Rounds with the Investigators 2012 | Breast Cancer

DR NEIL LOVE: So Hal, this one we got, actually, from a colleague of Sara’s at UCLA, Dr Barstis, who apparently is a listener to our audio programs. He’s on the clinical faculty there?

DR SARA HURVITZ: Yes. He actually trained me once upon a time. He’s an excellent clinician. Yes.

Rounds with the Investigators 2012 | Breast Cancer

QUESTION: A 77 y/o Afro-American woman with a markedly contracted right breast which on mammography did not demonstrate any finding typical of carcinoma but clinically resembled a carcinoma en cuirasses. Core biopsy showed it to be a Grade I, ER-positive, PR-positive lobular carcinoma.

Rounds with the Investigators 2012 | Breast Cancer

DR NEIL LOVE: The second kind of similar case that this physician wanted some input on was a 36-year-old woman with a 2.4-centimeter, ER-positive, HER2-negative tumor. And actually, I guess this physician went ahead and did an Oncotype. The problem is, now the insurance company won’t pay for it, but interestingly, the Oncotype’s low and, as a result, the patient’s not going to get chemo. And the physician pointed out in her note to us how ironic it is that the insurance company won’t pay for something that actually theoretically would save money.

Rounds with the Investigators 2012 | Breast Cancer

DR NEIL LOVE: We got a couple of cases from an oncologist in a small town in Illinois, and both of the patients have — I’m not going to identify the insurance company, but apparently not very good insurance that this doc takes and nobody else does. But both patients, the lack of coverage actually affected the management. And they’re both young women that this physician is asking about, Sara. The first one’s 38. Again, difficult time, wasn’t able to get worked up because of the lack of insurance coverage.

Rounds with the Investigators 2012 | Breast Cancer

QUESTION: What do you do with a woman in her late eighties or nineties, very vigorous, with a HER2-positive tumor? This is coming up fairly frequently.

DR HAROLD BURSTEIN: With regard to the 90-year-old, I would treat her very gently, and maybe a little touch of paclitaxel/trastuzumab, as we’ve talked about for some of our other low-risk patients, and see how she does.

DR SARA HURVITZ: Would you use vinorelbine?

DR BURSTEIN: I could. Sure.

DR LOVE: Is there an age limit to your T-DM1 adjuvant trial coming up?

Select Publications

Attal M et al. Maintenance treatment with lenalidomide after transplantation for myeloma: Analysis of secondary malignancies within the IFM 2005-02 trial. Proc International Myeloma Workshop 2011. Abstract

Davies FE et al. Are there benefits to long-term bisphosphonate treatment in multiple myeloma (MM)? Insights from temporal analyses of zoledronic acid (ZOL) versus clodronate (CLO) in the MRC Myeloma IX trial. Proc ASCO 2011;Abstract 8011.

RTP TV 2012: A Live CME Webcast Series Focused on Emerging Data Sets and Novel Therapeutic Strategies in the Management of Common Cancers

Using a fast-moving and conversational approach devoid of didactic presentations, this webcast series was designed to profile the people, papers and concepts that are shaping current clinical decision-making in a number of important cancer types. Each archived episode features 2 expert faculty members reviewing recent data, discussing challenging cases and responding to audience questions.

Click below to view any of the recorded video proceedings from the RTP TV webcast series. These CME activities feature video, PowerPoint and related web links.