Early Breast Cancer Highlights From ASCO 2020

Harold J. Burstein, MD, PhD


June 24, 2020

Highlights in early breast cancer from the ASCO 2020 Virtual Meeting are discussed by Dr Harold Burstein of Dana-Farber Cancer Institute.

Two studies in HER2-positive breast cancer provided data on refining adjuvant regimens. The KAITLIN trial compared a three-drug regimen of anthracycline, TDM-1, and pertuzumab with a four-drug regimen of anthracycline, trastuzumab, taxane, and pertuzumab, seeking to determine whether the addition of TDM-1 would improve long-term outcomes. The study showed no benefit from TDM-1; outcomes were identical for both groups.

The TRAIN-2 study asked whether anthracycline-based chemotherapy can safely be omitted in early-stage breast cancer. Results suggest that the answer is yes. Dr Burstein notes that omitting anthracyclines may also lower risk for cardiac damage.

Key ER-positive studies included long-term follow-up of the MINDACT trial, which used the 70-gene MammaPrint assay to stratify patients. The study showed that adding chemotherapy to endocrine therapy provided no benefit in patients identified as having high-risk clinical scores but low-risk genomic scores.

Finally, among triple-negative presentations, a large trial from China demonstrated that the use of so-called metronomic doses (1000 mg twice a day) of adjuvant capecitabine provided improved disease-free survival and a trend favoring overall survival.


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