By: Susan G. Komen
In the quest for personalized medicine, scientists have been studying why some breast cancers respond to certain therapies and others don’t. Dr. Martine Piccart, the recipient of this year’s prestigious Brinker Award for Scientific Distinction in Clinical Research, has been coordinating international clinical trials and other collaborations, thriving for real impact on better treatments and outcomes for breast cancer patients. But it hasn’t always been easy. We recently had a chance to chat with Dr. Piccart and learn more about what motivates her in her work.
1. How could your research help individuals facing breast cancer today and in years to come?
In the past, the clinical trial work done through Breast International Group (BIG), a group of international scientists who participate in global collaborations to make significant advances in breast cancer research and contribute to the faster development of better treatments, focused primarily on conducting trials in early breast cancer in the adjuvant setting. Several of those trials are now considered to be landmark, contributing to significant breakthroughs, and paving the way toward more personalized treatment of the disease.
Indeed, BIG trials are helping many patients today: HERA has already contributed to a major breakthrough in treating HER2-positive breast cancer; BIG 1-98 put aromatase inhibitors on the map; and SOFT changed how we treat young women with breast cancer. Another trial that can potentially improve the quality of life of many patients is MINDACT, the results of which will help determine which specific women within a population of breast cancer patients may not need chemotherapy.
Finally, a few years ago, BIG decided to expand its efforts to cover research in advanced (metastatic) breast cancer. We launched AURORA in 2014, an ambitious molecular screening research program aimed at understanding the drivers of breast cancer metastasis, and defining which tumors respond to treatment. Metastatic and primary breast cancer tissue specimens will be collected and analyzed for the first time on an international scale. By uncovering the molecular mechanisms underlying metastasis, we expect to be able to develop more personalized treatments for our patients in the future.
2. What made you decide to focus your research on clinical trials testing new therapeutic agents and incorporating translational research?
Women whose cancer is not responding to current therapies badly need innovative compounds with new mechanisms of action and smart combinations. New drug development remains challenging but is incredibly exciting today, given our much-improved understanding of the molecular basis of the disease. Translational research is vital for the future, because it provides the link between the discoveries in the laboratory (basic science research) and their application for the benefit of patients (clinical research). It has already succeeded in expanding our medical knowledge and bringing many discoveries to the clinic. Translational Research is our biggest hope for decreasing over- and undertreatment of our patients due to the current “one size fits all” approach.
3. What was the biggest challenge that you had to overcome in your career?
It hasn’t always been easy to keep a healthy balance between family and work. With a husband and three daughters, we have often had to come up with creative solutions. I have a fantastic husband who’s supported me throughout my entire career and who’s given me the room, opportunity and motivation to pursue a career in oncology. However, what I found more challenging was establishing myself in a predominantly male professional environment. You have to prove yourself every step along the way. When I was appointed president of ESMO (European Society for Medical Oncology), I was the first women to hold this position. And this was only a few years ago. Women still have a long way to go, but perceptions are slowly changing, and I’m positive that my daughters won’t encounter as many obstacles along the way.
4. What, in your opinion, is the most recent progress in breast cancer research that patients should be aware of?
Personalized medicine has made significant progress with key discoveries in the field of breast cancer treatment – namely with the development of endocrine therapies and anti-HER2 therapies. With the great work of basic and translational scientists, we have a better understanding today of the molecular mechanisms that drive resistance to these very effective “targeted” therapies, and we are witnessing the development of new agents able to delay endocrine resistance and resistance to the anti-HER2 agent trastuzumab. These agents allow better control of advanced disease and are now being tested in early breast cancer as well, where they are expected to successfully treat the disease.
5. What would you predict will be the next big breakthrough for breast cancer patients?
I believe that the practice of oncology is entering a ‘revolution’ rather than undergoing an ‘evolution.’ Although we’ve been talking about personalized breast cancer treatment for several years, we’re just now on the verge of taking a giant leap from dream to reality. Increasingly sophisticated technologies will continue to help us to further dissect breast cancer into the individual molecular aberrations driving the disease. We see a growing number of biomarkers being identified and tested for their potential with targeted therapies. Along with these new molecularly directed therapies, we are likely to witness the birth of a new treatment modality – namely immunotherapy – which may play an important role for certain breast cancer subtypes. Essential for the success of these new approaches are innovative clinical trials. Driving this highly innovative research forward is a high priority for BIG, its group members, and its partners around the world - whom I sincerely thank for their great support over the years.
6. What does receiving the Brinker Award for Scientific Distinction in Clinical Research mean to you?
I am of course extremely honored to be granted such a prestigious award. Today, as BIG co-founder and chair, much of my energy is devoted to building a strong international network of academic groups and their centres that is committed to ‘driving’ the breast cancer clinical and translational research agenda. This international nonprofit organization was founded just over 15 years ago, and today unites 56 academic research groups from around the world, leading more than 40 trials to date. Our approach through BIG comes at a crunch time for clinical research, and it will allow for better screening of more patients, and the selection of specific subpopulations of patients, in which we will be able to test and tailor new drugs. I hope to use this model to change our approach to clinical trials in cancer, with the benefit of patients in mind.
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