Open access
Open access
Powered by Google Translator Translator

Oncology – Breast

News Release: Sacubitril/Valsartan May Reduce Chemotherapy-Induced Cardiotoxicity in High-Risk Cancer Patients

20 Nov, 2024 | 18:38h | UTC

Introduction: A recent study presented at the American Heart Association’s Scientific Sessions 2024 introduces sacubitril/valsartan, a widely used heart failure medication, as a potential protective agent against heart damage in high-risk cancer patients undergoing anthracycline chemotherapy. Anthracyclines, while effective for treating various cancers such as breast cancer, leukemia, and lymphoma, carry a significant risk of cardiotoxicity, leading to cardiomyopathy and heart failure. The SARAH trial aimed to evaluate whether sacubitril/valsartan could mitigate this risk and preserve cardiac function during chemotherapy.

Highlights: The SARAH trial was a randomized, double-blind, placebo-controlled study involving 114 high-risk cancer patients at Erasto Gaertner Hospital in Curitiba, Brazil. High risk was defined by elevated high-sensitivity troponin I levels post-anthracycline infusion, indicating early signs of cardiac injury. Participants, predominantly women with breast cancer (81%), were randomized to receive sacubitril/valsartan or a placebo over 24 weeks.

Key findings include:

  • Significant Reduction in Cardiotoxicity: Sacubitril/valsartan was associated with a 77% reduction in the relative risk of cardiotoxicity compared to placebo. Cardiotoxicity was measured as a ≥15% reduction in global longitudinal strain (GLS), a sensitive marker of left ventricular function.
  • Improvement in Cardiac Function: Patients in the sacubitril/valsartan group experienced an average improvement in GLS by 2.55%, whereas those in the placebo group showed an average decline of 6.65%.
  • Dose Titration and Tolerance: The medication was initiated at a dose of 24/26 mg twice daily and titrated every two weeks to a target of 97/103 mg twice daily or the highest tolerated dose without side effects. It was generally well tolerated, with hypotension being more common in the treatment group (14% vs. 1.8%) but no significant differences in other adverse events.
  • Independent of Other Factors: The protective effect of sacubitril/valsartan was consistent regardless of cumulative anthracycline dose, HER2 status, presence of hypertension, or patient age.

Conclusion: The findings from the SARAH trial suggest that sacubitril/valsartan may offer a promising strategy to prevent chemotherapy-induced cardiotoxicity in high-risk cancer patients. By preserving cardiac function during anthracycline treatment, this medication has the potential to improve patient outcomes, enhance quality of life, and reduce the long-term burden of heart failure among cancer survivors. Further research with larger, more diverse populations and extended follow-up is warranted to confirm these results and assess the impact on long-term clinical outcomes.

Source: This research was conducted by the Heart Institute at the University of São Paulo, Brazil, and presented at the American Heart Association Scientific Sessions 2024.

Primary Source: American Heart Association News Release
https://newsroom.heart.org/news/a-common-heart-failure-medication-may-help-prevent-heart-damage-related-to-chemotherapy-6906417

Secondary Sources:

 

Cohort Study: Levonorgestrel IUD Use Linked to Increased Breast Cancer Risk in Premenopausal Women

20 Oct, 2024 | 18:13h | UTC

Background: Levonorgestrel-releasing intrauterine systems (LNG-IUSs) are increasingly used, especially among Danish premenopausal women over 30 years old, as a preferred method of hormonal contraception. Previous studies have suggested an increased risk of breast cancer with LNG-IUS use but did not adequately address the duration of continuous use or account for other hormonal contraceptive exposures.

Objective: To assess the risk of breast cancer associated with continuous use of LNG-IUSs, accounting for other hormonal exposures.

Methods: In this nationwide Danish cohort study, 78,595 first-time LNG-IUS users aged 15–49 years from 2000 to 2019 were identified and matched 1:1 by birth year to nonusers of hormonal contraceptives. Exclusion criteria included prior hormonal contraceptive use within 5 years, previous cancer, postmenopausal hormone therapy, and pregnancy at baseline. Participants were followed from initiation until breast cancer diagnosis, other cancer, pregnancy, hormone therapy initiation, emigration, death, or December 31, 2022. Cox proportional hazards models adjusted for confounders estimated hazard ratios (HRs) for breast cancer associated with continuous LNG-IUS use.

Results: During a mean follow-up of 6.8 years, 1,617 breast cancer cases occurred: 720 among LNG-IUS users and 897 among nonusers. The mean age was 38 years. Continuous LNG-IUS use was associated with a higher breast cancer risk compared to nonuse (HR, 1.4; 95% CI, 1.2–1.5). HRs by duration were 1.3 (95% CI, 1.1–1.5) for 0–5 years, 1.4 (95% CI, 1.1–1.7) for >5–10 years, and 1.8 (95% CI, 1.2–2.6) for >10–15 years. Excess breast cancer cases per 10,000 users were 14 (95% CI, 6–23), 29 (95% CI, 9–50), and 71 (95% CI, 15–127), respectively. The trend test for duration was not statistically significant (P = .15).

Conclusions: Continuous use of LNG-IUSs was associated with an increased risk of breast cancer among women aged 15–49 years compared to nonuse of hormonal contraceptives. The absolute increase in risk was low.

Implications for Practice: Healthcare providers should inform women about the potential increased breast cancer risk associated with LNG-IUS use, especially considering its widespread and long-term use among premenopausal women. While the absolute risk increase is small, this information is essential for making informed contraceptive choices.

Study Strengths and Limitations: Strengths include the large, nationwide cohort and adjustment for multiple confounders. Limitations include potential underestimation of risk due to unrecorded LNG-IUS removals before the recommended duration, lack of a statistically significant trend with duration suggesting possible low statistical precision or non-causal association, and the possibility of unmeasured confounding.

Future Research: Further studies are needed to confirm these findings, clarify the causal relationship, and understand the mechanisms underlying the potential increased breast cancer risk with LNG-IUS use.

Reference: Mørch LS, Meaidi A, Corn G, et al. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. Published online October 16, 2024. DOI: http://doi.org/10.1001/jama.2024.18575

 

RCT: Pembrolizumab Plus Chemotherapy Improved Overall Survival in Early-Stage Triple-Negative Breast Cancer

18 Sep, 2024 | 16:08h | UTC

Background: Early-stage triple-negative breast cancer (TNBC) is an aggressive subtype with limited treatment options and poor prognosis. The phase 3 KEYNOTE-522 trial previously demonstrated that adding pembrolizumab to chemotherapy improved pathological complete response rates and event-free survival in this population.

Objective: To determine whether neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab improves overall survival compared to neoadjuvant chemotherapy alone in patients with early-stage TNBC.

Methods: In this multicenter, randomized, double-blind, placebo-controlled phase 3 trial (KEYNOTE-522), 1174 patients with previously untreated stage II or III TNBC were randomized 2:1 to receive neoadjuvant pembrolizumab (200 mg every 3 weeks) plus chemotherapy (paclitaxel and carboplatin, followed by doxorubicin–cyclophosphamide or epirubicin–cyclophosphamide) or placebo plus the same chemotherapy regimen. After surgery, patients received adjuvant pembrolizumab or placebo every 3 weeks for up to nine cycles. The primary endpoints were pathological complete response and event-free survival; overall survival was a key secondary endpoint.

Results: After a median follow-up of 75.1 months, the estimated 5-year overall survival was 86.6% in the pembrolizumab–chemotherapy group versus 81.7% in the placebo–chemotherapy group (hazard ratio for death, 0.66; P=0.002). The 5-year event-free survival was 81.2% versus 72.2%, respectively (hazard ratio for event or death, 0.65; 95% CI, 0.51–0.83). Grade 3 or higher treatment-related adverse events occurred in 77.1% of patients receiving pembrolizumab–chemotherapy and 73.3% receiving placebo–chemotherapy. Serious treatment-related adverse events occurred in 34.1% and 20.1% of patients, respectively.

Conclusions: Neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab significantly improved overall survival compared to chemotherapy alone in patients with early-stage TNBC.

Implications for Practice: The addition of pembrolizumab to standard neoadjuvant chemotherapy, followed by adjuvant pembrolizumab, should be considered a new standard of care for patients with high-risk, early-stage TNBC, offering a significant survival benefit.

Study Strengths and Limitations: Strengths include the large, international, randomized design, the use of a placebo control, and long-term follow-up. Limitations include the inability to isolate the effects of neoadjuvant versus adjuvant pembrolizumab and the exclusion of adjuvant capecitabine from the treatment protocol.

Future Research: Further studies should focus on identifying biomarkers predictive of response to pembrolizumab, optimizing the sequencing and duration of immunotherapy, and evaluating the addition of other agents to improve outcomes in early-stage TNBC.

Reference: Schmid P, et al. Overall Survival with Pembrolizumab in Early-Stage Triple-Negative Breast Cancer. N Engl J Med. 2024. DOI: http://doi.org/10.1056/NEJMoa2409932

 

Meta-Analysis: Moderate Hypofractionation Improves Safety and Cosmesis Over Conventional Fractionation in Breast Cancer Radiotherapy

17 Sep, 2024 | 11:14h | UTC

Background:

Breast cancer remains the most prevalent malignancy among women worldwide, with postoperative radiation therapy playing a crucial role in reducing locoregional recurrence and improving survival outcomes. Conventional fractionation (CF), involving a total dose of approximately 50 Gy delivered over five to six weeks in daily fractions of 1.8–2 Gy, has been the historical standard. In recent years, hypofractionated regimens—including moderate hypofractionation (MHF) and ultra-hypofractionation (UHF)—have emerged as alternatives that offer shorter treatment durations. Despite evidence supporting hypofractionation, its adoption varies due to concerns about potential side effects, cosmetic outcomes, and the limited long-term data on UHF.

Objective:

To provide a comprehensive assessment of various radiation dose fractionation schemes—CF, MHF, and UHF—in breast cancer, focusing on side effects, cosmesis, quality of life, recurrence risks, and survival outcomes.

Methods:

A systematic review and meta-analysis were conducted by searching Ovid MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials from inception to 23 October 2023. Randomized controlled trials comparing CF (daily fractions of 1.8–2 Gy over 5–6 weeks), MHF (fractions of 2.65–3.3 Gy over 3–5 weeks), and UHF (five fractions) were included. Two independent investigators screened studies, extracted data, and assessed risk of bias using the Cochrane Collaboration’s tool and the GRADE approach. Pooled risk ratios (RRs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. A network meta-analysis integrated all available evidence.

Results:

From 1,754 studies, 35 trials encompassing 20,237 patients were included. Compared with CF, MHF significantly reduced the risk of grade ≥2 acute radiation dermatitis:

  • All patients: RR, 0.59; 95% CI, 0.51–0.69; P<0.001.
  • Breast-Conserving Therapy: RR, 0.54; 95% CI, 0.49–0.61; P<0.001.
  • Post-Mastectomy: RR, 0.68; 95% CI, 0.49–0.93; P=0.02.

MHF also showed lower incidences of:

  • Hyperpigmentation: RR, 0.77; 95% CI, 0.62–0.95; P=0.02.
  • Grade ≥2 Breast Shrinkage: RR, 0.92; 95% CI, 0.85–0.99; P=0.03.

MHF was associated with improved cosmesis and quality of life compared to CF. Survival and recurrence outcomes were similar across UHF, MHF, and CF regimens. While UHF demonstrated comparable safety and efficacy profiles, data were less conclusive due to fewer trials and shorter follow-up periods.

Conclusions:

Moderate hypofractionation improves safety profiles, cosmetic outcomes, and quality of life compared with conventional fractionation while maintaining equivalent oncological efficacy. Ultra-hypofractionation shows promise with similar short-term safety and effectiveness but requires further research for definitive conclusions.

Implications for Practice:

  • Preferred Regimen: MHF should be considered the preferred radiation therapy regimen for breast cancer patients due to reduced side effects, improved cosmesis, shorter treatment duration, and maintained oncological outcomes.
  • Ultra-Hypofractionation Potential: UHF offers advantages of further reduced treatment times and patient convenience but requires additional long-term data before widespread adoption.
  • Resource Utilization: Adoption of hypofractionated regimens can improve healthcare resource utilization and enhance patient quality of life.

Study Strengths and Limitations:

Strengths include a comprehensive assessment of both clinical and patient-centered outcomes across a large number of randomized controlled trials, providing a multidimensional perspective crucial for informed clinical decision-making.

Limitations involve potential risk of bias due to lack of blinding in some studies, variability in outcome reporting across trials, and limited long-term data on UHF regimens.

Future Research:

Further studies are needed to solidify the evidence base for UHF, particularly regarding long-term safety and efficacy. Research should focus on optimizing fractionation regimens tailored to patient-specific factors, such as breast size and smoking status, to enhance outcomes.

Reference:

Lee SF, Kennedy SKF, Caini S, et al. Randomised controlled trials on radiation dose fractionation in breast cancer: systematic review and meta-analysis with emphasis on side effects and cosmesis. BMJ. 2024. doi:10.1136/bmj-2023-079089

 

RCT: Omission of axillary dissection noninferior to complete dissection in clinically node-negative breast cancer with sentinel-node metastases – N Engl J Med

25 May, 2024 | 18:57h | UTC

Study Design and Population: This noninferiority trial explored the effects of omitting completion axillary-lymph-node dissection in patients with clinically node-negative primary T1 to T3 breast cancer who had one or two sentinel-node macrometastases. A total of 2766 patients were enrolled and randomized 1:1 to either undergo sentinel-node biopsy only or completion dissection. Patients received adjuvant treatment and radiation therapy as per national guidelines, focusing on recurrence-free survival as a secondary end point.

Main Findings: The study reported that the 5-year recurrence-free survival rates were 89.7% in the sentinel-node biopsy-only group and 88.7% in the dissection group, with a country-adjusted hazard ratio for recurrence or death at 0.89 (95% CI, 0.66 to 1.19), significantly below the noninferiority margin (P<0.001). This outcome demonstrates the noninferiority of the less invasive sentinel-node biopsy approach compared to the traditional dissection method in managing sentinel-node macrometastases.

Implications for Practice: The findings suggest that for clinically node-negative breast cancer patients with sentinel-node macrometastases, omitting axillary-lymph-node dissection could be considered a viable treatment option, potentially reducing the surgical burden without compromising recurrence-free survival outcomes. This could lead to adjustments in surgical practice and patient care strategies, emphasizing a less invasive approach while maintaining clinical efficacy.

 

Reference (link to abstract – $ for full-text):

Boniface, J. et al. (2024). Omitting Axillary Dissection in Breast Cancer with Sentinel-Node Metastases. N Engl J Med, 390(13), 1163-1175. DOI: 10.1056/NEJMoa2313487.

 

USPSTF Guideline: Biennial screening mammography recommended for women aged 40-74 to reduce breast cancer morbidity and mortality

1 May, 2024 | 21:45h | UTC

Study Design and Population:

The US Preventive Services Task Force (USPSTF) performed a systematic review and collaborated on modeling studies to evaluate the effectiveness of various mammography-based breast cancer screening strategies. This assessment included factors such as age of initiation and cessation of screening, screening intervals, modalities, and the use of supplemental imaging. The population studied consisted of cisgender women and all other persons assigned female at birth who are 40 years or older and at average risk of breast cancer.

 

Main Findings:

The USPSTF concludes with moderate certainty that biennial screening mammography for women aged 40 to 74 years provides a moderate net benefit in reducing the incidence of and progression to advanced breast cancer, as well as in decreasing breast cancer morbidity and mortality. However, the evidence is insufficient to assess the benefits and harms of mammography screening in women aged 75 and older, as well as the use of supplemental screening with ultrasound or MRI in women with dense breasts.

 

Implications for Practice:

Based on these findings, the USPSTF recommends biennial screening mammography for women aged 40 to 74 years. This recommendation aims to optimize breast cancer outcomes while considering the balance of benefits and harms of screening. There is a need for further research to clarify the benefits and risks associated with mammography in women older than 75 and for those with dense breasts considering supplemental screening.

 

Commentary on X (thread – click for more)

 

Reference (link to free full-text):

Screening for Breast Cancer US Preventive Services Task Force Recommendation Statement. JAMA. Published online April 30, 2024. doi:10.1001/jama.2024.5534

 

RCT: Aspirin fails to improve invasive disease-free survival in breast cancer patients

1 May, 2024 | 21:37h | UTC

This randomized clinical trial assessed the efficacy of daily aspirin (300 mg) as adjuvant therapy in reducing breast cancer recurrence among 3020 participants with high-risk nonmetastatic breast cancer across the United States and Canada. The study, which followed participants for a median of 33.8 months, found no significant benefit of aspirin on invasive disease-free survival or overall survival, with the hazard ratio for disease-free survival being 1.27 (95% CI, 0.99-1.63; P = .06) and for overall survival 1.19 (95% CI, 0.82-1.72). Given these findings, aspirin is not recommended as an adjuvant treatment for breast cancer, challenging earlier observational data that suggested a potential survival benefit in breast cancer survivors. The trial was concluded early due to the lack of observed benefits, with adverse event rates being similar in both the aspirin and placebo groups.

 

Commentary on X:

 

Reference (link to abstract – $ for full-text):

Wendy Y. Chen et al. (2024). Aspirin vs Placebo as Adjuvant Therapy for Breast Cancer: The Alliance A011502 Randomized Trial. JAMA, Published online April 29, 2024. doi:10.1001/jama.2024.4840

 

Cohort Study | Potential negative survival impact of PPI and palbociclib co-administration in breast cancer patients

8 Aug, 2023 | 13:07h | UTC

Concomitant Use of Proton Pump Inhibitors and Palbociclib Among Patients With Breast Cancer – JAMA Network Open

Commentary: Proton Pump Inhibitors May Compromise Efficacy of Palbociclib in Patients With Breast Cancer – Cancer Therapy Advisor

 

RCT | Mammography screening with AI reduces workload by 44.3% without loss in detection efficacy

4 Aug, 2023 | 12:13h | UTC

Artificial intelligence-supported screen reading versus standard double reading in the Mammography Screening with Artificial Intelligence trial (MASAI): a clinical safety analysis of a randomised, controlled, non-inferiority, single-blinded, screening accuracy study – The Lancet Oncology (link to abstract – $ for full-text)

News Release: First randomized trial finds AI-supported mammography screening is safe and almost halves radiologist workload – Lancet

Commentaries:

Large Mammography Study Shows Significant Benefits with AI-Aided Screening – Diagnostic Imaging

Expert reaction to interim safety analysis of randomised trial on AI-supported mammography screening – Science Media Centre

 

Systematic Review | Interstitial lung disease incidence at 11.7% in metastatic breast cancer patients using trastuzumab deruxtecan

3 Aug, 2023 | 13:36h | UTC

Incidence of interstitial lung disease and cardiotoxicity with trastuzumab deruxtecan in breast cancer patients: a systematic review and single-arm meta-analysis – ESMO Open

 

Review | Atypical hyperplasia of the breast: Clinical cases and management strategies

3 Aug, 2023 | 13:07h | UTC

Atypical hyperplasia of the breast: Clinical cases and management strategies – Cleveland Clinic Journal of Medicine

 

Systematic Review | Post-mastectomy RT likely lowers recurrence and improves survival in early breast cancer with 1-3 positive nodes

25 Jul, 2023 | 13:34h | UTC

Post‐mastectomy radiotherapy for women with early breast cancer and one to three positive lymph nodes – Cochrane Library

Summary: Is X-ray treatment (radiotherapy) after removal of breast tissue (mastectomy) better than no X-ray treatment in women diagnosed with breast cancer that has spread to one to three armpit lymph nodes? – Cochrane Library

 

RCT | Total breast reconstruction with autologous fat transfer using an expansion device vs implants in patients with breast cancer

28 Jun, 2023 | 13:12h | UTC

Effect of Total Breast Reconstruction With Autologous Fat Transfer Using an Expansion Device vs Implants on Quality of Life Among Patients With Breast Cancer: A Randomized Clinical Trial – JAMA Surgery (link to abstract – $ for full-text)

See also: Visual Abstract

Author Interview: Effect of Breast Reconstruction With Autologous Fat Transfer vs Implants on Quality of Life – JAMA

 

M-A | Effectiveness of physical therapy in axillary web syndrome after breast cancer

27 Jun, 2023 | 13:28h | UTC

Effectiveness of physical therapy in axillary web syndrome after breast cancer: a systematic review and meta-analysis – Supportive Care in Cancer

 

Review | Treatment options in HER2-low breast cancer and proposed treatment sequencing algorithm

26 Jun, 2023 | 00:27h | UTC

A review of treatment options in HER2-low breast cancer and proposed treatment sequencing algorithm – Cancer

 

Cohort Study | Steady reduction in breast cancer mortality from 1993-2015 in England

22 Jun, 2023 | 14:58h | UTC

Breast cancer mortality in 500 000 women with early invasive breast cancer in England, 1993-2015: population based observational cohort study – The BMJ

Invited Commentary: Risk of breast cancer death after a diagnosis of early invasive breast cancer – The BMJ

News Release: Women diagnosed with early breast cancer today are much less likely to die from the disease than 20 years ago – University of Oxford

 

Commentary on Twitter

 

Updated Guidance | Diagnosis and treatment of Early and locally advanced breast cancer

22 Jun, 2023 | 14:52h | UTC

Early and locally advanced breast cancer: diagnosis and management – National Institute for Health and Care Excellence

 

RCT | Increased detection of metastases via PET-CT alters treatment path in locally advanced breast cancer

16 Jun, 2023 | 14:02h | UTC

Impact of 18F-Labeled Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography Versus Conventional Staging in Patients With Locally Advanced Breast Cancer – Journal of Clinical Oncology (link to abstract – $ for full-text)

 

RCT | Dose-escalated simultaneous integrated boost radiotherapy in early breast cancer

15 Jun, 2023 | 15:04h | UTC

Dose-escalated simultaneous integrated boost radiotherapy in early breast cancer (IMPORT HIGH): a multicentre, phase 3, non-inferiority, open-label, randomised controlled trial – The Lancet

 

ASCO Guideline Update | Human epidermal growth factor receptor 2 testing in breast cancer

14 Jun, 2023 | 14:15h | UTC

Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology–College of American Pathologists Guideline Update – Journal of Clinical Oncology

Commentary: ASCO-CAP Guideline Update Confirms Previous Recommendations for HER2 Testing in Breast Cancer – ASCO Daily News

 

RCT | Capivasertib–fulvestrant improves PFS vs. fulvestrant alone in HR+ advanced breast cancer

13 Jun, 2023 | 13:54h | UTC

Capivasertib in Hormone Receptor–Positive Advanced Breast Cancer – New England Journal of Medicine (link to abstract – $ for full-text)

Video: Capivasertib in Advanced Breast Cancer | NEJM

Commentary: Capivasertib-fulvestrant therapy increases PFS in HR-positive breast cancer – MedicalXpress

 

Commentary on Twitter

 

RCT | Adding dalpiciclib to standard letrozole or anastrozole treatment outperforms placebo in HR+, HER2- advanced breast cancer

7 Jun, 2023 | 13:44h | UTC

Dalpiciclib plus letrozole or anastrozole versus placebo plus letrozole or anastrozole as first-line treatment in patients with hormone receptor-positive, HER2-negative advanced breast cancer (DAWNA-2): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial – The Lancet Oncology (link to abstract – $ for full-text)

Commentary: Dalpiciclib Combo Improves PFS Vs Placebo in HER2– Advanced Breast Cancer – Cancer Network

 

Review | Advances in systemic therapies for triple negative breast cancer

5 Jun, 2023 | 13:36h | UTC

Advances in systemic therapies for triple negative breast cancer – The BMJ

 

USPSTF Draft Statement recommends biennial screening mammography for women ages 40 to 74 years

22 May, 2023 | 13:56h | UTC

Breast Cancer: Screening – U.S. Preventive Services Task Force

Critical perspectives on the statement:

Earlier screening for breast cancer: Benefits and harms – Lown Institute

Video: Mammography – Does it save lives? | The USPSTF is incorrect | I review ALL the data – By Dr. Vinay Prasad

Why more mammograms aren’t the solution to breast cancer – Vox

 

ASCO Guideline Update | ESR1 mutation testing for HR+/HER2- metastatic breast cancer therapy

22 May, 2023 | 13:27h | UTC

Testing for ESR1 Mutations to Guide Therapy for Hormone Receptor–Positive, Human Epidermal Growth Factor Receptor 2–Negative Metastatic Breast Cancer: ASCO Guideline Rapid Recommendation Update – Journal of Clinical Oncology

Commentary: Guideline Update Provides New Testing and Treatment Recommendations for Patients With ER-Positive, HER2-Negative Metastatic Breast Cancer With ESR1 Mutations – ASCO Daily News

 

Stay Updated in Your Specialty

Telegram Channels
Free

WhatsApp alerts 10-day free trial

No spam, just news.