Article

Key clinical point: Lenvatinib may continue to benefit patients with unresectable hepatocellular carcinoma (uHCC) despite liver function deterioration to Child-Pugh class B (CP-B) after therapy initiation.

Major finding: CP-B vs CP-A patients receiving lenvatinib had a median progression-free survival (PFS) and overall survival (OS) of 3.7 months (95% CI 1.8-7.4) vs 6.5 months (95% CI 5.6-7.4) and 6.8 months (95% CI 2.6-10.3) vs 13.3 months (95% CI 11.6-16.1), respectively. CP-B patients receiving sorafenib had a median PFS and OS of only 0.5 months (95% CI 0.1-3.6) and 4.5 months (95% CI 2.9-6.1, respectively. Lenvatinib showed no new safety signals in CP-B patients.

Study details: This post hoc analysis included patients with uHCC from the REFLECT trial whose liver function deteriorated to CP-B or remained CP-A within 8 weeks of randomization to lenvatinib (CP-B: n = 60; CP-A: n = 413) or sorafenib (CP-B: n = 47; CP-A: n = 427).

Disclosures: This study was funded by Eisai Inc. and Merck Sharp & Dohme (MSD) LLC. Some authors declared serving as speakers, consultants, or advisors for various organizations, including Eisai and MSD.

Source: Huynh J et al. Lenvatinib in patients with unresectable hepatocellular carcinoma who progressed to Child-Pugh B liver function. Ther Adv Med Oncol. 2022;14:17588359221116608 (Aug 24). Doi: 10.1177/17588359221116608

Key clinical point: Lenvatinib may continue to benefit patients with unresectable hepatocellular carcinoma (uHCC) despite liver function deterioration to Child-Pugh class B (CP-B) after therapy initiation.

Major finding: CP-B vs CP-A patients receiving lenvatinib had a median progression-free survival (PFS) and overall survival (OS) of 3.7 months (95% CI 1.8-7.4) vs 6.5 months (95% CI 5.6-7.4) and 6.8 months (95% CI 2.6-10.3) vs 13.3 months (95% CI 11.6-16.1), respectively. CP-B patients receiving sorafenib had a median PFS and OS of only 0.5 months (95% CI 0.1-3.6) and 4.5 months (95% CI 2.9-6.1, respectively. Lenvatinib showed no new safety signals in CP-B patients.

Study details: This post hoc analysis included patients with uHCC from the REFLECT trial whose liver function deteriorated to CP-B or remained CP-A within 8 weeks of randomization to lenvatinib (CP-B: n = 60; CP-A: n = 413) or sorafenib (CP-B: n = 47; CP-A: n = 427).

Disclosures: This study was funded by Eisai Inc. and Merck Sharp & Dohme (MSD) LLC. Some authors declared serving as speakers, consultants, or advisors for various organizations, including Eisai and MSD.

Source: Huynh J et al. Lenvatinib in patients with unresectable hepatocellular carcinoma who progressed to Child-Pugh B liver function. Ther Adv Med Oncol. 2022;14:17588359221116608 (Aug 24). Doi: 10.1177/17588359221116608

Key clinical point: Lenvatinib may continue to benefit patients with unresectable hepatocellular carcinoma (uHCC) despite liver function deterioration to Child-Pugh class B (CP-B) after therapy initiation.

Major finding: CP-B vs CP-A patients receiving lenvatinib had a median progression-free survival (PFS) and overall survival (OS) of 3.7 months (95% CI 1.8-7.4) vs 6.5 months (95% CI 5.6-7.4) and 6.8 months (95% CI 2.6-10.3) vs 13.3 months (95% CI 11.6-16.1), respectively. CP-B patients receiving sorafenib had a median PFS and OS of only 0.5 months (95% CI 0.1-3.6) and 4.5 months (95% CI 2.9-6.1, respectively. Lenvatinib showed no new safety signals in CP-B patients.

Study details: This post hoc analysis included patients with uHCC from the REFLECT trial whose liver function deteriorated to CP-B or remained CP-A within 8 weeks of randomization to lenvatinib (CP-B: n = 60; CP-A: n = 413) or sorafenib (CP-B: n = 47; CP-A: n = 427).

Disclosures: This study was funded by Eisai Inc. and Merck Sharp & Dohme (MSD) LLC. Some authors declared serving as speakers, consultants, or advisors for various organizations, including Eisai and MSD.

Source: Huynh J et al. Lenvatinib in patients with unresectable hepatocellular carcinoma who progressed to Child-Pugh B liver function. Ther Adv Med Oncol. 2022;14:17588359221116608 (Aug 24). Doi: 10.1177/17588359221116608

Key clinical point: Sintilimab plus IBI305 (a bevacizumab biosimilar) exhibits a promising efficacy and safety profile in patients with advanced hepatocellular carcinoma (HCC).

Major finding: After a median follow-up of 17.8 months, the overall response rate was 34.0% (95% CI 20.0%-48.0%) and the median progression-free survival and overall survival were 10.5 months (95% CI 8.3-12.7 months) and 20.2 months (95% CI 16.1-24.3 months), respectively. The grade 3-5 adverse event rate was 20.0%.

Study details: Findings are from a single-center phase 1b clinical trial that included 50 patients with advanced HCC who received sintilimab plus IBI305 every 3 weeks.

Disclosures: This study was partly supported by the Non-profit Central Research Institution Fund of the Chinese Academy of Medical Sciences. The authors declared no conflicts of interest.

Source: Zhang W et al. Serum concentration of CD137 and tumor infiltration by M1 macrophages predict the response to sintilimab plus bevacizumab biosimilar in advanced hepatocellular carcinoma patients. Clin Cancer Res. 2022;28(16):3499-3508 (Aug 15). Doi: 10.1158/1078-0432.CCR-21-3972

Key clinical point: Sintilimab plus IBI305 (a bevacizumab biosimilar) exhibits a promising efficacy and safety profile in patients with advanced hepatocellular carcinoma (HCC).

Major finding: After a median follow-up of 17.8 months, the overall response rate was 34.0% (95% CI 20.0%-48.0%) and the median progression-free survival and overall survival were 10.5 months (95% CI 8.3-12.7 months) and 20.2 months (95% CI 16.1-24.3 months), respectively. The grade 3-5 adverse event rate was 20.0%.

Study details: Findings are from a single-center phase 1b clinical trial that included 50 patients with advanced HCC who received sintilimab plus IBI305 every 3 weeks.

Disclosures: This study was partly supported by the Non-profit Central Research Institution Fund of the Chinese Academy of Medical Sciences. The authors declared no conflicts of interest.

Source: Zhang W et al. Serum concentration of CD137 and tumor infiltration by M1 macrophages predict the response to sintilimab plus bevacizumab biosimilar in advanced hepatocellular carcinoma patients. Clin Cancer Res. 2022;28(16):3499-3508 (Aug 15). Doi: 10.1158/1078-0432.CCR-21-3972

Key clinical point: Sintilimab plus IBI305 (a bevacizumab biosimilar) exhibits a promising efficacy and safety profile in patients with advanced hepatocellular carcinoma (HCC).

Major finding: After a median follow-up of 17.8 months, the overall response rate was 34.0% (95% CI 20.0%-48.0%) and the median progression-free survival and overall survival were 10.5 months (95% CI 8.3-12.7 months) and 20.2 months (95% CI 16.1-24.3 months), respectively. The grade 3-5 adverse event rate was 20.0%.

Study details: Findings are from a single-center phase 1b clinical trial that included 50 patients with advanced HCC who received sintilimab plus IBI305 every 3 weeks.

Disclosures: This study was partly supported by the Non-profit Central Research Institution Fund of the Chinese Academy of Medical Sciences. The authors declared no conflicts of interest.

Source: Zhang W et al. Serum concentration of CD137 and tumor infiltration by M1 macrophages predict the response to sintilimab plus bevacizumab biosimilar in advanced hepatocellular carcinoma patients. Clin Cancer Res. 2022;28(16):3499-3508 (Aug 15). Doi: 10.1158/1078-0432.CCR-21-3972

Key clinical point: Several preoperative and postoperative factors predict the risk for arm lymphedema in patients who undergo breast cancer (BC) surgery.

Major finding: Young age (<60 years; P < .001), high body mass index (P < .001), advanced preoperative T and N classifications (P ≤ .01), total mastectomy (P < .001), axillary dissection (P < .001), and collagen disease (P = .024) were the preoperative risk factors for lymphedema. Postoperative bleeding (P   =   .017), chemotherapy (P < .001), and radiotherapy (P < .001) were among the postoperative risk factors for lymphedema.

Study details: Findings are from a nationwide retrospective cohort study including 84,022 women who underwent BC surgery, of which 1547 patients received treatments for lymphedema.

Disclosures: This work was supported by the Ministry of Health, Labour and Welfare, Japan, and other sources. N Michihata declared serving as an employee at The University of Tokyo.

Source: Konishi T et al. Risk factors for arm lymphedema following breast cancer surgery: A Japanese nationwide database study of 84,022 patients. Breast Cancer. 2022 (Aug 23). Doi: 10.1007/s12282-022-01395-5.

Key clinical point: Several preoperative and postoperative factors predict the risk for arm lymphedema in patients who undergo breast cancer (BC) surgery.

Major finding: Young age (<60 years; P < .001), high body mass index (P < .001), advanced preoperative T and N classifications (P ≤ .01), total mastectomy (P < .001), axillary dissection (P < .001), and collagen disease (P = .024) were the preoperative risk factors for lymphedema. Postoperative bleeding (P   =   .017), chemotherapy (P < .001), and radiotherapy (P < .001) were among the postoperative risk factors for lymphedema.

Study details: Findings are from a nationwide retrospective cohort study including 84,022 women who underwent BC surgery, of which 1547 patients received treatments for lymphedema.

Disclosures: This work was supported by the Ministry of Health, Labour and Welfare, Japan, and other sources. N Michihata declared serving as an employee at The University of Tokyo.

Source: Konishi T et al. Risk factors for arm lymphedema following breast cancer surgery: A Japanese nationwide database study of 84,022 patients. Breast Cancer. 2022 (Aug 23). Doi: 10.1007/s12282-022-01395-5.

Key clinical point: Several preoperative and postoperative factors predict the risk for arm lymphedema in patients who undergo breast cancer (BC) surgery.

Major finding: Young age (<60 years; P < .001), high body mass index (P < .001), advanced preoperative T and N classifications (P ≤ .01), total mastectomy (P < .001), axillary dissection (P < .001), and collagen disease (P = .024) were the preoperative risk factors for lymphedema. Postoperative bleeding (P   =   .017), chemotherapy (P < .001), and radiotherapy (P < .001) were among the postoperative risk factors for lymphedema.

Study details: Findings are from a nationwide retrospective cohort study including 84,022 women who underwent BC surgery, of which 1547 patients received treatments for lymphedema.

Disclosures: This work was supported by the Ministry of Health, Labour and Welfare, Japan, and other sources. N Michihata declared serving as an employee at The University of Tokyo.

Source: Konishi T et al. Risk factors for arm lymphedema following breast cancer surgery: A Japanese nationwide database study of 84,022 patients. Breast Cancer. 2022 (Aug 23). Doi: 10.1007/s12282-022-01395-5.

Key clinical point: Letrozole-associated controlled ovarian hyperstimulation (LetCOH) was as effective as conventional controlled ovarian hyperstimulation (cCOH) for fertility preservation (FP) and minimized the risk for supraphysiologic estrogen exposure; however, more patients in the LetCOH group relapsed.

Major finding: In the LetCOH vs cCOH group, estradiol peak at the ovulation trigger was lower, but oocyte maturation rates were significantly higher (P < .001), and the final number of mature oocytes collected was comparable (P   =   .281). Disease recurrence occurred in 17% and 7.2% of patients in the LetCOH and cCOH groups, respectively.

Study details: Findings are from a retrospective observational study including 97 patients with nonmetastatic breast cancer (BC) who were ≤ 40 years old and had undergone FP with LetCOH (n = 41) or cCOH (n = 56) before receiving chemotherapy.

Disclosures: This study did not receive any funding. I Demeestere declared receiving honoraria and support and serving as a consultant or advisor for several sources outside this work.

Source: Goldrat O et al. Efficacy and safety of controlled ovarian hyperstimulation with or without letrozole for fertility preservation in breast cancer patients: A multicenter retrospective study. Eur J Cancer. 2022;174:134-141 (Aug 20). Doi: 10.1016/j.ejca.2022.07.017

Key clinical point: Letrozole-associated controlled ovarian hyperstimulation (LetCOH) was as effective as conventional controlled ovarian hyperstimulation (cCOH) for fertility preservation (FP) and minimized the risk for supraphysiologic estrogen exposure; however, more patients in the LetCOH group relapsed.

Major finding: In the LetCOH vs cCOH group, estradiol peak at the ovulation trigger was lower, but oocyte maturation rates were significantly higher (P < .001), and the final number of mature oocytes collected was comparable (P   =   .281). Disease recurrence occurred in 17% and 7.2% of patients in the LetCOH and cCOH groups, respectively.

Study details: Findings are from a retrospective observational study including 97 patients with nonmetastatic breast cancer (BC) who were ≤ 40 years old and had undergone FP with LetCOH (n = 41) or cCOH (n = 56) before receiving chemotherapy.

Disclosures: This study did not receive any funding. I Demeestere declared receiving honoraria and support and serving as a consultant or advisor for several sources outside this work.

Source: Goldrat O et al. Efficacy and safety of controlled ovarian hyperstimulation with or without letrozole for fertility preservation in breast cancer patients: A multicenter retrospective study. Eur J Cancer. 2022;174:134-141 (Aug 20). Doi: 10.1016/j.ejca.2022.07.017

Key clinical point: Letrozole-associated controlled ovarian hyperstimulation (LetCOH) was as effective as conventional controlled ovarian hyperstimulation (cCOH) for fertility preservation (FP) and minimized the risk for supraphysiologic estrogen exposure; however, more patients in the LetCOH group relapsed.

Major finding: In the LetCOH vs cCOH group, estradiol peak at the ovulation trigger was lower, but oocyte maturation rates were significantly higher (P < .001), and the final number of mature oocytes collected was comparable (P   =   .281). Disease recurrence occurred in 17% and 7.2% of patients in the LetCOH and cCOH groups, respectively.

Study details: Findings are from a retrospective observational study including 97 patients with nonmetastatic breast cancer (BC) who were ≤ 40 years old and had undergone FP with LetCOH (n = 41) or cCOH (n = 56) before receiving chemotherapy.

Disclosures: This study did not receive any funding. I Demeestere declared receiving honoraria and support and serving as a consultant or advisor for several sources outside this work.

Source: Goldrat O et al. Efficacy and safety of controlled ovarian hyperstimulation with or without letrozole for fertility preservation in breast cancer patients: A multicenter retrospective study. Eur J Cancer. 2022;174:134-141 (Aug 20). Doi: 10.1016/j.ejca.2022.07.017

Key clinical point: Women who were diagnosed with breast cancer (BC) at a young age and underwent fertility preservation (FP) did not experience any increased risk for disease-specific mortality or relapse.

Major finding: Compared with women who did not undergo FP, disease-specific mortality was similar in women who underwent hormonal FP (adjusted hazard ratio [aHR] 0.59; 95% CI 0.32-1.09) and nonhormonal FP (aHR 0.51; 95% CI 0.20-1.29). Hormonal (aHR 0.81; 95% CI 0.49-1.37) and nonhormonal (aHR 0.75; 95% CI 0.35-1.62) FP were associated with similar relapse or death rates in a subcohort of 723 women with complete relapse information.

Study details: Findings are from an analysis of a population-based nationwide cohort study including 1275 women of reproductive age (18-44 years old) who were diagnosed with BC, of which 425 women received hormonal (n = 367) or nonhormonal (n = 58) FP treatment.

Disclosures: This study was supported by the Swedish Cancer Society and other sources. Prof. Bergh declared receiving grants and personal fees from several sources.

Source: Marklund A et al. Relapse rates and disease-specific mortality following procedures for fertility preservation at time of breast cancer diagnosis. JAMA Oncol. 2022 (Aug 25). Doi: 10.1001/jamaoncol.2022.3677

Key clinical point: Women who were diagnosed with breast cancer (BC) at a young age and underwent fertility preservation (FP) did not experience any increased risk for disease-specific mortality or relapse.

Major finding: Compared with women who did not undergo FP, disease-specific mortality was similar in women who underwent hormonal FP (adjusted hazard ratio [aHR] 0.59; 95% CI 0.32-1.09) and nonhormonal FP (aHR 0.51; 95% CI 0.20-1.29). Hormonal (aHR 0.81; 95% CI 0.49-1.37) and nonhormonal (aHR 0.75; 95% CI 0.35-1.62) FP were associated with similar relapse or death rates in a subcohort of 723 women with complete relapse information.

Study details: Findings are from an analysis of a population-based nationwide cohort study including 1275 women of reproductive age (18-44 years old) who were diagnosed with BC, of which 425 women received hormonal (n = 367) or nonhormonal (n = 58) FP treatment.

Disclosures: This study was supported by the Swedish Cancer Society and other sources. Prof. Bergh declared receiving grants and personal fees from several sources.

Source: Marklund A et al. Relapse rates and disease-specific mortality following procedures for fertility preservation at time of breast cancer diagnosis. JAMA Oncol. 2022 (Aug 25). Doi: 10.1001/jamaoncol.2022.3677

Key clinical point: Women who were diagnosed with breast cancer (BC) at a young age and underwent fertility preservation (FP) did not experience any increased risk for disease-specific mortality or relapse.

Major finding: Compared with women who did not undergo FP, disease-specific mortality was similar in women who underwent hormonal FP (adjusted hazard ratio [aHR] 0.59; 95% CI 0.32-1.09) and nonhormonal FP (aHR 0.51; 95% CI 0.20-1.29). Hormonal (aHR 0.81; 95% CI 0.49-1.37) and nonhormonal (aHR 0.75; 95% CI 0.35-1.62) FP were associated with similar relapse or death rates in a subcohort of 723 women with complete relapse information.

Study details: Findings are from an analysis of a population-based nationwide cohort study including 1275 women of reproductive age (18-44 years old) who were diagnosed with BC, of which 425 women received hormonal (n = 367) or nonhormonal (n = 58) FP treatment.

Disclosures: This study was supported by the Swedish Cancer Society and other sources. Prof. Bergh declared receiving grants and personal fees from several sources.

Source: Marklund A et al. Relapse rates and disease-specific mortality following procedures for fertility preservation at time of breast cancer diagnosis. JAMA Oncol. 2022 (Aug 25). Doi: 10.1001/jamaoncol.2022.3677

Key clinical point: In estrogen receptor-positive/human epidermal growth factor receptor-positive (ER+/HER2+) breast cancer (BC), HER2-enriched (HER2-E) tumors were more likely to respond poorly to aromatase inhibitor (AI) therapy and pose an increased risk for disease recurrence.

Major finding: AI-treated HER2-E tumors were associated with poorer Ki67 response and higher Ki67 expression level at 2-weeks timepoint compared with luminal A and B tumors (odds ratio 1.52-12.31; false discovery rate < 0.0001). HER2-E subtype was an independent predictor of shorter time to recurrence (hazard ratio 2.55; P   =   .022).

Study details: Findings are from the phase 3 POETIC trial including 342 patients with early ER+/HER2+ BC who were assigned to 2 weeks of perisurgical AI (n = 237) or no AI (n = 105).

Disclosures: This study was funded by Cancer Research UK. Some authors declared holding or filing patents or receiving grants, nonfinancial support, consulting fees, honoraria, or research funding from several sources.

Source: Bergamino MA et al. HER2-enriched subtype and novel molecular subgroups drive aromatase inhibitor resistance and an increased risk of relapse in early ER+/HER2+ breast cancer. EBioMedicine. 2022;83:104205 (Aug 16). Doi: 10.1016/j.ebiom.2022.104205

Key clinical point: In estrogen receptor-positive/human epidermal growth factor receptor-positive (ER+/HER2+) breast cancer (BC), HER2-enriched (HER2-E) tumors were more likely to respond poorly to aromatase inhibitor (AI) therapy and pose an increased risk for disease recurrence.

Major finding: AI-treated HER2-E tumors were associated with poorer Ki67 response and higher Ki67 expression level at 2-weeks timepoint compared with luminal A and B tumors (odds ratio 1.52-12.31; false discovery rate < 0.0001). HER2-E subtype was an independent predictor of shorter time to recurrence (hazard ratio 2.55; P   =   .022).

Study details: Findings are from the phase 3 POETIC trial including 342 patients with early ER+/HER2+ BC who were assigned to 2 weeks of perisurgical AI (n = 237) or no AI (n = 105).

Disclosures: This study was funded by Cancer Research UK. Some authors declared holding or filing patents or receiving grants, nonfinancial support, consulting fees, honoraria, or research funding from several sources.

Source: Bergamino MA et al. HER2-enriched subtype and novel molecular subgroups drive aromatase inhibitor resistance and an increased risk of relapse in early ER+/HER2+ breast cancer. EBioMedicine. 2022;83:104205 (Aug 16). Doi: 10.1016/j.ebiom.2022.104205

Key clinical point: In estrogen receptor-positive/human epidermal growth factor receptor-positive (ER+/HER2+) breast cancer (BC), HER2-enriched (HER2-E) tumors were more likely to respond poorly to aromatase inhibitor (AI) therapy and pose an increased risk for disease recurrence.

Major finding: AI-treated HER2-E tumors were associated with poorer Ki67 response and higher Ki67 expression level at 2-weeks timepoint compared with luminal A and B tumors (odds ratio 1.52-12.31; false discovery rate < 0.0001). HER2-E subtype was an independent predictor of shorter time to recurrence (hazard ratio 2.55; P   =   .022).

Study details: Findings are from the phase 3 POETIC trial including 342 patients with early ER+/HER2+ BC who were assigned to 2 weeks of perisurgical AI (n = 237) or no AI (n = 105).

Disclosures: This study was funded by Cancer Research UK. Some authors declared holding or filing patents or receiving grants, nonfinancial support, consulting fees, honoraria, or research funding from several sources.

Source: Bergamino MA et al. HER2-enriched subtype and novel molecular subgroups drive aromatase inhibitor resistance and an increased risk of relapse in early ER+/HER2+ breast cancer. EBioMedicine. 2022;83:104205 (Aug 16). Doi: 10.1016/j.ebiom.2022.104205

Key clinical point: Patients with human epidermal growth factor receptor 2-positive (ERBB2+) and triple-negative breast cancer (TNBC) are more likely to need radiation for brain metastasis (BRM) than those with other BC subtypes.

Major finding: At the 3-year timepoint, the cumulative incidences of BRM was highest in patients with ERBB2+/hormone receptor-negative (HR−) BC (25.3%). TNBC (hazard ratio 4.25), ERBB2+/HR+ BC (hazard ratio 1.94), and ERBB2+/HR− BC (hazard ratio 2.81; all P < .001) were associated with a shorter time from BC diagnosis to brain radiotherapy than HR+/ERBB2− BC. Patients who received radiotherapy for BRM were more likely to have TNBC or ERBB2+ BC than HR+/ERBB2− BC (P < .001).

Study details: Findings are from a retrospective, observational population-based cohort study including 3916 patients with metastatic BC, of which 31.0% had HR+/ERBB2− BC, 7.9% had ERBB2+/HR+ BC, 5.1% had ERBB2+/HR− BC, and 6.6% had TNBC.

Disclosures: This research was supported by Eli Lilly. Some authors declared serving as consultants, board members, or speakers or receiving grants or personal fees from several sources, including Eli Lilly.

Source: Wang XY et al. Analysis of rates of brain metastases and association with breast cancer subtypes in Ontario, Canada. JAMA Netw Open. 2022;5(8):e2225424 (Aug 12). Doi: 10.1001/jamanetworkopen.2022.25424

Key clinical point: Patients with human epidermal growth factor receptor 2-positive (ERBB2+) and triple-negative breast cancer (TNBC) are more likely to need radiation for brain metastasis (BRM) than those with other BC subtypes.

Major finding: At the 3-year timepoint, the cumulative incidences of BRM was highest in patients with ERBB2+/hormone receptor-negative (HR−) BC (25.3%). TNBC (hazard ratio 4.25), ERBB2+/HR+ BC (hazard ratio 1.94), and ERBB2+/HR− BC (hazard ratio 2.81; all P < .001) were associated with a shorter time from BC diagnosis to brain radiotherapy than HR+/ERBB2− BC. Patients who received radiotherapy for BRM were more likely to have TNBC or ERBB2+ BC than HR+/ERBB2− BC (P < .001).

Study details: Findings are from a retrospective, observational population-based cohort study including 3916 patients with metastatic BC, of which 31.0% had HR+/ERBB2− BC, 7.9% had ERBB2+/HR+ BC, 5.1% had ERBB2+/HR− BC, and 6.6% had TNBC.

Disclosures: This research was supported by Eli Lilly. Some authors declared serving as consultants, board members, or speakers or receiving grants or personal fees from several sources, including Eli Lilly.

Source: Wang XY et al. Analysis of rates of brain metastases and association with breast cancer subtypes in Ontario, Canada. JAMA Netw Open. 2022;5(8):e2225424 (Aug 12). Doi: 10.1001/jamanetworkopen.2022.25424

Key clinical point: Patients with human epidermal growth factor receptor 2-positive (ERBB2+) and triple-negative breast cancer (TNBC) are more likely to need radiation for brain metastasis (BRM) than those with other BC subtypes.

Major finding: At the 3-year timepoint, the cumulative incidences of BRM was highest in patients with ERBB2+/hormone receptor-negative (HR−) BC (25.3%). TNBC (hazard ratio 4.25), ERBB2+/HR+ BC (hazard ratio 1.94), and ERBB2+/HR− BC (hazard ratio 2.81; all P < .001) were associated with a shorter time from BC diagnosis to brain radiotherapy than HR+/ERBB2− BC. Patients who received radiotherapy for BRM were more likely to have TNBC or ERBB2+ BC than HR+/ERBB2− BC (P < .001).

Study details: Findings are from a retrospective, observational population-based cohort study including 3916 patients with metastatic BC, of which 31.0% had HR+/ERBB2− BC, 7.9% had ERBB2+/HR+ BC, 5.1% had ERBB2+/HR− BC, and 6.6% had TNBC.

Disclosures: This research was supported by Eli Lilly. Some authors declared serving as consultants, board members, or speakers or receiving grants or personal fees from several sources, including Eli Lilly.

Source: Wang XY et al. Analysis of rates of brain metastases and association with breast cancer subtypes in Ontario, Canada. JAMA Netw Open. 2022;5(8):e2225424 (Aug 12). Doi: 10.1001/jamanetworkopen.2022.25424

Key clinical point: Lapatinib demonstrated excellent survival outcomes in patients with small, node-negative, human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC), when used in combination with trastuzumab, but not when used as a substitute for trastuzumab.

Major finding: The 7-year disease-free survival (DFS) rate in the overall cohort was excellent (88.1%), with improved DFS outcomes observed in the trastuzumab (89.6%), trastuzumab followed by lapatinib (89.0%), and trastuzumab+lapatinib (89.1%) arms, but not as much in the lapatinib-only arm (84.3%; stratified log-rank P   =   .031).

Study details: Findings are from a subanalysis of the phase 3 ALTTO trial including 2821 patients with small (pathological tumor size ≤ 3 cm), lymph node-negative, early HER2+ BC who were randomly assigned to receive adjuvant therapy with trastuzumab, lapatinib, trastuzumab followed by lapatinib, or trastuzumab+lapatinib.

Disclosures: The ALTTO trial received funding from GlaxoSmithKline, Novartis Pharma AG, and other sources. Two authors declared being employees of and owning stocks in Novartis. The other authors reported ties with several sources, including Novartis.

Source: Nader-Marta G et al. Outcomes of patients with small and node-negative HER2-positive early breast cancer treated with adjuvant chemotherapy and anti-HER2 therapy-a sub-analysis of the ALTTO study. Br J Cancer. 2022 (Sep 1). Doi: 10.1038/s41416-022-01963-8

Key clinical point: Lapatinib demonstrated excellent survival outcomes in patients with small, node-negative, human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC), when used in combination with trastuzumab, but not when used as a substitute for trastuzumab.

Major finding: The 7-year disease-free survival (DFS) rate in the overall cohort was excellent (88.1%), with improved DFS outcomes observed in the trastuzumab (89.6%), trastuzumab followed by lapatinib (89.0%), and trastuzumab+lapatinib (89.1%) arms, but not as much in the lapatinib-only arm (84.3%; stratified log-rank P   =   .031).

Study details: Findings are from a subanalysis of the phase 3 ALTTO trial including 2821 patients with small (pathological tumor size ≤ 3 cm), lymph node-negative, early HER2+ BC who were randomly assigned to receive adjuvant therapy with trastuzumab, lapatinib, trastuzumab followed by lapatinib, or trastuzumab+lapatinib.

Disclosures: The ALTTO trial received funding from GlaxoSmithKline, Novartis Pharma AG, and other sources. Two authors declared being employees of and owning stocks in Novartis. The other authors reported ties with several sources, including Novartis.

Source: Nader-Marta G et al. Outcomes of patients with small and node-negative HER2-positive early breast cancer treated with adjuvant chemotherapy and anti-HER2 therapy-a sub-analysis of the ALTTO study. Br J Cancer. 2022 (Sep 1). Doi: 10.1038/s41416-022-01963-8

Key clinical point: Lapatinib demonstrated excellent survival outcomes in patients with small, node-negative, human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC), when used in combination with trastuzumab, but not when used as a substitute for trastuzumab.

Major finding: The 7-year disease-free survival (DFS) rate in the overall cohort was excellent (88.1%), with improved DFS outcomes observed in the trastuzumab (89.6%), trastuzumab followed by lapatinib (89.0%), and trastuzumab+lapatinib (89.1%) arms, but not as much in the lapatinib-only arm (84.3%; stratified log-rank P   =   .031).

Study details: Findings are from a subanalysis of the phase 3 ALTTO trial including 2821 patients with small (pathological tumor size ≤ 3 cm), lymph node-negative, early HER2+ BC who were randomly assigned to receive adjuvant therapy with trastuzumab, lapatinib, trastuzumab followed by lapatinib, or trastuzumab+lapatinib.

Disclosures: The ALTTO trial received funding from GlaxoSmithKline, Novartis Pharma AG, and other sources. Two authors declared being employees of and owning stocks in Novartis. The other authors reported ties with several sources, including Novartis.

Source: Nader-Marta G et al. Outcomes of patients with small and node-negative HER2-positive early breast cancer treated with adjuvant chemotherapy and anti-HER2 therapy-a sub-analysis of the ALTTO study. Br J Cancer. 2022 (Sep 1). Doi: 10.1038/s41416-022-01963-8

Key clinical point: Neratinib as monotherapy or in combination with capecitabine showed good survival outcomes and was well tolerated in a real-world setting of patients with advanced human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC) with or without brain metastases (BM).

Major finding: The median progression-free survival (PFS) and overall survival (OS) for all patients were 5.9 months (95% CI 4.9-7.4) and 15.0 months (95% CI 10.4-22.2), respectively, with survival outcomes being similar in patients with vs without BM. PFS and OS were significantly longer with neratinib+capecitabine vs neratinib (P ≤ .001). Diarrhea was the major adverse event (64%) with 10% being grade 3.

Study details: Findings are from a single-center retrospective study including 72 patients with advanced HER2+ BC who received neratinib (n = 27) or neratinib+capecitabine (n = 45). Thirty-eight patients had BM.

Disclosures: This study was supported by the Royal Marsden National Institute for Health and Care Research Biomedical Research Centre for Cancer, UK. The authors declared receiving research funding, speaker’s fees, honoraria, or travel support from several sources.

Source: Cunningham N et al. Neratinib in advanced HER2-positive breast cancer: Experience from the Royal Marsden Hospital. Breast Cancer Res Treat. 2022;195(3):333-340 (Aug 17). Doi: 10.1007/s10549-022-06703-3

Key clinical point: Neratinib as monotherapy or in combination with capecitabine showed good survival outcomes and was well tolerated in a real-world setting of patients with advanced human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC) with or without brain metastases (BM).

Major finding: The median progression-free survival (PFS) and overall survival (OS) for all patients were 5.9 months (95% CI 4.9-7.4) and 15.0 months (95% CI 10.4-22.2), respectively, with survival outcomes being similar in patients with vs without BM. PFS and OS were significantly longer with neratinib+capecitabine vs neratinib (P ≤ .001). Diarrhea was the major adverse event (64%) with 10% being grade 3.

Study details: Findings are from a single-center retrospective study including 72 patients with advanced HER2+ BC who received neratinib (n = 27) or neratinib+capecitabine (n = 45). Thirty-eight patients had BM.

Disclosures: This study was supported by the Royal Marsden National Institute for Health and Care Research Biomedical Research Centre for Cancer, UK. The authors declared receiving research funding, speaker’s fees, honoraria, or travel support from several sources.

Source: Cunningham N et al. Neratinib in advanced HER2-positive breast cancer: Experience from the Royal Marsden Hospital. Breast Cancer Res Treat. 2022;195(3):333-340 (Aug 17). Doi: 10.1007/s10549-022-06703-3

Key clinical point: Neratinib as monotherapy or in combination with capecitabine showed good survival outcomes and was well tolerated in a real-world setting of patients with advanced human epidermal growth factor receptor 2-positive (HER2+) breast cancer (BC) with or without brain metastases (BM).

Major finding: The median progression-free survival (PFS) and overall survival (OS) for all patients were 5.9 months (95% CI 4.9-7.4) and 15.0 months (95% CI 10.4-22.2), respectively, with survival outcomes being similar in patients with vs without BM. PFS and OS were significantly longer with neratinib+capecitabine vs neratinib (P ≤ .001). Diarrhea was the major adverse event (64%) with 10% being grade 3.

Study details: Findings are from a single-center retrospective study including 72 patients with advanced HER2+ BC who received neratinib (n = 27) or neratinib+capecitabine (n = 45). Thirty-eight patients had BM.

Disclosures: This study was supported by the Royal Marsden National Institute for Health and Care Research Biomedical Research Centre for Cancer, UK. The authors declared receiving research funding, speaker’s fees, honoraria, or travel support from several sources.

Source: Cunningham N et al. Neratinib in advanced HER2-positive breast cancer: Experience from the Royal Marsden Hospital. Breast Cancer Res Treat. 2022;195(3):333-340 (Aug 17). Doi: 10.1007/s10549-022-06703-3

Key clinical point: Addition of durvalumab to neoadjuvant chemotherapy (NACT) improved survival in women with early triple-negative breast cancer (TNBC) although improvement in the pathological complete response (pCR) rate was nonsignificant.

Major finding: In the overall cohort, durvalumab vs placebo improved 3-year invasive disease-free survival (hazard ratio [HR] 0.48; log-rank P   =   .036), distant disease-free survival (HR 0.31; log-rank P   =   .005), and overall survival (HR 0.24; log-rank P   =   .006) rates, despite no adjuvant component of durvalumab.

Study details: Findings are from the phase 2 GeparNuevo study including 174 patients with primary nonmetastatic TNBC who were randomly assigned to receive NACT with durvalumab or placebo.

Disclosures: This study was funded by AstraZeneca and Celgene. The authors declared receiving grants, personal fees, nonfinancial support, or other support from several sources.

Source: Loibl S et al. Neoadjuvant durvalumab improves survival in early triple-negative breast cancer independent of pathological complete response. Ann Oncol. 2022 (Aug 9). Doi: 10.1016/j.annonc.2022.07.1940

Key clinical point: Addition of durvalumab to neoadjuvant chemotherapy (NACT) improved survival in women with early triple-negative breast cancer (TNBC) although improvement in the pathological complete response (pCR) rate was nonsignificant.

Major finding: In the overall cohort, durvalumab vs placebo improved 3-year invasive disease-free survival (hazard ratio [HR] 0.48; log-rank P   =   .036), distant disease-free survival (HR 0.31; log-rank P   =   .005), and overall survival (HR 0.24; log-rank P   =   .006) rates, despite no adjuvant component of durvalumab.

Study details: Findings are from the phase 2 GeparNuevo study including 174 patients with primary nonmetastatic TNBC who were randomly assigned to receive NACT with durvalumab or placebo.

Disclosures: This study was funded by AstraZeneca and Celgene. The authors declared receiving grants, personal fees, nonfinancial support, or other support from several sources.

Source: Loibl S et al. Neoadjuvant durvalumab improves survival in early triple-negative breast cancer independent of pathological complete response. Ann Oncol. 2022 (Aug 9). Doi: 10.1016/j.annonc.2022.07.1940

Key clinical point: Addition of durvalumab to neoadjuvant chemotherapy (NACT) improved survival in women with early triple-negative breast cancer (TNBC) although improvement in the pathological complete response (pCR) rate was nonsignificant.

Major finding: In the overall cohort, durvalumab vs placebo improved 3-year invasive disease-free survival (hazard ratio [HR] 0.48; log-rank P   =   .036), distant disease-free survival (HR 0.31; log-rank P   =   .005), and overall survival (HR 0.24; log-rank P   =   .006) rates, despite no adjuvant component of durvalumab.

Study details: Findings are from the phase 2 GeparNuevo study including 174 patients with primary nonmetastatic TNBC who were randomly assigned to receive NACT with durvalumab or placebo.

Disclosures: This study was funded by AstraZeneca and Celgene. The authors declared receiving grants, personal fees, nonfinancial support, or other support from several sources.

Source: Loibl S et al. Neoadjuvant durvalumab improves survival in early triple-negative breast cancer independent of pathological complete response. Ann Oncol. 2022 (Aug 9). Doi: 10.1016/j.annonc.2022.07.1940