Collective advances on breast cancer
It’s a sobering estimate, but one in every eight women in the developed world is likely be diagnosed with breast cancer in her lifetime.
Yet while science is getting better at understanding the molecular types of breast cancer and how to treat them, some women receive unnecessary chemotherapy, while other types of breast cancer still completely defy treatment.
Add to the mix the possibility of some tumours developing resistance to treatment over time, and what’s left are yet more unanswered questions about humanity’s most corrosive disease.
The BREAST-PREDICT consortium led by UCD is leading the way on the issue of cancer treatment.
“There have been a lot of strides made in diagnostics and new therapeutic options in the breast cancer area, but there are still some challenges”, explains Professor William Gallagher, Professor of Cancer Biology at UCD School of Bimolecular and Biomedical Science.
Combination of approaches
The five-year BREAST-PREDICT Collaborative Cancer Research Centre programme funded by the Irish Cancer Society runs until 2018 and involves more than 20 principal investigators around Ireland.
The programme provides a framework for collecting information and tumour samples from nearly every breast cancer patient in the county, with their consent. The collective puts a strong emphasis on clinical trials and on combining ‘wetlab’ biological research with computational methods to understand how the cancer cells control their activities.
Professor Gallagher’s work in the consortium has already resulted in two major pipeline findings: an algorithm to help women with breast cancer to avoid receiving unnecessary chemotherapy and new insights into how patients with ‘triple-negative’ breast cancer are likely to fare.
Diagnostic tests help doctors to understand more about the type of breast cancer a patient has and what the appropriate treatment is
Predicting for patients
Diagnostic tests help doctors to understand more about the type of breast cancer a patient has and what the appropriate treatment is, yet many women are still treated with chemotherapy they don’t need, according to Professor Gallagher.
Working with Dr Adrian Bracken in Trinity College Dublin, Professor Gallagher has identified a new ‘prognostic signature’ in the biochemistry of early-stage breast cancer that has not spread to the lymph nodes. “At the moment tests classify patients with these cancers into low, intermediate and high grades of risk, but our approach classifies the patients more discretely into low or high risk groups with a very high degree of accuracy, we don’t have that grey zone in the middle”.
The OncoMasTR technology gets those results by looking at a handful of ‘master controllers’ of gene expression in the cell.
“Our approach classifies a much bigger proportion of patients as low risk, so it provides the basis for a new prognostic tool that should help avoid unnecessary treatments being given, and it also opens doors for prediction of drug responses further down the line”, explains Professor Gallagher, who is Chief Scientific Officer of OncoMark a UCD spin-out company that is bringing the technology towards the clinic.
Tackling the ‘triple negative’
Another challenge for research is ‘triple-negative’ breast cancer – so called because the tumours lack certain drug receptors. Triple-negative affects 10 to 15 per cent of breast cancer patients, but there are no targeted therapies currently available for the disease, and a big focus of BREAST-PREDICT is to address that.
The Irish consortium has teamed up with the EU project RATHER, a network of academic and commercial groups that Professor Gallagher coordinates, to discover a new signal in triple-negative cancer cells. The team found that an enzyme called CDK7 is a marker of poor prognosis, and new therapeutic target in triple-negative breast cancer.
Towards better diagnosis and therapies
BREAST-PREDICT is making strides in several other areas too – such as how cancer cells develop resistance to treatments and even how common medications such as aspirin and statins could affect how aggressive tumours are and how they respond to treatment.
“We are building a range of new clinical trials in Ireland driven by BREAST-PREDICT investigators, gathering data from patients over time”, says Professor Gallagher. “And the longer-term impact of our findings will be more accurate diagnosis and new therapeutic options for patients”
William Gallager obtained a PhD in Molecular and Cellular Biology from the Cancer Research UK Beatson Laboratories in Glasgow. In 1997, he moved to Paris to undertake a Marie Curie Individual Fellowship at Rhone-Poulenc Rorer (currently Sanofi-Aventis).