Making history with the WISDOM Trial: Because when women come together, beautiful things happen.

Making history with the WISDOM Trial: Because when women come together, beautiful things happen.

 

Precision Medicine Initiative: “A one-size fits all approach to prevention and early detection of breast cancer is not optimal for women” – The WISDOM Trial
Dr. Barbara Parker - WISDOM Trial Speaker
Dr. Barbara Parker

Dr. Barbara Parker, breast oncologist and Senior Deputy Director of Cancer Medicine, was the first of three keynote speakers.  She discussed breast cancer Precision Medicine, breast cancer incidence and death rates, and treatment advances for early and advanced breast cancer.

In summary, the most important take-away messages from Dr. Parker’s presentation include:

“Precision Medicine” was defined by the National Cancer Institute in 2015 and  focuses on prevention and treatment strategies that take patients’ individual characteristics into account.  “A one-size fits all approach to prevention and early detection of breast cancer is not optimal for women,” comments Dr.  Parker.  Precision Medicine in breast cancer involves:

  • Individualizing care based upon genes, environment, and prognosis; that is, individualizing care based upon family history and inherited genes, reproductive history and environmental exposures, and the prognosis of the cancer based on the tumor characteristics.
  • Targeting therapies to specific patients, tumors, and pathways based on the understanding of the risk factors , the subtype of breast cancer, and the molecular profile of some tumors.
  • Targeting screening and intervention strategies to patients at highest risk.  The WISDOM trial, discussed later in the evening, provides the opportunity to determine breast cancer risk at the point of screening and to assign breast cancer screening frequency based upon risk.

The latest statistics in breast cancer are the following:

  • 1 in 8 women will develop breast cancer.  Breast cancer comprises about 15% of all cancer cases in the US and is the second leading cause of cancer-related death in women, behind lung cancer.
  • Overall estimated 5-year survival in female breast cancer patients is around 90% but differs significantly across different stages of breast cancer; 99% when localized to the breast, 85% when localized to the breast and armpit, and 27% if spread to other parts of the body at diagnosis.
  • Common risk factors include family history, aging, obesity, alcohol consumption, delayed or no childbearing, high dose of radiation (for treating lymphomas) and menopausal hormone therapy.

In many situations especially in women over the age of 50, if we detect cancers earlier, patients may do better, live longer and have better options for smaller surgeries and may not require a mastectomy or chemotherapy, for example”.

“We know that breast cancer survival has improved over the past 20 years thanks in part to high quality, multidisciplinary care.  That means excellent surgical technique, high quality medical oncology, making the right judgment regarding chemotherapy and endocrine therapy, managing chemotherapy side effects, and biologic therapy (Herceptin) when indicated,  have made a tremendous impact on the management and survival of breast cancer – saving many lives”.

Breast cancer is not one disease, it consists of multiple subtypes that are treated diffierently.  Advances in treatment are encouraging:

Metastatic breast cancer

  • New drugs and novel combinations are effective
  • Patients are living longer with “chronic disease of breast cancer”

Early Stage – High Risk Stage II and Stage III

  • Novel drugs + chemotherapy given prior to surgery are very promising and may accelerate FDA approval of new effective drugs

Early Stage – Lower Risk Stage I and Stage II

  • Molecular profiling determines the majority of patients who can avoid chemotherapy and take endocrine therapy alone

Dr. Parker along with Dr. Lisa Madlensky co-chair the UCSD site for the Athena Breast Health Network.  “The purpose of Athena is to create an environment where scientists can rapidly integrate research findings into clinical care,” comment’s Dr. Parker.  The Athena consortium is composed of 5 University of California cancer centers.  For the WISDOM Study, multidisciplinary physicians from 13 Midwest hospitals are participating.

The Athena Breast Health Network has several strategic initiatives to improve the lives of woman at risk for, or diagnosed with, breast cancer:

For prevention:

  • Personalized risk assessment as part of the screening process – findings from the WISDOM Trial
  • Prevention counseling for high risk women (tamoxifen, raloxifene, life style and other recommendations

For screening and diagnosis:

  • Risk based screening and prevention
  • Tailored frequency of diagnostic procedures
  • Determine who is at risk for what type of breast cancer

For treatment:

  • Tailored interventions based upon molecular profiling and inherited risk

And for survivorship:

  • Better models of care to ensure latest research is integrated into recommendations that maximize quality and quantity of life

The WISDOM Trial is the largest initiative in the Network.  Did you sign up? 

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About the Doris A. Howell Foundation:

For the past 23 years, The Doris A. Howell Foundation for Women’s Health Research has been dedicated to keeping to women we love healthy by making a long-term, positive impact on women’s health.  To date, it is the premier organization advancing women’s health.

The organization does so by funding scholarships to students researching issues affecting women’s health; providing a forum for medical experts, scientists, doctors, and researchers to convey timely information on topics relevant to women’s health, and by funding research initiatives that improve the health of under-served women and increase awareness and advocacy in the community; bringing women’s health research to a full cycle.                                                                                                                                                                                                              ###

Summary & Design prepared by Carolyn Northrup and revised by Carole Banka, PHD with information provided by the key note speakers. 

 
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