4.5 Review

Breast cancer: an up-to-date review and future perspectives

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Trastuzumab Plus Endocrine Therapy or Chemotherapy as First-line Treatment for Patients with Hormone Receptor-Positive and HER2-Positive Metastatic Breast Cancer (SYSUCC-002)

Xin Hua et al.

Summary: This study aimed to compare the efficacy of endocrine therapy and chemotherapy as partner strategies with anti-HER2 therapy for first-line treatment of HR(+)HER2(+) metastatic breast cancer. The results showed that trastuzumab plus endocrine therapy was noninferior to trastuzumab plus chemotherapy in terms of progression-free survival, with a significantly higher prevalence of toxicity in the chemotherapy group.

CLINICAL CANCER RESEARCH (2022)

Article Oncology

Treatment Exposure and Discontinuation in the PALbociclib CoLlaborative Adjuvant Study of Palbociclib With Adjuvant Endocrine Therapy for Hormone Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Early Breast Cancer (PALLAS/AFT-05/ABCSG-42/BIG-14-03)

Erica L. Mayer et al.

Summary: The PALLAS study investigated the effectiveness of adding palbociclib to adjuvant endocrine therapy in early hormone receptor-positive, HER2-negative breast cancer. The analysis found that discontinuation of palbociclib was primarily due to adverse effects, and longer duration of palbociclib use did not significantly improve disease-free survival.

JOURNAL OF CLINICAL ONCOLOGY (2022)

Article Oncology

Pyrotinib plus capecitabine for patients with human epidermal growth factor receptor 2-positive breast cancer and brain metastases (PERMEATE): a multicentre, single-arm, two-cohort, phase 2 trial

Min Yan et al.

Summary: This study investigated the activity and safety of pyrotinib plus capecitabine in patients with HER2-positive metastatic breast cancer and brain metastases. The combination therapy showed a high intracranial objective response rate in patients who had not received radiotherapy and had acceptable safety profiles.

LANCET ONCOLOGY (2022)

Article Oncology

Aromatase inhibitors versus tamoxifen in premenopausal women with oestrogen receptor-positive early-stage breast cancer treated with ovarian suppression: a patient-level meta-analysis of 7030 women from four randomised trials

R. Bradley et al.

Summary: Aromatase inhibitors are more effective than tamoxifen in reducing the risk of breast cancer recurrence in premenopausal women receiving ovarian suppression. The main benefit is observed in the first 4 years of treatment, with no additional benefit or loss of benefit in the following years up to 10.

LANCET ONCOLOGY (2022)

Article Medicine, General & Internal

Event-free Survival with Pembrolizumab in Early Triple-Negative Breast Cancer

P. Schmid et al.

Summary: The addition of pembrolizumab to neoadjuvant chemotherapy followed by adjuvant pembrolizumab after surgery significantly prolonged event-free survival in patients with early triple-negative breast cancer.

NEW ENGLAND JOURNAL OF MEDICINE (2022)

Article Health Care Sciences & Services

Homologous Recombination Deficiency (HRD) and BRCA 1/2 Gene Mutation for Predicting the Effect of Platinum-Based Neoadjuvant Chemotherapy of Early-Stage Triple-Negative Breast Cancer (TNBC): A Systematic Review and Meta-Analysis

Yue Chai et al.

Summary: This meta-analysis assessed the predictive value of BRCA1/2 and homologous recombination deficiency (HRD) in the pCR rates of TNBC patients treated with platinum-based neoadjuvant chemotherapy (NAC). The results showed that BRCA1/2-mutated and HRD-positive TNBC patients could benefit from platinum-based NAC.

JOURNAL OF PERSONALIZED MEDICINE (2022)

Article Oncology

Biomarkers for Adjuvant Endocrine and Chemotherapy in Early-Stage Breast Cancer: ASCO Guideline Update

Fabrice Andre et al.

Summary: This article provides updated recommendations on the appropriate use of breast cancer biomarker assay results in guiding adjuvant endocrine and chemotherapy decisions for early-stage breast cancer. Based on the latest literature and expert consensus, specific biomarker assay results can be used to guide treatment decisions for patients who meet certain criteria. However, other factors such as disease stage, comorbidities, and patient preferences should also be considered.

JOURNAL OF CLINICAL ONCOLOGY (2022)

Article Oncology

FDA Approval Summary: Abemaciclib With Endocrine Therapy for High-Risk Early Breast Cancer

Melanie Royce et al.

Summary: Abemaciclib in combination with endocrine therapy has been approved for high-risk early breast cancer patients, showing a statistically significant improvement in invasive disease-free survival (IDFS) without detriment to overall survival.

JOURNAL OF CLINICAL ONCOLOGY (2022)

Article Medicine, General & Internal

Trastuzumab Deruxtecan versus Trastuzumab Emtansine for Breast Cancer

J. Cortes et al.

Summary: Among patients with HER2-positive metastatic breast cancer previously treated with trastuzumab and a taxane, trastuzumab deruxtecan was associated with a lower risk of disease progression or death compared to trastuzumab emtansine. However, treatment with trastuzumab deruxtecan was associated with interstitial lung disease and pneumonitis.

NEW ENGLAND JOURNAL OF MEDICINE (2022)

Article Medicine, General & Internal

Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer

Shanu Modi et al.

Summary: Trastuzumab deruxtecan demonstrated significantly longer progression-free and overall survival compared to physician's choice chemotherapy in patients with HER2-low metastatic breast cancer.

NEW ENGLAND JOURNAL OF MEDICINE (2022)

Article Surgery

A Prospective, Multicenter Registry Study to Evaluate the Clinical Feasibility of Targeted Axillary Dissection (TAD) in Node-positive Breast Cancer Patients

Sherko Kuemmel et al.

Summary: The study demonstrates the feasibility of TAD in a real-world cohort of breast cancer patients, which is of great importance for the de-escalation of surgical strategies.

ANNALS OF SURGERY (2022)

Article Cell Biology

Molecular subtyping and genomic profiling expand precision medicine in refractory metastatic triple-negative breast cancer: the FUTURE trial

Yi-Zhou Jiang et al.

Summary: The FUTURE trial demonstrated the clinical benefit of subtyping-based targeted therapy for refractory metastatic TNBC, with immunotherapy showing the highest objective response rate among the treatment arms. Somatic mutations of TOP2A and CD8 immunohistochemical score may have the potential to predict immunotherapy response in the immunomodulatory subtype of TNBC.

CELL RESEARCH (2021)

Article Oncology

Final Efficacy Results of Neratinib in HER2-positive Hormone Receptor-positive Early-stage Breast Cancer From the Phase III ExteNET Trial

Arlene Chan et al.

Summary: In early-stage breast cancer patients, neratinib provides a 5.1% increase in invasive disease-free survival and a 2.1% increase in overall survival at 8 years compared to placebo. For patients with residual disease after neoadjuvant therapy, the absolute benefits of neratinib are 7.4% and 9.1%, respectively.

CLINICAL BREAST CANCER (2021)

Article Oncology

Long-term standard sentinel node biopsy after neoadjuvant treatment in breast cancer: a single institution ten-year follow-up

Sabrina Kahler-Ribeiro-Fontana et al.

Summary: This study evaluated the outcomes of patients undergoing NAT who remained or converted to cN0 and received SNB, showing a high overall survival rate after 10-year follow-up. The use of standard SNB in cN1/2 patients who become cN0 after NAT was deemed acceptable and did not result in worse outcomes.
Article Oncology

Phase III, Randomized Study of Dual Human Epidermal Growth Factor Receptor 2 (HER2) Blockade With Lapatinib Plus Trastuzumab in Combination With an Aromatase Inhibitor in Postmenopausal Women With HER2-Positive, Hormone Receptor-Positive Metastatic Breast Cancer: Updated Results of ALTERNATIVE

Stephen R. D. Johnston et al.

Summary: Dual HER2 blockade with LAP plus TRAS plus AI showed superior progression-free survival (PFS) benefit versus TRAS plus AI in patients with HER2-positive/HR-positive MBC. This combination offers an effective and safe chemotherapy-sparing alternative treatment regimen for this patient population. Common adverse events were mostly grade 1 or 2 and serious adverse events were reported similarly across the three groups.

JOURNAL OF CLINICAL ONCOLOGY (2021)

Article Oncology

Customizing local and systemic therapies for women with early breast cancer: the St. Gallen International Consensus Guidelines for treatment of early breast cancer 2021

H. J. Burstein et al.

Summary: The 17th St Gallen International Breast Cancer Consensus Conference in 2021 was held virtually, with over 3300 participants discussing key issues related to early breast cancer diagnosis and treatment. The conference emphasized customized recommendations for breast cancer treatment, highlighting the importance of individualized clinical features in patient care.

ANNALS OF ONCOLOGY (2021)

Article Oncology

Adjuvant abemaciclib combined with endocrine therapy for high-risk early breast cancer: updated efficacy and Ki-67 analysis from the monarchE study

N. Harbeck et al.

Summary: Adjuvant abemaciclib combined with endocrine therapy significantly improved invasive disease-free survival in patients with early breast cancer, with an acceptable safety profile. Ki-67 index was prognostic but did not affect the benefits of abemaciclib. The robust treatment benefit of abemaciclib extended beyond the planned 2-year treatment period.

ANNALS OF ONCOLOGY (2021)

Article Oncology

Single-cell analyses reveal key immune cell subsets associated with response to PD-L1 blockade in triple-negative breast cancer

Yuanyuan Zhang et al.

Summary: The study indicates that high levels of baseline CXCL13(+) T cells are associated with effective responses to combination therapy in triple-negative breast cancer patients. These cells increase following combination therapy but decrease after monotherapy, highlighting their importance in predicting treatment outcomes.

CANCER CELL (2021)

Editorial Material Medicine, General & Internal

Adjuvant Capecitabine in Triple-Negative Breast Cancer New Strategies for Tailoring Treatment Recommendations

Heather A. Parsons et al.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2021)

Article Medicine, General & Internal

Effect of Capecitabine Maintenance Therapy Using Lower Dosage and Higher Frequency vs Observation on Disease-Free Survival Among Patients With Early-Stage Triple-Negative Breast Cancer Who Had Received Standard Treatment The SYSUCC-001 Randomized Clinical Trial

Xi Wang et al.

Summary: This study aimed to evaluate the efficacy and adverse effects of low-dose capecitabine maintenance therapy after standard adjuvant chemotherapy in early-stage triple-negative breast cancer. The results showed significantly improved 5-year disease-free survival in patients receiving capecitabine treatment.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2021)

Article Oncology

Palbociclib with adjuvant endocrine therapy in early breast cancer (PALLAS): interim analysis of a multicentre, open-label, randomised, phase 3 study

Erica L. Mayer et al.

Summary: The PALLAS trial investigated whether adding 2 years of palbociclib to adjuvant endocrine therapy could improve invasive disease-free survival in early-stage hormone-receptor-positive, HER2-negative breast cancer patients, but the results showed no significant benefit. The trial was then discontinued based on the lack of efficacy observed during the planned second interim analysis.

LANCET ONCOLOGY (2021)

Article Medicine, General & Internal

A Population-Based Study of Genes Previously Implicated in Breast Cancer

Chunling Hu et al.

Summary: This study provides population-based estimates of the prevalence and risk of breast cancer associated with pathogenic variants in known cancer-predisposition genes. The results highlight the varying levels of risk associated with different genes, such as high risk for BRCA1 and BRCA2 and moderate risk for PALB2, as well as associations with specific subtypes of breast cancer for genes like RAD51C and RAD51D.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

Article Medicine, General & Internal

Breast Cancer Risk Genes - Association Analysis in More than 113,000 Women

Leila Dorling et al.

Summary: This study sequenced samples from 60,466 women with breast cancer and 53,461 controls using a panel of 34 putative susceptibility genes, identifying associations between protein-truncating variants in certain genes and breast cancer risk. The results provide important information for genetic counseling and define genes that are most clinically useful for predicting breast cancer risk.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

Article Oncology

Efficacy of utidelone plus capecitabine versus capecitabine for heavily pretreated, anthracycline- and taxane-refractory metastatic breast cancer: final analysis of overall survival in a phase III randomised controlled trial

B. Xu et al.

Summary: The combination therapy of utidelone plus capecitabine significantly improved overall survival, progression-free survival, and overall response rate in heavily-pretreated patients with metastatic breast cancer, with no new safety concerns.

ANNALS OF ONCOLOGY (2021)

Article Oncology

Alpelisib plus fulvestrant for PIK3CA-mutated, hormone receptor-positive, human epidermal growth factor receptor-2enegative advanced breast cancer: final overall survival results from SOLAR-1

F. Andre et al.

Summary: The study confirmed a certain efficacy in overall survival when alpelisib was added to fulvestrant treatment in patients with PIK3CA-mutated hormone receptor-positive, human epidermal growth factor receptor-2-negative advanced breast cancer, prolonging the median survival time.

ANNALS OF ONCOLOGY (2021)

Article Oncology

Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

Hyuna Sung et al.

Summary: The global cancer burden in 2020 saw an estimated 19.3 million new cancer cases and almost 10.0 million cancer deaths. Female breast cancer surpassed lung cancer as the most commonly diagnosed cancer, while lung cancer remained the leading cause of cancer death. These trends are expected to rise in 2040, with transitioning countries experiencing a larger increase compared to transitioned countries due to demographic changes and risk factors associated with globalization and a growing economy. Efforts to improve cancer prevention measures and provision of cancer care in transitioning countries will be crucial for global cancer control.

CA-A CANCER JOURNAL FOR CLINICIANS (2021)

Article Biochemistry & Molecular Biology

Dalpiciclib or placebo plus fulvestrant in hormone receptor-positive and HER2-negative advanced breast cancer: a randomized, phase 3 trial

Binghe Xu et al.

Summary: Combination therapy of dalpiciclib and fulvestrant significantly prolongs progression-free survival in patients with hormone receptor-positive, HER2-negative advanced breast cancer, with neutropenia and leukopenia being the most common grade 3 or 4 adverse events. Serious adverse events rate is relatively low and supports dalpiciclib plus fulvestrant as a new treatment option for pretreated patients.

NATURE MEDICINE (2021)

Article Oncology

Phase I/II Trial of Exemestane, Ribociclib, and Everolimus in Women with HR+/HER2- Advanced Breast Cancer after Progression on CDK4/6 Inhibitors (TRINITI-1)

Aditya Bardia et al.

Summary: Treatment with ribociclib in combination with everolimus and exemestane showed promising efficacy and safety for patients with HR+/HER2(-) ABC after progression on a CDK4/6i, supporting further investigation of CDK4/6 blockade and PI3K/AKT/mTOR pathway targeting in this population.

CLINICAL CANCER RESEARCH (2021)

Article Oncology

Palbociclib for Residual High-Risk Invasive HR-Positive and HER2-Negative Early Breast Cancer-The Penelope-B Trial

Sibylle Loibl et al.

Summary: The study investigated the efficacy of palbociclib in breast cancer patients with residual invasive disease after neoadjuvant chemotherapy, showing that palbociclib in addition to endocrine therapy did not improve invasive disease-free survival. Some related serious adverse events were reported, but no significant difference between treatment arms.

JOURNAL OF CLINICAL ONCOLOGY (2021)

Article Oncology

Pertuzumab Plus High-Dose Trastuzumab in Patients With Progressive Brain Metastases and HER2-Positive Metastatic Breast Cancer: Primary Analysis of a Phase II Study

Nancy U. Lin et al.

Summary: The study aimed to investigate the efficacy of high-dose trastuzumab in treating HER2-positive MBC patients with CNS metastases. Although the CNS ORR was modest, 68% of patients experienced clinical benefit, suggesting that further study is warranted.

JOURNAL OF CLINICAL ONCOLOGY (2021)

Review Medicine, General & Internal

Breast cancer

Sibylle Loibl et al.

Summary: Breast cancer diagnosis and treatment have become increasingly complex, incorporating various biomarkers and neoadjuvant therapies, with de-escalation schemes for radiotherapy now becoming standard practice.

LANCET (2021)

Article Oncology

Alpelisib plus fulvestrant in PIK3CA-mutated, hormone receptor-positive advanced breast cancer after a CDK4/6 inhibitor (BYLieve): one cohort of a phase 2, multicentre, open-label, non-comparative study

Hope S. Rugo et al.

Summary: The study demonstrated that in patients with hormone receptor-positive, HER2-negative, PIK3CA-mutated advanced breast cancer who progressed on treatment with CDK4/6 inhibitors plus aromatase inhibitors, the combination therapy of Alpelisib and Fulvestrant showed activity with manageable toxicity.

LANCET ONCOLOGY (2021)

Article Medicine, General & Internal

Sacituzumab Govitecan in Metastatic Triple-Negative Breast Cancer

A. Bardia et al.

Summary: Patients with metastatic triple-negative breast cancer treated with Sacituzumab govitecan had significantly longer progression-free and overall survival compared to standard chemotherapy, but experienced more frequent myelosuppression and diarrhea as adverse events.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

Article Oncology

First-line atezolizumab plus nab-paclitaxel for unresectable, locally advanced, or metastatic triple-negative breast cancer: IMpassion130 final overall survival analysis

L. A. Emens et al.

Summary: The study showed that although A + nP for first-line treatment of triple-negative breast cancer did not significantly improve overall survival in the overall population, clinically meaningful benefits were observed in patients with PD-L1 expression on tumor infiltrating immune cells. The combination therapy remained safe and tolerable with longer follow-up.

ANNALS OF ONCOLOGY (2021)

Article Oncology

Primary results from IMpassion131, a double-blind, placebo-controlled, randomised phase III trial of first-line paclitaxel with or without atezolizumab for unresectable locally advanced/metastatic triple-negative breast cancer

D. Miles et al.

Summary: Combining atezolizumab with paclitaxel did not improve PFS or OS in PD-L1-positive aTNBC patients, although it showed some advantage in unconfirmed best overall response rate and duration of response.

ANNALS OF ONCOLOGY (2021)

Article Medicine, General & Internal

Adjuvant Olaparib for Patients with BRCA1- or BRCA2-Mutated Breast Cancer

Andrew N. J. Tutt et al.

Summary: In patients with high-risk, HER2-negative early breast cancer and germline BRCA1 or BRCA2 pathogenic or likely pathogenic variants, adjuvant olaparib after completion of local treatment and neoadjuvant or adjuvant chemotherapy was associated with significantly longer survival free of invasive or distant disease than placebo. Olaparib had limited effects on global patient-reported quality of life.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

Article Oncology

Efficacy of Neratinib Plus Capecitabine in the Subgroup of Patients with Central Nervous System Involvement from the NALA Trial

Sara A. Hurvitz et al.

Summary: The study found that in patients with HER2-positive breast cancer metastases, the combination therapy of neratinib plus capecitabine significantly improved progression-free survival and central nervous system outcomes compared to lapatinib plus capecitabine.

ONCOLOGIST (2021)

Review Oncology

St. Gallen/Vienna 2021: A Brief Summary of the Consensus Discussion on Customizing Therapies for Women with Early Breast Cancer

Christoph Thomssen et al.

Summary: Due to the COVID-19 pandemic, the 2021 St. Gallen/Vienna Consensus Conference on Early Breast Cancer Treatment Standards had to be held virtually, where organizers successfully managed to convene global contributors, leading to well-received scientific discussions with over 3,400 participants from 100+ countries. The virtual format introduced new elements such as audience-suggested Consensus questions and live audience interaction, doubling discussion time across different time zones.

BREAST CARE (2021)

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The 2019 World Health Organization classification of tumours of the breast

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Pembrolizumab for Early Triple-Negative Breast Cancer

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Trastuzumab Deruxtecan in Previously Treated HER2-Positive Breast Cancer

Shanu Modi et al.

NEW ENGLAND JOURNAL OF MEDICINE (2020)

Review Oncology

Endocrine Therapy in Early Breast Cancer

Katja Krauss et al.

BREAST CARE (2020)

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Alpelisib for PIK3CA-Mutated, Hormone Receptor-Positive Advanced Breast Cancer

Fabrice Andre et al.

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Overall Survival with Ribociclib plus Endocrine Therapy in Breast Cancer

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NEW ENGLAND JOURNAL OF MEDICINE (2019)

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Ten-year recurrence rates for breast cancer subtypes in the Netherlands: A large population-based study

Marissa C. van Maaren et al.

INTERNATIONAL JOURNAL OF CANCER (2019)

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Trastuzumab Emtansine for Residual Invasive HER2-Positive Breast Cancer

G. von Minckwitz et al.

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Hereditary Cancer Syndromes and Risk Assessment

[Anonymous]

OBSTETRICS AND GYNECOLOGY (2019)

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Carboplatin in BRCA1/2-mutated and triple-negative breast cancer BRCAness subgroups: the TNT Trial

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Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer

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Talazoparib in Patients with Advanced Breast Cancer and a Germline BRCA Mutation

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Overall Survival with Palbociclib and Fulvestrant in Advanced Breast Cancer

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Atezolizumab and Nab-Paclitaxel in Advanced Triple-Negative Breast Cancer

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Risks of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers

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JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2017)

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Olaparib for Metastatic Breast Cancer in Patients with a Germline BRCA Mutation

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Adjuvant Capecitabine for Breast Cancer after Preoperative Chemotherapy

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Adjuvant Pertuzumab and Trastuzumab in Early HER2-Positive Breast Cancer

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Ki67 assessment in breast cancer: an update

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70-Gene Signature as an Aid to Treatment Decisions in Early-Stage Breast Cancer

F. Cardoso et al.

NEW ENGLAND JOURNAL OF MEDICINE (2016)

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Ribociclib as First-Line Therapy for HR-Positive, Advanced Breast Cancer

G. N. Hortobagyi et al.

NEW ENGLAND JOURNAL OF MEDICINE (2016)

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Incidence and Time Path of Lymphedema in Sentinel Node Negative Breast Cancer Patients: A Systematic Review

Nick Gebruers et al.

ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION (2015)

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Breast Cancer Screening for Women at Average Risk 2015 Guideline Update From the American Cancer Society

Kevin C. Oeffinger et al.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2015)

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Adjuvant Paclitaxel and Trastuzumab for Node-Negative, HER2-Positive Breast Cancer

Sara M. Tolaney et al.

NEW ENGLAND JOURNAL OF MEDICINE (2015)

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Palbociclib in Hormone-Receptor-Positive Advanced Breast Cancer

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Regional Nodal Irradiation in Early-Stage Breast Cancer

Timothy J. Whelan et al.

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Adjuvant Ovarian Suppression in Premenopausal Breast Cancer

Prudence A. Francis et al.

NEW ENGLAND JOURNAL OF MEDICINE (2015)

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Radiation Field Design in the ACOSOG Z0011 (Alliance) Trial

Reshma Jagsi et al.

JOURNAL OF CLINICAL ONCOLOGY (2014)

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Adjuvant Exemestane with Ovarian Suppression in Premenopausal Breast Cancer

Olivia Pagani et al.

NEW ENGLAND JOURNAL OF MEDICINE (2014)

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Sentinel Lymph Node Surgery After Neoadjuvant Chemotherapy in Patients With Node-Positive Breast Cancer The ACOSOG Z1071 (Alliance) Clinical Trial

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JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2013)

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Prediction of Late Disease Recurrence and Extended Adjuvant Letrozole Benefit by the HOXB13/IL17BR Biomarker

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ASCO-CAP Guidelines for Breast Predictive Factor Testing: An Update

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Long-Term Results of Hypofractionated Radiation Therapy for Breast Cancer

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