Researchers from the ATAC and BIG 1-98 trials reported that CYP2D6 testing is not ready for prime time for gauging response to tamoxifen. While of the leading researchers in the field of CYP2D6 genotyping posed some key questions that need to be answered before CYP2D6 can be officially ruled out, or embraced, in clinical practice, these study results strongly suggest that CYPD2D6 testing should not be part of the standard of care, said Claudine Isaacs, MD.
Results from an observational study strongly indicated that circulating tumor cells (CTCs) are an independent prognostic marker in metastatic breast cancer at first-line chemotherapy, and an early predictive marker of clinical benefit after one cycle of chemotherapy. But questions remain about the value of CTCs for guiding treatment decision-making.
Jose Baselga, MD, PhD, and Michael Untch, MD, shared results from the NeoALLTO and GeparQuinto trials, respectively. NeoALLTO is a phase III, randomized, open-label, neoadjuvant study of lapatinib (Tykerb), trastuzumab (Herceptin), and their combination plus paclitaxel in women with HER2-positive primary breast cancer. GeparQuinto (GBG 44) is evaluating lapatinib vs trastuzumab in combination with neoadjuvant anthracycline- and taxane-based chemotherapy.
The SUCCESS adjuvant therapy trial enrolled 2,026 women with primary breast cancer and no clinical evidence of metastatic disease. Disease-free survival at three years was 88.1% in women with one or more circulating tumor cells (CTCs) in their peripheral blood before undergoing chemotherapy compared with 93.7% in women with no CTCs.
As the FDA considers whether to rescind approval for bevacizumab (Avastin) in the adjuvant setting, “disappointing” results from the GeparQuinto study indicate the agent may be best reserved for patients with triple-negative disease.