Managing TNBC

CE / CME

Cases and Challenges in the Optimal Treatment of Triple-Negative BC

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Nurse Practitioners: 1.00 Nursing contact hours, includes 1.00 hour of pharmacotherapy credit

Released: May 08, 2023

Expiration: May 07, 2024

Jeremy M. Force
Jeremy M. Force, DO

Activity

Progress
1
Course Completed

References

  1. National Institutes of Health. Cancer stat facts: Female breast cancer subtypes. seer.cancer.gov/statfacts/html/breast-subtypes.html. Accessed March 1, 2023.
  2. Sharma P. Biology and management of patients with triple-negative breast cancer. Oncologist. 2016;21:1050-1062.
  3. Dent R, Trudeau M, Pritchard KI, et al. Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res. 2007;13:4429-4434.
  4. Foulkes WD, Smith IE, Reis-Filho JS. Triple-negative breast cancer. N Engl J Med. 2010;363:1938-1948.
  5. Howard FM, Olopade OI. Epidemiology of triple-negative breast cancer: A review. Cancer J. 2021;27:8-16.
  6. Prakash O, Hossain F, Danos D, Lassak A, Scribner R, Miele L. Racial disparities in triple negative breast cancer: A review of the role of biologic and non-biologic factors. Front Public Health. 2020;8:576964.
  7. Dietze EC, Chavez TA, Seewaldt VL. Obesity and triple-negative breast cancer: Disparities, controversies, and biology. Am J Pathol. 2018;188:280-290.
  8. Lehmann BD, Jovanovic B, Chen X, et al. Refinement of triple-negative breast cancer molecular subtypes: Implications for neoadjuvant chemotherapy selection. PLoS One. 2016;11:e0157368.
  9. Asad S, Barcenas CH, Bleicher RJ, et al. Sociodemographic factors associated with rapid relapse in triple-negative breast cancer: A multi-institution study. J Natl Compr Canc Netw. 2021;19:797-804.
  10. National Comprehensive Cancer Network. Clinical practice guidelines in oncology: breast cancer. v.2.2023. nccn.org. Accessed March 1, 2023.
  11. Henry NL, Somerfield MR, Dayao Z, et al. Biomarkers for systemic therapy in metastatic breast cancer: ASCO guideline update. J Clin Oncol. 2022;40:3205-3221.
  12. Boddicker NJ, Hu C, Weitzel JN, et al. Risk of late-onset breast cancer in genetically predisposed women. J Clin Oncol. 2021;39:3430-3440.
  13. Tung N, Desai N. Germline genetic testing for women with breast cancer: Shifting the paradigm from whom to test to whom NOT to test. J Clin Oncol. 2021;39:3415-3418.
  14. Schmid P, Cortes J, Pusztai L, et al. Pembrolizumab for early triple-negative breast cancer. N Engl J Med. 2020;382:810-821.
  15. Schmid P, Cortes J, Dent R, et al. Event-free survival with pembrolizumab in early triple-negative breast cancer. N Engl J Med. 2022;386:556-567.
  16. Jacob SL, Huppert LA, Rugo HS. Role of immunotherapy in breast cancer. JCO Oncol Pract. 2023:OP2200483.
  17. Pembrolizumab [prescribing information]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2023.
  18. Tutt ANJ, Garber JE, Kaufman B, et al. Adjuvant Olaparib for patients with BRCA1- or BRCA2-mutated breast cancer. N Engl J Med. 2021;384:2394-2405.
  19. Olaparib [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; March 1, 2023.
  20. National Comprehensive Cancer Network. Management of immune-related toxicities. Version 1.2022. nccn.org. Accessed February 3, 202.
  21. Schneider BJ, Naidoo J, Santomasso BD, et al. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: ASCO guideline update. J Clin Oncol. 2021;39:4073-4126.
  22. Unger JM, Vaidya R, Albain KS, et al. Sex differences in risk of severe adverse events in patients receiving immunotherapy, targeted therapy, or chemotherapy in cancer clinical trials. J Clin Oncol. 2022;40:1474-1486.
  23. Brahmer JR, Lacchetti C, Schneider BJ, et al. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2018;36:1714-1768.
  24. Wood LS. Immune-related adverse events from immunotherapy: Incorporating care step pathways to improve management across tumor types. J Adv Pract Oncol. 2019;10:47-62.
  25. Cortes J, Rugo HS, Cescon DW, et al. Pembrolizumab plus chemotherapy in advanced triple-negative breast cancer. N Engl J Med. 2022;387:217-226.
  26. National Comprehensive Cancer Network. Management of immune-related toxicities. Version 1.2023. www.nccn.org. Accessed March 20, 2023.
  27. Rapoport BL, Anderson R, Cooksley T, Johnson DB. MASCC 2020 recommendations for the management of immune-related adverse events of patients undergoing treatment with immune checkpoint inhibitors. Support Care Cancer. 2020;28:6107-6110.
  28. Cortes J, Cescon DW, Rugo HS, et al. Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer (KEYNOTE-355): a randomised, placebo-controlled, double-blind, phase 3 clinical trial. Lancet. 2020;396:1817-1828.
  29. Rugo HS, Cortés J, Cescon DW, et al. KEYNOTE-355: Final results from a randomized, double-blind phase III study of first-line pembrolizumab + chemotherapy vs placebo + chemotherapy for metastatic TNBC. Presented at: ESMO Congress 2021; September 16-21, 2021. Abstract LBA16. 
  30. Bardia A, Mayer IA, Vahdat LT, et al. Sacituzumab govitecan-hziy in refractory metastatic triple-negative breast cancer. N Engl J Med. 2019;380:741-751.
  31. Goldenberg DM, Sharkey RM. Antibody-drug conjugates targeting TROP-2 and incorporating SN-38: A case study of anti-TROP-2 sacituzumab govitecan. MAbs. 2019;11:987-995.
  32. Bardia A, Hurvitz SA, Tolaney SM, et al. Sacituzumab govitecan in metastatic triple-negative breast cancer. N Engl J Med. 2021;384:1529-1541.
  33. Bardia A, Tolaney SM, Loirat D, et al. Sacituzumab govitecan versus treatment of physician’s choice in patients with previously treated, triple-negative breast cancer: final results from the phase 3 ASCENT study. J Clin Oncol. 2022;40:Abstract 1071.
  34. O'Shaughnessy J, Brufsky A, Rugo HS, et al. Analysis of patients without and with an initial triple-negative breast cancer diagnosis in the phase 3 randomized ASCENT study of sacituzumab govitecan in metastatic triple-negative breast cancer. Breast Cancer Res Treat. 2022;195:127-139.
  35. Loibl S, Loirat D, Tolaney SM, et al. Health-related quality of life in the phase III ASCENT trial of sacituzumab govitecan versus standard chemotherapy in metastatic triple-negative breast cancer. Eur J Cancer. 2023;178:23-33.
  36. Carey LA, Loirat D, Punie K, et al. Sacituzumab govitecan as second-line treatment for metastatic triple-negative breast cancer-phase 3 ASCENT study subanalysis. NPJ Breast Cancer. 2022;8:72.
  37. Rugo HS, Tolaney SM, Loirat D, et al. Safety analyses from the phase 3 ASCENT trial of sacituzumab govitecan in metastatic triple-negative breast cancer. NPJ Breast Cancer. 2022;8:98.
  38. Spring LM, Nakajima E, Hutchinson J, et al. Sacituzumab govitecan for metastatic triple-negative breast cancer: Clinical overview and management of potential toxicities. Oncologist. 2021;26:827-834.
  39. Fleming PJ, Jr., Karpio S, Lombardo N. Sacituzumab govitecan for treatment of refractory triple-negative metastatic breast cancer. J Adv Pract Oncol. 2021;12:747-752.
  40. Sacituzumab govitecan-hziy [prescribing information]. Morris Planes, NJ: Gilead Sciences, Inc; 2023.
  41. Modi S, Jacot W, Yamashita T, et al. Trastuzumab deruxtecan in previously treated HER2-low advanced breast cancer. N Engl J Med. 2022;387:9-20.
  42. Trastuzumab deruxtecan [prescribing information]. Basking Ridge, NJ: Daiichi Sankyo, Inc; 2022.
  43. Livraghi L, Garber JE. PARP inhibitors in the management of breast cancer: current data and future prospects. BMC Med. 2015;13:188.
  44. Robson M, Im SA, Senkus E, et al. Olaparib for metastatic breast cancer in patients with a germline BRCA mutation. N Engl J Med. 2017;377:523-533.
  45. Robson ME, Tung N, Conte P, et al. OlympiAD final overall survival and tolerability results: Olaparib versus chemotherapy treatment of physician's choice in patients with a germline BRCA mutation and HER2-negative metastatic breast cancer. Ann Oncol. 2019;30:558-566.
  46. Litton JK, Rugo HS, Ettl J, et al. Talazoparib in patients with advanced breast cancer and a germline BRCA mutation. N Engl J Med. 2018;379:753-763.
  47. Litton JK, Hurvitz SA, Mina LA, et al. Talazoparib versus chemotherapy in patients with germline BRCA1/2-mutated HER2-negative advanced breast cancer: final overall survival results from the EMBRACA trial. Ann Oncol. 2020;31:1526-1535.
  48. Rugo HS, Ettl J, Hurvitz SA, et al. Outcomes in clinically relevant patient subgroups from the EMBRACA study: Talazoparib vs physician's choice standard-of-care chemotherapy. JNCI Cancer Spectr. 2020;4:pkz085.
  49. Powell CA, Modi S, Iwata H, et al. Pooled analysis of drug-related interstitial lung disease and/or pneumonitis in nine trastuzumab deruxtecan monotherapy studies. ESMO Open. 2022;7:100554.
  50. LaFargue CJ, Dal Molin GZ, Sood AK, Coleman RL. Exploring and comparing adverse events between PARP inhibitors. Lancet Oncol. 2019;20:e15-e28.
  51. Hurvitz SA, Goncalves A, Rugo HS, et al. Talazoparib in patients with a germline BRCA-mutated advanced breast cancer: Detailed safety analyses from the phase III EMBRACA trial. Oncologist. 2020;25:e439-e450.
  52. Talazoparib [prescribing information]. New York, NY: Pfizer Inc; 2021.