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Millions of women with a type of breast cancer fuelled by the female hormone estrogen have benefited from treatments such as tamoxifen and femara, which in most cases successfully prevent breast cancer returning later in life.
However, a third of these hormone-driven breast cancers develop resistance to preventative treatments and the cancer becomes metastatic, spreading throughout the body.
Treatment resistance is the highest cause of mortality in breast cancer. Itâ€™s vitally important to prevent this metastatic stage of breast cancer but as yet there are no effective tests or personalised therapies that can identify or help these women and men.
NBCF-funded Dr Liz Caldon believes that the survival and quality of life would improve significantly if it was possible to predict from the first diagnosed cancer whether it is likely that someone’s cancer will recur, and then treat any recurrence with drugs that are specifically toxic to hormone resistant breast cancer.
But first she is focusing on improving our understanding of hormone resistant breast cancer, specifically the molecular changes that occur as the cancer cells develop resistance, including which genes might be involved.
With this knowledge she and her team will design better predictive tests that detect the presence of resistant cancer cells well before they start to grow as a secondary cancer. They will also determine if these cells have any particular qualities that mean they could be specifically targeted and destroyed during therapy.
Ultimately, this research project aims to eliminate the development of resistance to treatment and stop recurrence from ever happening, providing hope for women and men with hormone resistant breast cancer.
Thanks to medical research itâ€™s now widely recognised that harnessing the immune system is a powerful way to target and kill cancer.
Patients with high levels of immune cells within their tumour respond better to both standard therapies (radiotherapy and chemotherapy) and therapies designed to enhance the immune response against cancer (immunotherapy). However, many patients donâ€™t have immune cells in their tumours so these treatments are not very effective, and more research is needed.
One potential strategy for these patients is the use of white blood cells which are genetically engineered to eradicate cancer cells. These cells, called ‘chimeric antigen receptor T cells’ (CAR T cells), are very effective in blood cancers but donâ€™t work well in other cancers including breast cancer.
One reason for this is because cancer produces adenosine, a substance which has a powerful ability to suppress the immune system. It creates an environment designed to switch off immune cells, giving the cancer plenty of opportunity to grow unchecked.
In a four-year NBCF-funded study, Dr Paul Beavis aims to reprogram the CAR T cells to block the effects of adenosine, so the immune system can recognise, find and destroy any cancer in the body.
The adenosine pathway is most relevant in triple negative breast cancer which is the most aggressive and hardest to treat subtype. Development of a successful immunotherapy would be a significant breakthrough and would have a huge impact on the lives of women diagnosed the disease, and particularly for those with triple negative breast cancer.