Adam M. Brufsky, MD, PhD

Key opinion leaders discuss recent advancements and future directions in the HER2+ breast cancer space.

Expert panelists react to polling questions and give their input on the management both symptomatic and asymptomatic interstitial lung disease in HER2+ breast cancer, also touching on this impact in the era of COVID-19.

Experts discuss the careful monitoring of potential interstitial lung disease symptoms, how they proceed if symptoms progress, and how they handle this in patients who are asymptomatic.

Experts in breast cancer respond to polling questions surrounding the recognition of pneumonitis and interstitial lung disease.

A panel of experts weighs in the challenges of optimally sequencing therapy for patients with HER2+ breast cancer.

Key opinion leaders explore the appropriateness of prophylactic therapy for brain metastases and share their thoughts on best practices.

For breast cancer specialists, much of the excitement at ASCO revolved around the emerging field of checkpoint inhibition in breast cancer and other tumors; however, there were four non-checkpoint presentations in breast cancer that also proved provocative.

The etiology and risk factors of breast cancer–related lymphedema (BCRL) are multifactorial and not fully understood.

Bone health is a critical issue in the management of women with breast cancer. Many women who develop breast cancer are postmenopausal, which already predisposes them to osteoporosis. Systemic treatments for breast cancer, including chemotherapy and endocrine therapy, decrease circulating levels of estrogen in both pre- and postmenopausal women, further accelerating the natural process of bone loss. The primary concern in breast cancer patients is that this accelerated bone loss, known as cancer treatment–induced bone loss (CTIBL), will lead to an increase in fractures, chronic pain, and loss of mobility. Bisphosphonates are highly effective at slowing the rate of bone loss in postmenopausal women with osteoporosis and at preventing skeletal-related events in women with metastatic breast cancer. Many studies are now focusing on the role of bisphosphonates in preventing CTIBL in the adjuvant setting. Both oral and intravenous bisphosphonates have shown promising activity in preventing CTIBL in patients receiving chemotherapy or hormonal therapy. In addition, emerging data indicate that the use of bisphosphonates in the adjuvant setting may prevent disease recurrence and prolong survival. Data from a number of ongoing trials will further elucidate the role of bisphosphonates in the adjuvant setting over the next few years.

Based on preclinical data, antiangiogeneic therapy for cancer is both logical and rational. Tumors secrete proangiogenic factors, and the design of agents that target these factors has great potential to add to and in some cases replace cytotoxic chemotherapy.

During the 1990s, perhaps no other therapy for women with breast cancer was more controversial than high-dose chemotherapy with autologous bone marrow and/or peripheral stem cell support. With encouraging results from late phase I and early phase II trials in the early to mid-1990s, high-dose chemotherapy was promoted by its many enthusiastic proponents as a potentially great leap forward for women with high-risk, node-positive or metastatic disease.