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Join Date: Mar 2006
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more from Istanbul--Breast cancer group award and start of new trial
Breast Cancer Research Group Wins ESMO Award, Plans New Trial
Zosia Chustecka
October 2, 2006 (Istanbul) — A collaboration of breast cancer researchers who were responsible for the landmark Herceptin Adjuvant (HERA) trial showing the benefits of trastuzumab (Herceptin, Genentech) has won a new award from the European Society of Medical Oncology (ESMO).
The ESMO Lifetime Achievement Award in Targeted Therapies in Cancer Research and Treatment, worth €50,000 and supported by GlaxoSmithKline, was presented here at the society's 31st Congress. "This is the first time that such a significant award has been given," commented Aage Schultz, ESMO executive director.
The award was presented to the Breast International Group (BIG), cochaired by Martine Piccart, MD, from the Institute Jules Bordet, Brussels, Belgium, and Aaron Goldhirsch, MD, from the European Institute of Oncology in Milan, Italy. It recognizes their "outstanding commitment to breast cancer treatment and research over the past 10 years," said Paolo Paoletti, MD, senior vice president of the oncology medicine development center at GlaxoSmithKline. "Their coordinated and collaborative approach to breast cancer research will ultimately benefit women all over the world whose lives are touched by breast cancer."
Started in 1996, the BIG collaboration was formed to coordinate research efforts, Dr. Piccart explained. "At that time, breast cancer research was very fragmented, and there was a wasteful disposition of resources," she told journalists. "Since we began, 38 groups have joined in," she continued, "allowing us to conduct large clinical trials efficiently and rapidly."
The group's best-known achievement is the HERA trial, which was published in the New England Journal of Medicine last year. It involved more than 5000 women followed for 2.5 years and compared trastuzumab with observation in women with HER2-positive breast cancer after adjuvant chemotherapy. "In that very short period of time, we saw very striking results, with the risk of relapse being cut in half," she commented. "This was a very efficient way of bringing a new drug to patients," she added.
Which Cases Benefit From Chemotherapy?
The BIG collaboration is now working on another large study, Microarray for Node Negative Disease May Avoid Chemotherapy (MINDACT), which will involve 6000 women with node-negative breast cancer. "Although this is an early stage of breast cancer, nevertheless about 30% of these women will die, and we try to prevent this with chemotherapy," Dr. Piccart explained. "However, not all women benefit, and some women do very well with just surgery alone. We are convinced that too many women receive chemotherapy and needlessly suffer drug toxicity."
At present, the decision as to whether or not to administer chemotherapy postoperatively is made on the basis of classic clinical signs, such as tumor size, age of the patients, and presence of receptors, Dr. Piccart explained to Medscape. These signs suggest about one third of women are likely to benefit from chemotherapy.
"We are testing a new tool, known as the Amsterdam genetic signature, which comprises 70 genes, to see how it compares with the classic signs," she explained. All of the participants will have both tests. If both point to a high chance of benefit from chemotherapy, those patients will be treated, whereas if both tests suggest there will be no benefit, those women will not undergo chemotherapy.
"It is the women that fall in between the 2 that we want to focus on," Dr. Piccart said. "We suspect that the genetic signature will be a better predictor of benefit from chemotherapy than the classic signs, but of course we have to wait to see how the trial comes out," she commented. "The trial has only just begun; we will have to wait about 5 years for the answer."
N Eng J Med. 2005;353:1659-1672.
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