Personalized Medicine

In making decisions about adjuvant chemotherapy, biologic subtype has replaced nodal status and tumor size as parameters to consider, although subtype—and tests that define them—are still insufficient for the provision of optimal care, said Antonio C. Wolff, MD, Professor of Oncology at Johns Hopkins University School of Medicine, Baltimore.

The Breast Cancer Index (BCI), a polymerase chain reaction–based assay, can predict late recurrences in estrogen receptor (ER)-positive patients, according to results from the translational arm of the Arimidex, Tamoxifen, Alone or in Combination (TransATAC) trial population.

Eribulin mesylate (Halaven) is currently used in patients with metastatic breast cancer whose disease has progressed on other treatments, but the drug may be useful in earlier lines of therapy.

Some patients who test HER2 negative by conventional tests may still benefit from anti-HER2 agents. This is the conclusion of a study that examined HER2 mutations in detail which was presented by Ron Bose, MD, PhD, Assistant Professor, Oncology Division, Department of Medicine, Washington University School of Medicine in St Louis, MO.

The incidence of false-negative immunohistochemistry (IHC) is only 1% in patients with primary breast cancer, according to a prospective multicenter Canadian study presented at the meeting.

For patients with HER2-positive early breast cancer, 1 year of treatment with trastuzumab (Herceptin) remains the standard of care, according to the HERA trial and a subanalysis of the PHARE study.

Determining HER2 status utilizing novel central laboratory testing techniques has been shown to be more reliable than routine local HER2 testing, such as immunohistochemistry or in situ hybridization.

Ten-year disease control in patients with nonmetastatic breast cancer did not differ significantly between patients treated with a reduced-dose hypofractionated radiation therapy compared with a standard protocol, according to a study presented at the meeting.

Low-dose intraoperative radiation therapy has proved comparable with whole-breast irradiation for preventing breast cancer recurrence, according to the preliminary results of the large randomized Targeted Intraoperative Radiotherapy (TARGIT-A) trial.

Fewer than 0.5% of patients with breast cancer develop leukemia associated with chemotherapy, but this is 60% higher than the proportion documented in a previous analysis, according to a report based on the National Comprehensive Cancer Network (NCCN) database.