Chemotherapy or Not? Anthracycline or Not? Taxane or Not? Does Density Matter? Chemotherapy in Luminal Breast Cancer: Choice of Regimen.

Size: px
Start display at page:

Download "Chemotherapy or Not? Anthracycline or Not? Taxane or Not? Does Density Matter? Chemotherapy in Luminal Breast Cancer: Choice of Regimen."

Transcription

1 Chemotherapy in Luminal Breast Cancer: Choice of Regimen Andrew D. Seidman, MD Attending Physician Breast Cancer Medicine Service Memorial Sloan Kettering Cancer Center Professor of Medicine Weill Cornell Medical College Question Which of the following chemotherapy regimens are optimal options as adjuvant therapy for a 59 year old woman with a 1.7 cm., ER+, PR+, HER2 negative, node negative breast cancer with an 21 Gene Recurrence Score of 30? 1. doxorubicin, cyclophosphamide and docetaxel ( TAC ) 2. cyclophosphamide + methotrexate + fluorouracil (CMF) 3. doxorubicin + cyclophosphamide followed by a taxane (AC T) 4. docetaxel + cyclophosphamide ( TC ) 5. doxorubicin + cyclophosphamide (AC) 6. FEC or FAC The Questions: Choice of Chemotherapy for Luminal Breast Cancer Chemotherapy or Not? Anthracycline or Not? Taxane or Not? Does Density Matter? 1

2 It s All About The Talk Metastatic Breast Cancer 5 Historical Perspective 1985 NIH Consensus Conference: Premenopausal, node (+) : Chemotherapy Premenopausal, node ( ) : treatment not recommended, consider chemotherapy if "high risk" Postmenopausal, node (+), ER (+) : tamoxifen Postmenopausal, node (+), ER ( ) : consider chemotherapy, but cannot be recommended as standard practice Postmenopausal, node ( ) : no routine adjuvant therapy, may be considered for certain "high risk" patients 2

3 S1007: A Phase III, Randomized Clinical Trial of Standard Adjuvant Endocrine Therapy +/- Chemotherapy in Patients with 1-3 Positive Nodes, Hormone Receptor-Positive and HER2-Negative Breast Cancer with Recurrence Score of 25 or Less Ana M. Gonzalez Angulo, M.D. Primary Objective To determine the effect of chemotherapy in patients with node positive breast cancer who do not have high RS by 21-Gene RS Assay Patients with 1-3 positive nodes, and HR+ and HER2- breast cancer with RS 25 DFS for patients treated with chemotherapy compared to no chemotherapy and dependence on the magnitude of RS. Determine the optimal cutpoint for recommending chemotherapy or not. Chemotherapy Second Generation Regimens Third Generation Regimens 3

4 Biologic Heterogeneity Mandates Individualized Treatment Approaches 21 Gene Recurrence Score (RS) Assay 16 Cancer and 5 Reference Genes From 3 Studies PROLIFERATION Ki 67 STK15 Survivin Cyclin B1 MYBL2 INVASION Stromelysin 3 Cathepsin L2 HER2 GRB7 HER2 ESTROGEN ER PR Bcl2 SCUBE2 GSTM1 BAG1 RS = x HER2 Group Score x ER Group Score x Proliferation Group Score x Invasion Group Score x CD x GSTM x BAG1 CD68 Category RS (0-100) REFERENCE Low risk RS <18 Beta actin Int risk RS 18 and <31 GAPDH RPLPO High risk RS 31 GUS TFRC Paik et al. N Engl J Med. 2004;351: Standardized Quantitative 21 Gene RS Assay: Node, ER + Recurrence at 10 Years 40% 35% 30% 25% 20% 15% Low Risk Group Intermediate Risk Group High Risk Group Distant 10% 5% 0% Recurrence Score Lower RS s Higher RS s Lower likelihood of recurrence Greater likelihood of recurrence Greater magnitude of TAM benefit Lower magnitude of TAM benefit Minimal, if any, chemotherapy benefit Clear chemotherapy benefit 1) Paik et al NEJM 2004, 2) Habel et al Breast Cancer Research ) Paik et al JCO 2006, 4) Gianni et al JCO

5 Adjuvant Chemotherapy Regimens CMF = AC CAF/FAC CEF/FEC DC AC P/D DAC(Tac) FEC P/D AC > wkly P ddac P Differential Benefits by Subtype? The Anthracyclines Have Been a Mainstay: Clear Benefits in Unselected Patients 3.7% 4.6% EBCTCG, Lancet 2005 OS Gennari A et al, JNCI

6 Anthracycline sensitivity in HER2 positives TOP2 Deleted TOP2 Normal TOP2 Amplified DiLeo SABCS 2008 (abs 705) Anthracycline for Luminals? Unique, serious, potential late toxicities (cardiac, AML, MDS) Total/near total alopecia Increased likelihood of nausea Some evidence of effectiveness in all subgroups Limited prospective, reproducible data demonstrating a lack of differential benefit in any subset Mixed retrospective, data demonstrating effectiveness limited to subsets Biomarker identification and testing is evolving Adjuvant CMF or AC vs Capecitabine in women >65 Capecitabine Alone for Selected Luminals? Muss et al, NEJM

7 Meta analysis: Adjuvant taxane vs no taxane: DFS De Laurentiis, M. et al. J Clin Oncol; 26: Copyright American Society of Clinical Oncology Meta analysis: Adjuvant taxane vs no taxane: OS Copyright American Society of Clinical Oncology De Laurentiis, M. et al. J Clin Oncol; 26: Disease-free Survival among Patients Treated with or without Paclitaxel According to Estrogen-Receptor Status and HER2 Expression Hayes DF et al. N Engl J Med 2007;357:

8 No paclitaxel benefit Each of these 3 subsets shows a statistically significant benefit from paclitaxel with small sample size E1199: Best Taxane for Luminal BC? Docetaxel Paclitaxel Secondary Comparisons: q3w q1w q3w q1w 5-Year DFS 81.2% 77.6% 76.9% 81.5% compared to paclitaxel l q3w Primary Comparisons: Paclitaxel vs. Docetaxel: HR: 1.032; P = 0.61 q3w vs. q1w: HR: 1.062; P = 0.33 Hormone Receptor Positive* Hormone Receptor Negative* HR: 1.23 HR: 1.09 HR: 1.0 HR: 1.27 P = 0.02 P = HR: 1.28 P = 0.03 HR: 1.08 HR: 1.15 HR: 0.96 HR: 1.0 HR: 1.0 HR: 1.20 HR: 1.40 P = Year OS 87.3% 86.2% 86.5% 89.7% compared to paclitaxel q3w * Exploratory analysis HR: 1.13 HR: 1.02 HR: 1.0 HR: 1.32 P = 0.01 Meta analysis of disease free survival (DFS) according to ER status for Taxanes Copyright American Society of Clinical Oncology De Laurentiis, M. et al. J Clin Oncol; 26:

9 Meta analysis of disease free survival (DFS) according to HER 2 status De Laurentiis, M. et al. J Clin Oncol; 26: Copyright American Society of Clinical Oncology Weekly Paclitaxel was equally superior to every 3 Week Paclitaxel in Luminal or Triple Negs in E1199 HR HER2 No. DFS OS Pos Neg (0.97, 1.72) p=0.05 Neg Neg (0.98, 1.93 P=0.07 (0.92, 2.00) p= (0.91, 1.94) P=0.14 Taxane OR Anthracycline for Luminal BC?: US Oncology 9735 AC x 4 q3w Doxorubicin (60 mg/m 2 ) Cyclophosphamide (600 mg/m 2 ) N= % ER+ 48% N R n=510 TC x 4 q3w Docetaxel (75 mg/m 2 ) Cyclophosphamide (600 mg/m 2 ) n=506 Eligibility: Stage I, II, or III disease Jones et al. J Clin Oncol. 2006;24:

10 TC vs AC: DFS and OS From: Jones, S. et al. J Clin Oncol; 27: Copyright American Society of Clinical Oncology Summary of unplanned, exploratory analyses of disease-free survival hazard ratios (HR) and CI Docetaxel/cyclophosphamide (TC) is favored left of 1. Jones S et al. JCO 2009;27: by American Society of Clinical Oncology US Oncology TC versus TAC in HER2 ( ): (Relative Contribution of A added to to T in Luminals?) N = % power to detect a 3.4% DFS advantage for the anthracycline From: USOncologyResearch/X_ClinicalResearch/X_ClinicalTrialsDetail?PSTUDYNUM=06090 PI: J. Blum 10

11 If AC or Paclitaxel, 4 = 6 D U R A T I O N 6 vs 4 Rx Paclitaxel vs AC PI: L. Shulman Does Dose Density Matter in Luminal Breast Cancer? Conventional Schedule Dose Dense Schedule 1,000,000,000,000 Cell number 10,000,000, ,000,000 1,000,000 10, Weeks ChemoRx Benefit as Function of ER Status: 20 Year Experience of CALGB & U.S. Intergroup DFS OS Average hazard reduction (confidence interval) ER 8541 Lo Hi 36% (15 to 52%) 9344 No Tax Tax 25% (11 to 36%) 9741 q3 q2 23% (0 to 42%) Overall Lo q2 63% (43 to 76%) Neg (15 to 52%) (11 to 36%) (0 to 42%) (43 to 76%) Pos Neg Pos *After adjusting, no significant differences Berry DA, et al. JAMA % (-18 to 37%) 29% (3 to 48%) 8% (-27 to 36%) 12% (-4 to 25%) 25% (11 to 37%) 10% (-10 to 26%) 10% (-19 to 33%) 22% (-5 to 43%) 1% (-44 to 32%) 32% (-7 to 56%) 59% (34 to 74%) 18% (-41 to 52%) 11

12 ChemoRx Benefit as Function of ER Status: 20 Year Experience of CALGB & U.S. Intergroup DFS CALGB 8541 DFS CALGB 9344 DFS CALGB 9741 ER Positive ER R Negative Berry DA, et al. JAMA 2006 Years Years Years Ultimately, It May Be What Comes AFTER ChemoRx That Matters Most in Luminal BCs! COMPARISON OF TAILORX AND MINDACT TRIALS TAILORx MINDACT Groups TBCI BIG Population Node neg, ER+ Node neg, ER+/ Assay 21 gene RS 70 gene Prognostic Signature Utility Scale & Level of Evidence + or ++ II + or ++ III Tissue FPET Fresh or frozen Accrual Goal ~10,500 ~6,000 Randomized group RS (40%) Discordant risk (32%) Treat with hormones Treat by Randomization +/ chemotherapy clinical vs. genomic risk Non randomized groups RS < 11: Hormones RS > 25: Chemo + hormones Both low risk (13%):Hormones Both high risk (55%): Chemo hormones 12

13 Question Which of the following chemotherapy regimens are optimal options as adjuvant therapy for a 59 year old woman with a 1.7 cm., ER+, PR+, HER2 negative, node negative breast cancer with an 21 Gene Recurrence Score of 30? 1. doxorubicin, cyclophosphamide and docetaxel ( TAC ) 2. cyclophosphamide + methotrexate + fluorouracil (CMF) 3. doxorubicin + cyclophosphamide followed by a taxane (AC T) 4. docetaxel + cyclophosphamide ( TC ) 5. doxorubicin + cyclophosphamide (AC) 6. FEC or FAC My Choice: CMF Take Home Points: Adjuvant Chemotherapy for Luminal A Breast Cancer Relative benefit of chemotherapy in this intrinsic subset is modest Anti estrogen therapy plays a (the) major role in risk reduction Incremental differences in efficacy between 1 st, 2 nd, and 3 rd generation regimens are negligible while differences in early and late toxicities may not be First do no harm, or at least first do as little harm as possible 13

14 It s Our Time 14

One of the most mature trials that examined PROCEEDINGS. Hormone Therapy in Postmenopausal Women With Breast Cancer * William J.

One of the most mature trials that examined PROCEEDINGS. Hormone Therapy in Postmenopausal Women With Breast Cancer * William J. Hormone Therapy in Postmenopausal Women With Breast Cancer * William J. Gradishar, MD ABSTRACT *Based on a presentation given by Dr Gradishar at a roundtable symposium held in Baltimore on June 28, 25.

More information

Breast Cancer Educational Program. June 5-6, 2015

Breast Cancer Educational Program. June 5-6, 2015 Breast Cancer Educational Program June 5-6, 2015 Adjuvant Systemic Therapy For Early Breast Cancer: Who, What and for How Long? Debjani Grenier MD, FRCPC Medical Oncologist Disclosures Advisory Board Member:

More information

Management of ER+/HER2- Breast Cancer: New Options, New Insights, Coming Agents

Management of ER+/HER2- Breast Cancer: New Options, New Insights, Coming Agents Management of ER+/HER2- Breast Cancer: New Options, New Insights, Coming Agents P. Kelly Marcom, MD Associate Professor Co-Director Breast Cancer Clinical Research NCOA August 23, 2014 Off-Label Use Disclosure(s)

More information

Breast Cancer Update 2014 Prevention, Risk, and Treatment of Early Stage Breast Cancer. Kevin R. Fox, MD University of Pennsylvania

Breast Cancer Update 2014 Prevention, Risk, and Treatment of Early Stage Breast Cancer. Kevin R. Fox, MD University of Pennsylvania Breast Cancer Update 2014 Prevention, Risk, and Treatment of Early Stage Breast Cancer Kevin R. Fox, MD University of Pennsylvania Prevention of Breast Cancer Accepted treatments Tamoxifen (premenopausal

More information

Gentest für DCIS? SENOLOGIE update 2015 21. Mai 2015 Kongress-Eventzentrum LAKE SIDE Prof. Bernhard Pestalozzi, Klinik für Onkologie, USZ

Gentest für DCIS? SENOLOGIE update 2015 21. Mai 2015 Kongress-Eventzentrum LAKE SIDE Prof. Bernhard Pestalozzi, Klinik für Onkologie, USZ Gentest für DCIS? SENOLOGIE update 2015 21. Mai 2015 Kongress-Eventzentrum LAKE SIDE Prof. Bernhard Pestalozzi, Klinik für Onkologie, USZ Gliederung Einführung: Multigen Profile OncotypeDX (21-gene score)

More information

La Chemioterapia Adiuvante Dose-Dense. Lo studio GIM 2. Alessandra Fabi

La Chemioterapia Adiuvante Dose-Dense. Lo studio GIM 2. Alessandra Fabi La Chemioterapia Adiuvante Dose-Dense Lo studio GIM 2 Alessandra Fabi San Antonio Breast Cancer Symposium -December 10-14, 2013 GIM 2 study Epirubicin and Cyclophosphamide (EC) followed by Paclitaxel (T)

More information

Inteligentaj decidoj... Intelligente Entscheide bei der adjuvanten Therapie des Mammakarzinoms. Intelligent Questions?

Inteligentaj decidoj... Intelligente Entscheide bei der adjuvanten Therapie des Mammakarzinoms. Intelligent Questions? Intelligente Entscheide bei der adjuvanten Therapie des Mammakarzinoms Stefan Aebi Universitätsspital Bern, Inselspital Klinik für Medizinische Onkologie und Brust /Tumorzentrum der Frauenklinik Inteligentaj

More information

The Impact of Taxotere on Adjuvant Breast Cancer

The Impact of Taxotere on Adjuvant Breast Cancer The Impact of Taxotere on Adjuvant Breast Cancer a report by Pierre Fumoleau and Henri Roché Centre Georges François Leclerc, Dijon, and Institut Claudius Regaud, Toulouse, France DOI: 10.17925/EOH.2005.0.0.1l

More information

The current treatment landscape for early breast cancer: Advances in cytotoxic and endocrine treatment

The current treatment landscape for early breast cancer: Advances in cytotoxic and endocrine treatment The current treatment landscape for early breast cancer: Advances in cytotoxic and endocrine treatment Ahmad Awada, MD, PhD Head of Medical Oncology Clinic Institut Jules Bordet Université Libre de Bruxelles

More information

OI PARP ΑΝΑΣΤΟΛΕΙΣ ΣΤΟΝ ΚΑΡΚΙΝΟ ΤΟΥ ΜΑΣΤΟΥ ΝΙΚΟΛΑΙΔΗ ΑΔΑΜΑΝΤΙΑ ΠΑΘΟΛΟΓΟΣ-ΟΓΚΟΛΟΓΟΣ Β ΟΓΚΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ ΝΟΣ. ΜΗΤΕΡΑ

OI PARP ΑΝΑΣΤΟΛΕΙΣ ΣΤΟΝ ΚΑΡΚΙΝΟ ΤΟΥ ΜΑΣΤΟΥ ΝΙΚΟΛΑΙΔΗ ΑΔΑΜΑΝΤΙΑ ΠΑΘΟΛΟΓΟΣ-ΟΓΚΟΛΟΓΟΣ Β ΟΓΚΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ ΝΟΣ. ΜΗΤΕΡΑ OI PARP ΑΝΑΣΤΟΛΕΙΣ ΣΤΟΝ ΚΑΡΚΙΝΟ ΤΟΥ ΜΑΣΤΟΥ ΝΙΚΟΛΑΙΔΗ ΑΔΑΜΑΝΤΙΑ ΠΑΘΟΛΟΓΟΣ-ΟΓΚΟΛΟΓΟΣ Β ΟΓΚΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ ΝΟΣ. ΜΗΤΕΡΑ Study Overview Inhibition of poly(adenosine diphosphate [ADP]-ribose) polymerase

More information

Avastin in breast cancer: Summary of clinical data

Avastin in breast cancer: Summary of clinical data Avastin in breast cancer: Summary of clinical data Worldwide, over one million people are diagnosed with breast cancer every year 1. It is the most frequently diagnosed cancer in women 1,2, and the leading

More information

GUIDELINES ADJUVANT SYSTEMIC BREAST CANCER

GUIDELINES ADJUVANT SYSTEMIC BREAST CANCER GUIDELINES ADJUVANT SYSTEMIC BREAST CANCER Author: Dr Susan O Reilly On behalf of the Breast CNG Written: December 2008 Agreed at CNG: June 2009 & June 2010 Review due: June 2011 Guidelines Adjuvant Systemic

More information

Recommendation Strength Strong, supported by the evidence and expert consensus. Recommendation Benefit/Harm Evidence Quality

Recommendation Strength Strong, supported by the evidence and expert consensus. Recommendation Benefit/Harm Evidence Quality CHEMO- AND TARGETED THERAPY FOR WOMEN WITH HER2 NEGATIVE (OR UNKNOWN) ADVANCED BREAST Benefit/Harm Evidence Quality 1: Endocrine therapy, rather than chemotherapy, should be offered as the standard firstline

More information

Positività per HER-2 nei carcinomi subcentimetrici

Positività per HER-2 nei carcinomi subcentimetrici Positività per HER-2 nei carcinomi Antonella Ferro U.O. Oncologia Medica Trento Small Tumors Small tumors are becoming increasingly common with the use of mammography > screening Some of these tumors,

More information

Avastin in breast cancer: Summary of clinical data

Avastin in breast cancer: Summary of clinical data Avastin in breast cancer: Summary of clinical data Worldwide, over one million people are diagnosed with breast cancer every year 1. It is the most frequently diagnosed cancer in women 1,2, and the leading

More information

Metastatic Breast Cancer 201. Carolyn B. Hendricks, MD October 29, 2011

Metastatic Breast Cancer 201. Carolyn B. Hendricks, MD October 29, 2011 Metastatic Breast Cancer 201 Carolyn B. Hendricks, MD October 29, 2011 Overview Is rebiopsy necessary at the time of recurrence or progression of disease? How dose a very aggressive treatment upfront compare

More information

Treatment of Metastatic Breast Cancer: Endocrine Therapies. Robert W. Carlson, M.D. Professor of Medicine Stanford University

Treatment of Metastatic Breast Cancer: Endocrine Therapies. Robert W. Carlson, M.D. Professor of Medicine Stanford University Treatment of Metastatic Breast Cancer: Endocrine Therapies Robert W. Carlson, M.D. Professor of Medicine Stanford University MDACC Experience with FAC in Chemotherapy-Naive MBC Greenberg et al, J Clin

More information

Targeted Therapy in an Era of Genomic Medicine. George W. Sledge MD Stanford University

Targeted Therapy in an Era of Genomic Medicine. George W. Sledge MD Stanford University Targeted Therapy in an Era of Genomic Medicine George W. Sledge MD Stanford University Why Do Women Die of Breast Cancer? Bad biology Avoidable deaths Important subsets of breast cancers defined by molecular

More information

Pharmacogenetic Activities in SWOG Breast Cancer

Pharmacogenetic Activities in SWOG Breast Cancer Pharmacogenetic Activities in SWOG Breast Cancer Pharmacogenomics: Future Plans S8897 Adjuvant CMF vs. CAF/ no Treatment Ambrosone RO1: Other genes (TBCI approved, analyses ongoing) S0221 Adjuvant Dose

More information

Abstract Introduction. Aim of the study. Conclusion. Patients and methods. Keywords. Results. R. Abo El Hassan 1, M. Moneer 2

Abstract Introduction. Aim of the study. Conclusion. Patients and methods. Keywords. Results. R. Abo El Hassan 1, M. Moneer 2 Original Study Outcome of HER2 positive luminal operable breast cancer in comparison with outcome of other operable luminal breast cancer patients: Long follow-up of single center randomized study R. Abo

More information

Breast Cancer. Abstract. Keywords. Development of the 21-gene Assay Oncotype DX

Breast Cancer. Abstract. Keywords. Development of the 21-gene Assay Oncotype DX Evolution of the 21-gene Assay Oncotype DX from an Experimental Assay to an Instrument Assisting in Risk Prediction and Optimisation of Treatment Decision-making in Early Breast Cancer Christian Jackisch,

More information

Progress in Treating Advanced Triple Negative Breast Cancer

Progress in Treating Advanced Triple Negative Breast Cancer Progress in Treating Advanced Triple Negative Breast Cancer Lisa A. Carey, M.D. University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center Triple Negative Breast Cancer by Subtype

More information

Prognostic and Predictive Factors in Oncology. Mustafa Benekli, M.D.

Prognostic and Predictive Factors in Oncology. Mustafa Benekli, M.D. Prognostic and Predictive Factors in Oncology Mustafa Benekli, M.D. NCI Definitions ESMO Course -Essentials of Medical Oncology -Istanbul 2 Prognostic factor: NCI Definition A situation or condition, or

More information

Sequential adjuvant docetaxel and anthracycline chemotherapy for node positive breast cancers: a retrospective study

Sequential adjuvant docetaxel and anthracycline chemotherapy for node positive breast cancers: a retrospective study JBUON 2013; 18(2): 314-320 ISSN: 1107-0625 www.jbuon.com E-mail: info@jbuon.com ORIGINAL ARTICLE Sequential adjuvant docetaxel and anthracycline chemotherapy for node positive breast cancers: a retrospective

More information

New Approval Mechanism for Breast Cancer using pathologic Complete Response

New Approval Mechanism for Breast Cancer using pathologic Complete Response New Approval Mechanism for Breast Cancer using pathologic Complete Response Sandra M. Swain, MD, FACP Medical Director, Washington Cancer Institute MedStar Washington Hospital Center Professor of Medicine

More information

Maintenance therapy in in Metastatic NSCLC. Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai

Maintenance therapy in in Metastatic NSCLC. Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai Maintenance therapy in in Metastatic NSCLC Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai Definition of Maintenance therapy The U.S. National Cancer Institute s

More information

Adjuvant Therapy with Trastuzumab

Adjuvant Therapy with Trastuzumab Adjuvant Therapy with Trastuzumab Hiroji Iwata, M.D. Department of Breast Oncology, Aichi Cancer Center Hospital Although this presentation includes information regarding pharmaceuticals (including products

More information

Effect of Chemotherapy for Luminal A Breast Cancer

Effect of Chemotherapy for Luminal A Breast Cancer Yonago Acta medica 2013;56:51 56 Original Article Effect of Chemotherapy for Luminal A Breast Cancer Naotaka Uchida,* Takako Suda and Kiyosuke Ishiguro *Clinic of Surgery, Tottori Prefectural Kosei Hospital,

More information

Cellular, Molecular, and Biochemical Targets in Breast Cancer

Cellular, Molecular, and Biochemical Targets in Breast Cancer Cellular, Molecular, and Biochemical Targets in Breast Cancer Kristy Kummerow Ingrid Meszoely December 12, 2012 VUMC Resident Bonus Conference One size fits all surgical treatment of breast cancer Wilhelm

More information

Cytotoxic Therapy in Metastatic Breast Cancer

Cytotoxic Therapy in Metastatic Breast Cancer Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Cytotoxic Therapy in Metastatic Breast Cancer Cytotoxic Therapy in Metastatic Breast Cancer Version 2002: von Minckwitz Versions

More information

Update on neoadjuvant treatment of breast cancer

Update on neoadjuvant treatment of breast cancer Update on neoadjuvant treatment of breast cancer «IS PATHOLOGIC COMPLETE RESPONSE STILL A GOOD SURROGATE OF SURVIVAL?» Complete histological response varies according to tumoral type pcr (%) 40 35 30 25

More information

Measurement of HER2. Daniel F. Hayes, MD Clinical Director, Breast Oncology Program University of Michigan Comprehensive Cancer Center

Measurement of HER2. Daniel F. Hayes, MD Clinical Director, Breast Oncology Program University of Michigan Comprehensive Cancer Center Measurement of HER2 Daniel F. Hayes, MD Clinical Director, Breast Oncology Program University of Michigan Comprehensive Cancer Center Trastuzumab Metastatic Adjuvant Lapatinib Metastatic Trials Why Test

More information

Description of Procedure or Service. assays_of_genetic_expression_to_determine_prognosis_of_breast_cancer 11/2004 3/2015 3/2016 3/2015

Description of Procedure or Service. assays_of_genetic_expression_to_determine_prognosis_of_breast_cancer 11/2004 3/2015 3/2016 3/2015 Corporate Medical Policy Assays of Genetic Expression to Determine Prognosis of Breast File Name: Origination: Last CAP Review: Next CAP Review: Last Review: assays_of_genetic_expression_to_determine_prognosis_of_breast_cancer

More information

Jennifer Diamond M.D. Assistant Professor Developmental Therapeutics and Breast Oncology University of Colorado Anschutz Medical Campus SUMO Fall

Jennifer Diamond M.D. Assistant Professor Developmental Therapeutics and Breast Oncology University of Colorado Anschutz Medical Campus SUMO Fall Jennifer Diamond M.D. Assistant Professor Developmental Therapeutics and Breast Oncology University of Colorado Anschutz Medical Campus SUMO Fall Meeting September 26, 2015 To understand the biology and

More information

How To Use A Breast Cancer Test To Help You Choose Chemotherapy

How To Use A Breast Cancer Test To Help You Choose Chemotherapy Gene expression profiling and expanded immunohistochemistry tests for guiding adjuvant chemotherapy decisions in early breast cancer management: MammaPrint, Oncotype DX, IHC4 and Mammostrat Issued: September

More information

Strength of Study End Point(s): Progression-free survival

Strength of Study End Point(s): Progression-free survival AHFS Final Determination of Medical Acceptance: Off-label Use of Bevacizumab in Combination with Paclitaxel for the First-line Treatment of Metastatic Breast Cancer Drug/Drug Combination: Bevacizumab and

More information

SAMO FoROMe Post-ESMO 2013 Breast Cancer

SAMO FoROMe Post-ESMO 2013 Breast Cancer SAMO FoROMe Post-ESMO 2013 Breast Cancer Dr. med. Manuela Rabaglio Klinik und Poliklinik für Medizinische Onkologie Breast Cancer Track 300 Abstracts 142 Poster 11 Proffered paper 4 late breaking news

More information

Drug/Drug Combination: Bevacizumab in combination with chemotherapy

Drug/Drug Combination: Bevacizumab in combination with chemotherapy AHFS Final Determination of Medical Acceptance: Off-label Use of Bevacizumab in Combination with Chemotherapy for the Treatment of Metastatic Breast Cancer Previously Treated with Cytotoxic Chemotherapy

More information

Should we use Docetaxel in hormone- naïve prostate cancer? Karim Fizazi, MD, PhD Institut Gustave Roussy Villejuif, France

Should we use Docetaxel in hormone- naïve prostate cancer? Karim Fizazi, MD, PhD Institut Gustave Roussy Villejuif, France Should we use Docetaxel in hormone- naïve prostate cancer? Karim Fizazi, MD, PhD Institut Gustave Roussy Villejuif, France Disclosure Participation to advisory boards/honorarium from: Amgen, Astellas,

More information

Adjuvant Endocrine Therapy in Breast Cancer: 2015 Update

Adjuvant Endocrine Therapy in Breast Cancer: 2015 Update Adjuvant Endocrine Therapy in Breast Cancer: 2015 Update Shannon Puhalla, MD Director, Breast Cancer Clinical Research Program Magee Womens Cancer Program University of Pittsburgh Cancer Institute Questions

More information

Van Cutsem E et al. Proc ASCO 2009;Abstract LBA4509.

Van Cutsem E et al. Proc ASCO 2009;Abstract LBA4509. Efficacy Results from the ToGA Trial: A Phase III Study of Trastuzumab Added to Standard Chemotherapy in First-Line HER2- Positive Advanced Gastric Cancer Van Cutsem E et al. Proc ASCO 2009;Abstract LBA4509.

More information

Everolimus plus exemestane for second-line endocrine treatment of oestrogen receptor positive metastatic breast cancer

Everolimus plus exemestane for second-line endocrine treatment of oestrogen receptor positive metastatic breast cancer LONDON CANCER NEWS DRUGS GROUP RAPID REVIEW Everolimus plus exemestane for second-line endocrine treatment of oestrogen receptor positive metastatic breast cancer Everolimus plus exemestane for second-line

More information

What is the optimal sequence of anti-her2 therapy in metastatic breast cancer?

What is the optimal sequence of anti-her2 therapy in metastatic breast cancer? What is the optimal sequence of anti-her2 therapy in metastatic breast cancer? David Miles Mount Vernon Cancer Centre Northwood Middlesex UKBCM mee)ng: London 2013 Herceptin plus a taxoid extends survival

More information

Basics and limitations of adjuvant online an internet based decision tool

Basics and limitations of adjuvant online an internet based decision tool Basics and limitations of adjuvant online an internet based decision tool J. Huober SAKK, Bern 31.10.2013 Univ.-Frauenklinik Ulm Integratives Tumorzentrum des Universitätsklinikums und der Medizinischen

More information

New Treatment Options for Breast Cancer

New Treatment Options for Breast Cancer New Treatment Options for Breast Cancer Brandon Vakiner, PharmD., BCOP Clinical Pharmacy Specialist - Oncology The University of Iowa Hospitals and Clinics Assistant Professor (Clinical) University of

More information

HAVE YOU BEEN NEWLY DIAGNOSED with DCIS?

HAVE YOU BEEN NEWLY DIAGNOSED with DCIS? HAVE YOU BEEN NEWLY DIAGNOSED with DCIS? Jen D. Mother and volunteer. Diagnosed with DCIS breast cancer in 2012. An educational guide prepared by Genomic Health This guide is designed to educate women

More information

Dose-Dense Chemotherapy in High-Risk Breast Cancer: Treatment Outcome and Toxicity

Dose-Dense Chemotherapy in High-Risk Breast Cancer: Treatment Outcome and Toxicity original article < Dose-Dense Chemotherapy in High-Risk Breast Cancer: Treatment Outcome and Toxicity Salah El-Mesidy, MD, Mohsen Mokhtar, MD, Amr El-Kashif, MD, Loay Kasem, M.Sc Department of Clinical

More information

Miquel Àngel Seguí Palmer

Miquel Àngel Seguí Palmer Miquel Àngel Seguí Palmer HER2+ Breast Cancer is characterized by overexpression of HER2 receptors HER2+ Breast Cancer is characterized by overexpression of HER2 receptors HER2+ status is associated with

More information

Low dose capecitabine is effective and relatively nontoxic in breast cancer treatment.

Low dose capecitabine is effective and relatively nontoxic in breast cancer treatment. 1 Low dose capecitabine is effective and relatively nontoxic in breast cancer treatment. John T. Carpenter, M.D. University of Alabama at Birmingham NP 2508 1720 Second Avenue South Birmingham, AL 35294-3300

More information

Nancy E. Davidson, MD Johns Hopkins University. Breast Cancer

Nancy E. Davidson, MD Johns Hopkins University. Breast Cancer This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this

More information

Clinical Management Protocol Chemotherapy Breast Cancer. Protocol for Planning and Treatment

Clinical Management Protocol Chemotherapy Breast Cancer. Protocol for Planning and Treatment Protocol for Planning and Treatment The process to be followed when a course of chemotherapy is required to treat: BREAST CANCER Patient information given at each stage following agreed information pathway

More information

Der St. Gallen Consensus 2009 aus der Sicht eines Panelisten

Der St. Gallen Consensus 2009 aus der Sicht eines Panelisten Der St. Gallen Consensus 2009 aus der Sicht eines Panelisten Michael Gnant Medizinische Universität Wien Austrian Breast & Colorectal Cancer Study Group Daten Fakten - Konsequenzen Palais Ferstl, 25. März

More information

I will be having surgery and radiation treatment for breast cancer. Do I need drug treatment too?

I will be having surgery and radiation treatment for breast cancer. Do I need drug treatment too? What is node-positive breast cancer? Node-positive breast cancer means that cancer cells from the tumour in the breast have been found in the lymph nodes (sometimes called glands ) in the armpit area.

More information

Komorbide brystkræftpatienter kan de tåle behandling? Et registerstudie baseret på Danish Breast Cancer Cooperative Group

Komorbide brystkræftpatienter kan de tåle behandling? Et registerstudie baseret på Danish Breast Cancer Cooperative Group Komorbide brystkræftpatienter kan de tåle behandling? Et registerstudie baseret på Danish Breast Cancer Cooperative Group Lotte Holm Land MD, ph.d. Onkologisk Afd. R. OUH Kræft og komorbiditet - alle skal

More information

Evidence-based use of taxanes in the adjuvant setting of breast cancer. A review of randomized phase III trials

Evidence-based use of taxanes in the adjuvant setting of breast cancer. A review of randomized phase III trials Cancer Treatment Reviews (2007) 33, 474 483 available at www.sciencedirect.com journal homepage: www.elsevierhealth.com/journals/ctrv ANTI-TUMOUR TREATMENT Evidence-based use of taxanes in the adjuvant

More information

Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs. Case Study. Surgery. Lumpectomy and Radiation

Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs. Case Study. Surgery. Lumpectomy and Radiation Management of Postmenopausal Women with T1 ER+ Tumors: Options and Tradeoffs Michael Alvarado, MD Associate Professor of Surgery University of California San Francisco Case Study 59 yo woman with new palpable

More information

DECISION AND SUMMARY OF RATIONALE

DECISION AND SUMMARY OF RATIONALE DECISION AND SUMMARY OF RATIONALE Indication under consideration Clinical evidence Everolimus in combination with exemestane hormone therapy for oestrogen receptor positive locally advanced or metastatic

More information

Post ASCO 2012 Mammacarcinoom: Adjuvant. Sjoerd Rodenhuis

Post ASCO 2012 Mammacarcinoom: Adjuvant. Sjoerd Rodenhuis Post ASCO 2012 Mammacarcinoom: Adjuvant Sjoerd Rodenhuis ASCO 2012 Mammaca. adjuvant Controverse: Hebben bisfosfonaten in de adjuvante setting antitumor werking? Identificatie van N 0 mammacarcinomen,

More information

Systemic adjuvant treatment in invasive lobular breast cancer

Systemic adjuvant treatment in invasive lobular breast cancer Systemic adjuvant treatment in invasive lobular breast cancer P. Neven, H. Wildiers,P. Berteloot, O. Brouckaert, R. Paridaens, On behalf of MBC, UZ Leuven Introduction ILA: Particular but heterogeneous

More information

Local Coverage Determination (LCD): MolDX: Breast Cancer Assay: Prosigna (L36125)

Local Coverage Determination (LCD): MolDX: Breast Cancer Assay: Prosigna (L36125) Local Coverage Determination (LCD): MolDX: Breast Cancer Assay: Prosigna (L36125) Contractor Information Contractor Name Palmetto GBA LCD Information Document Information LCD ID L36125 Original ICD-9 LCD

More information

Appendix One. HER2-positive early breast cancer, its treatment and prognosis

Appendix One. HER2-positive early breast cancer, its treatment and prognosis Appendix One. HER2-positive early breast cancer, its treatment and prognosis Breast cancer and HER2/neu over-expression Health need is one of PHARMAC s nine decision criteria (http://www.pharmac.govt.nz/pdf/231205.pdf

More information

La personalizzazione terapeutica: quanto influisce l età

La personalizzazione terapeutica: quanto influisce l età La personalizzazione terapeutica: quanto influisce l età PierFranco Conte University of Padova Department of Surgery, Oncology and Gastroenterology IOV Istituto Oncologico Veneto I.R.C.C.S. Breast Cancer

More information

Breast Cancer Treatment Guidelines

Breast Cancer Treatment Guidelines Breast Cancer Treatment Guidelines DCIS Stage 0 TisN0M0 Tamoxifen for 5 years for patients with ER positive tumors treated with: -Breast conservative therapy (lumpectomy) and radiation therapy -Excision

More information

Genomic Medicine The Future of Cancer Care. Shayma Master Kazmi, M.D. Medical Oncology/Hematology Cancer Treatment Centers of America

Genomic Medicine The Future of Cancer Care. Shayma Master Kazmi, M.D. Medical Oncology/Hematology Cancer Treatment Centers of America Genomic Medicine The Future of Cancer Care Shayma Master Kazmi, M.D. Medical Oncology/Hematology Cancer Treatment Centers of America Personalized Medicine Personalized health care is a broad term for interventions

More information

New Trends & Current Research in the Treatment of Lung Cancer, Pt. II

New Trends & Current Research in the Treatment of Lung Cancer, Pt. II New Trends & Current esearch in the Treatment of Lung Cancer, Pt. II Howard (Jack) West, MD President & CEO, GACE Medical Director, Thoracic Oncology Program Swedish Cancer Institute Seattle, WA Cancer

More information

Mechanism Of Action of Palbociclib & PFS Benefit

Mechanism Of Action of Palbociclib & PFS Benefit A Phase II Randomized Controlled Trial of Palbociclib & Tamoxifen/Fulvestrant in Postmenopausal Women and Men With Hormone-Receptor Positive, HER2- Negative Metastatic Breast Cancer (MBC) Protocol Chair:

More information

Personalized Predictive Medicine and Genomic Clinical Trials

Personalized Predictive Medicine and Genomic Clinical Trials Personalized Predictive Medicine and Genomic Clinical Trials Richard Simon, D.Sc. Chief, Biometric Research Branch National Cancer Institute http://brb.nci.nih.gov brb.nci.nih.gov Powerpoint presentations

More information

Chemotherapy in Ovarian Cancer. Dr R Jones Consultant Medical Oncologist South Wales Gynaecological Oncology Group

Chemotherapy in Ovarian Cancer. Dr R Jones Consultant Medical Oncologist South Wales Gynaecological Oncology Group Chemotherapy in Ovarian Cancer Dr R Jones Consultant Medical Oncologist South Wales Gynaecological Oncology Group Adjuvant chemotherapy for early stage EOC Fewer than 30% women present with FIGO stage

More information

Targeted Therapy What the Surgeon Needs to Know

Targeted Therapy What the Surgeon Needs to Know Targeted Therapy What the Surgeon Needs to Know AATS Focus in Thoracic Surgery 2014 David R. Jones, M.D. Professor & Chief, Thoracic Surgery Memorial Sloan Kettering Cancer Center I have no disclosures

More information

Adjuvant Therapy Non Small Cell Lung Cancer. Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015

Adjuvant Therapy Non Small Cell Lung Cancer. Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015 Adjuvant Therapy Non Small Cell Lung Cancer Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015 No Disclosures Number of studies Studies Per Month 12 10 8 6 4 2 0 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3

More information

New Agents as Options in the Treatment of Breast Cancer in 2012 2013. Realities and Possibilities

New Agents as Options in the Treatment of Breast Cancer in 2012 2013. Realities and Possibilities New Agents as Options in the Treatment of Breast Cancer in 2012 2013. Realities and Possibilities Peter M. Ravdin, MD, PhD UT Health Science Center San Antonio San Antonio, TX 2012 2013 New Options for

More information

NATIONAL CANCER DRUG FUND PRIORITISATION SCORES

NATIONAL CANCER DRUG FUND PRIORITISATION SCORES NATIONAL CANCER DRUG FUND PRIORITISATION SCORES Drug Indication Regimen (where appropriate) BORTEZOMIB In combination with dexamethasone (VD), or with dexamethasone and thalidomide (VTD), is indicated

More information

In treating triple negative breast cancer,

In treating triple negative breast cancer, Treatment of triple negative breast cancer Triple negative breast cancers, as a subgroup, are associated with a poor prognosis. But different subtypes within triple negative disease are associated with

More information

Adjuvant treatment of breast cancer patients with trastuzumab

Adjuvant treatment of breast cancer patients with trastuzumab doi:10.2478/v10019-007-0020-y review Adjuvant treatment of breast cancer patients with trastuzumab Erika Matos, Tanja Čufer Institute of Oncology Ljubljana, Department of Medical Oncology, Ljubljana, Slovenia

More information

Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials

Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 5-year survival: an overview of the randomised trials Early Breast Cancer Trialists Collaborative Group (EBCTCG)*

More information

Chemotherapy and hormonal therapy for early breast cancer: Effects on recurrence and 15-year survival in an overview of the randomised trials

Chemotherapy and hormonal therapy for early breast cancer: Effects on recurrence and 15-year survival in an overview of the randomised trials Chemotherapy and hormonal therapy for early breast cancer: Effects on recurrence and 15year survival in an overview of the randomised trials Early breast cancer trialists' collaborative group (EBCTCG)

More information

Early and Locally Advanced Breast

Early and Locally Advanced Breast Early and Locally Advanced Breast Cancer Audrea H. Szabatura, Pharm.D., BCOP; and Amy Hatfield Seung, Pharm.D., BCOP Reviewed by Jared M. Freml, Pharm.D., BCOP; Clarence Chant, Pharm.D., BCPS, FCSHP; and

More information

Advances In Chemotherapy For Hormone Refractory Prostate Cancer. TAX 327 study results & SWOG 99-16 study results presented at ASCO 2004

Advances In Chemotherapy For Hormone Refractory Prostate Cancer. TAX 327 study results & SWOG 99-16 study results presented at ASCO 2004 Ronald de Wit Rotterdam Cancer Institute The Netherlands Advances In Chemotherapy For Hormone Refractory Prostate Cancer TAX 327 study results & SWOG 99-16 study results presented at Slide 1 Prostate Cancer

More information

J Clin Oncol 24:4888-4894. 2006 by American Society of Clinical Oncology INTRODUCTION

J Clin Oncol 24:4888-4894. 2006 by American Society of Clinical Oncology INTRODUCTION VOLUME 24 NUMBER 30 OCTOBER 20 2006 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T Impact on Survival of Time From Definitive Surgery to Initiation of Adjuvant Chemotherapy for Early-Stage Breast

More information

Recommendations for the management of early breast cancer

Recommendations for the management of early breast cancer Recommendations for the management of early breast cancer in women with an identified BRCA1 or BRCA2 gene mutation or at high risk of a gene mutation FEBRUARY 2014 Incorporates published evidence to August

More information

Sonneveld, P; de Ridder, M; van der Lelie, H; et al. J Clin Oncology, 13 (10) : 2530-2539 Oct 1995

Sonneveld, P; de Ridder, M; van der Lelie, H; et al. J Clin Oncology, 13 (10) : 2530-2539 Oct 1995 Comparison of Doxorubicin and Mitoxantrone in the Treatment of Elderly Patients with Advanced Diffuse Non-Hodgkin's Lymphoma Using CHOP Versus CNOP Chemotherapy. Sonneveld, P; de Ridder, M; van der Lelie,

More information

Pathologic Assessment Of The Breast And Axilla After Preoperative Therapy

Pathologic Assessment Of The Breast And Axilla After Preoperative Therapy Pathologic Assessment Of The Breast And Axilla After Preoperative Therapy W. Fraser Symmans, M.D. Associate Professor of Pathology UT M.D. Anderson Cancer Center Pathologic Complete Response (pcr) Proof

More information

Metastatic Breast Cancer: The Art and Science of Systemic Therapy. Vallerie Gordon MD, FRCPC Medical Oncologist CancerCare Manitoba

Metastatic Breast Cancer: The Art and Science of Systemic Therapy. Vallerie Gordon MD, FRCPC Medical Oncologist CancerCare Manitoba Metastatic Breast Cancer: The Art and Science of Systemic Therapy Vallerie Gordon MD, FRCPC Medical Oncologist CancerCare Manitoba Presenter Disclosure Faculty: Dr. Vallerie Gordon Relationships with commercial

More information

BREAST CANCER UPDATE C H R I S S Z Y A R T O, D O G E N E S E E H E M A T O L O G Y O N C O L O G Y F L I N T, M I

BREAST CANCER UPDATE C H R I S S Z Y A R T O, D O G E N E S E E H E M A T O L O G Y O N C O L O G Y F L I N T, M I BREAST CANCER UPDATE C H R I S S Z Y A R T O, D O G E N E S E E H E M A T O L O G Y O N C O L O G Y F L I N T, M I Overview Why is it important to understand breast cancer? Choosing wisely Appropriateness

More information

Cancer Treatments Subcommittee of PTAC Meeting held 18 September 2015. (minutes for web publishing)

Cancer Treatments Subcommittee of PTAC Meeting held 18 September 2015. (minutes for web publishing) Cancer Treatments Subcommittee of PTAC Meeting held 18 September 2015 (minutes for web publishing) Cancer Treatments Subcommittee minutes are published in accordance with the Terms of Reference for the

More information

J Clin Oncol 22:3700-3704. 2004 by American Society of Clinical Oncology INTRODUCTION

J Clin Oncol 22:3700-3704. 2004 by American Society of Clinical Oncology INTRODUCTION VOLUME 22 NUMBER 18 SEPTEMBER 15 2004 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T Effect of Doxorubicin Plus Cyclophosphamide on Left Ventricular Ejection Fraction in With Breast Cancer in

More information

J Clin Oncol 24:5381-5387. 2006 by American Society of Clinical Oncology INTRODUCTION

J Clin Oncol 24:5381-5387. 2006 by American Society of Clinical Oncology INTRODUCTION VOLUME 24 NUMBER 34 DECEMBER 1 2006 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T Phase III Trial Comparing Doxorubicin Plus Cyclophosphamide With Docetaxel Plus Cyclophosphamide As Adjuvant

More information

ESMO 2014 Summary Breast Cancer

ESMO 2014 Summary Breast Cancer ESMO 2014 Summary Breast Cancer 1 7. 1 0. 2 0 1 4 A N NA D U R I G OVA M E D I C A L O N CO LO GY U N I V E R S I T Y H O S P I TA L S O F G E N E VA Outline 1. Early Breast Cancer Her2+ Neoadjuvant: Lapatax

More information

Review of Breast Cancer Clinical Trials Conducted by the National Surgical Adjuvant Breast Project

Review of Breast Cancer Clinical Trials Conducted by the National Surgical Adjuvant Breast Project Surg Clin N Am 87 (2007) 279 305 Review of Breast Cancer Clinical Trials Conducted by the National Surgical Adjuvant Breast Project Lisa A. Newman, MD, MPH, FACS a, *, Eleftherios P. Mamounas, MD, MPH,

More information

New developments and controversies in breast cancer treatment: PARP Inhibitors: a breakthrough?

New developments and controversies in breast cancer treatment: PARP Inhibitors: a breakthrough? New developments and controversies in breast cancer treatment: PARP Inhibitors: a breakthrough? F. Cardoso, MD Champalimaud Cancer Center Lisbon, Portugal BBM 2010 Thank you to A Tutt & PRIME Oncology

More information

trastuzumab, 600mg/5mL solution for injection (Herceptin ) SMC No. (928/13) Roche Products Ltd

trastuzumab, 600mg/5mL solution for injection (Herceptin ) SMC No. (928/13) Roche Products Ltd trastuzumab, 600mg/5mL solution for injection (Herceptin ) SMC No. (928/13) Roche Products Ltd 06 December 2013 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product

More information

Stage II breast cancer

Stage II breast cancer CHAPTER 10 Stage II breast cancer Lori Jardines, MD, Bruce G. Haffty, MD, and Melanie Royce, MD, PhD This chapter focuses on the treatment of stage II breast cancer, which encompasses primary tumors >

More information

Adjuvant Chemotherapy for High-risk Node-positive Breast Cancer: a Tale of Three Generations

Adjuvant Chemotherapy for High-risk Node-positive Breast Cancer: a Tale of Three Generations Hong Kong J Radiol. 2011;14(Suppl):S46-55 REVIEW ARTICLE Adjuvant Chemotherapy for High-risk Node-positive Breast Cancer: a Tale of Three Generations RKC Ngan Department of Clinical Oncology, Queen Elizabeth

More information

Metastatic breast cancer, HER2 overexpression, first-line therapy in combination with a taxane and trastuzumab

Metastatic breast cancer, HER2 overexpression, first-line therapy in combination with a taxane and trastuzumab COMPENDIA TRANSPARENCY TRACKING FORM DRUG: Carboplatin INDICATION: Metastatic breast cancer, HER2 overexpression, first-line therapy in combination with a taxane and trastuzumab COMPENDIA TRANSPARENCY

More information

Breast and Lung Cancer Biomarker Research at ASCO: Changing Treatment Patterns

Breast and Lung Cancer Biomarker Research at ASCO: Changing Treatment Patterns July 2013 Edition Vol. 7, Issue 7 Breast and Lung Cancer Biomarker Research at ASCO: Changing Treatment Patterns By Julie Katz, MPH, MPhil Biomarkers played a prominent role in the research presented in

More information

January 2013 LONDON CANCER NEW DRUGS GROUP RAPID REVIEW. Summary. Contents

January 2013 LONDON CANCER NEW DRUGS GROUP RAPID REVIEW. Summary. Contents LONDON CANCER NEW DRUGS GROUP RAPID REVIEW Paclitaxel albumin (Abraxane ) as a substitute for docetaxel/paclitaxel for cancer Paclitaxel albumin (Abraxane ) as a substitute for docetaxel/ paclitaxel for

More information

Frequency of NHL Subtypes in Adults

Frequency of NHL Subtypes in Adults Chemotherapy Options Stephanie A. Gregory, M.D. The Elodia Kehm Professor of Medicine Director, Section of Hematology Rush University Medical Center Chicago, Illinois Frequency of NHL Subtypes in Adults

More information

Is the third-line chemotherapy feasible for non-small cell lung cancer? A retrospective study

Is the third-line chemotherapy feasible for non-small cell lung cancer? A retrospective study Turkish Journal of Cancer Volume 34, No.1, 2004 19 Is the third-line chemotherapy feasible for non-small cell lung cancer? A retrospective study MUSTAFA ÖZDO AN, MUSTAFA SAMUR, HAKAN BOZCUK, ERKAN ÇOBAN,

More information

Advances in Neoadjuvant and Adjuvant Therapy

Advances in Neoadjuvant and Adjuvant Therapy Advances in Neoadjuvant and Adjuvant Therapy Kathy S. Albain, MD, FACP Director, Breast Clinical Research Program Co-Director, Breast Oncology Center Director of the Thoracic Oncology Program Professor

More information

BREAST CANCER - METASTATIC & LOCALLY ADVANCED CHEMOTHERAPY REGIMENS Capecitabine. Capecitabine + Docetaxel. Capecitabine + Vinorelbine

BREAST CANCER - METASTATIC & LOCALLY ADVANCED CHEMOTHERAPY REGIMENS Capecitabine. Capecitabine + Docetaxel. Capecitabine + Vinorelbine Capecitabine Capecitabine 1000-1250mg/m 2 oral TWICE daily for 14 days Until disease progression Capecitabine + Docetaxel Capecitabine 750-1000mg/m 2 oral TWICE daily for 14 days Up to 6 cycles Capecitabine

More information