Breast Cancer | Hope S Rugo, MD

Breast Cancer Update, Issue 4, 2019 — Part 1: Our interview with Dr Rugo highlights the following topics as well as cases from her practice: Biology of triple-negative breast cancer (TNBC); implications for therapeutic decision-making (00:00) Median overall survival estimates for patients with metastatic TNBC (03:55) Survival outcomes for patients with metastatic ER-positive and HER2-positive breast cancer (05:42) Case: A woman in her early 30s with localized TNBC receives neoadjuvant chemotherapy on the control arm of the I-SPY 2 trial (08:27) Genetic testing for patients with TNBC (12:58) Fertility preservation in young women undergoing therapy for breast cancer (14:40) Perspective on the use of GnRH agonists for premenopausal women with TNBC (16:27) Importance of providing support to patients coping with a diagnosis of TNBC (18:31) I-SPY 2 trial: Neoadjuvant and personalized adaptive novel agents to treat breast cancer (20:36) Novel agents under evaluation in the I-SPY 2 trial (23:30) Investigation of immune checkpoint inhibitor combination approaches (25:43) Cooling caps to reduce chemotherapy-related hair loss (28:25) Use of frozen gloves and socks to lessen chemotherapy-induced peripheral neuropathy (31:26) Coping with the side effects of chemotherapy (32:32) Case: A woman in her early 60s with metastatic TNBC is treated with atezolizumab and nab paclitaxel (36:12) Importance of accurately determining tumor of origin in patients who present with metastatic disease after diagnosis of multiple primary cancers (39:10) Approach to genetic testing for women with metastatic TNBC (41:51) Use of genetic test results in clinical decision-making (45:57) Improvement in overall survival with atezolizumab and nab paclitaxel for patients with PD-L1-positive TNBC (47:33) Response and tolerability of atezolizumab with nab paclitaxel on the IMpassion130 study (50:37) Thyroid dysfunction associated with immune checkpoint inhibitors (53:26) Biologic rationale for the investigation of immune checkpoint inhibitors in breast cancer (56:36) Activity of anti-PD-1/PD-L1 antibodies in patients with breast cancer (58:25) Design, eligibility and outcomes of the IMpassion130 study evaluating atezolizumab with nab paclitaxel as first-line therapy for advanced TNBC (1:01:01) Therapeutic approach for patients with TNBC and BRCA mutations (1:06:05) Case: A woman in her early 40s with a germline BRCA1 mutation receives chemotherapy followed by maintenance olaparib for metastatic TNBC (1:09:16) Efficacy of olaparib and talazoparib for patients with advanced breast cancer and a germline BRCA mutation (1:13:16) Tolerability profile of olaparib versus talazoparib (1:17:22) Emerging data with the novel antibody-drug conjugates sacituzumab govitecan, trastuzumab deruxtecan and ladiratuzumab vedotin for advanced breast cancer (1:19:39) CME Information and select publications