This month we attended the 34th Annual Miami Breast Cancer Conference, hosted by the Physicians’ Education Resource (PER). This globally-recognized conference brings together healthcare professionals from all over the world to share and discuss the latest advances in breast cancer management and care.
There were many noteworthy discussions at this year’s event. We’ve picked our top three sessions related to ER+ breast cancer – and what they mean for ER+ breast cancer survivors.
Clearing the Confusion: An Expert Discussion on What Clinical Trials on Extended Anti-Estrogen Therapy Mean for Patients
Multiple trials have been conducted over the years to evaluate whether or not anti-estrogen therapy (both with Tamoxifen, and more recently, aromatase inhibitors) may help women with ER+ breast cancer lower their risk of recurrence if continued for longer than 5 years. Unfortunately, however, these trials have not provided the singular answer physicians have been looking for to help them decide whether an additional 5 years is right for their patients. Instead, trials continue to show that extending treatment with anti-estrogen therapy after 5 years benefits about 3-5 out of 100 women. With some women benefiting, but not all, physicians are left trying to figure out which patients are among those who are likely to benefit. In a lunch symposium event, we heard from an all-star panel of top physicians about the need to individualize the the decision to extend anti-estrogen therapy beyond 5 years, and factors they consider when deciding whether extended treatment is right for their patients. Such factors included the patient’s risk of recurrence, side effects, and a genomic test that helps with the decision by providing a patient’s risk of recurrence after 5 years, and predicting whether an additional 5 years of anti-estrogen therapy is likely to benefit that particular patient.
Presenters commented on the recent data on extended anti-estrogen therapy and how genomic tests can help:
“We are still left with a big grey area of not really understanding who we should offer therapy to or not. Genomic tests, I think, offer us the potential for really being able to make better decisions.” – Hope Rugo, MD, Oncologist at the University of California, San Francisco
“When it comes to AI extension, I think [with] the data it is simply very difficult to make a blanket accommodation if everyone should continue AI therapy. . . We hope that genomic classifiers that predict risk of late recurrence and perhaps even benefit from [extended] endocrine therapy will play an important role in devising an algorithm to help with these decisions.” – Eleftherios P. Mamounas, MD, Oncologist at University of Florida Health and Lead Investigator of the NSABP B-42 Trial assessing extended aromatase inhibitor therapy
See our blog summary from the San Antonio Breast Cancer Symposium for more details about the recent trials evaluating extended anti-estrogen therapy with an aromatase inhibitor and individualizing treatment decisions for women with ER+ breast cancer.
Study Demonstrates Use of Breast Cancer IndexSM (BCI) Leads to Significant Changes in Physician Recommendations for Extended Endocrine Therapy in ER+ Breast Cancer Patients
A study presented at the conference demonstrated that a genomic test called the Breast Cancer Index*, hada significant impact on doctors’ treatment recommendations and patient anxiety surrounding decision-making for extension of their anti-estrogen therapy. The study revealed that after receiving the results from the Breast Cancer Index test, physicians changed their treatment decisions for about 1 out of 3 women, and that 27% of physicians reported feeling strongly confident in their treatment recommendations after the Breast Cancer Index test, compared to 9% before the receiving the results.
Not only did doctors feel more confident in their treatment recommendations, but the majority of patients (81%) who were recommended to continue their anti-estrogen therapy for an additional 5 years said they were more likely to take their anti-estrogen medicine as prescribed after receiving their Breast Cancer Index results.
According to Dr. Tara Sanft, Assistant Professor of Medicine and Medical Director of Adult Survivorship for the Yale Cancer Center Survivorship Clinic:
These data show that beyond helping patients and doctors make informed treatment decisions, Breast Cancer Index makes patients feel better about those decisions because it lessens their anxiety and increases their confidence that they’ve made the right choice.
To learn more about Breast Cancer Index visit www.answersbeyond5.com
The Contribution of NSABP Clinical Trials to the Management of Early Breast Cancer
We all know that research is critical to providing the best possible care for breast cancer, and for helping patients and survivors make informed treatment decisions. On the last day of the conference, Dr. Norman Wolmark from Allegheny Health in Pittsburgh, Pennsylvania, talked about the influence of NSABP trials on breast cancer care. What is NSABP? It stands for the National Surgical Advuant Breast and Bowel Project, and for more than 50 years the group has been conducting clinical trials for breast cancer treatment. More recently, this has included cinical trials about the extended anti-estrogen therapy, which have suggested that breast cancer patients should receive personalized care.
What Did You Think?
Did you attend the conference, too? What did you learn? Was there a topic not covered that you’d like to learn more about? Share with us on social media with the hashtag #BeWisER.
*Breast Cancer Index Intended Use and Limitations
The Breast Cancer Index (BCI) Risk of Recurrence & Extended Endocrine Benefit Test is intended for use in patients diagnosed with estrogen receptor-positive (ER+), lymph node-negative (LN-) or lymph node positive (LN+; with 1-3 positive nodes) early-stage, invasive breast cancer, who are distant recurrence-free. BCI provides: 1) a quantitative assessment of the likelihood of both late (post-5 years) and overall (0-10 year) distant recurrence following an initial 5 years of endocrine therapy (LN- patients) or 5 years of endocrine therapy plus adjuvant chemotherapy (LN+ patients), and 2) prediction of likelihood of benefit from extended (>5 year) endocrine therapy. BCI results are adjunctive to the ordering physician’s workup; treatment decisions require correlation with all other clinical findings. This test was developed and its performance characteristics determined by Biotheranostics, Inc. lt has not been cleared or approved by the U.S. Food and Drug Administration. This test is used for clinical purposes. lt should not be regarded as investigational or for research. How this information is used to guide patient care is the responsibility of the physician. Biotheranostics is certified under the Clinical Laboratory lmprovement Amendments of 1988 to perform high complexity clinical laboratory testing.
This material was created by or on behalf of Biotheranostics, Inc. The content, products and services discussed in this material are offered to educate healthcare providers and/or consumers on molecular diagnostic testing performed by Biotheranostics, and should not be considered or used as a substitute for medical advice, diagnosis or treatment of specific medical conditions. To see BCI Intended Use & Limitations, please visit www.BreastCancerIndex.com