The 41st San Antonio Breast Cancer Symposium (SABCS) is a joint presentation of the UT Health Cancer center, Baylor College of Medicine, and the American Association for Cancer Research (AACR). More than 7,500 attendees from more than 90 countries attended this year’ SABCS. The Symposium provided a wide variety of new findings in clinical, translational, and basic research, hence showcasing an interesting forum for communication and exchange among world-renowned researchers, health professionals, and patient groups. Jida El Hajjar, Vice-president of investment and health promotion at the Foundation was there. Here's her report on some of the studies presented at this five-day symposium!
Five promising studies in breast cancer care
Breast cancer is the most common cancer in women and the second leading cause of cancer-related death, yet, there are substantial advances in the breast cancer research field!
1. TDM-1 improves survival after neoadjuvant therapy among women with HER-2 positive cancer and residual disease: Findings from the phase III clinical trial KATHERINE demonstrate that treating with adjuvant trastuzumab emtansine (T-DM1, Kadcyla) instead of adjuvant standard therapy of trastuzumab (Herceptin) would reduce the risk of recurrence by 50 percent in HER2-positive early-stage breast cancer patients who are at higher risk for recurrence after receiving taxane-based neoadjuvant (pre-surgery) therapy. “The standard of care has changed”, said Eric P. Winer, MD, of the Dana-Farber Cancer Institute, Boston, MA, in a discussion after the presentation of the trial results.
T-DM1 is currently approved in Canada to treat patients with metastatic HER2-positive breast cancer.
2. PDL-1 as a marker of responsiveness to treatment with Atezolizumab (Tecentriq) plus Nab-Paclitaxel (Taxol): PDL-1 expression is used as biomarker to predict response for certain immunotherapies. From the first interim analysis of the phase III study IMpassion 130, PDL-1 expression can identify patients with triple-negative breast cancer (TNBC) who will benefit from first line immunotherapy with Atezolizumab (Tecentriq) in combination with chemotherapy nab-paclitaxel (Taxol). This is the first phase III study to demonstrate a benefit of immunotherapy for TNBC and these results suggest that newly diagnosed metastatic TNBC patients should be tested for PDL-1 status.
3. Efficacy results of adding adjuvant chemotherapy agent Capecitabine (Xeloda) to standard anthracycline-based chemotherapy in early triple negative breast cancer: Results from the randomized, phase III GEICAM/CIBOMA clinical trial demonstrated that adding adjuvant capecitabine (Xeloda) to anthracycline-based chemotherapy (Adriamycin) did not significantly increase overall survival in early-stage TNBC patients. After a median follow-up of 7.3 years, the study reported an overall survival in the capecitabine arm of 86.2 percent versus 85.9 percent in the observation arm.
4. Energy Balance and Breast Cancer Aspects-II (EBBA-II): Exercising to change outcome. Findings from the EBBA-II trial showed that women who experienced a guided program of cardiovascular exercise during adjuvant therapy had better cardiovascular function than the ones who did not take part of the exercise program. Under supervision, the exercise group trained twice a week for 60 minutes each time, combining aerobics, stretching, and weight training. Investigators of this study observed that among the patients who were receiving adjuvant chemotherapy, those randomized to the exercise arm had returned to their baseline pre-surgery cardiovascular strength by the 12-month follow-up, whereas those in the control arm continued to experience decreased cardiovascular function. Following the presentation of the results, Dr. Kent Osborne, MD, Baylor College of Medicine noted that “Doctors need to start encompassing exercise and diet in their treatment plans.”
5. Ameliorating Quality of Life: Breast cancer survivors that are not candidate or are not interested in hormone replacement therapy, but are taking tamoxifen (Nolvadex) or an aromatase inhibitor, experience bothersome hot flashes as side effects of the treatment. In addition to impacting the quality of life, hot flashes are also linked to interruption of breast cancer therapy, which could ultimately increase the risk of breast cancer recurrence. In a randomized, double-blind, placebo-controlled clinical trial, investigators evaluated whether oxybutynin, a medication commonly used to treat urinary incontinence, could reduce hot flashes symptoms. Results of the study indicate that patients who took oxybutynin had lower hot flashes scores compared with the ones who had placebo. Moreover, women who were on the oxybutynin arm reported improvement in work life, sleep, social and leisure activities, and quality of life.