Day 4 in San Antonio (a day late)

Can you tell that things get overwhelming at a big scientific conference? My stamina is definitely different these days and I’m glad that things are starting to wind down. I’ve also learned a little about taking breaks and prioritizing the topics and activities that are the right fit rather than trying to take everything in. It’s also helpful to be around other advocates to share information and debrief regularly.

So, yesterday was Wednesday and I started the day very early with a special educational session on obesity and breast cancer because a dear friend of mine was providing the patient perspective. She did an excellent job and I was happy to see that the topic was presented much more respectfully than it has in the past. Still, it took a member of the audience to bring up that it’s not just about people eating or exercising, but also about metabolic activity, the endocrine system, and all of the medication we are taking to manage the cancer.

Immediately after the session, Martha Carlson from OurMBCLife grabbed a few of us to react to the information and they published what I said on social media, which I reproduced below. Had to highlight an amazing group, 2Unstoppable, which is doing an amazing job of supporting people with breast cancer, both early stage and metastatic, in setting and achieving healthy fitness goals. Another great resource is Unite for Her, which has nutritionists and dietary support as well as actual fruits and vegetables you can use your passport to receive regularly. Both organizations support people with breast cancer virtually, so your location isn’t a factor.

The conference continued for me with some really interesting presentations on different classes of medications, the pros and cons of the order of medication, and a review of some of the previous trials. One such study that several oncologists are describing as “practice changing” is the Right Choice Study, comparing IV chemotherapy to a specific oral therapy in a class called CDK4/6 for the first choice following an MBC diagnosis. The study showed that the oral therapy was more effective and far preferable to IV chemotherapy for the patients as well. In my experience and opinion, this study validated what many of the doctors are already doing and is a great step to provide them with the support as to why.

After a packed morning, the Alamo Breast Cancer Foundation hosted a lunch with four (4) of the breast oncologists at the FDA Oncology Center of Excellence. I’ve attended this lunch each time I’ve been at SABCS and again loved the discussion about how trials and their results are reviewed and approved by the FDA. During the question and answer session, the doctors on the panel (a racially diverse and all female panel, by the way) engaged with patient advocates in ways that demonstrated their deep care and concern for patients.

During the luncheon with the FDA, Andrea Downing with the Light Collective asked a question about how our digital data is being used by various companies, including and often especially pharmaceutical companies, to target advertisements, some which are misleading. The oncologists shared with us that anyone can send an ad that is inappropriate for any reason to the email “badad@fda.hhs.gov.” Always get great information every time we hear from these doctors!

During the afternoon, I attended a specific educational session focused on hereditary cancer and specifically those genetic mutations associated with a moderate risk of breast cancer. As many of you know, I carry the ATM genetic mutation, which is associated with a moderate risk of breast cancer; clearly I didn’t have such a moderate experience. The information shared was sobering and also really helpful, so looking forward to sharing more information about that.

The final educational event of the day was the Hot Topics Mentor session, which featured four different doctors to share about the items from the day that they each thought we should watch.

The first doctor/mentor to share covered much of what we’ve been hearing about Her2 low and the Destiny trials that I wrote about yesterday. He also highlighted a new AKT inhibitor, Capivasertib, which is anticipated to be approved by the FDA soon. This medication works similarly to Piqray, which as some of you know I was on for several years. The best part is that capivasertib doesn’t appear to cause the hyperglycemia that many of us struggled with on Piqray.

The second doctor/mentor to share was a radiologist who talked about some new PET agents that appears to work much better in ER+ cancer, Cerianna, and also brought up the possibilities of involving AI in radiology. He also brought up some of the efforts to address disparity issues and some outreach to African Americans at various locations.

The third doctor/mentor to share has a focus in immunology and vaccines. He discussed the possibilities of a vaccine to prevent breast cancer and also the possibility of halting the spread of breast cancer once it has escaped the breast. Work with viruses hasn’t been as successful and some of the focus in research is utilizing bacteria and even fungus to research options. This mentor also addressed how the microbiome often affects the efficacy of medication or other interventions. Fascinating and growing area of research and focus.

The final doctor/mentor of the evening gave us a primer on the cell cycle (DNA synthesis and mitosis) and then talked about how some of the medications taken by many of us are effective. He highlighted the Right Choice study I referenced above and the PACE trial, which looked closely at what to do when progression happens after a patient has taken a CDK4/6 inhibitor.

Had the privilege to end the day with dear and new friends, reviewing the day, debriefing and talking about anything but cancer. Thankful for the time with friends and all the smart people here trying to unravel the puzzle that is breast cancer.