Biotech Strategy Blog

Commentary on Science, Innovation & New Products with a focus on Oncology, Hematology & Cancer Immunotherapy

Posts tagged ‘San Antonio Breast Cancer’

The San Antonio Breast Cancer Symposium (#SABCS) starts next week (Dec 4 – 8).

Dr Jose Baselga Interviewed at 2011 San Antonio Breast Cancer Symposium Last year at SABCS, Dr Jose Baselga presented the results of the CLEOPATRA phase III trial in HER2+ metastatic breast cancer.

An impressive 6.1 months increase in progression free survival (PFS) of 18.5 vs. 12.4 months was seen by the addition of pertuzumab (Perjeta) to the combination of trastuzumab (Herceptin) and chemotherapy (docetaxel). You can read more on Pharma Strategy Blog.

Earlier this year, following pertuzumab’s approval by the FDA, Roche/Genentech announced that the CLEOPATRA study results demonstrated that women taking the pertuzumab, trastuzumab and chemotherapy combination lived significantly longer, i.e. an overall survival (OS) benefit. The exact amount of the OS benefit is not yet known, but the data will be presented next week in San Antonio. This is exciting news!

I will not be at SABCS due to the overlap with ASH, but like many will be following via Twitter. Without wishing to offend anyone not included, here’s my starting list of people I will be following for news and commentary:




  • Roche at Congresses @congressconnect (update Dec 6: surprising – tweeted that not covering SABCS this year)
  • Boehringer @Boehringer (added Dec 3)

Patient Advocates/Advocacy & Support Groups


I am sure there will be a lot of people contributing to the conversation from San Antonio so do follow the #SABCS Twitter hashtag for additional people you may wish to follow.

In case you missed it, here is the Pharma Strategy Blog video from SABCS 2011, presented by Sally Church, PhD (@MaverickNY):


I have had the privilege to attend many scientific and medical congresses this past year, and my belief from listening to many presentations is that drug development innovation comes from understanding basic biology, then applying this knowledge.

Lisa Coussens (UCSF) at the 2011 San Antonio Breast Cancer Symposium (SABCS) provided a good example of how scientific knowledge is being translated into medicine and applied to drug development.

In her plenary presentation, she outlined how our understanding of the biology of macrophages and the importance they play in breast cancer may lead to new drug targets.  As an example of this, she showed pre-clinical animal work on the Plexxikon drug PLX3397.  A human phase 1b/II clinical trial will start in the near future.

I have aggregated some of the live tweets from the session using Storify.  Social media can be a powerful tool to share highlights and top-line messages with those not at meetings, as well as have a real-time conversation with those in the same session. It was disappointing that the lack of wifi in meeting rooms prevented many international scientists and researchers from sharing their insights.

I look forward to watching the development of PLX3397, and am sure that we will see more drug development targeting macrophages.  Coussens presentation was outstanding and the highlight of SABCS for me.

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San Antonio – there is a lot of exciting new data at the San Antonio Breast Cancer Symposium (SABCS) this week.

As Sally Church pointed out in her SABCS video on Pharma Strategy Blog, the update to the BOLERO2 data  (previously presented by Jose Baselga at ECCO/ESMO 2011 in September) will be presented later this morning at SABCS.

As a side note it is worth noting that the NEJM paper published yesterday contains the Stockholm data, not the updated data that will be presented later today that will show further improvement in progression free survival (as compared to placebo) in post menopausal ER+ HER2- women who took everolimus combined with exemestane.

Despite the presentation of exciting data at SABCS this week, my opinion is that this is a good meeting, but not a great one (yet). The reason is not the quality of the science being presented this week, but the lack of quality discussants.

The unheralded discussant is the expert that puts the science in context for the audience. Whether it’s a discussion of a simple poster or of a plenary session, the discussants play an important role.

Yesterday at SABCS I sat through two general sessions (the equivalent of plenary sessions at other meetings) in the cavern like auditorium that I estimate sits two thousand attendees.

Of the 15 presentations, only the 3 on bisphosphonates were given a discussant. That is why this meeting to me is good, but not great.  Both ASCO and ESMO/ECCO do a much better job at having a expert put the data in context in an independent and unbiased review.

Why is a discussant important when it’s all about the scientific data?

The challenge with medicine, law and any other professions is that there is so much new data that we can only be experts in a very small area or subset of knowledge.

At SABCS there are basic scientists, medical students, researchers, oncologists, community physicians, patient advocates and survivors. What does the data presented mean to them?

The discussant looks at many aspects of a presentation and can be critical, positive and negative in their observations about:

  • Clinical Trial Design:  what were the limitations?
  • Results:  did it meet the endpoints, was the data significant?
  • Adverse events: is the AE profile a concern?
  • Comparison to literature:  how does this data compare to the literature?
  • Future research:  does this data suggest rational future trials or research?
  • Practice implications:  does the data impact the standard of care?

There are many more questions that come to mind.  Listening to a good discussant brings science to life.

It is, however, challenging being a discussant because like writing a blog, you are generating original content and expressing an opinion.

My view is that if a presentation is good enough to receive an oral presentation at a major meeting, then it’s good enough to be discussed.  I hope that SABCS will offer more discussants in future years and make this a great scientific meeting in return.

San Antonio – at the San Antonio Breast Cancer Symposium (SABCS), the Institute of Medicine (IOM) report on “Breast Cancer and the Environment” was eagerly anticipated.

Published today, the report appears to me to offer little in the way of new insight into how women should live in order to lower their environmental risk of breast cancer.

The review of the scientific literature undertaken by the IOM notes that epidemiologic studies have shown an association between some environmental risk factors and breast cancer. These include ionizing radiation & combination hormone therapy.

The report goes on to say that for many other environmental factors, the evidence is “limited, contradictory or absent”.

The conclusion from the report is that “women may have some opportunities to reduce their risk of breast cancer through personal actions:

  • Avoiding unnecessary medical radiation throughout life
  • Avoiding some forms of postmenopausal hormone therapy
  • Avoiding Smoking
  • Limiting Alcohol Consumption
  • Increasing physical activity
  • Minimizing weight gain (for those at risk of postmenopausal breast cancer)

Much of the above advice would apply to anyone looking to maintain a healthy lifestyle, but it’s hard to quantify the potential benefit.  The report notes the “potential risk reductions for any individual woman will vary and be modest.”

Given that non-smokers can end up with lung cancer, it’s hard to predict who will get cancer and to what extent exposure to environmental factors may have an impact.

Are some people more disposed to environmental risk factors than others?

As we move towards personalized medicine and a greater understanding of the individual genome, it will be interesting to see if we will gain more insight into who is most at risk from the environment.

Perhaps in the future we will be better able to identify those individuals whose genetic make-up result in them being more at risk from others of certain environmental stresses.

In the meantime, if you have an interest in the IOM Breast Cancer and the Environment report it is freely available to download.

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