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Breast Cancer Management in North Carolina: Updates for 2020

July 22, 2020 @ 12:00 pm - 1:00 pm

UNC Lineberger Cancer Network's Research to Practice lecture logo with Free CME, CNE, ACPE, and ASRT continuing education credits mark


Emily Ray, MD, MPH

Emily Ray, MD, MPH

Assistant Professor Medicine
UNC Lineberger Comprehensive Cancer Center
UNC School of Medicine
University of North Carolina at Chapel Hill


Breast Cancer Management in North Carolina:
Updates for 2020


Lecture Description

Dr. Emily Ray, from the UNC Lineberger Breast Oncology group, will describe relevant updates in systemic therapy for breast cancers for health care providers throughout the state of North Carolina.

Learning Objectives

  • Recognize the options for adjuvant therapy in early stage HER2+ breast cancer
  • Describe the role of genomic assays in determining adjuvant treatment for early stage hormone receptor-positive (HR+) breast cancer
  • Define the options for treating metastatic HER2+ breast cancer



Free Continuing Education credits:



Q&A Session

Attendees posted the following questions, but we didn’t have time at the end of the lecture to answer them.

  • In the face of BRCA positive, how do you factor in PARP inhibitors with MBC patients?
  • Do you consider maintenance treatment with PARP inhibitor of TN/BRCA after neoadjuvant therapy?
  • Continuing the same question….Is there a role for a PARP inhibitor after neoadjuvant chemo whether there is or is not residual disease?
  • A PARP inhibitor as maintenance after neoadiseasedjuvant treatment without residual
  • In a patient who is TN with BRCA and received neoadjuvant Chemo, if there is no residual, would you consider a PARP inhibitor?
  • Per Katherine…if residual DCIS, did the trial show benefit of switching to TDM-1?


Dr. Emily Ray responded with the following: I think I can summarize and answer the questions in 3 parts, as several are asking the same thing:

Question: Where do you sequence PARP inhibitors in your lines of therapy for metastatic TNBC with BRCA mutation?
Answer: PARP inhibitors are traditionally used in the 2nd line based on the initial study designs that required prior 1st-line chemotherapy. That said, they could be considered in the first line. I would consider this in the absence of visceral crisis for a patient with BRCA mutation.

Question: There were several questions regarding the use of PARP inhibitor maintenance in TN/BRCA mutated after NA chemo.
Answer: Use of PARP inhibitors in this context is not well studied, and I would not use them at this time, regardless of response to neoadjuvant therapy.

Question: Per Katherine…if residual DCIS, did the trial show benefit of switching to TDM-1?
Answer: The benefit was seen only in patients with residual invasive disease. If a patient had residual DCIS without invasive disease, I would continue trastuzumab +/- pertuzumab and not switch to TDM-1.



July 22, 2020
12:00 pm - 1:00 pm
Event Categories:
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UNC Lineberger Cancer Network
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