Breast cancer

News in brief: Dual immunotherapy in early NSCLC; Menopausal symptoms in breast cancer survivors; Thrombotic events with CDK 4/6 inhibitors

Thursday, 25 Feb 2021

Dual immunotherapy shows promise in early stage NSCLC

The first randomised study to report on the role of neoadjuvant combination checkpoint inhibitors for operable, early stage non-small cell lung cancer (NSCLC) has shown promising results for nivolumab plus ipilimumab. Results from the NEOSTAR phase 2 trial published in Nature Medicine showed that combined neoadjuvant therapy produced a significant clinical benefit, as assessed by major pathologic response (MPR) rate, as well as enhanced tumour immune cell infiltration and immunological memory, according to researchers from the University of Texas MD Anderson Cancer Center. The trial met its prespecified primary endpoint efficacy threshold in the combination arm, with eight of 21 treated patients (38%) achieving MPR, defined as ≤10% viable tumour at surgery. However with MPR in five of 23 treated patients (22%), neoadjuvant nivolumab monotherapy did not meet the efficacy benchmark.

Breast cancer survivors want better treatment for menopausal symptoms

Menopausal symptoms, sexual problems, mood and sleep difficulties are common after breast cancer and often not effectively managed, an Australian study has found.

A survey of more than 500 women conducted by the Breast Cancer Network Australia found that more than a quarter reported severe symptoms chemotherapy and endocrine therapy. A third (32%) were offered treatment, mostly by GPs (33%) or oncologists (26%), with half finding this “somewhat effective” and 34% reporting it ineffective. The majority (60%) wanted more support to manage their symptoms, according to the findings published in Breast Cancer Research and Treatment.

High thrombotic events with CDK 4/6 inhibitors for breast cancer

Higher rates of thrombotic events in women with breast cancer on CDK 4/6 inhibitors have been reported in real-world practice compared to rates reported from clinical trials, according to US researchers.

Investigators at Oregon Health & Science University looked at rates of thrombosis  in more than 260 adult breast cancer patients prescribed palbociclib, ribociclib, or abemaciclib.

The retrospective analysis revealed a much higher rate of events during treatment or within 30 days of CDK inhibitor discontinuation than reported in clinical trials with arterial thrombosis comprising over one-third of events. The highest incidence was with palbociclib followed by ribociclib, according to the study.

Researchers reported 29 thrombotic events occurring in 26 (9.8%) women. Of these events, 72% were venous and 34% were arterial. The 1‐year incidence of thrombosis was 10.4% overall, 10.9% on palbociclib, 8.3% on ribociclib, and 4.8% on abemaciclib.

Haemoglobin less than 10 g/dL was a statistically significant predictor of thrombosis (HR 3.53, P: .014) researchers note adding that thrombosis was associated with reduced overall survival (HR 1.28, P: .128, median 7.3 months) compared to not having a CDK‐associated clot (median 35.7 months).

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