Stepping Up Academic Research on Advanced Breast Cancer

Dr. Martine Piccart has seen much progress in breast cancer therapies – she also knows that academic research needs to do much more for women with advanced disease.

Dr. Martine Piccart, Director of Medicine at the Jules Bordet Institute and Professor of Oncology at the Université Libre of Brussels, has devoted her professional career to helping patients with breast cancer (BC). In 1996, she co-founded the Breast International Group (BIG), which she continues to chair. The organization brings together 55 academic research groups from around the world, runs clinical trials, and leads numerous research programs.

BIG has done important work, including valuable clinical trials of therapies for effective treatment of early breast cancer. But Dr. Piccart recognized that something important was missing: despite the great advances in treatment and outcomes for women with early BC, advanced BC remained poorly understood, with only palliative treatment options.

She was terribly frustrated that, with few exceptions, academic research had not made much progress into understanding advanced BC. A change was urgently needed, and she decided to do something about it.

For example, she notes, "We don't know why some women will develop disease in the bones and it will stay there for years, while other women will immediately develop metastases everywhere. Other women will have metastasis in the liver and the disease will stay in the liver for several years. The patterns of presentation are very heterogeneous and there is very little understanding of what's going on."

Her frustration pushed her to lead development of BIG’s AURORA program, launched in 2014. AURORA is a multinational molecular profiling program focused on metastatic BC. With a goal of recruiting 1,300 patients, the program seeks to improve knowledge about the evolution of the disease, understand why some patients respond extremely well or very poorly to standard or targeted treatments, and offer patients the possibility of participating in clinical trials with innovative targeted therapies.

Dr. Piccart clarifies the history behind these goals: Most research in advanced breast BC has been carried out by industry, focused on testing new drug treatments, while the academic community has fallen short in its efforts. Crucially, the mechanisms of disease progression are not understood. AURORA is mobilizing the academic community in Europe, taking advantage of the modern technologies available   which have dramatically improved over the last few years. "Then we can start to get a better understanding of the enemy," Dr. Piccart exlpains. "Because without having an understanding of the enemy, how can you fight in a smart way?"

Patient response to AURORA has been overwhelmingly positive, Dr. Piccart says. "They know that we need to come up with innovative ideas, they understand that studying their disease with greater depth, with modern technologies, can only bring knowledge, and knowledge, of course, will bring ideas for better treatment."

The name AURORA was chosen for a reason, says Dr. Piccart. "Maybe the program will bring a little bit of light in the darkness to a really dark disease."