Alternativas terapéuticas en fenotipo triple negativo Javier Cortes, Hospital Universitario Ramon y Cajal, Madrid
|
|
- Owen Sparks
- 5 years ago
- Views:
Transcription
1 Alternativas terapéuticas en fenotipo triple negativo Javier Cortes, Hospital Universitario Ramon y Cajal, Madrid Vall d Hebron Institute of Oncology (VHIO), Barcelona
2 Triple Negative Breast Cancer Immunohistochemistry ER PR HER2 ER and PR <1% nuclear Histology HER2 negative : IHC 0 or 1+ staining or 2+ IHC staining with negative FISH High grade ductal
3 Poor Outcome of Metastatic TNBC (N=112) Initial therapy Time on Treatment First distant relapse 12 weeks 9 weeks 4 weeks Median D.F.I. First line chemo Second line chemo Third line chemo Kassam F, Enright K, Dent et al. Clin Breast Cancer 2009
4 What is Standard Therapy For TNBC? No specific systemic regimen guidelines exist Little data on which to base decisions Few historical controls making it challenging to design clinical trials for this subgroup
5 TNBC: Current Treatment Strategies Anthracyclines Capecitabine Biologic agents Taxanes Platinum agents TNBC paradox: chemosensitive but relapse more aggressive with worse OS Cannot treat with existing targeted therapies (hormonal therapy or trastuzumab) Manage same as other BCs with same grade & stage Limited data available from prospective trials in this population Best available data mostly subpopulation analyses
6 Martin et al, ASCO 2009 CMTN: Antraciclinas vs. Docetaxel CMTN HER2 Luminal B Docetaxel 100 mg/m 2 x 4 ciclos Doxorrubicin 75 mg/m 2 x 4 ciclos Single agent Neoadjuvant Chemotherapy study with Doxorubicin or Docetaxel for 4 cycles in Stage II-IIIa (> 3 cm) pcr rate by phenotype
7 Taxanes For Metastatic TNBC? Retrospective subgroup analyses Placebo arm data Trial Phase N Setting Taxane Outcome in TNBC CALGB III 44 First- or second-line metastatic ECOG III 110 First-line metastatic AVADO 3 III 52 First-line metastatic Paclitaxel weekly and q3w Paclitaxel weekly Docetaxel q3w ORR = 26% TTF = 2.8 months OS = 8.6 months ORR = 11.7% 4 PFS = 5.3 months ORR = 23.1% PFS = 6.1 months 1. Harris, et al. Br Cancer Res O Shaughnessy, et al. SABCS Glaspy, et al. EBCC 2010
8 Proportion not progressed Probability of Survival Which taxane? 1.00 Nab-paclitaxel (n = 229) 1.00 Paclitaxel (n = 224) Investigator-Assessed Survival 0.75 P = HR = Median = 23.0 wks ( ) Median = 16.9 wks ( ) Wk nab-paclitaxel 150 mg/m 2 q3w (n = 74) 33.8 months nab-paclitaxel 300 mg/m 2 q3w (n = 76) 27.7 months Docetaxel 100 mg/m 2 q3w (n = 74) 26.6 months nab-paclitaxel 100 mg/m 2 q3w (n = 76) 22.2 months Months Gradishar W, et al. JCO 2005; Gradishar W, et al. JCO 2009
9 Which taxane? Lessons learnt from the neoadjuvant setting HER, human epidermal growth factor receptor; HR, hormone receptor; nab-p, nab-paclitaxel; pcr, pathological complete response; sb-p, solvent-based paclitaxel; SPARC, secreted protein acidic and rich in cysteine. Untch M, et al. SABCS 2015
10 Proportion Progression-Free CALGB NCCTG N063H - CTSU N = 900 (planned) Strata: Adj taxanes ER/PR status Exp 1 Control Exp 2 nab-paclitaxel 150 mg/m 2 weekly + bevacizumab 10 mg/kg q 2 wks 2 paclitaxel 90 mg/m 2 weekly + bevacizumab 10 mg/kg q 2 wks 1 ixabepilone 16 mg/m 2 weekly + bevacizumab 10 mg/kg q 2 wks 3 Restage q 2 cycles until disease progressio n Progression-Free Survival Comparison HR P-value 95% CI Pac Nab Ixa nab vs. pac ixa vs. pac 1.53 < Months From Study Entry
11 Capecitabine For Metastatic TNBC? Retrospective subgroup analyses Placebo arm data Trial Phase N Setting Treatment Outcome in TNBC Pooled analysis 1 III 208 Third-line or greater metastatic Capecitabine ORR = 15% PFS = 1.7 months RIBBON-1 2 III 50 First-line metastatic Capecitabine + placebo ORR = 24% PFS = 4.2 months 1. Rugo, et al. SABCS Glaspy, et al. EBCC 2010
12 TNT: Carboplatin vs Docetaxel in Advanced TNBC or BRCA1/2+ BC Patients with ER-, PgR-/unknown, and HER2- or BRCA1/2+ metastatic or recurrent LA BC (N = 376) Carboplatin AUC6 q3w x 6 cycles (n = 188) Docetaxel 100 mg/m 2 q3w x 6 cycles ( n = 188) For both arms, crossover upon progression allowed Primary endpoint: ORR in ITT population Secondary endpoints: PFS, OS, ORR (crossover), toxicity Subgroup analyses: BRCA1/2 mutation, basal-like subgroups, HRD biomarkers Tutt A, et al. SABCS 2014
13 Response at Cycle 3 or 6 (%) Carboplatin vs Docetaxel in Advanced TNBC or BRCA1/2+ BC (TNT): ORR Carboplatin Docetaxel Crossover P = % % P = % P = % 25.6% 33.3% P = % 28.1% 10 0 All Pts (n = 376) C D D C Crossover* (All pts; n = 182) BRCA1/2 Mutation (n = 43) No BRCA1/2 Mutation (n = 273) Tutt A, et al. SABCS 2014
14 Carboplatin vs Docetaxel in Advanced TNBC or BRCA1/2+ BC (TNT): Survival Survival, Mos Carboplatin Docetaxel Median PFS BRCA 1/2 mutated BRCA 1/2 not mutated Median OS Tutt A, et al. SABCS 2014
15
16
17
18 PFS estimate PFS estimate PFS estimate PFS estimate Bevacizumab-based Therapy: Significant Improvement in PFS E2100 (IRF assessment) 1 Bevacizumab + paclitaxel (n=368) Paclitaxel (n=354) 11.3 HR=0.48* ( ) p< Time (months) AVADO 2 Bevacizumab + docetaxel (n=247) Placebo + docetaxel (n=241) HR=0.67* ( ) p< RIBBON-1: taxane/anthracycline cohort Bevacizumab + taxane/ anthracycline (n=415) Placebo + taxane/anthracycline (n=207) HR=0.64* ( ) p< Time (months) RIBBON-1: capecitabine cohort 3 Bevacizumab + capecitabine (n=409) Placebo + capecitabine (n=206) HR=0.69* ( ) p= Time (months) Time (months) *Censored for non-protocol therapy before disease progression 15mg/kg q3w; Exploratory p-value 1. Gray, et al. JCO 2009; 2. Miles, et al. JCO Robert, et al. ASCO 2009
19 Meta-analysis:Analysis of PFS by Subgroups O Shaughnessy et al. ASCO 2010
20 ESME Program: Bevacizumab For MBC Delagoge S, et al, ASCO 2016
21 ESME Program: Bevacizumab For Metastatic TNBC Delagoge S, et al, ASCO 2016
22 Deconstructing the molecular portraits of breast cancer Basal-like Claudin-low HER2-enriched Normal-like Luminal A and B Prat & Perou Mol Oncol 2011; Prat et al. BCR 2010
23 Identification of Human TNBC Subtypes Basal-like 1: Cell cycle, DNA repair and proliferation genes Basal-like 2: Growth factor signaling (EGFR, MET, Wnt, IGF1R) IM: Immune cell processes (medullary breast cancer) M: Cell motility and differentiation, EMT processes MSL: Similar to M but growth factor signaling, low levels of proliferation genes (metaplastic cancers) LAR: Androgen receptor and downstream genes, luminal features Lehmann BD, et al. J Clin Invest. 2011
24 LAR Triple negative breast cancer is comprised of 6 molecularly distinct subtypes 10% are Luminal AR (LAR) LAR express higher levels of AR mrna vs other TNBC subtypes LAR breast cancers are heavily enriched in hormonally-regulated pathways Luminal AR is more closely related to hormone receptor positive breast cancer (Luminal A and B) than to other subtypes BL= Basal Like, IM = Immunomodulatory, ML= Mesenchymal-Like, MSL= Mesenchymal Stem-like, LAR = Luminal AR
25 LAR
26 LAR Traina TA, et al, SABC 2014
27 PFS (%) PFS (%) Progression-Free Survival by PREDICT AR Status ITT Population 0 1 Prior Regimens 100 n = n = PREDICT AR+ mpfs 16.0 weeks (95% CI: 10.4, 26.1) PREDICT AR+ mpfs 32.3 weeks (95% CI: 14.7, 60.3) PREDICT AR mpfs 8.0 weeks (95% CI: 7.1, 12.6) PREDICT AR mpfs 8.3 weeks (95% CI: 7.1, 15.7) Weeks Patients at risk PREDICT AR+ PREDICT AR Weeks ITT = Intent to Treat; mpfs = median progression-free survival; CI = confidence interval Cortes J, et al, ECCO 2015
28 Overall Survival (%) Overall Survival by PREDICT AR Status 100 ITT Population n = PREDICT AR+ mos 75.6 weeks (95% CI: 51.6, 91.4) PREDICT AR mos 32.3 weeks (95% CI: 20.7, 48.3) 0 Patients at risk PREDICT AR+ PREDICT AR Weeks PREDICT AR+ mos 18.0 months PREDICT AR mos 7.5 months Data cutoff 1Jul2015 ITT = intent to treat; mos = median survival; CI = confidence interval;. Cortes J, et al, ECCO 2015
29 IM Tumor cell X X T cell Anti-PDL1 X X Lung T cell Anti-PDL1 X X Akbari O, et al. Mucosal Immunol. 2010; Matsumoto K, et al. Biochem Biophys Res Commun. 2008; Chen, et al. Immunity, 2013 Dendritic cell
30 Mutational load: somatic mutations act as tumor antigens Lawrence et al, Nature 2013
31 Breast cancer has fewer mutations p<0.0001
32 Objective responses to PD-1/PD-L1 blockade in advanced TNBC Merck anti-pd1 Ab Genentech anti-pd-l1 Ab ORR 18% centrally reviewed N=32 58% PDL1+ 1% Three ORRs >1 year duration ORR 19% centrally reviewed N=21 (4 ORR +3 pseudoprogression) 23% PDL1+ IHC 2+/3+ 5%/10% Nanda 2014; Emens 2015
33 ML, MSL Eribulin Mesylate (E7389): A Novel Tubulin Targeted Agent
34 ML, MSL Eribulin Mesylate (E7389): EMT to MET phenoype Yoshida T, et al. Br J Cancer 2014
35 ML, MSL Eribulin Mesylate (E7389): EMT to MET phenoype Migration Invation Yoshida T, et al. Br J Cancer 2014
36 EMBRACE Trial: Eribulin vs TPC Overall results (n=762) Age Race Receptor status No. of organs involved Sites of disease <40 (n=51) 40 - <65 (n=560) 65 (n=151) Caucasian (n=703) Non-Caucasian (n=59) ER/PR + (n=528) ER/PR - (n=187) Unknown (n=47) ER/PR/HER2-negative (n=144) 2 (n=537) >2 (n=217) Visceral (n=624) Non-Visceral (n=130) Hazard ratio (95% CI) Favors ERIBULIN Favors TPC Based upon a stratified Cox analysis including geographic region, HER2 status, and prior capecitabine therapy as strata TPC: Treatment of Physician's Choice Cortes et al. Lancet 2011
37 Eribulin vs Capecitabine (Study 301) TN population Kaufman P, et al. JCO 2015
38 TNBC Subtypes: (Some) Research Strategies Basal-like 1: Cell cycle, DNA repair and proliferation genes PARPi, ± DNA damaging agents homologous recombination deficiency assay (BRCA-1 ness) Basal-like 2: Growth factor signaling (EGFR, MET, Wnt, IGF1R) IM: Immune cell processes (medullary breast cancer) M: Cell motility and differentiation, EMT processes MSL: Similar to M but growth factor signaling, low levels of proliferation genes (metaplastic cancers) LAR: Androgen receptor and downstream genes, luminal features EGFR (cetuximab, lapatinib) Self-renewal pathways (stem cell) Wnt Notch (PF , AACR 2012 Immune check point PD1/PDL1, CTLA4 Vaccines: MUC1, NYO-ESO1 (eribulin?) Plus PI3Ki, RAS/MEK/Erk, MET, PTEN etc, etc Agents targeting androgen receptor (enzalutamide, bicalutamide, etc)
ENFERMEDAD AVANZADA Qué hacemos con el triple negativo? Nuevas aproximaciones
ENFERMEDAD AVANZADA Qué hacemos con el triple negativo? Nuevas aproximaciones Javier Cortes, Hospital Universitario Ramon y Cajal, Madrid Vall d Hebron Institute of Oncology (VHIO), Barcelona Triple Negative
More informationSystemic therapy for TN advanced breast cancer
Systemic therapy for TN advanced breast cancer Javier Cortes, Ramon y Cajal University Hospital, Madrid Vall d Hebron Institute of Oncology (VHIO) & Medica Scientia Innovation Research (MedSIR), Barcelona,
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 informationContemporary Chemotherapy-Based Strategies for First-Line Metastatic Breast Cancer
Contemporary Chemotherapy-Based Strategies for First-Line Metastatic Breast Cancer Hope S. Rugo, MD Professor of Medicine Director, Breast Oncology and Clinical Trials Education University of California
More informationNovel Chemotherapy Agents for Metastatic Breast Cancer. Joanne L. Blum, MD, PhD Baylor-Sammons Cancer Center Dallas, TX
Novel Chemotherapy Agents for Metastatic Breast Cancer Joanne L. Blum, MD, PhD Baylor-Sammons Cancer Center Dallas, TX New Chemotherapy Agents in Breast Cancer New classes of drugs Epothilones Halichondrin
More informationSubtype-directed therapy of TNBC Global Breast Cancer Conference 2015 & 4th International Breast Cancer Symposium Jeju Island, Korea, April 2015
Subtype-directed therapy of TNBC Global Breast Cancer Conference 2015 & 4th International Breast Cancer Symposium Jeju Island, Korea, April 2015 Ruth M. O Regan, MD Visiting Professor and Division Chief
More informationManagement of Triple Negative Breast Cancer. Giuseppe Curigliano MD, PhD University of Milano and European Institute of Oncology
Management of Triple Negative Breast Cancer Giuseppe Curigliano MD, PhD University of Milano and European Institute of Oncology Outline Heterogeneity of TNBC Targeting TNBC by subtypes New antibody drug
More informationTriple negative breast cancer 2014 GASCO Annual meeting September 5 th 2014, Atlanta, GA
Triple negative breast cancer 2014 GASCO Annual meeting September 5 th 2014, Atlanta, GA Ruth M. O Regan, MD Professor and Vice-Chair for Educational Affairs, Department of Hematology and Medical Oncology,
More informationLa malattia triplo negativa metastatica: quali trattamenti nella pratica clinica?
2018 CARCINOMA MAMMARIO: I TRAGUARDI RAGGIUNTI E LE NUOVE SFIDE La malattia triplo negativa metastatica: quali trattamenti nella pratica clinica? Roma, 27 Ottobre 2018 Relatore: Francesca Poggio Disclosure
More informationTNBC: What s new Déjà vu All Over Again? Lucy R. Langer, MD MSHS Compass Oncology - SABCS 2016 Review February 21, 2017
TNBC: What s new Déjà vu All Over Again? Lucy R. Langer, MD MSHS Compass Oncology - SABCS 2016 Review February 21, 2017 The problem with TNBC 1. Generally more aggressive 2. ONLY chemotherapy 3. No other
More informationSystemic therapy of triple negative advanced breast cancer. Giuseppe Curigliano MD, PhD Breast Cancer Program Division of Early Drug Development
Systemic therapy of triple negative advanced breast cancer Giuseppe Curigliano MD, PhD Breast Cancer Program Division of Early Drug Development Outline State of the Art in the management of TN advanced
More informationRole of chemotherapy in BRCA and Triple negative breast cancer. Fernando Moreno Servicio de Oncología Médica Hospital Clinico San Carlos
Role of chemotherapy in BRCA and Triple negative breast cancer Fernando Moreno Servicio de Oncología Médica Hospital Clinico San Carlos Association between TNBC & germline mutations in BRCA 1/2 TNBC is
More informationTriple Negative Breast Cancer. Eric P. Winer, MD Dana-Farber Cancer Institute Harvard Medical School Boston, MA October, 2008
Triple Negative Breast Cancer Eric P. Winer, MD Dana-Farber Cancer Institute Harvard Medical School Boston, MA October, 2008 Triple Negative Breast Cancer 15% 25% Triple Negative 20% HER2+ ER+ Low Grade
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 informationSecuencia óptima de tratamiento de quimioterapia en el cáncer de mama metastásico
Secuencia óptima de tratamiento de quimioterapia en el cáncer de mama metastásico Javier Cortes, Ramon y Cajal University Hospital, Madrid, Spain Vall d Hebron Institute of ncology (VHI), Medica Scientia
More informationCancer du sein métastatique et amélioration de la survie Pr. X. Pivot
Cancer du sein métastatique et amélioration de la survie Pr. X. Pivot Date of preparation: November 2015. EU0250i TTP/PFS Comparaisons First line metastatic breast cancer Monotherapy Docetaxel Chan 1999
More informationHormone-Independent Metastatic Breast Cancer
Hormone-Independent Metastatic Breast Cancer Alison Stopeck, M.D. Director, Clinical Breast Cancer Program Arizona Cancer Center University of Arizona Tucson, AZ Discussion Points Heterogeneity of hormone
More informationEdith A. Perez, Ahmad Awada, Joyce O Shaughnessy, Hope Rugo, Chris Twelves, Seock-Ah Im, Carol Zhao, Ute Hoch, Alison L. Hannah, Javier Cortes
BEACON: A Phase 3 Open-label, Randomized, Multicenter Study of Etirinotecan Pegol (EP) versus Treatment of Physician s Choice (TPC) in Patients With Locally Recurrent or Metastatic Breast Cancer Previously
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 informationTriple-Negative Breast Cancer Time to Slice and Dice? Carsten Denkert, MD Charité University Hospital Berlin, Germany
Triple-Negative Breast Cancer Time to Slice and Dice? Carsten Denkert, MD Charité University Hospital Berlin, Germany Triple-Negative Breast Cancer (TNBC) 2018 Presentation Outline The molecular heterogeneity
More information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/
More information10/15/2012. Biologic Subtypes of TNBC. Topics. Topics. Histopathology Molecular pathology Clinical relevance
Biologic Subtypes of TNBC Andrea L. Richardson M.D. Ph.D. Brigham and Women s Hospital Dana-Farber Cancer Institute Harvard Medical School Boston, MA Topics Histopathology Molecular pathology Clinical
More informationPathways Underlying Aggressive Breast Cancers
Origin of Breast Cancer Subtypes Pathways Underlying Aggressive Breast Cancers HER2 and ER can be expressed in any subtype. Triple Negative -- a mixture of subtypes Joyce O Shaughnessy, MD Baylor Sammons
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 informationAdvances 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 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 informationOverview of nab-paclitaxel in Breast Cancer
Overview of nab-paclitaxel in Breast Cancer William J. Gradishar MD FASCO FACP Betsy Bramsen Professor of Breast Oncology Robert H. Lurie Comprehensive Cancer Center Northwestern University Feinberg School
More informationImmunotherapy for Breast Cancer. Aurelio B. Castrellon Medical Oncology Memorial Healthcare System
Immunotherapy for Breast Cancer Aurelio B. Castrellon Medical Oncology Memorial Healthcare System Conflicts Research support : Cascadian therapeutics, Puma biotechnology, Odonate therapeutics, Pfizer,
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 informationTreatment of Metastatic TRIPLE NEGATIVE BREAST CANCERS. Rebecca Dent, MD FRCP (Canada) Senior Consultant, Medical Oncology
Treatment of Metastatic TRIPLE NEGATIVE BREAST CANCERS Rebecca Dent, MD FRCP (Canada) Senior Consultant, Medical Oncology Overview of TNBC Still best way to define in clinical practice!? Survival (%) Treatment
More informationNew chemotherapy drugs in metastatic breast cancer. Guy Jerusalem, MD, PhD
New chemotherapy drugs in metastatic breast cancer Guy Jerusalem, MD, PhD MBC Patients survival over time Median survival increases over time, but is still measured in months This is not yet a chronic
More informationTreatment of Triple Negative Breast Cancer. Giuseppe Curigliano MD, PhD University of Milano and European Institute of Oncology
Treatment of Triple Negative Breast Cancer Giuseppe Curigliano MD, PhD University of Milano and European Institute of Oncology Outline Neoadjuvant treatment in triple negative EBC Picking optimal adjuvant
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 informationBreast Cancer Immunotherapy. Leisha A. Emens, MD PhD Johns Hopkins University Bloomberg Kimmel Institute for Cancer Immunotherapy
Breast Cancer Immunotherapy Leisha A. Emens, MD PhD Johns Hopkins University Bloomberg Kimmel Institute for Cancer Immunotherapy Conflict of Interest I have the following financial relationships to disclose:
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 informationMetastatic NSCLC: Expanding Role of Immunotherapy. Evan W. Alley, MD, PhD Abramson Cancer Center at Penn Presbyterian
Metastatic NSCLC: Expanding Role of Immunotherapy Evan W. Alley, MD, PhD Abramson Cancer Center at Penn Presbyterian Disclosures: No relevant disclosures Please note that some of the studies reported in
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 informationOptimizing anti-her-2 therapies for ABC Potential role of immunotherapy. Javier Cortes, Ramon y
Optimizing anti-her-2 therapies for ABC Potential role of immunotherapy Javier Cortes, Ramon y Cajal University Hospital, Madrid, Spain Vall d Hebron Institute of Oncology (VHIO), Medica Scientia Innovation
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 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 informationThe Role of Angiogenesis Inhibition in Breast Cancer Today: Lessons Learned
The Role of Angiogenesis Inhibition in Breast Cancer Today: Lessons Learned Hope S. Rugo, MD Professor of Medicine Director, Breast Oncology and Clinical Trials Education UCSF Helen Diller Family Comprehensive
More informationUpdate 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
More informationTNBC: Current Challenge and Perspectives. Henry L Gomez MD, PhD
TNBC: Current Challenge and Perspectives Henry L Gomez MD, PhD What Is a Triple-Negative Breast Cancer (TNBC)? Triple negative : ER negative, PgR negative, HER2 negative Depending on thresholds used
More information10/15/2012. Inflammatory Breast Cancer vs. LABC: Different Biology yet Subtypes Exist
Triple-Negative Breast Cancer: Optimizing Treatment for Locally Advanced Breast Cancer Beth Overmoyer MD Director, Inflammatory Breast Cancer Program Dana Farber Cancer Institute Overview Inflammatory
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 informationEvolving 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
More informationSystemic 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,
More informationUpdate on Breast Cancer
Update on Breast Cancer William J. Gradishar, MD Professor of Medicine Robert H. Lurie Comprehensive Cancer Center Feinberg School of Medicine Northwestern University Overview PARP Inhibitors Neoadjuvant
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 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 informationSystemic Treatment of Triple Negative Breast Cancer
Systemic Treatment of Triple Negative Breast Cancer Christoph Zielinski Comprehensive Cancer Center Medical University Vienna General Hospital, Vienna, Austria and Central European Cooperative Oncology
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 informationEGFR inhibitors in NSCLC
Suresh S. Ramalingam, MD Associate Professor Director of Medical Oncology Emory University i Winship Cancer Institute EGFR inhibitors in NSCLC Role in 2nd/3 rd line setting Role in first-line and maintenance
More informationL Oncologo Sperimentatore nel Disegno e nella Conduzione dello Studio Clinico
L Oncologo Sperimentatore nel Disegno e nella Conduzione dello Studio Clinico Antonino Musolino U.O.C. Oncologia Medica Azienda Ospedaliero-Universitaria di Parma LA SETTIMANA DEL GOIRC Negrar, 29 Aprile
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 informationSYSTEMIC TREATMENT OF TRIPLE NEGATIVE BREAST CANCER
SYSTEMIC TREATMENT OF TRIPLE NEGATIVE BREAST CANCER Sunil Shrestha 1*, Ji Yuan Yang, Li Shuang and Deepika Dhakal Clinical School of Medicine, Yangtze University, Jingzhou, Hubei Province, PR. China Department
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 informationChemotherapy 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
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 informationEarly Stage Disease. Hope S. Rugo, MD Professor of Medicine Director Breast Oncology and Clinical Trials Education UCSF Comprehensive Cancer Center
SABCS 2014: Early Stage Disease Hope S. Rugo, MD Professor of Medicine Director Breast Oncology and Clinical Trials Education UCSF Comprehensive Cancer Center Topics for Discussion Chemotherapy plus 10
More informationPost-ASCO 2017 Cancer du sein Triple Négatif
Post-ASCO 217 Cancer du sein Triple Négatif A.Ladjeroud, K.Bouzid Centre Pierre et Marie Curie- Alger Oran, 3 Septembre 217 Phase III Investigation of Neoadjuvant Carboplatin ± Veliparib in Combination
More information4, :00 PM 9:00 PM
Consensus or Controversy? Clinical Investigators Provide Their Perspectives on Practical Issues and Research Questions in the Management of Breast Cancer Robert W Carlson, MD John Crown, MD Charles E Geyer
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 informationTherapeutic Targets for Triple- Negative Breast Cancer: Focus on Platinums and EGFR Inhibition
Therapeutic Targets for Triple- Negative Breast Cancer: Focus on Platinums and EGFR Inhibition Lisa A Carey, MD Disclosures for Lisa A Carey, MD No real or apparent conflicts of interest to disclose Basal-Like
More informationCurrent and Future Perspectives in Treatment of Metastatic Triple Negative Breast Cancer (TNBC) Yeon Hee Park M.D., Ph.D.
Current and Future Perspectives in Treatment of Metastatic Triple Negative Breast Cancer (TNBC) Yeon Hee Park M.D., Ph.D. Breast Cancer Center, Medical Oncology Samsung Medical Center, Sungkyunkwan University
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 informationCáncer de mama HER2+/RE+ vs HER2+/RE : Una misma enfermedad? Dra E. Ciruelos Departamento de Oncología Médica Hospital Universitario 12 de Octubre
Cáncer de mama HER2+/RE+ vs HER2+/RE : Una misma enfermedad? Dra E. Ciruelos Departamento de Oncología Médica Hospital Universitario 12 de Octubre Recurrence of HER2-positive breast cancer (A) Time to
More informationTerapia sistemica neoadiuvante: in quali tumori? Quali risultati? Dott. Giacomo Pelizzari
Terapia sistemica neoadiuvante: in quali tumori? Quali risultati? Dott. Giacomo Pelizzari Neoadjuvant Treatment A window of opportunity Rational: Historically proposed to enable breast-conserving surgery
More informationMETRIC Study Key Eligibility Criteria
The METRIC Study METRIC Study Key Eligibility Criteria The pivotal METRIC Study is evaluating glembatumumab vedotin in patients with gpnmb overexpressing metastatic triple-negative breast cancer (TNBC).
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 informationNOVITA SUL TRATTAMENTO DEL CARCINOMA MAMMARIO: MALATTIA TRIPLO NEGATIVA
SUPERNOVAE IN ONCOLOGIA NOVITA SUL TRATTAMENTO DEL CARCINOMA MAMMARIO: MALATTIA TRIPLO NEGATIVA Dr. Matteo Lambertini U.O. Oncologia Medica 2 IRCCS AOU San Martino IST, Genova Pisa, 14 novembre 2015 AGENDA
More informationHow I Approach Triple Negative Breast Cancer (TNBC) Dr Tan Yew Oo Specialist Medical Oncologist Farrer Park Medical Centre Singapore
How I Approach Triple Negative Breast Cancer (TNBC) Dr Tan Yew Oo Specialist Medical Oncologist Farrer Park Medical Centre Singapore Connexion: Integrated Healthcare & Hospitality Complex Levels 11 to
More informationEmerging Therapies for Triple Negative Breast Cancer
Emerging Therapies for Triple Negative Breast Cancer Joseph A. Sparano, MD Professor of Medicine & Women s Health Albert Einstein College of Medicine Associate Chairman, Department of Oncology Montefiore
More informationBreast Cancer: Chemotherapy and Novel Agents
North Carolina Oncology Association & South Carolina Oncology Society Joint Membership Meeting ~ February 26 27, 2010 The Ballantyne Resort ~ Charlotte, NC Breast Cancer: Chemotherapy and Novel Agents
More informationTargeted Agents as Maintenance Therapy. Karen Kelly, MD Professor of Medicine UC Davis Cancer Center
Targeted Agents as Maintenance Therapy Karen Kelly, MD Professor of Medicine UC Davis Cancer Center Disclosures Genentech Advisory Board Maintenance Therapy Defined Treatment Non-Progressing Patients Drug
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 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 informationCustomizing Therapeutic Strategies in the Management of Metastatic Breast Cancer
Customizing Therapeutic Strategies in the Management of Metastatic Breast Cancer Vandana G Abramson, MD Assistant Professor of Medicine Division of Hematology/Oncology Vanderbilt University Breast Cancer
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 informationPostoperative Adjuvant Chemotherapies. Stefan Aebi Luzerner Kantonsspital
Postoperative Adjuvant Chemotherapies Stefan Aebi Luzerner Kantonsspital stefan.aebi@onkologie.ch Does Chemotherapy Work in Older Patients? ER : Chemotherapy vs nil Age
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 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 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 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 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 informationMetronomic chemotherapy for breast cancer
Metronomic chemotherapy for breast cancer M. Colleoni International Breast Cancer Study Group (IBCSG), Division of Medical Senology, European Institute of Oncology Metronomic Scheduling and Inhibition
More informationLOTUS (NCT ) randomized phase II trial
Overall survival update of the double-blind placebocontrolled randomized phase 2 LOTUS trial of firstline ipatasertib + paclitaxel for locally advanced/metastatic triple-negative breast cancer Rebecca
More informationPARP inhibitors for breast cancer
PARP inhibitors for breast cancer Mark Robson, MD Memorial Sloan Kettering Cancer Center Agenda Mechanism of action Clinical studies Resistance mechanisms Future directions Poly (ADP-ribose) Polymerases
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 informationAdvanced 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
More informationOverview and future horizons of PARP inhibitors in BRCAassociated. Judith Balmaña
Overview and future horizons of PARP inhibitors in BRCAassociated breast cancer Judith Balmaña PARP inhibitors: Mechanism of action Clinical development: Monotherapy In combination with chemotherapy Ongoing
More informationESMO Preceptorship Breast Cancer. Giuseppe Curigliano MD, PhD Breast Cancer Program Division of Early Drug Development Istituto Europeo di Oncologia
ESMO Preceptorship Breast Cancer Giuseppe Curigliano MD, PhD Breast Cancer Program Division of Early Drug Development Istituto Europeo di Oncologia Outline Rational for immune-based therapy in BC How to
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 informationPRO: Pathologic Complete Response Does Predict Outcome for Early Stage Breast Cancer Patients
PRO: Pathologic Complete Response Does Predict Outcome for Early Stage Breast Cancer Patients Amelia B. Zelnak, M.D., M.Sc. Assistant Professor of Hematology and Medical Oncology Winship Cancer Institute
More information2 nd line Therapy and Beyond NSCLC. Alan Sandler, M.D. Oregon Health & Science University
2 nd line Therapy and Beyond NSCLC Alan Sandler, M.D. Oregon Health & Science University Treatment options for advanced or metastatic (stage IIIb/IV) NSCLC Suitable for chemotherapy Diagnosis Unsuitable/unwilling
More informationHormone-Independent Metastatic Breast Cancer. Beth Overmoyer MD, FACP Assistant Professor of Medicine HMS Dana Farber Cancer Institute SOBO 2012
Hormone-Independent Metastatic Breast Cancer Beth Overmoyer MD, FACP Assistant Professor of Medicine HMS Dana Farber Cancer Institute SOBO 2012 Metastatic Breast Cancer MBC is a heterogeneous disease without
More informationCarrier Frequency. Breast Cancer and Treatment Options in Patients with BRCA1/2 mutations. Olivia Pagani On behalf of Bella Kaufman
Breast Cancer and Treatment Options in Patients with BRCA1/2 mutations Olivia Pagani On behalf of Bella Kaufman Carrier Frequency Prevalence of an altered disease gene in a given population 1 Background
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 informationMaintenance Therapy for Advanced NSCLC: When, What, Why & What s Left After Post-Maintenance Relapse?
Maintenance Therapy for Advanced NSCLC: When, What, Why & What s Left After Post-Maintenance Relapse? Mark A. Socinski, MD Professor of Medicine Multidisciplinary Thoracic Oncology Program Lineberger Comprehensive
More informationBreast Cancer and Treatment Options in Patients with BRCA1/2 mutations. Olivia Pagani On behalf of Bella Kaufman
Breast Cancer and Treatment Options in Patients with BRCA1/2 mutations Olivia Pagani On behalf of Bella Kaufman Carrier Frequency Prevalence of an altered disease gene in a given population Background
More information