Report of the 2010 ASCO Breast Cancer Symposium, October 1-3, 2010

This fall, the annual ASCO (American Society of Clinical Oncology) Breast Cancer Symposium brought together hundreds of medical professionals from around the world to National Harbor, MD to present and discuss the latest translational and clinical research on breast cancer. The Symposium featured many lively discussions on such topics as triple-negative breast cancer, diagnostic screening, and healthcare policy. BCRF grantees and BCRF-supported research were featured prominently throughout the Symposium.

A highlight of the meeting was the presentation of the 2010 Gianni Bonadonna Breast Cancer Award for outstanding research accomplishment to Dr. Nancy Davidson (University of Pittsburgh), a longstanding member of BCRF's Executive Board of Scientific Advisors. Dr. Davidson's work on breast cancer treatment and research has left an indelible mark on the clinical care of patients. In her keynote address, Dr. Davidson rallied the audience on the importance of mentoring the next generation of researchers and of "taking today's work to improve the lives of tomorrow." She detailed the arc of her research career, highlighting findings on the role of hormones, especially estrogen, in breast cancer development. Dr. Davidson recognized her mentorship of Dr. Shannon Puhalla, one of her current fellows at the University of Pittsburgh and a recipient of a BCRF-supported Career Development Award through the ASCO Cancer Foundation.

The 2010 meeting opened with presentations on prevention and risk assessment from two BCRF grantees, Drs. Carol Fabian (University of Kansas) and Christine Ambrosone (Roswell Park Cancer Institute). Dr. Fabian made the point that women who are at risk of developing breast cancer are not eager to take medications such as tamoxifen and raloxifene that have proven to decrease risk. She shared details from her work on the development and evaluation of newer preventive strategies that may have broader acceptance in the general population, including vitamin D, omega-3 fatty acids, and lignans (a weak estrogen found in high concentration in flax seed). These studies utilize risk biomarkers that were developed through her BCRF-funded work.

Dr. Ambrosone acknowledged BCRF support for her work related to the higher incidence of triple-negative (or "basal-like") breast cancer, an aggressive form of the disease, in young women of African ancestry as compared to women of European ancestry in the same age group. Dr. Ambrosone's team hypothesized that there may be distinct genetic profiles that evolved over time for survival adaptation, which when coupled with sun exposure, behavior, and lifestyle factors, may predispose African ancestry women to more aggressive breast cancers at an earlier age.

In a standing room only general session, BCRF Scientific Director Dr. Larry Norton (Memorial Sloan-Kettering Cancer Center) co-chaired a panel on imaging and screening. Presenters from the U.S. and the U.K. shared their analyses of data derived from several randomized clinical trials. One study examined screening and its link to reduced mortality rate from breast cancer in groups of women under 50 and over 70. Another reviewed mammography and new screening technologies, such as MRI. The third presenter used mathematic models to estimate the outcome from 20 mammography strategies that used varied ages of initial screening and cessation of screening, and interval of screening. All agreed that, while mammography is imperfect, it is without question the best tool for early breast cancer detection, and that efforts to support screening mammography should be encouraged.

During the one of the lunch breaks, Drs. Nancy Davidson (University of Pittsburgh) and Clifford Hudis (Memorial Sloan-Kettering Cancer Center) led small group tours highlighting a few of the project posters. These tours provided young faculty and other meeting attendees with the opportunity to ask questions of two of the leaders in breast cancer research.

BCRF grantee Dr. Lori Pierce (University of Michigan) co-chaired the general session on controversies in radiation therapy that featured researchers including Dr. Shelley Hwang (University of California, San Francisco), another BCRF grantee. This session provided the audience with an overview of current clinical research analyzing various approaches of radiation therapy in specific patient populations and based on different presentations of breast cancer. Issues addressed included the optimal selection of appropriate patients and the optimal use of available techniques, such as partial breast irradiation and intensity modulated radiation therapy.

In another session, Dr. Carlos Arteaga (Vanderbilt-Ingram Cancer Center), a BCRF grantee and the 2009 Bonadonna Award recipient, presented his work on targeted therapy advances. He focused on the combination of anti-HER2 drugs in the treatment of patients with HER2-overexpressing breast cancer. The current protocol of using single-agent therapies seems to have limited effectiveness. Early laboratory results on the effects of combining various anti-HER2 agents are encouraging and may provide additional treatment choices for patients with HER2-positive breast cancer.

The final panel of the Symposium featured BCRF grantees Drs. Lisa Carey (University of North Carolina) and Ana Maria Gonzalez-Angulo(University of Texas, MD Anderson Cancer Center). Drs. Carey, Gonzalez-Angulo, and their co-presenters discussed distinctive molecular characteristics found in patients with triple-negative breast cancer, and they also compared different approaches to clinical treatment of this form of the disease. In her presentation, Dr. Carey acknowledged the seminal work on the characterization of triple-negative breast cancer by her colleague at UNC and fellow BCRF grantee, Dr. Charles Perou.