SABCS 2021 Meeting News Preview - 7

PREVIEW EDITION | SABCSMEETINGNEWS.ORG
7
Clinical Science Forum to focus on breast cancer-specific use of
ablation for oligometastatic disease
R
E
vidence continues to emerge suggesting
that certain patients with
breast cancer with oligometastatic
disease may benefit from local ablation
of their metastases. However, much of
that evidence comes from single-center
or single-arm trials, according to Steven
Chmura, MD, PhD, Associate Professor
of Radiation and Cellular Oncology at the
University of Chicago.
" Many of these reports have shown the
same thing, " Dr. Chmura said. " In a select
group of patients who seem to have
limited disease, these patients do better
with ablation than you would expect of
the general population. "
In more recent years, some phase 2 trials
have compared palliative standard of
care treatments with or without ablation
and shown benefit, but these were across
several tumor types. Breast cancer-specific
data are lacking, Dr. Chmura said.
Dr. Chmura will moderate the SABCS
2021 Clinical Science Forum: The
Promise and Reality of Oligometastatic
Ablation for Breast Cancer on Thursday,
December 9. The session will include two
state-of-the-art presentations covering
what is currently known about ablation of
oligometastatic disease in breast cancer.
Yolande Lievens, MD, PhD, Associate
Professor and Chair of Radiation Oncology
at Ghent University Hospital in Belgium,
will discuss how to define oligometastatic
disease, the current consensus
on some of the terminology, and current
practice patterns in breast cancer.
" There currently seem to be two broad
categories for defining oligometastatic
disease, " Dr. Chmura said. " The first
involves looking at the number of visible
metastases and the second is related to
response to initial systemic therapy. "
In response to the rapidly increasing
interest and growing evidence in the use
of metastasis-directed radiotherapy for
oligometastatic disease, Dr. Chmura
noted that ASTRO and ESTRO published
a consensus document in 2020 in an
attempt to better define oligometastatic
disease.
Also during this SABCS forum, David
Palma, MD, PhD, a radiation oncologist at
the London Health Sciences Centre and
a clinician-scientist with the Ontario Institute
for Cancer Research in Canada, will
discuss the current literature and where
there are still gaps in knowledge when it
comes to oligometastatic
disease specific to
breast cancer.
One of the ongoing
challenges
in breast cancer
research, Dr.
Chmura said, is
that standard of
care systemic
therapies-such
as HER2-directed
agents and CDK
4/6 inhibitors-keep
improving outcomes.
" Trials are not trying to
replace those therapies but
are adding ablation on top of those, "
he said. " What we have to find out is if
that really improves survival or just adds
toxicity. "
Dr. Chmura is principal investigator
of the NRG BR002 trial, which he
hopes will provide some answers. NRG
BR002 is a phase 2R/3 trial of standard
of care therapy with or without
stereotactic radiotherapy and/or
surgical ablation for newly oligometastatic
breast cancer.
Basic Science Workshop will focus on patient-derived
models, mining data to understand breast cancer
THE SAN ANTONIO BREAST CANCER
Symposium will shine a spotlight on some
of the latest advances in basic science
related to breast cancer during the Basic
Science for Breast Oncologists workshop
on Tuesday, December 7.
" The best advances in breast cancer
research come from collaborating across
disciplines, and it's
amazing each year to
see how quickly science
evolves, " said workshop
moderator Alana Welm,
PhD, Professor and
Senior Director of Basic
Science at the University
of Utah Huntsman
Cancer Institute.
This workshop will
ALANA
WELM, PhD
feature four speakers
covering a wide range of
basic science topics.
Two of the speakers
will discuss the use of
technology for development
and exploitation of
patient-derived models
like organoids that allow for experiments
with models that better represent the
clinical disease. These experiments help
with understanding of how breast cancer
initially develops or test new therapeutic
strategies, Dr. Welm said.
" The latest innovations have allowed
these models to be used in co-culture
systems to better understand, for example,
how immune cells interact with tumor
cells, " Dr. Welm said.
Jennifer Rosenbluth, MD, PhD, Assistant
Professor at the University of California,
San Francisco, and a member of the UCSF
Breast Oncology Program, will discuss genome
editing in human organoids as new
models of discovery.
Senthil Muthuswamy,
PhD, Associate Professor
of Medicine at Harvard
Medical School and Director
of the Cell Biology Program
therapy, or cloning the T cell receptors to
find particular antigens that might be used
as immunotherapy targets. "
The other two presentations will be talks
on mining the ever-growing resources of
existing data that have been made publicly
available, and on exactly how much experimental
data (and/or mined in silico data)
is needed before a clinical trial for a new
therapy, biomarker, etc., can be launched.
Daniel Stover, MD, Assistant Professor of
Medicine & Biomedical Informatics at the
Ohio State University Comprehensive CanTHE
BEST ADVANCES IN BREAST CANCER
RESEARCH COME FROM COLLABORATING
ACROSS DISCIPLINES, AND IT'S AMAZING EACH
YEAR TO SEE HOW QUICKLY SCIENCE EVOLVES. "
at the Beth Israel Deaconess
Medical Center, will give
a presentation on tricking
T cells into action and how
patient-derived organoids
can be used to identify and
expand tumor-specific T cells.
" These tumor-specific immune cells are
very rare amongst all of the immune cells
in the blood, but organoid co-cultures can
be used to selectively expand these cells,
since they proliferate when they see their
specific targets, " Dr. Welm said. " Future applications
might include transferring those
T cells back into the patient for immunocer
Center, will discuss in silico experimentation,
including a review of available tools
to access and analyze existing datasets.
Finally, Bora Lim, MD, Associate Professor
of Breast Oncology and Director
of Translational Research at the Lester
and Sue Smith Breast Center at Baylor
College of Medicine, will help attendees
understand how to tell when basic science
discoveries are ready to translate.
" I hope participants will see how techniques
that were previously not possible
are now becoming feasible and how these
advances might be applied to important
clinical questions, " Dr. Welm said. ■
MEETING NEWS
U
" These results are being
analyzed and, in the
next few months,
we hope to have
more definitive
evidence as
to whether
or not early
intervention
can improve
progression-free
survival, " Dr.
Chmura said.
Following Dr.
Lievens' and Dr.
Palma's presentations,
Dr. Chmura hopes to devote a
significant amount of time to audience
questions and further discussion.
" I hope that session participants will
learn more about current accepted definitions
and some of the ongoing trials
specific to breast cancer, " Dr. Chmura
said. " I hope they take away some hope
that there may be improved therapeutic
options for this select group of patients
but, importantly, also caution or skepticism
to not just apply results from other
disease types to breast cancer. " ■
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