Dr. C. Kent Osborne, codirector of the San Antonio Breast Cancer Symposium, discusses research that will be presented at the 2012 meeting – and how it might affect clinical practice.
Dr. Osborne is professor of medicine and molecular and cellular biology and director of the Lester and Sue Smith Breast Center and of the Dan L. Duncan Cancer Center at Baylor College of Medicine, Houston.
Once again, thousands of oncologists are heading to San Antonio and the annual breast cancer symposium. What makes this meeting so important to the breast cancer community?
DR. OSBORNE: Well, it’s the largest annual meeting devoted to presentation of new research findings in breast cancer research, both clinical trials and basic and translational research. And it’s in its 33rd year, I think now, so it’s become the standard for people to attend to find out the latest research results in breast cancer.
The buildup to the 2012 symposium has been relatively quiet compared with the excitement last year. Can you give us a preview of some of the phase III trials that will be reporting results in San Antonio?
DR. OSBORNE: I didn’t think of it as being more quiet, because to me I think it’s more exciting. There are several trials that I think are going to have a big impact.
One is the so-called ATLAS trial from the U.K., which looked at the question of duration of tamoxifen adjuvant therapy. Two prior studies, although smaller ones, suggested that prolonging tamoxifen beyond 5 years to, say, 10 years was no more effective than stopping at 5 years. This trial is a much larger trial and looks to extending tamoxifen to more than 5 years, and it will be interesting to see the results, to see whether it confirms the other two trials or whether it provides a different result that winds up changing practice.
In addition, in the HER2 setting there are two extremely important studies coming out that will probably be practice changing or practice confirming, maybe. One is the HERA trial in HER2positive patients, where patients were randomized between 1 year and 2 years of trastuzumab after their chemotherapy, and depending on that result we might wind up either continuing to stop trastuzumab at 1 year, which is the current recommendation, or extending it to 2 years.
At then the same time there is a trial from France, the PHARE trial, which looked at 6 months of trastuzumab versus 1 year. So I think these two trials – one looking at a shorter duration and one looking at a longer duration – will help to set the standard of the duration of trastuzumab therapy in patients with HER2-positive breast cancer.
I think both of those are going to be extremely important studies.
What are some of the other pressing topics? Will we be hearing about triple-negative breast cancer?
DR. OSBORNE: There is a session that contains several interesting papers on triple-negative breast cancer, as we begin to define the pathways that are responsible for its development and progression. And then there is another study that’ll be coming out that looks at another inhibitor in combination with an aromatase inhibitor in estrogenpositive type breast cancer. It looks at an inhibitor of cyclin-dependent kinase 4/6 along with an aromatase inhibitor, and we’ll see if it provides similar data to the BOLERO-2 trial using a slightly different drug and a different target. But that should be very interesting as well, as we begin to learn what other pathways besides the estrogen receptor can contribute to breast cancer growth in patients with ER-positive metastatic disease.
Anything about biomarkers?
DR. OSBORNE: There will be some trials looking at biomarkers in patients on the NEOSPHERE trial – that was a neoadjuvant trial of the combination of trastuzumab and pertuzumab, which might tell us something about a resistance mechanism or sensitivity biomarkers – and then in the CLEOPATRA study there will be some biomarker studies relating outcome to the biomarkers. That should be of interest as well.
There always are some biomarker studies that will be presented, and those are two that come to mind that will be particularly interesting.
Thank you Dr. Osborne. Our reporting team will be in San Antonio for this important meeting, so I think we will see you there.
DR. OSBORNE: Thank you.
Thank you very much.