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Table 5: Interviews with Key Opinion Leaders
Question Representative Responses
What exciting scientific Basic biology
opportunities do you • A deeper understanding of the biology of the steps of metastasis is needed to
see for advancing make improved, targeted treatments
our understanding of • For ER+ breast cancer, we need to understand more about late relapse and how
metastasis? best to treat it
Translational and clinical research:
• Significant preclinical literature points to our ability to prevent or slow metastasis,
but not shrink overt metastatic tumors; to translate this we need drug-
combination experiments and new clinical trials design
• Developing more effective treatments for TNBC and IBC and controlling brain
metastases are the biggest unmet medical need today related to MBC
• For HER2+ breast cancer, we need to develop the safest long-term regimens for
controlling the disease
What do you think is • The many targeted therapies in phase II and III MBC trials are among the most
the most promising exciting (see Table 2). Still many more opportunities to identify new targets and
target for developing combinations of targets are in the research stages
new therapeutics • The therapeutics farthest along in drug development are CDK4/6 inhibitors,
aimed at metastasis? PARP inhibitors for BRCA carriers with breast cancer, and HSP90 inhibitors
• All areas of new therapeutics outlined in your questions below are important;
caution against picking only 1 or 2 as priority areas
• We need to understand all of these as they relate to MBC
o Cancer stem cells
o Cell invasion
o Cell signalling and proliferation as it relates to MBC
o Tumor dormancy
o Immune system
o End organ microenvironment and the signals between the end organ
and metastatic cell
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