Dr. Eric P. Winer
“Our understanding of breast cancer biology is better than it’s ever been,” Dr. Winer told the ASCO Daily News. “We’re going to continue to see advances over the next couple of years—although many are incremental, the increments are bigger than they were in the past.”
The vast majority of women with stage I-III, HER2-positive breast cancer “are cured of their disease,” he said, but for the “relatively small number” who are not, better treatment to prevent recurrence is an ongoing need. Those themes will be prevalent when he delivers the Gianni Bonadonna Lecture on June 3.
“We need better treatments for some patients; for others, we need to consider carefully how to begin to back off on therapy and save patients from unnecessary toxicity,” he said. “We can begin to ask questions about treatment de-escalation when almost all patients are doing well and the only potential improvement arises from reduction in the burden of treatment.”
Dr. Winer first became interested in breast cancer in medical school.
“I was interested in the disease as a medical student, and then it just kept coming up as a clinical problem that captured my attention,” he said. “I found the clinical management and biologic questions in breast cancer to be both complex, challenging, and endlessly fascinating. I initially joined the faculty at Duke University, and as it turned out, they needed someone to help develop a breast cancer unit. I have been so fortunate to love my work and to have the opportunity to grow in it. In the years ahead, I hope I continue to make some modest contribution.”
Dr. Winer has personally led or helped guide dozens of clinical trials. One of his achievements was overseeing a study in which patients with early-stage HER2-positive breast cancer received a limited course of paclitaxel with trastuzumab.1 Compared to standard regimens, there was far less toxicity, and the risk of disease recurrence remained exceedingly low.
“That treatment became a standard for stage I breast cancer around the world over the past couple of years,” Dr. Winer said.
He is equally proud of what he has been able to accomplish working with colleagues, notably ASCO CEO Clifford A. Hudis, MD, FACP, FASCO, in the Alliance for Clinical Trials in Oncology (the Alliance), formerly known as the Cancer and Leukemia Group B (CALGB). Together, they led the Breast Committee of the CALGB and then the Alliance for almost 15 years.
Dr. Winer is most proud, however, of the groups of investigators and clinicians he has been able to mentor at Dana-
Farber over the last 2 decades. These individuals have since established independent research careers and thriving clinical practices that have had a major impact on patients with breast cancer.
“I have had the incredible fortune of working with great people who have just flourished in their careers. Their success has been enormously gratifying for me,” he said.
Continued Clinical Challenges
The clinical and molecular characteristics of the tumor can help elucidate which tumors pose a higher risk for the patient and which do not, but that does not guarantee treatment outcomes are uniform. Dr. Winer hopes the current clinical trial arena will drive an era of great precision.
“We have learned that breast cancer is truly a family of diseases, and each family member requires a different approach,” he said.
In the years ahead, Dr. Winer hopes that even greater individualization will be possible, and that new approaches will be developed for patients who are still losing their lives to breast cancer.
When the science justifies a change, “we have to be ready to individualize. We have to be careful not to fall into a trap of thinking we know how to individualize treatment when we don’t,” he said.
–Michelle Dalton, ELS