Recent Breast Cancer Research Results Suggest New Treatment Options

During the past 18 months, numerous clinical trials have reported important findings that impact breast cancer treatment. In two recent articles in The ASCO Post, Jame Abraham, MD, Cleveland Clinic’s Director of Medical Breast Oncology and Co-Director of the Comprehensive Breast Cancer Program, reviews some of the latest research highlights, excerpted from “Breast Cancer Year in Review: 2014 and Beyond.”

Genetics and Adjuvant Therapy

• A study on mutations in PALB2 suggests that breast cancer risk for PALB2 mutation carriers may overlap with risk for BRCA2 mutation carriers. As investigators continue to identify more genes like PALB2, they can develop better and more effective treatment and risk-reduction strategies.
• Other studies focused on adjuvant therapies based on receptor status. A phase II study of adjuvant paclitaxel and trastuzumab reported a 98.7 percent, three-year invasive disease-free survival rate. This study suggests a less toxic treatment protocol that will change oncology practice in low-risk patients like those who participated in the trial.
• Another study investigated using a targeted anti-HER2 agent in addition to chemotherapy, finding that all patient subgroups benefited from the addition of the agent. The key finding from this long-term follow-up analysis is the benefit of the anti-HER2 agent beyond five years and as long as 10 years.
• Two related studies, the TEXT and SOFT trials, investigated the benefit of using adjuvant ovarian suppression in combination with an aromatase inhibitor or tamoxifen to treat premenopausal women with receptor-positive breast cancer. Findings indicate adjuvant treatment with the aromatase inhibitor exemestane plus ovarian suppression significantly reduced tumor recurrence, moreso than tamoxifen combined with ovarian suppression.

Read the Part 1 review at The ASCO Post

Endocrine Therapeutics and Survivorship Research

• The phase II PALOMA-1/TRIO-18 trial reported supporting data that accelerated U.S. Food and Drug Administration approval for palbociclib. Palbociclib is a highly selective inhibitor of cyclin-dependent kinase 4 and 6 and is the first CDK inhibitor approved for use in breast cancer patients. This oral agent is used in combination with letrozole in treating postmenopausal women with estrogen receptor–positive, HER2-negative metastatic breast cancer.
• Another Phase II study, FIRST, compared the efficacy of two endocrine therapeutics in women with advanced breast cancer. Women given fulvestrant had a longer overall survival compared with those given anastrozole. If the phase III trial confirms these results, investigators believe the FDA should consider approving fulvestrant as a first-line agent in treating advanced disease.
• Preserving fertility is a key issue when treating premenopausal women with early-stage breast cancer. POEMS-SWOG S0230, a randomized phase III trial, evaluated reducing premature ovarian failure by using a luteinizing hormone-releasing hormone analog in combination with chemotherapy. Fewer cases of ovarian failure and more pregnancies occurred in women who received the hormone analog with chemotherapy, compared with those who received only standard chemotherapy.
• A nutrition study of more than 2,400 women with early-stage breast cancer suggested that dietary intervention during their standard cancer therapy favorably influenced survival in the hormone receptor-negative subgroup.
• Another survivorship study focused on how exercise impacts treatment-induced joint pain compared with standard care for previously inactive breast cancer survivors. Participants who completed regular aerobic exercise sessions reported a 29 percent decrease in their worst joint pain scores, compared with a 3 percent increase in joint pain reported by those who received standard care.

Read the Part 2 review at The ASCO Post