Residual Invasive HER2-positive Early Breast Cancer After Neoadj Chemo: Final IDFS and Updated OS analysis - HER2CLIMB-02: Randomized, Double-blind Phase 3 Trial of Tucatinib and TDM1 for Previously Treated HER2-positive Metastatic Breast Cancer

In a recent conversation with CancerNetwork®, Sara A. Hurvitz, MD, FACP, senior vice president and director of the Clinical Research Division at Fred Hutch Cancer Center and head of the Division of Hematology and Oncology at the University of Washington Department of Medicine, discussed new treatment options for patients with metastatic HER2-positive breast cancer.  In the discussion, Hurvitz highlighted findings from the phase 3 HER2CLIMB-02 trial (NCT03975647), which assessed the efficacy and safety of tucatinib (Tukysa) plus ado-trastuzumab emtansine (Kadcyla; T-DM1) in patients with HER2-positive breast cancer, specifically those with brain metastases.  Patients enrolled in this trial experienced a significant improvement in progression-free survival (PFS) with the tucatinib-based regimen. Data presented at the 2023 San Antonio Breast Cancer Symposium (SABCS) highlighted that the median time to disease progression or death was 9.5 months (95% CI, 7.4-10.9) and 7.4 months (95% CI, 5.6-8.1 in the experimental arm and placebo arm, respectively (HR, 0.76; 95% CI, 0.61-0.95; P = .0163). In patients with brain metastases, the median time to disease progression or death was 7.8 months (95% CI, 6.7-10.0) and 5.7 months (95% CI, 4.6-7.5) in the experimental arm and placebo arm, respectively (HR, 0.64; 95% CI, 0.46-0.89). Investigators reported that toxicity in the experimental arm was generally manageable and reversible. “This was a study that only enrolled patients who were naive to trastuzumab deruxtecan [T-DXd; Enhertu],” Huvitz said. “We know that T-DXd has substantial improvements in PFS and survival, so having so many patients receive this [agent] after progression is certainly going to impact our ability to observe survival differences. About 15% of patients in each arm also went on to receive tucatinib. These are pretty exciting results for our patients, especially those with brain metastases. This study did enroll, as I said, patients with brain metastases, who comprised 44% or so of the entire population enrolled in this study. These are interesting data, and we'll see if this regimen is ultimately approved.” Reference Hurvitz SA, Loi S, O'Shaughnessy J, et al. HER2CLIMB-02: randomized, double-blind phase 3 trial of tucatinib and trastuzumab emtansine for previously treated HER2-positive metastatic breast cancer. Presented at the 2023 San Antonio Breast Cancer Symposium; December 5-9, 2023; San Antonio, TX. Session GS01-10.

In discussion with Dr. Hope Rugo, covering the San Antonio Breast Cancer Symposium 2023 Highlights from Community Oncology perspective. We covered 4 important practice informing studies with Dr. Rugo: - NATALEE Update – Ribociclib + Nonsteroidal AI as Adj Treatment in Patients with HR+/HER2− Early Breast Cancer: Final iDFS analysis - MONARCH 3 – Final OS Results of Abemaciclib Plus a Nonsteroidal AI as First-line Therapy for HR+, HER2– Advanced Breast Cancer - INAVO120 – Phase III Study of Inavolisib or Placebo in Combination with Palbociclib and Fulvestrant in Patients with PIK3CA-mut, HR+, HER2– Locally Adv/Metastatic Breast Cancer - TROPION-Breast01 – Phase III Study of Dato-DXd vs Chemo for Patients with Previously Treated Inoperable/Metastatic HR+, HER2– Breast Cancer

In a conversation with CancerNetwork®, Amy Tiersten, MD, spoke about how findings from the phase 1/2 ASPIRE trial (NCT03304080) may support anastrozole (Arimidex) plus palbociclib (Ibrance), trastuzumab (Herceptin), and pertuzumab (Perjeta) as a first-line treatment for patients with hormone receptor (HR)–positive, HER2-positive metastatic breast cancer. Data presented at the 2023 San Antonio Breast Cancer Symposium (SABCS)highlighted a clinical benefit rate of 97% (95% CI, 83%-100%; P

The Oncology Journal Club - Delivering Oncology News DifferentlyThe Oncology Podcast, brought to you by The Oncology Network, is proud to present Episode 1 in the second series of The Oncology Journal Club.Join Professor Craig Underhill, Dr Kate Clarke and Professor Christopher Jackson in this trans-Tasman review of 2023 practice-changing papers.For papers, bios and other links visit the Show Notes on our website.For the latest oncology news visit www.oncologynews.com.au.We invite healthcare professionals to join The Oncology Network for free - you'll also receive our free weekly publication The Oncology Newsletter.The Oncology Podcast - An Australian Oncology Perspective

The Oncology Journal Club - Delivering Oncology News DifferentlyThe Oncology Podcast, brought to you by The Oncology Network, is proud to present Part 2 of our 2023 Review Episode of The Oncology Journal Club.Join Professor Craig Underhill, Dr Kate Clarke and Professor Christopher Jackson in this trans-Tasman review of 2023 practice-changing papers.For papers, bios and other links, visit our website's Show Notes.For the latest oncology news visit www.oncologynews.com.au.We invite healthcare professionals to join The Oncology Network for free - you'll also receive our free weekly publication The Oncology Newsletter.The Oncology Podcast - An Australian Oncology Perspective

In discussion with Dr. Eleonora Teplinsky, covering the San Antonio Breast Cancer Symposium 2023 Highlights from Community Oncology perspective. We covered 4 important practice informing studies with Dr. Teplinsky: - NSABP B-51 – Loco-regional Irradiation in Patients with Biopsy-proven Axillary Node Involvement at Presentation Who Become Pathologically Node Negative After Neoadjuvant Chemotherapy - IDEA Update – Five-year Outcomes of the IDEA trial of Endocrine Therapy Without Radiotherapy After Breast-Conserving Surgery for Postmenopausal Patients Aged 50-69 With Genomically-Selected Favorable Stage I Breast Cancer - ICARO - Nodal Burden and Nodal Recurrence in Patients With Isolated Tumor Cells After Neoadjuvant Chemotherapy Treated with Axillary Dissection or Nodal Radiation - Keynote-522 Update - Event Free Survival with neoadjuvant and adjuvant pembrolizumab in TNBC

The last week was a busy one for us here at CURE® and across the oncology space in general. There were two major meetings we covered: the San Antonio Breast Cancer Symposium and the American Society of Hematology Annual Meeting.  The San Antonio Breast Cancer Symposium — also known as SABCS — features breast cancer research conducted around the globe. We had editors on the ground in San Antonio, as well as back in our office covering the meeting. Here are some highlights from SABCS.  And, to view all of our conference coverage, be sure to check out curetoday.com/conference Kadcyla Is the ‘First Therapy to Show Improved Survival' in a Breast Cancer Subset For in patients with HER2-positive early breast cancer that still had remaining invasive disease after undergoing neoadjuvant therapy Kadcyla outperformed Herceptin when it came to overall survival, which is the time until death of any cause, and invasive disease-free survival, which is the time patients live without experience metastases or invasive disease.  The findings, which come out of the KATHERINE trial, mark the “first therapy to show an improved survival after post-surgical therapy in patients with HER2-positive early breast cancer and residual invasive disease after neoadjuvant therapy,” according to study author, Dr. Sibylle Loibl, who presented the findings at SABCS.  More specifically, at the 8.4-year follow-up mark, 70.1% of patients in the Kadcyla group and 62% in the Herceptin group were still alive. Also at that point, 32.2% given Kadcyla did not develop invasive disease, compared with 19.7% of patients in the Herceptin group.  Keytruda, Chemo Show Early-Stage Breast Cancer Event-Free Survival Benefits Findings from phase 3 KEYNOTE-522 trial showed that presurgical Keytruda plus chemotherapy, followed by postsurgical Keytruda led to improved event-free survival — that's time a patient lives without complications from their disease — in patients with high-risk, early-stage triple-negative breast cancer.  At a median follow-up of 63.1 months, the five-year event-free survival rate was 81.3% with neoadjuvant Keytruda/chemotherapy followed by adjuvant Keytruda compared with 72.3% in those who received placebo/chemotherapy and then placebo. These findings, according to Dr. Peter Schmid, further support the use of this Keytruda regimen as the standard of care for this patient population.  Tecentriq Plus Perjeta, Herceptin, Chemo Does Not Improve pCR in HER2+ Breast Cancer Another phase 3 trial — the APTneo Michelangelo — showed that adding Tecentriq and Herceptin to Perjeta and chemotherapy actually did not lead to a statistically significant improvement in pathologic complete response (that's the disappearance of cancer) when given in the presurgical setting for patients with HER2-positive breast cancer.  The study found that while Tecentriq and Herceptin-containing regimens did lead to a higher number of pathologic complete responses, these difference between the two treatment groups was not statistically significant, meaning that the researchers could not definitively say that one therapy was the result of better outcomes.  No Racial Difference in Recurrence-Free Survival in HR+, HER2- Breast Cancer While research has shown that Black and White patients with HR-positive, HER2-negative breast cancer tend to have different survival outcomes, research presented at SABCS found that three-year recurrence-free survival is actually comparable between the two groups.   “More aggressive treatment can improve outcomes for (patients with HR-positive, basal-type tumors), as demonstrated by improved (overall survival) in (those who) achieved pathologic complete response,” study investigators stated in the poster. “These data highlight the importance of genomic testing to help optimize treatment and reduce outcome disparities in Black women.”

San Antonio Breast Cancer Symposium is here, and this year, OFTIM (Oncology for the Inquisitive Mind) is bringing you the latest and greatest in all things breast cancer. With over 10000 attendees, the research and vibrant discussions did not disappoint, with updates, controversies and complexities. Taking centre stage were PIK3CA mutation treatments, updates on CDK4/6 inhibitors and the age-old question - does exercise improve outcomes for our patients?Studies discussed in today's episode (subscription may be required)MONARCH-3KATHERINEINAVO120PREFERABLE EFFECTFor more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of Music Unlimited: https://pixabay.com/users/music_unlimited-27600023/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice. Hosted on Acast. See acast.com/privacy for more information.

The 2023 San Antonio Breast Cancer Symposium featured five days of research presentations, educational sessions, and advocacy meetings. Dr. Matthew Goetz, noted breast cancer researcher at the Mayo Clinic, explained the top research presented that will make an immediate difference for people diagnosed with breast cancer. Listen to the podcast to hear Dr. Goetz explain: a study on inavolisib, a promising new treatment for advanced-stage, hormone receptor-positive breast cancer that's stopped responded to tamoxifen or an aromatase inhibitor how the immunotherapy medicines Keytruda (chemical name: pembrolizumab) and Opdivo (chemical name: nivolumab) can be used to treat early-stage, triple-negative breast cancer overall survival results from the MONARCH-3 study on Verzenio (chemical name: abemaciclib) why overall survival is such an important study end point

The Oncotype DX Breast DCIS Score test is used to help people and their doctors make decisions about whether radiation after lumpectomy surgery to remove DCIS would offer more benefits than risks. At the 2023 San Antonio Breast Cancer Symposium, Dr. Seema Khan presented results from the E4112 study, evaluating the ability of the Oncotype DX Breast DCIS Score to accurately predict which women would benefit from radiation after DCIS surgery and which women could safely skip radiation. Listen to the podcast to hear Dr. Khan explain: the design of the study, including why a prospective study is important the results how the results fit into the current context of DCIS care

At the 2023 San Antonio Breast Cancer Symposium, Dr. Hatem Azim presented a new analysis of information from the POSITIVE trial, which found that younger women diagnosed with early-stage, hormone receptor-positive breast cancer could safely pause hormonal therapy to try to become pregnant. His new analysis looked at whether the women could use fertility preservation and assisted reproductive technologies (ART) without increasing the risk of the cancer coming back (recurrence). Listen to the podcast to hear Dr. Azim discuss: the types of fertility preservation and ART used which techniques were the most successful the results of his analysis

Dr. G. Thomas Budd, an oncologist and Dr. Justin Johnson, an immunologist, are collaborating on research looking at a vaccine to prevent triple-negative breast cancer. At the 2023 San Antonio Breast Cancer Symposium, they presented a poster on the encouraging first results from three small studies. Listen to the podcast to hear Dr. Johnson explain: how the people in the study are responding to the vaccine why having an immune response to the vaccine is important the protein the vaccine targets

Dr. Kelly Shanahan, trained as an OB/GYN, has been living with metastatic breast cancer for 10 years. For many years, she tried to join a clinical trial. In 2021, she finally did. At the 2023 San Antonio Breast Cancer Symposium, she told us about her experience. Listen to the podcast to hear Dr. Shanahan explain: why and how she joined a trial what she's experienced while being in the trial why clinical trials are important to her personally why clinical trials are important for everyone

CDK4/6 inhibitors are used to treat both early-stage and advanced-stage hormone receptor-positive, HER2-negative breast cancer.  The CDK4/6 inhibitors are: Ibrance (chemical name: palbociclib) Kisqali (chemical name: ribociclib) Verzenio (chemical name: abemaciclib) At the 2023 San Antonio Breast Cancer Symposium, Dr. Stephanie Graff moderated an educational session to help people and their doctors decide on treatments after a CDK4/6 inhibitor has stopped working. Listen to the podcast to hear Dr. Graff explain: how the oral SERD, Orserdu (chemical name: elacestrant), might be used how PARP inhibitors, such as Lynparza (chemical name: olaparib) or Talzenna (chemical name: talazoparib) might be used why using a CDK4/6 inhibitor after another CDK4/6 inhibitor probably won't be used

Scalp cooling can help people keep some or quite a lot of their hair when receiving a chemotherapy regime that can cause hair loss. At the 2023 San Antonio Breast Cancer Symposium, Richard Paxman, CEO of Paxman Scalp Cooling, explained the updated patient assistance programs his company offers. Listen to the podcast to hear Richard explain: the Paxman Patient Assistance Program other resources Paxman offers where to get more information on scalp cooling if your medical oncologist doesn't have any

Blood cancer treatments — and one treatment type, in particular — were the point of much discussion last week. The FDA said that it is investigating instances of secondary malignancies in patients with blood cancers treated with CAR-T cell therapy. Also, the drug manufacturer for a novel CAR-T cell therapy submitted an application to introduce the treatment into the United States market.  Blood cancers will continue to be a hot topic this week, as later in the week we'll be covering the American Society of Hematology Annual Meeting. And before that, we'll also be covering the San Antonio Breast Cancer Symposium.  Chance or CAR-T: Expert Weighs in on FDA Investigation One of the biggest headlines in the cancer space last week was that the Food and Drug Administration (FDA) announced that they are investigating instances of T-cell malignancies — such as CAR-positive lymphoma — occurring in patients with blood cancers that were treated with CAR-T cell therapy.  CAR-T cell therapy is a newer type of blood cancer treatment that involves extracting patients' blood and reengineering their immune T cells to find and fight cancer. Those new T cells are then multiplied and infused back into the patient. Since the first CAR-T cell product was approved in 2017, this treatment modality has drastically improved outcomes for patients with certain types of blood cancers.  It's worth mentioning that the FDA's Nov. 28 report about T-cell malignancies did not definitively say that CAR-T cell therapies are directly causing secondary diseases. They also did not mention the frequency at which these T-cell malignancies are occurring. I spoke with Dr. John Lister, who said that perhaps it's the manufacturing process that could be the root cause, but perhaps it is also just chance, as research has shown that many patients with cancer hold a higher risk of developing a second cancer. For now, we're just going to have to wait and see what further data tells us.  FDA Biologics License Application Filed for Obe-Cel for Adult R/R B-ALL Also in CAR-T cell therapy news, last week a pharmaceutical company submitted a Biologics License Application to the FDA for their CAR-T cell therapy, obe-cel to be used for patients with relapsed or refractory B-cell acute lymphoblastic leukemia (ALL).  When a pharmaceutical company files a Biologics License Application to the FDA, they're essentially asking the agency to allow them to bring the drug to the market. The company submitting the drug must provide the FDA with multiple pieces of information, including findings from preclinical and clinical studies showing that the drug is safe.  In this instance, the pharmaceutical company cited data from the FELIX study, from which, early data showed that 76% if patients responded to the therapy, including 54.3% who had a complete response, meaning that their disease essentially disappeared. Now, updated findings from the trial will be presented at the upcoming ASH Annual Meeting happening next week.  

My guest today on the DiepCJourney podcast has a blog and website titled, No Half Measures, Living Out loud.  2017 was a pivotal year in the life of my guest, Abigail Johnston. Early that year, while dual nursing her twin boys she felt a lump in her left breast. The next few months involved multiple appointments with radiologists, oncologists, and surgeons. Abigail was diagnosed with metastatic breast cancer.  Abigail Johnston is a wife, mother, writer, educator, earned her JD after completing law school and is a patient advocate. She begins the interview by sharing her experience at the National AACR conference held in early 2023. She sat on a panel with the FDA speaking about the importance of overall survival as an important end point in clinical trials. With all the complexities on that topic, she felt the FDA worked hard to make sure her voice was heard. Attending conferences allows her to meet other patient advocates and for Abigail and me, this is always one of the highlights of traveling to these meetings. We met in person in December of 2022 at the San Antonio Breast Cancer Symposium. As she says, “Those in person hugs, nothing is better, honestly.” She talks about the idea of “finding a purpose after a serious trauma.” Abigail states that trauma changes you fundamentally as a human being. The question becomes, how do you carry that trauma? Advocacy is the way Abigail has found some purpose in “the derailment of her life.” It has become an overarching theme in her life. This was a podcast interview that felt comfortable, informative, and one I will go back and listen to myself often. You can reach out to Abigail and find more of her work in the following links: Blog: No Half Measures: Living Out Loud Bio: Abigail's Story Contact Information: Email Abigail Place to find Abigail's writing and work: Social Media and Elsewhere      

Megan-Claire Chase is a breast cancer survivor who deals with a lot of effects from treatment and being diagnosed with lobular breast cancer at a very young age. But she excitedly begins our conversation by saying her pain melted away at the San Antonio Breast Cancer Symposium when she was able to meet patient advocates in person for the first time. Social media connects many of us but the conference we both attended in early December of 2023 allowed us to sit down together to share intimate conversations, ask each other how we are doing, and share our advocacy work. I was fortunate to be one of those advocates to finally meet her in person at the meeting. Megan-Claire experienced strange symptoms for about two years that were left without a diagnosis. Her mother had ovarian cancer when she was pregnant with Megan-Claire. She states she felt this made her a miracle baby for her parents. Megan-Claire felt certain at some point in her lifetime she would get cancer because she has a strong history in her family. Because of this she was able to get a mammogram at age thirty-five and have it covered by insurance. Being hyper aware of her body due to family history of cancer, the signs she saw were concerning. She noticed tiny green bruising on her legs, weight gain, loss of hair on the left side of her head, and a “zit” on the outside of her left breast. She knew something was not right. Megan-Claire shares with us she would like the medical community to be more aware that black women and other women of color will present with different symptoms that her white counterparts. This leads us to a more in-depth conversation on health disparities, implicit biases in breast cancer care and what Megan-Claire accomplishes in her community and advocacy work to improve the communication between the patient and physician. Megan-Claire will be participating in a community event to connect patients and provide these resources June 15-21 of 2023. The event and other ways to join Megan-Claire on social media can be found here. National Black Family Cancer Awareness Week started by the FDA through the Oncology Center of Excellence. Megan-Claire's Linked Account: https://www.linkedin.com/in/megan-claire-chase/ Breast Cancer Program Director: Share Cancer Support          

In this wellred classic episode from all the way back in 2017, we sit down with the AMAZING Caitlin Brodnick!   Caitlin Brodnick is a performer on Upright Citizens Brigade Theatre's Maude Night. She performs sketch, standup, and storytelling regularly in New York City and Los Angeles. She is a writer for Glamour.com, and a blogger for Huffington Post. Her stories have been featured on the MOTH podcast, and quoted by the AV Club. As a breast cancer awareness advocate, and she has been invited to speak at the San Antonio Breast Cancer Symposium and various locations in New York City. Caitlin works closely with the organization FORCE, and Sloan Kettering Memorial Hospital as a breast cancer awareness advocate, helping to connect with other women who are BRCA positive. The boys all have new specials on AMAZON!! Check out Drew's new podcast Gravy Baby Listen to Puttin On Airs with Trae and Corey! For bonus Trae go to Patreon.com/TraeCrowder For Bonus Corey go to PartTimeFunnyMan.com Learn more about your ad choices. Visit megaphone.fm/adchoices

We are delighted to welcome Ann Camden back for another episode of The Burn. Ann was diagnosed with Stage III breast cancer at 38. She then had a Stage IV recurrence at 45. More recently, she was diagnosed with leptomeningeal disease - fluid of the brain, spine and many other organs. Ann is a mother of twin teenage girls and married to her college sweetheart, Jeff. In this episode Ann reads her piece “A Three-Prong Legacy Effort” from Wildfire Magazine's 2022 “Legacy Stories” issue. Ann's story is about creating the tangible things you pass down. April and Ann discuss where you spend time and energy on creating a legacy to remember, leaving legacy journals intended for loved ones to read after passing on, and being human, messy and unfinished while building legacy. They will also discuss what we actively choose to pass on to our children, and normalizing conversations about cancer with them. Ann's essay is included in Wildfire's book “Igniting the Fire Within: Stories of Healing, Hope & Humor” out now. More about Ann: https://www.instagram.com/anncamdennc/ and https://down-not-out.comPurchase a print or digital copy of the “Legacy Stories” issue of Wildfire Magazine: https://www.wildfirecommunity.org/shop/mbc22Enjoy listening to “Rooting Stories in Music: Riding Shotgun” also featuring Ann Camden: https://player.captivate.fm/episode/5ce9e575-0744-4515-95e3-14050ca66d8fMore about the San Antonio Breast Cancer Symposium: https://www.sabcs.org/Get the free Wildfire email newsletter: https://www.wildfirecommunity.orgLearn about Wildfire writing workshops: https://www.wildfirecommunity.org/workshopsShop Wildfire merch & more: https://www.wildfirecommunity.org/shopSend your voice recording testimonial to editor@wildfirecommunity.org*Free* The Burn Writing Companion: Guided Prompt Journal (Vol. 1): https://www.wildfirecommunity.org/the-burnBuy the Wildfire book “Igniting the Fire Within: Stories of Healing, Hope & Humor, Inside Today's Young Breast Cancer Community”: https://www.amazon.com/dp/B0BJVJ629F?ref_=pe_3052080_397514860