With precision-guided approaches to care establishing themselves across tumor types, newer systemic therapy regimens are almost exclusively developed for the treatment of histological or biomarker subtypes within a larger disease state. One of the most prevalent examples of this is breast cancer, which has seen significant and consistent progress in terms of advancing overall survival in the treatment of HER2-positive tumors.
“HER2-positive breast cancer is unique and it’s relatively rare for a particular type of cancer to be defined by one genetic alteration that is driving the tumor biology,” said Sara A. Hurvitz, MD, who is featured in this issue of ONCOLOGY®. “The success of that is absolutely outstanding, but that type of story is not going to be possible in a number of other tumor subtypes.”
Hurvitz, who is director of the Breast Cancer Clinical Research Program at the David Geffen School of Medicine at University of California, Los Angeles, and co-chair of the 20th Annual International Congress on the Future of Breast Cancer® West, hosted by Physicians’ Education Resource®, LLC (PER®), also discussed underwhelming responses noted with the use of immunotherapy in triple-negative breast cancer and the future of these agents. “I do think that there needs to be more work done to define biomarkers, subsets, and settings where this these agents are going to have the best therapeutic index, the highest efficacy, and the lowest chance of causing significant toxicity,” she said.
Also in this issue, ONCOLOGY® editorial board member E. David Crawford, MD, and colleagues, propose a new model for guiding the treatment of prostate cancer that focuses on a “transitional state,” which occurs during the interval of progression to metastatic castration-resistant prostate cancer.
“Recognizing the transition state, the period before these events, is crucial to extending survival and improving quality of life,” they wrote, adding that nonmetastatic castration-resistant prostate cancer, metastatic castration-sensitive prostate cancer, and oligometastatic disease represent essential moments in the progression of disease that warrant intervention in the hopes of delaying metastasis.
A thought-provoking Clinical Quandaries is presented by Alejandro Gabutti, MD; and Tommaso Cascella, MD, of a 36-year-old patient with a diagnosis of hepatocellular carcinoma.
As always, the articles within these pages and more on breakthroughs in oncology across multidisciplinary specialties can be found at CancerNetwork.com, home of the journal ONCOLOGY®.