Report from 32nd Annual San Antonio Breast Cancer Symposium, Dec. 10-13, 2009

BCRF grantees delivered key lectures and helped organize the world's largest annual symposium devoted to breast cancer research and physician education. Since 2007, this annual event has been presented in collaboration with the American Association for Cancer Research.

BCRF researcher Kent Osborne, MD (Baylor College of Medicine) co-directed the symposium with Charles A. Coltman, Jr., MD (UT Health Science Center). This year's meeting hosted more than 8,000 physicians and scientists from 90 countries around the world. Osborne, who chaired the opening and closing sessions, also hosted a press conference on Friday Dec. 11 about new, potential treatments for breast cancer entitled Drugs in the Pipeline: What's Emerging in Late-Stage Trials. At the event, BCRF researcher Jenny Chang, MD (Baylor College of Medicine) described a study she is running on drugs called gamma-secretase inhibitors that may attack one of the chemical pathways regulating hard-to-treat breast cancer stem cells.

The Symposium's most distinguished invitation to speak, The McGuire Lecture, went to BCRF grantee Martine Piccart-Gebhart, MD, PhD (The Jules Bordet Institute, Belgium). Her presentation on Saturday, Dec. 12, International Breast Cancer Research: Launching an Expedition to the Moon, reminded attendees that true success at tailored, or personalized medicine in breast cancer "requires a cultural revolution in the way we conduct trials," and that this will be akin to "a huge NASA-type collaborative effort." She should know; she's responsible for initiating it.

In 1996, Piccart-Gebhart, who is based in Brussels, teamed up with colleagues to create the Breast International Group (BIG), a collaborative model for conducting clinical trials, including those for adjuvant therapies and translational research. Today, BIG is comprised of 45 research groups in 38 countries. Piccart-Gebhart described some of the accomplishments and challenges of BIG's early studies, emphasizing that all were designed to combat a "one-strategy-fits-all" approach to treating breast cancer. She also described several upcoming BIG trials, and urged the need to create a new generation of collaborative clinical studies that "embark on new routes for the tandem development of new adjuvant therapies" and that "move biomarkers to earlier stages of disease at the neo-adjuvant setting."

The AACR Distinguished Lecture in Breast Cancer Research described some of the nuances of breast cancer originating cells, which are often called breast cancer stem cells. In this talk, BCRF-awardee Robert Weinberg, PhD (The Whitehead Institute) outlined some of the reasons that a small percentage of breast cancer cells remain elusive to primary treatment and play a key role in metastasis. He also cited the early results that an anti-parasitic drug called salinomycin can selectively kill breast cancer cells.

AACR's Outstanding Investigator Award for Breast Cancer Research went to BCRF's Charles Perou, PhD (UNC, Chapel Hill). In a stimulating discussion of "molecular portraits" of breast cancer, Perou detailed the 5 subtypes of breast cancer-basal-like, HER2 enriched, luminal A, luminal B and the recently defined Claudin-low, that he and his colleagues have identified through genetic confirmation and through identifying gene expression patterns associated with those types. Perou emphasized that identifying the sub-type correctly is one of the important factors in gauging response to chemotherapy. Claudin-low is the sub-type name associated with the non-hormone receptor positive cancers that are also sometimes called "triple negative" disease.

Since the oncology community has confirmed that excessive weight and the metabolic changes in the body that correspond with it are risk factors for breast cancer and its recurrence, many approaches to reducing weight, increasing exercise as well as investigations of medically managing the metabolic changes associated with overweight are under way. As a result of this scrutiny, an interesting epidemiological observation has been made. Patients with diabetes who took metformin, a long-established, safe drug that lowers insulin levels, had lower incidences of cancer as well as better outcomes.

During a panel discussion at the conference, BCRF grantee Pamela Goodwin, MD (Mount Sinai Hospital, Toronto) described the launch of a randomized clinical trial of over 3,500 women with high-risk, early stage breast cancer; she is leading the study along with Dr. Lois Shepherd and others from the National Cancer Institute of Canada, in order to determine whether metformin directly targets and kills breast cancer cells. BCRF is one of the funders of this study.

Finally, in a closing day session that inaugurated a new feature of San Antonio's conference, BCRF researchers presented three of four "year-in-review" expert overviews. Clifford Hudis, MD (MSKCC), Ian Smith, MD (Royal Marsden Hospital, UK) and Carlos Arteaga, MD (Vanderbilt University), summarized the most important advances in metastatic breast cancer management, clinical trials in early breast cancer and developments in translational research, respectively. An estimated 3,000 meeting attendees stayed for this final session. Osborne, who chaired the session, said that if this program receives a favorable response, it may become a regular part of the annual events.

View video of the Closing Day Year-In-Review Sessions (click on Sun, December 13th, Year in Review)

View Highlights of the 2009 Meeting