SABCS 2023 Highlights Breast Cancer De-Escalation

The San Antonio Breast Cancer Symposium (SABCS), now in its 46th year, will begin on Tuesday, December 5.

SABCS has come a long way since its start in a hotel next to the San Antonio airport in 1977. At the time, a handful of San Antonio breast cancer researchers decided to invite nearby community oncologists to the hotel to share their findings and compare notes for a few hours. About 30 people attended.

From there, SABCS has grown into the world’s leading breast cancer meeting with 10,000 people expected to attend this year and more than 1700 original research abstracts presented at the San Antonio convention center, according to SABCS co-director Virginia Kaklamani, MD, leader of the breast cancer program at University of Texas Health San Antonio.

What sets SABCS apart is “that it covers every single aspect of breast cancer” from prevention to end-of-life, with multiple opportunities for cross-pollination between topics. “You see the conversations that happen” among physicians and other attendees and “the next set of clinical trials” taking shape, Kaklamani told Medscape Medical News.

Kaklamani said the most impactful presentations have been saved for three general sessions, happening on Wednesday, Thursday, and Friday mornings.

De-escalation — avoiding overtreatment — is a hot topic at this year’s meeting. Kaklamani pointed to two studies, in particular, being presented back-to-back in the Thursday general session.

The first (abstract GS02-07) explores what to do when a positive axillary lymph node turns negative after neoadjuvant therapy.

“We’ve been waiting for results [from this study] for quite some time because we are hoping that chemotherapy will be enough” and women won’t have to have surgery, she said.

The other study (GS02-08) considers omitting radiation in women past age 50 who have a favorable genomic profile. Again, this represents “a big step in trying not to do too much,” Kaklamani said.

Antibody-drug conjugates (ADCs) are another major theme at the meeting.

Kaklamani flagged two general session presentations on ADCS — one (GS01-10) on Wednesday that explores adding tucatinib to the ADC trastuzumab-emtansine in HER2-positive metastatic breast cancer, and another (GS03-12) on Friday that highlights long-term survival outcomes associated with adding trastuzumab-emtansine in early HER2-positive breast cancer. 

Other sessions will highlight breast cancer prevention, a topic that hasn’t been getting enough attention amid the emphasis on treatment, Kaklamani said.

New this year are career development sessions for women and young investigators on Saturday as well as new rapid oral presentations for preliminary clinical findings that could lead to bigger trials.   

SABCS is jointly sponsored by UT Health San Antonio and the American Association for Cancer Research.

Kaklamani is a consultant for Menarini, Lilly, AstraZeneca, Daiichi, Novartis, and Pfizer.

M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who worked for several major news outlets before joining Medscape. Alex is also an MIT Knight Science Journalism fellow. Email: [email protected].

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