What are the top 5 breast cancer advancements of 2017?

Targeted therapies: PARP inhibitors

A highlight from American Society of Clinical Oncology (ASCO) this year (2–5 June 2017, IL, USA) was the OlympiAD trial Data. This Phase III clinical trial compared PARP inhibitor (olaparib) monotherapy with standard therapy in approximately 300 patients with a germline BRCA mutation and HER2–negative metastatic breast cancer. Data from the study demonstrated that olaparib provided a significant benefit over standard therapy, reduced the chance of progression of advanced BRCA-related breast cancer by 42%, and delayed progression by 2.8 months

Pre-pectoral implants

Pre-pectoral implant-based surgery, which works by placing the implant directly under the skin and over the muscle, has gained popularity due to its more minimal approach compared with traditional breast reconstruction methods. This transition to muscle-sparing reconstruction has demonstrated excellent short-term outcomes; the key advantages being that it avoids animation deformity, helps prevent shoulder dysfunction, and has a lower incidence of capsular contracture. While the initial short-term results are promising, long-term outcomes are yet to be reported and this is an area that will be one to watch over the coming year

Avoidance of further axillary surgery in sentinel node-positive patients

Another clinical highlight from this year was the results from the American College of Surgeons Oncology Group ACOSOG Z0011 trial, which questioned the belief that all breast cancer axillary nodes must be removed.
The multicentre, randomized Phase III trial demonstrated that 10-year overall survival for patients treated with sentinel lymph node dissection alone was noninferior to overall survival for those treated with axillary lymph node dissection (among women with T1 or T2 invasive primary breast cancer, no palpable axillary adenopathy and one or two sentinel lymph nodes containing metastases).
The findings demonstrated that avoidance of further axillary surgery in sentinel node-positive patients was feasible and did not support routine use of axillary lymph node dissection in this patient population, based on 10-year outcomes.
“Axillary lymph node dissection is an effective method of maintaining regional control but it is associated with a significant risk [for]complications such as lymphedema, numbness, axillary web syndrome and decreased upper-extremity range of motion”.

CDK4/6 inhibitors

At this year’s ASCO meeting, data were presented from the MONARCH 2 Phase iII trial, which demonstrated that adding abemaciclib to fulvestrant reduced the risk of disease progression or death by 45% versus fulvestrant alone in patients with HR+/HER2- advanced breast cancer who progressed on endocrine therapy.
Later in the year, the US FDA approved abemaciclib for use in combination with fulvestrant in women with HR+/HER2- advanced breast cancer with disease progression following endocrine therapy. This CDK4/6 inhibitor was approved as a monotherapy for patients with HR+/HER2- breast cancer with metastatic disease who have previously received endocrine therapy and chemotherapy.

APHINITY trial

Data from the APHINITY Phase III trial,  presented at ASCO in June and published in the New England Journal of Medicine in July, demonstrated a very small benefit of chemotherapy plus trastuzumab plus placebo versus chemotherapy plus trastuzumab plus pertuzumab as adjuvant therapy alone on risk of recurrence of invasive disease in patients with HER2-positive early breast cancer.
“The addition of pertuzumab to trastuzumab-based chemotherapy improved disease-free survival in the adjuvant setting for patients with early-stage HER2-positive breast cancer. Double antibody therapy using trastuzumab and pertuzumab is commonly used in the neoadjuvant setting, but long-term outcomes data were lacking. Results from the APHINITY trial support the use of pertuzumab in the adjuvant setting, especially in women at high risk of distant metastases.
Following on from this, the FDA granted a priority review to a supplemental biologics license application for pertuzumab for use in combination with trastuzumab and chemotherapy for the adjuvant treatment of patients with HER2-positive early breast cancer.


More in the following link: https://www.oncology-central.com/2017/10/24/top-5-breast-cancer-advancements-2017/