Gap Persists Between Research Results, Application

WASHINGTON—“Without even waiting for the research of tomorrow, we could save tens or hundreds of thousand of lives if we could apply 100% of what we know now about breast cancer diagnosis and treatment,” said Gabriel Hortobagyi, MD, chairman of Breast Medical Oncology, M.D. Anderson Cancer Center. “There is still a persistent gap between what we have learned and its application into clinical practice, simply because the translation of research into clinical practice is very slow.”

Dr. Hortobagyi spoke at a panel about priorities in breast cancer treatment and research at the Susan G. Komen Breast Cancer Foundation’s fourth annual research conference.

“Although the benefits of a multidis-ciplinary approach seem self-evident,” he continued, “it has taken several decades to develop a truly multidisciplinary approach to diagnosis and treatment.” A multidisciplinary approach is important, he said, “not only for patient care but also for the direction in which research is heading. It is important for all members of the breast cancer team to interact fully and frequently so as to develop a balanced research and care program.”

Fellow panelist Nancy E. Davidson, MD, professor of oncology, Johns Hopkins School of Medicine, agreed. “I see a lot of interplay between the laboratory and the clinic,” she said. “Many of the questions we deal with in the lab are based on real clinical problems we see in our patients every day.”

Clifford Hudis, MD, chief, Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, said, “What can we do to enhance life now? We need to apply what we now know to all women, regardless of their socioeconomic status. It is terrible that socioeconomic status still predicts outcomes, when there is little evidence to show that fundamental biology is different among women of different ethnic and economic groups.”

Dr. Hortobagyi said that the time has come to expend the political effort needed to break down barriers to the optimal use of screening mammograms. “We have to emphasize our strengths and accomplishments,” he said, in the push for increased screening. He added that developing useful biomarkers of early disease “might lead us to earlier diagnoses at little risk and toxicity.” Another avenue for improving current treatment, he said, lies in combining treatment modalities.

Dr. Davidson reminded the audience that information about new therapies and prevention strategies must be disseminated to do any good. “We need to educate both health care providers and consumers if we are going to take what we know and apply it to patient care.”

Susan Braun, president and CEO of the Komen Foundation, said that the organization has sponsored an imaging grants program to look at early detection and is looking at ways to overcome barriers to inclusion in clinical trials.

The Foundation is a member of a cancer advocacy consortium that is working with insurers and federal officials to obtain third-party reimbursement for treatment in clinical trials. Ms. Braun said that the consortium is negotiating for appropriate regulation or legislation.