Breast Cancer 2012 - New Aspects

Abstract

Treatment options as well as the characteristics for therapeutic decisions in patients with primary and advanced breast cancer are increasing in number and variety. New targeted therapies in combination with established chemotherapy schemes are broadening the spectrum, however potentially promising combinations do not always achieve a better result. New data from the field of pharmacogenomics point to prognostic and predictive factors that take not only the properties of the tumour but also inherited genetic properties of the patient into consideration. Current therapeutic decision-making is thus based on a combination of classical clinical and modern molecular biomarkers. Also health-economic aspects are more frequently being taken into consideration so that health-economic considerations may also play a part. This review is based on information from the recent annual congresses. The latest of these are the 34th San Antonio Breast Cancer Symposium 2011 and the ASCO Annual Meeting 2012. Among their highlights are the clinically significant results from the CLEOPATRA, BOLERO-2, EMILIA and SWOG S0226 trials on the therapy for metastatic breast cancer as well as further state-of-the-art data on the adjuvant use of bisphosphonates within the framework of the ABCSG-12, ZO-FAST, NSABP-B34 and GAIN trials.

Keywords: ABCSG-12; BOLERO-2; CLEOPATRA; EMILIA; GAIN; NSABP-B34; TDM-1; ZO-FAST; everolimus; pertuzumab.

Conflict of interest statement

Conflict of Interest This publication was sponsored by Novartis Pharma GmbH. The authors alone are responsible for the content of this publication.

Figures

Fig. 1

Tryphaena trial – median changes in the left ventricular ejection fraction (LVEF) of the treatment groups A–C (arm A: 3 × FEC + H + P followed by 3 × Doc + H + P; arm B: 3 × FEC followed by Doc + H + P; arm C: 6 × Docetaxel + Carboplatin + H + P) .

Fig. 2

Comparison of survival according to pathological complete response (pCR) in patients with HER2-postive breast cancer receiving neoadjuvant chemotherapy with and without Trastuzumab compared to patients with HER2-negative tumours .

Fig. 3

GeparTrio analysis: pCR rate according to subtype and supplemented according to Minckwitz G et al. .

Fig. 4

CLEOPATRA trial – central, independent evaluation of the primary endpoint progression-free survival (PFS). Modified after Baselga et al. .

Fig. 5

Progression-free survival in the EMILIA trial. Adapted after Blackwell et al. .

Fig. 6

SWOG S0226 trial – Evaluation of the primary endpoint progression-free survival. Adapted after Mehta et al. .

Fig. 7

BOLERO-2 trial – final, central evaluation of the primary endpoint progression-free survival (PFS) after 18 months median follow-up time. Adapted after Piccart et al. .