Some older women with luminal A breast cancer can safely abandon radiation therapy, studies show

Source / Disclosure The issuer: sauce: Whelan TJ, et al. Abstract LBA501. Announcement location: ASCO Annual Meeting; June 3-7, 2022. Chicago. Disclosure: Whelan reports research funding from Exact Sciences to his institution. See the summary for relevant financial disclosures of all other researchers. Add topics to email alerts Receive an email when a new article is posted Please enter your email address to receive emails when new articles are posted .. "data-action " subscribe "> Subscribe The request could not be processed. Please try again later.If you continue to have this issue, please contact us customerservice@slackinc.com.. Return to Healio Chicago — A prospective study presented at the ASCO Annual Meeting shows that patients with low-grade luminal A breast cancer over the age of 55 receiving endocrine therapy can safely avoid radiation therapy after breast-conserving surgery. "We estimate that these results apply to as many as 30,000 to 40,000 women a year who can avoid the prevalence, inconvenience and cost of radiation therapy." Timothy Joseph Welan, MD, FASCO, Professor of Oncology at McMaster University and Chairman of the Canadian Research Committee for Breast Cancer Research said in a presentation. Source: Adobe Stock. Background and method Adjuvant radiation therapy is then common Breast-conserving surgery According to Welan, the risk of local recurrence has been reduced by 67%. However, daily treatment for up to 5 weeks can be inconvenient and costly for the patient and can result in serious acute and delayed toxicity and rare life-threatening side effects. As the risk of local recurrence has decreased and surgical techniques and systemic therapy have improved, can Whelan et al. Use the results of biomarker screening to identify patients with very low-risk disease who can omit adjuvant radiation therapy? I tried to judge. Timothy Joseph Welan The single-arm Phase 3 LUMINA trial enrolled 500 patients aged 55 years and older (mean age 67 years, mean tumor size 1.1 cm) with lymph node-negative breast cancer and luminal type A tumors, with an ER Defined as 1%. As mentioned above, PR exceeds 20%, HER2 is negative, and Ki67 is 13.25% or less. Ki67 protein It is associated with the growth of cancer cells. Patients from 26 centers across Canada between August 2013 and July 2017 underwent breast-conserving surgery and received endocrine therapy for at least 5 years. Local recurrence served as the main result. Secondary outcomes included contralateral breast cancer, recurrence, DFS, and OS. The median follow-up was 5 years. Main survey results The results showed 10 invasive local recurrence events, against a 5-year local recurrence rate of 2.3% (90% CI, 1.3-3.8). Researchers have similar 5-year contralateral breast cancer rates (1.9%; 90% CI, 1.1-3.2; n 8) and 2.7% (90% CI, 1.6-4.1) recurrence rates (n 12). Was observed. .. Whelan reported a 5-year DFS rate of 89.9% (90% CI, 87.5-92.2) and a 5-year OS rate of 97.2% (90% CI, 95.5-98.4). Only one patient died of breast cancer. Implications "T1N0, grade 1 to grade 2 intraluminal breast cancer over the age of 55 had a very low local recurrence rate 5 years after breast-conserving surgery treated with endocrine therapy alone," Whelan said. "The positive and controlled nature of this multicenter study confirms that such patients are candidates for the omission of radiation therapy." perspective Back to top Deborah M. Accelerator Rod, MD More than two-thirds of all breast cancers are luminal A cancers. They are ER and PR positive and HER2 negative, with low levels of the protein Ki67, which reflects cell proliferation. In this study, women had 13% luminal A cancer and lymph node-negative Ki67, which was thought to be inferior. They are the most advantageous of invasive cancers. Over the last decade, we have gained more knowledge about breast cancer behavior based on molecular subtyping. The results of these studies have provided us with information about cancers that require more treatment and cancers that can be phased out. Further refinement of this is to reduce morbidity and improve quality of life without compromising oncological outcomes. The great strength of this study is that it is positive and many centers have participated. This is supported by other studies and defines patients with newly treated breast cancer who can omit the standard of care radiation. These findings also confirm the results of the PRIME II study. This study has some limitations. This is a single-group study with no comparative radiation therapy and includes the fact that older patients with smaller tumors are involved. Long-term follow-up is important because local recurrence of ER-positive cancer continues to increase after 5 years. In addition, some older patients may prefer radiation therapy (especially accelerated partial breast irradiation for one week) to the five-year endocrine therapy required in this study. Omission of radiation therapy should be seen as an option for older women with localized breast cancer who have the favorable characteristics of receiving endocrine therapy. In NYU, the Department of Radiation Oncology has a PRECISION assay using a genomic assay called PAM50 (Prosgina, Veracyte) and an oncotype DX assay (Exact Sciences). Deborah M. Accelerator Rod, MD Perlmutter Cancer CenterNYU Langone Health Disclosure: Axelrod has not reported disclosure of relevant financial information. perspective Back to top Kamran Ahmed, MD LUMINA is an important clinical trial investigating the role of radiation therapy omission in low-risk early-stage breast cancer. This followed the results of PRIME II and CALGB9343, with particular attention to patients with luminal A disease. Five-year data presented at ASCO showed that adjuvant endocrine therapy alone had a low risk of recurrence. It is important to note that not all patients with early-stage breast cancer are the same while waiting for further data to mature. Patients should also discuss the ratio of their own risks and benefits when deciding on radiation therapy individually with the radiation oncologist. schedule. Kamran Ahmed, MD Mofit Cancer Center Disclosure: Ahmed has not reported disclosure of relevant financial information. Add topics to email alerts Receive an email when a new article is posted Please enter your email address to receive emails when new articles are posted .. "data-action " subscribe "> Subscribe The request could not be processed. Please try again later.If you continue to have this issue, please contact us customerservice@slackinc.com.. Return to Healio ASCO Annual Meeting Sources 1/ https://Google.com/ 2/ https://www.healio.com/news/hematology-oncology/20220608/some-older-women-with-luminal-a-breast-cancer-can-safely-forgo-radiotherapy-study-shows The mention sources can contact us to remove/changing this article