Miami Breast Cancer Conference Agenda Takes a Multidisciplinary Approach to Care

Debu Tripathy, MD

The 39th Annual Miami Breast Cancer Conference® (MBCC) makes its return to the Fontainebleau Miami Beach in Florida with a twist on both the agenda and the setting. In the 2 years since the last in-person meeting, the conference has expanded its reach with a virtual component that faculty and attendees will continue to leverage in 2022.

Since the mid-1980s, MBCC has provided an opportunity for breast cancer specialists from all disciplines to learn about emerging therapeutic strategies that they can translate into clinical practice. This year’s conference will fulfill that mission as a combined virtual and live meeting with the option for remote participation.

“This actually allows us to have a larger faculty, an international faculty,” said Debu Tripathy, MD, professor and chair of the Department of Breast Medical Oncology, Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center in Houston and longtime leader of the Miami Breast Cancer Conference^®. Patrick I. Borgen, MD, chair of the Department of Surgery at Maimonides Medical Center in Brooklyn, New York, serves as chair of the conference. Joining Tripathy as cochairs of the meeting are Anees Chagpar, MD, MBA, MPH, FACS, FRCS(C), and Hope S. Rugo, MD, FASCO. Chagpar is a professor in the Department of Surgery at Yale School of Medicine in New Haven, Connecticut. Rugo, a 2020 Giants of Cancer Care^® award winner in the education category, is a professor of medicine and director of Breast Oncology and Clinical Trials Education at the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center.

Another key feature of the meeting is that it is multidisciplinary. “We have nurses, pathologists, radiologists, medical radiation, medical oncologists, and surgical oncologists all together. We believe that it takes a village,” Tripathy said.

He emphasized that the goal is for any physician treating a patient with breast cancer to know “the entire picture,” even if it is outside their area of specialty. “We want surgeons to know what’s going on in genomics, and we want the medical oncologists to know what is going on with the latest surgical and radiation technologies and postoperative pain management,” Tripathy said. “Basically, we want everybody who attends the conference to be able to go back to their office on Monday and be able to really communicate with their patients about the latest comprehensive and multidisciplinary treatment planning and how it may apply to them.”

Customizing Care for Patients With Breast Cancer

On the heels of the San Antonio Breast Cancer Symposium, the motto of MBCC—“hear it on Friday, use it on Monday”—will shine as the faculty contextualizes what the key data from the latest readouts mean for clinical practice. Tripathy said a key focus will be on adaptive therapies and personalization of therapies, with discussions covering recent innovations such as developments on the immunotherapy front and with newer targeted agents, including use of selective estrogen receptor downregulators (SERDs), PARP inhibitors, and antibody-drug conjugates (ADCs).

For example, data from the phase 3 EMERALD trial (NCT03778931), which demonstrated that the oral SERD elacestrant led to a 30% reduction in the risk of disease progression or death compared with standard-of-care fulvestrant in patients with estrogen receptor–positive, HER2-negative metastatic breast cancer who previously received CDK4/6 inhibition. Elacestrant is the first agent to demonstrate a statistically significant and clinically meaningful improvement in progression-free survival for these patients, so Aditya Bardia, MD, MPH, will unpack how these data are likely to have investigators rethinking standard approaches to care, especially for those harboring ESR1 mutations.¹ Bardia is an assistant professor of medicine at Harvard Medical School and an attending physician, medical oncology, at Massachusetts General Hospital in Boston, Massachusetts.

Sequencing remains a prominent topic and will be the focus of several discussions at this year’s meeting. As the ADC fam-trastuzumab deruxtecan-nxki (Enhertu) makes waves in the second line against standard-of-care ado-trastuzumab emtansine (T-DM1; Kadcyla), leading investigator Sara M. Tolaney, MD, MPH, will tackle how data from DESTINY-Breast03 (NCT03529110) will reshape the way metastatic HER2-positive breast cancer is approached.² Tolaney, who is chief of the Division of Breast Oncology and associate director of the Susan F. Smith Center for Women’s Cancers at Dana-Farber Cancer Institute and associate professor of medicine at Harvard Medical School in Boston, Massachusetts, will also discuss how novel agents will play a role in treatment selection in the third and later lines of therapy. Additionally, Mark D. Pegram, MD, the Suzy Yuan-Huey Hung Endowed Professor of Medical Oncology and associate dean for clinical research quality at Stanford University School of Medicine, associate director of clinical research at the Stanford Comprehensive Cancer Institute, and medical director of the Stanford Clinical Translational Research Unit in California, will leverage how the data from the subgroup analysis of patients with brain metastases enrolled in DESTINY-Breast03 may influence treatment decisions for this patient population compared with other available agents.²

In triple-negative breast cancer (TNBC), Kevin Kalinsky, MD, MS, will look at the role of ADCs in addition to how the latest data in immunotherapy, specifically from KEYNOTE-355 (NCT02819518), will influence treatment decisions.

There also will be many practical sessions focused on important care issues, such as use of neoadjuvant chemotherapy, managing treatment-related toxicities (eg, cardiotoxicity), optimizing treatment sequencing, and imaging and cancer staging considerations. “Symptom control research is research aimed at trying to prevent, treat, and better understand symptoms caused by cancer and cancer treatment,” Charles L. Loprinzi, MD, said in an interview ahead of the conference. His presentation, “My Approach Toward Breast Cancer Treatment-Related Toxicity Management,” will take place today at 3:40 pm. Loprinzi is a consultant in the Division of Medical Oncology in the Department of Oncology and Department of Oncology at Mayo Clinic in Rochester, Minnesota.

The conference also will feature patient speakers who will share their cancer journeys so that physicians can learn from those stories. Tomorrow, Brittney Beadle will take the main stage to deliver the Patti Hennessy Keynote Address. Beadle received a diagnosis of breast cancer at age 18 years, when she was finishing high school. She will discuss how she has learned to live in remission and is learning to let go of the moments marked by a devastating diagnosis.

All Sides of the Story

Additionally, several hot topic medical debates are planned. “We pick a controversial topic and have 2 people duke it out, but it’s all in good fun,” Tripathy said. During the meeting, he will be engaging in a Medical Crossfire® debate with Sara A. Hurvitz, MD, medical director of the Jonsson Comprehensive Cancer Center Clinical Research Unit at the University of California, Los Angeles on the use of adjuvant immune checkpoint inhibitors (ICIs) entitled “Adjuvant Immune Checkpoint Inhibitor for a Patient With Pathological Complete Response After Neoadjuvant ICI Plus Chemotherapy: Yes or No.”

The Medical Crossfire^® debates this year will also cover topics featuring experts in several disciplines, including the pros and cons of delivering 10 years of adjuvant endocrine therapy and whether surgical excision or multiple core biopsies are favorable in determining pathological complete response.

Beyond the tracks giving attendees the opportunity to take in sessions across disciplines, the Sunday agenda broadens the topics across the breast cancer care spectrum. This includes a session from Chagpar, who will discuss getting into clinical research. “One of the things that’s great about the Miami Breast Cancer Conference® is that it really brings together all kinds of [individuals] in the community who are dedicated to delivering the best quality of care to patients with diseases of the breast,” Chagpar said. “Yes, it does bring together some of the biggest national experts who are very well versed in clinical research, but it also brings together some of those frontline [individuals]—[those] who are in the trenches, delivering care to [patients] with breast cancer every day—who may or may not be as involved in clinical research but who may really be interested in how they can really contribute [and] how they can move the field forward.”

As always, the meeting will host several opportunities for in-person and virtual attendees to debate topics with their peers during question-and-answer sessions as well as the “Meet the Faculty” case discussion sessions. For an additional opportunity to gather and greet your colleagues, please attend the “Poster Discussion and Get Acquainted Reception” today at 5:30 pm.

References

1. Bardia A, Neven P, Streich G, et al. Elacestrant, an oral selective estrogen receptor degrader (SERD), vs investigator’s choice of endocrine monotherapy for ER+/HER2-advanced/metastatic breast cancer (mBC) following progression on prior endocrine and CDK4/6 inhibitor therapy: Results of EMERALD phase 3 trial. Presented at: 2021 San Antonio Breast Cancer Symposium; December 7-10, 2021; San Antonio, TX. Abstract GS2-02. Accessed February 25, 2022. bit.ly/3543GfV
2. Hurvitz S, Kim SB, Chung WP, et al. Trastuzumab deruxtecan (T-DXd; DS-8201a) vs. trastuzumab emtansine (T-DM1) in patients (pts) with HER2+ metastatic breast cancer (mBC): subgroup analyses from the randomized phase 3 study DESTINY-Breast03. Presented at: 2021 San Antonio Breast Cancer Symposium; December 7-10, 2021; San Antonio, TX. Abstract GS3-01. Accessed February 25, 2022. bit.ly/3sh4gj4