CancerNetwork presents exclusive coverage from the annual San Antonio Breast Cancer Symposium. As part of our preconference coverage, we present an interview with Dr. Kent Osborne, director of the Lester and Sue Smith Breast Cancer Center and the Dan L. Duncan Cancer Center at the Baylor College of Medicine, where he is also a professor of medicine in cellular and structural biology. Dr. Osborne is the moderator of the year in review session and he has been involved with the meeting since its beginning.
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Dr. Kent Osborne
CancerNetwork: Dr. Osborne, what is in your opinion one of the most exciting results that we will hear about at the meeting?
Dr. Osborne: Well, I think there are a couple. First of all, the results of a large randomized trial known as the CLEOPATRA trial in patients with metastatic breast cancer, breast cancer that has spread already to other parts of the body. This trial, along with several others reported earlier this year looks at a combination of drugs that block the growth factor receptor called HER2. HER2 is a driver of the cancer and a cause of the cancer in about 20% to 25% of patients with breast cancer. We have made excellent progress in blocking that pathway but still, some patients are resistant and what we’re discovering based on studies that were presented earlier this year and studies that are going to be presented at the San Antonio meeting; we’re going to find that a combination of drugs to more completely block the pathway is superior to the old standby which is the drug, Herceptin (or trastuzumab) which has itself made a big impact in survival for breast cancer in patients with this kind of breast cancer. We’re seeing a more effective regimen is the combination of other drugs that also block the pathway and we will see the results of the CLEOPATRA study that hopefully will continue to show this result.
CancerNetwork: Can you give us a sense of how many patients become resistant to Herceptin?
Dr. Osborne: Well, if you look in the adjuvant setting, that is getting chemotherapy or other hormonal therapy or Herceptin after surgery in patients where there is no evidence of disease. First of all, that used to be thought of as a bad tumor. These are aggressive tumors and they metastasize early and patients recur soon. Chemotherapy itself is quite effective in these tumors and the use of chemotherapy reduced the risk of recurrence by about half in these patients. So let’s say a woman presented with a HER2 positive breast cancer and had several positive lymph nodes. That person’s chance of recurrence in 10 years might be 60% to 70%. Well, chemotherapy lowered that by half, maybe down to 30%, 35%. Well, the addition of trastuzumab to the chemotherapy lowered it by another half so with trastuzumab plus chemotherapy, we have converted what is normally thought of as a more aggressive kind of breast cancer into a relatively good kind of a breast cancer . . .
Click here to read more of this interview with Dr. Osborne.