Lori Goldstein, MD, the director of the Naomi and Phil Lippincott Breast Evaluation Center, Fox Chase Cancer Center, discusses a neoadjuvant trial of lapatinib and trastuzumab with or without endocrine therapy for 12 weeks vs. 24 weeks in patients with HER2 overexpressing breast cancer.

The study determined that a 24-week regimen was more effective than a 12 -week regimen.  While it is clear that a longer regimen is beneficial, it is unknown how this will impact overall survival, or if endocrine therapy given only before surgery has the same impact if given before and after surgery, says Goldstein.

Videos

Dr. Lori Goldstein on Neoadjuvant Treatment for HER2+ Breast Cancer

Lori Goldstein, MD, director, The Naomi and Phil Lippincott Breast Evaluation Center, deputy associate director, Clinical Research, Fox Chase Cancer Center, discusses mechanisms of resistance to endocrine therapy.

Some mechanisms of resistance to endocrine therapy have to do with ER co-regulation and downstream effects (signaling transduction interaction) with PI3K, AKT3, and MAPK. In her presentation at the 

13th Annual International Congress on the Future of Breast CancerÂ®

, Goldstein discussed new agents and new opportunities in this space: mTOR, HDAC, and CDK4/6 inhibitors.

Goldstein notes that there is also earlier data in the areas of SARC inhibition and androgen synthesis inhibition.

Dr. Goldstein on Mechanisms of Resistance to Endocrine Therapy

Lori J. Goldstein, MD, founded the Naomi and Phil Lippincott Breast Evaluation Center (BEC) at Fox Chase Cancer Center over 20 years ago. This multidisciplinary center not only meets the physical demands of cancer patients but also meets their psychosocial needs.

The center employs both social workers and educators that provide education about both the resources available and vocabulary. Not only does the center address the needs of the patients but also the needs of the whole family.

BEC addresses the psychosocial needs of breast cancer patients in multiple ways, it has several clinical psychiatrists on staff, special programs for women with young families, and past patients have donated several items they found useful.

Naomi and Phil Lippincott Breast Evaluation Center

Dr. Lori Goldstein from Fox Chase Cancer Center on the Fox Chase Breast Evaluation Center

Dr. Goldstein on the Fox Chase Breast Evaluation Center

Lori J. Goldstein, MD, director, The Naomi and Phil Lippincott Breast Evaluation Center, co-leader, Breast Cancer Clinical Research Program, Fox Chase Cancer Center, discusses the role of fulvestrant (Faslodex) in the metastatic breast cancer setting.

Fulvestrant is a selective estrogen receptor down-regulator (SERD) that is equivalent to aromatase inhibitors in the second-line setting and anastrozole (Arimidex) in the first-line setting.

The Phase III CONFIRM trial compared fulvestrant at doses of 250 mg and 500 mg in order to discover the best dosing schedule. The result of the trial is a 500 mg dose administered on days 1, 14 and 28, followed by 500 mg every 28 days.

Long-term trials suggest that fulvestrant offers a superior time to progression over anastrozole in the first-line setting. The trial investigating this idea is still in early phases but does supply further choices for patients with metastatic estrogen receptor positive breast cancer.

Dr. Lori Goldstein from Fox Chase Cancer Center on Fulvestrant in Metastatic Breast Cancer

Lori J. Goldstein, MD

Articles

Dr. Lori Goldstein on Neoadjuvant Treatment for HER2+ Breast Cancer

Dr. Goldstein on Mechanisms of Resistance to Endocrine Therapy

Dr. Goldstein on the Fox Chase Breast Evaluation Center

Dr. Goldstein on Fulvestrant in Metastatic Breast Cancer