Christopher Twelves, MD, Professor and Honorary Consultant in Medical Oncology, University of Leeds, highlights key findings from the 2012 San Antonio Breast Cancer Symposium, which took place in December 2012.

In the adjuvant setting, Twelves says, there is clear indication from the HERA trial that one year of trastuzumab is as effective as two years of trastuzumab. This trial showed that disease-free survival and overall survival (OS) was similar with both treatment durations.

In patients with HER2-positive metastatic breast cancer, the novel therapies T-DM1 and pertuzumab have proven substantial effectiveness.

In the endocrine setting, data from the ATLAS trial showed that 10 years of the hormonal therapy tamoxifen reduced mortality risk by 2.8% and the rate of recurrence by 25%, demonstrating superiority to five years of tamoxifen.

In hormone receptor-positive metastatic breast cancer, everolimus has shown the ability to reverse resistance, Twelves says. In final progression-free survival (PFS) analysis of the phase III BOLERO-2 trial, data demonstrated that the addition of everolimus to exemestane prolonged PFS in all patient subsets.

A larger dose of fulvestrant was superior in the CONFIRM trial, offering another option in ER-positive metastatic breast cancer patients. The median OS in the 500 mg arm was 26.4 months compared to 22.3 months in the 250 mg arm (HR = 0.81; 

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Dr. Twelves Highlights Findings From the 2012 SABCS

Christopher Twelves, MD, Professor and Honorary Consultant in Medical Oncology, University of Leeds, discusses results from a phase III trial that compared capecitabine to eribulin mesylate in earlier lines of treatment for women with metastatic breast cancer.

Capecitabine is the current standard in early-line treatments for metastatic breast cancer. Eribulin had a great challenge to overcome, since it was compared to what is consider one of the best drugs in this circumstance, explains Twelves.  

The trial showed trends toward the superiority of eribulin in this setting but the results were still considered to be statistically negative, states Twelves. In the trial, overall survival was increased by 15.9 months with eribulin compared to 14.5 months for capecitabine with a P value of .305. 

The seemingly superior nature of eribulin in these patients prompted further investigation into subpopulation analyses. Overall, HER2-positive patients did not benefit from eribulin while those with HER2- and ER-negative tumors responded well to eribulin. Twelves notes that patients with triple-negative breast cancer seemed to benefit substantially more from treatment with eribulin compared to capecitabine, warranting further study. 

Christopher Twelves, MD, discusses results from a phase III trial that compared capecitabine to eribulin mesylate in women with metastatic breast cancer. 

Dr. Twelves Compares Eribulin and Capecitabine

Christopher Twelves, MD, Professor of Clinical Cancer Pharmacology and Oncology and Head of the Clinical Cancer Research Group at the University of Leeds in the United Kingdom on the Value of the Negative Iniparib Trial Results

Dr. Twelves on the Value of the Iniparib Trial Results

Christopher Twelves, MD, Professor of Clinical Cancer Pharmacology and Oncology and Head of the Clinical Cancer Research Group at the University of Leeds in the United Kingdom on Negative Phase III Iniparib Announcements

Dr. Twelves on Negative Phase III Iniparib Announcements

Christopher Twelves, MD, Professor of Clinical Cancer Pharmacology and Oncology and Head of the Clinical Cancer Research Group at the University of Leeds in the United Kingdom Describes Iniparib Clinical Trials

Christopher Twelves, MD

Articles

Dr. Twelves Highlights Findings From the 2012 SABCS

Dr. Twelves Compares Eribulin and Capecitabine

Dr. Twelves on the Value of the Iniparib Trial Results

Dr. Twelves on Negative Phase III Iniparib Announcements

Dr. Twelves Describes Iniparib Clinical Trials