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7 interesting highlights from the 2018 San Antonio Breast Cancer Symposium

Last month, we had the opportunity to attend the 2018 San Antonio Breast Cancer Symposium (SABCS). Here’s some of the key highlights to come out of the conference. 

  1. The addition of immunotherapy to chemotherapy can benefit some metastatic triple negative breast cancer patients 
    New phase III data of the Impassion130 trial showed that metastatic triple negative patients with positive PD-L1 biomarkers on immune cells showed increased progression free survival and overall survival when adding immunotherapy atezolizumab to nab-paclitaxel chemotherapy. Patients who did not have PD-L1 expression did not benefit from this combination. The study also looked at the BRCA mutation status and found that the results were consistent regardless of whether the patient had a BRCA mutation. Read more   

  1. Adjuvant T-DM1 for early staged HER2+ breast cancer patients likely will be new standard of care  
    Phase III of the KATHERINE study compared the use of trastuzumab emtansine (T-DM1) versus trastuzumab alone for HER2+ early stage breast cancer patients treated with neo-adjuvant therapy. The preliminary results found that patients who had neo-adjuvant therapy and still had the presence of a tumour at the time of surgery benefited from adjuvant treatment of T-DM1. There was a 50% reduction in invasive recurrence for patients who received T-DM1. This benefit was overwhelmingly consistent across several subgroups. Read more 

  1. Improved outcomes for patients who achieved pathological complete response (pCR) following neo-adjuvant chemotherapy 
    In a global analysis of 52 studies and over 27,000 patients who received neo-adjuvant chemotherapy and achieved pathological complete response (the lack of any residual disease at the time of surgery) were 69% less likely to have a recurrence. Event-free survival (EVS) and overall survival (OS) was significantly improved particularly for triple negative breast cancer and HER2+ breast cancer, with 82% and 68%, respectively, less likely to have recurrence. Read more 

  1. Lowering the dose of tamoxifen continues to provide benefit to DCIS patients 
    The study compared a low-dose, 5 mg per day, of tamoxifen with a typical 20mg per day in women with ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS) and atypical ductal carcinoma (ADH). The results found that the lower dose continued to reduce the risk of recurrence by 52%. It also found that it reduced contralateral breast cancer (new breast cancer in the other breast) by 75% indicating that it could benefit in a preventative setting but more exploration of this needed. Read more 

  1. Patients with PIK3CA mutation have better progression free survival with combination of alpelisib and fulvestrant 
    New data from the phase III SOLAR-1 trial found that patients who have advanced ER+ breast cancer and have positive PIK3CA mutation benefit from improved progression free survival when treated with alpelisib and fulvestrant than with fulvestrant alone. This benefit was seen regardless of the line of therapy or prior CDK4/6 inhibitor treatment, but the largest benefits were seen in the 2nd line setting. This study also determined that using liquid biopsies to assess the PIK3CA mutation were better at predicting benefit of this treatment combination. Read more 

  1. Beta-blockers and ACE inhibitors can help reduce cardiac side effects during trastuzumab treatment 
    This study looked at the benefits of adding cardiac treatment drugs, specifically an ACE inhibitor called lisinopril or a beta-blocker called carvedilol, to adjuvant trastuzumab treatment for early stage HER2+ breast cancer patients. For patients taking trastuzumab + an anthracycline chemotherapy, the addition of the cardiac drugs reduced cardiotoxicity by 47% for the ACE inhibitor and 51% for the beta-blocker. For patients who were receiving trastuzumab alone, however, there was no significant decrease in cardiac events. Read more  

  1. Oxybutynin can aid in management of hot flashes associated with breast cancer treatment 
    Hot flashes, a common side effect of breast cancer treatment, can often lead to discontinuation or non-compliance to drugs like tamoxifen. A new trial found that the use of oxybutynin, a drug commonly used to treat overactive bladder, can significantly reduce hot flash frequency and severity and can help improve quality of life. Furthermore, oxybutynin did not interfere with the effectiveness of tamoxifen and additional side effects associated with oxybutynin were low. Read more 

Photo by Matthew LeJune on Unsplash