Professor Andreas Evdokiou
When customs officials offered Professor Evdokiou smuggled elephant tusks that had been seized at the Australian border, he jumped at the chance. He is using bone from the tusks to trial a range of drugs to treat breast cancer that has spread to the bones (bone metastasis).
Thanks to NBCF funding, Professor Evdokiou and his team at the University of Adelaide are aiming to understand why bone provides such fertile ‘soil’ for tumour cells to develop.
Their work is vital because once breast cancer has spread away from the primary site in the breast to other parts of the body (most commonly to the bone), it is essentially incurable and the major cause of mortality from the disease. Bone metastasis causes bone destruction, which can lead to increased risk of fracture, chronic pain and even paralysis. New and more effective treatments to prevent breast metastasis are urgently required.
He is particularly exploring the role of two types of bone cell that drive the turnover of bone: osteoclasts, large cells that remove old bone leaving a cavity; and osteoblasts, which lay down new bone to fill the cavity.
“If cancer cells move into the bone, they secrete a variety of factors that talk to the normal cells in our body, telling them to degrade more bone,” Professor Evdokiou explains.
“Bone degradation allows for the release of factors from the bone itself that attract other cells into the tumour area and these cells change to become osteoclasts, which degrade bone. So there is this vicious cycle of cancer cells talking to osteoclasts, leading to more bone degradation, more factors being released, more tumour cells growing. The osteoblasts, which lay down new bone, can’t keep up with the amount of bone loss.”
That is where the elephant tusks come in. Professor Evdokiou and his team place the bone-absorbing osteoclast cells on top of pieces of tusks and, in time, the cells absorb the bone of the tusks and leave behind craters.
“We are then able to trial a range of different drugs and we see whether the drugs can stop the cells from eating away at the bone,” Professor Evdokiou says.
He says his team is using a new drug, currently in clinical trial, which targets cancer cells in the bone tumour without affecting normal cells.
“These drugs can stop tumour growth in bone in the laboratory,” he says. “Two weeks after treatment, the tumour disappears and the bone heals.”
Professor Evdokiou and his team are also investigating whether some drugs that are used to treat osteoporosis can treat breast cancer that has spread to bone.
“We need to hit the cancer from different angles so we can avoid drug resistance from a single therapy,” he says. “The plan is to change the behaviour of the tumour cells in bone using anti-osteoporotic drugs combined with low-dose chemotherapy, so that we can cure the cancer while building new bone and maintaining a healthy skeleton at the same time.”
Professor Evdokiou says his motivation to work in breast cancer research comes from his family and the hope that research provides for everyone.
“Both my wife and I come from big families and so many of our relatives have been touched by cancer,” he says. “One thing that cancer patients have in common is hope. What keeps their hope alive – and my hope alive – is cancer research.”
In loving memory of Sheelah Baxter.