Novel Preoperative Therapies for HER2-Positive Breast Cancer. Debu Tripathy, MD University of Southern California Norris Comprehensive Cancer Center
|
|
- Clinton Cooper
- 6 years ago
- Views:
Transcription
1 Novel Preoperative Therapies for HER2-Positive Breast Cancer Debu Tripathy, MD University of Southern California Norris Comprehensive Cancer Center
2 Key Findings to Date in the Neoadjuvant Therapy of HER2+ Breast Cancer Pathological complete response (pcr) rate predicts longterm outcome, possibly to a greater extent than HER2- (esp HR+) cases HER2+ cases exhibit greater pcr rate than HER2- cases with chemotherapy alone Addition of trastuzumab significantly improves pcr rate and DFS when added to chemotherapy pcr rates are greater in HR-negative vs HR+ cases for HER2+ and the difference in outcome based on pcr is greater in HR- (as is the case with HER2-negative)
3 HER2 Positivity Confers Higher pcr Rate But Worse DFS and OS with Standard Chemotherapy N = 710, Stage II/III, standard preoperative chemotherapy pcr Breast, Nodes HER2-Negative 20/287 = 7% HER2+ 12/51 = 23.5% P= DFS % HER + HER2 - Negative P= Months Penault-Llorca F, et al. Oncologist 2007; 12:390
4 Multivariate Backward Stepwise # Analysis of Treatment and Baseline Factors* (n=5172 excluding trastuzumab treatment) # Dose-density, concomitant/sequential, histological type, triple (ER/PR/HER) receptor status were removed because of p>0.05 *Factors grouped as in histograms von Minckwitz G, et al SABCS 2008; abst. 79
5 Neoadjuvant Therapy with Trastuzumab Higher pcr with HR-Negative Status Peintinger F, et al. Ann Oncol 2008; 19:2020
6 DFS with Standard Anthracycline/Taxane Chemotherapy: Results from I SPY-1 Trial Based on Intrinsic Gene Profile Subsets Esserman, L and I SPY-1 Investigators, unpublished data
7 Effect of Trastuzumab on Neo-Adjuvant Therapy for HER2-Positive Disease % CI (41 87%) p= % CI (43 84%) p=0.016 P + FEC alone H + (P FEC) pcr (%) % n= % n= % n= % n=19 0 DSMB reviewed data (n=34) Final results (n=42) Buzdar A, et al. JCO 2005; 23:3676
8 NOAH Study Design HER2-positive LABC (IHC 3+ or FISH+) HER2-negative LABC (IHC 0/1+) H + AT q3w x 3 cycles n=117 n=118 n=99 T + AT q3w x 3 cycles T + AT q3w x 3 cycles H + T q3w x 4 cycles H q3w x 4 cycles + CMF q4w x 3 cycles Surgery followed by radiotherapy a T q3w x 4 cycles CMF q4w x 3 cycles Surgery followed by radiotherapy a T q3w x 4 cycles CMF q4w x 3 cycles Surgery followed by radiotherapy a H continued q3w to week 52 AT, doxorubicin (60 mg/m 2 ), paclitaxel (150 mg/m 2 ); H, trastuzumab (8 mg/kg loading dose then 6 mg/kg); T, paclitaxel (175 mg/m 2 ); a Hormone receptor-positive patients will receive adjuvant tamoxifen Gianni L, et al., Lancet 2010; 375:377
9 NOAH: pcr: Intent-to-Treat Population Patients, % % p = p = % p = p = % 17% 19% 16% 0 With H Without H HER2- negative HER2-positive With H Without H HER2- negative HER2-positive pcr tpcr pcr: pathologic complete response in breast tpcr: total pathologic complete response in breast and nodes Gianni L, et al., Lancet 2010; 375:377
10 NOAH: EFS in HER2+ Population Median F/U 3.2 yr Probability Event Free Survival (EFS) H + CT CT Regimen 3 Yr EFS 3 Yr OS H + CT 71% 87% CT 56% 79% Months H + CT (n =115) CT (n = 112) HR (95% CI) P value Months EFS (events) ( ).013 OS (events) Symptomatic CHF = 2% Gianni L, et al., Lancet 2010; 375:377
11 Critical Questions and Hypothesis about HER2-Directed Neoadjuvant Therapy Are anthracylines more effective in combination with trastuzumab and is the combination safe? Are HER2+ tumors addicted to HER2? Can bypass pathways be overcome by dual targeting? Is dual targeting safe? Can dual targeting replace chemotherapy?
12 Concurrent Neoadjuvant Trastuzumab and Anthracyline compared to TCH: MDACC Experience PH FECH TCH N pcr 60.6% 43.3% p = ccr 80.8% 58.9% p = Yr RFS 93% 71% p < Yr OS 96% 86% p = Decline in LVEF from baseline 0.08% 0.08% p = 0.52 Note: PH FECH Group was significantly younger and had lower tumor stage and less pre-existing cardiac disease Bayraktar S, et al., ASCO 2011; abstract 532
13 Lapatinib or Trastuzumab Combined With Neoadjuvant Chemotherapy: The GeparQuinto Study (GBG 44) Untch et al. SABCS 2010; abstract S3-1
14 Neoadjuvant Chemotherapy Plus Lapatinib or Trastuzumab: Efficacy pcr Rate EC D/ Lapatinib EC D/ Trastuzumab P Value ypt0, ypn0 22% 31% <.05 ypt0/is, ypn0 30% 45% <.05 ypt0/is, ypnx 35% 50% <.05 Breast Conservation Rate 56% 66% NR Untch et al. SABCS 2010; abstract S3-1
15 Neo ALTTO Study Design Invasive operable HER2+ BC T > 2 cm (inflammatory BC excluded) LVEF 50% N=450 Stratification: T 5 cm vs. T > 5 cm ER or PgR + vs. ER & PgR N 0-1 vs. N 2 Conservative surgery or not R A N D O M I Z E lapatinib paclitaxel trastuzumab paclitaxel lapatinib trastuzumab paclitaxel 6 wks + 12 wks S U R G E R Y F E C X 3 lapatinib trastuzumab lapatinib trastuzumab 34 weeks 52 weeks of anti-her2 therapy Baselga J et al. SABCS 2010; abstract S3-3
16 NeoALTTO: Safety Lapatinib/ Trastuzumab (n = 152) Lapatinib (n = 154) Trastuzumab (n = 149) Grade 3 Adverse Events Diarrhea 32 (21%) 36 (23%) 3 (2%) Liver 13 (9%) 20 (13%) 2 (1%) Neutropenia 13 (9%) 24 (16%) 4 (3%) Skin 10 (7%) 10 (7%) 4 (3%) Treatment Discontinuation Due to Adverse Event 33 (22%) 29 (19%) 2 (1%) No major cardiac events 1 death on lapatinib/trastuzumab arm immediately after treatment ended Baselga J et al. SABCS 2010; abstract S3-3
17 NeoALTTO Efficacy pcr and tpcr L: lapatinib; T: trastuzumab; L+T: lapatinib plus trastuzumab pcr pathologic complete response HR: hormone receptors Baselga J et al. SABCS 2010; abstract S3-3
18 pcr by Hormone Receptor Status L: lapatinib; T: trastuzumab; L+T: lapatinib plus trastuzumab pcr pathologic complete response HR: hormone receptors Baselga J et al. SABCS 2010; abstract S3-3
19 CHER-LOB Trial Amended to 1250 mg Amended to 750 mg Guarneri V, et al. ASCO 2011 Abstr # 507
20 CHER-LOB Trial: Toxicity CT = Chemotherapy; T = Trastuzumab; L = Lapatinib Guarneri V, et al. ASCO 2011 Abstr # 507
21 CHER-LOB Trial: Cardiac Function CT = Chemotherapy; T = Trastuzumab; L = Lapatinib Guarneri V, et al. ASCO 2011 Abstr # 507
22 CHER-LOB Trial: Efficacy CT = Chemotherapy; T = Trastuzumab; L = Lapatinib pcr = ypt0/tis, ypn0 Guarneri V, et al. ASCO 2011 Abstr # 507
23 Eligibility criteria: Operable or locally advanced/ inflammatory HER2 + breast cancer Chemonaive Primary tumors > 2 cm Randomized Phase II Study of Neoadjuvant Pertuzumab Plus Trastuzumab: NeoSphere R A N D O M I Z E Primary endpoint: pcr rates Secondary endpoints including: clinical response Docetaxel (T) Trastuzumab (H) (n = 107) Docetaxel (T) Trastuzumab (H) Pertuzumab (P) (n = 107) Trastuzumab (H) Pertuzumab (P) (n = 107) Docetaxel (T) Pertuzumab (P) (n = 96) All q 3 weeks 4 S U R G E R Y FEC q 3 weeks 3 H q 3 weeks, cycles 5-17 FEC q 3 weeks 3 H q 3 weeks, cycles 5-17 T q 3 weeks 4 FEC q 3 weeks 3 H q 3 weeks, cycles 5-17 FEC q 3 weeks 3 H q 3 weeks, cycles 5-21 FEC: 5-fluorouracil/epirubicin/ cyclophosphamide Gianni et al. SABCS 2010; abstract S3-2
24 NeoSphere: Efficacy of Neoadjuvant Pertuzumab Plus Trastuzumab Pathologic Complete Response TH (n = 107) THP (n = 107) HP (n = 107) TP (n = 96) pcr in Breast 29% 46% 17% 24% By Hormone Receptor Status ER + /PgR + 20% 26% 6% 17% ER /PgR 37% 63% 29% 30% By Nodal Status Node negative 21.5% 39% 11% 18% Node positive 7.5% 6.5% 6% 6% CR + PR + SD a 107 (100%) 106 (99%) 99 (92.5%) 94 (98%) a Investigator assessed Gianni et al. SABCS 2010; abstract S3-2
25 NeoSphere pcr rates: ITT Population Summary p = p = p = pcr, % ± 95% CI TH THP HP TP H, trastuzumab; P, pertuzumab; T, docetaxel Gianni et al. SABCS 2010; abstract S3-2
26 NeoSphere: Safety of Neoadjuvant Pertuzumab Plus Trastuzumab Grade 3 Adverse Events TH (n = 107) THP (n = 107) HP (n = 108) TP (n = 94) Neutropenia 57% 45% 1% 55% Febrile Neutropenia 7.5% 8% 0 7% Leukopenia 12% 5% 0 7% Diarrhea 4% 6% 0 4% The incidence of other grade 3 adverse events, including asthenia, granulocytopenia, rash, and drug hypersensitivity, was < 5%. No significant cardiac effect with combined trastuzumab and pertuzumab was noted over 4 cycles of neoadjuvant treatment. Gianni et al. SABCS 2010; abstract S3-2
27 [TITLE]
28 TBCRC 006: Neoadjuvant Lapatinib + Trastuzumab Without Chemotherapy: Study Schema [TITLE] Lapatinib (L) + Trastuzumab (T) + Endocrine therapy if ER+ Chang J, et. al. ASCO 2011 Abstr # 505
29 Chang J, et. al. ASCO 2011 Abstr # 505
30 Amplified Not Amplified Not Amplified Amplified Focal HER-2 amplified clones (FHAC) accounts for 21% of the FISH+ /IHC - cases and 30% of the FISH+ / IHC equivocal (2+) cases Sukov WR, et al. ASCO 2009, abstr 520
31 Loss of HER2 Post Neoadjuvant Trastuzumab Pre Treatment Post Treatment HER2 FISH CEP 17 FISH Fusion HER2 and CEP 17 FISH Mittendorf EA, et al. Clinical Cancer Res 2009;15:7381
32 CHER-LOB Trial: pcr Rate by p95 Status CT = Chemotherapy; T = Trastuzumab; L = Lapatinib Guarneri V, et al. ASCO 2011 Abstr # 507
33 [TITLE]
34 Molecular Effects and pcr to Neoadjuvant Trastuzumab and Lapatinib Holmes FA, et al. ASCO 2011 Abstr # 506
35 Molecular Effects and pcr to Neoadjuvant Trastuzumab and Lapatinib Resistant tumors are more highly networked Holmes FA, et al. ASCO 2011 Abstr # 506
36 Strategies for HER2+ Neoadjuvant Therapy For clinical care, use best adjuvant regimen Biomarker-driven therapies using neoadjuvant model for research Dual pathway blockade Lapatinib, pertuzumab mtor, PI3K, Akt inhibitors IGF-1R, HER3, c-met Angiogenesis inhibitors Stem cell targeting, epigenetic therapy Testing switching strategies in the case of resistance
37 I-SPY 2 Adaptive Trial: Learn, Drop, Graduate, and Replace Agents Over Time HER 2 (+) Randomize Paclitaxel + Trastuzumab* Paclitaxel + Trastuzumab* + New Agent A Paclitaxel + Trastuzumab* + New Agent B Paclitaxel Taxol + + Trastuzumab* + New Agent FC AC Surgery Learn, Adapt from each patient as we go along Pt is On Study Randomize Paclitaxel *Or Equivalent HER 2 ( ) Paclitaxel Taxol + + New Agent CF Paclitaxel Taxol + + New Agent GH D Paclitaxel + New Agent E AC Surgery
Novel 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 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 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 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 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 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 informationTreatment of Early Stage HER2-positive Breast Cancer
Treatment of Early Stage HER2-positive Breast Cancer 3 November 2012 Edward H. Romond, M.D. Professor of Medicine Lucille Parker Markey Cancer Center University of Kentucky Lexington, KY Molecular Portrait
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 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 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 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 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 informationIntroduction. Approximately 20% of invasive breast cancers
Introduction Approximately 2% of invasive breast cancers overexpress HER2 The current standard of care for neoadjuvant therapy is dual-targeted therapy with trastuzumab and pertuzumab plus chemotherapy
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 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 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 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 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 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 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 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 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 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 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 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 informationRethinking neoadjuvant therapy: neoadjuvant therapy as a platform for drug development in HER2 positive breast cancer
2016.04.29 GBCC luncheon symposium Rethinking neoadjuvant therapy: neoadjuvant therapy as a platform for drug development in HER2 positive breast cancer Seoul National University Bundang Hospital Seoul
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 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 informationOPTIMIZING NONANTHRACYLINES FOR EARLY BREAST CANCER. Stephen E. Jones, M.D. US Oncology Research, McKesson Specialty Health The Woodlands, Tx
OPTIMIZING NONANTHRACYLINES FOR EARLY BREAST CANCER Stephen E. Jones, M.D. US Oncology Research, McKesson Specialty Health The Woodlands, Tx ANTHRACYCLINES AND TAXANES ARE COMMONLY USED USED IN MOST REGIMENS
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 informationLo Studio Geparsepto. Alessandra Fabi Oncologia Medica 1
Lo Studio Geparsepto Alessandra Fabi Oncologia Medica 1 nab-paclitaxel Versus Solvent-Based Paclitaxel in Neoadjuvant Chemotherapy for Early Breast Cancer (GeparSepto GBG 69): A Randomised, Phase III Trial
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 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 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 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 informationpan-canadian Oncology Drug Review Initial Clinical Guidance Report Pertuzumab (Perjeta) Neoadjuvant Breast Cancer April 30, 2015
pan-canadian Oncology Drug Review Initial Clinical Guidance Report Pertuzumab (Perjeta) Neoadjuvant Breast Cancer April 30, 2015 DISCLAIMER Not a Substitute for Professional Advice This report is primarily
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 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 informationIntegrating the New with the Old Recent Advances in Adjuvant Systemic Treatment Strategies for Breast Cancer
Integrating the New with the Old Recent Advances in Adjuvant Systemic Treatment Strategies for Breast Cancer Kathy S. Albain, M.D., FACP Professor of Medicine Loyola University Chicago Stritch School of
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 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 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 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 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 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 informationTaking NeoadjuvantTreatment into the Clinic
Taking NeoadjuvantTreatment into the Clinic The Data and the Challenges Karen A Gelmon MD FRCPC Professor Medicine University of British Columbia Medical Oncologist BC Cancer Agency NeoadjuvantTherapy
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 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 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 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 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: 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 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 informationIdeal neo-adjuvant Chemotherapy in breast ca. Dr Khanyile Department of Medical Oncology, University of Pretoria
Ideal neo-adjuvant Chemotherapy in breast ca Dr Khanyile Department of Medical Oncology, University of Pretoria When is neo-adjuvant Chemo required? Locally advanced breast ca: - Breast conservative surgery
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 informationTarget biologico e meccanismo d azione dei farmaci anti-her2: il continuum dal setting Neoadiuvante alla malattia metastatica
Target biologico e meccanismo d azione dei farmaci anti-her2: il continuum dal setting Neoadiuvante alla malattia metastatica Giuseppe Curigliano MD, PhD Breast Cancer Program Division of Experimental
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 informationWhat to do after pcr in different subtypes?
What to do after pcr in different subtypes? Luca Moscetti Breast Unit Università degli Studi di Modena e Reggio Emilia Policlinico di Modena, Italy Aims of neoadjuvant therapy in breast cancer Primary
More informationNeoadjuvant and Adjuvant Therapy for HER2 Positive Disease
ADJUVANT AND NEOADJUVANT THERAPY FOR HER2-POSITIVE DISEASE Neoadjuvant and Adjuvant Therapy for HER2 Positive Disease Stephen K. Chia, MD, FRCP(C) OVERVIEW Since the initial description of the HER2 proto-oncogene
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 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 informationMalattia HER-2 positiva
Novità sul trattamento del carcinoma mammario Malattia HER-2 positiva Patrizia Vici Neoadjuvant - Adjuvant - Advanced Prognostic/Predictive factors..her-2 heterogeneity.. Neoadjuvant Phase II Pre-planned
More informationHerceptin Pivotal Studies
Herceptin Pivotal Studies Nuhad K Ibrahim, MD, FACP Associate Professor of Medicine Breast Medical Oncology Department MD Anderson Cancer Center Houston, TX, USAE-mail: nibrahim@mdanderson.org Herceptin
More information(Neo-) Adjuvant chemotherapy and biological agents. Giuseppe Curigliano MD, PhD University of Milano and European Institute of Oncology
(Neo-) Adjuvant chemotherapy and biological agents Giuseppe Curigliano MD, PhD University of Milano and European Institute of Oncology Outline Neoadjuvant treatment in triple negative and HER2 positive
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 informationASCO 2017 BREAST CANCER HIGHLIGHTS
Post-ASCO 24 th June 2017, Dolce La Hulpe, Belgium ASCO 2017 BREAST CANCER HIGHLIGHTS Martine J. Piccart-Gebhart, MD, PhD Jules Bordet Institute, Brussels, Belgium Université Libre de Bruxelles Breast
More informationTrastuzumab (Herceptin) for HER2 positive early, locally advanced and inflammatory breast cancer neoadjuvant treatment
Trastuzumab (Herceptin) for HER2 positive early, locally advanced and inflammatory breast cancer neoadjuvant treatment August 2010 This technology summary is based on information available at the time
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 informationAdjuvant chemotherapy in older breast cancer patients: how to decide?
Adjuvant chemotherapy in older breast cancer patients: how to decide? H. Wildiers University Hospitals Leuven Belgium Wildiers H, Kunkler I, Lancet Oncol 2007 Biganzoli L, Wildiers H, Lancet Oncol. 2012
More informationSupplementary appendix
Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Cortazar P, Zhang L, Untch M, et al. Pathological
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 informationRadiotherapy Management of Breast Cancer Treated with Neoadjuvant Chemotherapy. Julia White MD Professor, Radiation Oncology
Radiotherapy Management of Breast Cancer Treated with Neoadjuvant Chemotherapy Julia White MD Professor, Radiation Oncology Agenda Efficacy of radiotherapy in the management of breast cancer in the Adjuvant
More informationthat the best available evidence has not demonstrated that pcr can predict long-term outcomes in the neoadjuvant setting.
pcr in one arm of a randomized clinical trial comparing two neoadjuvant chemotherapies predicts for improved event-free or overall survival in that arm of the clinical trial. perc noted that the NeoALTTO
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 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 informationPoint of View on Early Triple Negative
Point of View on Early Triple Negative Valentina Rossi, MD UOSD Oncologia dei Tumori della Mammella Azienda Ospedaliera S.Camillo-Forlanini VRossi@scamilloforlanini.rm.it Outline Neoadjuvant Setting IPSY-2
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 informationHighlights. Padova,
Highlights P Pronzato Padova, 17.11.2012 Last 12 Months Main Meetings SABCS 2011 (San Antonio) EBCC 8 2012 (Wien) ASCO 2012 (Chicago) ESMO/ECCO 2012 (Wien) The Medical Oncology Job Risk Manager Strategy
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 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 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 informationThe 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 informationPIK3CA Mutations in HER2-Positive Breast Cancer
2016.4.29. GBCC PIK3CA Mutations in HER2-Positive Breast Cancer Seock-Ah Im, MD, PhD. Department of Internal Medicine Seoul National University Hospital Contents Introduction TCGA data HER2 signaling pathway
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 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 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 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 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 informationShould pertuzumab be used as part of neoadjuvant treatment prior to the release of the APHINITY trial results?
Commentary Should pertuzumab be used as part of neoadjuvant treatment prior to the release of the APHINITY trial results? Tom Wei-Wu Chen 1, Ching-Hung Lin 1,2, Chiun-Sheng Huang 3 1 Department of Oncology,
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 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 informationSan Antonio Breast Cancer Symposium, December 5-9, San Antonio Breast Cancer Symposium, December 5-9, 2017
San Antonio Breast Cancer Symposium, December 5-9, 2017 Survival analysis of the prospectively randomized phase III GeparSepto trial comparing neoadjuvant chemotherapy with weekly nab-paclitaxel with solvent-based
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 informationSt Gallen 2017 controversies & consensus
St Gallen 2017 controversies & consensus Shani Paluch-Shimon, MBBS, MSc Head, Breast Cancer Service for Young Women Breast Unit, Division of Oncology Sheba Medical Centre June 2017 St Gallen 2017 De-escalation
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 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 informationADAPT: Her 2+/ HR - S. Kümmel Brustzentrum Kliniken Essen-Mitte
American Society of Clinical Oncology Jun 2016 ADAPT: Her 2+/ HR - S. Kümmel Brustzentrum Kliniken Essen-Mitte American Society of Clinical Oncology Jun 2016 Final analysis of the WSG- ADAPT HER2+/HR-
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 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 informationAdjuvant Chemotherapy + Trastuzumab
Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Adjuvant Chemotherapy + Trastuzumab (Optimal Drugs / Dosage / Trastuzumab) Adjuvant Chemotherapy (Optimal Drugs / Optimal Dosage
More information