Metasta&c Breast Cancer 2018
|
|
|
- Holly Norman
- 5 years ago
- Views:
Transcription
1 Metasta&c Breast Cancer 2018 November 2, 2018 Douglas W. Blayney, MD Professor of Medicine, Stanford University School of Medicine Stanford Cancer Ins&tute 1
2 Disclosures Research support to Stanford Amgen BeyondSpring Pharma Equity Madorra Artelo Consul&ng Apobiologix, Mylan, Heron, Tersera, CEARE No off-label discussion
3 Topics for today Breast Cancer Metastases How and where Treatment Pallia&ve care Chemotherapy Endocrine therapy Other Targets Her2, Cyclin Dependent Kinase 4,6, Mtor, etc. Others Special circumstances Immune therapy Radia&on Surgery End of life care 3
4 4
5 5
6 How is the Diagnosis of Metasta&c Breast Cancer Made? Biopsy 6
7 Topics for today Breast Cancer Metastases How and where Treatment Pallia&ve care Chemotherapy Endocrine therapy Other Targets Her2, Cyclin Dependent Kinase 4,6, Mtor, etc. Others Special circumstances Immune therapy Radia&on Surgery End of life care 7
8 A palliative approach can help Palliative Diagnosis Development of a treatment plan Active treatment End of Life Care Curative Remission / Survivorship
9 Early palliative care improves quality of life FACT-L Functional Assessment of Cancer Therapy: Lung LCS Lung Cancer Subscale TOI Trial Outcome Index Temel et al. NEJM, 2010
10 Median survival 11.6 months Palliative care improves survival Median survival 8.9 months P =.02 Temel et al. NEJM, 2010
11 Pallia&ve care vs. Hospice
12 Walking with you
13 Topics for today Breast Cancer Metastases How and where Treatment Pallia&ve care Chemotherapy Endocrine therapy Other Targets Her2, Cyclin Dependent Kinase 4,6, Mtor, etc. Others Special circumstances Immune therapy Radia&on Surgery End of life care 13
14 Chemotherapy Anthracyclines Doxorubicin Pegylated liposomal doxorubicin Taxanes Paclitaxel An&metabolites Capecitabine Gemcitabine Other single agents Cyclophosphamide Carbopla&n/cisPla&n Docetaxel Albumin-bound paclitaxel Epirubicin Ixabepilone 14
15 Topics for today Breast Cancer Metastases How and where Treatment Pallia&ve care Chemotherapy Endocrine therapy Other Targets Her2, Cyclin Dependent Kinase 4,6, Mtor, etc. Others Special circumstances Immune therapy Radia&on Surgery End of life care 15
16 Important subsets of breast cancers defined by molecular markers and by clinical treatment options Breast cancer is a family of diseases, not one disease. ER+ All Breast Cancer HER2+ Basaloid 16
17 Estrogen Receptor 17
18 Hormonal Treatment of Advanced Breast Cancer GNRH agonists (A) Premenopausal LH FSH Selective Estrogen Receptor Modulators Tamoxifen Fulvestrant Aromotase Inhibitors Anastrozole Letrozole Examustane (B) Postmenopausal Antiestrogen Breast carcinoma Breast carcinoma Antiestrogen Adapted with permission from Tellez C, et al. Surg Oncol Clin North Am. 1995;4: Estrogen Ovary Adrenal Estrogen Androstenedione Aromatase inhibitor GNRH = Gonadotropin-releasing hormone; LH = Luteinizing hormone; FSH = Follicle-stimulating hormone. Peripheral aromatization
19 The Role of Aromatase in Estrogen Biosynthesis and Tumor Growth Adrenal gland Peripheral tissues Aromatase Aromatase = Estrogen = Androstenedione Receptor Tumor Postmenopausal women
20 40% 30% 25% 1 st Line 2 nd Line 3 rd Line Sequential hormone therapy Optimimum sequence not defined, often paired with CDK4-6 inhibotor, or Mtor inhibitor Patients with Disease Progression on One Hormone Therapy May Respond to Another Hormone Therapy Duration of first Chemotherapy hormonal response predicts probability of second anti-hormone response 15% 4 th Line Bavior C et al. Ann Oncol. 2012, Epub Feb 8; Osborne Ck, Schiff R. Ann Res Med.2011;62:
21 Management of ER+ Metastatic Breast Cancer Post-menopausal Serial anti-hormone maneuvers Aromatase inhibitor (AI) SERM/D + CK4-6 inhibitor Everolimus (MTor inhibitor)+ AI Steroidal AI if prior non-steroidal AI (e.g. examustane) Estrogens Androgen 21
22 Topics for today Breast Cancer Metastases How and where Treatment Pallia&ve care Chemotherapy Endocrine therapy Other Targets Her2, Cyclin Dependent Kinase 4,6, MTor, etc. Others Special circumstances Immune therapy Radia&on Surgery End of life care 22
23 What is Targeted Therapy? Well-defined molecular target Target is correlated with biology Target measurable in the clinic Target correlated with therapeu&c effect 23
24 Targeted Therapies for HER2+ Trastuzumab Breast Cancer: Trastuzumab, Lapatinib, Pertuzumab and T-DM1 Trastuzumab Lapatinib Her-2 pathway ado-trastuzumab emantasine Lapatinib T-DM1 Neratinib Antibody: Trastuzumab P P P HER2 Cytotoxic: DM1 Stable linker: MCC Emtansine P P Inhibition of microtubule polymerization Emtansine release Lysosome P Internalization Nucleus Adapted from LoRusso PM, et al. Clin Cancer Res 2011; Spector NL, Blackwell KL. J Clin Oncol 2009; Nelson MH, et al. Ann Pharmacother 2006; Lewis Phillips GD, et al. Cancer Res
25 Trastuzumab AC TH % AC T 87% 75% OVERALL SURVIVAL HR (95%CI) AC T AC TH 0.67 ( ) log-rank P % HR=0.48, 2P=3x % Years From Randomization B31/N9831 Romond, et al., New England Journal of Medicine (2005).
26
27 TCGA Significantly Mutated Genes (First 507 Cases) (FDR<0.15) SMGs with FDR<0.15 by at least two tests (Fisher s, LR, or Convolution) 27 Cancer Genome Atlas Network. Nature Oct 4;490(7418):61-70.
28 Multiple genetic mutations can A Model for Breast Cancer Development over Molecular Time accumulate between carcinogenic event and detection Which are the driver mutations? Which are the passenger mutations? Nik-Zainal, et al., Cell 149, , May 25,
29 Breast Cancer: Subtypes Reflect Genomic Complexity SMART CANCERS STUPID CANCERS Genome-wide Circos plots of somatic rearrangements Stephens, PJ et al. Nature 462: , Stanford Cancer Center 29
30 The Orphan Disease Era A myriad of rare diseases Many genomic drivers IT-driven Complex biology Uncertain therapeu&cs Phase III trials difficult Courtesy George Sledge, Jr, M.D. 30
31 Triple negative breast cancer: Genetic chaos More neo-antigens at cell surface (immunotherapy targets) More Shah, S potential et al. Nature 2012 pathway targets 31
32 Topics for today Breast Cancer Metastases How and where Treatment Pallia&ve care Chemotherapy Endocrine therapy Other Targets Her2, Cyclin Dependent Kinase 4,6, Mtor, etc. Others Special circumstances Immune therapy Radia&on Surgery End of life care 32
33 T Cell Aeacking a Cancer Cell Why Doesn t the Immune System do it s Job? 33
34 Mechanism of Action: Ipilimumab releases the CTLA-4 brake on T-cells Jim Allison M.D. Anderson Brunet,..., Golstein, Nature 1978: A new member of the immunoglobulin superfamily CTLA-4 34 Ledford H. Nature. 2014;508(7494):24-6.
35 Co-s&mulatory and co-inhibitory molecules Stanford Hospital and Clinics & Stanford School of Medicine Business Confiden6al 35
36 Anti-PD-1 is superior to and better tolerated than anti-ctla4 (melanoma) Ledford H. Nature. 2014;508(7494):24-6. Robert C, et al. N Engl J Med. 2015;372(26): Stanford Cancer Center 36
37 Organs Affected by Immune Checkpoint Blockade Michael A. Postow, M.D., Robert Sidlow, M.D., and Matthew D. Hellmann, M.D. N Engl J Med Volume 378(2): January 11, 2018 Postow MA et al. N Engl J Med 2018;378: Stanford Cancer Center 37
38 Topics for today Breast Cancer Metastases How and where Treatment Pallia&ve care Chemotherapy Endocrine therapy Other Targets Her2, Cyclin Dependent Kinase 4,6, Mtor, etc. Others Special circumstances Immune therapy Radia&on Surgery End of life care 38
39 Taylor, et al. Int J. Rad Bio Phys 69: , 2007
40 Topics for today Breast Cancer Metastases How and where Treatment Pallia&ve care Chemotherapy Endocrine therapy Other Targets Her2, Cyclin Dependent Kinase 4,6, Mtor, etc. Others Special circumstances Immune therapy Radia&on Surgery End of life care 40
41 Gemci&bine Metastatectomy Courtesy: Brendan Visser, M.D. 41
42 Topics for today Breast Cancer Metastases How and where Treatment Pallia&ve care Chemotherapy Endocrine therapy Other Targets Her2, Cyclin Dependent Kinase 4,6, Mtor, etc. Others Special circumstances Immune therapy Radia&on Surgery End of life care 42
43 Ques&on: Have you spoken to your medical team about end of life care? Who brought it up first? What type of informa&on was conveyed?
44 Ques&on: What scares you most about end of life, about dying?
45 Now that you know what comes to mind The dying process Loss of control How will this affect those I love How will others react Isola&on Meaning
46 Topics for today Breast Cancer Metastases How and where Treatment Pallia&ve care Chemotherapy Endocrine therapy Other Targets Her2, Cyclin Dependent Kinase 4,6, Mtor, etc. Others Special circumstances Immune therapy Radia&on Surgery End of life care 46
47 Thank 47
Metastatic Breast Cancer What is new? Subtypes and variation?
Metastatic Breast Cancer What is new? Subtypes and variation? Anne Blaes, MD, MS University of Minnesota, Division of Hematology/Oncology Director, Adult Cancer Survivor Program Current estimates for metastatic
Adjuvant Systemic Therapy in Early Stage Breast Cancer
Adjuvant Systemic Therapy in Early Stage Breast Cancer Julie R. Gralow, M.D. Director, Breast Medical Oncology Jill Bennett Endowed Professor of Breast Cancer Professor, Global Health University of Washington
Treatment Options for Breast Cancer in Low- and Middle-Income Countries: Adjuvant and Metastatic Systemic Therapy
Women s Empowerment Cancer Advocacy Network (WE CAN) Conference Bucharest, Romania October 2015 Treatment Options for Breast Cancer in Low- and Middle-Income Countries: Adjuvant and Metastatic Systemic
It is a malignancy originating from breast tissue
59 Breast cancer 1 It is a malignancy originating from breast tissue including both early stages which are potentially curable, and metastatic breast cancer (MBC) which is usually incurable. Most breast
COME HOME Innovative Oncology Business Solutions, Inc.
Innovative Oncology Business Solutions, Inc. Breast Cancer Diagnostic/Therapeutic Pathway V11, April 2015 Required Structured Data Fields: ICD9 Code Stage Staging Components Performance Status Treatment
Mdi Medical Management of Breast Cancer Morbidity and Mortality Aug 13, 2009 Irina Kovatch, PGY3 Introduction Metastatic disease is the principal cause of death from breast cancer Metastatic events often
Disease Update: Metastatic Breast Cancer
Disease Update: Metastatic Breast Cancer Aimee Faso, PharmD, BCOP, CPP Oncology Clinical Specialist, GI/Breast UNC Hospitals and Clinics August 2015 Objectives Identify treatment choices of metastatic
Triple Negative Breast Cancer: Part 2 A Medical Update
Triple Negative Breast Cancer: Part 2 A Medical Update April 29, 2015 Tiffany A. Traina, MD Breast Medicine Service Memorial Sloan Kettering Cancer Center Weill Cornell Medical College Overview What is
Targe:ng HER2 in Metasta:c Breast Cancer in 2014
Targe:ng HER2 in Metasta:c Breast Cancer in 2014 Kimberly L. Blackwell MD Professor Department of Medicine and Radia:on Oncology Duke University Medical Center Director, Breast Cancer Program Duke Cancer
Treatment of Metastatic Breast Cancer. Prof RCCoombes Imperial College London
Treatment of Metastatic Breast Cancer Prof RCCoombes Imperial College London Metastatic Breast Cancer: General Guidelines Specialized oncology nurses (if possible specialized breast nurses) should be part
Advanced HER2+ Breast Cancer: New Options and How to Deploy Them. José Baselga MD, PhD
Advanced HER2 Breast Cancer: New Options and How to Deploy Them José Baselga MD, PhD HER2 signaling results in a multitude of cellular effects, including increased cellular proliferation HER2 HER3 RAS
When is Chemotherapy indicated in Advanced Luminal Breast Cancer?
When is Chemotherapy indicated in Advanced Luminal Breast Cancer? Soo-Chin Lee Head & Senior Consultant Department of Haematology-Oncology Clinical Care National University Cancer Institute, Singapore
Index. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Adjuvant therapy, for early-stage triple-negative breast cancer, 740 742 in older early-stage breast cancer patients, 790 795 anti-her2-directed
Radiation therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Chemotherapy Chemotherapy is a cancer
Overcoming resistance to endocrine or HER2-directed therapy
Overcoming resistance to endocrine or HER2-directed therapy Jane Lowe Meisel, MD Assistant Professor of Hematology and Medical Oncology Winship Cancer Institute at Emory University 1 Background While most
Immunoconjugates in Both the Adjuvant and Metastatic Setting
Immunoconjugates in Both the Adjuvant and Metastatic Setting Mark Pegram, M.D. Director, Stanford Breast Oncology Program Co-Director, Molecular Therapeutics Program Trastuzumab Treatment of Breast Tumor
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE. Proposed Health Technology Appraisal
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Proposed Health Technology Appraisal Everolimus in combination with exemestane for the treatment of advanced or metastatic HER2 negative, oestrogen
Systemic Management of Breast Cancer
Systemic Management of Breast Cancer Why Who When What How long Etc. Vernon Harvey Rotorua, June 2014 Systemic Management of Breast Cancer Metastatic Disease Adjuvant Therapy Aims of therapy Quality of
Chemotherapy With or Without Targeted Drugs* in Metastatic Breast Cancer
Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Chemotherapy With or Without Targeted Drugs* in Metastatic Breast Cancer * Substances without published evidence based on at
Expanding Therapeutic Strategies for HER2-Positive Metastatic Breast Cancer
Expanding Therapeutic Strategies for HER2-Positive Metastatic Breast Cancer Sara A. Hurvitz, MD, FACP Associate Professor of Medicine University of California Los Angeles Los Angeles, California Trastuzumab
6/22/2017 TARGETING THE TARGETS IN 2017 TARGETING THE TARGETS IN 2017
TARGETING THE TARGETS IN 2017 Primary Care Focus Symposium July 1, 2017 Grace Wang MD I do not have any relevant financial relationships to disclose at this time TARGETING THE TARGETS IN 2017 What are
Multimedia Appendix 6 Educational Materials Table of Contents. Intervention Educational Materials Audio Script (version 1)
Multimedia Appendix 6 Educational Materials Table of Contents Intervention Educational Materials... 1 Audio Script (version 1)... 1 Text (version 1)... 5 Slides (version 1)... 17 Audio Script (version
Metastatic breast cancer: sequence of therapies
Metastatic breast cancer: sequence of therapies Clinical Case Discussion Nadia Harbeck, MD PhD Breast Center, Department of Gynecology and Obstetrics University of Munich, Ludwig-Maximilians University
Update in the treatment of Her2- overexpressing breast cancers. Fabrice ANDRE Institut Gustave Roussy Villejuif, France
Update in the treatment of Her2- overexpressing breast cancers Fabrice ANDRE Institut Gustave Roussy Villejuif, France Questions Should tumors
Intro to Cancer Therapeutics
An Intro to Cancer Therapeutics Christopher R. Chitambar, MD Professor of Medicine Division of Hematology & Oncology Froedtert and Medical College of Wisconsin Clinical Cancer Center cchitamb@mcw.edu Intro
Endocrine Therapy 2017: Is There a Better Single Agent and when Should we Use it?
Endocrine Therapy 2017: Is There a Better Single Agent and when Should we Use it? ET1 ET2 ET3 Targeted agent 1 Targeted agent 2 Hope S. Rugo, MD Director, Breast Oncology and Clinical Trials Education
Endocrine Therapy of Metastatic Breast Cancer
Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Endocrine Therapy of Metastatic Breast Cancer Endocrine Therapy of Metastatic Breast Cancer Version 2002: Gerber / Friedrichs
Open Clinical Trials: What s Out There Now Paula D. Ryan, MD, PhD
Open Clinical Trials: What s Out There Now Paula D. Ryan, MD, PhD Hanahan and Weinberg, 2000 Acquired Capabilities of Cancer Clinical Trials When should I consider a clinical trial? How do I find the right
Outline of the presentation
Outline of the presentation Breast cancer subtypes and classification Clinical need in estrogen-positive (ER+) metastatic breast cancer (mbc) Sulforaphane and SFX-01: the preclinical evidence STEM Phase
Breast Cancer. Breast Cancer. Established breast cancer risk factors. Established breast cancer risk factors. Cancer incidence.
Breast Cancer A buffet of breast cancer topics Wendy Y. Chen, MD MPH Dana-Farber Cancer Institute Brigham and Women s Hospital Disclosures: none Not related to anything presented in this lecture Wendy
See Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: (Herceptin) Reference Number: ERX.SPA.42 Effective Date: 07.01.16 Last Review Date: 05/17 Line of Business: Commercial [Prescription Drug Plan] Revision Log See Important Reminder at the
Dieta Brandsma, Department of Neuro-oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
What is hot in breast cancer brain metastases? Dieta Brandsma, Department of Neuro-oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands 8th Annual Brain Metastases Research and Emerging Therapy
Beyond the Guidelines: Clinical Investigators Provide Their Perspectives on Current Strategies and Ongoing Research in the Management of Breast Cancer
Beyond the Guidelines: Clinical Investigators Provide Their Perspectives on Current Strategies and Ongoing Research in the Management of Breast Cancer Wednesday, December 11, 2013 7:30 PM 9:30 PM San Antonio,
Newly diagnosed with metatastic disease: where do we go from here? Rick Michaelson Saint Barnabas Medical Center
Newly diagnosed with metatastic disease: where do we go from here? Rick Michaelson Saint Barnabas Medical Center A Diagnosis of Advanced Breast Cancer Leads To Many Immediate Questions How am I supposed
Recent Update in Management of Breast Cancer: Medical Oncology. Jin Hee Ahn, M.D., PhD. 23-April-2015
2015 GBCC & 4 th IBCS 1/37 Recent Update in Management of Breast Cancer: Medical Oncology Jin Hee Ahn, M.D., PhD. 23-April-2015 Department of Oncology, Asan Medical Center, UUCM, Seoul, Korea 2/37 3/37
HER2-positive Breast Cancer
HER2-positive Breast Cancer Multiple choices what to use when? Thomas Ruhstaller Brustzentrum St. Gallen Adjuvant setting NCIC MA5 N Engl J Med 06, 2103 6 x CEF can 6 x CMF oral HER2 + pg schlecht in allen
Dennis J Slamon, MD, PhD
I N T E R V I E W Dennis J Slamon, MD, PhD Dr Slamon is Professor of Medicine, Chief of the Division of Hematology/Oncology and Director of Clinical and Translational Research at UCLA s David Geffen School
Update on the Management of HER2+ Breast Cancer. Christian Jackisch, MD, PhD Sana Klinikum Offenbach Offenbach, Germany
Update on the Management of HER2+ Breast Cancer Christian Jackisch, MD, PhD Sana Klinikum Offenbach Offenbach, Germany Outline Treatment strategies for HER2-positive metastatic breast cancer since First
Targeting CDK 4/6. Jee Hyun Kim, M.D., Ph.D. Seoul National University College of Medicine
2016.04.30 GBCC Education Symposium Targeting CDK 4/6 Jee Hyun Kim, M.D., Ph.D. Seoul National University College of Medicine Contents Cyclins -CDKs in cell cycle control CDK 4/6 in breast cancer Preclinical
Systemic therapy: HER-2 update. Hans Wildiers Multidisciplinair Borst Centrum/Algemene medische oncologie UZ Leuven
Systemic therapy: HER-2 update Hans Wildiers Multidisciplinair Borst Centrum/Algemene medische oncologie UZ Leuven New drugs Strategic issues Specific anti-her2 drugs Lapa$nib /Nera$nib Baselga & Swain,
Advances in Breast Cancer Therapeutics in the Adjuvant and Metastatic Settings. Eve Rodler, MD University of California at Davis October 2016
Advances in Breast Cancer Therapeutics in the Adjuvant and Metastatic Settings Eve Rodler, MD University of California at Davis October 2016 17th Annual Advances in Oncology September 30-October 1, 2016
Disclosures. Objectives. Novel Agents in the Systemic Management of Breast Cancer (Breast Cancer Update 2012) Peter Kabos, MD
Mountain States Cancer Conference 2012 Novel Agents in the Systemic Management of Breast Cancer (Breast Cancer Update 2012) Peter Kabos, MD University of Colorado Denver Disclosures No relevant disclosures
Recent advances in the management of metastatic breast cancer in older adults
Recent advances in the management of metastatic breast cancer in older adults Laura Biganzoli Medical Oncology Dept New Hospital of Prato Istituto Toscano Tumori Italy Important recent advances in the
Non-hormonal therapies in advanced breast cancer: new and emerging approaches
Non-hormonal therapies in advanced breast cancer: new and emerging approaches Outline Review goals of treatment Demystify chemotherapy decision making Look at the evidence for improvements over time Discuss
A vision for HER2 future
School of Medical Oncology Department of Medical and Biological Sciences - University of Udine Department of Oncology - University Hospital of Udine A vision for HER2 future Current therapeutic algorithm
CDK4 and CDK6 Inhibitor
CDK4 and CDK6 Inhibitor Abemaciclib, LY2835219 Derived from Shapiro GI. 1 Drug Discovery Platform: Cancer Cell Signaling JUNIPER: A Randomized Phase 3 Study of Abemaciclib Plus Best Supportive Care Versus
See Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: (Verzenio) Reference Number: CP.PHAR.355 Effective Date: 10.24.17 Last Review Date: 05.18 Line of Business: Commercial, Medicaid Revision Log See Important Reminder at the end of this
Breast Cancer. Dr. Andres Wiernik 2017
Breast Cancer Dr. Andres Wiernik 2017 Agenda: The Facts! (Epidemiology/Risk Factors) Biological Classification/Phenotypes of Breast Cancer Treatment approach Local Systemic Agenda: The Facts! (Epidemiology/Risk
Extended Hormonal Therapy
Extended Hormonal Therapy Dr. Caroline Lohrisch, Medical Oncologist, BC Cancer Agency Vancouver Centre November 1, 2014 www.fpon.ca Optimal Endocrine Therapy for Women with Hormone Receptor Positive Early
BREAST CANCER BREAST CANCER
BREAST CANCER George Raptis, M.D., M.B.A Division of Medical Oncology & Hematology College of Physicians & Surgeons Columbia University BREAST CANCER Epidemiology - Commonest cancer in women - About 235,000
METASTATIC BREAST CANCER: CONTROLLING THE HERD WHEN THE HORSES ARE OUT OF THE BARN
METASTATIC BREAST CANCER: CONTROLLING THE HERD WHEN THE HORSES ARE OUT OF THE BARN V A L L E R I E G O R D O N B S C, M D, F R C P C M E D I C A L O N C O L O G I S T A S S I S T A N T P R O F E S S O
Midwest Metastatic Breast Cancer Conference. Douglas Yee, M.D. Director Masonic Cancer Center University of Minnesota
Midwest Metastatic Breast Cancer Conference Douglas Yee, M.D. Director Masonic Cancer Center University of Minnesota Presented By: Title Sponsor: Historical Overview & Evolution of Metastatic Breast Cancer
Appendix 2. Adjuvant Regimens. AC doxorubin 60 mg/m 2 every 3 weeks x 4 cycles Cyclophosphamide 600 mg/m 2
Appendix 2 Adjuvant Regimens AC doxorubin 60 mg/m 2 every 3 weeks x 4 cycles Cyclophosphamide 600 mg/m 2 CMF IV cyclophosphamide 600 mg/m 2 days 1 & 8 every 4 weeks methotrexate 40 mg/m 2 for 6 cycles
See Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: (Verzenio) Reference Number: CP.PHAR.355 Effective Date: 10.24.17 Last Review Date: 02.19 Line of Business: Commercial, Medicaid Revision Log See Important Reminder at the end of this
Breast Cancer. Themes. Who Gets it? + Why? Breast Cancer Care Update Breast Cancer Risk Factors Genetic ~ 5-6% of all
Themes Breast Cancer Care Update 2011 Dr. Anil Abraham Joy Provincial Chair, Alberta Breast Cancer Program Palliative Care Conference October 24, 2011 The Perversity of Cancer Diversity Heterogeneity (Breast
RECENT ADVANCES BREAST CANCER THERAPY. Bhanu Priya B, 2 Basavanna P L, 1 Postgraduate, 2 Professor Department of Pharmacology, MMC&RI, Mysore
RECENT ADVANCES BREAST CANCER THERAPY 1 Bhanu Priya B, 2 Basavanna P L, 1 Postgraduate, 2 Professor Department of Pharmacology, MMC&RI, Mysore Brief overview Introduction Etiology Pathogenesis Symptoms
Luminal early breast cancer: (neo-) adjuvant endocrine therapy
CAMPUS GROSSHADERN CAMPUS INNENSTADT KLINIK UND POLIKLINIK FÜR FRAUENHEILKUNDE UND GEBURTSHILFE DIREKTOR: PROF. DR. MED. SVEN MAHNER Luminal early breast cancer: (neo-) adjuvant endocrine therapy Nadia
Breast cancer treatment
Report from the San Antonio Breast Cancer Symposium Breast cancer treatment Determining the best options for select patient groups Sara Soldera, MD, Resident; Nathaniel Bouganim, MD, FRCPC, Medical Oncologist;
Predicting outcome in metastatic breast cancer
Predicting outcome in metastatic breast cancer Aleix Prat, MD, PhD Medical Oncology Department Translational Genomics and Targeted Therapeutics in Solid Tumors Monday, 15 th January, Manchester, UK Disclosures
Mechanisms of hormone drug resistance
Mechanisms of hormone drug resistance Ljiljana Stamatović Institute for Oncology and Radiology of Serbia Tenth UMOS Conference, Belgrade, 16-17 th May 2015. Hormone receptor-positive breast cancer (HR+
Use of Ovarian Suppression and Ablation in Breast Cancer Treatment
Use of Ovarian Suppression and Ablation in Breast Cancer Treatment Dr Marina Parton Consultant Medical Oncologist Royal Marsden and Kingston Hospitals Overview Breast cancer phenotypes Use of ovarian manipulation
Best of San Antonio 2008
Best of San Antonio 2008 Ellie Guardino, MD/PhD Assistant Professor Stanford University BIG 1 98: a randomized double blind phase III study evaluating letrozole and tamoxifen given in sequence as adjuvant
Updates From San Antonio Breast Cancer Symposium 2017
Updates From San Antonio Breast Cancer Symposium 2017 Rob Coleman University of Sheffield Presentation Outline New Insights into adjuvant endocrine treatment Duration of treatment Perioperative therapy
Johns Hopkins Clinical Update Webinar
Johns Hopkins Clinical Update Webinar Ben Ho Park, M.D., Ph.D. Department of Oncology Johns Hopkins University February 2015 This presentation is the intellectual property of the author/presenter. Contact
Pro: Hormone Therapy in HR positive MBC is the preferred option!
Pro: Hormone Therapy in HR positive MBC is the preferred option! Alexandru Eniu, MD, PhD Medical Oncologist Head, Day Hospital Unit Department of Breast Tumors Cancer Institute Ion Chiricuţă Cluj-Napoca,
Update on New Perspectives in Endocrine-Sensitive Breast Cancer. James R. Waisman, MD
Update on New Perspectives in Endocrine-Sensitive Breast Cancer James R. Waisman, MD Nothing to disclose DISCLOSURE TAILORx Oncotype Recurrence Score TAILORx Study Design Sparano, J Clin Oncol 2008;26:721-728
Presenter: Dr. Suman Rao May 13, 2016
Presenter: Dr. Suman Rao May 13, 2016 1 2010 Breast Cancer Estimates 207,090 NEW CASES 4% Melanoma of Skin 2% Thyroid 31% Breast 13% Lung & Bronchus 2% Pancreas 11% Colon & Rectum 4% Ovary 6% Uterus 3%
Breast Cancer Earlier Disease. Stefan Aebi Luzerner Kantonsspital
Breast Cancer Earlier Disease Stefan Aebi Luzerner Kantonsspital stefan.aebi@onkologie.ch Switzerland Breast Cancer Earlier Disease Diagnosis and Prognosis Local Therapy Surgery Radiation therapy Adjuvant
What is new in HR+ Breast Cancer? Olivia Pagani Breast Unit and Institute of oncology of Southern Switzerland
What is new in HR+ Breast Cancer? Olivia Pagani Breast Unit and Institute of oncology of Southern Switzerland Outline Early breast cancer Advanced breast cancer Open questions Outline Early breast cancer
Comprehensive Genomic Profiling, in record time. Accurate. Clinically Proven. Fast.
Comprehensive Genomic Profiling, in record time Accurate. ly Proven. Fast. PCDx advantages Comprehensive genomic profiling, in record time PCDx Comprehensive Genomic Profiling (CGP) provides precise information
Aggiornamenti tra ricerca e clinica: il carcinoma della mammella
Aggiornamenti tra ricerca e clinica: il carcinoma della mammella Filippo Montemurro Unit of (INCO) Fondazione del Piemonte per l Oncologia Candiolo Cancer Institute (IRCCs) Research Needs in Breast Cancer
Clinical Policy: Lapatinib (Tykerb) Reference Number: CP.PHAR.79 Effective Date: Last Review Date: 11.17
Clinical Policy: (Tykerb) Reference Number: CP.PHAR.79 Effective Date: 10.01.11 Last Review Date: 11.17 Line of Business: Medicaid Revision Log See Important Reminder at the end of this policy for important
LAPATINIB-Resistance to small Molecule ErbB2 Tyrosine Kinase Inhibitor (TKI)
LAPATINIB-Resistance to small Molecule ErbB2 Tyrosine Kinase Inhibitor (TKI) Prim Mr Sc Dr Suzana Vasović Institute for oncology and radiology of Serbia UMOS, X Conference, 16.05.2015 Belgrade How do we
Combination Immunotherapy Approaches Chemotherapy, Radiation Therapy, and Dual Checkpoint Therapy
Combination Immunotherapy Approaches Chemotherapy, Radiation Therapy, and Dual Checkpoint Therapy Dr. David B. Page Providence Portland Medical Center Earle A. Chiles Research Institute Funding & Disclosures
Systemic Therapy Considerations in Inflammatory Breast Cancer
Systemic Therapy Considerations in Inflammatory Breast Cancer Shani Paluch-Shimon, MBBS, MSc Director, Breast Oncology Unit Shaare Zedek Medical Centre, Jerusalem Israel Disclosures Roche: Speakers bureau,
A Layperson's Guide to Endocrine (Hormone) Therapy
A Layperson's Guide to Endocrine (Hormone) Therapy What we will cover What is the endocrine system Basic definition of endocrine therapy Classes of endocrine drugs How you can utilise endocrine therapy
非臨床試験 臨床の立場から 京都大学医学部附属病院戸井雅和
資料 2 2 非臨床試験 臨床の立場から 京都大学医学部附属病院戸井雅和 1 Preclinical studies Therapeutic Window: Efficacy/Toxicity Disease Specificity Subtype Specificity Combination: Concurrent/Sequential Therapeutic situation: Response/
EARLY BREAST CANCER, HER2-POSITIVE
EARLY BREAST CANCER, HER2-POSITIVE CLINICAL CASE DISCUSSION Elżbieta Senkus Medical University of Gdańsk Gdańsk, Poland esmo.org DISCLOSURES Honoraria: Amgen, Astellas, AstraZeneca, Bayer, BMS, Celgene,
HER2-Targeted Rx. An Historical Perspective
HER2-Targeted Rx An Historical Perspective Trastuzumab: Front Line Rx for MBC Median 20.3 v. 25.1 mo P = 0.046 HR 0.8 65% of control patients crossed over Slamon D, et al. N Engl J Med, 2001; 344:783 Trastuzumab:Front-line
Breast Cancer Breast Managed Clinical Network
Initial Evaluation Clinical Stage Pre-Treatment Evaluation Treatment and pathological stage Less than 4 positive lymph nodes Adjuvant Treatment ER Positive HER2 Negative (see page 2 & 3 ) HER2 Positive
Manejo do câncer de mama RH+ na adjuvância: o que há de novo?
II Simpósio Internacional de Câncer de Mama para o Oncologista Clínico Manejo do câncer de mama RH+ na adjuvância: o que há de novo? INGRID A. MAYER, MD, MSCI Assistant Professor of Medicine Director,
Evolving Paradigms in HER2+ MBC: Strategies for Individualizing Therapy with Available Agents
Evolving Paradigms in HER2+ MBC: Strategies for Individualizing Therapy with Available Agents Kimberly L. Blackwell MD Professor Department of Medicine and Radiation Oncology Duke University Medical Center
New Drug Development in HER2+ Breast Cancer
New Drug Development in HER2+ Breast Cancer Philippe Aftimos, M.D. Senior Research Physician Clinical Pharmacology Unit Institut Jules Bordet Background Amplification of HER2 occurs in approximately 20%
The efficacy of second-line hormone therapy for recurrence during adjuvant hormone therapy for breast cancer
517734TAM6210.1177/1758834013517734Therapeutic Advances in Medical OncologyR Mori and Y Nagao research-article2013 Therapeutic Advances in Medical Oncology Original Research The efficacy of second-line
Clinical Management Guideline for Breast Cancer
Initial Evaluation Clinical Stage Pre-Treatment Evaluation Treatment and pathological stage Adjuvant Treatment Less than 4 positive lymph nodes ER Positive HER2 Negative (see page 2 & 3 ) Primary Diagnosis:
Seigo Nakamura,M.D.,Ph.D.
Seigo Nakamura,M.D.,Ph.D. Professor of Surgery Director of Breast Center Showa University Hospital Chairman of the board of directors Japan Breast Cancer Society Inhibition of Estrogen-Dependent Growth
José Baselga, MD, PhD
i n t e r v i e w José Baselga, MD, PhD Dr Baselga is Physician-in-Chief at Memorial Sloan-Kettering Cancer Center in New York, New York. Tracks 1-15 Track 1 Track 2 Track 3 Track 4 Track 5 Track 6 Track
Clinical activity of fulvestrant in metastatic breast cancer previously treated with endocrine therapy and/or chemotherapy
ORIGINAL ARTICLE 2018 Mar 16. [Epub ahead of print] Clinical activity of fulvestrant in metastatic breast cancer previously treated with endocrine therapy and/or chemotherapy Mi Hwa Heo, Hee Kyung Kim,
Sesiones interhospitalarias de cáncer de mama. Revisión bibliográfica 4º trimestre 2015
Sesiones interhospitalarias de cáncer de mama Revisión bibliográfica 4º trimestre 2015 Selected papers Prospective Validation of a 21-Gene Expression Assay in Breast Cancer TAILORx. NEJM 2015 OS for fulvestrant
Progress in the management of metastatic breast cancer in 2018: Is a cure in the horizon?
Progress in the management of metastatic breast cancer in 2018: Is a cure in the horizon? By Gerardo Colón-Otero, MD Mayo Clinic Florida Address correspondence to: Gerardo Colón-Otero, MD Professor of
Mechanisms of Resistance to. Lisa A. Carey, M.D. University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center
Mechanisms of Resistance to Hormonal Therapy Lisa A. Carey, M.D. University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center Antagonizing Estrogen Dependent Growth Premenopausal
Current Optimal Sequence and Duration of Endocrine Treatment
[Symposium 7] Present and Future of Endocrine Therapy 07 Apr, 2018@GBCC Current Optimal Sequence and Duration of Endocrine Treatment Breast Oncology Center The Cancer Institute Hospital of JFCR Shinji
Regimens highlighted in red contain an expensive drug that is not currently publicly funded for the regimen and treatment intent.
Palliative Breast Cancer Regimens The following table lists the evidence-informed regimens (both IV and non-iv) for breast cancer used in the palliative setting. It is expected that the prescribing oncologist
Her 2 Positive Advanced Breast Cancer: From Evidence to Practice
Her 2 Positive Advanced Breast Cancer: From Evidence to Practice Sunil Verma MD, FRCP(C) Medical Director, Tom Baker Cancer Center Professor and Head, Department of Oncology Cumming School of Medicine,
ASCO 2017 BREAST CANCER HIGHLIGHTS
Post-ASCO 24 th June 2017, Dolce La Hulpe, Belgium ASCO 2017 BREAST CANCER HIGHLIGHTS Martine J. Piccart-Gebhart, MD, PhD Jules Bordet Institute, Brussels, Belgium Université Libre de Bruxelles Breast
Page. Objectives: Hormone Therapy Resistance: Challenges and Opportunities. Research Support From Merck
Hormone Therapy Resistance: Challenges and Opportunities Pamela. N. Munster, MD University of California, San Francisco Financial Disclosures Research Support From Merck Objectives: Understanding the current
Kazuhiro Araki, Yasuo Miyoshi
Editorial Abundant options to avoid toxicity and alternative strategies for human epidermal growth factor receptor 2-positive and hormone receptor-positive advanced breast cancer Kazuhiro Araki, Yasuo
Hormonal Management of Metastatic Breast Cancer
Hormonal Management of Metastatic Breast Cancer Dr. Khaled Abulkhair, PhD Medical Oncology SCE, Royal College, UK Ass. Professor of Clinical Oncology Mansoura University, Egypt Case For Discussion A 63
Targeted Agents In Breast Cancer. Wonderful Music With New Instruments
Targeted Agents In Breast Cancer Wonderful Music With New Instruments 1 Trends In Cancer Mortality In Women in US At This Rate We Will Beat Breast Cancer In 2040 Is the cause screening?? Is the cause better
OPTIMAL ENDOCRINE THERAPY IN EARLY BREAST CANCER
OPTIMAL ENDOCRINE THERAPY IN EARLY BREAST CANCER STEPHEN E. JONES, M.D. US ONCOLOGY RESEARCH THE WOODLANDS, TX TOPICS PREMENOPAUSAL BREAST CANCER POSTMENOPAUSAL BREAST CANCER THE FUTURE TOPICS PREMENOPAUSAL