JSCO2016: International Session 11 Breast Cancer

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The 54th Annual Meeting of Japan Society of Clinical Oncology (JSCO2016)

"Renovation of Cancer Medicine in the Mature Society"



International Session 1: Lung Cancer
International Session 2: Colorectal Cancer
International Session 3: Gastric Cancer
International Session 4: Urological Cancer (Prostate and Renal Cancer)
International Session 5: Supportive Care for Adverse Events
International Session 6: Gynecological Cancer (Uterine Body Cancer and Ovarian Cancer)
International Session 7: Central Nervous System Tumor
International Session 8: New Development of Particle Beam Therapy for Cancer
International Session 9: International Cooperation in Radiation Medicine
International Session 10: Recent Advances In Cancer Immunotherapy
International Session 11: Breast Cancer
International Session 12: Pharmacology of Antitumor Agents: New Drug Application (NDA)
International Session 13: Malignant Lymphoma
International Session 14: Palliative Care
International Session 15: Radiation Therapy
International Session 16: Head and Neck Cancer
International Session 17: Skin Cancer (Malignant Melanoma)
International Session 18: Hepato-Biliary and Pancreas Cancers
International Session 19: Leukemia
International Session 20: Ethics for Clinical Research
International Session 21: Esophageal Cancer
International Session 22: Bone and Soft Tissue Tumor
FACO/JSCO Joint Symposium

Abstract Archives (in Japanese)

International Session 11: Breast Cancer


Current strategy for the treatment of breast cancer in Japan
Shigeru Imoto (Department of Breast Surgery, Kyorin University Hospital)
Recent advances in molecular biology bring us new predictive tools of multi-gene signature and newly targeted therapy against HER family and cycline-dependent kinase in breast cancer. On the other hand, breast cancer incidence in Japan is increasing in number and the mortality rate remains high. In this session, current strategy for the treatment of breast cancer is reviewed from the results of several trials organized in Japan: a neoadjuvant trial to compare goserelin and anastrozole with goserelin and tamoxifen for premenopausal and hormone-receptor positive breast cancer patients (STAGE), efficacy of screening to compare mammography and breast ultrasound with mammography alone for premenopausal women at age 40-49 (J-Stage), utility of TS-1 monotherapy for the first-line chemotherapy of advanced or metastatic breast cancer (SELECT BC) and clinical benefit of capecitabine against residual disease for breast cancer patients who received primary chemotherapy followed by breast surgery (CREATE-X). These trials were carried out from several questionnaires raised by Japanese investigators. For example, the incidence rate had a peak at age 40s of Japanese women and screening mammography has some limitation to detect early breast cancer in premenopausal dense breast. If breast cancer is detected more frequently by breast ultrasound, neoadjuvant and combined endocrine treatment may be beneficial for favorable subtype of breast cancer from the results of adjuvant trials of "SOFT" and "TEXT". Oral fluoropyrimidine chemotherapy is not recommended as a standard care for first-line chemotherapy in recurrent breast cancer and primary chemotherapy in operable breast cancer. However, TS-1 and capecitabine demonstrated clinical advantage under certain conditions. Taking our experience into consideration, we should manage Japanese breast cancer patients with multi-disciplinary and original approach.


Recent advances in breast cancer management: The US perspective
Anees B. Chagpar (Surgical Oncology, Surgery, Yale University, USA)
There have been a number of significant advances in breast cancer management over the past year. A synopsis of some of the most critical advances in the multidisciplinary management of breast cancer will be presented from a US perspective.


Year in review from Asia
Young-Hyuck Im (Division of Hematology/Medical Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea)
Although survival rates among patients with breast cancer (BC) have improved in recent years, metastatic BC still remains an incurable disease for most patients. An understanding of the biology of BC has led to important advances in developing targeted therapies and it is important to incorporate these therapies to improve and optimize patient outcomes.
Estrogen receptor (ER)-positive BC represents 60-70% of all BCs. In this subgroup of BCs, endocrine therapies are effective both in the adjuvant and metastatic settings, although resistance remains a major issue. Recent studies have identified a number of resistance mechanisms, such as acquired ESR1 mutations, constitutive activation of CDK 4/6; FGFR pathways, survival signals of PI3K/Akt/mTOR, and epigenetic modifications by HDAC, etc, which could be novel therapeutic targets. In HER2 subgroup of BC, several HER2 targeting agents, including trastuzumab, lapatinib, pertuzumab, and TDM-1, are now widely used in clinics and considered a standard of care. Despite the important advances in these potent anti-HER2 therapies, these drugs are generally not curative in the metastatic setting, due to several mechanisms of anti-HER2 therapy resistance, such as activating HER2 mutations, loss of HER2 expression, and constitutive activation of downstream effectors, such as the phosphatase and tensin homologue (PTEN) and PI3K pathways. Recent study support the evidence that combining targeted agent with anti-HER2 therapy may overcome resistance of anti-HER2 therapy.
Triple-negative BC(TNBC) is clinically defined as lacking expression of the ER, progesterone receptor (PR), and HER2. To date, there are no approved therapies for this subtype of BC. Using next generation sequencing, potential genetic subgroup of TNBC have led to promising therapeutic approaches, including DNA-damaging agents (i.e., platinum salts and PARP inhibitors), as well as immunotherapy. Here, I will introduce recent advances in the treatment of BC.


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