San Antonio Breast Cancer Symposium 2009

Along with many other health issues, obese breast cancer patients face a particularly grim prognosis, with an amplified risk of recurrence and an increased risk of dying of the disease, according to results from a long-term, large-scale study in a Danish population. The researchers also noted that a larger body habitus negatively impacted treatment results.

The RIBBON-2 trial met its primary endpoint to prolong progression-free survival, making the bevacizumab-chemotherapy combination a new treatment option, said principal investigator Adam Brufsky, MD. The trial continued the evaluation of bevacizumab plus chemotherapy to treat metastatic breast cancer after previous treatment failures.

The targeted combination of lapatinib (Tykerb) plus trastuzumab (Herceptin) led to a median overall survival of 14 months in women with refractory metastatic breast cancer, according to an updated analysis of the phase III EGF104900 trial. A bonus: The majority of toxicities were low-grade.

Despite a better dose loading schedule and compelling preclinical data, the combination of fulvestrant and anastrozole did not demonstrate any advantage in first relapse of hormone receptor-positive breast cancer, according to first results from the FACT trial.

Researchers in Taiwan and China found that alternating mammography and ultrasound led to a higher cancer detection rate in women aged 40-49. Meanwhile in the UK, a group from West Midlands Research Collaborative have made a case for starting screening at age 40 in certain ethnic groups. Finally, German investigators assessed the value of semi-annual ultrasound exams in high-risk women.

Denosumab prevented more events, was better tolerated, and was more convenient for breast cancer patients with skeletal metastasis, according to results from a randomized double-blind trial that matched the RANK ligand inhibitor against zoledronic acid.

Exemestane alone and exemestane following tamoxifen, are equally appropriate treatment options, according to results from TEAM, the first trial prospectively powered to test the superiority of five years of aromatase inhibitors compared with a specific sequential strategy in postmenopausal women with endocrine-sensitive breast cancer.

Results from the CONFIRM trial found that a higher dose of fulvestrant was significantly more effective than a lower dose but did not lead to more toxicity, reported Angelo DiLeo, MD, who added “we anticipate that the 500-mg regimen will become the established dose for fulvestrant.”

SAN ANTONIO—Options for breast cancer prevention range from “noninvasive” lifestyle changes (diet, nutrition, exercise) to more radical surgical approaches. During an SABCS 2009 educational session, Judy Garber, MD, from Boston’s Dana-Farber Cancer Institute, outlined some of the advances in chemoprevention of ER-negative/HER2-positive breast cancers.

SAN ANTONIO—Investigators from Breast International Group 1-98 study and the Intergroup Exemestane Study updated their respective trial results at SABCS 2009. From the BIG 1-98 data, letrozole continued to show survival advantage, while exemestane offered protective benefits, based on IES study results.