Abstract
SummaryThis article reviews the clinically most relevant presentations at the San Antonio Breast Cancer Symposium (SABCS) 2017 on the topics lifestyle factors, hormone receptor-positive advanced disease, liquid biopsies, and prognosis.In a retrospective analysis of the Women’s Health Initiative Observational Study, a reduction in the body mass index (BMI) of at least 5% within 3 years significantly reduced the risk of breast cancer compared to women with a stable weight (HR 0.77; 95% CI 0.78–0.98). In the MONALEESA-7 trial investigating ribociclib or placebo in combination with endocrine therapy as first-line treatment in pre- and perimenopausal women with hormone receptor-positive, human epidermal growth factor 2 (HER2)-negative metastatic breast cancer, a significantly longer progression-free survival was shown for patients treated with ribociclib compared to the placebo group (23.8 vs. 13.0 months; HR 0.55; 95% CI 0.43–0.72; P < 0.001). In a pooled toxicity and efficacy analysis of elderly women treated with a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor in combination with an aromatase inhibitor in first-line, toxicities of higher grade were more common in elderly compared to younger patients, despite comparable efficacy. And the Clinical Treatment Score post-5 years (CTS5), accurately estimated the risk of late recurrence after 5 years of adjuvant endocrine treatment using routinely available clinical parameters.
Highlights
Advanced hormone receptor-positive breast cancer In San Antonio, the first results of the MONALEESA7 study were presented [5]. In this randomized phase III trial, ribociclib or placebo, each combined with goserelin and tamoxifen or a non-steroidal aromatase inhibitor, was investigated as first-line treatment in 627 pre- and perimenopausal women with hormone receptor (HR)-positive, human epidermal growth factor 2(HER2)-negative advanced breast cancer (ABC)
Patients treated with the cyclin dependent kinase 4/6 (CDK4/6) inhibitor ribociclib had a significantly longer progression-free survival (PFS), the primary endpoint of the trial, compared to the placebo group with 23.8 versus 13.0 months (HR 0.55; 95% CI 0.43–0.72; P < 0.001)
In MONALEESA-7, the efficacy of cyclin-dependent kinase 4/6 (CDK4/6) inhibition as first-line treatment in pre- and perimenopausal women with HRpositive, HER2-negative ABC was clearly shown, and this treatment should be considered as a new standard of care
Summary
Obesity is an established risk factor for the development of breast cancer in postmenopausal woman [1], whereas the influence of weight loss on breast cancer risk is not as clear, because data were conflicting [2]. At the San Antonio Breast Cancer Conference (SABCS) 2017, Chlebowski R. T. presented a retrospective analysis of the associations between weight change and breast cancer incidence in postmenopausal women participating in the Women’s Health Initiative Observational Study [3]. During a median follow-up of 11.4 years, 3061 of the 61,335 women enrolled in the study developed invasive breast cancer. Height and weight were measured at baseline and at year 3. Compared to a stable body mass index (BMI), weight loss
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