In this special-edition podcast, we focus on the clinical value of gene expression profiling tests to analyse a number of different genes in breast cancer cells to predict the risk of cancer recurrence, and to provide insight into the biological natural history of the individual tumour. The results of gene expression profiling tests can help determine who may benefit from adjuvant treatment after surgery.
Notably, this year is the 20th anniversary of the 2 seminal papers which showed that gene expression could predict clinical outcomes for breast cancer patients. That 70-gene signature, which later became Mammaprint, was published first in Nature, and then followed up a few months later with survival data in a publication in the New England Journal of Medicine.
Today we speak with the first author of the most recent New England Journal of Medicine paper, from 2016, demonstrating the clinical value of MammaPrint as a decision aid for early breast cancer, Dr Fatima Cardoso (Director Breast Unit Champalimaud Clinical Center, Lisbon, Portugal). This result from the MINDACT study was followed up in a 2021 Lancet Oncology publication, which provided level 1 evidence of the validity of that 70-gene signature. We also interview Dr William Audeh (Chief Medical Officer at Agendia BV, CA, USA) to discuss the implications of the MINDACT trial and the added value of the genomic profiling tools MammaPrint and Blueprint. Dr Audeh also touches upon the FLEX study, which provides whole transcriptome data linked with a clinical database annotated with over 800 clinical characteristics, over 90 sites in USA and > 9K patients enrolled with the ambition to enroll 30K. We also touch upon new data from the I-SPY trial, which indicates that within the high-risk region, there is also information to be gained by stratifying patients into High Risk 1 and 2 categories.
Enjoy listening!
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Table of Contents: SABCS 2021
Featured articles
Early-Stage Breast Cancer
Aromatase inhibitors outperform tamoxifen in premenopausal women
Concurrent taxane plus anthracycline most beneficial in reducing risk of breast cancer
Reduced risk of recurrence with ovarian suppression plus tamoxifen/exemestane
Metformin does not improve outcomes in patients with early-stage breast cancer
Omitting sentinel lymph node biopsy improves arm symptoms
HR-positive/HER2-negative Breast Cancer
Addition of palbociclib to standard endocrine therapy does not improve outcome in adjuvant treatment
The SERD elacestrant improves outcomes for patients unresponsive to endocrine therapy
Consistent overall survival benefit of ribociclib in advanced breast cancer
Premenopausal women benefit from adjuvant chemotherapy next to endocrine therapy
Promising anti-tumour activity of the CDK7-inhibitor samuraciclib plus fulvestrant
ctDNA is prognostic and predictive for response to ribociclib plus letrozole
Early switch to fulvestrant plus palbociclib beneficial for patients with ESR1 mutation
Triple-Negative Breast Cancer
Single-cell spatial analysis can predict response to neoadjuvant immunotherapy
Neoadjuvant pembrolizumab plus chemotherapy benefits event-free survival in TNBC
Early use of ctDNA testing can identify likelihood of relapse in TNBC
Pembrolizumab plus chemotherapy benefits patients with combined positive score ≥10
Neratinib plus trastuzumab plus fulvestrant shows encouraging clinical activity
Phase 1–3 Trials
Datopotamab deruxtecan shows promising anti-tumour activity
Trastuzumab deruxtecan outperforms trastuzumab emtansine
Nivolumab plus ipilimumab serve promising dual checkpoint inhibition
Entinostat plus exemestane improves progression-free survival in Chinese patients
Efficacy of pyrotinib plus capecitabine confirmed in previously treated patients
Basic and Translational Research
Using genomics to match treatments improves outcomes
Loss of ASXL1 tumour suppressor promotes resistance to CDK4/6 inhibitors
Inducers of ferroptosis are potential drugs to target p53-mutated TNBC cells
MAPK-pathway alterations are associated with resistance to anti-HER2 therapy
Genomic signatures of DCIS define biology and correlate with clinical outcomes
BRCA2 linked to inferior outcomes with CDK4/6 inhibitors plus endocrine therapy
Miscellaneous
Olaparib is well tolerated as an additional treatment
Race effects the likelihood to develop lymphoedema following breast cancer treatment
Sentinel lymph node staging is non-inferior to complete axillary lymph node dissection
One in 7 breast cancers detected during screening are overdiagnosed
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