CTRC-AACR San Antonio Breast Cancer Symposium, Dec. 5-9

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The 40th Annual CTRC-AACR San Antonio Breast Cancer Symposium

The annual meeting of the San Antonio Breast Cancer Symposium was held from Dec. 5 to 9 in San Antonio, Texas, and attracted more than 7,500 participants from around the world, including medical oncologists, radiation oncologists, researchers, and other health care professionals. The conference highlighted recent advances in the risk, diagnosis, treatment, and prevention of breast cancer, with presentations focusing on emerging treatments in hard-to-treat patient populations, including patients with metastatic breast cancer.

In one study, Richard Gray, of the University of Oxford in the United Kingdom, and colleagues performed a meta-analysis of all trials that involved dose intensification of chemotherapy in breast cancer patients.

The investigators found that giving exactly the same drug at the same doses but every two weeks rather than every three weeks reduced the risk of breast cancer recurrence and death by 15 and 13 percent, respectively.

"In this analysis, the drugs were exactly the same and at the same dose -- just the time frames were shorter. We also found similar results when looking at all other dose-intensification approaches, about a 15 percent lower risk of recurrence and death," Gray said. "We were surprised by how strong and consistent the findings from our study were, and there were few additional side effects with dose-intense schedules compared with standard-schedule chemotherapy, so the benefits seem to outweigh the risks."

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In the phase III EMBRACA study, Jennifer Litton, M.D., of the University of Texas MD Anderson Cancer Center in Houston, and colleagues evaluated the efficacy of the once-daily poly ADP-ribose polymerase (PARP) inhibitor, talazoparib, in patients with advanced human epidermal growth factor receptor 2 (HER2)-negative breast cancer with germline BRCA mutation.

"We found an improvement in progression-free survival (PFS) associated with talazoparib as compared with chemotherapy of physician's choice (PCT) (capecitabine, eribulin, gemcitabine, or vinorelbine)," Litton said. "Specifically, we found that the median PFS was 8.6 months with talazoparib as compared to 5.6 with PCT, which was statistically significant. A preplanned interim analysis of overall survival was performed, even though the data were not yet mature. We found a positive trend favoring talazoparib, with a 24 percent lower risk of mortality."

Another outcome that stood out, according to Litton, was the time to deterioration, which was 24.3 months for talazoparib as compared with 6.3 months for PCT.

The study was funded by Pfizer, the manufacturer of talazoparib, and one author disclosed financial ties to several pharmaceutical companies.

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In patients with early-stage breast cancer with low levels of HER2, Louis Fehrenbacher, M.D., of Kaiser Permanente Vallejo Medical Center in California, and colleagues found that the addition of trastuzumab to standard adjuvant chemotherapy does not improve invasive disease-free survival.

The investigators randomized 3,270 patients with early-stage breast cancer that was either immunohistochemistry (IHC) 1+, IHC 2+, and/or in-situ hybridization-negative to standard adjuvant chemotherapy with or without a year of trastuzumab. The investigators found that the five-year invasive disease-free survival was 89.6 percent among those who received trastuzumab and 89.2 percent among those who only received chemotherapy. Subdividing patients by HER2 IHC level, extent of lymph node involvement, or hormone receptor status did not alter the results.

The study was partly funded by Genentech.

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As part of the Women's Health Initiative observational study, Rowan Chlebowski, M.D., Ph.D., of the City of Hope in Duarte, Calif., and colleagues evaluated 61,335 patients, of whom 3,061 women developed invasive breast cancer during an average of 11.4 years of follow-up.

"We found that women who had a weight loss of greater than or equal to 5 percent had a 12 percent reduced risk of developing breast cancer. Even larger weight loss, of greater than or equal to 15 percent, was associated with a higher reduction in breast cancer risk of 37 percent," Chlebowski said.

One author disclosed financial ties to the pharmaceutical industry.

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