Clinical Edge Journal Scan

Key clinical point: Patients with breast cancer (BC) who did not achieve pathological complete response (pCR) after receiving neoadjuvant chemotherapy (NACT) showed improved survival outcomes after adjuvant aspirin use.

Major finding: The 5-year disease-free survival and distant metastasis-free survival were improved with vs without aspirin use in the whole cohort (adjusted hazard ratio [aHR] 0.48, P = .01; and aHR 0.57, P = .04, respectively) and in higher-risk patients with nodal disease (aHR 0.48, P = .02; and aHR 0.43, P = .008, respectively).

Study details: Findings are from a retrospective study including 637 patients with BC who did not achieve pCR after receiving NACT, of which 138 patients used aspirin after diagnosis.

Disclosures: This study did not receive any funding. Dr. Unni declared serving on advisory boards for various sources.

Source: Johns C et al. Aspirin use is associated with improvement in distant metastases outcome in patients with residual disease after neoadjuvant chemotherapy. Breast Cancer Res Treat. 2023 (Mar 30). Doi: 10.1007/s10549-023-06920-4

Key clinical point: Patients with breast cancer (BC) who did not achieve pathological complete response (pCR) after receiving neoadjuvant chemotherapy (NACT) showed improved survival outcomes after adjuvant aspirin use.

Major finding: The 5-year disease-free survival and distant metastasis-free survival were improved with vs without aspirin use in the whole cohort (adjusted hazard ratio [aHR] 0.48, P = .01; and aHR 0.57, P = .04, respectively) and in higher-risk patients with nodal disease (aHR 0.48, P = .02; and aHR 0.43, P = .008, respectively).

Study details: Findings are from a retrospective study including 637 patients with BC who did not achieve pCR after receiving NACT, of which 138 patients used aspirin after diagnosis.

Disclosures: This study did not receive any funding. Dr. Unni declared serving on advisory boards for various sources.

Source: Johns C et al. Aspirin use is associated with improvement in distant metastases outcome in patients with residual disease after neoadjuvant chemotherapy. Breast Cancer Res Treat. 2023 (Mar 30). Doi: 10.1007/s10549-023-06920-4

Key clinical point: Patients with breast cancer (BC) who did not achieve pathological complete response (pCR) after receiving neoadjuvant chemotherapy (NACT) showed improved survival outcomes after adjuvant aspirin use.

Major finding: The 5-year disease-free survival and distant metastasis-free survival were improved with vs without aspirin use in the whole cohort (adjusted hazard ratio [aHR] 0.48, P = .01; and aHR 0.57, P = .04, respectively) and in higher-risk patients with nodal disease (aHR 0.48, P = .02; and aHR 0.43, P = .008, respectively).

Study details: Findings are from a retrospective study including 637 patients with BC who did not achieve pCR after receiving NACT, of which 138 patients used aspirin after diagnosis.

Disclosures: This study did not receive any funding. Dr. Unni declared serving on advisory boards for various sources.

Source: Johns C et al. Aspirin use is associated with improvement in distant metastases outcome in patients with residual disease after neoadjuvant chemotherapy. Breast Cancer Res Treat. 2023 (Mar 30). Doi: 10.1007/s10549-023-06920-4

Key clinical point: Women who started receiving statins after the diagnosis of breast cancer (BC) had a significantly decreased risk for breast cancer-specific death (BCD).

Major finding: The risk for BCD was significantly lower in the overall cohort of patients who used vs never used statins (hazard ratio [HR] 0.74; 95% CI 0.63-0.86) and in the subgroup of patients with estrogen receptor-positive BC (HR 0.77; 95% CI 0.63-0.94), post-menopausal women (HR 0.74; 95% CI 0.63-0.88), and women with advanced stage BC (HR 0.65; 95% CI 0.49-0.84).

Study details: Findings are from a large, population-based cohort study including 14,976 women with newly diagnosed BC, of which 4060 patients received statins after the diagnosis of BC.

Disclosures: This study was supported by the Auckland Medical Research Foundation, New Zealand. The authors declared no conflict of interests.

Source: Scott OW et al. Post-diagnostic statin use and breast cancer-specific mortality: A population-based cohort study. Breast Cancer Res Treat. 2023 (Mar 17). Doi: 10.1007/s10549-022-06815-w

Key clinical point: Women who started receiving statins after the diagnosis of breast cancer (BC) had a significantly decreased risk for breast cancer-specific death (BCD).

Major finding: The risk for BCD was significantly lower in the overall cohort of patients who used vs never used statins (hazard ratio [HR] 0.74; 95% CI 0.63-0.86) and in the subgroup of patients with estrogen receptor-positive BC (HR 0.77; 95% CI 0.63-0.94), post-menopausal women (HR 0.74; 95% CI 0.63-0.88), and women with advanced stage BC (HR 0.65; 95% CI 0.49-0.84).

Study details: Findings are from a large, population-based cohort study including 14,976 women with newly diagnosed BC, of which 4060 patients received statins after the diagnosis of BC.

Disclosures: This study was supported by the Auckland Medical Research Foundation, New Zealand. The authors declared no conflict of interests.

Source: Scott OW et al. Post-diagnostic statin use and breast cancer-specific mortality: A population-based cohort study. Breast Cancer Res Treat. 2023 (Mar 17). Doi: 10.1007/s10549-022-06815-w

Key clinical point: Women who started receiving statins after the diagnosis of breast cancer (BC) had a significantly decreased risk for breast cancer-specific death (BCD).

Major finding: The risk for BCD was significantly lower in the overall cohort of patients who used vs never used statins (hazard ratio [HR] 0.74; 95% CI 0.63-0.86) and in the subgroup of patients with estrogen receptor-positive BC (HR 0.77; 95% CI 0.63-0.94), post-menopausal women (HR 0.74; 95% CI 0.63-0.88), and women with advanced stage BC (HR 0.65; 95% CI 0.49-0.84).

Study details: Findings are from a large, population-based cohort study including 14,976 women with newly diagnosed BC, of which 4060 patients received statins after the diagnosis of BC.

Disclosures: This study was supported by the Auckland Medical Research Foundation, New Zealand. The authors declared no conflict of interests.

Source: Scott OW et al. Post-diagnostic statin use and breast cancer-specific mortality: A population-based cohort study. Breast Cancer Res Treat. 2023 (Mar 17). Doi: 10.1007/s10549-022-06815-w

Key clinical point: First-line palbociclib plus letrozole proved to be a more effective treatment option than letrozole alone in a real-world population of older patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2−) metastatic breast cancer (BC).

Major finding: Real-world progression-free survival (22.2 vs 15.8 months; adjusted hazard ratio 0.59; P < .001) was significantly prolonged and real-world best tumor response rate was significantly higher (52.4% vs. 22.1%; adjusted odds ratio 2.0; P < .001) in patients receiving palbociclib+letrozole vs letrozole alone.

Study details: Findings are from a retrospective cohort study including 796 women aged ≥65 years with HR+/HER2− metastatic BC who initiated first-line treatment with palbociclib+letrozole or letrozole alone.

Disclosures: This study was sponsored by Pfizer Inc. Three authors declared being employees of and owning stocks in Pfizer Inc. The other authors declared receiving advisory board fees, consulting fees, honoraria, or research funding from Pfizer Inc and other sources.

Source: Rugo HS et al. Real-world comparative effectiveness of palbociclib plus letrozole versus letrozole in older patients with metastatic breast cancer. Breast. 2023 (Mar 27). Doi: 10.1016/j.breast.2023.03.015

Key clinical point: First-line palbociclib plus letrozole proved to be a more effective treatment option than letrozole alone in a real-world population of older patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2−) metastatic breast cancer (BC).

Major finding: Real-world progression-free survival (22.2 vs 15.8 months; adjusted hazard ratio 0.59; P < .001) was significantly prolonged and real-world best tumor response rate was significantly higher (52.4% vs. 22.1%; adjusted odds ratio 2.0; P < .001) in patients receiving palbociclib+letrozole vs letrozole alone.

Study details: Findings are from a retrospective cohort study including 796 women aged ≥65 years with HR+/HER2− metastatic BC who initiated first-line treatment with palbociclib+letrozole or letrozole alone.

Disclosures: This study was sponsored by Pfizer Inc. Three authors declared being employees of and owning stocks in Pfizer Inc. The other authors declared receiving advisory board fees, consulting fees, honoraria, or research funding from Pfizer Inc and other sources.

Source: Rugo HS et al. Real-world comparative effectiveness of palbociclib plus letrozole versus letrozole in older patients with metastatic breast cancer. Breast. 2023 (Mar 27). Doi: 10.1016/j.breast.2023.03.015

Key clinical point: First-line palbociclib plus letrozole proved to be a more effective treatment option than letrozole alone in a real-world population of older patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2−) metastatic breast cancer (BC).

Major finding: Real-world progression-free survival (22.2 vs 15.8 months; adjusted hazard ratio 0.59; P < .001) was significantly prolonged and real-world best tumor response rate was significantly higher (52.4% vs. 22.1%; adjusted odds ratio 2.0; P < .001) in patients receiving palbociclib+letrozole vs letrozole alone.

Study details: Findings are from a retrospective cohort study including 796 women aged ≥65 years with HR+/HER2− metastatic BC who initiated first-line treatment with palbociclib+letrozole or letrozole alone.

Disclosures: This study was sponsored by Pfizer Inc. Three authors declared being employees of and owning stocks in Pfizer Inc. The other authors declared receiving advisory board fees, consulting fees, honoraria, or research funding from Pfizer Inc and other sources.

Source: Rugo HS et al. Real-world comparative effectiveness of palbociclib plus letrozole versus letrozole in older patients with metastatic breast cancer. Breast. 2023 (Mar 27). Doi: 10.1016/j.breast.2023.03.015

Key clinical point: Omission of surgical axillary staging (AS) worsened overall survival (OS) but not breast cancer-specific survival (BCSS) in older women with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2−) early-stage breast cancer (BC).

Major finding: Women who did not undergo AS had similar BCSS (adjusted hazard ratio [HR] 0.98; 95% CI 0.77-1.25) but poorer OS (adjusted HR 1.14; 95% CI 1.04-1.25) compared with those who underwent AS.

Study details: Findings are from a population-based cohort study including 17,370 women aged 65-95 years with ER+/HER2− early-stage BC who underwent surgery, of which 1771 patients did not undergo AS.

Disclosures: This study was supported by the Ontario Ministry of Health and the Ministry of Long-Term Care, Canada. The authors declared no conflict of interests.

Source: Castelo M et al. The association between surgical axillary staging, adjuvant treatment use and survival in older women with early stage breast cancer: A population-based study. Ann Surg Oncol. 2023 (Mar 14). Doi: 10.1245/s10434-023-13274-0

Key clinical point: Omission of surgical axillary staging (AS) worsened overall survival (OS) but not breast cancer-specific survival (BCSS) in older women with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2−) early-stage breast cancer (BC).

Major finding: Women who did not undergo AS had similar BCSS (adjusted hazard ratio [HR] 0.98; 95% CI 0.77-1.25) but poorer OS (adjusted HR 1.14; 95% CI 1.04-1.25) compared with those who underwent AS.

Study details: Findings are from a population-based cohort study including 17,370 women aged 65-95 years with ER+/HER2− early-stage BC who underwent surgery, of which 1771 patients did not undergo AS.

Disclosures: This study was supported by the Ontario Ministry of Health and the Ministry of Long-Term Care, Canada. The authors declared no conflict of interests.

Source: Castelo M et al. The association between surgical axillary staging, adjuvant treatment use and survival in older women with early stage breast cancer: A population-based study. Ann Surg Oncol. 2023 (Mar 14). Doi: 10.1245/s10434-023-13274-0

Key clinical point: Omission of surgical axillary staging (AS) worsened overall survival (OS) but not breast cancer-specific survival (BCSS) in older women with estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2−) early-stage breast cancer (BC).

Major finding: Women who did not undergo AS had similar BCSS (adjusted hazard ratio [HR] 0.98; 95% CI 0.77-1.25) but poorer OS (adjusted HR 1.14; 95% CI 1.04-1.25) compared with those who underwent AS.

Study details: Findings are from a population-based cohort study including 17,370 women aged 65-95 years with ER+/HER2− early-stage BC who underwent surgery, of which 1771 patients did not undergo AS.

Disclosures: This study was supported by the Ontario Ministry of Health and the Ministry of Long-Term Care, Canada. The authors declared no conflict of interests.

Source: Castelo M et al. The association between surgical axillary staging, adjuvant treatment use and survival in older women with early stage breast cancer: A population-based study. Ann Surg Oncol. 2023 (Mar 14). Doi: 10.1245/s10434-023-13274-0

Key clinical point: Patients with early breast cancer (BC) who achieve pathological complete response (pCR) with neoadjuvant chemotherapy can nevertheless be at risk for disease relapse if there is nodal involvement at diagnosis and tumors are large and have lobular histology.

Major finding: Disease-free survival (DFS) was worse in the overall cohort (hazard ratio [HR] 1.94; P < .001) and in patients with triple-negative BC (TNBC; HR 2.45; P < .001) who did vs did not have initial positive lymph node involvement. Lobular histology (HR 3.55; P = .003) and large tumors (cT3/4; HR 2.07; P = .033) were also associated with a higher risk for shorter DFS in patients with TNBC and human epidermal growth factor receptor 2-positive BC, respectively.

Study details: This retrospective pooled analysis included 2066 patients with BC who had achieved pCR.

Disclosures: This study was funded by Projekt DEAL, Germany. Some authors declared receiving consulting fees, honoraria, travel expenses, research grants, or honoraria or having other ties with several sources.

Source: Huober J et al. Identifying breast cancer patients at risk of relapse despite pathological complete response after neoadjuvant therapy. NPJ Breast Cancer. 2023;9:23 (Apr 7). Doi: 10.1038/s41523-023-00525-2

Key clinical point: Patients with early breast cancer (BC) who achieve pathological complete response (pCR) with neoadjuvant chemotherapy can nevertheless be at risk for disease relapse if there is nodal involvement at diagnosis and tumors are large and have lobular histology.

Major finding: Disease-free survival (DFS) was worse in the overall cohort (hazard ratio [HR] 1.94; P < .001) and in patients with triple-negative BC (TNBC; HR 2.45; P < .001) who did vs did not have initial positive lymph node involvement. Lobular histology (HR 3.55; P = .003) and large tumors (cT3/4; HR 2.07; P = .033) were also associated with a higher risk for shorter DFS in patients with TNBC and human epidermal growth factor receptor 2-positive BC, respectively.

Study details: This retrospective pooled analysis included 2066 patients with BC who had achieved pCR.

Disclosures: This study was funded by Projekt DEAL, Germany. Some authors declared receiving consulting fees, honoraria, travel expenses, research grants, or honoraria or having other ties with several sources.

Source: Huober J et al. Identifying breast cancer patients at risk of relapse despite pathological complete response after neoadjuvant therapy. NPJ Breast Cancer. 2023;9:23 (Apr 7). Doi: 10.1038/s41523-023-00525-2

Key clinical point: Patients with early breast cancer (BC) who achieve pathological complete response (pCR) with neoadjuvant chemotherapy can nevertheless be at risk for disease relapse if there is nodal involvement at diagnosis and tumors are large and have lobular histology.

Major finding: Disease-free survival (DFS) was worse in the overall cohort (hazard ratio [HR] 1.94; P < .001) and in patients with triple-negative BC (TNBC; HR 2.45; P < .001) who did vs did not have initial positive lymph node involvement. Lobular histology (HR 3.55; P = .003) and large tumors (cT3/4; HR 2.07; P = .033) were also associated with a higher risk for shorter DFS in patients with TNBC and human epidermal growth factor receptor 2-positive BC, respectively.

Study details: This retrospective pooled analysis included 2066 patients with BC who had achieved pCR.

Disclosures: This study was funded by Projekt DEAL, Germany. Some authors declared receiving consulting fees, honoraria, travel expenses, research grants, or honoraria or having other ties with several sources.

Source: Huober J et al. Identifying breast cancer patients at risk of relapse despite pathological complete response after neoadjuvant therapy. NPJ Breast Cancer. 2023;9:23 (Apr 7). Doi: 10.1038/s41523-023-00525-2

Key clinical point: Data from a multi-institutional US database of more than 2.5 million screening mammograms showed that digital breast tomosynthesis (DBT) was superior to digital mammography (DM) for the purpose of breast cancer (BC) screening.

Major finding: Compared with DM, DBT led to significantly higher cancer detection rates (adjusted odds ratio [OR] 1.24), biopsy rate (adjusted OR 1.33), and positive predictive value of recall (adjusted OR 1.33; all P < .001).

Study details: Findings are from a retrospective study including 2,528,063 screening mammograms in 1,100,447 women aged 40-79 years.

Disclosures: This study did not report the source of funding. Some authors declared receiving grants, travel support, consulting fees, or payments from various sources.

Source: Conant EF et al. Mammographic screening in routine practice: Multisite study of digital breast tomosynthesis and digital mammography screenings. Radiology. 2023 (Mar 14). Doi: 10.1148/radiol.221571

Key clinical point: Data from a multi-institutional US database of more than 2.5 million screening mammograms showed that digital breast tomosynthesis (DBT) was superior to digital mammography (DM) for the purpose of breast cancer (BC) screening.

Major finding: Compared with DM, DBT led to significantly higher cancer detection rates (adjusted odds ratio [OR] 1.24), biopsy rate (adjusted OR 1.33), and positive predictive value of recall (adjusted OR 1.33; all P < .001).

Study details: Findings are from a retrospective study including 2,528,063 screening mammograms in 1,100,447 women aged 40-79 years.

Disclosures: This study did not report the source of funding. Some authors declared receiving grants, travel support, consulting fees, or payments from various sources.

Source: Conant EF et al. Mammographic screening in routine practice: Multisite study of digital breast tomosynthesis and digital mammography screenings. Radiology. 2023 (Mar 14). Doi: 10.1148/radiol.221571

Key clinical point: Data from a multi-institutional US database of more than 2.5 million screening mammograms showed that digital breast tomosynthesis (DBT) was superior to digital mammography (DM) for the purpose of breast cancer (BC) screening.

Major finding: Compared with DM, DBT led to significantly higher cancer detection rates (adjusted odds ratio [OR] 1.24), biopsy rate (adjusted OR 1.33), and positive predictive value of recall (adjusted OR 1.33; all P < .001).

Study details: Findings are from a retrospective study including 2,528,063 screening mammograms in 1,100,447 women aged 40-79 years.

Disclosures: This study did not report the source of funding. Some authors declared receiving grants, travel support, consulting fees, or payments from various sources.

Source: Conant EF et al. Mammographic screening in routine practice: Multisite study of digital breast tomosynthesis and digital mammography screenings. Radiology. 2023 (Mar 14). Doi: 10.1148/radiol.221571

Key clinical point: In patients with early, operable breast cancer (BC), peritumoral injection of a local anesthetic (lidocaine) prior to surgery improved survival outcomes.

Major finding: Peritumoral infiltration of lidocaine at the time of surgery led to 26% improvement in disease-free survival (hazard ratio [HR] 0.74; P = .017) and 29% improvement in overall survival (HR 0.71; P = .019) at a median follow-up of 68 months. No adverse events related to injection of lidocaine were reported.

Study details: Findings are from the phase 3 study including 1583 patients with early, operable BC who did not receive prior neoadjuvant treatment and were randomly assigned to undergo surgery with or without a peritumoral injection of 0.5% lidocaine 7-10 minutes preoperatively.

Disclosures: This study was supported by Department of Atomic Energy, India. Dr. Sudeep Gupta declared receiving research funding from several sources.

Source: Badwe RA et al. Effect of peritumoral infiltration of local anesthetic before surgery on survival in early breast cancer. J Clin Oncol. 2023 (Apr 6). Doi: 10.1200/JCO.22.01966

Key clinical point: In patients with early, operable breast cancer (BC), peritumoral injection of a local anesthetic (lidocaine) prior to surgery improved survival outcomes.

Major finding: Peritumoral infiltration of lidocaine at the time of surgery led to 26% improvement in disease-free survival (hazard ratio [HR] 0.74; P = .017) and 29% improvement in overall survival (HR 0.71; P = .019) at a median follow-up of 68 months. No adverse events related to injection of lidocaine were reported.

Study details: Findings are from the phase 3 study including 1583 patients with early, operable BC who did not receive prior neoadjuvant treatment and were randomly assigned to undergo surgery with or without a peritumoral injection of 0.5% lidocaine 7-10 minutes preoperatively.

Disclosures: This study was supported by Department of Atomic Energy, India. Dr. Sudeep Gupta declared receiving research funding from several sources.

Source: Badwe RA et al. Effect of peritumoral infiltration of local anesthetic before surgery on survival in early breast cancer. J Clin Oncol. 2023 (Apr 6). Doi: 10.1200/JCO.22.01966

Key clinical point: In patients with early, operable breast cancer (BC), peritumoral injection of a local anesthetic (lidocaine) prior to surgery improved survival outcomes.

Major finding: Peritumoral infiltration of lidocaine at the time of surgery led to 26% improvement in disease-free survival (hazard ratio [HR] 0.74; P = .017) and 29% improvement in overall survival (HR 0.71; P = .019) at a median follow-up of 68 months. No adverse events related to injection of lidocaine were reported.

Study details: Findings are from the phase 3 study including 1583 patients with early, operable BC who did not receive prior neoadjuvant treatment and were randomly assigned to undergo surgery with or without a peritumoral injection of 0.5% lidocaine 7-10 minutes preoperatively.

Disclosures: This study was supported by Department of Atomic Energy, India. Dr. Sudeep Gupta declared receiving research funding from several sources.

Source: Badwe RA et al. Effect of peritumoral infiltration of local anesthetic before surgery on survival in early breast cancer. J Clin Oncol. 2023 (Apr 6). Doi: 10.1200/JCO.22.01966

Key clinical point: In women with 2-3 ipsilateral foci of breast cancer (BC), breast-conserving surgery (BCS; lumpectomy plus adjuvant radiation) resulted in a local recurrence rate that was below the a priori determined clinically acceptable threshold of 8%.

Major finding: BCS resulted in a highly acceptable 5-year local recurrence rate of 3.1% (95% CI 1.3%-6.4%) in patients with multiple ipsilateral BC.

Study details: Findings are from the phase 2 American College of Surgeons Oncology Group Z11102 (Alliance) trial including 204 women aged ≥40 years with multiple ipsilateral BC who underwent BCS.

Disclosures: This study was supported by the US National Institutes of Health. Some authors declared owning stocks; serving on editorial boards, in leadership positions, or as employees; receiving research funding, honoraria, or travel and accommodation expenses; or having other ties with various sources.

Source: Boughey JC et al. Local recurrence after breast-conserving therapy in patients with multiple ipsilateral breast cancer: Results from ACOSOG Z11102 (Alliance). J Clin Oncol. 2023 (Mar 28). Doi: 10.1200/JCO.22.02553

Key clinical point: In women with 2-3 ipsilateral foci of breast cancer (BC), breast-conserving surgery (BCS; lumpectomy plus adjuvant radiation) resulted in a local recurrence rate that was below the a priori determined clinically acceptable threshold of 8%.

Major finding: BCS resulted in a highly acceptable 5-year local recurrence rate of 3.1% (95% CI 1.3%-6.4%) in patients with multiple ipsilateral BC.

Study details: Findings are from the phase 2 American College of Surgeons Oncology Group Z11102 (Alliance) trial including 204 women aged ≥40 years with multiple ipsilateral BC who underwent BCS.

Disclosures: This study was supported by the US National Institutes of Health. Some authors declared owning stocks; serving on editorial boards, in leadership positions, or as employees; receiving research funding, honoraria, or travel and accommodation expenses; or having other ties with various sources.

Source: Boughey JC et al. Local recurrence after breast-conserving therapy in patients with multiple ipsilateral breast cancer: Results from ACOSOG Z11102 (Alliance). J Clin Oncol. 2023 (Mar 28). Doi: 10.1200/JCO.22.02553

Key clinical point: In women with 2-3 ipsilateral foci of breast cancer (BC), breast-conserving surgery (BCS; lumpectomy plus adjuvant radiation) resulted in a local recurrence rate that was below the a priori determined clinically acceptable threshold of 8%.

Major finding: BCS resulted in a highly acceptable 5-year local recurrence rate of 3.1% (95% CI 1.3%-6.4%) in patients with multiple ipsilateral BC.

Study details: Findings are from the phase 2 American College of Surgeons Oncology Group Z11102 (Alliance) trial including 204 women aged ≥40 years with multiple ipsilateral BC who underwent BCS.

Disclosures: This study was supported by the US National Institutes of Health. Some authors declared owning stocks; serving on editorial boards, in leadership positions, or as employees; receiving research funding, honoraria, or travel and accommodation expenses; or having other ties with various sources.

Source: Boughey JC et al. Local recurrence after breast-conserving therapy in patients with multiple ipsilateral breast cancer: Results from ACOSOG Z11102 (Alliance). J Clin Oncol. 2023 (Mar 28). Doi: 10.1200/JCO.22.02553

Key clinical point: A dose of 25 mg exemestane 3 times weekly was noninferior to the standard once-daily dose in decreasing serum estradiol levels in postmenopausal women with stage 0-II estrogen receptor-positive (ER+) breast cancer (BC).

Major finding: Compared with once-daily exemestane, 3-times-weekly exemestane was noninferior (difference in percentage change 2.0%; P for noninferiority = .02) whereas once-weekly exemestane was less effective in decreasing serum estradiol levels in participants who received ≥80% of the active scheduled pills and underwent blood testing as per protocol. The adverse event rate was similar across all treatment arms.

Study details: This phase 2b trial included 180 postmenopausal women with stage 0-II, ER+ BC who were randomly assigned to receive 25 mg exemestane once daily, 3 times weekly, or once weekly for 4-6 weeks before surgery.

Disclosures: This study was supported by the US National Cancer Institute and other sources. Two authors declared being principal investigators, holding stocks, or receiving partial salary support or personal fees from various sources.

Source: Serrano D et al. Efficacy of alternative dose regimens of exemestane in postmenopausal women with stage 0 to II estrogen receptor-positive breast cancer: A randomized clinical trial. JAMA Oncol. 2023 (Mar 23). Doi: 10.1001/jamaoncol.2023.0089

Key clinical point: A dose of 25 mg exemestane 3 times weekly was noninferior to the standard once-daily dose in decreasing serum estradiol levels in postmenopausal women with stage 0-II estrogen receptor-positive (ER+) breast cancer (BC).

Major finding: Compared with once-daily exemestane, 3-times-weekly exemestane was noninferior (difference in percentage change 2.0%; P for noninferiority = .02) whereas once-weekly exemestane was less effective in decreasing serum estradiol levels in participants who received ≥80% of the active scheduled pills and underwent blood testing as per protocol. The adverse event rate was similar across all treatment arms.

Study details: This phase 2b trial included 180 postmenopausal women with stage 0-II, ER+ BC who were randomly assigned to receive 25 mg exemestane once daily, 3 times weekly, or once weekly for 4-6 weeks before surgery.

Disclosures: This study was supported by the US National Cancer Institute and other sources. Two authors declared being principal investigators, holding stocks, or receiving partial salary support or personal fees from various sources.

Source: Serrano D et al. Efficacy of alternative dose regimens of exemestane in postmenopausal women with stage 0 to II estrogen receptor-positive breast cancer: A randomized clinical trial. JAMA Oncol. 2023 (Mar 23). Doi: 10.1001/jamaoncol.2023.0089

Key clinical point: A dose of 25 mg exemestane 3 times weekly was noninferior to the standard once-daily dose in decreasing serum estradiol levels in postmenopausal women with stage 0-II estrogen receptor-positive (ER+) breast cancer (BC).

Major finding: Compared with once-daily exemestane, 3-times-weekly exemestane was noninferior (difference in percentage change 2.0%; P for noninferiority = .02) whereas once-weekly exemestane was less effective in decreasing serum estradiol levels in participants who received ≥80% of the active scheduled pills and underwent blood testing as per protocol. The adverse event rate was similar across all treatment arms.

Study details: This phase 2b trial included 180 postmenopausal women with stage 0-II, ER+ BC who were randomly assigned to receive 25 mg exemestane once daily, 3 times weekly, or once weekly for 4-6 weeks before surgery.

Disclosures: This study was supported by the US National Cancer Institute and other sources. Two authors declared being principal investigators, holding stocks, or receiving partial salary support or personal fees from various sources.

Source: Serrano D et al. Efficacy of alternative dose regimens of exemestane in postmenopausal women with stage 0 to II estrogen receptor-positive breast cancer: A randomized clinical trial. JAMA Oncol. 2023 (Mar 23). Doi: 10.1001/jamaoncol.2023.0089

Key clinical point: Polatuzumab vedotin (Pola)-rituximab-cyclophosphamide, doxorubicin, and prednisone (R-CHP) compared with other novel regimens prolongs progression-free survival (PFS) in patients with previously untreated activated B-cell (ABC)-type diffuse large B-cell lymphoma (DLBCL).

Major finding: Pola-R-CHP prolonged PFS in patients with ABC-type DLBCL compared with rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)+bortezomib (hazard ratio [HR] 0.52; P  =  .02); R-CHOP+ibrutinib (HR 0.43; P  =  .001), R-CHOP+lenalidomide (HR 0.51; P  =  .009), obinutuzumab-CHOP (HR 0.46; P  =  .008), R-CHOP (HR 0.40; P < .001), and bortezomib, rituximab, and cyclophosphamide (HR 0.44; P  =  .07). Pola-R-CHP had no PFS benefit in patients with germinal center B-cell (GCB)-type DLBCL.

Study details: This was a network meta-analysis of 12 randomized controlled trials involving 8376 patients with previously untreated ABC- or GCB-type DLBCL who received Pola-R-CHP or other regimens.

Disclosures: This study did not report the funding source. The authors declared no conflicts of interest.

Source: Sheng Z et al. Superiority of polatuzumab vedotin over other novel agents in previously untreated ABC‑type diffuse large B‑cell lymphoma: A network meta‑analysis of 20 RCTs. Ann Hematol. 2023;102:1011-1017 (Mar 22). Doi: 10.1007/s00277-023-05161-1

Key clinical point: Polatuzumab vedotin (Pola)-rituximab-cyclophosphamide, doxorubicin, and prednisone (R-CHP) compared with other novel regimens prolongs progression-free survival (PFS) in patients with previously untreated activated B-cell (ABC)-type diffuse large B-cell lymphoma (DLBCL).

Major finding: Pola-R-CHP prolonged PFS in patients with ABC-type DLBCL compared with rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)+bortezomib (hazard ratio [HR] 0.52; P  =  .02); R-CHOP+ibrutinib (HR 0.43; P  =  .001), R-CHOP+lenalidomide (HR 0.51; P  =  .009), obinutuzumab-CHOP (HR 0.46; P  =  .008), R-CHOP (HR 0.40; P < .001), and bortezomib, rituximab, and cyclophosphamide (HR 0.44; P  =  .07). Pola-R-CHP had no PFS benefit in patients with germinal center B-cell (GCB)-type DLBCL.

Study details: This was a network meta-analysis of 12 randomized controlled trials involving 8376 patients with previously untreated ABC- or GCB-type DLBCL who received Pola-R-CHP or other regimens.

Disclosures: This study did not report the funding source. The authors declared no conflicts of interest.

Source: Sheng Z et al. Superiority of polatuzumab vedotin over other novel agents in previously untreated ABC‑type diffuse large B‑cell lymphoma: A network meta‑analysis of 20 RCTs. Ann Hematol. 2023;102:1011-1017 (Mar 22). Doi: 10.1007/s00277-023-05161-1

Key clinical point: Polatuzumab vedotin (Pola)-rituximab-cyclophosphamide, doxorubicin, and prednisone (R-CHP) compared with other novel regimens prolongs progression-free survival (PFS) in patients with previously untreated activated B-cell (ABC)-type diffuse large B-cell lymphoma (DLBCL).

Major finding: Pola-R-CHP prolonged PFS in patients with ABC-type DLBCL compared with rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)+bortezomib (hazard ratio [HR] 0.52; P  =  .02); R-CHOP+ibrutinib (HR 0.43; P  =  .001), R-CHOP+lenalidomide (HR 0.51; P  =  .009), obinutuzumab-CHOP (HR 0.46; P  =  .008), R-CHOP (HR 0.40; P < .001), and bortezomib, rituximab, and cyclophosphamide (HR 0.44; P  =  .07). Pola-R-CHP had no PFS benefit in patients with germinal center B-cell (GCB)-type DLBCL.

Study details: This was a network meta-analysis of 12 randomized controlled trials involving 8376 patients with previously untreated ABC- or GCB-type DLBCL who received Pola-R-CHP or other regimens.

Disclosures: This study did not report the funding source. The authors declared no conflicts of interest.

Source: Sheng Z et al. Superiority of polatuzumab vedotin over other novel agents in previously untreated ABC‑type diffuse large B‑cell lymphoma: A network meta‑analysis of 20 RCTs. Ann Hematol. 2023;102:1011-1017 (Mar 22). Doi: 10.1007/s00277-023-05161-1