Manejo do câncer de mama RH+ na adjuvância: o que há de novo?

Size: px
Start display at page:

Download "Manejo do câncer de mama RH+ na adjuvância: o que há de novo?"

Transcription

1 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, Clinical Core of Breast Cancer SPORE Division of Hematology/Oncology Vanderbilt University

2 Adjuvant Endocrine Therapy for ER+ Breast Cancer EGFR HER2 Growth factor receptor Estrogen Oophorectomy Cytoplasm RAS RAF MEK MAPK SOS GRB2 Shc PI3K Akt/ m-tor Estrogen receptor Aromatase inhibitors (AIs) Nonsteroidal AIs Anastrozole Letrozole Steroidal AIs Exemestane Nucleus P P AF1 AF1 DBD DBD Cofactor complex LBD LBD P Cell growth Selective estrogen receptor modulators (SERMs) Tamoxifen Toremifene Adapted from Yardley DA, et al. J Clin Oncol. 2011;29(suppl 27). Abstract 268.

3 Impact of adjuvant endocrine therapy (Tamoxifen) ~ 50% Risk reduction ~ 30% Risk reduction Early Breast Cancer Collaborative Trialists Group (EBCCTG) 2011

4 AI adjuvant phase III trials for postmenopausal women J Clin Oncol; 26:

5 Meta-analysis of breast cancer outcomes in adjuvant trials: 5 years of AI vs. Tamoxifen Recurrence Mortality Dowsett M et al. JCO 2010;28:

6 Meta-analysis of breast cancer outcomes in adjuvant trials: Tamoxifen x 5 years vs. Tamoxifen AI x 5 years Recurrence Mortality Dowsett M et al. JCO 2010;28:

7 Long-Term Risk of Breast Cancer Recurrence More than 50% of women who take 5 years of endocrine therapy will have a recurrence after year hazard rate ER/PgR+ (n=2257) ER/PgR (n=1305) 0.2 Recurrence Years Saphner et al. J Clin Oncol. 1996;14:2738

8 Adjuvant tamoxifen for 10 years versus 5 years in ER+ breast cancer: ATLAS, a phase III randomized trial ~50% were premenopausal ~50% were postmenopausal Lancet 2012

9 ATLAS: recurrence and mortality benefits Lancet 2012

10 ATLAS: breast CA vs. other causes mortality Lancet 2012

11 attom: 10 vs. 5 years Tamoxifen N=6953 Note: ~ 50% of women participating in the trial had unknown ER status! Recurrence RR = 0.85 (95% CI ; p=0.003) - Absolute reduction 4% Mortality RR = 0.88 (95% CI ; p=0.06) - Absolute reduction 2% Gray et al. Abstract 5, ASCO 2013

12 Impact of menopausal status at initial diagnosis of breast cancer in women in the JMA.17 trial - DFS Pre-menopausal women at diagnosis derive the most benefit from this strategy Goss P E et al. Ann Oncol 2013;24:

13 Optimal duration of extended AI therapy? JMA.17 (N= 5,187) JMA.17R (N= 1,800) Tamoxifen x 5 y (post-menopausal women) Letrozole x 5 years Placebo x 5 years Letrozole x 5 years Placebo x 5 years

14 Possible Surrogate Markers for Hormone Resistance LUM A LUM B ER PR HER2 RS Low Ki-67 High Ki-67 Hormone-sensitive Hormone-resistant

15 Risk of Distant Recurrence Using Oncotype DX (21-Gene RS) in Patients Treated with Anastrozole or Tamoxifen: ATTAC Study Objective was to evaluate the prognostic ability of 21-gene RS assay in patients treated in ATAC study RS score was predictive of risk of recurrence in postmenopausal patients with ER+ with either node negative or node positive disease being treated with either tamoxifen or anastrozole Rate of Distant Recurrence at 9 Years Population N Low RS Intermediate RS High RS Lymph Node Negative 872 4% 10% 22% Tamoxifen 432 3% 10% 30% Anastrozole 440 4% 11% 12% Lymph Node Positive % 27% 46% Tamoxifen % 28% 42% Anastrozole % 25% 50% Dowsett et al. SABCS 2008, Abstract 53

16 Recurrence Score in LN+ (1-3) ER+ breast cancer S1007 SWOG Gonzalez-Angulo

17 Combined Targeting of ER and Growth Factor Receptor Pathways EGFR HER2 Growth factor receptor Estrogen Oophorectomy Cytoplasm Nucleus RAS RAF mtor inhibitors Everolimus Sirolimus Temsirolimus MEK MAPK SOS P AF1 AF1 GRB2 P Shc DBD PI3K Akt/ m-tor DBD Cofactor complex LBD LBD P Estrogen receptor Cell growth Aromatase inhibitors (AIs) Nonsteroidal AIs Anastrozole Letrozole Steroidal AIs Exemestane Estrogen receptor downregulator (ERD) Fulvestrant Selective estrogen receptor modulators (SERMs) Tamoxifen Toremifene Adapted from Yardley DA, et al. J Clin Oncol. 2011;29(suppl 27). Abstract 268.

18 SWOG and UNIRAD: Everolimus in the Adjuvant High-Risk Breast Cancer Setting SWOG-NSABP 1,2 Phase 3 study; N = 3,500 Pre and postmenopausal women with HR + HER2 breast cancer Prior standard neoadjuvant or adjuvant chemotherapy Everolimus 10 mg/day for 1 y + endocrine therapy for 5 y Placebo for 1 y + endocrine therapy for 5 y Primary endpoint: Invasive DFS Secondary endpoints: OS, DRFS, biomarkers, safety Stratification: Node negative (all RS > 25) 1-3 positive lymph nodes (all RS > 25) 4 positive lymph nodes and RS 25 4 positive lymph nodes and RS > 25 Neoadjuvant chemotherapy UNIRAD 3 Phase 3 study; N = 1,984 Pre and postmenopausal women with HR + HER2 breast cancer ( 4+ nodes) Relapse-free after 3 y of adjuvant endocrine therapy Everolimus 10 mg/day for 2 y + AI or tamoxifen Placebo for 2 y + AI or tamoxifen Primary endpoint: DFS at 2 y Secondary endpoints: OS, biomarkers, safety Stratification: Endocrine therapy (tamoxifen vs AIs) Adjuvant chemotherapy (previous adjuvant vs neoadjuvant chemotherapy) 1. Chavez-MacGregor M, et al. SABCS 2012; Abstract OT (poster) Accessed January 15, 2013; 3. Andre F, et al. St. Gallen Poster 220.

19 A phase II neoadjuvant trial of BKM120 or BYL719 in combination with letrozole in post-menopausal patients with operable ER+ breast cancer Breast Cancer Stage II/III ER+/HER2 Post-menopausal (N=360) Ki-67 TUNEL P-Akt, etc. Mutation analysis microarrays RPPA Biopsy 1:1:1 3 weeks Arm 1: Letrozole BKM120 Arm 2: Letrozole BYL719 Arm 3: Letrozole Placebo Biopsy Ki-67 TUNEL P-Akt, etc microarrays RPPA 21 weeks Letrozole BKM120 Letrozole BYL719 Letrozole Placebo Surgery Path CR PEPI score Clinical Response Whole exome analysis Mayer, VICC/ SU2C

20 Phase III Study Evaluating Palbociclib (PD ), a Cyclin-Dependent Kinase (CDK) 4/6 Inhibitor in Patients With Hormone-receptor-positive, HER2-normal Primary Breast Cancer With High Relapse Risk After Neoadjuvant Chemotherapy "PENELOPE-B Pre- and postmenopausal women: ER+ early breast cancer + High risk of relapse (high CPS-EG score*) + No pcr after neoadjuvant taxanecontaining chemotherapy Endocrine therapy + Palbociclib x 1 year Endocrine therapy + Placebo x 1 year 1ary Endpoint: Invasive Disease - Free Survival (idfs) * clinical-pathologic stage - estrogen/grade GBG78/BIG 1-13

21 How do we chose the appropriate adjuvant endocrine therapy agent? Tamoxifen Aromatase Inhibitors Better day/day tolerance but: Risk of thromboembolic events Risk for uterine cancers Worse day/day tolerance: Fatigue Vasomotor symptoms Arthralgia Osteoporosis But potentially more efficacious for resistant tumors

22 How do we chose the appropriate adjuvant endocrine therapy agent? Upfront AI x 5 years Tamoxifen x 2-3 y + AI x 2-3 years Early benefit: Minimize risk of early relapse that could translate into long-term benefit Two effective agents: Minimize risk of late recurrence, hoping that shortterm losses will be more than compensated by long-term gains

23 How do we chose the appropriate duration of adjuvant endocrine therapy? 5 years 10 years Less toxic Potentially enough for low risk cases Better for late relapses, should be considered for high risk cases

24 How do we chose adjuvant endocrine therapy? Menopausal Status/ Clinical Setting Options Duration of Tamoxifen Duration of AI Total duration POST PRE At adjuvant endocrine therapy start AI monotherapy N/A 5 years 5 years Tam AI 2-3 years 2-3 years 5 years Middle of Tamoxifen Tam AI 2-3 years 2-3 years 5 years Middle of AI AI Tam 2-3 years 2-3 years 5 years At 5 years of Tamoxifen completion Tam AI 5 years 5 years 10 years Tam monotherapy Tam monotherapy 10 years N/A 10 years 10 years N/A 10 years

25 How do we chose adjuvant endocrine therapy? Menopausal Status/ Clinical Setting PERI At adjuvant endocrine therapy start Options Tam monotherapy Duration of Tamoxifen Duration of AI Total duration 10 years N/A 10 years Middle of Tamoxifen 2-3 years 2-3 years 5 years Tam AI* * At 5 years of Tamoxifen completion Tam AI* 5 years 5 years 10 years * Only if post-menopausal status is established at the time of the switch

Seigo Nakamura,M.D.,Ph.D.

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

More information

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 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

More information

Extended Hormonal Therapy

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

More information

William J. Gradishar MD

William J. Gradishar MD Northwestern University Feinberg School of Medicine Adjuvant Endocrine Therapy For Postmenopausal Women SOBO 2013 William J. Gradishar MD Betsy Bramsen Professor of Breast Oncology Director, Maggie Daley

More information

Assessment of Risk Recurrence: Adjuvant Online, OncotypeDx & Mammaprint

Assessment of Risk Recurrence: Adjuvant Online, OncotypeDx & Mammaprint Assessment of Risk Recurrence: Adjuvant Online, OncotypeDx & Mammaprint William J. Gradishar, MD Professor of Medicine Robert H. Lurie Comprehensive Cancer Center of Northwestern University Classical

More information

Emerging Approaches for (Neo)Adjuvant Therapy for ER+ Breast Cancer

Emerging Approaches for (Neo)Adjuvant Therapy for ER+ Breast Cancer Emerging Approaches for (Neo)Adjuvant Therapy for E+ Breast Cancer Cynthia X. Ma, M.D., Ph.D. Associate Professor of Medicine Washington University in St. Louis Outline Current status of adjuvant endocrine

More information

PROGNOSTICO DE PACIENTES COM CA DE MAMA METASTATICO HER2+: PODEMOS FAZER MAIS? TDM-1 AND BEYOND!

PROGNOSTICO DE PACIENTES COM CA DE MAMA METASTATICO HER2+: PODEMOS FAZER MAIS? TDM-1 AND BEYOND! II Simpósio Internacional de Câncer de Mama para o Oncologista Clínico PROGNOSTICO DE PACIENTES COM CA DE MAMA METASTATICO HER2+: PODEMOS FAZER MAIS? TDM-1 AND BEYOND! INGRID A. MAYER, MD, MSCI Assistant

More information

Adjuvant Endocrine Therapy: How Long is Long Enough?

Adjuvant Endocrine Therapy: How Long is Long Enough? Adjuvant Endocrine Therapy: How Long is Long Enough? Harold J. Burstein, MD, PhD Dana-Farber Cancer Institute Harvard Medical School Boston, Massachusetts hburstein@partners.org I have no conflicts to

More information

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 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

More information

Best of San Antonio 2008

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

More information

OPTIMAL ENDOCRINE THERAPY IN EARLY BREAST CANCER

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

More information

Hormone therapyduration: Can weselectthosepatientswho benefitfromtreatmentextension?

Hormone therapyduration: Can weselectthosepatientswho benefitfromtreatmentextension? Hormone therapyduration: Can weselectthosepatientswho benefitfromtreatmentextension? Ivana Sestak, PhD Centre for Cancer Prevention Wolfson Institute of Preventive Medicine Queen Mary University London

More information

Extended Adjuvant Endocrine Therapy

Extended Adjuvant Endocrine Therapy Extended Adjuvant Endocrine Therapy After all, 5 years Tamoxifen works.. For women with ER+ primary breast cancer, previous studies have shown that treatment with tamoxifen for 5 years has a carry-over

More information

Mechanisms of Resistance to. Lisa A. Carey, M.D. University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center

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

More information

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 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

More information

8/8/2011. PONDERing the Need to TAILOR Adjuvant Chemotherapy in ER+ Node Positive Breast Cancer. Overview

8/8/2011. PONDERing the Need to TAILOR Adjuvant Chemotherapy in ER+ Node Positive Breast Cancer. Overview Overview PONDERing the Need to TAILOR Adjuvant in ER+ Node Positive Breast Cancer Jennifer K. Litton, M.D. Assistant Professor The University of Texas M. D. Anderson Cancer Center Using multigene assay

More information

Choosing between different hormonal therapies. Rudy Van den Broecke UZ Ghent

Choosing between different hormonal therapies. Rudy Van den Broecke UZ Ghent Choosing between different hormonal therapies Rudy Van den Broecke UZ Ghent What is the golden standard in premenopausal hormonal sensitive early breast cancer? Ovarian Suppression alone 5 years Tamoxifen

More information

(Neo-) adjuvant endocrine therapy

(Neo-) adjuvant endocrine therapy (Neo-) adjuvant endocrine therapy F. Cardoso, MD Director, Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal ESO Breast Cancer Program Coordinator ESMO Board of Directors & Chair NR Committee

More information

Current Optimal Sequence and Duration of Endocrine Treatment

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

More information

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 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

More information

The Oncotype DX Assay in the Contemporary Management of Invasive Early-stage Breast Cancer

The Oncotype DX Assay in the Contemporary Management of Invasive Early-stage Breast Cancer The Oncotype DX Assay in the Contemporary Management of Invasive Early-stage Breast Cancer Cancer The Biology Century Understanding and treating the underlying tumor biology Cancer genetic studies demonstrate

More information

Adjuvant Systemic Therapy in Early Stage Breast Cancer

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

More information

ORMONOTERAPIA ADIUVANTE: QUALE LA DURATA OTTIMALE? MARIANTONIETTA COLOZZA

ORMONOTERAPIA ADIUVANTE: QUALE LA DURATA OTTIMALE? MARIANTONIETTA COLOZZA ORMONOTERAPIA ADIUVANTE: QUALE LA DURATA OTTIMALE? MARIANTONIETTA COLOZZA THE NATURAL HISTORY OF HORMONE RECEPTOR- POSITIVE BREAST CANCER IS VERY LONG Recurrence hazard rate 0.3 0.2 0.1 0 ER+ (n=2,257)

More information

The Latest Research: Hormonal Therapies

The Latest Research: Hormonal Therapies The Latest Research: Hormonal Therapies Sameer Gupta, M.D., M.P.H 9/29/2018 Attending Physician, Hematology/Oncology Bryn Mawr Hospital Clinical Assistant Professor, Jefferson Medical College Disclosures

More information

Oncotype DX testing in node-positive disease

Oncotype DX testing in node-positive disease Should gene array assays be routinely used in node positive disease? Yes Christy A. Russell, MD University of Southern California Oncotype DX testing in node-positive disease 1 Validity of the Oncotype

More information

The Neoadjuvant Model as a Translational Tool for Drug and Biomarker Development in Breast Cancer

The Neoadjuvant Model as a Translational Tool for Drug and Biomarker Development in Breast Cancer The Neoadjuvant Model as a Translational Tool for Drug and Biomarker Development in Breast Cancer Laura Spring, MD Breast Medical Oncology Massachusetts General Hospital Primary Mentor: Dr. Aditya Bardia

More information

The TAILORx Trial: A review of the data and implications for practice

The TAILORx Trial: A review of the data and implications for practice The TAILORx Trial: A review of the data and implications for practice Angela DeMichele, MD, MSCE Jill & Alan Miller Endowed Chair in Breast Cancer Excellence Professor of Medicine and Epidemiology University

More information

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? 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

More information

Sesiones interhospitalarias de cáncer de mama. Revisión bibliográfica 4º trimestre 2015

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

More information

William J. Gradishar MD

William J. Gradishar MD Northwestern University Feinberg School of Medicine Adjuvant Endocrine Therapy For Postmenopausal Women SOBO 2011 William J. Gradishar MD Betsy Bramsen Professor of Breast Oncology Director, Maggie Daley

More information

Ruth M. O Regan, MD Professor and Vice-Chair for Educational Affairs, Department of Hematology and Medical Oncology, Emory University, Chief of

Ruth M. O Regan, MD Professor and Vice-Chair for Educational Affairs, Department of Hematology and Medical Oncology, Emory University, Chief of Endocrine Therapy of Advanced Breast Cancer School of Breast Oncology November 9 th 2013 Ruth M. O Regan, MD Professor and Vice-Chair for Educational Affairs, Department of Hematology and Medical Oncology,

More information

Metastatic breast cancer: sequence of therapies

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

More information

Novel Strategies in Systemic Therapies: Overcoming Endocrine Therapy Resistance

Novel Strategies in Systemic Therapies: Overcoming Endocrine Therapy Resistance Novel Strategies in Systemic Therapies: Overcoming Endocrine Therapy Resistance Richard S. Finn, MD Division of Hematology/ Oncology Director, Translational Oncology Laboratory Geffen School of Medicine

More information

Mechanisms of hormone drug resistance

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+

More information

Advances in the Diagnosis and Treatment of Breast Cancer. Carol Tweed, M.D. Anne Arundel Medical Center DeCesaris Cancer Institute Annapolis, MD

Advances in the Diagnosis and Treatment of Breast Cancer. Carol Tweed, M.D. Anne Arundel Medical Center DeCesaris Cancer Institute Annapolis, MD Advances in the Diagnosis and Treatment of Breast Cancer Carol Tweed, M.D. Anne Arundel Medical Center DeCesaris Cancer Institute Annapolis, MD Disclosures Genomic Health: Speaker and Consultant AstraZeneca:

More information

Targeting CDK 4/6. Jee Hyun Kim, M.D., Ph.D. Seoul National University College of Medicine

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

More information

ATAC Trial. 10 year median follow-up data. Approval Code: AZT-ARIM-10005

ATAC Trial. 10 year median follow-up data. Approval Code: AZT-ARIM-10005 ATAC Trial 10 year median follow-up data Approval Code: AZT-ARIM-10005 Background FDA post-approval commitment analysis to update DFS, TTR, OS and Safety Prof. Jack Cuzick on behalf of ATAC/LATTE Trialists

More information

Hormone therapy in Breast Cancer patients with comorbidities

Hormone therapy in Breast Cancer patients with comorbidities Hormone therapy in Breast Cancer patients with comorbidities Diana Crivellari Centro di Riferimento Oncologico Aviano- ITALY Madrid November 9th, 2007 Main issues Comorbidities in elderly women Hormonal

More information

Metastatic Breast Cancer What is new? Subtypes and variation?

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

More information

Endocrine Therapy in Premenopausal Breast Cancer. Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology, PA US Oncology

Endocrine Therapy in Premenopausal Breast Cancer. Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology, PA US Oncology Endocrine Therapy in Premenopausal Breast Cancer Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology, PA US Oncology Ovarian Ablation or Suppression vs. Not in ER + or ER UK Breast Cancer

More information

Terapia adiuvante con inibitori delle Kinasi Cliclina Dipendenti 4/6: quale futuro? Filippo Montemurro

Terapia adiuvante con inibitori delle Kinasi Cliclina Dipendenti 4/6: quale futuro? Filippo Montemurro Terapia adiuvante con inibitori delle Kinasi Cliclina Dipendenti 4/6: quale futuro? Filippo Montemurro Unit of Investigative Clinical Oncology Istituto di Candiolo (IRCCS) Disclosures Speaker s Honoraria

More information

Adjuvant endocrine therapy (essentials in ER positive early breast cancer)

Adjuvant endocrine therapy (essentials in ER positive early breast cancer) Adjuvant endocrine therapy (essentials in ER positive early breast cancer) Giuseppe Curigliano MD, PhD Breast Cancer Program Division of Experimental Therapeutics Outline Picking optimal adjuvant endocrine

More information

10/15/2012. Overcoming Endocrine Therapy Resistance. The Problem in ER+ Tumors is Endocrine Therapy Resistance

10/15/2012. Overcoming Endocrine Therapy Resistance. The Problem in ER+ Tumors is Endocrine Therapy Resistance Overcoming Endocrine Therapy Resistance Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology Slide Credits: Hope Rugo, MD The Problem in ER+ Tumors is Endocrine Therapy Resistance

More information

Adjuvant Hormonal Therapy in Peri- and Postmenopausal. Breast Cancer

Adjuvant Hormonal Therapy in Peri- and Postmenopausal. Breast Cancer Breast Cancer Adjuvant Hormonal Therapy in Peri- and Postmenopausal Breast Cancer Paula D. Ryan, Paul E. Goss Massachusetts General Hospital, Boston, Massachusetts, USA Key Words. Breast cancer Aromatase

More information

Role of Genomic Profiling in (Minimally) Node Positive Breast Cancer

Role of Genomic Profiling in (Minimally) Node Positive Breast Cancer Role of Genomic Profiling in (Minimally) Node Positive Breast Cancer Kathy S. Albain, MD, FACP Professor of Medicine Dean s Scholar Loyola University Chicago Stritch School of Medicine Cardinal Bernardin

More information

NSABP: FB-11. Shannon Puhalla, MD

NSABP: FB-11. Shannon Puhalla, MD NSABP: FB-11 Phase II Randomized Study Evaluating the Biological and Clinical Effects of the Combination of Palbociclib with Letrozole as Neoadjuvant Therapy in Post- Menopausal Women with Estrogen Receptor

More information

Is Gene Expression Profiling the Best Method for Selecting Systemic Therapy in EBC? Norman Wolmark Miami March 8, 2013

Is Gene Expression Profiling the Best Method for Selecting Systemic Therapy in EBC? Norman Wolmark Miami March 8, 2013 Is Gene Expression Profiling the Best Method for Selecting Systemic Therapy in EBC? Norman Wolmark Miami March 8, 2013 Changing Phases claudin low Lum A Lum B Basal Her2 NIH Consensus Development Panel,

More information

The Role of Novel Assays in the Prediction of Benefit from Extended Adjuvant Endocrine Therapy for Breast Cancer

The Role of Novel Assays in the Prediction of Benefit from Extended Adjuvant Endocrine Therapy for Breast Cancer The Role of Novel Assays in the Prediction of Benefit from Extended Adjuvant Endocrine Therapy for Breast Cancer Erin Roesch, MD, and Claudine Isaacs, MD Abstract Endocrine therapy in the adjuvant setting

More information

NSABP Pivotal Breast Cancer Clinical Trials: Historical Perspective, Recent Results and Future Directions

NSABP Pivotal Breast Cancer Clinical Trials: Historical Perspective, Recent Results and Future Directions 1 1 NSABP Pivotal Breast Cancer Clinical Trials: Historical Perspective, Recent Results and Future Directions Terry Mamounas, M.D., M.P.H., F.A.C.S. Medical Director, Comprehensive Breast Program UF Health

More information

Recent Update in Management of Breast Cancer: Medical Oncology. Jin Hee Ahn, M.D., PhD. 23-April-2015

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

More information

Breast Cancer. Dr. Andres Wiernik 2017

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

More information

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

More information

Multigene Testing in NCCN Breast Cancer Treatment Guidelines, v1.2011

Multigene Testing in NCCN Breast Cancer Treatment Guidelines, v1.2011 Multigene Testing in NCCN Breast Cancer Treatment Guidelines, v1.2011 Robert W. Carlson, M.D. Professor of Medicine Stanford University Chair, NCCN Breast Cancer Treatment Guidelines Panel Selection of

More information

38 years old, premenopausal, had L+snbx. Pathology: IDC Gr.II T-1.9cm N+2/4sn ER+100%st, PR+60%st, Her2-neg, KI %

38 years old, premenopausal, had L+snbx. Pathology: IDC Gr.II T-1.9cm N+2/4sn ER+100%st, PR+60%st, Her2-neg, KI % 38 years old, premenopausal, had L+snbx Pathology: IDC Gr.II T-1.9cm N+2/4sn ER+100%st, PR+60%st, Her2-neg, KI67 5-10% Question: What will you do now? 1. Give adjuvant chemotherapy 2. Send for Oncotype

More information

Endocrine Therapy of Advanced Breast Cancer School of Breast Oncology November 2012

Endocrine Therapy of Advanced Breast Cancer School of Breast Oncology November 2012 Endocrine Therapy of Advanced Breast Cancer School of Breast Oncology November 2012 Ruth M. O Regan, MD Professor and Vice-Chair for Educational Affairs, Department of Hematology and Medical Oncology,

More information

Profili di espressione genica

Profili di espressione genica Profili di espressione genica Giampaolo Bianchini MD Ospedale San Raffaele, Milan - Italy Gene expression profiles Transcriptomics Gene DNA mrna mirnas Protein metilation Metabolite Genomics Transcriptomics

More information

Targeted Agents In Breast Cancer. Wonderful Music With New Instruments

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

More information

UK Interdisciplinary Breast Cancer Symposium. Should lobular phenotype be considered when deciding treatment? Michael J Kerin

UK Interdisciplinary Breast Cancer Symposium. Should lobular phenotype be considered when deciding treatment? Michael J Kerin UK Interdisciplinary Breast Cancer Symposium Should lobular phenotype be considered when deciding treatment? Michael J Kerin Professor of Surgery National University of Ireland, Galway and Galway University

More information

Luminal early breast cancer: (neo-) adjuvant endocrine therapy

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

More information

Endocrine Therapy of Metastatic Breast Cancer

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

More information

When is Chemotherapy indicated in Advanced Luminal Breast Cancer?

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

More information

Lecture 5. Primary systemic therapy: clinical and biological endpoints

Lecture 5. Primary systemic therapy: clinical and biological endpoints Lecture 5 Primary systemic therapy: clinical and biological endpoints Valentina Guarneri, M.D., Ph.D. Primary systemic therapy in breast cancer Firstly introduced d into clinical i l practice in 70s for

More information

Medical Policy An independent licensee of the Blue Cross Blue Shield Association

Medical Policy An independent licensee of the Blue Cross Blue Shield Association Assays of Genetic Expression in Tumor Tissue as a Technique Page 1 of 67 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Assays of Genetic Expression in Tumor Tissue

More information

Page. Objectives: Hormone Therapy Resistance: Challenges and Opportunities. Research Support From Merck

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

More information

TRIALs of CDK4/6 inhibitor in women with hormone-receptor-positive metastatic breast cancer

TRIALs of CDK4/6 inhibitor in women with hormone-receptor-positive metastatic breast cancer TRIALs of CDK4/6 inhibitor in women with hormone-receptor-positive metastatic breast cancer Marta Bonotto Department of Oncology University Hospital of Udine TRIALs of CDK4/6 inhibitor in women with hormone-receptor-positive

More information

Targeting mtor pathway in ER+/Her2- breast cancers. Fabrice ANDRE Gustave Roussy

Targeting mtor pathway in ER+/Her2- breast cancers. Fabrice ANDRE Gustave Roussy Targeting mtor pathway in ER+/Her2- breast cancers Fabrice ANDRE Gustave Roussy Outline mtor pathway Clinical development of rapalogs in breast cancer Moving beyond rapalogs mtor pathway LKB1 Ras-raf-

More information

Agents in the Treatment of ER+ Aromatase Inbitor-Resistant Metastatic Breast Cancer: M-THOR Inhibitors

Agents in the Treatment of ER+ Aromatase Inbitor-Resistant Metastatic Breast Cancer: M-THOR Inhibitors Agents in the Treatment of ER+ Aromatase Inbitor-Resistant Metastatic Breast Cancer: M-THOR Inhibitors Valero, M.D., Professor of Medicine and Deputy Chairman Department of Breast Medical Oncology The

More information

Genomic Profiling of Tumors and Loco-Regional Recurrence

Genomic Profiling of Tumors and Loco-Regional Recurrence 1 Genomic Profiling of Tumors and Loco-Regional Recurrence Terry Mamounas, M.D., M.P.H., F.A.C.S. Medical Director, Comprehensive Breast Program UF Health Cancer Center at Orlando Health Professor of Surgery,

More information

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 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

More information

Outline of the presentation

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

More information

Objectives Critically review presentations on 1. Local therapy 2. Adjuvant chemotherapy for isolated local regional recurrence 3. The optimal duration

Objectives Critically review presentations on 1. Local therapy 2. Adjuvant chemotherapy for isolated local regional recurrence 3. The optimal duration Objectives Critically review presentations on 1. Local therapy 2. Adjuvant chemotherapy for isolated local regional recurrence 3. The optimal duration of endocrine therapy 4. Advances in HER2 directed

More information

Pro: Hormone Therapy in HR positive MBC is the preferred option!

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,

More information

Breast Cancer Earlier Disease. Stefan Aebi Luzerner Kantonsspital

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

More information

The worldwide overview: updated (2005-6) meta-analyses of hormonal treatment trials

The worldwide overview: updated (2005-6) meta-analyses of hormonal treatment trials The worldwide overview: updated (2005-6) meta-analyses of hormonal treatment trials Richard Gray, for the Early Breast Cancer Trialists Collaborative Group (EBCTCG) Main questions, 2005-6 1) 5 years of

More information

The ALTERNATE trial: assessing a biomarker driven strategy for the treatment of post-menopausal women with ER+/Her2 invasive breast cancer

The ALTERNATE trial: assessing a biomarker driven strategy for the treatment of post-menopausal women with ER+/Her2 invasive breast cancer Review Article Page 1 of 7 The ALTERNATE trial: assessing a biomarker driven strategy for the treatment of post-menopausal women with ER+/Her2 invasive breast cancer Vera Jean Suman 1, Matthew J. Ellis

More information

Biomarkers for HER2-directed Therapies : Past Failures and Future Perspectives

Biomarkers for HER2-directed Therapies : Past Failures and Future Perspectives Biomarkers for HER2-directed Therapies : Past Failures and Future Perspectives Ian Krop Dana-Farber Cancer Institute Harvard Medical School Inchon 2018 Adjuvant Trastuzumab Improves Outcomes in HER2+ Breast

More information

(Neo-) adjuvant endocrine therapy

(Neo-) adjuvant endocrine therapy (Neo-) adjuvant endocrine therapy F. Cardoso, MD Director, Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal ESO Breast Cancer Program Coordinator ESMO Board of Directors & NR Committee Chair

More information

Adjuvant Endocrine Therapy in Pre- and Postmenopausal Patients

Adjuvant Endocrine Therapy in Pre- and Postmenopausal Patients Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Adjuvant Endocrine Therapy in Pre- and Postmenopausal Patients Adjuvant Endocrine Therapy in Pre- and Postmenopausal Patients

More information

Session II: Academic Research in Breast Cancer: Challenges and Opportunities Robert L. Comis, MD ECOG-ACRIN Group Co-Chair

Session II: Academic Research in Breast Cancer: Challenges and Opportunities Robert L. Comis, MD ECOG-ACRIN Group Co-Chair Session II: Academic Research in Breast Cancer: Challenges and Opportunities Robert L. Comis, MD ECOG-ACRIN Group Co-Chair Symposium: Innovation in Breast Cancer 2014 Madrid, Spain February 21, 2014 Cancer

More information

Endocrine therapy as adjuvant or neoadjuvant therapy for breast cancer: selecting the best agents, the timing and duration of treatment

Endocrine therapy as adjuvant or neoadjuvant therapy for breast cancer: selecting the best agents, the timing and duration of treatment Review Article Page 1 of 12 Endocrine therapy as adjuvant or neoadjuvant therapy for breast cancer: selecting the best agents, the timing and duration of treatment Jun-Jie Li, Zhi-Min Shao Department of

More information

Hormonal Management of Metastatic Breast Cancer

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

More information

Systemic Treatment of Breast Cancer. Hormone Therapy and Chemotherapy, Curative and Palliative

Systemic Treatment of Breast Cancer. Hormone Therapy and Chemotherapy, Curative and Palliative Systemic Treatment of Breast Cancer Hormone Therapy and Chemotherapy, Curative and Palliative Systemic Therapy Invasive breast cancers Two forms Curative Palliative Curative Systemic Therapy Adjuvant Therapy

More information

The efficacy of second-line hormone therapy for recurrence during adjuvant hormone therapy for breast cancer

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

More information

SOFTly: The Long Natural History of [Trials for] [premenopausal] ER+ Breast Cancer

SOFTly: The Long Natural History of [Trials for] [premenopausal] ER+ Breast Cancer SOFTly: The Long Natural History of [Trials for] [premenopausal] ER+ Breast Cancer Charles Moertel Lecture May 12, 2017 Gini Fleming Charles Moertel Founder of NCCTG Dedication to high quality clinical

More information

Rationale For & Design of TAILORx. Joseph A. Sparano, MD Albert Einstein College of Medicine Montefiore-Einstein Cancer Center Bronx, New York

Rationale For & Design of TAILORx. Joseph A. Sparano, MD Albert Einstein College of Medicine Montefiore-Einstein Cancer Center Bronx, New York Rationale For & Design of TAILORx Joseph A. Sparano, MD Albert Einstein College of Medicine Montefiore-Einstein Cancer Center Bronx, New York Declining Breast Cancer Mortality & Event Rates in Adjuvant

More information

Giuseppe Viale for the BIG 1 98 Collaborative and International Breast Cancer Study Groups

Giuseppe Viale for the BIG 1 98 Collaborative and International Breast Cancer Study Groups Central Review of ER, PgR and HER2 in BIG 1 98 Evaluating Letrozole vs. Letrozole Tamoxifen vs. Tamoxifen Letrozole as Adjuvant Endocrine Therapy for Postmenopausal Women with Hormone Receptor Positive

More information

Implications of Progesterone Receptor Status for the Biology and Prognosis of Breast Cancers

Implications of Progesterone Receptor Status for the Biology and Prognosis of Breast Cancers 日大医誌 75 (1): 10 15 (2016) 10 Original Article Implications of Progesterone Receptor Status for the Biology and Prognosis of Breast Cancers Naotaka Uchida 1), Yasuki Matsui 1), Takeshi Notsu 1) and Manabu

More information

Advances in Breast Cancer ASCO 2018

Advances in Breast Cancer ASCO 2018 Advances in Breast Cancer ASCO 2018 Wylie Hosmer, MD Hartford Healthcare Cancer Institute Special Thanks to Dawn Holcombe for help with slide preparation TAILORx ASCO Highlights HER2 6 vs 12 Long Term

More information

ASCO 2018 Breast Cancer Highlights

ASCO 2018 Breast Cancer Highlights ASCO 2018 Breast Cancer Highlights Angie DeMichele, MD, MSCE Jill & Alan Miller Endowed Chair in Breast Cancer Excellence Professor of Medicine and Epidemiology Co-Leader, Breast Cancer Program, Abramson

More information

Oncotype DX tools User Guide

Oncotype DX tools User Guide Oncotype DX tools User Guide This guide provides an overview of the data and quick access to the Oncotype DX tools Oncotype DX tools offers two quantitative calculator tools that may be used together with

More information

Treatment of Metastatic Breast Cancer. Prof RCCoombes Imperial College London

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

More information

Index. Note: Page numbers of article titles are in boldface type.

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

More information

A Slow Starvation: Adjuvant Endocrine Therapy of Breast Cancer

A Slow Starvation: Adjuvant Endocrine Therapy of Breast Cancer A Slow Starvation: Adjuvant Endocrine Therapy of Breast Cancer Dr. Susan Ellard Surgical Oncology Update October 24, 2009 Disclosure slide Participant in various meetings or advisory boards sponsored by

More information

Intro to Cancer Therapeutics

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

More information

Overcoming resistance to endocrine or HER2-directed therapy

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

More information

The Oncotype DX Assay A Genomic Approach to Breast Cancer

The Oncotype DX Assay A Genomic Approach to Breast Cancer The Oncotype DX Assay A Genomic Approach to Breast Cancer Pathology: 20 th and 21 st Century Size Age Phenotype Nodal status Protein/Gene Genomic Profiling Prognostic & Predictive Markers Used in Breast

More information

Inibitori delle chinasi ciclino dipendenti nel trattamento della malattia metastatica HR-positiva Gli studi clinici

Inibitori delle chinasi ciclino dipendenti nel trattamento della malattia metastatica HR-positiva Gli studi clinici Inibitori delle chinasi ciclino dipendenti nel trattamento della malattia metastatica HR-positiva Gli studi clinici Laura Orlando UOC Oncologia & Breast Unit Brindisi Verona 22/04/2016 Summary Studi con

More information

Lessons Learnt from Neoadjuvant Hormone Therapy. 10 Lessons Learnt from Neoadjuvant Endocrine Therapy. Lesson 1

Lessons Learnt from Neoadjuvant Hormone Therapy. 10 Lessons Learnt from Neoadjuvant Endocrine Therapy. Lesson 1 Lessons Learnt from Neoadjuvant Hormone Therapy Mike Dixon Clinical Director Breakthrough Research Unit Edinburgh 10 Lessons Learnt from Neoadjuvant Endocrine Therapy 10 Lessons Learnt from Neoadjuvant

More information

Lessons Learnt from Neoadjuvant Hormone Therapy. Mike Dixon Clinical Director Breakthrough Research Unit Edinburgh

Lessons Learnt from Neoadjuvant Hormone Therapy. Mike Dixon Clinical Director Breakthrough Research Unit Edinburgh Lessons Learnt from Neoadjuvant Hormone Therapy Mike Dixon Clinical Director Breakthrough Research Unit Edinburgh 10 Lessons Learnt from Neoadjuvant Endocrine Therapy 10 Lessons Learnt from Neoadjuvant

More information

Updates From San Antonio Breast Cancer Symposium 2017

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

More information