By: Dr. Dennis Slamon
2017 Brinker Award Winner
Established by Komen in 1992, the Brinker Awards for Scientific Distinction recognize the efforts of pioneers in two critically important areas of the fight to end breast cancer: Clinical Research and Basic Science. This year’s winners join the ranks of an esteemed group of scientists who have been recognized for advancing breast cancer research and medicine with the Brinker Awards – the highest scientific honor awarded by Susan G. Komen, the world’s leading breast cancer organization.
We recently spoke with Dr. Dennis Slamon, winner of the 2017 Brinker Award for Scientific Distinction in Clinical Research, about his career in breast cancer research.
1. How could your research help individuals facing breast cancer today and in years to come?
There are a couple of ways that I believe our research has made a lasting impact in breast cancer, and hopefully saved many lives.
First, we identified a unique type of breast cancer caused by the HER2 alteration. Before identifying this subtype, women who had HER2-positive breast cancer were being treated with traditional therapies like everyone else, but experiencing shorter disease-free and overall survival. We asked, “Why?” We found that the HER2 alteration, when present, does drive breast cancer. So, we worked with a company – Genentech – to develop an antibody therapy that would target HER2, ultimately doing the initial clinical trials that got the drug Herceptin approved. It’s completely changed breast cancer treatment for patients with HER2-positive disease, who at one time had among the worst outcomes and today have some of the best outcomes.
Our work has impacted the lives of women with estrogen receptor (ER)-positive, HER2-negative breast cancer as well. For the last four and a half decades, we’ve been using therapies to target the hormone pathway – hormone receptors or hormones themselves – and that’s made a significant impact. But, we’ve taken it about as far as it can go. We wanted to know if there was something else we could do for those women who didn’t benefit, or who recurred after receiving those treatments. Our laboratory work showed that targeting the CDK4/6 pathway could make an impact for these patients, so we tested a CDK4/6 inhibitor – one that had just been sitting on the shelf, and was originally developed for another disease. We found that it had profound effects on treating breast cancer and improving outcomes. It’s been a big change for those patients, and it’s just recently been approved by the FDA in the last couple of years.
2. What made you decide to focus your research on targeted therapies?
We were looking at all cancers for molecular alterations that we thought might be targetable when we found the HER2 signal that defined about 20 percent of the breast cancer population. We also saw that HER2 was associated with aggressive tumors, so that discovery ultimately set my path into targeted therapies for breast cancer. When we saw that the drug trastuzumab (Herceptin) really was safe and was effective, and we were seeing patients respond dramatically to the drug when their tumor had pretty much progressed through everything else, it was extremely gratifying. It certainly drove us and continues to drive us in our work.
3. What was the biggest challenge that you had to overcome in your career?
Initially, people were skeptical about the idea that an antibody therapy would work. Prior antibodies had been tried in many different malignancies, and had failed. But we continued to produce data from the laboratory that showed that the science all stacked up – an effective antibody could work to inhibit tumor growth. Ultimately, it took some convincing, but we were able to test the antibody in women, and we began to see that the drug was safe, didn’t have the side effects of traditional therapy, and was effective.
Dr. Dennis Slamon
4. What is, in your opinion, the most recent progress in breast cancer research that patients should be aware of?
I think it’s remarkable that the knowledge in breast cancer has led the way in all of oncology. Due in large part to the work done in breast cancer research, people began to realize that we need to think about cancers differently, not just as monolithic diseases defined solely by the organs in which they arose. Breast cancer is a spectrum of many diseases, and many different things can break to turn a normal breast cell into a malignant cell. Now, therapies are developed around determining what’s broken first, and then using – or developing – the appropriate therapy to treat the tumor. Today, in large part because of targeted therapies, we can more effectively cure early-stage disease and treat patients with metastatic breast cancer, extending patients’ lives.
The pace of research in breast cancer is really quite fast. Things have significantly changed from just 10 or 20 years ago. We still have challenges and we still have more to do, but the pace and acceleration at which we’re able to achieve progress is remarkable, and it will only continue to grow.
5. What would you predict will be the next big breakthrough for breast cancer patients?
There’s a lot of space that we need to fill in for triple negative breast cancer, a subtype of breast cancer for which there are currently no targeted therapies. Some of the research into targeting DNA repair pathways – like that done by my fellow Brinker Award winner Dr. Alan Ashworth – has significant promise as well. Additionally, we’re also learning how to combine different inhibitors to develop even more effective therapies.
6. What does receiving the Brinker Award for Scientific Distinction mean to you?
I’m very honored to receive the award. I feel gratified that the work that my team and I did is being recognized by Komen and by my peers in the breast cancer community.
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