Update on systemic treatment for newly diagnosed inflammatory breast cancer

Chainitikun, Sudpreeda; Saleem, Sadia; Valero, Vicente; Ueno, Naoto T.

doi:10.1016/j.jare.2020.08.014

Cited by 31 publications

(18 citation statements)

References 105 publications

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“…cN1-2 eligible if T size ≥1.5 cm. 3 , high risk breast cancer was defined as cT4/anyN/M0, any cT/N2-3/M0, or cT1-3/N0-1/M0, with RD. Patients with clinical stage cT1mi/T1a/T1b/N0 at disease presentation are not eligible.…”

Section: Discussionmentioning

confidence: 99%

“…The standard of care for HER2+ IBC is a combined multimodality approach, that includes neoadjuvant therapy with dual anti-HER2 antibodies and anthracyclinebased chemotherapy with AC-THP (doxorubicin and cyclophosphamide, followed by paclitaxel or docetaxel with trastuzumab and pertuzumab) or non-anthracycline based chemotherapy with TCHP (docetaxel or paclitaxel, carboplatin, trastuzumab, and pertuzumab), followed by surgery, radiotherapy, and adjuvant systemic therapy (3)(4)(5)(6)(7)(8). Although the optimal neoadjuvant chemotherapy backbone with dual HER2 blockade for IBC patients is not well-established, regimens that omit anthracyclines, such as TCHP, have been used progressively more often on the basis of similar pathological complete response (pCR) and event-free survival rates; these regimens are associated with lower rates of cardiac toxicity and a lower risk of developing acute myeloid leukemia and myelodysplastic syndrome (5,(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

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What is the best treatment recommendation for HER2+ IBC with residual disease?—a narrative review

Zakon¹,

Valero²

2021

Chin Clin Oncol

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Objective: The purpose of this article review is to discuss the current adjuvant approach for human epidermal growth factor receptor 2 (HER2) gene amplification or overexpression inflammatory breast cancer (IBC), as well as promising therapies to improve the prognosis of these patients, with the main focus on the high risk setting of patients with residual disease after neoadjuvant therapy.Background: IBC is a rare and very aggressive form of breast cancer. HER2+ is more frequent in IBC than in non-IBC. A combined multimodality therapy is essential for better outcomes in non-metastatic HER2+ IBC patients, including neoadjuvant chemotherapy, with dual HER2 blockade, local therapy with surgery and radiotherapy, and adjuvant systemic therapy, which is defined on the basis of pathological response and hormone receptor (HR) status. Dual HER2 blockade with trastuzumab and pertuzumab combined to neoadjuvant chemotherapy improved the pathological complete response (pCR) rate. However, HER+ IBC patients with residual disease at surgery have a high risk of recurrence and death.Methods: A comprehensive review was conducted through Medline/PubMed database, ClinicalTrials.gov, and conference abstracts.Conclusions: Escalation of adjuvant therapy for patients with HER2+ IBC with residual invasive disease after neoadjuvant therapy is recommended. Adjuvant ado-trastuzumab emtansine and neratinib, for HR+ disease, are the most recent advances in this setting, with a clinically meaningful improvement in invasive disease-free survival (iDFS). Despite the clinical advances, reducing the risk of central nervous system recurrence remains an unmet need. Several promising clinical trials are ongoing to improve patients' prognosis in this high-risk of recurrence setting.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

What is the best treatment recommendation for HER2+ IBC with residual disease?—a narrative review

Zakon¹,

Valero²

2021

Chin Clin Oncol

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“…Among the BC subtypes, triple-negative (TN) IBC accounts for 20% to 40% of all IBC cases, and within this subtype, ~30% present with lymph node and distant metastasis at diagnosis and have the poorest prognosis [ 3 , 4 ]. Anthracycline–taxane-based chemotherapy remains the backbone of neoadjuvant therapy for TN IBC; however, the efficacy of this treatment is poor, with a dismal 15-year survival rate of ~20–30% [ 5 , 6 , 7 ]. The lack of effective therapies against TN IBC is due, in part, to a lack of clinical trials because (1) TN IBC is a different clinical and molecular entity than TN non-IBC, which causes the exclusion of TN IBC patients from most clinical trials [ 8 , 9 , 10 ] and (2) IBC is rare, making patient recruitment difficult for specific TN IBC clinical trials.…”

Section: The Clinical Burden Of Ibcmentioning

confidence: 99%

“…IBC is highly metastatic, and despite deploying a multidisciplinary approach to tackle this disease, the current anthracycline–taxane approach is minimally effective, with a very low 15-year survival rate of ~20–30% [ 5 , 6 , 7 ]. In other words, IBC patients do not have the luxury of waiting until efficacious therapies are found.…”

Section: The Urgency Of Applying Novel Efficacious and Economically A...mentioning

confidence: 99%

Proactive Immunotherapeutic Approaches against Inflammatory Breast Cancer May Improve Patient Outcomes

Alonso-Miguel

Fiering

Arias-Pulido

2022

Cells

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Inflammatory breast cancer (IBC) is highly metastatic at the onset of the disease with no IBC-specific treatments, resulting in dismal patient survival. IBC treatment is a clear unmet clinical need. This commentary highlights findings from a recent seminal approach in which pembrolizumab, a checkpoint inhibitor against programmed cell death protein 1 (PD-1), was provided to a triple-negative IBC patient as a neoadjuvant immune therapy combined with anthracycline–taxane-based chemotherapy. We highlight the findings of the case report and offer a perspective on taking a proactive approach to deploy approved immune checkpoint inhibitors. On the basis of our recently published research study, we propose in situ vaccination with direct injection of immunostimulatory agents into the tumor as an option to improve outcomes safely, effectively, and economically for IBC patients.

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“…NACT with dual anti-HER2 antibodies (HP) is a standard regimen for HER2+ IBC based on multiple clinical data (14,29). In the TRYPHAENA study (30,31) reported the non-anthracycline regimen for 6 cycles [docetaxel, carboplatin, trastuzumab and pertuzumab (TCHP) regimen] had the promising highest pCR rate of 66.2% compared with 57.3-61.6% of anthracycline containing regimens for 6 cycles (FEC followed by docetaxel regimen).…”

Section: Systemic Treatment For Neoadjuvant Her2+ Ibcmentioning

confidence: 99%

What is the best systemic treatment for newly diagnosed inflammatory breast cancer?—a narrative review

Chainitikun¹,

Mingmalairak²,

Parinyanitikul³

2021

Chin Clin Oncol

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Objective: The propose of this review to discuss of the systemic treatment options for newly diagnosed inflammatory breast cancer (IBC) including the recent data of immune checkpoint inhibitor, CDK4/6 inhibitor and anti-HER2 therapy. Aim to provide a pragmatic treatment in a gray area or concerning issues of real-world practice.Background: IBC is a rare and aggressive disease. Upfront systemic treatment followed by surgery and radiation therapy or "Tri-modality" treatment is a standard of care for newly diagnosed IBC. Due to its rarity, the data of systemic treatment for IBC has been extrapolated mostly from non-IBC clinical trials. Methods:We summarized the recent data of systemic treatment stratified by concerning topics and breast cancer subtypes. Some topics are less likely to have strong data from IBC clinical trial to supports. Therefore, we interpolate the non-IBC data to support our review.Conclusions: IBC is challenging in the clinical management. The development of novel systemic treatment is urgently needed, especially for IBC-specific clinical trials.

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Update on systemic treatment for newly diagnosed inflammatory breast cancer

Abstract: Graphical abstract

Cited by 31 publications

References 105 publications

What is the best treatment recommendation for HER2+ IBC with residual disease?—a narrative review

What is the best treatment recommendation for HER2+ IBC with residual disease?—a narrative review

Proactive Immunotherapeutic Approaches against Inflammatory Breast Cancer May Improve Patient Outcomes

What is the best systemic treatment for newly diagnosed inflammatory breast cancer?—a narrative review

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