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SABCS: Translational Before It Was Cool

<ѻý class="mpt-content-deck">— Growing, evolving while adhering to founding principles
Last Updated December 4, 2018
MedpageToday

SAN ANTONIO -- The San Antonio Breast Cancer Symposium (SABCS) continues to grow, thrive, and evolve by being ahead of its time and adhering to the same principles that guided the initial meeting 41 years ago.

When fewer than 100 breast cancer specialists gathered for the inaugural program in 1977, SABCS became one of the first international conferences limited to a specific type of cancer, said symposium codirector C. Kent Osborne, MD, of Baylor College of Medicine, who attended that first meeting. From the beginning, the program brought together researchers and clinicians and encouraged a level of interaction and communication that was novel for the time but now integral to advances in all fields of cancer.

"One of the reasons it's popular is that we've always viewed this as a translational meeting," Osborne told ѻý. "Translational now means taking discoveries from the laboratory into the clinic, but it was always the theme of this meeting.

"At at lot of meetings, if you're in basic science you go to one room and if you want to hear the clinical science you go to a different room. The originators of this meeting, particularly Bill McGuire and Chuck Coltman, felt that it was really important for clinicians to hear what the basic scientists were saying and for basic scientists to hear what the clinicians were saying. Mutual education."

The more than 7,500 breast cancer specialists from around the world expected for the 2018 SABCS will find the same basic format that was in place when the initial meeting was held. With a few exceptions, the program has no overlapping or concurrent programs, affording every meeting participant the opportunity to attend essentially the entire meeting.

Codirector Virginia Kaklamani, MD, of UT Health San Antonio Cancer Center, attended SABCS for the first time in 2000. She was immediately struck by the translational nature of the program, a term that was still gaining traction at the time.

"You have the basic scientists, the clinical scientists, the radiologists and radiation oncologists, the medical oncologists, the surgeons, the ancillary personnel all in one room," she said. "You really get to see how the progression occurs from the lab to the clinic and the patient. That's what makes it a unique conference."

During the 1980s, organizers encouraged breast cancer researchers to submit abstracts of their own work for presentation at the meeting, which initially consisted of lectures and educational sessions. Osborne said that's when SABCS "really took off."

Over the years, the world's leaders in breast cancer research and clinical care have participated in the symposium, presenting original research and sharing knowledge, insights, and experiences in lectures and discussion sessions.

Despite having few concurrent sessions, the program has continued to evolve with the addition of new ways to present information. Last year organizers introduced a "controversies" session, which will return this year. Daniel Hayes, MD, of the University of Michigan in Ann Arbor, and Harold Burstein, MD, of Dana-Farber Cancer Institute in Boston, will debate the question: Should all women with breast cancer and positive lymph nodes receive chemotherapy?

At another session, Ingrid Mayer, MD, of Vanderbilt University in Nashville, Tennessee, will discuss the evolving science of neoadjuvant endocrine therapy for hormone receptor-positive breast cancer, omitting chemotherapy in that setting. For the first time, SABCS will explore the potential of artificial intelligence and deep-learning technology for advancing the field of breast cancer. Nico Karssemeijer, PhD, of Radboud University Medical Center in Nijmegen, The Netherlands, and Andrew H. Beck, MD, PhD, of PathAI in Cambridge, Massachusetts, will be the featured speakers.

"We've been talking about how artificial intelligence might impact cancer, and now we have some pretty mature data," said Kaklamani. "It's something we're all going to be seeing in clinical practice in the next few years."

Speakers at several other sessions will share new information about the status of genomics and biomarker analyses as aids to clinical decision making in breast cancer.

Over the years, a number of landmark clinical trials in breast cancer have been reported at the meeting, and data from several anticipated studies will be presented this year, including initial and follow-up reports. Examples include:

  • Biomarker analysis of the IMpassion130 trial of immunotherapy in metastatic triple-negative breast cancer
  • Randomized phase III comparison of adjuvant trastuzumab emtansine (T-DM1, Kadcyla) vs. trastuzumab (Herceptin) in HER2+ breast cancer with residual disease after neoadjuvant therapy
  • Phase III trial of capecitabine after standard chemotherapy for early triple-negative breast cancer
  • Final results of a potentially practice-changing comparison of 6 vs. 12 months of adjuvant trastuzumab for early-stage HER2+ breast cancer
  • Randomized trial comparing neoadjuvant endocrine therapy with or without a CDK4/6 inhibitor
  • Meta-analysis of 12 randomized trials evaluating continuation of extending adjuvant therapy with an aromatase inhibitor to 10 years -- plus a new randomized trial evaluating the issue
  • New data from a randomized trial of a PI3K inhibitor plus endocrine therapy for advanced breast cancer
  • Multiple studies evaluating the role of radiation therapy in early breast cancer

The 2018 SABCS begins Tuesday with a half-day of education sessions. The general program begins Wednesday and continues through Saturday. ѻý will provide on-site coverage from beginning to end.

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    Charles Bankhead is senior editor for oncology and also covers urology, dermatology, and ophthalmology. He joined ѻý in 2007.