San Antonio Breast Cancer Symposium, Dec. 9 to 12

The annual San Antonio Breast Cancer Symposium was held from Dec. 9 to 12 in San Antonio. Attendees included medical oncologists, radiation oncologists, researchers, and other health care professionals. The conference highlighted recent advances in the risk, diagnosis, treatment, and prevention of breast cancer, and presentations focused on emerging treatments in hard-to-treat patient populations, including patients with metastatic breast cancer.

As part of the HER2CLIMB-05 study, Erika Hamilton, M.D., of the Sarah Cannon Research Institute in Nashville, Tennessee, and colleagues found that adding tucatinib to standard trastuzumab and pertuzumab (HP) maintenance in a first-line human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer setting prolongs disease control.

The authors randomly assigned 654 patients with HER2-positive advanced breast cancer who completed four to eight cycles of induction chemotherapy plus HP without disease progression to receive either tucatinib or a placebo with continued HP. The aim of the study was to determine if the benefit patients receive from first-line maintenance therapy could be extended by adding tucatinib to HP after taxane induction.

The researchers found that adding tucatinib to standard HP maintenance extended progression-free survival (PFS) by 8.6 months, a significant amount of time for patients living with metastatic disease. The benefit was consistent across key subgroups, including patients with hormone receptor-positive and hormone receptor-negative disease, with and without brain metastases. The safety profile was manageable, with the expected tucatinib-related liver enzyme elevations and manageable diarrhea.

“We are essentially seeing a chemotherapy-free strategy that helps patients remain on treatment longer before their disease progresses. While the overall survival data are not yet mature, the consistency of the PFS benefit makes this an important finding for HER2-positive metastatic breast cancer,” Hamilton said. “Right now, tucatinib is used in later-line settings, so this represents a potential future shift where we may be able to offer patients a strategy to prolong the maintenance phase of first-line therapy by not only delaying disease progression but also prolonging time off cytotoxic chemotherapy. If approved, this could broaden how we think about maintenance therapy for HER2-positive metastatic breast cancer.”

The study was funded by Seagen (acquired by Pfizer), which manufactures tucatinib.

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As part of the phase 2 ENHANCE clinical trial, Jun J. Mao, M.D., of the Memorial Sloan Kettering Cancer Center in New York City, and colleagues found that both real and sham acupuncture improve breast cancer survivors” perceived cognitive impairment compared with usual care alone, with real acupuncture demonstrating a more significant benefit compared to sham acupuncture.