Article

Key clinical point: Adjuvant pembrolizumab boosts disease-free survival (DFS) in patients with early-stage non–small-cell lung cancer (NSCLC) after complete resection.

Major finding: DFS was 53.6 months in the pembrolizumab group vs. 42.0 months in the placebo group (hazard ratio 0.76; P = .0014). The DFS benefit was generally consistent across patients with programmed death ligand-1 tumor proportion score of <1%, 1%-49%, and ≥50%.

Study details: The data come from an interim analysis of the phase 3 PEARLS/KEYNOTE-091 trial, in which 1177 adults with stage IB, II, or IIIA NSCLC were randomly assigned to receive 200 mg pembrolizumab (n = 590) or placebo (n = 587) every 3 weeks.

Disclosures: The trial was funded by Merck Sharp & Dohme Corp. L Paz-Ares, MER O’Brien, U Dafni, K Oselin, D Isla, A Martinez-Marti, M Faehling, M Tsuboi, K Nakagawa, J Yang, SM Keller, RA Stahel, S Peters, and B Besse reported ties with one or more pharmaceutical companies, including Merck Sharp & Dohme. The other authors reported no conflicts of interest.

Source: Paz-Ares L et al. VP3-2022: Pembrolizumab (pembro) versus placebo for early-stage non-small cell lung cancer (NSCLC) following complete resection and adjuvant chemotherapy (chemo) when indicated: Randomized, triple-blind, phase III EORTC-1416-LCG/ETOP 8-15 – PEARLS/KEYNOTE-091 study. Ann Oncol. 2022;33(4):451-453 (Mar 17). Doi: 10.1016/j.annonc.2022.02.224

Key clinical point: Adjuvant pembrolizumab boosts disease-free survival (DFS) in patients with early-stage non–small-cell lung cancer (NSCLC) after complete resection.

Major finding: DFS was 53.6 months in the pembrolizumab group vs. 42.0 months in the placebo group (hazard ratio 0.76; P = .0014). The DFS benefit was generally consistent across patients with programmed death ligand-1 tumor proportion score of <1%, 1%-49%, and ≥50%.

Study details: The data come from an interim analysis of the phase 3 PEARLS/KEYNOTE-091 trial, in which 1177 adults with stage IB, II, or IIIA NSCLC were randomly assigned to receive 200 mg pembrolizumab (n = 590) or placebo (n = 587) every 3 weeks.

Disclosures: The trial was funded by Merck Sharp & Dohme Corp. L Paz-Ares, MER O’Brien, U Dafni, K Oselin, D Isla, A Martinez-Marti, M Faehling, M Tsuboi, K Nakagawa, J Yang, SM Keller, RA Stahel, S Peters, and B Besse reported ties with one or more pharmaceutical companies, including Merck Sharp & Dohme. The other authors reported no conflicts of interest.

Source: Paz-Ares L et al. VP3-2022: Pembrolizumab (pembro) versus placebo for early-stage non-small cell lung cancer (NSCLC) following complete resection and adjuvant chemotherapy (chemo) when indicated: Randomized, triple-blind, phase III EORTC-1416-LCG/ETOP 8-15 – PEARLS/KEYNOTE-091 study. Ann Oncol. 2022;33(4):451-453 (Mar 17). Doi: 10.1016/j.annonc.2022.02.224

Key clinical point: Adjuvant pembrolizumab boosts disease-free survival (DFS) in patients with early-stage non–small-cell lung cancer (NSCLC) after complete resection.

Major finding: DFS was 53.6 months in the pembrolizumab group vs. 42.0 months in the placebo group (hazard ratio 0.76; P = .0014). The DFS benefit was generally consistent across patients with programmed death ligand-1 tumor proportion score of <1%, 1%-49%, and ≥50%.

Study details: The data come from an interim analysis of the phase 3 PEARLS/KEYNOTE-091 trial, in which 1177 adults with stage IB, II, or IIIA NSCLC were randomly assigned to receive 200 mg pembrolizumab (n = 590) or placebo (n = 587) every 3 weeks.

Disclosures: The trial was funded by Merck Sharp & Dohme Corp. L Paz-Ares, MER O’Brien, U Dafni, K Oselin, D Isla, A Martinez-Marti, M Faehling, M Tsuboi, K Nakagawa, J Yang, SM Keller, RA Stahel, S Peters, and B Besse reported ties with one or more pharmaceutical companies, including Merck Sharp & Dohme. The other authors reported no conflicts of interest.

Source: Paz-Ares L et al. VP3-2022: Pembrolizumab (pembro) versus placebo for early-stage non-small cell lung cancer (NSCLC) following complete resection and adjuvant chemotherapy (chemo) when indicated: Randomized, triple-blind, phase III EORTC-1416-LCG/ETOP 8-15 – PEARLS/KEYNOTE-091 study. Ann Oncol. 2022;33(4):451-453 (Mar 17). Doi: 10.1016/j.annonc.2022.02.224

Key clinical point: A Dutch population-based study demonstrated the survival benefits of tyrosine kinase inhibitor (TKI) therapy in patients with stage IV non–small-cell lung cancer (NSCLC) harboring activating mutations in the epidermal growth factor receptor (EGFR) gene.

Major finding: The median overall survival ranged from 3.5 months in the EGFR- group aged >65 years (for whom TKI is not indicated) to 23.6 months in the EGFR+ group aged <50 years treated with TKIs. In the EGFR+ group, TKI use vs. nonuse reduced mortality risk by 53% (hazard ratio 0.47; 95% CI 0.42-0.51).

Study details: The data come from a retrospective cohort study that included 31,291 patients with nonsquamous stage IV NSCLC from the population-based Netherlands Cancer Registry.

Disclosures: The study received no funding. MJ Aarts, HJM Groen, and JGJV Aerts reported ties with one or more pharmaceutical companies. The other authors reported no conflicts of interest.

Source: ten Berge DMHJ et al. A population-based study describing characteristics, survival and the effect of TKI treatment on patients with EGFR mutated stage IV NSCLC in the Netherlands. Eur J Cancer. 2022;165:195-204 (Mar 3). Doi: 10.1016/j.ejca.2022.01.038

Key clinical point: A Dutch population-based study demonstrated the survival benefits of tyrosine kinase inhibitor (TKI) therapy in patients with stage IV non–small-cell lung cancer (NSCLC) harboring activating mutations in the epidermal growth factor receptor (EGFR) gene.

Major finding: The median overall survival ranged from 3.5 months in the EGFR- group aged >65 years (for whom TKI is not indicated) to 23.6 months in the EGFR+ group aged <50 years treated with TKIs. In the EGFR+ group, TKI use vs. nonuse reduced mortality risk by 53% (hazard ratio 0.47; 95% CI 0.42-0.51).

Study details: The data come from a retrospective cohort study that included 31,291 patients with nonsquamous stage IV NSCLC from the population-based Netherlands Cancer Registry.

Disclosures: The study received no funding. MJ Aarts, HJM Groen, and JGJV Aerts reported ties with one or more pharmaceutical companies. The other authors reported no conflicts of interest.

Source: ten Berge DMHJ et al. A population-based study describing characteristics, survival and the effect of TKI treatment on patients with EGFR mutated stage IV NSCLC in the Netherlands. Eur J Cancer. 2022;165:195-204 (Mar 3). Doi: 10.1016/j.ejca.2022.01.038

Key clinical point: A Dutch population-based study demonstrated the survival benefits of tyrosine kinase inhibitor (TKI) therapy in patients with stage IV non–small-cell lung cancer (NSCLC) harboring activating mutations in the epidermal growth factor receptor (EGFR) gene.

Major finding: The median overall survival ranged from 3.5 months in the EGFR- group aged >65 years (for whom TKI is not indicated) to 23.6 months in the EGFR+ group aged <50 years treated with TKIs. In the EGFR+ group, TKI use vs. nonuse reduced mortality risk by 53% (hazard ratio 0.47; 95% CI 0.42-0.51).

Study details: The data come from a retrospective cohort study that included 31,291 patients with nonsquamous stage IV NSCLC from the population-based Netherlands Cancer Registry.

Disclosures: The study received no funding. MJ Aarts, HJM Groen, and JGJV Aerts reported ties with one or more pharmaceutical companies. The other authors reported no conflicts of interest.

Source: ten Berge DMHJ et al. A population-based study describing characteristics, survival and the effect of TKI treatment on patients with EGFR mutated stage IV NSCLC in the Netherlands. Eur J Cancer. 2022;165:195-204 (Mar 3). Doi: 10.1016/j.ejca.2022.01.038

Key clinical point: The third-generation tyrosine kinase inhibitor (TKI) lorlatinib demonstrated real-world safety and effectiveness in patients with advanced ROS1-rearranged (ROS1+) non–small-cell lung cancer (NSCLC) after failure of at least one ROS1 TKI.

Major finding: Median progression-free survival was 7.1 (95% CI 5.0-9.9) months and median overall survival was 19.6 (95% CI 12.3-27.5) months. The overall response rate was 45% and the disease control rate was 82%. There were no new safety signals.

Study details: The data come from a retrospective real-world LORLATU cohort study that included patients with advanced ROS1+ NSCLC (n = 80) from a French expanded access program.

Disclosures: The study was funded by French Thoracic Cancer Intergroup and Pfizer. S Baldacci, B Besse, D Moro-Sibilot, J Cadranel, V Westeel, B Roch, and J Bennouna reported ties with one or more pharmaceutical companies, including Pfizer. The other authors reported no conflicts of interest.

Source: Girard N et al. Lorlatinib for advanced ROS1+ non–small-cell lung cancer: Results of the IFCT-1803 LORLATU study. ESMO Open. 2022;7(2):100418 (Feb 25). Doi: 10.1016/j.esmoop.2022.100418

Key clinical point: The third-generation tyrosine kinase inhibitor (TKI) lorlatinib demonstrated real-world safety and effectiveness in patients with advanced ROS1-rearranged (ROS1+) non–small-cell lung cancer (NSCLC) after failure of at least one ROS1 TKI.

Major finding: Median progression-free survival was 7.1 (95% CI 5.0-9.9) months and median overall survival was 19.6 (95% CI 12.3-27.5) months. The overall response rate was 45% and the disease control rate was 82%. There were no new safety signals.

Study details: The data come from a retrospective real-world LORLATU cohort study that included patients with advanced ROS1+ NSCLC (n = 80) from a French expanded access program.

Disclosures: The study was funded by French Thoracic Cancer Intergroup and Pfizer. S Baldacci, B Besse, D Moro-Sibilot, J Cadranel, V Westeel, B Roch, and J Bennouna reported ties with one or more pharmaceutical companies, including Pfizer. The other authors reported no conflicts of interest.

Source: Girard N et al. Lorlatinib for advanced ROS1+ non–small-cell lung cancer: Results of the IFCT-1803 LORLATU study. ESMO Open. 2022;7(2):100418 (Feb 25). Doi: 10.1016/j.esmoop.2022.100418

Key clinical point: The third-generation tyrosine kinase inhibitor (TKI) lorlatinib demonstrated real-world safety and effectiveness in patients with advanced ROS1-rearranged (ROS1+) non–small-cell lung cancer (NSCLC) after failure of at least one ROS1 TKI.

Major finding: Median progression-free survival was 7.1 (95% CI 5.0-9.9) months and median overall survival was 19.6 (95% CI 12.3-27.5) months. The overall response rate was 45% and the disease control rate was 82%. There were no new safety signals.

Study details: The data come from a retrospective real-world LORLATU cohort study that included patients with advanced ROS1+ NSCLC (n = 80) from a French expanded access program.

Disclosures: The study was funded by French Thoracic Cancer Intergroup and Pfizer. S Baldacci, B Besse, D Moro-Sibilot, J Cadranel, V Westeel, B Roch, and J Bennouna reported ties with one or more pharmaceutical companies, including Pfizer. The other authors reported no conflicts of interest.

Source: Girard N et al. Lorlatinib for advanced ROS1+ non–small-cell lung cancer: Results of the IFCT-1803 LORLATU study. ESMO Open. 2022;7(2):100418 (Feb 25). Doi: 10.1016/j.esmoop.2022.100418

Key clinical point: Higher vs. lower plasma levels of cell-free DNA (cfDNA) were associated with a greater proportion of lesions and progression events and worse survival in patients with advanced anaplastic lymphoma kinase gene-positive (ALK+) non–small-cell lung cancer (NSCLC).

Major finding: There was a positive correlation between plasma cfDNA levels and the number of lesions (Spearman’s correlation 0.30; P < .0001). Patients who had greater than the median vs. less than or equal to the median plasma levels of the cfDNA biomarker had a higher risk for disease progression events (alectinib group: adjusted hazard ratio [aHR] 2.04 [P = .0305]; crizotinib group: aHR 1.83 [P = .0169]) and mortality (alectinib group: HR 2.52 [P = .0333]; crizotinib group: HR 2.63 [P = .0096]).

Study details: The data come from an exploratory retrospective analysis including treatment-naive patients from the phase 3 ALEX trial who were randomly assigned to receive twice-daily 600 mg alectinib (n = 152) or 250 mg crizotinib (n = 151).

Disclosures: The study was funded by F. Hoffmann-La Roche Ltd. The authors reported ties with one or more pharmaceutical companies.

Source: Dziadziuszko R et al. Circulating cell-free DNA as a prognostic biomarker in patients with advanced ALK+ non–small cell lung cancer in the global phase III ALEX trial. Clin Cancer Res. 2022 (Mar 1)1. Doi: 10.1158/1078-0432.CCR-21-2840

Key clinical point: Higher vs. lower plasma levels of cell-free DNA (cfDNA) were associated with a greater proportion of lesions and progression events and worse survival in patients with advanced anaplastic lymphoma kinase gene-positive (ALK+) non–small-cell lung cancer (NSCLC).

Major finding: There was a positive correlation between plasma cfDNA levels and the number of lesions (Spearman’s correlation 0.30; P < .0001). Patients who had greater than the median vs. less than or equal to the median plasma levels of the cfDNA biomarker had a higher risk for disease progression events (alectinib group: adjusted hazard ratio [aHR] 2.04 [P = .0305]; crizotinib group: aHR 1.83 [P = .0169]) and mortality (alectinib group: HR 2.52 [P = .0333]; crizotinib group: HR 2.63 [P = .0096]).

Study details: The data come from an exploratory retrospective analysis including treatment-naive patients from the phase 3 ALEX trial who were randomly assigned to receive twice-daily 600 mg alectinib (n = 152) or 250 mg crizotinib (n = 151).

Disclosures: The study was funded by F. Hoffmann-La Roche Ltd. The authors reported ties with one or more pharmaceutical companies.

Source: Dziadziuszko R et al. Circulating cell-free DNA as a prognostic biomarker in patients with advanced ALK+ non–small cell lung cancer in the global phase III ALEX trial. Clin Cancer Res. 2022 (Mar 1)1. Doi: 10.1158/1078-0432.CCR-21-2840

Key clinical point: Higher vs. lower plasma levels of cell-free DNA (cfDNA) were associated with a greater proportion of lesions and progression events and worse survival in patients with advanced anaplastic lymphoma kinase gene-positive (ALK+) non–small-cell lung cancer (NSCLC).

Major finding: There was a positive correlation between plasma cfDNA levels and the number of lesions (Spearman’s correlation 0.30; P < .0001). Patients who had greater than the median vs. less than or equal to the median plasma levels of the cfDNA biomarker had a higher risk for disease progression events (alectinib group: adjusted hazard ratio [aHR] 2.04 [P = .0305]; crizotinib group: aHR 1.83 [P = .0169]) and mortality (alectinib group: HR 2.52 [P = .0333]; crizotinib group: HR 2.63 [P = .0096]).

Study details: The data come from an exploratory retrospective analysis including treatment-naive patients from the phase 3 ALEX trial who were randomly assigned to receive twice-daily 600 mg alectinib (n = 152) or 250 mg crizotinib (n = 151).

Disclosures: The study was funded by F. Hoffmann-La Roche Ltd. The authors reported ties with one or more pharmaceutical companies.

Source: Dziadziuszko R et al. Circulating cell-free DNA as a prognostic biomarker in patients with advanced ALK+ non–small cell lung cancer in the global phase III ALEX trial. Clin Cancer Res. 2022 (Mar 1)1. Doi: 10.1158/1078-0432.CCR-21-2840

Key clinical point: Pyrotinib-based therapy could prolong survival in patients with lapatinib-resistant, human epidermal growth factor receptor 2 positive (HER2+) metastatic breast cancer, including those with brain metastases and those who benefitted from prior lapatinib.

Major finding: The overall survival was not reached, and the median progression-free survival (PFS) was 8 months (95% CI 5.1-10.9) in the overall cohort and 7.1 (95% CI 5.6-8.6) months in patients with brain metastases. Patients who benefitted from lapatinib therapy ≥6 vs. <6 months prior had a longer PFS after pyrotinib treatment (P = .034). Diarrhea was the most common grade 3-4 adverse event (14.5%).

Study details: This real-world study included 76 patients with HER2+ metastatic breast cancer who received pyrotinib-based therapy after lapatinib progression.

Disclosures: This work was financially supported by the National Key Research and Development Program of China, High-level Innovation Team of Nanjing Medical University, and other sources. The authors declared no conflicts of interest.

Source: Hua Y et al. Treatment with pyrotinib-based therapy in lapatinib-resistant HER2-positive metastatic breast cancer: a multicenter real-world study. Ther Adv Med Oncol. 2022;14 :1-9 (Mar 24). Doi: 10.1177/17588359221085232

Key clinical point: Pyrotinib-based therapy could prolong survival in patients with lapatinib-resistant, human epidermal growth factor receptor 2 positive (HER2+) metastatic breast cancer, including those with brain metastases and those who benefitted from prior lapatinib.

Major finding: The overall survival was not reached, and the median progression-free survival (PFS) was 8 months (95% CI 5.1-10.9) in the overall cohort and 7.1 (95% CI 5.6-8.6) months in patients with brain metastases. Patients who benefitted from lapatinib therapy ≥6 vs. <6 months prior had a longer PFS after pyrotinib treatment (P = .034). Diarrhea was the most common grade 3-4 adverse event (14.5%).

Study details: This real-world study included 76 patients with HER2+ metastatic breast cancer who received pyrotinib-based therapy after lapatinib progression.

Disclosures: This work was financially supported by the National Key Research and Development Program of China, High-level Innovation Team of Nanjing Medical University, and other sources. The authors declared no conflicts of interest.

Source: Hua Y et al. Treatment with pyrotinib-based therapy in lapatinib-resistant HER2-positive metastatic breast cancer: a multicenter real-world study. Ther Adv Med Oncol. 2022;14 :1-9 (Mar 24). Doi: 10.1177/17588359221085232

Key clinical point: Pyrotinib-based therapy could prolong survival in patients with lapatinib-resistant, human epidermal growth factor receptor 2 positive (HER2+) metastatic breast cancer, including those with brain metastases and those who benefitted from prior lapatinib.

Major finding: The overall survival was not reached, and the median progression-free survival (PFS) was 8 months (95% CI 5.1-10.9) in the overall cohort and 7.1 (95% CI 5.6-8.6) months in patients with brain metastases. Patients who benefitted from lapatinib therapy ≥6 vs. <6 months prior had a longer PFS after pyrotinib treatment (P = .034). Diarrhea was the most common grade 3-4 adverse event (14.5%).

Study details: This real-world study included 76 patients with HER2+ metastatic breast cancer who received pyrotinib-based therapy after lapatinib progression.

Disclosures: This work was financially supported by the National Key Research and Development Program of China, High-level Innovation Team of Nanjing Medical University, and other sources. The authors declared no conflicts of interest.

Source: Hua Y et al. Treatment with pyrotinib-based therapy in lapatinib-resistant HER2-positive metastatic breast cancer: a multicenter real-world study. Ther Adv Med Oncol. 2022;14 :1-9 (Mar 24). Doi: 10.1177/17588359221085232

Key clinical point: In patients with pT1aN0M0, human epidermal growth factor receptor 2 positive (HER2+) invasive breast cancer adding systemic therapy after surgical excision had clinical outcomes similar to local therapy alone.

Major finding: Overall survival was similar in all patients with pT1aN0M0 HER2-positive breast cancer who received local therapy+systemic therapy or only local therapy (P = .206), including the matched cohort of patients with hormone receptor positive (P = .107) and negative (P = .369) breast cancer.

Study details: This retrospective cohort study included 8948 patients with HER2+, pT1aN0M0 breast cancer, of which 4026 patients received local therapy only and 4922 patients received local therapy+adjuvant chemotherapy/HER2 therapy.

Disclosures: This study did not report any source of funding. CW Towe declared serving as consultant, providing expert testimony, and receiving research funding from several sources.

Source: Cao L et al. A comparison of local therapy alone with local plus systemic therapy for stage I pT1aN0M0 HER2+ breast cancer: A National Cancer Database analysis. Cancer. 2022 (Apr 1). Doi: 10.1002/cncr.34200

Key clinical point: In patients with pT1aN0M0, human epidermal growth factor receptor 2 positive (HER2+) invasive breast cancer adding systemic therapy after surgical excision had clinical outcomes similar to local therapy alone.

Major finding: Overall survival was similar in all patients with pT1aN0M0 HER2-positive breast cancer who received local therapy+systemic therapy or only local therapy (P = .206), including the matched cohort of patients with hormone receptor positive (P = .107) and negative (P = .369) breast cancer.

Study details: This retrospective cohort study included 8948 patients with HER2+, pT1aN0M0 breast cancer, of which 4026 patients received local therapy only and 4922 patients received local therapy+adjuvant chemotherapy/HER2 therapy.

Disclosures: This study did not report any source of funding. CW Towe declared serving as consultant, providing expert testimony, and receiving research funding from several sources.

Source: Cao L et al. A comparison of local therapy alone with local plus systemic therapy for stage I pT1aN0M0 HER2+ breast cancer: A National Cancer Database analysis. Cancer. 2022 (Apr 1). Doi: 10.1002/cncr.34200

Key clinical point: In patients with pT1aN0M0, human epidermal growth factor receptor 2 positive (HER2+) invasive breast cancer adding systemic therapy after surgical excision had clinical outcomes similar to local therapy alone.

Major finding: Overall survival was similar in all patients with pT1aN0M0 HER2-positive breast cancer who received local therapy+systemic therapy or only local therapy (P = .206), including the matched cohort of patients with hormone receptor positive (P = .107) and negative (P = .369) breast cancer.

Study details: This retrospective cohort study included 8948 patients with HER2+, pT1aN0M0 breast cancer, of which 4026 patients received local therapy only and 4922 patients received local therapy+adjuvant chemotherapy/HER2 therapy.

Disclosures: This study did not report any source of funding. CW Towe declared serving as consultant, providing expert testimony, and receiving research funding from several sources.

Source: Cao L et al. A comparison of local therapy alone with local plus systemic therapy for stage I pT1aN0M0 HER2+ breast cancer: A National Cancer Database analysis. Cancer. 2022 (Apr 1). Doi: 10.1002/cncr.34200

Key clinical point: Imaging can be dependably used for estimating the size of clinical T1 tumors to plan lumpectomy; however, overestimation by preoperative imaging size (PIS) should be considered for larger tumors.

Major finding: Significant correlation was observed between PIS and postoperative pathology size (PPS), highest when estimated with ultrasound (correlation coefficient [r] 0.628) followed by mammography (r 0.571; both P < .001). Although ultrasound underestimated T1 (mean difference between PIS and PPS [MD] −3.47 mm; 95% CI −4.02 to −2.91 mm) and T2 (MD −2.20 mm; 95% CI −3.39 to −1.02 mm) tumors, mammogram underestimated T1 tumors (MD −2.91; 95% CI −3.51 to −2.32) and overestimated T2 tumors (MD 0.90; 95% CI −0.44 to 2.24), all within the range of concordance.

Study details: This study identified 1512 tumors in 1502 patients with invasive breast cancer who underwent their first surgery.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Kapur H et al. Accuracy of preoperative imaging estimates: Opportunities to de-escalate surgery for early invasive breast cancer. Am J Surg. 2022 (Mar 30). Doi:  10.1016/j.amjsurg.2022.03.053

Key clinical point: Imaging can be dependably used for estimating the size of clinical T1 tumors to plan lumpectomy; however, overestimation by preoperative imaging size (PIS) should be considered for larger tumors.

Major finding: Significant correlation was observed between PIS and postoperative pathology size (PPS), highest when estimated with ultrasound (correlation coefficient [r] 0.628) followed by mammography (r 0.571; both P < .001). Although ultrasound underestimated T1 (mean difference between PIS and PPS [MD] −3.47 mm; 95% CI −4.02 to −2.91 mm) and T2 (MD −2.20 mm; 95% CI −3.39 to −1.02 mm) tumors, mammogram underestimated T1 tumors (MD −2.91; 95% CI −3.51 to −2.32) and overestimated T2 tumors (MD 0.90; 95% CI −0.44 to 2.24), all within the range of concordance.

Study details: This study identified 1512 tumors in 1502 patients with invasive breast cancer who underwent their first surgery.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Kapur H et al. Accuracy of preoperative imaging estimates: Opportunities to de-escalate surgery for early invasive breast cancer. Am J Surg. 2022 (Mar 30). Doi:  10.1016/j.amjsurg.2022.03.053

Key clinical point: Imaging can be dependably used for estimating the size of clinical T1 tumors to plan lumpectomy; however, overestimation by preoperative imaging size (PIS) should be considered for larger tumors.

Major finding: Significant correlation was observed between PIS and postoperative pathology size (PPS), highest when estimated with ultrasound (correlation coefficient [r] 0.628) followed by mammography (r 0.571; both P < .001). Although ultrasound underestimated T1 (mean difference between PIS and PPS [MD] −3.47 mm; 95% CI −4.02 to −2.91 mm) and T2 (MD −2.20 mm; 95% CI −3.39 to −1.02 mm) tumors, mammogram underestimated T1 tumors (MD −2.91; 95% CI −3.51 to −2.32) and overestimated T2 tumors (MD 0.90; 95% CI −0.44 to 2.24), all within the range of concordance.

Study details: This study identified 1512 tumors in 1502 patients with invasive breast cancer who underwent their first surgery.

Disclosures: This study did not receive any funding. The authors declared no conflicts of interest.

Source: Kapur H et al. Accuracy of preoperative imaging estimates: Opportunities to de-escalate surgery for early invasive breast cancer. Am J Surg. 2022 (Mar 30). Doi:  10.1016/j.amjsurg.2022.03.053

Key clinical point: Increased stromal tumor-infiltrating lymphocytes (sTIL) were associated with improved survival in young patients (<40 years old) with early-stage, node-negative (N0), triple negative breast cancer (TNBC) who were naive to systemic therapy.

Major finding: At 15 years, the cumulative incidence of distant metastasis or death was only 2.1% (95% CI 0%-5.0%) in patients with high sTIL (≥75%) compared with 38.4% (95% CI 32.1%-44.6%) in patients with low sTIL (<30%), with an increase in overall survival by 19% for every 10% increase in sTIL (adjusted hazard ratio 0.81; 95% CI 0.76-0.87).

Study details: The study evaluated prospectively collected population-based cohort data of 441 patients aged <40 years who had N0 TNBC and had not received neoadjuvant systemic therapy.

Disclosures: This study was supported by The Netherlands Organization for Health Research and Development, A Sister’s Hope, De Vrienden van UMC Utrecht, and other sources. The authors declared serving as consultants, advisors, or in speaker’s bureaus or receiving research grants or travel and accommodation expenses from several sources.

Source: de Jong VMT et al. Prognostic value of stromal tumor-infiltrating lymphocytes in young, node-negative, triple-negative breast cancer patients who did not receive (neo)adjuvant systemic therapy. J Clin Oncol. 2022 (Mar 30). Doi: 10.1200/JCO.21.01536

Key clinical point: Increased stromal tumor-infiltrating lymphocytes (sTIL) were associated with improved survival in young patients (<40 years old) with early-stage, node-negative (N0), triple negative breast cancer (TNBC) who were naive to systemic therapy.

Major finding: At 15 years, the cumulative incidence of distant metastasis or death was only 2.1% (95% CI 0%-5.0%) in patients with high sTIL (≥75%) compared with 38.4% (95% CI 32.1%-44.6%) in patients with low sTIL (<30%), with an increase in overall survival by 19% for every 10% increase in sTIL (adjusted hazard ratio 0.81; 95% CI 0.76-0.87).

Study details: The study evaluated prospectively collected population-based cohort data of 441 patients aged <40 years who had N0 TNBC and had not received neoadjuvant systemic therapy.

Disclosures: This study was supported by The Netherlands Organization for Health Research and Development, A Sister’s Hope, De Vrienden van UMC Utrecht, and other sources. The authors declared serving as consultants, advisors, or in speaker’s bureaus or receiving research grants or travel and accommodation expenses from several sources.

Source: de Jong VMT et al. Prognostic value of stromal tumor-infiltrating lymphocytes in young, node-negative, triple-negative breast cancer patients who did not receive (neo)adjuvant systemic therapy. J Clin Oncol. 2022 (Mar 30). Doi: 10.1200/JCO.21.01536

Key clinical point: Increased stromal tumor-infiltrating lymphocytes (sTIL) were associated with improved survival in young patients (<40 years old) with early-stage, node-negative (N0), triple negative breast cancer (TNBC) who were naive to systemic therapy.

Major finding: At 15 years, the cumulative incidence of distant metastasis or death was only 2.1% (95% CI 0%-5.0%) in patients with high sTIL (≥75%) compared with 38.4% (95% CI 32.1%-44.6%) in patients with low sTIL (<30%), with an increase in overall survival by 19% for every 10% increase in sTIL (adjusted hazard ratio 0.81; 95% CI 0.76-0.87).

Study details: The study evaluated prospectively collected population-based cohort data of 441 patients aged <40 years who had N0 TNBC and had not received neoadjuvant systemic therapy.

Disclosures: This study was supported by The Netherlands Organization for Health Research and Development, A Sister’s Hope, De Vrienden van UMC Utrecht, and other sources. The authors declared serving as consultants, advisors, or in speaker’s bureaus or receiving research grants or travel and accommodation expenses from several sources.

Source: de Jong VMT et al. Prognostic value of stromal tumor-infiltrating lymphocytes in young, node-negative, triple-negative breast cancer patients who did not receive (neo)adjuvant systemic therapy. J Clin Oncol. 2022 (Mar 30). Doi: 10.1200/JCO.21.01536

Key clinical point: Nearly 40% of patients with breast cancer reported severe cancer-related fatigue for up to 4 years after diagnosis, with depression and receipt of hormone therapy being the key risk factors.

Major finding: The estimated risk for severe global fatigue increased from 13.8% at diagnosis to 64.5% at 4 years postdiagnosis in 19% of patients clustered in the deteriorating group, whereas it remained persistently high in 21% of patients clustered in the high-risk group (94.8% at diagnosis and 64.6% at year 4). Depression (P < .001) and receipt of hormonal therapy (P = .0359) were associated with severe global fatigue trajectory.

Study details: This longitudinal analysis of the ongoing prospective CANcer TOxicity trial included 4173 women with stage I, II, or III breast cancer.

Disclosures: This study is supported by Susan G. Komen, Odyssea, French Foundation for Cancer Research, and others. The authors declared serving as consultants, advisory members, or leaders; owning stocks; or receiving honoraria, research funding, or travel and accommodation expenses from several sources.

Source: Vaz-Luis I et al. Long-term longitudinal patterns of patient-reported fatigue after breast cancer: A group-based trajectory analysis. J Clin Oncol. 2022 (Mar 15). Doi: 10.1200/JCO.21.01958

Key clinical point: Nearly 40% of patients with breast cancer reported severe cancer-related fatigue for up to 4 years after diagnosis, with depression and receipt of hormone therapy being the key risk factors.

Major finding: The estimated risk for severe global fatigue increased from 13.8% at diagnosis to 64.5% at 4 years postdiagnosis in 19% of patients clustered in the deteriorating group, whereas it remained persistently high in 21% of patients clustered in the high-risk group (94.8% at diagnosis and 64.6% at year 4). Depression (P < .001) and receipt of hormonal therapy (P = .0359) were associated with severe global fatigue trajectory.

Study details: This longitudinal analysis of the ongoing prospective CANcer TOxicity trial included 4173 women with stage I, II, or III breast cancer.

Disclosures: This study is supported by Susan G. Komen, Odyssea, French Foundation for Cancer Research, and others. The authors declared serving as consultants, advisory members, or leaders; owning stocks; or receiving honoraria, research funding, or travel and accommodation expenses from several sources.

Source: Vaz-Luis I et al. Long-term longitudinal patterns of patient-reported fatigue after breast cancer: A group-based trajectory analysis. J Clin Oncol. 2022 (Mar 15). Doi: 10.1200/JCO.21.01958

Key clinical point: Nearly 40% of patients with breast cancer reported severe cancer-related fatigue for up to 4 years after diagnosis, with depression and receipt of hormone therapy being the key risk factors.

Major finding: The estimated risk for severe global fatigue increased from 13.8% at diagnosis to 64.5% at 4 years postdiagnosis in 19% of patients clustered in the deteriorating group, whereas it remained persistently high in 21% of patients clustered in the high-risk group (94.8% at diagnosis and 64.6% at year 4). Depression (P < .001) and receipt of hormonal therapy (P = .0359) were associated with severe global fatigue trajectory.

Study details: This longitudinal analysis of the ongoing prospective CANcer TOxicity trial included 4173 women with stage I, II, or III breast cancer.

Disclosures: This study is supported by Susan G. Komen, Odyssea, French Foundation for Cancer Research, and others. The authors declared serving as consultants, advisory members, or leaders; owning stocks; or receiving honoraria, research funding, or travel and accommodation expenses from several sources.

Source: Vaz-Luis I et al. Long-term longitudinal patterns of patient-reported fatigue after breast cancer: A group-based trajectory analysis. J Clin Oncol. 2022 (Mar 15). Doi: 10.1200/JCO.21.01958

Key clinical point: Patients with trastuzumab-refractory human epidermal growth factor receptor 2 positive (HER2+) metastatic breast cancer achieved satisfactory clinical efficacy after switching to lapatinib as the HER2-blockade therapy.

Major finding: After a median follow-up of 33.1 months, patients achieved a median progression free survival (PFS) of 8.5 months, with brain metastases (hazard ratio [HR] 1.582; P = .041) and ≥2 metastatic sites (HR 1.679; P = .007) being independent prognostic markers for PFS. Diarrhea (3.8%) and hand-foot syndrome (9.4%) were the most common grade ≥3 adverse events.

Study details: Findings are from the phase 2 SYSUCC-005 study including 159 women with HER2-positive refractory metastatic breast cancer who rapidly progressed during prior adjuvant/first-line trastuzumab therapy and switched to lapatinib with either capecitabine or vinorelbine.

Disclosures: This study was funded by the Joint Fund of the National Natural Science Foundation of China and Natural Science Foundation of Guangdong Province, among other sources. The authors declared no conflicts of interest.

Source: Duan F et al. The efficacy of human epidermal growth factor receptor 2 (HER2) blockade switching mode in refractory patients with HER2-positive metastatic breast cancer: A phase II, multicenter, single-arm study (SYSUCC-005). BMC Cancer. 2022;22:271 (Mar 15). Doi: 10.1186/s12885-022-09399-2

Key clinical point: Patients with trastuzumab-refractory human epidermal growth factor receptor 2 positive (HER2+) metastatic breast cancer achieved satisfactory clinical efficacy after switching to lapatinib as the HER2-blockade therapy.

Major finding: After a median follow-up of 33.1 months, patients achieved a median progression free survival (PFS) of 8.5 months, with brain metastases (hazard ratio [HR] 1.582; P = .041) and ≥2 metastatic sites (HR 1.679; P = .007) being independent prognostic markers for PFS. Diarrhea (3.8%) and hand-foot syndrome (9.4%) were the most common grade ≥3 adverse events.

Study details: Findings are from the phase 2 SYSUCC-005 study including 159 women with HER2-positive refractory metastatic breast cancer who rapidly progressed during prior adjuvant/first-line trastuzumab therapy and switched to lapatinib with either capecitabine or vinorelbine.

Disclosures: This study was funded by the Joint Fund of the National Natural Science Foundation of China and Natural Science Foundation of Guangdong Province, among other sources. The authors declared no conflicts of interest.

Source: Duan F et al. The efficacy of human epidermal growth factor receptor 2 (HER2) blockade switching mode in refractory patients with HER2-positive metastatic breast cancer: A phase II, multicenter, single-arm study (SYSUCC-005). BMC Cancer. 2022;22:271 (Mar 15). Doi: 10.1186/s12885-022-09399-2

Key clinical point: Patients with trastuzumab-refractory human epidermal growth factor receptor 2 positive (HER2+) metastatic breast cancer achieved satisfactory clinical efficacy after switching to lapatinib as the HER2-blockade therapy.

Major finding: After a median follow-up of 33.1 months, patients achieved a median progression free survival (PFS) of 8.5 months, with brain metastases (hazard ratio [HR] 1.582; P = .041) and ≥2 metastatic sites (HR 1.679; P = .007) being independent prognostic markers for PFS. Diarrhea (3.8%) and hand-foot syndrome (9.4%) were the most common grade ≥3 adverse events.

Study details: Findings are from the phase 2 SYSUCC-005 study including 159 women with HER2-positive refractory metastatic breast cancer who rapidly progressed during prior adjuvant/first-line trastuzumab therapy and switched to lapatinib with either capecitabine or vinorelbine.

Disclosures: This study was funded by the Joint Fund of the National Natural Science Foundation of China and Natural Science Foundation of Guangdong Province, among other sources. The authors declared no conflicts of interest.

Source: Duan F et al. The efficacy of human epidermal growth factor receptor 2 (HER2) blockade switching mode in refractory patients with HER2-positive metastatic breast cancer: A phase II, multicenter, single-arm study (SYSUCC-005). BMC Cancer. 2022;22:271 (Mar 15). Doi: 10.1186/s12885-022-09399-2