ASCO 2017 BREAST CANCER HIGHLIGHTS
|
|
- Maximilian Warren
- 5 years ago
- Views:
Transcription
1 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 International Group (BIG aisbl), Chair
2 ASCO 2017 Breast Cancer (BC) Highlights The three breaking news Molecular profiling / biomarkers [Locoregional therapy : see text] Plan of the talk Locoregional relapse: chemotherapy (CT)? Randomized trials of CT regimens for high risk BC (luminal B / TNBC / HER2+) TNBC HER2+ BC Luminal BC [Brain metastases : see text] Key messages for clinical practice
3 ASCO 2017 Breast Cancer Highlights The 3 breaking news The end of large adjuvant trials for HER2+ BC The promising results of anti-pd(l)1 incorporation into neoadjuvant CT regimens, even in luminal BC! The positive results of OLYMPIAD (olaparib or CT of physician s choice in BRCA mutation carriers with advanced disease)
4 S U R G E R Y Central confirmation of HER2 status (N = 4805) Randomisation and treatment within 8 weeks of surgery APHINITY: Trial Design R Chemotherapy* + trastuzumab + pertuzumab Chemotherapy* + trastuzumab + placebo Anti-HER2 therapy for a total of 1 year (52 weeks) (concurrent with start of taxane) Radiotherapy and/or endocrine therapy may be started at the end of adjuvant chemotherapy F O L L O W - U P 10 Y E A R S *A number of standard anthracycline-taxane-sequences or a non-anthracycline (TCH) regimen were allowed
5 APHINITY: Statistical Assumptions EXPECTED 3-year IDFS rate* Placebo vs. Pertuzumab HR= % vs. 91.8% (Δ=2.6%) Placebo arm IDFS rate was based on BCIRG 006 data 1, assuming a 35% / 65% node-negative / node-positive split 379 events and 4800 patients required for 80% power and alpha of 5% * IDFS as per FDA definition with exclusion of second primary non BC 1 Slamon D, NEJM 2011
6 APHINITY: Intent-to-Treat Primary Endpoint Analysis Invasive Disease-free Survival 63% N+ 36% HR Number neededto treat: % A-based CT ASCO 2017, LBA 500
7
8 APHINITY: Cardiac Endpoints N (%) Pertuzumab n=2364 Treatment difference (95% CI) Placebo n=2405 Primary cardiac endpoint 17 (0.7) 0.4 (0.0, 0.8) 8 (0.3) Heart failure NYHA III/IV + LVEF drop* Cardiac death** 15 (0.6) 2 (0.08) 6 (0.2) 2 (0.08) Recovered according to LVEF 7 4 Secondary cardiac endpoint Asymptomatic or mildly symptomatic LVEF drop* 64 (2.7) -0.1 (-1.0, 0.9) 67 (2.8) *LVEF drop = ejection fraction drop 10% from baseline AND to below 50%; **Identified by the Cardiac Advisory Board for the trial according to a prospective definition
9 APHINITY: Common Grade 3 Adverse Events Pertuzumab n=2364 Placebo n=2405 Neutropenia 385 (16.3%) 377 (15.7%) Febrile Neutropenia 287 (12.1%) 266 (11.1%) Anaemia 163 ( 6.9%) 113 ( 4.7%) Diarrhoea 232 (9.8%) 90 ( 3.7%) - with chemotherapy and targeted therapy 232 ( 9.8%) 90 ( 3.7%) - with targeted therapy (post-chemotherapy) 12 ( 0.5%) 4 ( 0.2%) - with AC->T (N=1834; 1894) 137 ( 7.5%) 59 ( 3.1%) - with TCH (N= 528; 510) 95 (18.0%) 31 ( 6.1%)
10 N = 180 N = 69 I-SPY 2 TRIAL Schema: HER2- Signatures Presented By Rita Nanda at 2017 ASCO Annual Meeting (abst 506)
11 I-SPY 2 Results Reporting Presented By Rita Nanda at 2017 ASCO Annual Meeting (abst 506)
12 Pembrolizumab graduated in all HER2- signatures:<br />Both HR+/HER2- and TN Presented By Rita Nanda at 2017 ASCO Annual Meeting (abst 506)
13 Adverse Events of Special Interest <br />(including immune-related toxicities) Presented By Rita Nanda at 2017 ASCO Annual Meeting (abst 506)
14 !
15
16
17
18
19 Definition ESMO-MCBS substantial improvements Curative setting A & B or non-curative setting 5 & 4 Curative A B C Non-curative Olaparib PFS HR 0.58 ( ) should be < longer time to deterioration of quality of life Pertuzumab [DFS HR > 0.8]
20 Molecular profiling ASCO 2017 Breast Cancer Highlights is not ready for prime time but is there to stay! Reliable Informative about disease biology (ex. ESR1 mutations ) Broadens access to clinical trials New potential biomarkers of response to therapy FGFR amplification (FISH 2.0) and endocrine resistance (abst 1013) CtDNA drop on day 15 of fulvestrant + palbociclib predicts large benefit (PFS 11m) (abst 1016)
21 ASCO 2017 Breast Cancer Highlights Molecular profiling (plasma/tumor) in MBC N of patients CtDNA N= 318 N= 39/71 with PD on AI Primary tumor/relapse pairing N= 61 pairs Testing Foundation med. (62 genes) ESR1 digital PCR Targeted gene sequencing Results Positivity = 90% Recapitulates known mutations Positivity for mutations = 50% most = polyclonal Shift in clinical subtype means drastic changes at genomic level abstract
22 ASCO 2017 Breast Cancer Highlights Potential new biomarkers of (lack of) response to treatment in MBC N of patients FGFR amplification 95 HR+ MBC ctdna early dynamic change N= 445 patients from PALOMA-3 N 60 patients with baseline / D15 samples Testing FISH Digital pcr (pik3ca / ESR1) Results Positive in 25% (younger patients, PgR ) Linked to shorter TTP under endocrine therapy Baseline: pikca mutation ctdna = 22% ESR1 mutation ctdna = 26% D15: suppression of ctdna more frequent in palbociclib arm and associated with prolonged PFS (± 11m) abstract
23 ASCO 2017 Breast Cancer Highlights Isolated locoregional relapse: chemotherapy YES or NO (CALOR Trial) (abst 513) N= 162 patients Completely resected isolated LR relapse (+ RT if + margins) 104 ER+ 58 ER Endocrine treatment R R CTX CTX CTX CTX 10y follow-up DFS H.R DFS H.R ( ) results
24 ASCO 2017 Breast Cancer Highlights Randomized trials of (neo)adjuvant CT in high risk BC Can we omit anthracyclines?
25 Can we omit anthracyclines in high risk patients? (selected by genomic profiling : oncotype-dx/mammaprint) Plan B trial (abst 504) N = 2116 Mindact trial (abst 516) N = 1301 (mostly N-) C L G H ABC trials (ASCO 2016) N = N+ RS > 11 C H G L C H G H 1-3 N+ N- 4 N+ N RS > 11 4 N+ R R R Doc Cyclo x6 EC x4 Doc x4 Doc-Capecit A/T regimen Doc Cyclo x6 TAC x6 or AC x4 Pwk 5y results 5y results 4y results D.F.S. H.R ( ) D.F.S. H.R ( ) id.f.s. H.R ( )
26 ASCO 2017 Breast Cancer Highlights Randomized trials of (neo)adjuvant CT in high risk BC Does platinum have a special merit or is it just another alkylating agent?
27 ASCO 2017 Breast Cancer Highlights GeparOcto: Platinum weekly or high dose cyclophosphamide? (abst 518) N= 961 o+ TNBC 43% HER2+ 40% N+ 46% G3 66% R E E E P P P C C C S u r 150 mg/sqm 225 mg/sqm 2000 mg/sqm L D P L D P L D P L D P L D P L D P L D P L D P L D P L D P L D P L D P g e r y 20 mg/sqm 80 mg/sq If TNBC Cb weekly If HER2+ Identical pcr rates 48% High toxicity / discontinuation rates: 16% and 34% Severe toxicities (pneumonitis / pneumonia 2 toxic ) E= Epirubicin P= paclitaxel C= cyclophosphamide LD= liposomal doxorubicin Cb= carboplatin trastuz pertuz
28 ASCO 2017 Breast Cancer Highlights Triple Negative Breast Cancer
29 ASCO 2017 Breast Cancer Highlights: TNBC The Brightness trial (abst 520) pcr AC x 4 53% 634 women with TNBC Veliparib 50 mg PO BiD T2-T4 No-2 T1 N1-2 R AC x 4 57% Placebo Carbo AUC 6 mg/ml/min Placebo Carbo Veliparib 50 mg PO BiD Placebo Veliparib Paclitaxel 80 mg/ml/min P L A C E B O Placebo AC x 4 31%
30 ASCO 2017 Breast Cancer Highlights HER2+ B.C.
31 ASCO 2017 Breast Cancer Highlights HER2+ BC: advanced disease N = 1095 > 6 m from adj T 44% de novo met. N = 355 PD after CT + Trastuzumab (75%) A) Update on MARIANNE (abst 1003) R R TDM1 + Pertuzumab TDM1 Docetaxel + Trastuzumab B) The Alternative study : an effective chemo-sparing option (abst 1004) A.I. + Trastuzumab + Pertuzumab A.I. + Trastuzumab A.I. + Lapatinib At median follow-up of 55 m Median OS = 52 m, identical in 3 arms Crossover to TDM1: 18% Crossover to Pertuzumab 10% Better toxicity profile in TDM1 arms PFS 11 m 5.7 m 8.3 m PFS HR 0.62 ( ) p Triplet superior but more toxic (rash/diarrhea)
32 Number of patients APT trial (abst 511) N = 406 (mostly N o HR + ) ASCO 2017 Breast Cancer Highlights HER2+ BC: early disease A) Update on already presented trials NEOALTTO (abst 502) ALTTO (abst 502) N = 455 N = 8381 Regimen(s) Weekly P x12 + Trastuzumab x1y Weekly P + Trastuzumab or Lapatinib or Trastuzumab + Lapatinib then FEC x3 anti HER 2 for 1 year A T or T Cb with Trastuzumab, Lapatinib, Trastuzumab Lapatinib, Trastuzumab + Lapatinib Seq. CTX/anti HER 2 = 55% Medical follow-up 6.5 years 6.5 years 6.9 years (705 events) Results 7y DFS = 93.3% ER+ 94.6% ER 90.7% 7y 7y RFI RFI = 97.5% = 97.5% 4 distant relapses 5 locoregional relapses pcr do better than non pcr (significantly for all and for HR ) But 7y EFS for pcr = 77%! 85% T + L 6y DFS 84% T L (no p value!) 82% T For HR : HR 0.80 T + L
33 ASCO 2017 Breast Cancer Highlights HER2+ BC: early disease B) New trials Neoadjuvant trial TRAIN 2 Adjuvant trial SHORT-HER
34 ASCO 2017 Breast Cancer Highlights HER 2 + BC : the TRAIN 2 neoadjuvant trial Do anthracyclines still provide benefit in the presence of dual HER2 blockade? Stage II/III HER2+BC N=438 R C A R B O F E C P P F E C P P F E C P P P P P P P P P P P P P P P P P P P P P P P P P P S U R G E R Y pcr 67% pcr 68% F (500 mg/sqm) E (90 mg/sqm) C (500 mg/sqm) Carbo AUC 6 mg/ml/min q3 weeks P = 80 mg/sqm day 1+8 No difference! High degree of neurotoxicity! (gr 2 30%) BOOG, abst 507, ASCO 2017
35 [N=2500 needed] N=1250 recruited N = 54% ER+ = 68% Postmenop. = 63% ASCO 2017 Breast Cancer Highlights HER 2 + BC The SHORT-HER adjuvant trial (abst 501) R T D D D E C E C E C E C F E C F E C F E C D D D D 5y DFS HR 1.15 ( ) Docetaxel (100 mg/sqm) FE (60) C E (90) C Trastuzumab Non inferiority margin set at 1.29 Non inferiority can not be claimed Reduced risk of LVEF drops in the short arm T 1 y 85.4% vs 87.5% 5y DFS rates Conte, abst 501
36 ASCO 2017 Breast Cancer Highlights LUMINAL B.C.
37 ASCO 2017 Breast Cancer Highlights Luminal BC: advanced disease The MONARCH-2 Trial (abst 1000)
38
39
40
41
42 ASCO 2017 Breast Cancer (BC) Highlights Luminal BC: CDK4-6 inhibitors for advanced disease MONALEESA-2 PALOMA-1 TREND trial Quality of life (abst. 1020) O.S. (abst. 1001) Palbociclib alone or with ET at PD on ET (abst. 1002) Number of patients N=668 N=165 (median follow-up = 65m) N=115 Type of trial Phase III Randomized phase 2 2 stage non-comparative Treatment arms Letrozole + ribociclib Letrozole + placebo Letrozole + palbociclib Letrozole PD on ET same ET + palbociclib Palbociclib alone Results Similar time to quality of life deterioration Med OS 36m vs 33m (pns) Similar clinical benefit rates of 55-60%
43 ASCO 2017 Breast Cancer Highlights Luminal BC: early disease The SOLE Trial (abst 503)
44 SOLE: Study of Letrozole Extension<br />After 4 to 6 years of Prior Adjuvant Endocrine Therapy<br />Postmenopausal, HR-positive, Node-positive Presented By Marco Colleoni at 2017 ASCO Annual Meeting
45 Statistical Considerations Presented By Marco Colleoni at 2017 ASCO Annual Meeting
46 Characteristics Presented By Marco Colleoni at 2017 ASCO Annual Meeting
47 Primary Endpoint: Disease-Free Survival Presented By Marco Colleoni at 2017 ASCO Annual Meeting
48 SOLE: Conclusions Presented By Marco Colleoni at 2017 ASCO Annual Meeting
49 ASCO 2017 Breast Cancer (BC) Highlights Luminal BC: early disease The Korean NEST neoadjuvant trial (abst. 516) N= 174 premonopausal HER2 ER+ (Allred 5) Node+ R AC x 4 T x 4 24 weeks 24 weeks Zoladex + Tamoxifen S u r g e r y RR pcr Breast pcr Nodes Switch to 84% 3% 14% 13% 71% 1% 5% 7% But very similar results if Ki67 20%!
50 ASCO 2017 Breast Cancer (BC) Highlights Luminal BC: early disease The FATA-GIM3 trial (Italy) with a 3x2 factorial design (abst. 515) N= 3697 Anastrozole Upfront AI x 5y 89.8% 5y DFS Median age : 64y Node 64% HER2+ 9% Adj CTX 38% R Exemestane R 5y DFS HR 0.89 (95% CI pns) Letrozole Tam x 2y AI x 3y 88.5% 5y DFS No difference Very small difference (pns)
51 ASCO 2017 Breast Cancer Highlights Take home messages for clinical pratice
52 ASCO 2017 Breast Cancer (BC) Highlights Messages for clinical practice Early disease Locoregional relapse Advanced disease TNBC HER2 BC Luminal BC BRCA Mutation Carbo pcr in well designed Brightness trial but long-term outcome still unknown Consider dual HER2 blockade (P+T) if N+ / ER Intermittent AI in y 5 to 10? Hope for anti-pd(l)1 + chemo as neoadjuvant therapy If ER and complete excision chemo to be considered (CALOR trial) Dual HER2 blockade (T+P) + AI = effective chemo sparing option Abemaciclib: new option in ET resistant patients, in combination with fulvestrant (MONARCH-2) Olaparib likely to be a new standard of care (ESMO clinical benefit scale: 4)
53 ESMO Magnitude of Clinical Benefit Scale! SURVEY! Deadline 30 th June 2017
54 ASCO 2017 Breast Cancer (BC) Highlights Messages for clinical practice Small volume disease and HR+ Early HER2+ BC Large volume disease and/or HR Tolaney regimen Consider dual HER2 blockade Cost considerations (US) (trastuzumab + pertuzumab) Trastuzumab Trastuzumab + Pertuzumab Trastuzumab + Lapatinib Trastuzumab x 9 weeks $ $ $ $ N+ / ER+ : how to position sequential trastuzumab neratinib?
55 Thank you!!!
56 Back up
57 Demographics Presented By Rita Nanda at 2017 ASCO Annual Meeting (abst 506)
58
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 informationSustained benefits for women with HER2-positive early breast cancer JORGE MADRID BIG GOCCHI PROTOCOLO HERA
Sustained benefits for women with HER2-positive early breast cancer JORGE MADRID BIG GOCCHI PROTOCOLO HERA The fascinating history of Herceptin 1981 1985 1987 1990 1992 1998 2000 2005 2006 2008 2011 Murine
More informationSystemic Therapy of HER2-positive Breast Cancer
Systemic Therapy of HER2-positive Breast Cancer Tanja Cufer, MD, PhD University Clinic Golnik, Medical Faculty Ljubljana, Slovenia ESO ESMO Masterclass, Belgrade 2017 Relative Risk HER2-positive Breast
More informationUpdate 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 informationSystemic Therapy of HER2-positive Breast Cancer
Systemic Therapy of HER2-positive Breast Cancer Tanja Cufer, MD, PhD University Clinic Golnik, Medical Faculty Ljubljana, Slovenia ESO ESMO Masterclass, Belgrade 2018 HER2-positive Breast Cancer Adjuvant
More informationBreast Cancer: ASCO Poster Review
Breast Cancer: ASCO Poster Review Carmen Criscitiello, MD, PhD Istituto Europeo di Oncologia Milano HER2+ SUBTYPE Research questions in early HER2+ BC De-escalation of toxicity without compromising efficacy
More informationWhen 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 informationBREAST CANCER SLIDE DECK 2017 Selected abstracts from:
BREAST CANCER SLIDE DECK 2017 Selected abstracts from: 2017 ASCO ANNUAL MEETING 2 6 June 2017 Chicago, USA Supported by Eli Lilly and Company. Eli Lilly and Company has not influenced the content of this
More informationNovel Preoperative Therapies for HER2-Positive Breast Cancer. Debu Tripathy, MD University of Southern California Norris Comprehensive Cancer Center
Novel Preoperative Therapies for HER2-Positive Breast Cancer Debu Tripathy, MD University of Southern California Norris Comprehensive Cancer Center Key Findings to Date in the Neoadjuvant Therapy of HER2+
More informationThe Role of Pathologic Complete Response (pcr) as a Surrogate Marker for Outcomes in Breast Cancer: Where Are We Now?
1 The Role of Pathologic Complete Response (pcr) as a Surrogate Marker for Outcomes in Breast Cancer: Where Are We Now? Terry Mamounas, M.D., M.P.H., F.A.C.S. Medical Director, Comprehensive Breast Program
More informationNeo-adjuvant and adjuvant treatment for HER-2+ breast cancer
Neo-adjuvant and adjuvant treatment for HER-2+ breast cancer Angelo Di Leo «Sandro Pitigliani» Medical Oncology Unit Hospital of Prato Istituto Toscano Tumori Prato, Italy NOAH: Phase III, Open-Label Trial
More informationAny News in EBC? Ann H. Partridge, MD, MPH Dana-Farber Cancer Institute November 11, 2016
Any News in EBC? Ann H. Partridge, MD, MPH Dana-Farber Cancer Institute November 11, 2016 Yes! Age disparities vary by tumor subtype Genomic risk prediction data in young women Adjuvant systemic therapy
More informationPost-ESMO 2012: Tamara Rordorf Klinik für Onkologie UniversitätsSpital Zürich T.Rordorf, SAMO Luzern 1
Post-ESMO 2012: Breast Cancer Tamara Rordorf Klinik für Onkologie UniversitätsSpital Zürich 1 Neoadjuvant treatment (in Her-2 positive disease) neoadjuvant trials abstracts: breast sparing surgery, biomarkers,
More informationUpdates 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 informationDisease 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
More informationEARLY STAGE BREAST CANCER ADJUVANT CHEMOTHERAPY. Dr. Carlos Garbino
EARLY STAGE BREAST CANCER ADJUVANT CHEMOTHERAPY Dr. Carlos Garbino EARLY BREAST CANCER ADJUVANT CHEMOTHERAPY SUSTANTIVE DIFFICULTIES FOR A WORLDWIDE APPLICABILITY DUE TO IMPORTANT INEQUALITIES + IN DIFFERENT
More informationDR LUIS MANSO UNIDAD TUMORES DE MAMA Y GINECOLÓGICOS HOSPITAL 12 DE OCTUBRE MADRID
DR LUIS MANSO UNIDAD TUMORES DE MAMA Y GINECOLÓGICOS HOSPITAL 12 DE OCTUBRE MADRID RESUMEN DE ARTICULOS THERESA BOLERO 3 NOAH UP-DATE GEPAR SIXTO RADIOTHERAPY EBCTCG CTCs MISCELANEAS Lancet Oncol 2014;
More informationPositive HER-2 tumor. How to incorporate the new drugs into neoadjuvance
Oncology Department Vall d Hebron University Hospital Barcelona. Spain Positive HER-2 tumor. How to incorporate the new drugs into neoadjuvance Javier Cortés June/2013 MD Anderson experience Buzdar et
More informationOvercoming 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 informationMetastatic 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 informationSystemic 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,
More informationTargeting 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 informationSesiones 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 informationAppendix 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
More informationBreast : ASCO Abstracts for Review
Breast : ASCO 2011 Susana Campos, MD, MPH Dana Farber Cancer Institute Abstracts for Review Prevention Neoadjuvant Metastatic Brain mets LBA 504: Exemestane for primary prevention of breast cancer in postmenopausal
More informationMetastatic 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 informationLocally Advanced Breast Cancer: Systemic and Local Therapy
Locally Advanced Breast Cancer: Systemic and Local Therapy Joseph A. Sparano, MD Professor of Medicine & Women s Health Albert Einstein College of Medicine Associate Chairman, Department of Oncology Montefiore
More informationRecent 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
More informationThe next wave of successful drug therapy strategies in HER2-positive breast cancer. Hans Wildiers University Hospitals Leuven Belgium
The next wave of successful drug therapy strategies in HER2-positive breast cancer Hans Wildiers University Hospitals Leuven Belgium Trastuzumab in 1st Line significantly improved the prognosis of HER2-positive
More informationA 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
More informationBest 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 informationJules Bordet Institute, Brussels, Belgium Université Libre de Bruxelles Breast International Group (BIG aisbl), Chair ESMO President
Symposium «Evaluation of the Belgian Cancer Plan» Brussels, November 26th, 2012 Personalized oncology in Europe: only a dream if national health systems do not get involved in diagnostics and pivotal cancer
More informationSystemic Therapy for Locally Advanced Breast Cancer
Systemic Therapy for Locally Advanced Breast Cancer Soo-Chin Lee Head & Senior Consultant Department of Haematology-Oncology National University Cancer Institute, Singapore Clinical Care Senior Principal
More informationExiste-t-il un sous groupe à risque qui pourrait bénéficier d une modification de la durée de traitement par trastuzumab? X. Pivot CHRU De Besançon
Existe-t-il un sous groupe à risque qui pourrait bénéficier d une modification de la durée de traitement par trastuzumab? X. Pivot CHRU De Besançon In 25 results of 4 Adjuvant Herceptin trials have definitively
More informationASCO 2018 Breast Cancer updates. June 29 th 2018 Einav Gal-Yam Sheba MC
ASCO 2018 Breast Cancer updates June 29 th 2018 Einav Gal-Yam Sheba MC Early BC Adjuvant Chemotherapy benefit in HR-pos Nneg BC TAILORX Slide 1 Presented By Joseph Sparano at 2018 ASCO Annual Meeting TAILORx
More informationCOME 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
More information(Neo)Adjuvant Chemotherapy and biological Agents (essentials in HER2 and TN early breast cancer)
(Neo)Adjuvant Chemotherapy and biological Agents (essentials in HER2 and TN early breast cancer) Giuseppe Curigliano MD, PhD Breast Cancer Program Division of Experimental Therapeutics Outline Neoadjuvant
More informationInibitori 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 informationHER2-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
More informationBREAST CANCER RISK REDUCTION (PREVENTION)
BREAST CANCER RISK REDUCTION (PREVENTION) Articles Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled
More informationWhat 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 informationUpdate 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
More informationEvolving Insights into Adjuvant Chemotherapy. Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology
Evolving Insights into Adjuvant Chemotherapy Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology 80 70 60 50 40 30 20 10 0 EBCTCG 2005/6 Overview Control Arms with No Systemic
More informationHighlights in breast cancer
CONGRESS HIGHLIGHTS SPECIAL EDITION 309 Highlights in breast cancer W. Lybaert, MD In this article, the most important new studies presented at ESMO 2017 in Madrid in early (EBC) and metastatic breast
More informationDR. BOMAN N. DHABHAR Consulting Oncologist Jaslok Hospital, Fortis Hospital Mulund, Wockhardt Hospital Mumbai & BND Onco Centre INDIA
Recent Advances of Docetaxel in Management of Breast Cancer DR. BOMAN N. DHABHAR Consulting Oncologist Jaslok Hospital, Fortis Hospital Mulund, Wockhardt Hospital Mumbai & BND Onco Centre INDIA 1 ADJUVANT
More informationTreatment of Early Stage HER2-positive Breast Cancer (One size does not fit all)
Treatment of Early Stage HER2-positive Breast Cancer (One size does not fit all) 8 November 2014 Edward H. Romond, M.D. Professor of Medicine Lucille Parker Markey Cancer Center University of Kentucky
More informationThe Expert Thoughts. Alessandra Fabi Oncologia Medica 1
The Expert Thoughts Alessandra Fabi Oncologia Medica 1 My Thoughts Neoadjuvant: from the lessons of the history Adjuvant: Escalation and De-escalation Advanced and HER2+ : field for immunomodulation Brain
More informationLecture 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 informationASCO and San Antonio Updates
ASCO and San Antonio Updates 30 th Annual Miami Breast Cancer Conference March 7-10, 2013 Debu Tripathy, MD Professor of Medicine University of Southern California Norris Comprehensive Cancer Center Breakthroughs
More informationExpanding 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
More informationTriple negative breast cancer -neoadjuvant and adjuvant systemic therapy
Triple negative breast cancer -neoadjuvant and adjuvant systemic therapy Sung-Bae Kim, MD, PhD Department of Oncology Asan Medical Center University of Ulsan College of Medicine Seoul, Korea DISCLOSURE
More informationEndocrine 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 informationFDA Briefing Document Oncologic Drugs Advisory Committee Meeting. September 12, sbla /51 Pertuzumab (PERJETA ) Applicant: Genentech, Inc.
/51 FDA Briefing Document Oncologic Drugs Advisory Committee Meeting September 12, 2013 /51 Pertuzumab (PERJETA ) Applicant: Genentech, Inc. Disclaimer: The attached package contains background information
More informationBiomarkers 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 informationPredicting 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
More informationHer 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,
More informationBreast 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;
More information(NEO-)ADJUVANT THERAPY FOR HER-2+ EBC
(NEO-)ADJUVANT THERAPY FOR HER-2+ EBC Rebecca Dent, MD FRCP (Canada) Senior Consultant, National Cancer Center Singapore Associate Professor, Duke-NUS www.abc-lisbon.org When to question a pathology report?
More informationReview of adjuvant and neo-adjuvant abstracts from SABCS 2011 January 7 th 2012
Review of adjuvant and neo-adjuvant abstracts from SABCS 2011 January 7 th 2012 Ruth M. O Regan, MD Professor and Vice-Chair for Educational Affairs, Department of Hematology and Medical Oncology, Emory
More informationTriple Negative Breast cancer New treatment options arenowhere?
Triple Negative Breast cancer New treatment options arenowhere? Ofer Rotem, M.D., B.Sc. Breast Unit, Davidoff center Rabin Medical center October 2017 Case 6/2013 - M.D., 38 years old woman, healthy, no
More informationNew Targeted Agents Demonstrate Greater Efficacy and Tolerability in the Treatment of HER2-positive Breast Cancer
New Evidence reports on presentations given at ASCO 2012 New Targeted Agents Demonstrate Greater Efficacy and Tolerability in the Treatment of HER2-positive Breast Cancer Presentations at ASCO 2012 Breast
More informationDennis 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
More informationXII Michelangelo Foundation Seminar
XII Michelangelo Foundation Seminar The opportunity of the neoadjuvant approach L. Gianni, Milan, I XII Michelangelo Foundation Seminar Milano, October 12, 2012 The opportunity of the neoadjuvant approach
More informationNadia Harbeck Breast Center University of Cologne, Germany
Evidence in Favor of Taxane Based Combinations and No Anthracycline in Adjuvant and Metastatic Settings Nadia Harbeck Breast Center University of Cologne, Germany Evidence in Favor of Taxane Based Combinations
More informationNeoadjuvantTreatment In BC When, How, Who?
NeoadjuvantTreatment In BC When, How, Who? Clifford Hudis, M.D. Chief, Breast Cancer Medicine Service, MSKCC Professor of Medicine, Weill Cornell Medical College President, ASCO 15 Potential Benefits Of
More informationTriple 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
More informationAdjuvant 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 informationersonalized adjuvant therapy based on clinica trials in breast cancer: dream or reality?
Global Breast Cancer Conference Jeju Island, Korea 20-22 April 2017 ersonalized adjuvant therapy based on clinica trials in breast cancer: dream or reality? Martine J. Piccart Gebhart, MD, PhD Institut
More information(Neo) Adjuvant systemic therapy for HER-2+ EBC
(Neo) Adjuvant systemic therapy for HER-2+ EBC F. Cardoso, MD Director, Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal ESMO Board of Directors & NR Committee Chair ESO Breast Cancer Program
More informationUK 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 informationNovel Preoperative Therapies for HER2-Positive Breast Cancer
Key Findings to Date in the Neoadjuvant Therapy of H2+ Breast Cancer Novel Preoperative Therapies for H2-Positive Breast Cancer Debu Tripathy, MD University of Southern California Norris Comprehensive
More informationConsiderations in Adjuvant Chemotherapy. Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology
Considerations in Adjuvant Chemotherapy Joyce O Shaughnessy, MD Baylor Sammons Cancer Center Texas Oncology US Oncology 80 70 60 50 40 30 20 10 0 EBCTCG 2005/6 Overview Control Arms with No Systemic Treatment
More informationEnfermedad con sobreexpresión de HER-2 neu
Enfermedad con sobreexpresión de HER-2 neu Elsa Dalmau Parc Taulí Sabadell. Hospital Universitari. Enfermedad con sobreexpresión de HER-2 neu ÍNDICE Neoadyuvancia Adyuvancia Enfermedad avanzada Enfermedad
More informationTreatment of Early-Stage HER2+ Breast Cancer
Treatment of Early-Stage HER2+ Breast Cancer Chau T. Dang, MD Chief, MSK Westchester Medical Oncology Service Breast Medicine Service Memorial Sloan Kettering Cancer Center Disclosures I have research
More informationRecent 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 informationClinical Research on PARP Inhibitors and Triple-Negative Breast Cancer (TNBC)
Clinical Research on PARP Inhibitors and Triple-Negative Breast Cancer (TNBC) Eric P Winer, MD Disclosures for Eric P Winer, MD No real or apparent conflicts of interest to disclose Key Topics: PARP and
More informationEARLY 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,
More informationThe Three Ages of Systemic Adjuvant Therapy for EBC
The Three Ages of Systemic Adjuvant Therapy for EBC 1896-2018 Nicholas Wilcken Westmead Hospital Petersham Institute University of Sydney Questions to be answered (concentrating on chemotherapy) Why should
More informationMultimedia 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 informationTriple-Negative Breast Cancer
June 2017 Triple-Negative Breast Cancer Amir Sonnenblick, MD, PhD Sharett institute of oncology Hadassah-Hebrew university medical center, Jerusalem, Israel This presentation is the intellectual property
More informationA case of a BRCA2-mutated ER+/HER2 breast cancer during pregnancy
ESMO Preceptorship Programme Breast Cancer Lisbon 16,17 September 2016 Emanuela Risi Sandro Pitigliani Medical Oncology Department Hospital of Prato, Istituto Toscano Tumori, Prato, Italy A case of a BRCA2-mutated
More informationEndocrine treatment might NOT be the preferred option in Hrpos MBC. Dr. Mircea Dediu Sanador Hospital Bucharest Summer School Bucharest 2015
Endocrine treatment might NOT be the preferred option in Hrpos MBC Dr. Mircea Dediu Sanador Hospital Bucharest Summer School Bucharest 2015 Overall survival not improved by the AI treatment Benefit in
More informationTriple Negative Breast Cancer
GASCO 2016 San Antonio Breast Cancer Symposium Review Triple Negative Breast Cancer Amelia Zelnak, MD, MSc Atlanta Cancer Care Northside Hospital Cancer Institute Disclosures: consultant for Novartis,
More informationImmunoconjugates 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
More informationBreast 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 informationKarcinom dojke. PANEL: Semir Bešlija, Zdenka Gojković, Robert Šeparović, Tajana Silovski
Karcinom dojke PANEL: Semir Bešlija, Zdenka Gojković, Robert Šeparović, Tajana Silovski MBC: HER2 PHEREXA: Study Design Multicenter, randomized, open-label phase III trial Stratified by prior CNS disease,
More informationXII Michelangelo Foundation Seminar
XII Michelangelo Foundation Seminar Paradigm shift? The Food and Drug Administration collaborative project P. Cortazar, Silver Spring, USA FDA Perspective: Moving from Adjuvant to Neoadjuvant Trials in
More informationCurrent and Future perspectives of HER2+ BC
2018.4.6 GBCC Satellite symposium Current and Future perspectives of HER2+ BC Jee Hyun Kim, M.D., Ph.D. Seoul National University Bundang Hospital Seoul National University College of Medicine Disclaimer
More informationTRIALs 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 informationRoohi Ismail-Khan, MD, MS
Roohi Ismail-Khan, MD, MS Associate Member Department of Breast Oncology H. Lee Moffitt Cancer Center Associate Professor University of South Florida Department of Oncological Sciences September 27, 2018
More informationDieta 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
More informationAdjuvant Chemotherapy TNBC & HER2 Subtype
Adjuvant Chemotherapy TNBC & HER2 Subtype 2015.08.15 Gun Min Kim Yonsei Cancer Center Division of Medical Oncology Department of Internal Medicine Yonsei University College of Medicine gmkim77@yuhs.ac
More informationBeyond 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,
More informationMEDICAL ONCOLOGY NEWS IN BREAST CANCER 2014
MEDICAL ONCOLOGY NEWS IN BREAST CANCER 2014 Dr Thomas Yau Clinical Assistant Professor MBBS(HK), MRCP (UK), FHKCP (Med Onc), FHKAM( Medicine), FRCP(London) Queen Mary Hospital The University of Hong Kong
More informationTreatment 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 informationNon-anthracycline Adjuvant regimens in Early Breast Cancer. Yeesoo Chae, MD, PhD Medical Oncology Kyungpook National University Medical Center
Non-anthracycline Adjuvant regimens in Early Breast Cancer Yeesoo Chae, MD, PhD Medical Oncology Kyungpook National University Medical Center Contents Role of Anthracyclines in adjuvant treatment EBCTCG2012
More informationNon-Anthracycline Adjuvant Therapy: When to Use?
Northwestern University Feinberg School of Medicine Non-Anthracycline Adjuvant Therapy: When to Use? William J. Gradishar MD Betsy Bramsen Professor of Breast Oncology Director, Maggie Daley Center for
More informationHER2-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
More informationGene Signatures in Breast Cancer: Moving Beyond ER, PR, and HER2? Lisa A. Carey, M.D. University of North Carolina USA
Gene Signatures in Breast Cancer: Moving Beyond ER, PR, and HER2? Lisa A. Carey, M.D. University of North Carolina USA When Are Biomarkers Ready To Use? Same Rules for Gene Expression Panels Key elements
More informationRIBOCICLIB EN PRIMERA LINEA DE TRATAMIENTO. Dra. Elena Aguirre H.U. Miguel Servet
RIBOCICLIB EN PRIMERA LINEA DE TRATAMIENTO Dra. Elena Aguirre H.U. Miguel Servet INTRODUCTION ADVANCED BREAST CANCER HR+/HER2- YES Consider Chemo VISCERAL CRISIS? NO Endocrine Therapy X3 Toxicity Progresive
More information