A Focus on Metastasis, and Some Final Reflections
CR Magazine: Collaberation – Results


SUNDAY, DEC. 14, 2008

A Focus on Metastasis, and Some Final Reflections

Posted by Musa Mayer

It’s Sunday, the last day of the 2008 San Antonio Breast Cancer Symposium, and most people have already left, for another year. All the drug company booths have been broken down, the overflow seating has been folded away, and the vast hall through which 9,200 researchers, oncologists, industry folks and advocates thronged only yesterday has now been transformed into a long curtained corridor leading to Hall D, where the last of the general sessions is being held.

My advocate friends and I sat up late last night in one of the hotel bars, reflecting on this year’s meeting over a glass of wine. As women of  “a certain age,” we first lamented the impact on our poor sore knees of the long walks from session to session on the cavernous convention center’s thinly carpeted concrete floors. Then we got down to some serious talking. What research had we found most interesting? What were the themes of this conference? Were we leaving discouraged, or feeling hopeful?

While we all found different aspects of the conference important, one point of consensus on which we could agree was how important it was to finally see a significant research focus on metastasis, as presented by two of the plenary speakers, both of whom were honored at the meeting. As advocates, we know at a visceral level how important this work is. Each of us has lost many friends to metastatic breast cancer. Each of us lives with the fear firsthand that our own breast cancer may one day spread.

Patricia Steeg, of the National Cancer Institute, received the 2008 Komen Brinker Award for Scientific Distinction for her work on breast cancer metastasis. Steeg, who discovered the first metastasis suppressor gene, lectured on the importance of metastatic colonization as a unique and little-studied process. As the director of a research Center of Excellence on breast cancer brain metastasis, Steeg, along with her team at the National Cancer Institute, has made significant progress in characterizing HER2-positive brain metastases, identifying gene signatures and exploring new targets for drug development based on metastatic colonization. In an era when women with metastatic disease are living longer, the brain has become a “sanctuary” site for metastasis, and the incidence of brain metastases is increasing. [Read a related story in CR.]

New approaches are desperately needed. “Growth in the primary site is not  identical to growth in a distant site,” said Steeg. “We need to use metastatic models in drug development.”

The recipient of the AACR Distinguished Leadership Award in Breast Cancer Research, Joan Massagué, of Memorial Sloan-Kettering Cancer Center, has also focused his research on metastasis. At the symposium this week, his lecture detailed his work on gene signatures for specific metastatic sites and on how TGF-beta (a growth factor that plays a role in cancer) affects cell growth and division in lung metastasis. In experiments in mice, Massagué has found that different organs select for distinct “species” of metastasis, each adapted to the unique structural challenges presented by the organ site. He has shown that these different organ “tropisms” that go to lungs, bone or the brain derive from different sets of genes, and has begun to explore key genes associated with each metastatic site.

Looking back on the SABCS and five days of blogging, it’s obvious that I’ve only been able to touch upon a few examples of all the diverse research presented in the plenary and general sessions, not to mention the hundreds of posters that I haven’t even had an opportunity to read yet. Although the halls of the convention center here in San Antonio are empty now, with all the attendees winging their way home to the four corners of the earth, I’m reassured that the meat of the symposium will remain publicly available online. On the SABCS website, abstracts can be searched for and read, and slides and posters can be viewed and even downloaded. And, in a few weeks time, important talks will be made available on the SABCS website in the form of slide presentations with audio. It’s a wonderful resource that I know I will be consulting all year long, until I find myself back in San Antonio again.

See you next year!