Improving outcomes the St Gallen way

This issue comes out as breast cancer specialists from around the world gather in Vienna for the 15th biannual St Gallen International Breast Cancer Conference, to discuss what we’ve learnt over the past two years about optimal treatment of early breast cancer, and to agree consensus guidelines based on the latest results of sound, practice-influencing clinical trials.

While the venue has moved from St Gallen in Switzerland to Vienna’s spacious Austria Centre, the format remains the same. Questions of clinical uncertainty will be debated at a four-hour public consensus-session held on the last morning, with the aim of reaching a consensus among a panel of 50 of the most influential leaders in the field.

Published evidence has shown that periodic consensus summaries like this one greatly help to standardise optimal therapy at an international level.

The global influence of this conference is rooted in the quality and credibility of the evidence that is discussed and debated – evidence that is derived largely from pivotal, multi-institutional trials run by the world’s most influential breast cancer study groups, rather than through exclusively company-sponsored, purely drug-related trials.

This favourable research context is in turn a legacy of longstanding close cooperation between experienced leaders of outstanding trial groups from various continents, all aiming at a common goal – longer relapse-free survival for patients with primary breast cancer, or even definitive cure.

As more therapies and more complex treatment strategies become available for a wider array of common cancers, adopting this successful model of consensus conference might seem an obvious idea, to delay tumour relapse and prolong tumour-free survival for other groups of patients.

That, however, may be easier said than done, given the extent of competition not only between companies, but also between trial groups at a national and international level.

I feel it is important not to close this short editorial without remembering Professor Umberto Veronesi, a great (surgical) oncologist from Milan, Italy, who recently passed away. A global pioneer of this multimodal – surgical and medical – approach to primary therapy of breast cancer, his insights and vision transformed the care of this group of patients internationally.

While missing him sadly in person, and as a compassionate, frequent speaker at our conference, we will actively remember this outstanding leader in our new series of ‘Umberto Veronesi Memorial Lectures’, which will enrich the scientific programmes of all future St Gallen International Breast Cancer Conferences.