Medscape InDiscussion: Breast Cancer Medscape

Drs Lidia Schapira and Norah Lynn Henry discuss adjuvant endocrine therapy.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/969538). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Adjuvant Endocrine Therapy for Women With Hormone Receptor–Positive Breast Cancer: ASCO Clinical Practice Guideline Focused Update https://ascopubs.org/doi/10.1200/JCO.18.01160
Evidence-Based Approaches for the Management of Side-Effects of Adjuvant Endocrine Therapy in Patients With Breast Cancer https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30666-5/fulltext
Acupuncture for Arthralgia-Induced by Aromatase Inhibitors in Patients With Breast Cancer: A Systematic Review and Meta-analysis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883140/
Long-Term Results From a Randomized Blinded Sham- and Waitlist-Controlled Trial of Acupuncture for Joint Symptoms Related to Aromatase Inhibitors in Early Stage Breast Cancer (S1200) https://ascopubs.org/doi/abs/10.1200/JCO.2021.39.15_suppl.12018
Adverse Events and Perception of Benefit From Duloxetine for Treating Aromatase Inhibitor-Associated Arthralgias https://academic.oup.com/jncics/article/5/2/pkab018/6130825
Predictors of Aromatase Inhibitor Discontinuation as a Result of Treatment-Emergent Symptoms in Early-Stage Breast Cancer https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3341106/
Active Symptom Monitoring and Endocrine Therapy Persistence in Young Women With Breast Cancer https://maps.cancer.gov/overview/DCCPSGrants/abstract.jsp?applId=10337861&term=CA266012
Patient-Reported Outcomes and Early Discontinuation in Aromatase Inhibitor-Treated Postmenopausal Women With Early Stage Breast Cancer https://academic.oup.com/oncolo/article/21/5/539/6401566?login=false
Effect of a Switch of Aromatase Inhibitors on Musculoskeletal Symptoms in Postmenopausal Women With Hormone-Receptor-Positive Breast Cancer: The ATOLL (Articular Tolerance of Letrozole) Study https://pubmed.ncbi.nlm.nih.gov/20035381/
Benefits of Digital Symptom Monitoring With Patient-Reported Outcomes During Adjuvant Cancer Treatment https://ascopubs.org/doi/full/10.1200/JCO.20.03375
Cohort Study of Adherence to Adjuvant Endocrine Therapy, Breast Cancer Recurrence and Mortality https://www.nature.com/articles/bjc2013116
Atrophic Vaginitis in Breast Cancer Survivors: A Difficult Survivorship Issue https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4493485/
Caution: Vaginal Estradiol Appears to Be Contraindicated in Postmenopausal Women on Adjuvant Aromatase Inhibitors https://www.annalsofoncology.org/article/S0923-7534(19)57558-5/fulltext
Management of Genitourinary Syndrome of Menopause in Breast Cancer Survivors: An Update https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8894268/

Drs Lidia Schapira and Kevin Kalinsky discuss the RxPONDER trial and immunotherapy.
Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/963171). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
21-Gene Assay to Inform Chemotherapy Benefit in Node-Positive Breast Cancer https://www.nejm.org/doi/10.1056/NEJMoa2108873
Tailoring Adjuvant Endocrine Therapy for Premenopausal Breast Cancer https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193457/
Randomized Comparisons of Adjuvant Aromatase Inhibitor Exemestane Plus Ovarian Function Suppression vs Tamoxifen in Premenopausal Women With Hormone Receptor–Positive Early Breast Cancer: Update of the TEXT and SOFT Trials https://www.abstractsonline.com/pp8/#!/10462/presentation/645
Breast Cancer Index https://www.breastcancerindex.com/
Abemaciclib Combined With Endocrine Therapy for the Adjuvant Treatment of HR+, HER2−, Node-Positive, High-Risk, Early Breast Cancer (monarchE) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768339/
Continuous Versus Intermittent Extended Adjuvant Letrozole for Breast Cancer: Final Results of Randomized Phase III SOLE (Study of Letrozole Extension) and SOLE Estrogen Substudy https://linkinghub.elsevier.com/retrieve/pii/S0923-7534(21)02492-3
Event-free Survival With Pembrolizumab in Early Triple-Negative Breast Cancer https://www.nejm.org/doi/10.1056/NEJMoa2112651

Drs Lidia Schapira and Kathryn Ruddy discuss treatment and follow-up care for premenopausal women with breast cancer.
Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/963169). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
MutYH Mutation Carriers Have Increased Breast Cancer Risk https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.26506
Kathryn J. Ruddy, MD, MPH Biography https://www.mayoclinic.org/biographies/ruddy-kathryn-j-m-d/BIO-20055748?_escaped_fragment_=&p=1
Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer https://www.nejm.org/doi/full/10.1056/nejmoa1804710
About Oncotype DX Breast DCIS Score https://www.oncotypeiq.com/en-US/breast-cancer/healthcare-professionals/oncotype-dx-breast-dcis-score/about-the-test
Goserelin for Ovarian Protection During Breast-Cancer Adjuvant Chemotherapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4405231/
Adjuvant Ovarian Suppression in Premenopausal Breast Cancer https://www.nejm.org/doi/full/10.1056/NEJMoa1412379
Who Are the Women Who Enrolled in the POSITIVE Trial: A Global Study to Support Young Hormone Receptor Positive Breast Cancer Survivors Desiring Pregnancy https://www.sciencedirect.com/science/article/pii/S096097762100429X
Pregnancy After Breast Cancer https://www.cancer.org/cancer/breast-cancer/living-as-a-breast-cancer-survivor/pregnancy-after-breast-cancer.html
Pragmatic Cluster Randomized Trial to Evaluate Effectiveness and Implementation of Enhanced EHR-Facilitated Cancer Symptom Control (E2C2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275300/

Drs Lidia Schapira and Nadine Tung discuss how BRCA status affects choosing therapy for patients with early-stage breast cancer.
Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/963168). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.
Resources
TBCRC 031: Randomized Phase II Study of Neoadjuvant Cisplatin Versus Doxorubicin-Cyclophosphamide in Germline BRCA Carriers With HER2-Negative Breast Cancer (the INFORM trial) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8462533/
Adjuvant Olaparib for Patients with BRCA1- or BRCA2-Mutated Breast Cancer https://www.nejm.org/doi/full/10.1056/NEJMoa2105215
Validation of a Novel Staging System for Disease-Specific Survival in Patients With Breast Cancer Treated With Neoadjuvant Chemotherapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107758/
Table 1 from Validation of a Novel Staging System for Disease-Specific Survival in Patients With Breast Cancer Treated With Neoadjuvant Chemotherapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107758/table/T1/?report=objectonly
Abemaciclib Combined With Endocrine Therapy for the Adjuvant Treatment of HR+, HER2−, Node-Positive, High-Risk, Early Breast Cancer (monarchE) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768339/
Evaluation of Efficacy and Safety of PARP Inhibitors in Breast Cancer: A Systematic Review and Meta-analysis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215282/pdf/main.pdf
LYNPARZA® (olaparib) Prescribing Information. AstraZeneca; 2020. https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/208558s014lbl.pdf
Management of Hereditary Breast Cancer: American Society of Clinical Oncology, American Society for Radiation Oncology, and Society of Surgical Oncology Guideline https://ascopubs.org/doi/full/10.1200/JCO.20.00299
A Population-Based Study of Genes Previously Implicated in Breast Cancer https://www.nejm.org/doi/full/10.1056/NEJMoa2005936
TBCRC 048: Phase II Study of Olaparib for Metastatic Breast Cancer and Mutations in Homologous Recombination-Related Genes https://ascopubs.org/doi/10.1200/JCO.20.02151
Cancer Risks and Mortality in Heterozygous ATM Mutation Carriers https://academic.oup.com/jnci/article/97/11/813/2521263?login=false
Neoadjuvant Talazoparib in Patients With Germline BRCA1/2 (gBRCA1/2) Mutation-Positive, Early HER2-Negative Breast Cancer (BC): Results of a Phase 2 Study https://ascopubs.org/doi/abs/10.1200/JCO.2021.39.15_suppl.505

Drs Lidia Schapira and Antonio Wolff resume their discussion on the current research on DCIS and other forms of lower-risk early breast cancer, and how medical oncologists can work to create an optimal treatment plan.
Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/963167). The topics and discussions are planned, produced, and reviewed independently of our advertiser. This podcast is intended only for US healthcare professionals.
Resources
Abemaciclib Combined With Endocrine Therapy for the Adjuvant Treatment of HR+, HER2-, Node-Positive, High-Risk, Early Breast Cancer (monarchE) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768339/
Tamoxifen for early breast cancer: an overview of the randomised trials https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(97)11423-4/fulltext
Adjuvant Palbociclib for Early Breast Cancer: The PALLAS Trial Results (ABCSG-42/AFT-05/BIG-14-03) https://ascopubs.org/doi/10.1200/JCO.21.02554?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Palbociclib for Residual High-Risk Invasive HR-Positive and HER2-Negative Early Breast Cancer—The Penelope-B Trial https://ascopubs.org/doi/10.1200/JCO.20.03639?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Verzenio® (abemaciclib) Significantly Reduced the Risk of Cancer Returning in People with High Risk HR+, HER2- Early Breast Cancer https://investor.lilly.com/news-releases/news-release-details/verzenior-abemaciclib-significantly-reduced-risk-cancer
Pfizer Provides Update on Phase 3 PALLAS Trial of IBRANCE® (palbociclib) Plus Endocrine Therapy in HR+, HER2- Early Breast Cancer https://www.pfizer.com/news/press-release/press-release-detail/pfizer-provides-update-phase-3-pallas-trial-ibrancer
NATALEE: Phase III study of ribociclib (RIBO) + endocrine therapy (ET) as adjuvant treatment in hormone receptor–positive (HR+), human epidermal growth factor receptor 2–negative (HER2–) early breast cancer (EBC). https://ascopubs.org/doi/abs/10.1200/JCO.2019.37.15_suppl.TPS597
FDA Approval Summary: Abemaciclib With Endocrine Therapy for High-Risk Early Breast Cancer https://ascopubs.org/doi/full/10.1200/JCO.21.02742#:~:text=The%20US%20Food%20and%20Drug,%2D67%20score%20%E2%89%A5%2020%25.
Adjuvant abemaciclib combined with endocrine therapy for high-risk early breast cancer: updated efficacy and Ki-67 analysis from the monarchE study https://www.annalsofoncology.org/action/showPdf?pii=S0923-7534%2821%2904494-X

Drs Lidia Schapira and Antonio Wolff discuss the current research on DCIS and other forms of lower-risk early breast cancer, and how medical oncologists can work to create an optimal treatment plan.
Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/963165). The topics and discussions are planned, produced, and reviewed independently of our advertiser. This podcast is intended only for US healthcare professionals.
Resources
Questions About the BRCA1 and BRCA2 Gene Study and Breast Cancer https://www.genome.gov/10000940/brca1brca2-study-faq
Overcoming Barriers in Ductal Carcinoma In Situ Management: From Overtreatment to Optimal Treatment https://ascopubs.org/doi/10.1200/JCO.21.01674
Preoperative Breast MRI for Newly Diagnosed Ductal Carcinoma in Situ: Imaging Features and Performance in a Multicenter Setting (ECOG-ACRIN E4112 Trial) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8474966/
Addressing Overtreatment of Screen Detected DCIS; The LORIS Trial https://www.ejcancer.com/article/S0959-8049(15)00697-8/fulltext
Feasibility of a Prospective, Randomised, Open-label, International Multicentre, Phase III, Non-inferiority Trial to Assess the Safety of Active Surveillance for Low Risk Ductal Carcinoma In Situ -- The LORD study https://www.ejcancer.com/article/S0959-8049(15)00394-9/fulltext
The COMET (Comparison of Operative versus Monitoring and Endocrine Therapy) Trial: A Phase III Randomised Controlled Clinical Trial for Low-Risk Ductal Carcinoma In Situ (DCIS) https://bmjopen.bmj.com/content/9/3/e026797.long