SAN ANTONIO, Texas — The optimum duration of adjuvant therapy and new data on the efficacy of trastuzumab in human epidermal growth factor receptor 2 (HER2)–negative tumors are just two of the hot topics that will be addressed at the forthcoming San Antonio Breast Cancer Symposium (SABCS) 2017.
The largest breast cancer meeting in the world is celebrating its 40th anniversary this year. To mark the occasion, Richard Pazdur, MD, the director of the US Food and Drug Administration’s Oncology Center of Excellence, will be giving the SABCS 40th Anniversary Award Lecture on the past and future of cancer drug development.
Running from December 5 to 9, the 5-day program will combine abstracts and posters presenting new data from the cutting edge of breast cancer research, alongside endowed lectures, workshops, and educational sessions setting out the state of the art in the field.
Medscape Medical News asked symposium co-director, Carlos L. Arteaga, MD, professor of medicine and cancer biology and director of the Breast Cancer Program at Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, Tennessee, to highlight some of what he considered to be the most important presentations.
One abstract (GS1-02) he highlighted as important but at the same time “very controversial” is a randomized study from the National Surgical Adjuvant Breast and Bowel Project. It is testing the hypothesis that adjuvant trastuzumab can improve patient outcomes even in patients who do not meet the criteria for HER2 gene amplification or overexpression.
“It’s very important because, if positive, it could extend the indication for trastuzumab,” Dr Arteaga said.
“If negative, it would basically inform as to the lack of benefit from a drug that is expensive and that these patients do not need. So, clearly, this is something that will have important clinical implications,” he said.
Another question that will be addressed in San Antonio this year is that of the duration of adjuvant therapy, with several abstracts exploring shorter treatment periods.
“One of the important priorities in breast cancer is the issue of overtreatment,” said Dr Arteaga. “We clearly overtreat; we treat too long and treat too many people that don’t need it.”
We clearly overtreat.
However, he underlined that de-escalating therapy requires “careful investigation, because, in doing so, you could be affecting the outcome of patients that may need that prolonged therapy.”
One of the new studies will report on 9 weeks vs 1 year of adjuvant trastuzumab in patients with HER2-positive early breast cancer.
Another study will report results from an additional 2 years vs 5 years of aromatase inhibitor (AIs) treatment after an initial 5 years of therapy.
Women have to take AIs for years, but adverse effects from these drugs often lead to nonadherence. One of the most troubling side effects for women receiving this therapy is arthritis-like joint symptoms. A study (GS4-04) presented at the meeting this year will look at the effect of acupuncture on joint symptoms in patients taking AIs.
On the afternoon of December 7, there will be a series of presentations on the use of temporary ovarian suppression with a gonadotropin-releasing hormone analog during chemotherapy as a strategy to preserve ovarian function in women with hormone receptor–positive early breast cancer (GS4-01, GS4-02, and GS4-03; General Session 4 in Hall 3).
Another abstract that Dr Arteaga noted as being important is from a study (GS5-07) of body weight and breast cancer risk, which will be presented on December 8.
Value-Based Medicine
Aside from the key abstracts, Dr Arteaga highlighted the opening session of the meeting, which will take place on December 5 (International Session, Hemisfair Ballroom 2 and 3). This will take a global view of value-based medicine and will include a speaker from Jordan alongside those from the United States.
Three plenary lectures are scheduled, covering the potential for radiation therapy to convert a tumor into an in situ vaccine, mutational signatures in breast cancer, and individualizing the management of axillary lymph nodes.
Finally, for clinicians, a special session on Friday afternoon titled “View From the Trenches: What Will You Do on Monday Morning?” will highlight presentations at the meeting that could have an immediate effect on treatment decisions.
Dr Arteaga believes that delegates will “leave the meeting with a sense of optimism about the progress of this disease.” He noted that breast cancer mortality rates continue to decline every year “to the point that we are considering de-escalating therapy because we realize that we are overtreating and treating for too long in many cases.”
He added that attendees will also leave with the sense of a meeting that is diversifying because there will be symposia “that are not necessarily covering new findings but are reviewing the state of the art,” including epigenetics, issues in radiation oncology, the tumor microenvironment, and liquid biopsies.
Dr Arteaga concluded that people are going to be “excited about the progress made over the last year, and about what to do next both in the clinic and in the laboratory.”
Dr Arteaga has disclosed no relevant financial relationships.
San Antonio Breast Cancer Symposium (SABCS) 2017. December 5 to 9, 2017. San Antonio, Texas.
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