Dr. Brufsky on Challenges in Breast Cancer Treatment

Adam M. Brufsky, MD, PhD, professor of medicine, associate chief, Division of Hematology/Oncology, co-director, Comprehensive Breast Cancer Center, associate director, Clinical Investigation, University of Pittsburgh Medical Center Hillman Cancer Center, discusses remaining challenges in breast cancer treatment.

Brufsky highlights the need to identify low-risk patients who do not need to receive treatment.

For example, if a patient presents with a 3-cm low-grade tumor, a Nottingham score of 4, Ki-67 of 5%, 100% estrogen receptor expression, and 90% progesterone receptor expression, they can receive hormonal therapy alone, despite being premenopausal. Also, the patient does not require genomic testing, explains Brufsky.

Similarly, in triple-negative breast cancer (TNBC), identification of predictive biomarkers to determine who could benefit without active therapy versus who requires additional treatments, such as immunotherapy, is an unmet need, says Brufsky.

Though PD-L1 testing has been used frequently, deciding who to treat with immunotherapy without the use of additional biomarkers has proved to be a challenge in TNBC, concludes Brufsky.

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