Breast Cancer Subtype Influences Pattern of Intracranial Recurrence in Metastatic Breast Cancer Treated with Stereotactic Radiosurgery
Purpose: Brain metastases occur in 10 –30% of patients with metastatic breast cancer (mBC) [1]. Stereotactic radiosurgery (SRS) has become an established treatment modality for brain metastases in mBC, providing a less neurotoxic option than whole brain radiotherapy [2]. The aim of this study was to study the pattern of intracranial r elapse following SRS in different breast cancer subtypes. (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: J.R. Galante, P. Abdul Haris, J. Timbres, S. Hassan, K. Blythe, K. Chia, A. Swampillai, L. Brazil, E.J. Sawyer, O. Al-Salihi Source Type: research
Patterns of Response to Treatment and Further Treatment on Progression in Patients Receiving CDK4/6 Inhibitors (CDK4/6i) for ER+ve, HER2-ve Metastatic Breast Cancer (MBC)
Purpose: CDK4/6i in combination with endocrine treatment (ET) increases response rates and prolongs progression-free survival (PFS) in patients with ER+ve HER2-ve MBC when used in the first- or second-line setting. The patterns of response to treatment with CDK4/6i are not well characterised in the literature and treatment used at the point of progression is not standardised. (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: R. Goh, A. Makris, A. Guppy, C. Westbury Source Type: research
Real-world Experience within Standard NHS Use of Traztuzumab Deruxtecan as Late Line Therapy for Advanced HER-2-positive Breast Cancer
Purpose: The authorisation of traztuzumab deruxtecan (Enhertu) in March 2021 within the NHS is based on phase II study data [1], reporting a response rate (RR) of 61%, with preliminary overall survival (OS) of 24.6 months, which is remarkable in a heavily pre-treated HER2-positive population. Although impressive, this data should be backed up by further phase III data, or through robust data from real-world use of this drug. (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: S. Graef, R. Kussaibati, K. Herring, L. Pallan, M. Jafri, M. Tsalic, D. Henderson, R. Thompson, D. Rea Source Type: research
The Importance of One-step Nucleic Amplification Assay (OSNA) in Early Breast Cancer Patients Who Have Had Upfront Breast Cancer Surgery
Purpose: To audit the diagnostic service at Croydon University Hospital and identify how many newly diagnosed early breast cancer patients with initially clinically node-negative disease had a change in lymph node (LN) status following sentinel lymph node biopsy (SLNB) using one-step nucleic acid amplification assay (OSNA). (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: S. Hudson-Phillips, A. Nanda, N. Patel, S. Maheshwaran, J. Parikh, N. Bees, A. Arnaout, L. Alarcon, S. Horn, S. Joshi, L. Noor, S. Nimalasena, N. Somaiah, J. Noble, W. Al Sarakbi, U. Asghar Source Type: research
Streamlining Breast Radiotherapy Pathway: from Breast PTV, Implementation of Auto-plan Breast Script (Inverse Planning IMRT) and ‘as Per Protocol Approval’ at Oxford University Hospitals NHS Foundation Trust (OUH)
Purpose: Breast radiotherapy represents a significant workload. At the OUH clinicians had to approve tangential fields, plans were optimised using forward plan IMRT and a final clinician approval was required before treatment. This pilot aimed to implement breast CTV [1] to facilitate inverse planning IMRT and ‘as per protocol approval’ by a senior physicist to shorten the breast radiotherapy pathway and allow patients to start radiotherapy sooner. (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: H. Jones, E. Burke, A. Gallagher, S. Padmanaban, S. Oliveros Source Type: research
Single-centre Experience Comparing PBI to WBRT and the Effects on Volume of Breast Tissue Treated, Heart and Lung Dosimetry
Purpose: The IMPORT-LOW trial demonstrated non-inferiority of partial-breast radiotherapy (PBI) compared with standard whole breast radiotherapy (WBRT) with regards to local relapse in patients with early breast cancer with equivalent or fewer late normal tissue effects at 5 years [1]. This led to UK practice change, with selected low-risk patients offered PBI [2]. We aim to evaluate our single-centre experience by comparing volume of breast tissue treated, heart and lung dosimetry in patients treated with PBI compared to WBRT. (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: R. Kanani, A. Chowdhury, M. Lovegrove, A. Anderson, K. Szubert, M. Chiu, S. Needleman Source Type: research
Audit to Evaluate Recurrence Rates in Patients with DCIS Treated with Adjuvant Radiotherapy and the Role of Endocrine Treatment
Purpose: Ductal carcinoma-in-situ (DCIS) comprises 20 –25% of screening detected breast cancers [1], with a low 20-year mortality rate of 3% [2]. Radiotherapy has been found to halve the likelihood of recurrence, versus breast-conserving surgery (BCS) alone, to 15% at 10 years [3–5]. There is conflicting evidence if endocrine therapy gives a signif icant benefit in patients treated with BCS and radiotherapy [6,7]. Furthermore, endocrine therapy can cause significant morbidity and up to 20% of patients do not tolerate the full course of treatment [8]. (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: R. Khan, P. Muehlschlegel, M. Conwill, M. Kubiak, M. Chiu, S. Needleman Source Type: research
Toxicity and Healthcare Utilisation of Dose-dense Chemotherapy for Early Breast Cancer
Purpose: Clinical trials provide evidence that dose-dense chemotherapy (ddC) is more efficacious than standard chemotherapy schedules in the treatment of early breast cancer (EBC). The impact on toxicity and healthcare utilisation remains uncertain in real-world populations. The aim of this retrospective adjusted cohort comparison was to measure the impact following adoption of ddC. (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: B. Langley, M. Brennan, D. Cameron, L. Hayward, P.S. Hall Source Type: research
A Retrospective Study of Fulvestrant Monotherapy in HR-positive, HER2-negative Advanced Breast Cancer – a Real-life Experience in a UK Centre
Purpose: The study aim was to assess the demographics and clinical outcomes of patients with hormone receptor-positive, HER2-negative advanced breast cancer who received single-agent fulvestrant, a selective oestrogen receptor degrader (SERD), in East and North Hertfordshire NHS Trust. (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: A.S. Malek, M. Bienz, N. Shah Source Type: research
Impact of Adjuvant Abemaciclib on Service Provision within a District General Hospital Cancer Centre
Purpose: Two years of adjuvant abemaciclib with endocrine therapy was approved by NICE [1] in July 2022 for hormone receptor-positive (HR+) HER2-negative (HER2 –) node-positive early breast cancer (EBC) at high-risk of recurrence. There is concern around additional oncology service provision needs of this cohort who would previously have been discharged to surveillance. We have therefore reviewed our service to estimate the impact of this additional trea tment on projected service provision needs. (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: Y. Odding, P. Barnes Source Type: research
Breast Cancers with a HER2/CEP17 Ratio of 2.0 or Greater and an Average HER2 Copy Number of Less Than 4.0 per Cell: Frequency, Characteristics and Survival Outcomes in those Receiving HER2-targeted Treatment
Purpose: 2018 ASCO CAP testing guidelines for HER2 recommended a change from ‘positive’ to ‘negative’ in cases of IHC 2+, FISH HER2/CEP17 ratio ≥2.0 and HER2 copy number (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: G. Patel, Y.-C. Lam, J. Brown, G. Donald, C. Harper-Wynne Source Type: research
A UK Real-world Evaluation of Efficacy and Toxicity of Second-line Trastuzumab Emtansine and Third-line Trastuzumab Deruxtecan in HER2-positive Advanced Breast Cancer
Purpose: Trastuzumab emtansine is routinely offered to patients in the second-line setting for advanced human epidermal growth factor receptor 2 (HER-2)-positive breast cancers. There is a paucity of UK real-world data on the progression-free survival (PFS) with trastuzumab emtansine therapy after prior pertuzumab and the risk of cardiotoxicity. Trastuzumab deruxtecan is currently approved for use after 2 or more anti-HER2 therapies based on DESTINY-Breast01 single-arm trial showing an overall response rate of 60.9% and median PFS of 16.4 [1]. (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: S. Peters, H.C. Tang, T. Shafiq, S. Karim, S. Khan, S. Trivedi, A. Anand, H.B. Sheikh, S. Saghir, J. Lui, D.S. Prabhu, T. Mathew, E.A. Rakha, S. Madhusudan Source Type: research
Health Inequality in Breast Cancer Patients: a Single Institution Review
Purpose: Locally advanced breast cancer occurs in 10 –30% of new patients, and rarely with fungating breast wounds (FBW) [1]. FBW occurs from infiltration into skin, blood and lymphatics and if left untreated may have significant physiological, psychological and emotional consequences on patients and families [1,2]. Management requires systemic trea tment, alongside wound care and radiotherapy [1,3]. Ethnicity has been shown to impact outcomes of breast cancer, with higher mortality found in Black women compared to Caucasians [5]. (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: E. Scott, A. Chowdhury, R. Kanani, M. Chiu, S. Needleman Source Type: research
Palbociclib or Ribociclib with Aromatase Inhibitor in Post-menopausal Women with ER+/HER2 – Advanced Breast Cancer? Real-world Overall Survival Evidence
Purpose: The CDK4/6 inhibitors, palbocilib [1] and ribociclib [2,3], have shown significant improvements in progression-free survival (PFS) in ER+/HER2 – advanced breast cancers. In the MONALEESA-2 trial, ribociclib showed a significant median overall survival (OS) of 63.9 months [4]. However, in the PALOMA-2 study [5], palbociclib showed a median OS of 53.9 months that was non-significant. The observed differences in OS have generated uncertaint y around which CDK4/6 inhibitor to choose in routine clinical practice. (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: H.K.C. Tang, K. De Souza, O. Ahmad, T. Shafiq, S. Khan, A. Anand, S. Karim, S. Trivedi, E.A. Rahka, S. Madhusudan Source Type: research
Should Locoregional Treatment be Performed in de novo Metastatic Breast Cancer? A Retrospective Single-centre Experience
We report the impact of different LRTs on breast cancer survival in this heterogeneous disease. (Source: Clinical Oncology)
Source: Clinical Oncology - May 6, 2023 Category: Radiology Authors: J. Walker, J. Timbres, S. Kendall, E. Sawyer, J. Mansi, G. Azad Source Type: research
