Dr. Douglas Blayney, past ASCO president and oncologist, gives us his thoughts on some of the key scientific themes presented at the 2023 ASCO annual meeting. In the field of breast cancer, there are three key areas of interest Dr. Blayney discusses. First, there is growing attention towards the use of CDK 4/6 inhibitors in the treatment of hormone positive breast cancer. Second, the significance of somatic cell DNA testing is being recognized. This testing can inform treatment decisions at different stages of the disease and help identify when a change in treatment is necessary. Lastly, there is a focus on the emerging role of antibody drug conjugates, which can selectively kill cancer cells in a more targeted way. Samira and Dr. Blayney also discuss how patients learn from and use this new information in partnership with their physician.

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Key Highlights:

About our guest:

Dr. Doug Blayney is an oncology physician who specializes in breast cancer. His research focuses on quality improvement in cancer care systems, new drug development, and patient experience improvement. At the American Society of Clinical Oncology (ASCO), he was founding Editor-in-Chief of its flagship practice journal, and as President, started the ASCO Quality Symposium and began planning for ASCO’s CancerLinq. He was a founding member of the National Comprehensive Cancer Network (NCCN) Growth Factor Guideline panel, and is a past member of the U.S. Food and Drug Administration’s Oncology Drugs Advisory Committee and the NCCN Board of Directors. Dr. Blayney leads the Manta Cares Scientific Advisory Board.

Key Moments:

8 minutes: What is a CDK 4/6 inhibitor? “When that estrogen receptor growth pathway is shut down, the cell compensates, or many of the cancer cells compensate by this CDK 4/6 pathway. And it turns out that if you combine estrogen blockade with blockade of the CD46 pathway at various steps, you can have an augmented or more effective therapeutic approach.”

18 minutes: On the types of DNA and how they impact cancer treatment decisions: “There are two kinds of DNA. There's germline DNA, which is present in every cell in our body. Then there is somatic mutation, which happens to various cells. Whether it's in a breast cell or a lung lining cell or a colon lining cell, an accumulation of those mutations in the right spot can lead to a cancer.”

33 minutes: On thinking about decision making with new scientific advances: “Your listeners may remember that 20 or 30 years ago, randomized clinical trial looked at circulating tumor cells monitoring versus standard monitoring. And the circulating tumor cell DNA did not improve survival, probably because of the sensitivity of the test. Plus the treatments 20 or 30 years ago weren't as efficacious. There weren't as many of them. So if the cancer was growing, but you didn't have an effective treatment for it, so what? Looking at this now, the situation has changed. The test is probably more sensitive, and we have more treatments.”

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