Research Highlights from ASCO: Evolving Treatment Options for Breast Cancer
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Welcome to Reach MD. You're listening. Teoh Breaking Boundaries and Breast Cancer sponsored by Lily. Historically, breast cancer has often been portrayed as an immunological cold or silent disease. But the emergence of immuno therapies targeting breast cancers has fundamentally changed the way we think about this disease. And with the ongoing evolution of other systemic treatments such as endocrine therapies, targeted treatments and bone modifying drugs, the opportunities to further change perceptions toward breast cancer are always nearby. Taking us part of the way are the latest research updates coming out of Ask Owes annual meeting and on today's program will dive into some highlighted studies making positive impacts in the field. This is breaking boundaries and breast cancer, and I'm Ari Onassis Novich. Joining Me is Dr Bora Limb, assistant professor in the department of Breast Medical Oncology at the University of Texas, MD. Anderson Cancer Center. Dr. Lim is a translational investigator who is currently overseeing five active breast cancer trials and associated biomarker studies. Dr. Lim, welcome to the program. Thank you, Mario God, that I'm here to discuss them Exciting findings from the school with you guys before we dig into some of the highlighted studies coming out of ASCO curriculum. Can you give us some background on the expanding range of therapies that have been developed for breast cancer and the impacts they've made in this field so far? So the breast cancer research has been exciting. I would say this is one of the most rapidly changing field reading. The Easy sold it to more era that the most exciting changes that have been happening in breast cancer for the last few years I would include that Number one, the immunotherapy we just wanted the topic, the room to discuss and the targeted their development, including, such as Syndicate for six inhibitor. We just saved a lot of women's life as well as the pier three kinds targeted agents and some of the new therapy is a combination strategise up old. Those agents, plus chemotherapy, were the others. Thank you for that, Dr Lim. So let's turn to some reports that got a fair amount of attention at Ascot this year, starting with Kino +355 which focused on amino therapy for metastatic triple negative breast cancer. What can you tell us about this study? Latino 355 has been the most exciting study that a lot of people have been reading those studies medicine, breast cancer. So as you know that there was a study called Impression 1 30 which that to the very first approval off checking inhibitor immunotherapy in breast cancer two years back. Studying that easily. Zermatt, which is kind of like the companion immunotherapy in combination Abraxane just now. Packer Texel, which is just a matter to this study. However, dis specific study also allowed a different regimen. Call the carpet plucking Plus you inside of me that is a commonly used for the first line medicine, triple negative breast cancer setting, and in there they allowed patients to be randomized into 2 to 1 fashion. 22 out of three will receive the evening out there. You just a pimp. Release a map, plus either texting or couple. Petegem cited being or the remaining one of three was going to receive the classical versus chemotherapy and then compare who did better. How was the survival in six months without the progression and so on and so forth? Did the results of line with what you had expected, or were there any surprises for you here I would say the surprising part was for me and was it was very, very similar to what we have seen in that things. Realism averages Antipodean Juan Comfort to Pemberley is a man who, which was studied in this specific study, which is in keeping one on combination chemotherapy. So the major difference off this true study or one we're using the map paclitaxel for sixties, especially study, used either tax saying or cover put in a gym side of being. And yet the hasert racial was exactly around your 0.6 to 0.65 which is a reduction about a 20 person risk off patients haven't progressed at six months after initiation to study, which is very identical, reaches a surprise to me. But more importantly, this study with one step ahead and even started a patient expressing PD l one. And I mean, that's the speak analysis. The benefit was a slightly larger in terms of their survival, which was a another big success in the story of the even a bear in breast cancer turning to targeted therapies. There were several reports coming out of ASCO that got our attention. When was the by leave trial. What do we need to know about this? Studies pursuits and the findings. So the violence study was very exciting. Starts cross that. Who is following the p three seeing mutation? We just common in er positive breast cancer, which could be as high as 40% of older populations. There were already had a solar one study that was published, which left to the approval Ph three kindness Alfa inhibitor I policy, However, even though that studies show the efficacy off using the pair three kinds of visioneer positive breast cancer, while we did not know, is that whether that because it will stay after a patient has progressed on, see ticket for six inhibitor, so is this study was specifically designed to test the patient who has progressed on City Cape for six and a better exposure and excitingly that because you were still the truth. So even for this patient who have progress already on the city kid for six inhibitor, the progression free survival at six months was greater than 50%. We just a success with the medium progression free survival off 7.3 months. So that tells you that even after a patient has failed some the best therapy out there. If you can target a special communication for that patient, that strategy could still work as a well impacted, targeted therapies. For those just tuning in your listening to breaking boundaries and breast cancer on Reach, MD. I'm Mario NASA novich and joining me is Dr Bora limb to discuss recent advances in the breast cancer field presented at this year's ASCO meeting. So let's stay with targeted therapies for a moment and cover the par civil trial. Since this got on our radar for endocrine sensitive cancers, can you walk us through the study? So the particle trial is another study that we've been kind of waiting for. So as you know that the ER positive breast cancer patients with metastatic disease, this patient have any a lot more new age. I'll people live long, but their happiness, their long debate as to prep Asians who has had a very little exposures than decree therapy were who had a greater than 12 months after they completed the previous and the cream therapy for their previous breast cancer. Do we need to use the full bathroom reaches more aggressive form of Shop based and the Queen therapy as a combination partner off the I brands. Like or publicly war. Can you actually keep the are my taste inhibitor, which is appeal form, and some people may actually think that is easier. And then that was a stand because we have had a few studies such as Falcon Study, during the full vast trending superior compared to the pew base, which is arm appeasing the therapy. So basically, what we did was we just render me, you know, divide them into one toe in fashion. One group get the help of a quick little ******* and the other group that problems that clip plus a I. So this was something that was not blinded thing exciting part of the study Iwas the frequency was exactly the same. The hazard ratio was 1.1. There was no significant difference. So we proved that actually the pew form in combination I brands in the endocrine, naive or indifferent, sensitive patient they find by more than 12 months since the last. The completion of the therapy actually is a good strategy. So I think this was good news for the patient and then I think there's a lot of or thereby marker that is coming out from the study, that which you will be furthers. Study by the group. I want to shift it a diagnostic side for a moment to focus on risk monitoring for breast cancer recurrence. And I understand there was some long term follow up data from the Mind Act study, which tracked the performance of genetic testing. What would it take away from this report? So the man minded study when it was first published in New England Journal of Medicine through the ball Old median survival was around like five years, and they're the key point of the My index study is that we mere stratify ing the patient's risk based on clinical risk factors. Can the 70 gene based signature would add any benefit? Why kind of separating patients into clinically high risk and yet genomic lee? Low risk, clinical, high risk and genetically high risk. So in the patient who had a high clinical risk factor that doctors would engage, bought economically role dress. The benefit of the chemotherapy was only 1.5% in the original study. Now we're at the point that the median follow is too close to nine years, 8.7 years to be exact. And then there that difference off the chemotherapy benefit was even more so. Now it's 0.9%. So this kind of add the benefit off having real additional tool genomic study to tell you whether my giving therapy to therapy today participation would maybe at the toxicity, but not truly the clinical benefit. Leslie. Let's take a step back and consider this year's ask a meeting as a whole. What else has been particularly exciting for you in terms of making new headway into the breast cancer space? So they, I think, as a researcher, I think the biggest kind of excitement off Haskell 20 training was really there. He immunotherapy. We already had a me in a therapy based study that was are being provided FDA. There was in the watchman study that was presenting Esmael and then now eat this Kino 355 This is very, very exciting that people used to tell us that all breast cancer is the union cold cancer. There's no any of their people if it But I think now we're really learning that that is not the case. What really left with us is that every single study are using slightly different biomarker how to determine that even cold and even hot. So that war that left for us, but at the same time, that is very exciting challenge. And then, you know, addition, there have been very small studies have been published. Were they presented in the ASCO meeting to say there might be even different strategy that in turn, airplane that unit there can be combined and they actually have a better synergistic effect? Overall, Dr Lim, as a highly active researcher yourself, what's next on the agenda for you? I was Personally, I have been very interested in something called Self that pathway. So cells when they're old and they're MK damage, they have to go through a cell, that cold apoptosis and yet the cancer cells having a lot of mechanism to overcome back by expressing different proteins and to our excitement there have seen a approval something cold PCO two inhibitor, such as financial clocks that has been now being studied breast cancer. So I would love to hear what's happening there and also to participating in the study. And so they might be a new big of their people. Breast cancer, who knows? But it's Ah, that's what is exciting for me. Well, it's exciting to see how these various research updates are changing the breast cancer landscape for the better. And I want to thank my guest Dr Bora limb for joining me to discuss some of the latest data presented at ASCO. Dr Lim. It was great having you on the program. Thank you very much, Mario. You've been listening to breaking Boundaries and breast cancer sponsored by Lily. To access other episodes of the series visit reach MD dot com, where you could be part of the knowledge. Thank you for listening. The preceding program was sponsored by Lily. Content for the series is produced and controlled by Reach MD. This series is intended for healthcare professionals on Lee. To revisit any part of this discussion and to access other episodes in the series visit, reach MD dot com. Thank you for listening