Report from SABCS from a patient advocate

SABCSShirley and I are here in San Antonio at SABCS (San Antonio Breast Cancer Symposium), a premier conference for oncologists and researchers from around the world with an attendance of about 7000 people.

AN INTERNATIONAL EXPERIENCE

It’s my first experience, but Shirley is a veteran and has been here six times. She was surprised and happy to see metastatic presentations throughout the four day conference. “Years ago” she said, “it seemed like metastatic was relegated to the last day.” We have met many people — researchers, oncologists, radiation oncologists and advocates–from the US and internationally– and have had some significant and interesting conversations. Getting a world perspective is particularly eye opening:  A breast surgeon from Iran pointed out to me that metastatic breast cancer  in Iran is not usually treated, since it is a terminal disease. In India, Her2 treatments are rare because of the costs. In Colombia and Brazil, breast cancer advocacy groups exist, but do not usually include metastatic. In many parts of the world, there is still a stigma associated with cancer and particularly breast cancer.

BONE MODIFYING AGENTS

Many of us with bone mets are familiar with bisphosphonate drugs like zometa and xgeva that strengthen bones and are usually taken every few weeks initially and then every couple of months after a year or two.  I did attend a wonderful session on Bone Metastases  and Bone Modifying Agents. Speaker Alison Stopeck MD from University of Arizona in Tucson offered arguments and evidence of the superiority of denosumab (xgeva) over zoledronic acid (zometa) in terms of longer time to a first SRE (skeletal related event) meaning a fracture;  better control of pain and fewer side effects.  So that is something I added to my list to discuss with my oncologist.

HER2: Perjeta and TDM-1

Last night was the most hopeful and exhilarating presentation–a panel of experts on Her2+ breast cancer. Among them were Dennis Slamon, MD from UCLA, the original researcher and 20 year crusader for herceptin research and Kimberly Blackwell, MD from Duke University, one of the researchers on TDM-1 .  The panel of clinician/researchers were enthusiastic about the range of options now available for Her2+ metastatic disease and the excitement was contagious. Dr. Slamon spoke about the potential of  HER2+ MBC becoming a chronic disease in the near future. Dr. Blackwell urged patients to rethink a “cure” for cancer, pointing out that in most fields of medicine, except for infectious diseases like pneumonia or smallpox or tuberculosis, diseases are managed and not cured. People are treated chronically in the US for cholesterol, hypertension, diabetes, arthritis, etc and hopefully HER2+ metastatic breast cancer will soon be included in this list.

ER+ NEWS

Using higher doses of fulvestrant (faslodex) provided longer overall survival without adding to toxicity for metastatic ER+ patients. Results were from the phase 3 CONFIRM trial, so check with your oncologist, if this applies to you.

NO METASTATIC BREAKTHROUGHS

There’s been no groundbreaking announcement or significant finding for metastatic disease, other than the HER2 advances, which were already known. We are expecting the announcement this evening on the final data for OS (overall survival) for perjeta and TDM-1 is expected to be approved in January or February by the FDA.

As someone living with Triple Negative Breast Cancer, I was hoping for more progress reported on novel treatments, but perhaps I’m a bit naive. There is a veritable alphabet soup of pathways and molecules being investigated. When I met Dr. Slamon last night I said, “I hope there is someone out there with your dedication and determination who is studying TNBC.”

“Oh, there is,” he said, “there definitely is.”

Ginny Knackmuhs, MBCN

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10 Responses to Report from SABCS from a patient advocate

  1. katherinembc says:

    Reblogged this on ihatebreastcancer and commented:
    Ginny reports from the San Antonio Breast Cancer Symposium: Dr. Blackwell urged patients to rethink a “cure” for cancer, pointing out that in most fields of medicine, except for infectious diseases like pneumonia or smallpox or tuberculosis, diseases are managed and not cured. People are treated chronically in the US for cholesterol, hypertension, diabetes, arthritis, etc and hopefully HER2+ metastatic breast cancer will soon be included in this list.

  2. So spectacular to get to meet you guys in person….. and I hope you saw my tweet about your “is there a doctor on the plane” story. I credited you in the tweet….

    BIG GIANT HUGS!!!

  3. Susan says:

    Thank you for this excellent report from SABCS. I too was frustrated that there are no new breakthroughs for triple negative MBC as well as all MBC. I keep hoping that through genetic subtyping of breast cancer tumors as suggested in:http://www.onclive.com/publications/Oncology-live/2012/November-2012/Subtyping-Breast-Cancer-Genome-Analysis-Opens-Door-to-New-Era-in-Targeted-Therapies/1, would bring us hope for more advances in MBC. There has to be much more funding that goes in to research for MBC.

  4. MBCNbuzz says:

    KOB–thanks for the reblog!

    AM- Yes, really nice meeting you and some of the other bloggers. So nice to know the person behind the blog! (I did see your tweet.)

    Susan: Yes, definitely more MBC research. We need to also speak out about the research funding cuts to NIH.

  5. metacj says:

    Great report! Yes, there is more research going on, but I share the same concerns that there is nearly enough for inflammatory, triple negative and metastatic disease. That was readily apparent at the talks and the poster sessions. We desperately need a re-apportionment of funding so that stage IV cancer, across the board, is funded to the extent that they can begin to save lives.

  6. mary keane says:

    I’m wondering if you were impressed with the drug P0332991 developed in California – it seems to have great possibilities.

    • MBCNbuzz says:

      Mary
      I missed that session, but I know there are a lot of drugs focusing on kinase inhibitors. Is this one of them? Can you give us a short summary of what impressed you? Thanks.

      • Mary Keane says:

        This is what I know about it. The drug has been combined with Femara for er+ and it is possible to combine it with the HER therapies. It is a pill and not a chemo. It is showing an impressive pfs but also an overall survival benefit. It was developed at UCLA with funding from the Noreen Fraser Foundation, but now with participation from Pfizer. One of its developers is the same dr. that developed herceptin. It is currently in phase 1 trials at Abramson Cancer center, U Penn. If possible, I would like MBCN to perhaps Google this drug and post it on its Newsfeed. It is being called one of the most exciting bc drugs in a decade.

  7. Mary Keane says:

    The drug is being used with femara and possibly the HER drugs. It has shown impressive pfs and overall survival. It is in Phase 1 at U Penn. It is not a chemo but a pill. It was developed at UCLA by the same dr. who developed herceptin. It was funded in part by the Noreen Fraser Foundation and is now funded by Pfizer. Perhaps you can get this on your news feed. They are saying this is one of the most important drugs for bc in a decade. Hope so

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