News
Clinical Topics
Integrative Care
Global Bulletin
All News
Approval Alert
Media
2 Minute Drill
Around the Practice
Between the Lines
Clinical Consult
Expert Interviews
Face Off
Medical World News
Morning Rounds
OncView
Podcasts
Readout 360
Satellite Sessions
Sponsored Media
Training Academy
Year in Review
Conferences
Publications
All Journals
For Authors
Tumor Board
Events
Frontline Forum
CME/CE
Resources
Contemporary Concepts
Awareness Month
Interactive Tools
Nurse Practitioners/Physician's Assistants
Partners
Sponsored
Subscribe
Print Subscription
eNewsletter

logo
Spotlight
Around the Practice
Between the Lines
Contemporary Concepts
Journal
OncView
Podcasts
Readout 360
2022 ASCO Genitourinary Cancers Symposium Urothelial Cancer Updates
CancerNetwork® Inaugural Face-Off
Contemporary Concepts in Hematologic Oncology
Insights from Experts at Mayo Clinic on Translating Evidence to Clinical Practice
Optimizing Outcomes in Patients with HER2+ Metastatic Breast Cancer
Clinical
Acute Myeloid Leukemia
Brain Cancer
Breast Cancer
Gastrointestinal Cancer
Genitourinary Cancer
Gynecologic Cancer
Hematology
Leukemia
Lung Cancer
Lymphoma
Pediatric Cancers
Skin Cancer
Clinical Topics
Integrative Care
Global Bulletin
All News
Approval Alert
2 Minute Drill
Around the Practice
Between the Lines
Clinical Consult
Expert Interviews
Face Off
Medical World News
Morning Rounds
OncView
Podcasts
Readout 360
Satellite Sessions
Sponsored Media
Training Academy
Year in Review
Conferences
All Journals
For Authors
Tumor Board
Frontline Forum
CME/CE
Contemporary Concepts
Awareness Month
Interactive Tools
Nurse Practitioners/Physician's Assistants
Partners
Sponsored
Print Subscription
eNewsletter
Advertisement
Breast Cancer
| Kidney Cancer
| Leukemia
| Lymphoma
| Multiple Myeloma
| Non-Small Cell Lung Cancer (NSCLC)
| Small Cell Lung Cancer (SCLC)
| Adverse Effects
| Biomarkers
| Bladder Cancer
| Brain Cancer
| Cervical Cancer
| Colorectal Cancer
| Endometrial Cancer
| Esophageal Cancer
| Gastrointestinal Cancer
| Genitourinary Cancers
| Gynecologic Cancers
| Head & Neck Cancer
| Hematology
| Hormone-related Cancers
| Immunotherapy
| Infection
| Liver Cancer
| Lung Cancer
| Mesothelioma
| Neuroendocrine Tumors
| Oncology
| Ovarian Cancer
| Ovarian Cancer Clincal Consult
| Pancreatic Cancer
| Pediatric Cancers
| Prostate Cancer
| Radiation Oncology
| Sarcoma
| Screening
| Skin Cancer & Melanoma
| Surgery
| Thoracic Malignancies
| Thyroid Cancer
View All >>
  • Adverse Effects
  • Biomarkers
  • Bladder Cancer
  • Brain Cancer
  • Breast Cancer
  • Cervical Cancer
  • Colorectal Cancer
  • Endometrial Cancer
  • Esophageal Cancer
  • Gastrointestinal Cancer
  • Genitourinary Cancers
  • Gynecologic Cancers
  • Head & Neck Cancer
  • Hematology
  • Hormone-related Cancers
  • Immunotherapy
  • Infection
  • Kidney Cancer
  • Leukemia
  • Liver Cancer
  • Lung Cancer
  • Lymphoma
  • Mesothelioma
  • Multiple Myeloma
  • Neuroendocrine Tumors
  • Non-Small Cell Lung Cancer (NSCLC)
  • Oncology
  • Ovarian Cancer
  • Ovarian Cancer Clincal Consult
  • Pancreatic Cancer
  • Pediatric Cancers
  • Prostate Cancer
  • Radiation Oncology
  • Sarcoma
  • Screening
  • Skin Cancer & Melanoma
  • Small Cell Lung Cancer (SCLC)
  • Surgery
  • Thoracic Malignancies
  • Thyroid Cancer

SPOTLIGHT -

Around the Practice
| Between the Lines
| Contemporary Concepts
| Journal
| OncView
| Podcasts
| Readout 360
| 2022 ASCO Genitourinary Cancers Symposium Urothelial Cancer Updates
| CancerNetwork® Inaugural Face-Off
| Contemporary Concepts in Hematologic Oncology
| Insights from Experts at Mayo Clinic on Translating Evidence to Clinical Practice
| Optimizing Outcomes in Patients with HER2+ Metastatic Breast Cancer

Patterns of Genetic Recurrence in DCIS Suggest Undertreatment With Biomarker-Directed Strategies

Apr 11, 2022
Kyle Doherty
Article
Conference|American Association for Cancer Research Annual Meeting (AACR)

A significant proportion of patients with nonclonal ductal carcinoma in situ were found to have recurrence that was not genetically linked to the primary tumor.

Patients with ductal carcinoma in situ who recieved biomarker-driven therapy were found by investigators to be undertreated due to recurrence that was not genetically linked to the primary tumor, according to a presentation from American Association for Cancer Research (AACR) 2022 Annual Meeting.1

“Data from the 12% of patients in our cohort who developed new, independent primary tumors raised the question of whether using these genetic biomarkers for prediction of recurrence is a good idea,” Tanjina Kader, PhD, a postdoctoral researcher at the Peter MacCallum Cancer Centre in Melbourne, Australia, said in a news release.2 “The fact that these patients did not have one of the genetic events that are more common in recurring DCIS would suggest that their risk was low, leading to undertreatment.”

Kader said DCIS is a preinvasive breast lesion, suggesting that it is the stage right before invasive breast cancer. Patients diagnosed with DCIS are receive surgery or surgery combined with radiotherapy and, following this initial treatment, most do not recur. However, 25% of these patients will come back with either DCIS or invasive breast cancer, half of which will be invasive cancer.

In this analysis of 67 patients with DCIS who experienced ipsilateral recurrence, Kader and colleagues found 18% of cases were non-clonal. The likelihood of clonality was not found to be significantly associated with the grade of the primary DCIS, estrogen receptor (ER), or HER2 status of the primary DCIS, the recurrence type, or prior radiotherapy treatment. These new primary tumors suggest that there is a high-risk environment or a genetic predisposition for these patients and as a result, these patients are highly susceptible to developing new tumors.

“These findings can influence how patients are managed in the clinic,” Kader said. “For example, the occurrence of a new primary lesion in the same patient suggests a high-risk breast environment in which new tumors may develop over the years. Therefore, such patients would be candidates for preventative breast removal surgery even if the tumor is small, and they might be referred to genetic testing to ascertain whether they have any genetic predisposition.”

Investigators assembled cohorts of non-recurrent (n = 32) and recurrent (n = 71) patients with DCIS. For DNA sequencing, the analysis used either a targeted sequencing panel, whole exome sequencing, or low-coverage whole genome sequencing. The method of DNA sequencing was chosen based on DNA availability.

Investigators observed no significant differences between patients with nonrecurrent and recurrent disease in terms of disease grade, ER status, HER2 status, or initial treatment type.

When investigators compared the genomic profiles of the nonrecurrent and recurrent cohorts, they found that multiple chromosomal changes and TP53 mutation status could be potential biomarkers to predict recurrence from primary DCIS. In patients with clonal recurrence (n = 55) changes in chromosomes 5, 11, 17, and 20 were highly enriched, but were not among patients with nonrecurrence (n = 12).

Clonal primary DCIS harbored more TP53 mutations compared with non-recurrent DCIS (P < .05). However, because not all recurrent tumors are clonal and the genomic profiles of non-clonal and non-recurrent cases are very similar, Kader said it is still unclear whether clinicians should use biomarkers to predict for DCIS recurrence.

“We are proposing that, in the future, instead of treating all recurrent patients the same way, we have to first find out whether these patients fit into nonclonal [recurrence],” Kader said during her presentation. “Because for these patients, surgery only is not going to be sufficient. These patients are highly susceptible to developing new tumors and therefore they should consider preventative therapies, [including] bilateral mastectomy, endocrine therapy, or genetic counseling.”

Kader noted that study limitations included the phylogenetic analysis being based solely on chromosomal changes. A full phylogenetic analysis of all tumor-specific mutation was unable to be performed because the study authors lacked the baseline genetic information from normal cells. Investigators did examine the most relevant breast cancer driver mutations, including TP53 and PIK3CA.

References

  1. Kader T, Mahale S, Zethoven M, et al. Predictive biomarkers of recurrence may not be useful for deescalating treatment of breast ductal carcinoma in situ due to de novo ipsilateral breast carcinoma development. Poster presented at: 2022 AACR Annual Meeting; April 8-13, 2022; New Orleans, LA. Abstract 43.
  2. AACR. Recurrent non-invasive breast tumors may not always be related to the primary lesion. News release. April 10, 2022. Accessed April 10, 2022.
Related Videos
The August CancerNetwork Snap Recap takes a look back at key FDA news updates, as well as expert perspectives on the chemotherapy shortage.
Ann H. Partridge, MD, MPH, talks about how fertility preservation can positively impact the psychosocial health in patients with breast cancer.
Daniel G. Stover, MD, describes how findings from the phase 3 NATALEE trial may support expanding the portion of patients who receive CDK 4/6 inhibitors as a treatment for hormone receptor–positive, HER2-negative breast cancer.
Daniel G. Stover, MD, suggests that stromal tumor infiltrating lymphocytes may serve as a biomarker of immune activation and can potentially help optimize therapy with microtubule-targeting agents for patients with metastatic breast cancer.
Sara M. Tolaney, MD, MPH, discusses how, compared with antibody-drug conjugates, chemotherapy produces low response rates and disease control in the treatment of those with hormone receptor–positive, HER2-negative metastatic breast cancer.
Hope Rugo, MD, speaks to the importance of identifying patients with aromatase inhibitor–resistant, hormone receptor–positive, HER2-negative advanced breast cancer who are undergoing treatment with capivasertib/fulvestrant who may be at a high risk of developing diabetes or hyperglycemia.
Sara M. Tolaney, MD, MPH, describes the benefit of sacituzumab govitecan for patients with HER2-low metastatic breast cancer seen in the final overall survival analysis of the phase 3 TROPiCS-02 study.
An expert from Dana-Farber Cancer Institute describes which patients hormone receptor-positive,  HER2-negative breast cancer will benefit most from treatment with sacituzumab govitecan.
An expert from Dana-Farber Cancer Institute highlights the unmet needs that sacituzumab govitecan meets in the treatment of advanced hormone receptor-positive, HER2-negative breast cancer.
An expert from Dana-Farber Cancer Institute highlights data that supported the FDA’s approval of sacituzumab govitecan for advanced hormone receptor–positive, HER2-negative breast cancer.
Related Content

Neratinib Combo Yields Meaningful Benefit in HR+ HER2-Mutant Breast Cancer

September 18th 2023

Oncology On-The-Go Podcast: De-escalating Breast Cancer Treatment

May 8th 2023

Diet and Exercise Intervention Associated With Better pCR in TNBC or HR+, HER2– BC

September 6th 2023

Oncology On-The-Go Podcast: Time to Treatment for Breast Cancer in Rural Populations

February 27th 2023

Sacituzumab Govitecan Improves OS Vs Chemo in HR+/HER2– Breast Cancer

August 28th 2023

T-DM1/Brain SRS May Increase Risk of Radionecrosis in Breast Cancer

August 27th 2023

Neratinib Combo Yields Meaningful Benefit in HR+ HER2-Mutant Breast Cancer

September 18th 2023

Oncology On-The-Go Podcast: De-escalating Breast Cancer Treatment

May 8th 2023

Diet and Exercise Intervention Associated With Better pCR in TNBC or HR+, HER2– BC

September 6th 2023

Oncology On-The-Go Podcast: Time to Treatment for Breast Cancer in Rural Populations

February 27th 2023

Sacituzumab Govitecan Improves OS Vs Chemo in HR+/HER2– Breast Cancer

August 28th 2023

T-DM1/Brain SRS May Increase Risk of Radionecrosis in Breast Cancer

August 27th 2023

Neratinib Combo Yields Meaningful Benefit in HR+ HER2-Mutant Breast Cancer

September 18th 2023

Oncology On-The-Go Podcast: De-escalating Breast Cancer Treatment

May 8th 2023

Diet and Exercise Intervention Associated With Better pCR in TNBC or HR+, HER2– BC

September 6th 2023

Oncology On-The-Go Podcast: Time to Treatment for Breast Cancer in Rural Populations

February 27th 2023

Sacituzumab Govitecan Improves OS Vs Chemo in HR+/HER2– Breast Cancer

August 28th 2023

T-DM1/Brain SRS May Increase Risk of Radionecrosis in Breast Cancer

August 27th 2023
Related Content
Advertisement

Responses in patients with hormone receptor–positive, HER2-mutated breast cancer who crossed over to receive neratinib plus fulvestrant and trastuzumab support the necessity of neratinib in the triplet regimen.

Neratinib Combo Yields Meaningful Benefit in HR+ HER2-Mutant Breast Cancer

September 18th 2023
Article

Responses in patients with hormone receptor–positive, HER2-mutated breast cancer who crossed over to receive neratinib plus fulvestrant and trastuzumab support the necessity of neratinib in the triplet regimen.


Rakhshanda Rahman, MD, FRCS, FACS, emphasizes educating patients and physicians on the potential risks and benefits of new approaches and technologies involved in the de-escalation of breast cancer treatment.

Oncology On-The-Go Podcast: De-escalating Breast Cancer Treatment

May 8th 2023
Podcast

Rakhshanda Rahman, MD, FRCS, FACS, emphasizes the importance of educating patients and physicians on the potential risks and benefits of new approaches and technologies involved in the de-escalation of breast cancer treatment.


Despite seeming to elicit more pathological complete responses in patients with hormone receptor–positive, HER2-negative triple-negative breast cancer receiving neoadjuvant chemotherapy, diet and exercise did not affect relative dose intensity.

Diet and Exercise Intervention Associated With Better pCR in TNBC or HR+, HER2– BC

September 6th 2023
Article

Despite seeming to elicit more pathological complete responses in patients with hormone receptor–positive, HER2-negative triple-negative breast cancer receiving neoadjuvant chemotherapy, diet and exercise did not affect relative dose intensity.


Minh-Tri Nguyen, MD, spoke with CancerNetwork® about differences between time to treatment, socioeconomic status, and clinical outcomes in rural and urban patients with breast cancer.

Oncology On-The-Go Podcast: Time to Treatment for Breast Cancer in Rural Populations

February 27th 2023
Podcast

Minh-Tri Nguyen, MD, spoke with CancerNetwork® about differences between time to treatment, socioeconomic status, and clinical outcomes in rural and urban patients with breast cancer.


Updated findings from the phase 3 TROPiCS-02 trial support sacituzumab govitecan as a standard treatment for hormone receptor–positive, HER2-negative breast cancer, according to Sara Tolaney, MD, MPH.

Sacituzumab Govitecan Improves OS Vs Chemo in HR+/HER2– Breast Cancer

August 28th 2023
Article

Updated findings from the phase 3 TROPiCS-02 trial support sacituzumab govitecan as a standard treatment for hormone receptor–positive, HER2-negative breast cancer, according to Sara Tolaney, MD, MPH.


When combined with brain stereotactic radiosurgery, trastuzumab emtansine appears to produce minimal acute skin effects among patients with non-metastatic breast cancer.

T-DM1/Brain SRS May Increase Risk of Radionecrosis in Breast Cancer

August 27th 2023
Article

When combined with brain stereotactic radiosurgery, trastuzumab emtansine appears to produce minimal acute skin effects among patients with non-metastatic breast cancer.

About
Advertise
CureToday.com
OncLive.com
OncNursingNews.com
TargetedOnc.com
Contact
Terms and Conditions
Privacy
Do Not Sell My Personal Information
Contact Info

2 Clarke Drive
Cranbury, NJ 08512

609-716-7777

© 2023 MJH Life Sciences

All rights reserved.