National Breast Cancer Coalition

Call To Action Online July 2019

Congratulations 2019 Project LEAD® Grads!

It takes a certain kind of advocate, one who is passionate, committed and intellectually curious about science as well as one who is willing to challenge business as usual, to participate in NBCC’s renowned Project LEAD® program.

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In July 2019, 58 advocates gathered in La Jolla, CA for a week of rigorous and dedicated study. This year’s class was a diverse group of women and men from 21 different states, Puerto Rico, Canada, and Australia. They completed challenging homework assignments and a week-long demanding coursework on topics such as genetics, epidemiology, immunology, and study design, taught by a premier group of expert faculty.

Graduates of this one-of-a-kind program will play a critical role in programs such as the Department of Defense Breast Cancer Research Program, NBCC’s Artemis Project®, clinical trials, and local research programs around the country and the world. They are better able to translate complex science and medical information within their communities. They help ensure that advocates have a credible voice anywhere decisions about breast cancer research are being made.

We look forward to all that they will achieve in the fight to end breast cancer!

Public Policy: Take Action!

One of NBCC’s highest legislative priorities this year is the Metastatic Breast Cancer Access to Care Act, H.R. 2178/S. 1374. This legislation would waive the 5 month waiting period for Social Security Disability Insurance and 24 month waiting period for Medicare for individuals with metastatic breast cancer who qualify for social security disability.

The Metastatic Breast Cancer Access to Care Act , spearheaded by NBCC, was introduced in the House as H.R. 2178 on April 9 by Representatives Peter King (R-NY) and Kathy Castor (D-FL). The House bill currently has 101 cosponsors. On May 8, Senators McSally (R-AZ) and Chris Murphy (D-CT) introduced S. 1374 in the Senate. The Senate bill currently has 7 cosponsors.

The 116th Congress will adjourn for August recess on July 26 in the House and on August 2 in the Senate through September 9. During this time Representatives and Senators will be in their home districts. This is our opportunity to act and contact them when they are not on the Hill and ask them to support NBCC’s priorities. Find out more about what you can do during August here.

Share your Stories

NBCC believes that quality care must be accessible to everyone. Making certain all those with metastatic disease have access is an important and major step. Your help is critical in making this happen. If you or a family member have been diagnosed with metastatic breast cancer, we want to hear from you about how waiving Medicare waiting periods would affect you and your family. Stories from advocates like you will advance this important legislative priority. Please send your story to 
MyStory@breastcancerdeadline2020.org.

Ending Breast Cancer from the Oval Office

Our next president can have a tremendous role in helping end breast cancer. Between federal budget proposals, executive orders, and appointments to the National Institutes of Health and Department of Defense, and the FDA, we need a president who will support policy for breast cancer research and affordable health care.

That is why NBCC has once again launched its Breast Cancer Caucus campaign for the 2020 elections in order to encourage presidential candidates to support our public policy platform.

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Visit NBCC’s
Breast Cancer Caucus page
to see who has signed onto our platform, and see how you can play a crucial role in spreading this platform and NBCC’s message. Campaign events, social media, and letters to editors are some of the ways that you can Take Action to End Breast Cancer.

Our next president can be an advocate for our mission, and your efforts can help make that happen.

Science Spotlight

Why a CDK4/6 Inhibitor for Early Stage, Hormone Receptor-Positive Breast Cancer?

In the United States, in 2019, it is estimated that 268,600 women and 2,670 men will be diagnosed with invasive breast cancer (excluding 62,930 women who will be diagnosed with in situ breast cancer).1,2 In addition, 41,760 women and 500 men will die of breast cancer.1,2

Approximately 75% of breast cancer is hormone receptor positive (HR+), and most breast cancer deaths occur in HR+ women. Additionally, among women and men “successfully treated” for early stage breast cancer, approximately 20-30 percent will have a distant recurrence sometime in their life. And while the risk of recurrence is greater in the first 5 years after a diagnosis of HR- breast cancer (e.g., triple negative and HER2+ breast cancer), patients with HR+ tumors have a consistent long-term risk of death from breast cancer and a greater risk than HR- individuals after 7 years. And the risk of distant recurrence is worsened by higher stage and/or node positive disease.

Tamoxifen and aromatase inhibitors have provided exceptional therapeutic value for patients with HR+/HER2- disease since the early 1970’s and 1990’s, respectively. However, breast cancer can still recur in many cases.

More recently, cyclin-dependent kinase [CDK] 4/6 inhibitors have been studied in advanced/metastatic HR+/HER2- breast cancer, and to date, three agents (palbociclib [Ibrance], ribociclib [Kisqali], and abemaciclib [Verzenio]) are now FDA-approved for use, combined with hormone therapy, as a first-line treatment in advanced/metastatic breast cancer for demonstrating robust improvements in progression-free survival.3-5 Importantly, in June 2019, investigators presented interim results of the MONALEESA-7 trial of ribociblib highlighting significant improvement in overall survival for premenopausal metastatic HR+/HER2- breast cancer.6

How Do CDK4/6 Inhibitors Work?

CDK4/6 inhibitors work by restricting breast cancer cells from dividing.7 Under normal conditions, the cellular division is tightly regulated by the retinoblastoma (Rb) protein to halt abnormal growth. Cyclin proteins, CDK 4 and 6 interfere with Rb, allowing for cellular division. CDK4/6 inhibitors stop this process, and research by Slamon and colleagues in the mid 2000’s, demonstrated that HR+ breast cancer is most sensitive to CDK4/6 inhibitors.8 These findings resulted in numerous trials that led to the development of the above-mentioned CDK4/6 inhibitors currently FDA approved for metastatic HR+/HER2- breast cancer.

With success in the metastatic setting, multiple trials are now underway to evaluate CDK4/6 inhibitors in the adjuvant setting, the NATALEE clinical trial being one of them. NATALEE aims to further reduce the risk of dying from breast cancer in the high-risk (anatomic Stage 2 and 3) adjuvant setting for HR+/HER2- disease.

How Is NBCC Involved?

Over the years, NBCC has built a network of trained and committed advocates dedicated to collaborating with scientists to advance meaningful research. These advocates receive training through our renowned intensive science training program, Project LEAD®.

In late 2018, NBCC initiated a collaboration with Translational Research in Oncology (TRIO), and Novartis on the NATALEE trial, as part of our long-standing Clinical Trials Initiative. NBCC advocate involvement has been key in several trials including the pivotal trial of trastuzumab and the TAILORx trial. NBCC partnership decisions on clinical trials follow rigorous criteria including significance of the research question, rigor of study design, and ethical conduct of the trial among others.

NBCC has already had input into the design of this study, and will continue to be involved in the implementation and execution of this study which is currently underway and recruiting patients. In addition, NBCC will support trial enrollment initiatives in the United States and around the world.

If you are interested in hearing more about this trial, we invite you to view a 45-minute special presentation that was provided by Dr. Nicholas McAndrew, a trial investigator, at NBCC’s 2019 Advocate Leadership Session.

Learn more about the NBCC’s clinical trial partnerships here.

Ultimately, through initiatives such as this one, we will reach our goal of knowing how to end breast cancer by preventing women from getting the disease and preventing it from spreading. Thank you for your support of the National Breast Cancer Coalition and your continued commitment to ending breast cancer.

References
1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA: a cancer journal for clinicians. 2019;69(1):7-34. doi: 10.3322/caac.21551. PubMed PMID: 30620402.
2. American Cancer Society. Cancer Facts & Figures 2019. Atlanta: American Cancer Society; 2019.
3. Inman S. FDA approves palbociclib for metastatic breast cancer. Onclive website. onclive.com/web-exclusives/fda-approves-palbociclib-for-metastatic-breast-cancer. Published February 3, 2015. Accessed October 16, 2018.
4. FDA approves abemaciclib as initial therapy for HR-positive, HER2-negative metastatic breast cancer. FDA website. fda.gov/drugs/informationondrugs/approveddrugs/ucm598404.htm. Published February 26, 2018. Accessed October 20, 2018.
5. FDA expands ribociclib indication in HR-positive, HER2-negative advanced or metastatic breast cancer. FDA website. fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm613803.htm. Published July 18, 2018. Accessed October 20, 2018.
6. Im SA, Lu YS, Bardia A, et al. Overall Survival with Ribociclib plus Endocrine Therapy in Breast Cancer. N Engl J  Med. 2019 Jun 4.
7. Lundberg AS, Weinberg RA. Control of the cell cycle and apoptosis. Eur J Cancer. 1999;35(4):531-539. doi: 10.1016/S0959-8049(99)00046-5.
8. Finn RS, Dering J, … Slamon DJ. PD 0332991, a selective cyclin D kinase 4/6 inhibitor, preferentially inhibits proliferation of luminal estrogen receptor-positive human breast cancer cell lines in vitro. Breast Cancer Res. 2009;11(5):R77.

OTHER NEWS

Resilience - Philip Guston Exhibition - September 23, 2019 - Hauser & Wirth - Los Angeles, CA

Save the date for Resilience, an evening of art and celebration to benefit NBCC on Monday, September 23, 2019 in Los Angeles, CA. Thanks to the generosity of Hauser & Wirth all proceeds raised from this unique event will support NBCC’s mission to end breast cancer. Additional information is available here.

Les Girls - October 20, 2019 - Avalon Hollywood - Los Angeles, CA

Please join us in celebrating the 19th annual Les Girls Cabaret on Sunday, October 20, 2019, at the Avalon Hollywood. This year we are honoring Cindy Harrell-Horn. The event will continue our tradition of a witty and fun evening with plenty of song and dance, to raise funds for NBCC. Further information and a reservation form can be found here.

New York Gala - October 28, 2019 - The Pierre - New York

Join us on Monday, October 28, 2019 for the 24th Annual New York Gala. This annual fundraising event should not be missed. Find out further details or RSVP here.

Attention all LEAD Grads! Upcoming Webinar

Don’t miss this exciting upcoming LEADcast! On August 7th at 1pm -2:30pm EST, Dr. Karen Cichowski will give a presentation entitled “Dissecting the Tumor Specificity of Cancer Drivers.”

Dr. Cichowski is a Professor of Medicine at Harvard Medical School, and a Professor of Medicine and Genetics at Brigham and Women's Hospital. The focus of Dr. Cichowski’s research laboratory is to elucidate how deregulated cell signaling drives cancer. Dr. Cichowski’s lab is also part of a Cancer Research United Kingdom (CRUK) Global Challenge Award (see SpecifiCancer.org) that is collectively studying why cancers grow in some tissues and not in others. This multi-lab partnership, led by long-time Artemis Project participant, Dr. Stephen Elledge, is comprised of researchers in the USA, the UK, and the Netherlands, who are examining our cells’ DNA to identify which genes control whether cells divide or not. By looking at the DNA in different locations in the body, this screen will allow the team to look at whether certain genes are only active in specific tissues. This will provide vital information on known cancer drivers, as well as allowing the team to identify new potential drivers of cancer. Alongside this, the researchers will be assessing how well different cancer drugs work in different types of cancer, and if this can be linked to the activity of cancer drivers.

To register for this exclusive, LEAD grads-only webinar, please reach out to Skye Wilson at
swilson@breastcancerdeadline2020.org.

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