Adjuvant and neoadjuvant therapy for (based on the materials of the 16th St. Gallen International Breast Cancer Conference)


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

On March 23, 2019, the 16th St. Gallen International Breast Cancer Conference (Vienna) has examined the contraversial issues on the clinical approaches to the treatment of breast cancer in order to reach agreement among the 52 most influential world leaders in this field. The results of randomized trials were discussed to narrow or, conversely, expand the standards of local and systemic treatment of breast cancer. The use of trastuzumab in combination with pertuzumab in combination with neoadjuvant and adjuvant chemotherapy has significantly improved the results of treatment of HER2-positive breast cancer. An expert panel has recommended therapy with trastuzumab emtansine (T-DM1) for the treatment of residual invasive HER2-positive breast cancer. Patients with triple negative breast cancer with a pathological invasive residual disease previously treated with neoadjuvant systemic therapy with anthracyclines or taxane-containing chemotherapy regimens may be offered adjuvant therapy with capecitabine (6 to 8 cycles). Most (80%) experts have recommended neoadjuvant endocrine therapy for postmenopausal women with luminal A breast cancer stage II-III.

Full Text

Restricted Access

About the authors

V. F Semiglazov

N.N. Petrov National Medical Research Oncology Center

Email: vsemiglazov@mail.ru
MD, Corr. Member of RAS, Professor, Head of the Research Department, Chief Scientist at the Research Department of Breast Cancer 68, Leningradskaya Street, Pesochny settlement, St. Petersburg 197758, Russian Federation

V. V Semiglazov

Pavlova First St. Petersburg State Medical University

St. Petersburg, Russia

References

  1. Burstein H.J., Lacchetti C., Anderson H., et al. Adjuvant Endocrine Therapy for Women With Hormone Receptor-Positive Breast Cancer: ASCO Clinical Practice Guideline Focused Update. J Clin Oncol. 2019:37(5):423-38. Doi: 10.1200/ JCO.18.01160.
  2. Curigliano G., Burstein H.J., Winer E.P, et al. Deescalating and escalating treatments early stage breast cancer: the St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017. Ann Oncol 2017:28:1700-12. doi: 10.1093/annonc/ mdx308.
  3. Semiglazov V.F.,Semiglazov V.V., Dashyan G.A., et al. Phase II randomized trial of primary endocrine therapy chemotherapy in postmenopausal patients with estrogen receptor positive breast cancer. Cancer.2007;110(2):244-54. Doi:10.1002/ cncr. 22789.
  4. Semiglazov V.F. Dashyan G.A., Semiglazov M, et al. 198 Prognostic values of breast cancer subtypes: from phase 2 randomised trial of neoadjuvant therapy. Breast. 2015;24:S92.
  5. Gnant M, Mlineritsch B., Stoeger H., et al. Zoledronic acid combined with adjuvant endocrine therapy of tamoxifen versus anastrozol plus ovarian function suppression in premenopausal early breast cancer: final analysis of the Austrian Breast and Colorectal Cancer Study Group Trial 12. Ann Oncol. 2015:26(2):313-20. Doi: 10.1093/ annonc/mdu544.
  6. Gnant M., Pfeiler G., Steger G.G., et al. Adjuvant denosumab in postmenopausal patients with hormone receptor-positive breast cancer (ABCSG-18): disease-free survival results from a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2019;20(3):339-51. doi: 10.1016/S1470-2045(18)30862-3.
  7. Sikov W.M., Berry D.A., Perou C.M., et al. Impact of the addition of carboplatin and/or bevacizumab to neoadjuvant once-per-week paclitaxel followed by dose-dense doxorubicin and cyclophosphamide pathologic complete response rates stage I-II triple-negative brast cancer: CALGB 40603 (Alliance). Clin. Oncol. 2015:33(1):13-21. doi: 10.1200/JCo.2014.57.0572.
  8. Denduluri N., Somerfield M.R., Eisen A., et al. Selection of Optimal Adjuvant Chemotherapy Regimens for Human Epidermal Growth Factor Receptor 2 (HER2)-Negative and Adjuvant Targeted Therapy for HER2-Positive Breast Cancers: An American Society of Clinical Oncology Guideline Adaptation of the Cancer Care Ontario Clinical Practice Guideline. J Clin Oncol. 2016;34(20):2416-27. Doi: 10.1200/ JCO.2016.67.0182.
  9. Loibl S., Weber K.E., Timms K.M., et al. Survival analysis of carboplatin added to an anthracycline/ taxane-based neoadjuvant chemotherapy and HRD score as predictor of response-final results from GeparSixto. Ann Oncol. 2018;29( 12):2341 -47. doi: 10.1093/annonc/ mdy460.
  10. Masuda N., lee S.J., Ohtani S., et al. Adjuvant Capecitabine for Breast Cancer after Preoperative Chemotherapy. N Engl J Med. 2017;376(22):2147-59. Doi: 10.1056/ NEJMoa1612645.
  11. Martin M., Barrios C.H., Torrecilla L., et al. Efficacy results form the CIBOMA 2004-01/ GEICAM 2003-11 study: a randomized phase III trial assessing adjuvant capecitabine after standard chemotherapy for patients with early triple negative breast cancer. SABCS 2018.
  12. von Minckwitz G., Procter M., de Azambuja E., et al. APHINITYSteering Committee and Investigators. Adjuvant Pertuzumab and Trastuzumab in Early HER2-Positive Breast Cancer. N Engl J Med. 2017;377(2):122-31. Doi: 10.1056/ NEJMoa1703643.
  13. Gianni L., Pienkowski T, Im Y.H., et al. 5-year analysis of neoadjuvant pertuzumab and trastuzumab inpatients with locally advanced, inflammatory, or early-stage HER2-neoSphere): multicentre, open-label, phase 2 randomised trial. Lancet Oncol. 2016:17(6):791-800. doi: 10.1016/S1470-2045(16)00163-7.
  14. Schneeweiss A., Chia S., Hickish T, et al. Pertuzumab plus trastuzumab in combination with standard neoadjuvant anthracycline-containing and anthracycline-free chemotherapy regimens in patients with HER2-positive early breast cancer: a randomized phase ll cardiac safety study (TRYPHAENA). Ann Oncol.2013:24(9):2278-84. doi: 10.1093/annonc/mdt182.
  15. Earl HM. PERSEPHONE: 6 versus (m) adjuvant trastuzumab in patients (pts) with HER2 positive (+) early breast cancer (EBC): Randomised phase 3 non-inferiority trial with definitive 4-year (yr) disease-free survival (DFS) results. J Clin Oncol. 2018. doi: 10.1200/JCO.2018.36.15_ suppl.506.
  16. Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials. Lancet Oncol. 2018:19:27-39. doi: 10.1016/S1470-2045(17)30777-5.
  17. Martin M., Holmes F.A., Ejlertsen B., et al. ExteNET Study Group. Neratinib after trastuzumab-based adjuvant therapy in HER2-positive breast cancer (ExteNET):5-year analysis of a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncof. 2017;18(12),1688-1700. doi: 10.1016/51470-2045(17) 30717-9.
  18. von Minckwitz G., Huang C.S., Mano M.S., et al. Trastuzumab Emtansine for Residual Invasive HER2-Positive Breast Cancer. N Engl J Med. 2019;380(7):617-28. doi: 10.1056/NEJ Moa1814017.
  19. Sparano J.A., Gray R.J., Makower D.F, et al. Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Breast Cancer. N Engl J Med. 2018;379(2):111-21. Doi: 10.1056/ NEJMoa1804710.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2019 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies