Innovation and Patient Empowerment at the CURE Educated Patient Breast Cancer Summit

The 49th Annual Miami Breast Cancer Conference recently hosted a cornerstone event for the advocacy community: the CURE Educated Patient® Breast Cancer Summit. Designed to bridge the gap between high-level clinical data and the lived experience of patients, the summit brought together leading oncologists, researchers and survivors to discuss the rapidly shifting landscape of care.

Optimization over de-escalation

The summit began with a shift in terminology regarding local therapies. Dr. Reshma Jagsi of the Emory University School of Medicine proposed replacing the term "de-escalation" of surgery and radiation with "optimization". Jagsi explained that the goal is to identify patients who can safely avoid "potentially toxic treatments" without compromising survival.

Reflecting on her 25 years in the field, she noted that radiation oncology has moved from a standard "more than six weeks of radiation" to shorter, more intense hypofractionated courses. "I’ve never met [a patient] who wouldn’t rather meet me for coffee than come in for an extra dose of radiation," Jagsi remarked, emphasizing that the decision to forgo or reduce treatment must be patient-centered and based on personal values.

Precision medicine and resistance

Addressing the medical management of hormone receptor-positive disease, Dr. Neil M. Iyengar, Associate Professor in the Department of Hematology and Medical Oncology Emory University School of Medicine, highlighted the challenge of endocrine therapy resistance. He explained that while traditional therapies like tamoxifen act as a "Trojan horse" to block estrogen, cancer cells often find ways to stay activated. This has led to the development of oral SERDs and CDK 4/6 inhibitors, which strategize to "turn them off and stop cancer cell replication".

Iyengar stressed the importance of balancing efficacy with quality of life. "I don’t want somebody on a therapy if they’re suffering just because it’s extending their progression-free survival," he said, noting that side effects like diarrhea or low white blood cell counts must be "compatible with that person's lifestyle". He also advocated for exercise as a vital "lifestyle intervention," citing data that shows just two one-hour sessions per week can reduce fatigue and "improve their quality of life".

The rise of ADCs and liquid biopsies

The summit explored the "biological missiles" of oncology: antibody-drug conjugates (ADCs). Dr. Kevin Kalinsky, a medical oncologist at the Emory University School of Medicine, compared ADCs to a "GPS" that tells chemotherapy exactly where to go, targeting specific proteins to deliver the drug directly to the cancer cell. He noted that while progress is being made across all types, there remains a "real unmet need for further advances in triple negative breast cancer (TNBC).”

In tandem with new treatments, the summit looked at advanced monitoring tools. Dr. W. Fraser Symmans, a professor in the department of pathology at The University of Texas MD Anderson Cancer Center, discussed ctDNA (circulating tumor DNA), which he likened to a "message in a bottle" found in the bloodstream. This technology allows doctors to "train your own personal test on the DNA from your cancer" to look for minimal residual disease. While the technology is powerful, Symmans cautioned that the field is still working to establish "clinical utility" — proving that acting on these blood tests lead to better outcomes.

Empowered decision-making and holistic care

Dr. Elisabeth King, vice president of operations for the Tampa General Hospital Cancer Institute, reminded the audience that while all cancer is genetic, only 5% to 10% is hereditary. She emphasized that "family history still really matters" and that a negative genetic test does not mean zero risk.

Patient and TV personality Guerdy Abraria of “The Real Housewives of Miami” shared how the Oncotype DX test provided her with a sense of agency. "I was able to feel like I had control over a decision to foresee what would be most beneficial for me," she said, describing the scientific results as a "no brainer" that allowed her to follow "the yellow brick road" of her treatment.

The summit also tackled the difficult reality of side effects. Dr. Ann H. Partridge, interim chair of the Department of Medical Oncology at the Dana-Farber Cancer Institute, emphasized that clinicians must be careful "not to make the treatment worse than the disease". She discussed the pervasive nature of menopausal symptoms, such as hot flashes and vaginal dryness, and urged patients to be vocal. "If your doctor's not bringing them up with you... bring them up. Don't be afraid," she encouraged.

Narrative and empathy

The day concluded with a focus on the human side of the clinic. Filmmaker and survivor Carolyn Jones spoke of the profound impact of her oncology nurse who made her feel "normal" during chemotherapy. Dr. Patrick I. Borgen, chair of the Miami Breast Cancer Conference, reflected on the "astronomical" progress made over four decades — shifting from a time when one in four patients died to a much higher survival rate today.

"I’ve given up on teaching empathy," Borgen said candidly, explaining that his team recruits for values first. He advised patients to ensure their "well-being matters to your doctor... that's the person you choose.”

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