Komen Advocates In Science ASCO Attendance
Guest blog from Komen Advocates In Science: Karen Durham, Mary Elliott, Cheryl Jernigan, Sandy Finestone, & Kimberly Wright…with a special thank you to Elda Railey, Research Advocacy Network, for her thoughtful edits.
Only 4 out of 100 breast cancer patients get an absolute benefit from chemotherapy.
Shocked? That was certainly the reaction of the Komen Advocates in Science (AIS) members who participated in this year’s research advocate training sponsored by Susan G. Komen for the Cure® and conducted by the Research Advocacy Network during the 2012 American Society of Clinical Oncology’s (ASCO) Breast Cancer Symposium last month.
No, that doesn’t mean the other 96 women receive no benefit from chemotherapy. Some receive no benefit, others receive a very high benefit, and most fall somewhere in between. But, how does one know where they lie on the spectrum of therapy benefit?
First, AIS participants took a field trip to Genomic Health to learn more about the “promise of genomics” and how it can and is “changing the practice of medicine…one patient at a time.” Genomic Health developed a genomic assay for breast cancer that can assist in determining whether a patient will benefit from adding chemotherapy to their treatment and the likelihood that early-stage breast cancer will recur. Imagine having quantitative information based on your own tumor that you and your physician will use to determine which treatment is best for you–instead of based on the average of patients with similar factors as you.
At the ASCO Symposium, an overarching theme was “more is not necessarily better” and genomics was a common thread throughout the presentations. This move toward personalized medicine will spare many women from the toxic side effects of cancer drugs that offer them little benefit. However, it was noted that imaging techniques still seem to apply a “one size fits all” approach. Future advances may well lie in designing new imaging sequences and selective imaging based on tumor biology.
Dr. Monica Morrow, from Memorial Sloan-Kettering Cancer Center, noted that since 1980, patients and doctors have believed that removing a little larger area around the tumor and removing additional lymph nodes would lead to a reduction of local recurrence. Now, we are discovering this does not improve outcomes when a patient is low risk (ER+, PR+, HER2-) or higher risk triple negative (ER-, PR-, HER2-). More surgery is not necessarily better. Yet patients often still opt for “more” because they still believe it is better…be it surgery or drug therapy. Advocates can help create a better understanding of what research has already demonstrated to be effective and the risks of overtreatment.
For those with advanced cancer, the promise of genomics hasn’t made significant inroads yet. While there are a number of new systemic therapies in clinical trials, we don’t yet know who might benefit most from the treatment. As advocates, we must continue to ask the questions and demand clinical trials that not only provide new therapies, but also the biomarkers to indicate who will benefit (based on tumor biology) from them.
All the research in the world will not cure cancer or prevent deaths if people don’t have access to information, or the prevention, diagnosis or treatment strategies discovered. Otis Brawley, MD, from American Cancer Society, spoke of inequities within our society and healthcare system that lead to 6,000 avoidable deaths each year. This statistic reinforces what we already know–that community grants and programs funded by Komen Affiliates remain crucial to patients and their families across the nation to get the information and access to screening and treatment that they need to fight breast cancer.
The experience gave all the opportunity to learn more about:
- New and emerging evidence-based treatments;
- Genomic assays used to better tailor treatment decisions;
- Promising research that could tailor care and substantially impact practice, including survivorship care;
- Issues impacting equitable access and health disparities; and
- Controversies in current treatment protocols and practice.
This training gave us the opportunity to establish and strengthen networks with fellow advocates, researchers, and clinicians. While we may have left the meeting physically tired, we left with more enlightened and energized spirits to forge ahead in our efforts to put an end to this disease which knows no barrier. For more information about AIS and to access the online application, go to www.komen.org/ais.
Photographs courtesy of Genomic Health. AIS Members participated in Komen Funded Training at Genomic Health during the American Society of Clinical Oncology Breast Health Symposium September, 2012.
About the author
Nancy G. Brinker promised her dying sister, Susan G. Komen, she would do everything in her power to end breast cancer forever. In 1982, that promise became Susan G. Komen and launched the global breast cancer movement. Today, Komen is the world’s largest grassroots network of breast cancer survivors and activists fighting to save lives, empower people, ensure quality care for all and energize science to find the cures. Thanks to events like the Komen Race for the Cure®, we have invested more than $1.9 billion to fulfill our promise, becoming the largest source of nonprofit funds dedicated to the fight against breast cancer in the world.