San Antonio Breast Cancer Conference
Some of you may be aware that the annual San Antonio Breast Cancer Symposium opens today and runs through Saturday (http://www.sabcs.org/Overview/index.asp). This is the largest annual breast cancer meeting in the world, and more than 20,000 doctors, scientists, researchers, advocates, and pharmaceutical representatives converge on the Texas city. Be aware that there likely will be news stories over the next few days, and those stories likely will be an overly positive version of reality.
Be aware that there will be lots of media attention to reports coming out of this meeting, and many of them will be overly optimistic. Read everything with a skeptical grain of salt. There are, however, always important findings that will continue to build the research base, and, occasionally, there is some really big news.
Attention at this meeting is already focused on a neoadjuvant trial for her2 positive breast cancer and the question of whether a complete pathological repsonse (meaning that no cells are seen after surgery) results in longer survival. Here is the start of the Medscape summary and then a link to read more. If you are really interested, you can go to the link of the homepage and sign up for reports over the next days.
SABCS May Clarify Some BIG Breast Cancer Issues
The 36th Annual San Antonio Breast Cancer Symposium (SABCS) lacks an obvious headlining study, but a number of presentations, especially in the areas of metastatic and HER2-positive disease, will vie to be big topics of conversation among the thousands of attendees as they move through the 5-day meeting, which starts on December 10.
The neoadjuvant treatment of HER2-positive breast cancer is the subject of the international Neo-Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization Trial (NeoALTTO), which is likely to receive significant attention (presentation S1-01).
Much of the curiosity about the trial, which is managed by the Breast International Group (BIG), is related to whether or not pathologic complete response (pCR) will correlate with progression-free and overall survival. "That result is anticipated to generate a lot of excitement," said symposium cochair Carlos L. Arteaga, MD, from the Vanderbilt–Ingram Comprehensive Cancer Center in Nashville, Tennessee. He and 2 other symposium cochairs spoke at premeeting press briefing last month.
A proven correlation is important because pCR, which is defined as the absence of invasive cancer in the breast and lymph nodes, has not yet been demonstrated to predict longer-term breast cancer outcomes, the US Food and Drug Administration (FDA) acknowledged earlier this year. Nevertheless, in October, the FDA approved pertuzumab (Perjeta, Genentech), a neoadjuvant therapy, for the treatment of HER2-positive breast cancer on the basis of pCR results. The FDA also issued a draft guidance on the use of the measure in trials in this setting. The FDA has said that the high-risk HER2-positve breast cancer population justified the gamble of using pCR, an unproven marker, as the basis of an accelerated conditional approval of neoadjuvant treatment.