An NCI Expert’s Breast Cancer Takeaways From ASCO 2019

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Topics include: Emerging Research

What’s the latest news in breast cancer care? As part of our coverage of the 2019 American Society of Clinical Oncology (ASCO) meeting in Chicago, expert Dr. Larissa Korde, from the National Cancer Institute, shares treatment research updates and gives insight to upcoming breast cancer clinical trials. Dr. Korde also discusses the top three tips for breast cancer patients who are learning about their disease and treatment options. 

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Rebecca Seago-Coyle:

And over that course of time, being involved in clinical research really became a passion.  And then when I had the opportunity to come back to NCI to move further along in my career doing—overseeing clinical research it was really something that I couldn't pass up.  

And so all of it is really just to get more insight into things that are going on, to get more insight into things that we want to bring into the larger Phase III trials and then also to hear the fruit of all of our labors.  

But I think there are sort of incremental improvements in things that we've been seeing already. Data from the Mona Lisa study, looking at using CDK4/6 inhibitors.  Specifically in premenopausal women we have had data suggesting that these drugs work well in premenopausal women.  I think we have some confirmation of that.  There is an update to data from the IMpassion130 study looking at the use of atezolizumab (Tecentriq) in patients with triple-negative breast cancer treated for first?line metastatic disease, and so I think that is important information to get out to our patients.  

There is an update on patient-reported outcomes in cosmesis from one of the large NCI?sponsored trials that looked at partial breast radiation versus whole breast radiation. So I think these are all sort of exciting additions to studies that we've already seen some information from. 

We have several studies that are focused on a population of women that have early-stage triple-negative breast cancer that receive neoadjuvant chemotherapy but still have some residual disease when they go to surgery.  So there are some studies looking at using different types of chemotherapy in that setting and one study looking at using a PD-L1 inhibitor in that setting.  

We have some studies looking to sort of hone in on the best surgical techniques and local therapies for patients who have had neoadjuvant chemotherapy.  We have one study which has recently completed accrual looking at post??sorry, presurgery endocrine therapy.  We have a new study that's just opened up for HER2-positive metastatic breast cancer looking at adding a checkpoint inhibitor, a PD-L1 inhibitor to the standard therapy of chemotherapy plus targeted therapy.  

So really lots of exciting things going on, lots of studies that we're very, very excited about.  

Dr. Korde:

I mean, I think the most important thing is really being educated about knowing about your disease. And maybe one other thing is really thinking about kind of what's important to you.  So as we learn more about treatments we learn about efficacy of treatments, meaning, you know, how well they work, we also learn about side effects of treatments and toxicities and what to expect from those treatments. And we also know that sort of learning a lot about the tumor helps us to really target the tumor in the best way possible.  

So I think for patients sort of trying to take in this huge amount of information that comes every year from a large clinical meeting, I think for each individual patient sort of knowing what type of tumor you have, knowing what sort of treatments would be potentially offered to you, learning and asking your doctor about the side effects of those treatments.

And then I think the last thing is really just having a conversation about what's the most important thing to you and what do you want to get out of your treatment.  And if that is sort of I want to do something that has the least side effects or I want to do something that is the most aggressive treatment possible, you know, what's out there for me.  Really just having that informed discussion with your doctor but thinking about how do these things affect me.  

The FDA has a pathway called accelerated approval where based on very early trial results they will approve a drug with the caveat that they need confirmatory data.  And so that's what happened here.  It was an accelerated approval, and a subsequent Phase III was planned and enrolled that would then hopefully confirm the results of the earlier phase studies.  And what was presented today at ASCO was actually that the confirmatory study was negative, meaning that it did not show a benefit for this additional drug.  

And I think it really just??I think it stresses the importance of, you know, we absolutely want to get excited about early data, we absolutely want to be able to bring these things out to the community as quickly as possible, but we have to be a little bit tempered and realize that sometimes we do the confirmatory studies we don't actually get the same result.  And so it really just goes to show that you have to have definitive clinical trial data. It's just so important to do those large randomized Phase III trials that give us that level of evidence that we can then say for sure this drug is something we want to get out to our community. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on August 20, 2019