At the San Antonio Breast Cancer Symposium, researchers shared new findings that advance our understanding on both treatment and prevention of breast cancer. Here are a few highlights that made the news.
Dose-dense chemotherapy reduces breast cancer recurrence
Forty years ago, BCRF Scientific Director Dr. Larry Norton pioneered the use of dose-dense chemotherapy – a protocol which calls for less time between chemotherapy doses compared with a standard treatment plan. In a presentation from the Early Breast Cancer Trialists’ Group at this year’s meeting, this once controversial treatment protocol was further validated.
Researchers found that increasing the dose intensity by either shortening the interval between treatment cycles or sequential treatment such as giving drugs sequentially rather than concurrently, reduced breast cancer recurrence and deaths due to breast cancer compared to standard protocols.
The study authors analyzed results from over 25 trials including more than 34,000 women and found a 15 percent reduction in breast cancer recurrence and 13 percent reduction in breast cancer deaths in patients receiving a dose-dense therapy regimen compared to standard treatment protocols.
You can read more about the study here.
Does Herceptin benefit patients with low HER2 expression?
About 15 percent of breast cancers are HER2 positive and another 45 percent have low levels of HER2. For the latter, standard treatment protocol does not call for the use of HER2-targeted therapies like trastuzumab, also known as Herceptin.
At SABCS 2017, researchers presented findings from a randomized Phase III study to test whether patients who had low HER2 expression would benefit from receiving Herceptin.
Investigators from the National Surgical Breast and Bowel Project (NSABP) compared trastuzumab plus chemotherapy to chemotherapy alone in 3,270 breast cancer patients whose tumors had detectable, but low levels of the HER2 protein. The study revealed no benefit of the added HER2-therapy in improving outcomes for these women, answering an important question about selecting the most appropriate treatment for breast cancer patients and avoiding overtreatment.
Preserving fertility in young women with breast cancer
An analysis of five clinical trials that included 873 pre-menopausal women with ER-positive breast cancer has supported the addition of therapeutic ovarian suppression to preserve ovarian function and fertility during breast cancer treatment.
Results from an analysis by Dr. Matteo Lambertini (Institut Jules Bordet, Brussels, Belgium) showed that a drug analog of gonadotropin-releasing hormone (GnRHa) reduced the risk of chemotherapy-induced premature ovarian insufficiency and amenorrhea (interruption of menses) in young women being treated for early stage breast cancer. The findings suggest that this protocol may be a useful strategy to preserve fertility for women who want to have children after treatment for breast cancer.
You can hear more on the use of ovarian suppression with breast cancer treatment in our Facebook Live interview with Dr. Ann Partridge.
Weight loss after menopause decreases breast cancer risk
In an analysis from the Women’s Health Initiative, which included more than 61,000 women, most of whom were overweight or obese at the time of study enrollment, Dr. Rowan Chlebowski and colleagues reported that women who lost at least five percent body weight after menopause were 12 percent less likely to develop breast cancer compared to women whose weight remained stable. In addition, those who lost more than 15 percent body weight had a 37 percent decrease in breast cancer risk. The study investigators noted that while gaining more than 5 percent body weight did not increase breast cancer risk overall, it did increase the risk of triple negative breast cancer.
Read more about the story and view a short video with Dr. Chlebowski here.
How much endocrine therapy is enough?
For women with early stage ER-positive breast cancer, five years of endocrine therapy (aromatase inhibitor or tamoxifen) has been clinically shown to significantly reduce the risk of recurrence. Studies have suggested that extending endocrine therapy beyond five years can further reduce that risk.
A report from the Austrian Breast and Colorectal Study Group tested this in a trial involving 3,484 postmenopausal women with ER-positive, early-stage breast cancer who had completed five years of endocrine therapy. The study compared the benefit of an additional two years of aromatase inhibitor (AI) therapy vs. five years of added AI therapy. They reported that women in the two-year group had the same benefit in disease-free survival as women who continued AI use for an additional five years. As AI therapy comes with significant side effects, reducing the length of time for optimal benefit is good news for many women. Read more about the study in the here.
Read more about SABCS 2017 in our blog featuring presentations from BCRF investigators, along with our Facebook Live videos.
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