Drs Banu Arun and Avan J. Armaghani discuss the evolving treatment landscape of targeted therapy for advanced and metastatic breast cancer, including risk factors, quality of life, and treatment access.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982651). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Breast Cancer https://emedicine.medscape.com/article/1947145-overview

Breast Cancer and HER2 https://emedicine.medscape.com/article/1689966-overview#:~:text=Metastatic%20Breast%20Cancer-,Practice%20Essentials,20%25%20of%20invasive%20breast%20cancers.

Personalized Medicine https://www.genome.gov/genetics-glossary/Personalized-Medicine

Emerging Digital Technologies in Cancer Treatment, Prevention, and Control https://pubmed.ncbi.nlm.nih.gov/34850933/

Introduction to Antibody-drug Conjugates https://pubmed.ncbi.nlm.nih.gov/34842621/

Antibody-drug Conjugates and Subgroups of Advanced and Metastatic Breast Cancer: Strategies, Resistance, Emerging Data https://www.medscape.com/viewarticle/982644 

Pertuzumab, Trastuzumab, and Docetaxel for HER2-positive Metastatic Breast Cancer (CLEOPATRA): End-of-study Results From a Double-blind, Randomised, Placebo-controlled, Phase 3 Study https://pubmed.ncbi.nlm.nih.gov/32171426/

Trastuzumab Deruxtecan in Previously Treated HER2-positive Breast Cancer https://pubmed.ncbi.nlm.nih.gov/31825192/

Trastuzumab Deruxtecan Versus Trastuzumab Emtansine in Patients With HER2-positive Metastatic Breast Cancer: Updated Results From DESTINY-Breast03, a Randomised, Open-label, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/36495879/

Trastuzumab Deruxtecan (T-DXd) With or Without Pertuzumab Versus Taxane, Trastuzumab and Pertuzumab in HER2-positive Metastatic Breast Cancer (DESTINY-Breast09) https://clinicaltrials.gov/ct2/show/NCT04784715

Targeting HER3 for Cancer Treatment: A New Horizon for an Old Target https://pubmed.ncbi.nlm.nih.gov/36764093/

A Review of Triple-negative Breast Cancer https://www.medscape.com/viewarticle/727195_4

Tucatinib Versus Placebo Added to Trastuzumab and Capecitabine for Patients With Pretreated HER2+ Metastatic Breast Cancer With and Without Brain Metastases (HER2CLIMB): Final Overall Survival Analysis https://pubmed.ncbi.nlm.nih.gov/34954044/

Progression-free Survival: What Does It Mean for Psychological Well-being or Quality of Life? https://www.ncbi.nlm.nih.gov/books/NBK137763/

A Study of Tucatinib Plus Trastuzumab Deruxtecan in HER2+ Breast Cancer (HER2CLIMB-04) https://clinicaltrials.gov/ct2/show/NCT04539938

A Study of Tucatinib or Placebo With Trastuzumab and Pertuzumab for Metastatic HER2+ Breast Cancer (HER2CLIMB-05) https://clinicaltrials.gov/ct2/show/NCT05132582

Tyrosine Kinase Inhibitors https://www.ncbi.nlm.nih.gov/books/NBK563322/

Drs Banu Arun and Stephanie Graff discuss drug access, clinical trials, and health disparities in advanced and metastatic breast cancer, and inclusion-based solutions for physicians and institutions.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982650). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Breast Cancer https://emedicine.medscape.com/article/1947145-overview

A Review of Triple-Negative Breast Cancer https://www.medscape.com/viewarticle/727195_4

Oral Selective Estrogen Receptor Degraders (SERDS) as a Novel Breast Cancer Therapy: Present and Future From a Clinical Perspective https://pubmed.ncbi.nlm.nih.gov/34360578/

Introduction to Antibody-Drug Conjugates https://pubmed.ncbi.nlm.nih.gov/34842621/

Sacituzumab Govitecan (Rx) https://reference.medscape.com/drug/trodelvy-sacituzumab-govitecan-1000280

Trastuzumab Deruxtecan (Rx) https://reference.medscape.com/drug/enhertu-trastuzumab-deruxtecan-4000032

T-DM1 https://www.cancer.gov/publications/dictionaries/cancer-terms/def/t-dm1

Estrogen and Progesterone Receptor Testing in Breast Cancer: ASCO/CAP Guideline Update https://pubmed.ncbi.nlm.nih.gov/31928404/

Breast Cancer and HER2 https://emedicine.medscape.com/article/1689966-overview

Sacituzumab Govitecan in Metastatic Triple-Negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/33882206/

Disparity of Race Reporting and Representation in Clinical Trials Leading to Cancer Drug Approvals From 2008 to 2018 https://pubmed.ncbi.nlm.nih.gov/31415071/

Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer https://pubmed.ncbi.nlm.nih.gov/35665782/

Trastuzumab Deruxtecan Versus Trastuzumab Emtansine for Breast Cancer https://pubmed.ncbi.nlm.nih.gov/35320644/

I-SPY 2: A Neoadjuvant Adaptive Clinical Trial Designed to Improve Outcomes in High-Risk Breast Cancer https://pubmed.ncbi.nlm.nih.gov/33312344/

Immune Checkpoint Inhibitors in Neoadjuvant Therapy of Non-Small Cell Lung Cancer: A Systematic Review and Meta-analysis https://pubmed.ncbi.nlm.nih.gov/35280480/

Increasing Racial and Ethnic Diversity in Cancer Clinical Trials: An American Society of Clinical Oncology and Association of Community Cancer Centers Joint Research Statement https://pubmed.ncbi.nlm.nih.gov/35588469/

Increasing Racial and Ethnic Equity, Diversity, and Inclusion in Cancer Treatment Trials: Evaluation of an ASCO-Association of Community Cancer Centers Site Self-Assessment https://pubmed.ncbi.nlm.nih.gov/36630663/

An Assessment of the Feasibility and Utility of an ACCC-ASCO Implicit Bias Training Program to Enhance Racial and Ethnic Diversity in Cancer Clinical Trials https://pubmed.ncbi.nlm.nih.gov/36630671/

The Implicit Association Test in Health Professions Education: A Meta-Narrative Review https://pubmed.ncbi.nlm.nih.gov/31535290/

Increasing Black Patient Participation in Metastatic Breast Cancer Clinical Trials: The BECOME (Black Experience of Clinical Trials and Opportunities for Meaningful Engagement) Project https://ascopubs.org/doi/abs/10.1200/JCO.2022.40.16_suppl.1014#

Achieving Culturally Competent Cancer Care: A Qualitative Study Drawing on the Perspectives of Cancer Survivors and Oncology Nurses https://pubmed.ncbi.nlm.nih.gov/31841798/

Drs Banu Arun and Hope S. Rugo discuss immunotherapy, immunotoxicity, and comorbidities among diverse patient populations in advanced and metastatic breast cancer.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982649). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

The Emerging CDK4/6 Inhibitor for Breast Cancer Treatment https://pubmed.ncbi.nlm.nih.gov/35251463/

Endocrine Therapy Combined With Targeted Therapy in Hormone Receptor-positive Metastatic Breast Cancer https://pubmed.ncbi.nlm.nih.gov/32852380/

Introduction to Antibody-Drug Conjugates https://pubmed.ncbi.nlm.nih.gov/34842621/

Trastuzumab Deruxtecan for Breast Cancer https://pubmed.ncbi.nlm.nih.gov/35704495/

Triple Negative Breast Cancer: A Thorough Review of Biomarkers https://pubmed.ncbi.nlm.nih.gov/31927455/

Immunotherapy in Breast Cancer: An Overview of Current Strategies and Perspectives https://pubmed.ncbi.nlm.nih.gov/36781869/

Post-neoadjuvant Treatment Strategies in Breast Cancer https://pubmed.ncbi.nlm.nih.gov/35267554/

PARP and PARG Inhibitors in Cancer Treatment https://pubmed.ncbi.nlm.nih.gov/32029455/

PD-1/PD-L1 Pathway: Current Researches in Cancer https://pubmed.ncbi.nlm.nih.gov/32266087/

Checkpoint Blockade in the Treatment of Breast Cancer: Current Status and Future Directions https://pubmed.ncbi.nlm.nih.gov/29808015/

Neoantigens: Promising Targets for Cancer Therapy https://pubmed.ncbi.nlm.nih.gov/36604431/

Atezolizumab and Nab-paclitaxel in Advanced Triple-negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/30345906/

Nab-paclitaxel Dose and Schedule in Breast Cancer https://www.medscape.com/viewarticle/849295

VENTANA PD-L1 (SP142) Assay https://www.accessdata.fda.gov/cdrh_docs/pdf16/p160002c.pdf

Primary Results From IMpassion131, a Double-blind, Placebo-controlled, Randomised Phase III Trial of First-line Paclitaxel With or Without Atezolizumab for Unresectable Locally Advanced/Metastatic Triple-negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/34219000/

Pembrolizumab Plus Chemotherapy in Advanced Triple-negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/35857659/

Gemcitabine and Carboplatin for Pretreated Metastatic Breast Cancer: The Predictive Value of Immunohistochemically Defined Subtypes https://pubmed.ncbi.nlm.nih.gov/22350024/

PD-L1 IHC 22C3 PharmDx https://www.accessdata.fda.gov/cdrh_docs/pdf15/p150013c.pdf

Pembrolizumab for Early Triple-negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/32101663/

18th St. Gallen International Breast Cancer Conference 2023 https://www.oncoconferences.ch/events/sgbcc-2023/

Prognostic and Predictive Value of Immune-related Gene Expression Signatures vs Tumor-infiltrating Lymphocytes in Early-stage ERBB2/HER2-positive Breast Cancer: A Correlative Analysis of the CALGB 40601 and PAMELA Trials https://pubmed.ncbi.nlm.nih.gov/36602784/

Molecular Subtypes and Imaging Phenotypes of Breast Cancer https://pubmed.ncbi.nlm.nih.gov/27599892/

I-SPY 2: A Neoadjuvant Adaptive Clinical Trial Designed to Improve Outcomes in High-risk Breast Cancer https://pubmed.ncbi.nlm.nih.gov/33312344/

Luminal B Breast Cancer: Patterns of Recurrence and Clinical Outcome https://pubmed.ncbi.nlm.nih.gov/27542253/

Study of Pembrolizumab (MK-3475) Plus Chemotherapy Versus Placebo Plus Chemotherapy for HR+/HER2- Locally Recurrent Inoperable or Metastatic Breast Cancer (MK-3475-B49/KEYNOTE-B49) https://clinicaltrials.gov/ct2/show/NCT04895358

Utility of the CPS + EG Scoring System in Triple-negative Breast Cancer Treated With Neoadjuvant Chemotherapy https://pubmed.ncbi.nlm.nih.gov/34186505/

Drs Banu Arun and Kevin Kalinsky discuss immunotherapy in the treatment of advanced and metastatic breast cancer, including recent studies, side effects, access to treatment, and disparities in care.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982648). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

21-Gene Assay to Inform Chemotherapy Benefit in Node-Positive Breast Cancer https://pubmed.ncbi.nlm.nih.gov/34914339/

Prevalence Study of PD-L1 SP142 Assay in Metastatic Triple-Negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/33030848/

Atezolizumab and Nab-Paclitaxel in Advanced Triple-Negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/30345906/

Primary Results From IMpassion131, a Double-Blind, Placebo-Controlled, Randomised Phase III Trial of First-Line Paclitaxel With or Without Atezolizumab for Unresectable Locally Advanced/Metastatic Triple-Negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/34219000/

Pembrolizumab Plus Chemotherapy Versus Placebo Plus Chemotherapy for Previously Untreated Locally Recurrent Inoperable or Metastatic Triple-Negative Breast Cancer (KEYNOTE-355): A Randomised, Placebo-Controlled, Double-Blind, Phase 3 Clinical Trial https://pubmed.ncbi.nlm.nih.gov/33278935/

Sacituzumab Govitecan in Metastatic Triple-Negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/33882206/

Study of Sacituzumab Govitecan-hziy Versus Treatment of Physician's Choice in Patients With Previously Untreated Metastatic Triple-Negative Breast Cancer (ASCENT-03) https://clinicaltrials.gov/ct2/show/NCT05382299

Study of Sacituzumab Govitecan-hziy and Pembrolizumab Versus Treatment of Physician's Choice and Pembrolizumab in Patients With Previously Untreated, Locally Advanced Inoperable or Metastatic Triple-Negative Breast Cancer (ASCENT-04) https://clinicaltrials.gov/ct2/show/NCT05382286

Datopotamab Deruxtecan, a Novel TROP2-Directed Antibody-Drug Conjugate, Demonstrates Potent Antitumor Activity by Efficient Drug Delivery to Tumor Cells https://pubmed.ncbi.nlm.nih.gov/34413126/

Phase II Multicenter Study of Durvalumab and Olaparib in Platinum Treated Advanced Triple-negative Breast Cancer (DORA) (DORA) https://clinicaltrials.gov/ct2/show/NCT03167619

A Phase II Study of Talazoparib After Platinum or Cytotoxic Nonplatinum Regimens in Patients With Advanced Breast Cancer and Germline BRCA1/2 Mutations (ABRAZO) https://pubmed.ncbi.nlm.nih.gov/30563931/

Pembrolizumab for Early Triple-Negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/32101663/

Parallel Genomic Alterations of Antigen and Payload Targets Mediate Polyclonal Acquired Clinical Resistance to Sacituzumab Govitecan in Triple-Negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/34404686/

Drs Banu Arun and Nadine Tung discuss access to genetic counseling and germline genetic testing, and their earlier incorporation into the multidisciplinary management of patients with breast cancer.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982646). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Stage IV (Advanced or Metastatic) Breast Cancer https://nbcf.org.au/about-breast-cancer/diagnosis/stage-4-advanced-or-metastatic-breast-cancer/

Cases in Precision Medicine: The Role of Tumor and Germline Genetic Testing in Breast Cancer Management https://pubmed.ncbi.nlm.nih.gov/31634909/

Breast Cancer https://emedicine.medscape.com/article/1947145-overview

PIK3CA Gene https://medlineplus.gov/genetics/gene/pik3ca/#synonyms

ESR1 Mutations in Breast Cancer https://pubmed.ncbi.nlm.nih.gov/31318440/

Breast Cancer and HER2 https://emedicine.medscape.com/article/1689966-overview

BRCA Gene Mutations: Cancer Risk and Genetic Testing https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#what-are-brca1-and-brca2

PARP and PARG Inhibitors in Cancer Treatment https://pubmed.ncbi.nlm.nih.gov/32029455/

Consensus Guideline on Genetic Testing for Hereditary Breast Cancer https://www.breastsurgeons.org/docs/statements/Consensus-Guideline-on-Genetic-Testing-for-Hereditary-Breast-Cancer.pdf

Triple Negative Breast Cancer: A Thorough Review of Biomarkers https://pubmed.ncbi.nlm.nih.gov/31927455/

NCCN Guidelines® Insights: Breast Cancer, Version 4.2021 https://pubmed.ncbi.nlm.nih.gov/34794122/

Olaparib for Metastatic Breast Cancer in Patients With a Germline BRCA Mutation https://pubmed.ncbi.nlm.nih.gov/28578601/

Talazoparib in Patients With Advanced Breast Cancer and a Germline BRCA Mutation https://pubmed.ncbi.nlm.nih.gov/30110579/

Olaparib https://reference.medscape.com/drug/lynparza-olaparib-999934

Talazoparib https://reference.medscape.com/drug/talzenna-talazoparib-1000290

Efficacy of Platinum-Based and Non-Platinum-Based Drugs on Triple-Negative Breast Cancer: Meta-analysis https://pubmed.ncbi.nlm.nih.gov/36242046/

Third-line Therapy https://www.cancer.gov/publications/dictionaries/cancer-terms/def/third-line-therapy

Management of Hormone Receptor-Positive, HER2-Negative Early Breast Cancer https://pubmed.ncbi.nlm.nih.gov/32546323/

Endocrine Therapy for ER-Positive/HER2-Negative Metastatic Breast Cancer https://pubmed.ncbi.nlm.nih.gov/30056727/

The Emerging CDK4/6 Inhibitor for Breast Cancer Treatment https://pubmed.ncbi.nlm.nih.gov/35251463/

Progression-Free Survival https://www.cancer.gov/publications/dictionaries/cancer-terms/def/progression-free-survival

PARP1 https://www.mycancergenome.org/content/gene/parp1/

Platinum-Based Systematic Therapy in Triple-Negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/35026309/

TBCRC009: A Multicenter Phase II Clinical Trial of Platinum Monotherapy With Biomarker Assessment in Metastatic Triple-Negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/25847936/

Carboplatin in BRCA1/2-Mutated and Triple-Negative Breast Cancer BRCAness Subgroups: The TNT Trial https://pubmed.ncbi.nlm.nih.gov/29713086/

Taxanes for Adjuvant Treatment of Early Breast Cancer https://pubmed.ncbi.nlm.nih.gov/31476253/

Overcoming Platinum and PARP-Inhibitor Resistance in Ovarian Cancer https://pubmed.ncbi.nlm.nih.gov/32560564/

A Phase II Study of Talazoparib After Platinum or Cytotoxic Nonplatinum Regimens in Patients With Advanced Breast Cancer and Germline BRCA1/2 Mutations (ABRAZO) https://pubmed.ncbi.nlm.nih.gov/30563931/

Myelodysplastic Syndrome (MDS) https://emedicine.medscape.com/article/207347-overview

Drs Banu Arun and Filipa Lynce discuss what the future holds for antibody-drug conjugates in different metastatic breast cancer subgroups, including efficacy, strategies, and toxicities.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982644). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

New Antibody-Drug Conjugates (ADCs) in Breast Cancer -- an Overview of ADCs Recently Approved and in Later Stages of Development https://pubmed.ncbi.nlm.nih.gov/36046357/

Stage 4 (Advanced or Metastatic) Breast Cancer https://nbcf.org.au/about-breast-cancer/diagnosis/stage-4-advanced-or-metastatic-breast-cancer/

HER2/neu Test https://www.cancer.gov/publications/dictionaries/cancer-terms/def/her2-neu-test

Triple Negative Breast Cancer: A Thorough Review of Biomarkers https://pubmed.ncbi.nlm.nih.gov/31927455/

Management of Hormone Receptor-Positive, HER2-Negative Early Breast Cancer https://pubmed.ncbi.nlm.nih.gov/32546323/

BRCA Gene Mutations: Cancer Risk and Genetic Testing https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#what-are-brca1-and-brca2

Payloads for Antibody–Drug Conjugates https://pubs.acs.org/doi/10.1021/acs.oprd.2c00227

Bystander Effect of Antibody-Drug Conjugates: Fact or Fiction? https://pubmed.ncbi.nlm.nih.gov/35305211/

Trastuzumab Emtansine for Residual Invasive HER2-Positive Breast Cancer https://pubmed.ncbi.nlm.nih.gov/30516102/

Trastuzumab Deruxtecan Versus Trastuzumab Emtansine for Breast Cancer https://pubmed.ncbi.nlm.nih.gov/35320644/

CLEOPATRA: A Phase III Evaluation of Pertuzumab and Trastuzumab for HER2-Positive Metastatic Breast Cancer https://pubmed.ncbi.nlm.nih.gov/21147694/

Sacituzumab Govitecan in Metastatic Triple-Negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/33882206/

TROPiCS-02: A Phase III Study Investigating Sacituzumab Govitecan in the Treatment of HR+/HER2- Metastatic Breast Cancer https://pubmed.ncbi.nlm.nih.gov/32223649/

The Emerging CDK4/6 Inhibitor for Breast Cancer Treatment https://pubmed.ncbi.nlm.nih.gov/35251463/

Preclinical and Clinical Efficacy of Trastuzumab Deruxtecan in Breast Cancer Brain Metastases https://pubmed.ncbi.nlm.nih.gov/36074155/

Tucatinib, Trastuzumab, and Capecitabine for HER2-Positive Metastatic Breast Cancer https://pubmed.ncbi.nlm.nih.gov/31881136/

Datopotamab Deruxtecan, a Novel TROP2-Directed Antibody-Drug Conjugate, Demonstrates Potent Antitumor Activity by Efficient Drug Delivery to Tumor Cells https://pubmed.ncbi.nlm.nih.gov/34413126/

Parallel Genomic Alterations of Antigen and Payload Targets Mediate Polyclonal Acquired Clinical Resistance to Sacituzumab Govitecan in Triple-Negative Breast Cancer https://pubmed.ncbi.nlm.nih.gov/34404686/

PARP and PARG Inhibitors in Cancer Treatment https://pubmed.ncbi.nlm.nih.gov/32029455/