San Antonio Breast Cancer Symposium
Since its establishment in 1977, the San Antonio Breast Cancer Symposium (SABCS) has evolved from a one-day meeting primarily attended by local oncologists to become of one of the premier international breast cancer conferences. The number of registered attendees has grown exponentially over the meeting’s history, from 526 individuals in 1990 to 7576 individuals in 2015. The 2016 Symposium featured original research, invited lectures, and panel discussions by academic and community oncologists who represented 90 countries and six continents.
SABCS strives “to provide state-of-the-art information on the experimental biology, etiology, prevention, diagnosis, and therapy of breast cancer and premalignant breast disease, to an international audience of academic and private physicians and researchers.” Over 1300 papers were accepted for presentation at the 2016 Symposium, many of which directly related to the development and implementation of value-based oncology care. Topics in the areas of health services and outcomes research included the development of guidelines for risk-based follow-up care in breast cancer; the value of whole-exome and transcriptome sequencing of resistant estrogen-receptor–positive metastatic breast cancer; and the use of menopausal symptoms as a predictor for treatment adherence.
The Symposium recognizes oncologists, surgeons, and clinical researchers who have added to the clinical and scientific knowledge of breast cancer. At the 2016 Symposium, the Susan G. Komen Brinker Awards for Scientific Distinction were presented to Charles Perou, PhD, May Goldman Shaw Distinguished Professor of molecular oncology at University of North Carolina School of Medicine (Chapel Hill, NC), for his work in applying genomic data to aid in the selection of appropriate breast cancer therapies; and to Monica Morrow, MD, FACS, chief of the breast surgery service at Memorial Sloan Kettering Cancer Center (New York, NY), for her commitment to ensuring that women are presented with evidence-based surgical options.
SABCS has long been committed to promoting value-based care. The plenary lecture of the 2016 Symposium was given by Peter B Bach, MD, MAPP, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center (New York, NY), and a leading expert on the influence of costs of care on patient outcomes. Entitled “The Global Cost of Cancer Care,” Dr Bach’s lecture focused on the ways in which the rising prices of cancer treatment and maintenance have influenced the financial well-being of cancer patients, leading to high early discontinuation rates, medication nonadherence, and adverse outcomes. Dr Bach also highlighted the implementation of DrugAbacus (www.drugabacus.com), a website he helped create that allows providers and institutions to “manipulate various metrics to determine the ‘value’ of cancer drugs.” The availability of DrugAbacus has “shifted the conversation of value-based pricing from one of theory to one more focused on implementation, and has been cited as a source of pricing for both CVS and Express Scripts,” according to Dr Bach. “The price should be dealt with as a feature of the drug, like its toxicity or its potential benefits.”
Common menopausal symptoms such as nausea and headaches can be used as predictive tools for adherence to the aromatase inhibitor tamoxifen, according to an analysis of data from the International Breast Cancer Intervention Study (IBIS-1).
Extended observation for adverse reactions following subcutaneously administered trastuzumab (Herceptin, Genentech/Roche) serves as an unnecessary use of health care resources.
A genomic analysis revealed significant differences in the genomic landscape of estrogen receptor-positive metastatic breast cancers when compared with ER-positive primary tumors.
Loperamide plus budesonide reduces the rate of toxic effects associated with neratinib (PB272, Puma Biotechnology) for patients with human epidermal growth factor receptor-2 positive (HER2+) breast cancer, according to study results.