Breast Cancer 2013: 2 TAM Trials Top List

Shira Berman

Disclosures

December 23, 2013

In This Article

Reorienting Research to Quality of Life

Moving beyond clinical trial data, Drs. Schapira and Miller focused on a number of seemingly small changes that have occurred in the breast cancer research arena that will have huge effects on the way that clinical trials will be conducted in future years.

First, in keeping with what was seen in ATLAS, aTTom, START, and CALGB 9343, researchers have been approaching quality of life assessments in a very formal and rigorous way, enabling clinicians to really understand the effects of treatments on patients’ everyday lives.

"I am encouraged by the increased attention paid to quality of life studies and substudies," noted Dr. Schapira. "They will provide evidence-based guidance for recommendations for clinicians caring for these patients. Learning to better manage the symptoms as well as the side effects of treatment is crucial to providing top-quality care."

However, the continued decline in funding from the National Institutes of Health[5] and the reorganization of the cooperative groups[6] may be undermining the ability of investigators in the United States to conduct the research needed to define top-quality breast cancer care. Given the changes already in place, wondered Dr. Miller, "what -- if any -- is the future of publically funded clinical research in the United States?"

The answer may lie in another important change that Dr. Miller noted within the breast cancer research arena: the continued rise in importance of European-led trials. Indeed, 3 of the 4 key trials described above were led by research groups in the United Kingdom.

What will be the effect of shifting toward a more patient-centered trial approach and toward a more European-led trial structure?

The newest update from GLOBOCAN[7] shows a sharp rise in breast cancer incidence and mortality worldwide; across all regions, the incidence of breast cancer is highest in Western Europe, with Northern Europe and Southern Europe coming in not far behind. The increasing focus on robust research programs throughout Europe and on coordinating clinical trials designed to identify ways to improve outcomes in patients with breast cancer may be just what is needed to help reverse these epidemiologic trends and to bring much-needed top-quality research data to the clinic in the coming years.

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