Click here to view as PDF.New research and Emerging Trends from the San Antonio Breast Cancer Symposium
The 30th Annual Charles A. Coltman, Jr. San Antonio Breast Cancer Symposium (SABCS) was held December 13–16, 2007, at the Henry B. Gonzalez Convention Center, San Antonio, Texas. The scientific program consisted of invited lectures and mini-symposia by experts in clinical and basic research, selected slide and poster presentations chosen from the submitted abstracts, and case discussions.
The SABCS is a division of the Cancer Therapy & Research Center (CTRC) at the University of Texas Health Science Center at San Antonio. The CTRC is an independent, nonprofit institution directed by a volunteer Board of Governors committed to providing the highest quality cancer treatment, research, and education. Its objective is to provide state-of-the-art information on the experimental biology, etiology, prevention, diagnosis, and therapy of breast cancer and premalignant breast disease to an international audience of academic and private physicians and researchers.
This symposium is directed primarily toward academic and private physicians and researchers involved in breast cancer in medical, surgical, gynecologic, and radiation oncology, as well as other appropriate health care professionals. The majority of participants are physicians and researchers, with a smaller representation of affiliated health care professionals.
At this most recent SABCS, the CTRC and the American Association for Cancer Research (AACR) announced a collaboration for future symposia, the result of which will be renamed the CTRC-AACR San Antonio Breast Cancer Symposium
beginning in 2008. As stated in the announcement, “Complementing the clinical strengths of the highly regarded annual San Antonio Breast Cancer Symposium, the AACR’s scientific prestige in basic, translational, and clinical cancer research will create a unique and comprehensive scientific meeting that will advance breast cancer research for the benefit of patients.”
Patient Characteristics and Time Course of CNS Metastases In Patients with HER2-Positive Metastatic Breast Cancer: Results of a Prospective, Observational Study of More Than 1,000 Patients
Clinically apparent central nervous system (CNS) metastases are reported to occur in 6% to 16% of women with metastatic breast cancer. The true incidence is not known, as autopsy series have revealed CNS metastases in 18% to 34% of patients with metastatic breast cancer. The development of brain metastases has been associated with young age, HER2-positive status, estrogen receptor–negative status, and basal phenotype.
Patients with HER2-positive metastatic breast cancer are much more likely to develop CNS metastases than those with HER2-negative metastatic breast cancer, with estimates of the incidence ranging from 23% to 48% based on retrospective reviews of trastuzumab trials and single institution experiences. Predictors of CNS metastasis are not well characterized.
Denise A. Yardley, MD, from the Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, Tennessee, presented the results of an analysis of RegistHER data performed to characterize the incidence and predictors of CNS metastases among patients with HER2-positive metastatic breast cancer.
RegistHER is an observational cohort of 1,030 women with HER2-positive metastatic breast cancer treated in community and academic settings. Patients were enrolled in the RegistHER study between January 2003 and February 2006. This analysis was restricted to patients with metastatic breast cancer diagnosed on or before July 1, 2005 (N = 772). The median follow-up from diagnosis of metastatic breast cancer was 20 months at the time of data cutoff (December 30, 2006).
A total of 173 patients (22.4%) developed CNS metastases, of whom 35 (4.5%) had CNS metastases at the time of diagnosis, and 138 (17.9%) developed CNS metastases as a later site of disease progression. Patients who developed CNS metastases were younger (<50 yr of age, 46% vs. 39%), had disease that was hormone receptor– negative (52% vs. 40%) and had a greater disease burden (>2 metastatic sites at initial diagnosis, 60% vs. 52%), compared with patients without CNS metastases.
Among patients who later developed CNS metastases, the CNS was the only site of disease progression in 50 (36.2%) and was a first site of progression in conjunction with other sites in 14 (10.1%). Median time to CNS progression among patients without CNS disease at baseline was 12.1 months.
The brain is the first metastatic target of the HER2-positive cells in about 50% of patients, rather than a late occurrence, said Dr. Yardley. On the other hand, treatment with trastuzumab appears to extend survival in women with brain metastases, even though the drug does not cross the blood-brain barrier.
Gemcitabine/Docetaxel Versus Capecitabine/ Docetaxel in Patients With Anthracycline-Pretreated Metastatic Breast Cancer: New Phase III Data Demonstrate Similar Efficacy and Suggest Better Tolerability for Gemcitabine/Docetaxel