The changing landscape of breast cancer clinical research. ESMO-Award Lecture, ECCO-9 Hamburg, 18 September 1997.
Clinical research for breast cancer is moving in three new directions following: 1) a critical analysis of three decades of randomized clinical trials for early disease; 2) increasing awareness of this lethal disease among women, generating women's associations which are pressing for improved breast cancer education, screening and treatment; 3) an exponential growth in our understanding of breast cancer molecular biology, leading to a number of innovative therapies with new targets in the cancer cell or its environment. It is the remarkable work of the Oxford Group which has finally vindicated the use of our three main weapons against breast cancer micro-metastases, namely tamoxifen, chemotherapy and ovarian ablation. There is now consensus that clinical research in the adjuvant setting may gain speed and efficiency through intergroup collaboration. Such an 'Intergroup' has been recently created in Europe and will collaborate with the American-Canadian Intergroup. Women's associations have only recently stepped forward to demand better care, and more effective therapies: they are becoming new partners in identifying critical issues in breast cancer research. Medical oncologists involved in breast cancer research are facing a new challenge: the optimal integration of traditional breast cancer therapies, namely endocrine treatments and chemotherapy, and entirely new strategies targeting signal transduction, apoptosis or angiogenesis. In view of the above, there is no doubt that we are entering a new and exciting era in breast cancer clinical research.
Piccart
M J
MJ
Chemotherapy Unit, Jules Bordet Institute, Brussels, Belgium. mpiccart@resulb.ulb.ac.be
D000970:Antineoplastic Agents / Q000494:pharmacology*; D001363:Awards and Prizes; D001943:Breast Neoplasms / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008495:Medical Oncology / Q000639:trends*; D009362:Neoplasm Metastasis; D009389:Neovascularization, Pathologic; D012106:Research
D000970:Antineoplastic Agents