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Update Breast Cancer 2022 Part 1 - Early Stage Breast Cancer
Manfred Welslau1, Volkmar Müller2, Diana Lüftner3
1Onkologie Aschaffenburg, Aschaffenburg, Germany.
Abstract:
Evidence relating to the treatment of breast cancer patients with early-stage disease has increased significantly in the past year. Abemaciclib, olaparib, and pembrolizumab are new drugs with good efficacy in the relevant patient groups. However, some questions remain unanswered. In particular, it remains unclear which premenopausal patients with hormone receptor-positive breast cancer should be spared unnecessary treatment. The question of the degree to which chemotherapy exerts a direct cytotoxic effect on the tumor or reduces ovarian function through chemotherapy could be of key importance. This group of patients could potentially be spared chemotherapy. New, previously experimental biomarker analysis methods, such as spatial analysis of gene expression (spatial transcriptomics) are gradually finding their way into large randomized phase III trials, such as the NeoTRIP trial. This in turn leads to a better understanding of the predictive factors of new therapies, for example immunotherapy. This review summarizes the scientific innovations from recent congresses such as the San Antonio Breast Cancer Symposium 2021 but also from recent publications.
Insights
New breast cancer drugs show promise, but identifying which premenopausal patients can avoid chemotherapy remains key. Biomarker analysis is improving treatment selection for early-stage hormone receptor-positive breast cancer.
Area of Science:
- Oncology
- Genomics
- Pharmacology
Background:
- Recent advancements in early-stage breast cancer treatment have introduced new drugs like abemaciclib, olaparib, and pembrolizumab.
- Uncertainty persists regarding the optimal treatment strategy for premenopausal patients with hormone receptor-positive breast cancer, specifically concerning the necessity of chemotherapy.
Purpose of the Study:
- To review recent innovations in early-stage breast cancer treatment.
- To explore the role of chemotherapy's cytotoxic effects versus ovarian function reduction in treatment decisions.
- To highlight the integration of novel biomarker analyses, such as spatial transcriptomics, in clinical trials.
Main Methods:
- Review of recent scientific publications and presentations from key oncology congresses (e.g., San Antonio Breast Cancer Symposium 2021).
- Analysis of emerging biomarker technologies, including spatial transcriptomics, in the context of large-scale clinical trials like NeoTRIP.
Main Results:
- New drugs (abemaciclib, olaparib, pembrolizumab) demonstrate efficacy in specific early-stage breast cancer patient groups.
- Biomarker analysis methods are increasingly incorporated into phase III trials, enhancing understanding of predictive factors for therapies, including immunotherapy.
- The impact of chemotherapy on tumor cytotoxicity versus ovarian function requires further elucidation for personalized treatment approaches.
Conclusions:
- Continued research is needed to refine treatment strategies for premenopausal, hormone receptor-positive breast cancer patients, potentially sparing them from unnecessary chemotherapy.
- Novel biomarker analyses are crucial for identifying predictive factors and optimizing the use of new therapies, including targeted agents and immunotherapy.
- Integrating findings from recent congresses and publications provides a comprehensive overview of the evolving landscape in early-stage breast cancer management.
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