News from the San Antonio Breast Cancer Symposium 2012
Lisa Carey, MD, Medical Director of the Breast Center at the University of North Carolina comments on this year's Symposium.Thursday, December 7, 2012
I wouldn't say that there is anything that has been presented this year that is going to have an immediate impact on how we treat triple negative breast cancer patients, today, but, overall, I see great promise for the future. The data related to deep genomic analysis are just exploding.
I know that is hard for patients who are waiting for a major step forward, but we aren't there yet in terms of the big phase III trial because the targets aren't clear at this point. In fact, triple negative breast cancer is going to lead the way in changing how we think about cancer and how we treat it. Right now, we usually start with the disease. You have stage IIb, HER2+ breast cancer, for example-and we treat that disease. With triple negative breast cancer, and probably many others as well, we need to start with the person, with the individual tumor. We need to sequence that tumor and identify the genes that are driving it. That's a significant change.
I think that in the next few years, we will have a panel of breast cancer genes and we will sequence every patient and treat what is there. If you look at the HER2 study that Ron Bose presented today or the new data on LAR TNBC, you can see that we have already identified some actionable targets. These may occur in small subsets of patients, but they are opening new doors to treatment that we will see in the near future.
The other thing I want to stress to today's patients is that we can often treat your disease successfully right now with conventional therapy. We get very good results for early TNBC. I think you can see that in what appears to be a negative study on the benefits, or lack thereof, of bevacizumab for adjuvant therapy. The overall survival rate exceeded the study's expectations, and I think that this reflects an improvement in treatment and outcomes for these patients. I have patients come to me who have read about TNBC on the web and think they are doomed, but the reality is that we have effective therapy for early TNBC and these patients often do very well.
There are many unmet needs for TNBC and a real need to develop these genomically based therapies, but I think there is progress now-and there will be much more in the future.
I wouldn't say that there is anything that has been presented this year that is going to have an immediate impact on how we treat triple negative breast cancer patients, today, but, overall, I see great promise for the future. The data related to deep genomic analysis are just exploding.
I know that is hard for patients who are waiting for a major step forward, but we aren't there yet in terms of the big phase III trial because the targets aren't clear at this point. In fact, triple negative breast cancer is going to lead the way in changing how we think about cancer and how we treat it. Right now, we usually start with the disease. You have stage IIb, HER2+ breast cancer, for example-and we treat that disease. With triple negative breast cancer, and probably many others as well, we need to start with the person, with the individual tumor. We need to sequence that tumor and identify the genes that are driving it. That's a significant change.
I think that in the next few years, we will have a panel of breast cancer genes and we will sequence every patient and treat what is there. If you look at the HER2 study that Ron Bose presented today or the new data on LAR TNBC, you can see that we have already identified some actionable targets. These may occur in small subsets of patients, but they are opening new doors to treatment that we will see in the near future.
The other thing I want to stress to today's patients is that we can often treat your disease successfully right now with conventional therapy. We get very good results for early TNBC. I think you can see that in what appears to be a negative study on the benefits, or lack thereof, of bevacizumab for adjuvant therapy. The overall survival rate exceeded the study's expectations, and I think that this reflects an improvement in treatment and outcomes for these patients. I have patients come to me who have read about TNBC on the web and think they are doomed, but the reality is that we have effective therapy for early TNBC and these patients often do very well.
There are many unmet needs for TNBC and a real need to develop these genomically based therapies, but I think there is progress now-and there will be much more in the future.
Christine Wilson for TNBC Foundation