As with most other events planned for this year, the ASCO 2020 Conference was rescheduled as a virtual event, originally set to be held in Chicago from May 29th to 31st. The American Society of Clinical Oncology (ASCO) Conference is a key research conference that brings together clinicians, researchers, and patient advocates from around the world. The conference included over 5,000 abstracts, posters, slides and videos, a day of video broadcasts and around 147 virtual exhibits. While we weren’t able to come together in person this year, ASCO successfully hosted a virtual conference that shared an incredible amount of research that’s relevant to breast cancer patients. Below are some of the highlights.
Does locoregional therapy improve overall survival in women with stage IV breast cancer?
Data from the ECOG-ACRIN E2108 trial showed that using surgery and radiation to treat stage IV breast cancer, compared with systemic treatment alone, did not extend the overall survival of patients. The addition of surgery and radiation to treat stage IV breast cancer also failed to improve 3-year progression free survival.
Capecitabine maintenance may be beneficial for patients treated for early stage triple negative breast cancer
This study demonstrated patients with operable triple negative breast cancer who received metronomic capecitabine (twice daily for a year) as maintenance therapy after standard local therapy had better 5-year disease free survival than those who did not (83% vs. 73%).
Health disparities in breast cancer outcomes for Black women with metastatic breast cancer
Unequal representation in studies might be one of the reasons why Black women have been found to be 40% more likely to die from their breast cancer diagnosis compared to White women. Researchers studied the clinical outcomes of Black and White metastatic breast cancer patients at Emory Winship Cancer Institute, which engages with the Black population. Findings of this study showed that Black women had worse treatment outcomes and poorer survival rates compared to White women.
Neoadjuvant chemotherapy benefits patients with higher disease progression
Researchers explored treatment outcomes and patterns for early-stage triple negative breast cancer (eTNBC). This study showed that neoadjuvant chemotherapy benefited patients whose breast cancer was higher than stage II.
Tucatinib shows intracranial efficacy in patients with HER2-positive metastatic breast cancer
While tucatinib in combination with trastuzumab and capecitabine showed superior survival in heavily pre-treated women with HER2-positive metastatic breast cancer, this newest analysis specifically examined the patients in the trail that were also living with brain metastasis. What this analysis showed was that patients with brain metastasis who received tucatinib had an average of 9.9 months of progression free survival vs. 4.2 months for the group that did not receive tucatinib. In addition, the group treated with tucatinib had a median overall survival of 18 months compared to 12 months for patients not receiving tucatinib.
Initiating adjuvant endocrine therapy 12 to 24 months after diagnosis is comparable to current time of initiation
In a study of 391,594 women diagnosed with Stage II and III ER-positive and PR-positive, HER2-negative and invasive breast cancer, research found no negative impact on survival if adjuvant endocrine therapy begins 12 to 24 months after diagnosis compared to within 12 months of diagnosis. This result was found after accounting for age, race/ethnicity, insurance type, residence type, neighborhood income and education, comorbidity, cancer grade and stage, and when they received other cancer treatments and surgery.
The immunotherapy, pembrolizumab in combination with chemotherapy, improved progression free survival for patients with triple negative stage IV breast cancer who were PD-L1 positive
The latest results from the KEYNOTE-355 trial showed that patients with metastatic triple negative breast cancer whose tumours expressed PD-L1 (with a combined positive score of 10 or higher) who were treated with pembrolizumab in combination with a variety of chemotherapies had 9.7 months of progression free survival compared with 5.6 months for patients receiving chemotherapy alone.
AI can detect patients with residual tumors to spare breast surgery
Researchers looked into using Artificial Intelligence to detect breast cancer patients with residual tumor in the breast to identify patients that can forego surgery. The study of 570 women with stage I-III breast cancer found that AI may be able to reliably identify patients without residual disease and spared breast surgery in future trials.
What’s next for HR-positive/HER2-negative metastatic breast cancer patients after a CDK4/6 inhibitor?
Newly released data from the BYLieve trial shows that alpelisib plus fulvestrant may be an option for patients with a PIK3CA mutation after they’ve progressed on a CDK4/6 inhibitor.
Metastatic breast cancer patients can engage in moderate walking during active treatment
Metastatic breast cancer patients in their 3or or 4th line if chemotherapy used the Fitbit App to monitor their walking activity and filled out questionnaires at the beginning of the study, 12 weeks after and 24 weeks after. 49% of the participants were able to complete the 24-week walking program during active treatment.
De novo metastatic patients fare better than recurrent metastatic breast cancer patients
De novo metastatic breast cancer patients were found to have better outcomes compared to recurrent metastatic breast cancer patients. One factor of this finding is that more cases of triple negative and less cases of HER2-positive breast cancer were found amongst patients with recurrent metastatic breast cancer. However, future research is needed because even without these, de novo metastatic breast cancer patients still fared better.