Breast Cancer Update 2

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Neil Love, MD

(Every December brings the annual insanity that is the San Antonio Breast Cancer Symposium, particularly for this intrepid inquisitor who attends far fewer meeting sessions than in the past and instead spends his days and nights with an audio crew asking people about what happened at the conference and what it all means. The result is always a breast cancer research and educational bonanza without parallel. Sitting down at my computer after the first marathon day of the 2007 meeting, I encountered an instant message from a colleague who could not attend but was curious about what happened.)

Thursday, December 13, 2007 @ 11:30 PM

OncMeister: So how was it?

DrNeil: Dude, you have no idea! This morning, I go over to the first oral session and Peto is supposed to give the lead paper. As I walk in, Kent Osborne’s semifrantic voice is filling the air, asking, “Does anyone know where Dr Peto is?”

OncMeister: I love it! Peto is like Sting!

DrNeil: Totally! So anyhow, the room is filled with thousands of bright, eager, silent faces, and finally they decide to let the second speaker, Kathy Albain, present.

OncMeister: How was that?

DrNeil: Super-cool. Love RT-PCR. Anyhow, then they say Sir Richard is here and will give his presentation now. So Peto goes up there and says how sorry he is for being late, but he has a bad cold and goes through his talk, stopping like every two minutes for these explosive paroxysms of coughing, looking like he’s about to die.

OncMeister: Weren’t you supposed to interview him right after the session?

DrNeil: Uh-huh.

OncMeister: Knowing your obsession with germs, I’m sure you were thrilled.

DrNeil: Dude, we ordered like a gallon of Purell® to the interview suite.

OncMeister: Did he show?

DrNeil: Yep…sort of slides in and collapses into his chair. I’m like, “Richard, we don’t have to do this,” but he’s like, “No, I just need a few minutes to catch my breath and get my voice back.” Anyhow, after about an hour of him sipping tea, he does his usual amazing interview and announces that tomorrow night, when he presents the initial results of the ATLAS study, there will be about a 15 percent relative reduction in risk of recurrence with 10 versus five years of tamoxifen!

OncMeister: I love it! Remember the 2000 NIH Consensus Conference when he was defiant in continuing the trial, in spite of the NCI alert?

DrNeil: Totally. He’s the man.

OncMeister: Who else did you interview?

DrNeil: The venerable cowboy, Steve [Stephen] Jones.

OncMeister: I love him.

DrNeil: Me too. Great voice, super-knowledgeable and he always is nice enough to comment that he enjoys listening to our programs.

OncMeister: Who else?

DrNeil: The aforementioned Kathy Albain, who presented probably the most anticipated paper of the meeting — the Oncotype node-positive stuff.

OncMeister: What’s the bottom line?

DrNeil: Seems like patients with low recurrence scores don’t benefit from chemo, but their prognosis without chemo isn’t that great either.

OncMeister: Still, why take chemo if it’s not going to help?

DrNeil: Totally, but they want more data to be sure.

OncMeister: Always want more data, don’t they?

DrNeil: Got to have it! So, later in the afternoon, Kathy Miller and Cliff Hudis drop by for a joint interview to review what happened today.

OncMeister: Interesting duo. Did they behave for a change?

DrNeil: Pretty much, although as we were walking out the door, I heard some pretty choice remarks about the ODAC review of E2100 and bev for breast cancer.

OncMeister: Wish I could have heard that part.

DrNeil: Super-amusing and depressing, simultaneously.

OncMeister: Anybody else?

DrNeil: Nancy Lin.

OncMeister: Brain-met diva!

DrNeil: Totally. Really good stuff on lapat and the brain.

OncMeister: Love TKIs!

DrNeil: Onc-tinib. Our final victim was Joyce O. She just left here in her bright red ensemble.

OncMeister: Encyclopedia of breast cancer.

DrNeil: Totally.

OncMeister: What did she say?

DrNeil: She threw out the interesting concept that if TC is now the new “standard” adjuvant chemo for node-negative and some node-positive patients, and if nab is more effective than docetaxel in metastatic disease…

OncMeister: …as per the randomized Phase II by Billy G.

DrNeil: Exactly. So her point is, someday perhaps we will be using nab/C rather than TC.

OncMeister: Until something better comes along, G-d willing.

DrNeil: Totally.

— Neil Love, MD
DrNeilLove@ResearchToPractice.com
March 13, 2008

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