DR LOVE: First at the last San Antonio meeting we saw more follow-up from the BCIRG-006 study where they did have a nonanthracycline arm, TCH. Dennis Slamon went through the follow-up there.

And then at ASCO, we saw data from the NSABP looking at the question of anthracycline or not. When you look at these 2 data sets and others that address the anthracycline question, what do you come up with?

DR SLEDGE: What I come up with, particularly as a result of the recent NSABP presentation, is that there’s probably a small, modest additional benefit for the addition of anthracyclines. This is a difference, I think, in the recent NSABP trial of just a few percent, as I recall, but it’s probably there and it’s probably real. To my mind, if we’re talking about a 10% or a 20% difference in survival, then I usually insist with the patient that they take the therapy. If we’re talking about a small difference, then I think it’s always reasonable to sit down and discuss those differences with the patient.

We have data going back to Alan Coates from 20 years ago, one of my favorite adjuvant pieces of data, where if you talk to women about adjuvant therapy, something like half of all women will take an adjuvant chemotherapy for a 1% or 2% difference in terms of long-term outcome. So I think certainly if we’re talking about a 2% or 3% difference with an anthracycline, many women would certainly be willing to accept that therapy, given the toxicities that are there and are real. But there’s also some who would not.

Early-stage breast cancer (BC) in the adjuvant and neoadjuvant settings

Genomic assays and (neo)adjuvant treatment decision-making

Management of metastatic BC (mBC)

CDK4/6 inhibitors for the treatment of BC

Novel approaches under investigation in BC