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Surg Onc Study Notes > Breast Cancer Trials > Flashcards

Breast Cancer Trials Flashcards

1
Q

NSABP B 4

A
  • MRM vs Total mastectomy with radiation vs Total mastectomy alone
  • 40 % clinically node negative, node positive after dissection
  • 18 % mastectomy alone with nodal recurrence (median 14 months)
  • No increase distant met rate
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2
Q

NSABP B 6

A
  • (MRM) vs (lumpectomy + ax dissection) vs (lumpectomy + ax dissection + ax radiation)
  • < 4 cm tumors
  • BCS equivalent to MRM
  • Radiation reduces LR by 2/3
  • NO OS benefit
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3
Q

NSABP B13

A
  • Surgery alone vs. surgery plus adjuvant chemotherapy in N0 patients with HR neg tumors
  • Improved disease-free survival rate for adjuvant chemotherapy group
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4
Q

NSABP B14

A
  • Surgery alone vs. surgery plus adjuvant tamoxifen in node-negative patients with estrogen receptor-positive tumors
  • Improved disease-free survival rate for adjuvant tamoxifen group
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5
Q

NSABP B18

A

Does Neoadjuvant AC vs adjuvant AC increase lumpectomy rate
Yes it does

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6
Q

NSABP B21

A
  • Lumpectomy plus tamoxifen vs. lumpectomy plus tamoxifen plus XRT vs. lumpectomy plus XRT for node-negative tumors <1 cm
  • Combination of XRT and tamoxifen was more effective than either alone in reducing ipsilateral breast tumor recurrence
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7
Q

NSABP B32

A
  • (Lumpectomy + SNLB and Ax dissection) vs (Lumpectomy + SNLB and Ax dissection only for positive node)
  • No difference in any measure if SLN negative
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8
Q

NSABP B51

A
  • Radiation vs no radiation in patients who are node negative after NACT (initially node positive)
  • Only T1-T3 and N1
  • No difference in RFS, DFS at 5 yrs
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9
Q

Create X trial?

A
  • Adjuvant Capecitabine after nCT for TNBC
  • Improves DFS
  • Improves OS in triple neg
  • Most improvement in triple negative
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10
Q

Keynote 522 TNBC?

A

Stage 2 and 3 TNBC higher PCR with Chemo + Pembro

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11
Q

Olympia trial?

A

PARP inhibitor (Olaparib) improves DFS in BRCA

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12
Q

APHINITY trial?

A
  • TCHP vs TCH adjuvant for early breast cancer
  • Improvement with TCHP
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13
Q

KATHERINE trial?

A
  • Adjuvant TDM1 improves DFS after nCHT for HER2 positive cancer vs adjuvant anti-HERa agents alone
  • T1c and above included
  • Dual anti HER allowed
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14
Q

AMAROS

A
  • Ax dissection vs radiation for T1-T2, N0 with any positive SLN
    * 33% additional positive nodes on ALND after SLN
  • Equal outcomes, less side effects with radiation
  • Mastectomy also included
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15
Q

ACOSOG Z011exclusions

A

Neoadjuvant therapy
Matted nodes
Extranodal extension
3 or more positive

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16
Q

ACOZOG Z010

A

Significance of axillary micromets and bone marrow mets by IHC in H&E negative LN
10 % positive by IHC, no OS impact
3 % bone marrow positive, reduces OS

17
Q

ACOZOG Z1071

A
  • Accuracy of SNLB after NACT in node positive
  • FNR primary end point
  • 2 or more SLN identified in 81%
    * FNR 12.6%
  • PCR 41%
18
Q

ALLIANCE A11202 (ongoing)

A
  • Axillary radiation and RNI vs Ax dissection and RNI in patients with positive SLN after NACT
19
Q

IDEA trial (Individualized decisions for endocrine therapy alone)

A
  • Non randomized single arm
  • Non inferiority of omiting radiation in low risk HR+ tumors in patients 50-69 yrs
  • <2 cm, HRpos, low oncotype <18, high compliance with endocrine therapy
    5 and 3.6 percent 5 yr recurrence
20
Q

NSABP P1

A

High risk ( Gail >1.66% in 5 years, LCIS or post menopausal)
Tamoxifen 20 mg QD for 5 yrs vs placebo
Tamoxifen reduces invasive cancers (49%) and invasive HR+ cancer (69%)

21
Q

NSABP P2

A

Raloxifene vs Tamoxifen in post menopausal (Gail >1.66%)
Raloxifene 76% as effective
Much fewer side effects

22
Q

TEXT and SOFT trials

A
  • AI + Ovarian suppression superior to Tamoxifen + ovarian suppression
  • HR+ breast cancer in premenopausal women
23
Q

ATAC

A
  • AI superior to Tamoxifen in HR + post menopausal
24
Q

CALOR trial

A
  • Chemo for recurrence improves prognosis
  • Especially if recurrence is triple neg
25
Q

TailorX

A
  • Oncotype in T1-T1, NO HR+ tumors
  • Intermediate score (11-25) endocrine non inferior to chemoendocrine in post menopausal
26
Q

RxPonder

A
  • Oncotype for HR+ tumors with 1-3 LN positive, post menopausal
  • No benefit to chemo if RS<25
27
Q

NSABP B17/ RTOG 9804/ SWEDCIS/ EORTC 10853

A

Radiation for DCIS after BCS
Reduces invasive and non invasive recurrence by 50%

28
Q

NSABP B24 DCIS

A

Tamoxifen vs placebo after BCS and RT for DCIS
50% reduction in breast cancer in HR+ group
NO benefit in HR- group

29
Q

NSABP B39 DCIS

A

ABPI for DCIS (< 3cm) and Stage 1/2 breast cancer < 3 nodes
Slightly higher LRR with ABPI
No difference in OS

30
Q

NSABP B35 DCIS

A

Tamoxifen vs anastrozole DCIS
AI superior in < 60

31
Q

MONARCHE

A

CDK4/6 in adjuvant setting improves DFS

Surg Onc Study Notes (18 decks)

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