The 42nd Annual CTRC-AACR San Antonio Breast Cancer Symposium

The annual San Antonio Breast Cancer Symposium was held from Dec. 10 to 14 in Texas and attracted more than 7,500 participants from around the world, including medical oncologists, radiation oncologists, researchers, and other health care professionals. The conference highlighted recent advances in the risk, diagnosis, treatment, and prevention of breast cancer, with presentations focusing on emerging treatments in hard-to-treat patient populations, including patients with metastatic breast cancer.

In one study, W. Fraser Symmans, M.D., of the University of Texas MD Anderson Cancer Center in Houston, and colleagues found that using residual cancer burden (RCB) following neoadjuvant chemotherapy serves as an accurate and reliable predictor of breast cancer recurrence and survival among four breast cancer subtypes.

“The amount of RCB after neoadjuvant chemotherapy provides prognostic information in all four subtypes of breast cancer. We can calibrate an RCB score that provides an accurate estimate of an individual’s risk of disease recurrence, and the method is generalizable across 12 institutions or clinical trial networks,” Symmans said. “The prognostic risk can be accurately estimated from the RCB index after neoadjuvant chemotherapy.”

Symmans noted that a standardized approach using usual pathology materials, without the need for additional testing or cost, can be implemented anywhere.

“With the strong results reported from this large meta-analysis, the pathology community could recommend RCB be reported routinely after neoadjuvant chemotherapy,” Symmans concluded.

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In another study, Milan Radovich, Ph.D., and Bryan P. Schneider, M.D., of the Indiana University School of Medicine in Indianapolis, and colleagues found that among patients with triple-negative breast cancer who have residual disease after neoadjuvant chemotherapy, the presence of circulating tumor DNA (ctDNA) after surgery predicts a high risk for relapse.

“This study also found that triple-negative breast cancer patients who have the presence of ctDNA and circulating tumor cells have an even higher risk of recurrence as compared to those without the presence of these two biomarkers,” Radovich said.

Schneider said that the results of this study set the foundation for future studies and provide important information on a subset of triple-negative breast cancer patients who are likely to be at a higher risk of recurrence and another subset who may have excellent outcomes.

“We are now in the process of expanding these research efforts in a clinical trial, evaluating targeted therapies in patients with triple-negative breast cancer using the presence or absence of ctDNA to guide best treatment,” Schneider said.

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After six years of follow-up as part of the phase III APHINITY Trial, Martine Piccart, M.D., Ph.D., of the Institut Jules Bordet in Brussels, and colleagues found that the addition of pertuzumab to the combination of trastuzumab and chemotherapy after surgery further reduces the risk for cancer recurrence and mortality in patients with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer.

“The addition of trastuzumab to chemotherapy after surgery has revolutionized treatment outcomes for patients with HER2-positive early breast cancer, yet roughly 30 percent of patients will still experience recurrence of their disease, a condition for which effective treatments are now available but cure is no longer possible,” Piccart said in a statement. “By adding a different yet complementary HER2 inhibitor, pertuzumab, to this treatment regimen, we hope to further reduce the risk of recurrence and advanced disease in this patient population.”

The study was funded by Roche/Genentech, the manufacturer of pertuzumab.

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