Key Studies in Early Breast Cancer From ASCO 2021

Dr. Harold Burstein, breast cancer specialist from Dana-Farber Cancer Institute, discusses practice-changing research and advances in early-stage breast cancer from the 2021 American Society of Clinical Oncology Annual Meeting.

He first reports on OlympiA, a phase 3 trial of adjuvant olaparib after neoadjuvant chemotherapy in patients with BRCA1/2 mutations and high-risk HR+/HER2- disease. The results showed a substantial invasive and distant disease-free survival benefit and underscored the need for genetic testing for BRCA mutations in patients with early-stage disease.

Next, he discusses two studies in triple-negative breast cancer. EA1131 was a phase 3 postoperative trial of platinum-based chemotherapy vs capecitabine in patients with residual disease after neoadjuvant chemotherapy. The negative results suggested that additional chemotherapy does not improve outcomes.

In contrast, adding durvalumab to neoadjuvant chemotherapy significantly improved outcomes in GeparNuevo, calling into question whether the drug is needed in the later adjuvant setting.

Next, Dr. Burstein looks at the ADAPT-HR-/HER2+ trial of de-escalated neoadjuvant pertuzumab plus trastuzumab, which suggested that patients with early pathologic complete responses may be suitable for further de-escalation.

Finally, he reports on a retrospective analysis of more than 330,000 US individuals that puts the well-known financial toxicity associated with cancer care into numbers and shows the impact on people’s lives beyond their diagnosis.

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Professor, Department of Medicine, Harvard Medical School

Institute Physician, Dana-Farber Cancer Institute, Boston, Massachusetts

Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships.