Recommendations for research priorities in breast cancer by the Coalition of Cancer Cooperative Groups Scientific Leadership Council: systemic therapy and therapeutic individualization

Abstract

Over 9,000 women with breast cancer are enrolled annually on clinical trials sponsored by the National Cancer Institute (NCI), accounting for about one-third of all patients enrolled on NCI-sponsored trials. Thousands are also enrolled on pharmaceutical-sponsored studies. Although breast cancer mortality rates have recently declined for the first time in part due to systemic therapeutic advances, coordinated efforts will be necessary to maintain this trend. The Coalition of Cancer Cooperative Groups convened the Scientific Leadership Council in breast cancer (BC), an expert panel, to identify priorities for future research and current trials with greatest practice-changing potential. Panelists formed a consensus on research priorities for chemoprevention, development and application of molecular markers for predicting therapeutic benefit and toxicity, intermediate markers predictive of therapeutic effect, pathogenesisbased therapeutic approaches, utilization of adaptive designs requiring fewer patients to achieve objectives, special and minority populations, and effects of BC and treatment on patients and families. Panelists identified 13 ongoing studies as High Priority and identified gaps in the current trial portfolio. We propose priorities for current and future clinical breast cancer research evaluating systemic therapies that may serve to improve the efficiency of clinical trials, identify individuals most likely to derive therapeutic benefit, and prioritize therapeutic strategies.

Protein expression, survival and docetaxel benefit in node-positive breast cancer treated with adjuvant chemotherapy in the FNCLCC - PACS 01 randomized trial

“…Benefits in terms of survival, first demonstrated in the 1970s with the CMF (cyclophosphamide, methotrexate, fluorouracil) regimen, were improved with the addition of anthracycline in the 1980s [2]. Recently, third-generation regimens, based on the addition of taxane, were shown as even more efficient [3].…”

Gene expression profile predicts outcome after anthracycline-based adjuvant chemotherapy in early breast cancer

“…Benefits of CT were first demonstrated in the 1970s with the CMF (cyclophosphamide, methotrexate, fluorouracil) regimen, then with the addition of anthracycline in the 1980s [5]. During the last decade, 4-6 cycles of anthracycline plus cyclophosphamide +/-fluorouracil have been used as "standard" adjuvant regimens for axillary lymph node-negative (N-) and positive (N+) patients [6].…”

Recommendations for research priorities in breast cancer by the coalition of cancer cooperative groups scientific leadership council: imaging and local therapy

“…The objectives of the breast cancer SLC were to evaluate the current state of the art of breast cancer detection, prevention, and management, review the current portfolio of breast cancer clinical trials, identify gaps in the current portfolio, and provide recommendations for prioritizing current and future research. The initial report by the SLC focused on the use of systemic therapy for prevention and treatment of breast cancer [7]. This report focuses on breast cancer detection and imaging, and management of localized disease with surgery and radiation by the same expert panel using methods that were previously described in the prior report.…”