2024-SABCS-Takeaways - 14

RISK REDUCTION, DISPARITIES & MORE
Researchers share insights
on effects of exercise, racial disparities,
and preventive interventions
Several presentations at the 2024 SABCS®
focused on the insight that a robust
immune system is an important factor in
the prevention and treatment of cancer.
Experts discussed how various conditions
such as obesity, activity, structural barriers,
vaccinations and other factors shape
immune systems and affect patients before
treatment begins. Registered attendees can
access source presentations and slides until
March 31, 2025.
TAKEAWAY ONE:
Weight and Obesity
Reducing breast cancer
risk through weight loss
means losing ≥10%
baseline weight. Losing
more weight is better
for patient outcome,
whether the loss stems
from caloric reduction,
bariatric surgery, or
pharmacotherapy.
But weight loss alone
should not be the sole
focus. An emphasis on
healthful lifestyle choices
should also be a priority.
Even without weight loss,
adding exercise brings
benefits to general health,
quality of life, and survival.
14
TAKEAWAY TWO:
Right-Sizing Tamofixen
Tamoxifen 20 mg daily
was shown to reduce the
risk of ER-positive breast
cancer in the NSABP
P-1 trial in 1998. But
uptake has been poor,
just over 16% in a 2016
survey, largely because of
unacceptable toxicity.
Trials investigating the
preventative effects of
lower doses began in the
early 2000s, with as little
as 1 mg tamoxifen daily
showing similar effects
when compared to the
traditional 20 mg dose.
Current trials aim to
clarify the effectiveness
of smaller doses and
what biomarkers are
most appropriate to
demonstrate prevention
in a reasonable time
frame. Multiple trials
are using breast density
as a surrogate for
cancer inception and/or
progression.
TAKEAWAY THREE:
Vaccines and
Immune Activity
Cancer vaccines have a
decades-long history of
generating a measurable
immune response with
little to no effect on
tumor burden. Validated
targets such as MUC1,
a surface protein found
on most human tumors,
failed in more than 1,000
therapeutic vaccine trials
between 1999 and 2014,
most after phase I.
What those early
researchers could
not know was the
dampening effect
both tumor and tumor
microenvironment
(TME) can have on
immune activity. Current
approaches combine
therapeutic vaccines
with checkpoint
inhibitors and other
therapies to modulate
immune suppression.
Combination therapies
show improved clinical
activity, but at the cost
of additional clinical and
financial toxicity.
Cancer interception
and prevention are the
next steps. Vaccination in
the premalignant setting
could intercept cancer
development to stop
progression. Vaccination
of individuals at high risk
for cancer development
such as BRCA1/2
carriers could prevent the
initiation of cancer.
Both approaches rely
on the same hypothesis,
that the immune system
is less suppressed in the
absence of cancer than
it is in the presence of
tumor and TME. A more
robust immune system
2024 SABCS®
| Takeaways
2024-SABCS-Takeaways

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