ASCO 2015 Highlights

Although many clinicians are already prescribing fulvestrant (Faslodex) at a dose of 500 mg, a phase 3 study presented at the meeting confirmed the superiority of this dose over 250 mg.

A comparison of letrozole (Fem­ara) with tamoxifen (Nolva­dex) demonstrated that the former may be superior for the treatment of postmenopausal estrogen receptor (ER)-positive patients who have lobular carcinoma, according to a subanalysis of patients in the phase 3 BIG 1-98 trial.

Black women and other racial minorities are less likely than white women to receive sentinel lymph node (SLN) dissection as the standard of care for clinically node-negative breast cancer, and this has negative consequences, an analysis of the Surveillance, Epidemiology and End Results (SEER)/Medicare database suggested.

Axillary lymph node dissection (ALND) may not be necessary after neoadjuvant chemotherapy in most patients, according to investigators who found that sentinel lymph node (SLN) dissection correctly staged more than 90% of patients.

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.

A trend toward improved overall survival (OS) with eribulin mesylate (Halaven) was demonstrated in the global phase 3 clinical trial comparing this newer agent with capecitabine (Xeloda) in patients with previously treated metastatic breast cancer.

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.