C. Kent Osborne, MD, of Baylor College of Medicine, was presented with the 2016 Gianni Bonadonna Breast Cancer Award and Lecture on Saturday, June 4. In his award lecture, Dr. Osborne described the translational research milestones achieved in the area of endocrine resistance.
Dr. C. Kent Osborne
“Making progress in breast cancer research is a lot like putting together a puzzle—a large, complex puzzle—with each small discovery adding a piece. … I’m not sure the puzzle will ever be totally solved, because we can always ask additional questions to improve our understanding of the disease, its prevention, diagnosis, and treatment.
I’ve had the opportunity to view, firsthand, remarkable changes that have happened over the last 4 decades in the care of patients [with breast cancer]. At the beginning, breast cancer was largely a surgical disease, prior to the ‘war on cancer’ that was declared during the Nixon Administration in 1971. Now we are in the era of molecular characterization, precision medicine, and targeted therapy.
What could our future treatments be? We have receptor tyrosine kinases, integrins, stress kinase pathways, and ER mutants all playing a role here. They do this by phosphorylation inside the nucleus phosphorylating estrogen receptor, other co-activators, and other transcription factors. You can imagine that, depending on the tumor, you would have PI3 kinase pathway inhibitors like mTOR/PI3 kinase inhibitors, AKT inhibitors, or HSP90 inhibitors. You might have high doses of SERDs and SERMs working, particularly in the mutant ER situation. You may have ERG transcription blockade, an epigenetic approach, with JQ1 or one of the BET inhibitors. Finally, CAK4/6 inhibitors or inhibitors of who knows what.”