Breast Cancer | Charles E Geyer Jr, MD

published 1 month ago by Dr Neil Love

Breast Cancer Update for Surgeons, Issue 1, 2019 — Part #1: Our interview with Dr Geyer highlights the following topics as well as cases from his practice: Case: A premenopausal woman in her mid-40s with Grade II, ER/PR-positive, HER2-negative lobular breast cancer, a 21-gene assay Recurrence Score (RS) of 10 and a deleterious CHEK2 mutation undergoes a bilateral mastectomy (00:00) Impact of gene-expression assay results on therapeutic decision-making  (04:54) Results of the Phase III TAILORx trial evaluating chemoendocrine therapy versus endocrine therapy alone for patients with ER-positive, HER2-negative, node-negative breast cancer and an intermediate RS (07:00) Clinical utility of the 21-gene and 70-gene assays (12:29) Benefit with the addition of ovarian function suppression to endocrine therapy for premenopausal women with ER-positive breast cancer at high risk for recurrence (14:11) Approach to assessing the adequacy of ovarian function suppression in premenopausal patients receiving aromatase inhibition (17:01) Significance of clinical risk category in prognosis and in the prediction of chemotherapy benefit by age and RS in the TAILORx trial (19:04) Use of adjuvant bone-modifying agents to reduce the risk of aromatase inhibitor-associated bone loss and fracture (24:51) Role of the 21-gene assay RS in guiding neoadjuvant therapy decision-making for ER-positive, HER2-negative localized breast cancer (27:39) Mechanism of action, efficacy and tolerability of CDK4/6 inhibitors for ER-positive, HER2-negative metastatic breast cancer (31:33) Investigation of CDK4/6 inhibitors alone or in combination with endocrine therapy in the neoadjuvant and adjuvant settings (36:00) Case: A postmenopausal woman in her mid-50s with Grade I, ER-positive, PR-negative, HER2-negative infiltrating ductal carcinoma (IDC) with 1 positive node and a RS of 20 receives an aromatase inhibitor and denosumab (39:49) Approach to the selection of adjuvant endocrine therapy; management of aromatase inhibitor-associated arthralgias (43:33) Clinical and genomic risk to guide the use of adjuvant therapy for breast cancer (46:22) Prospective data with and ongoing evaluation of the 21-gene and 70-gene assays for patients with node-positive disease (49:23) Results from the Phase III KATHERINE study evaluating adjuvant T-DM1 versus trastuzumab for patients with HER2-positive localized breast cancer and residual disease after neoadjuvant treatment (54:20) Rationale for the design and entry criteria of the KATHERINE study (58:18) Mechanism of action, activity and tolerability of antibody-drug conjugates (1:02:46) Second opinion: Therapeutic options for a patient in her mid-40s with recurrent, locally advanced, ER/PR-positive, HER2-positive breast cancer (1:06:23) Clinical implications of the KATHERINE trial results (1:14:53) CME information and select publications  

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