As the UK’s largest breast cancer charity, we are dedicated to funding the most cutting edge research into this devastating disease, so that we can prevent it, stop people dying and improve the lives of those affected.
To celebrate Breast Cancer Awareness Month, we have gathered together 10 things we now know thanks to research, that we didn’t last year:
1. A lung cancer drug could hold the key for thousands of women with breast cancer
Crizotinib is a drug currently used to treat certain types of lung cancer, but back in April, Professor Lord’s team at the Breast Cancer Now Toby Robins Research Centre discovered that it also has exciting potential for thousands of people with breast cancer. The researchers found that in cells with a particular genetic defect – one commonly found in lobular breast cancer – the drug was able to kill the cancer without harming healthy cells.
We want to make sure this exciting discovery is available to patients as quickly as possible, so through the Breast Cancer Now Catalyst Programme we are now funding a clinical trial of crizotinib for patients with advanced lobular breast cancer.
2. What might be causing the newest breast cancer drugs to stop working
Our cells have vast systems in place to protect our DNA from damage. When DNA damage does occur, cells can become cancerous, so it is often faults in the DNA protecting systems that allow the cancer to grow. A new group of drugs targeting a particular type of these faults are PARP inhibitors, which can kill cancer cells that have a mutation in one of their BRCA genes. Already used as a treatment for ovarian cancer, the first PARP inhibitor – Olaparib – was licensed in the US for advanced BRCA mutated breast cancer earlier this year.
Unfortunately, over time cancer cells can become resistant to these drugs, and the treatment becomes unable to kill the cancer. Our researchers have been working with PARP inhibitors from the very start, and this year have brought us closer to understanding why these drugs stop working and what we can do to change that. In May, our scientists identified certain mutations in the PARP1 gene that could mean that PARP inhibitors don’t work. Then, in summer, the same group of scientists working in a worldwide collaboration discovered a brand-new group of proteins which are involved in repairing DNA damage.
This discovery also has implications for cancer treatments, as the researchers found that faults in this group of proteins could be stopping PARP inhibitors from working, but might also make cancer cells more susceptible to other types of treatment. These findings could, in the future, help doctors make better predictions of who PARP inhibitors might not work for, so they can alter treatment early on and ensure everyone receives the treatment that is best for them.
3. We can use people’s lymph nodes to predict whether some people’s cancer might spread
Currently, when a person is diagnosed with breast cancer, doctors investigate whether the cancer cells have already spread to the lymph nodes surrounding the breast. Those whose cancer has spread to the lymph nodes are usually given more intensive treatment as the cancer tends to be more aggressive.
At the start of 2018, Dr Anita Grigoriadis and her team at the Breast Cancer Now Research Unit, King’s College London shared their discovery that looking at the cancer-free lymph nodes as well might add valuable information about how likely the cancer is to spread to other parts of the body. If this finding is confirmed by larger studies it could mean that patients with higher chances of their cancer spreading are offered more intensive treatments early on, and others can be spared treatments that may not benefit them.
To provide women with the most accurate picture of how likely they are to develop breast cancer, we need to uncover which genetic, lifestyle or environmental factors can influence that risk. The Generations Study not only analyses information provided by its 113,000 participants to look for patterns, but also collaborates with other studies worldwide to build our knowledge about breast cancer risk.
This year the Generations Study contributed to the largest global study to date looking into the link between BMI and developing breast cancer before the menopause. The study found that having a higher body mass index (BMI) at a younger age is linked to a smaller chance of developing breast cancer before the menopause.
Researchers now need to investigate this link to find out the biological mechanisms causing this connection, and we would encourage women of all ages to maintain a healthy weight throughout their life to help lower their overall risk of cancer and other health conditions.
5. A hormone called AMH could help us determine someone’s breast cancer risk
The team at the Breast Cancer Now Generations Study took part in a second collaboration this year aimed at finding out more about the factors linked to someone developing breast cancer. The researchers analysed blood samples from nearly 6,000 pre-menopausal women worldwide, to see whether the fertility hormone “Anti-Müllerian hormone” – only detectable before the menopause – was linked to likelihood of developing breast cancer. They found that those with the highest levels the hormone in their blood, were 60% more likely to develop breast cancer than those with the lowest levels. This was true for breast cancer developed both before and after the menopause.
The team are now examining whether incorporating levels of this hormone into current risk prediction models could help give pre-menopausal women a better idea of their chance of developing breast cancer.
6. Targeting KIFC1 could be a new line of attack for triple negative breast cancer
Each year around 7,500 women in the UK are diagnosed with triple negative breast cancer. More commonly affecting younger women and sometimes more aggressive than other types of breast cancer, triple negative tends to be hard to treat.
In March, our researchers discovered 37 genes that when silenced, suppress a tumour's growth without affecting healthy cells. One of the most promising genes for new drug discovery was KIFC1 – and the researchers found that inactivating this gene in the lab could kill cancer cells without damaging healthy cells. Triple negative breast cancer cells are especially susceptible to this due to their specific molecular make-up. The researchers are now looking to discover drugs that can block KIFC1 in the hope of creating a targeted therapy for triple negative breast cancers.
7. A new type of blood test could tell us who an exciting new drug will work for
Palbociclib is a new and potentially life-changing drug for people with hormone receptor positive and HER2 negative breast cancer that has spread. The drug can delay progression of the disease for around 10 extra months when added to the standard treatment, but unfortunately it does not work for everyone.
Currently, women must wait two to three months to find out if the drug is working, but researchers have found that a new type of blood test, called a liquid biopsy, could be used to detect changes in the tumour’s DNA, and therefore indicate whether the drug is working much sooner. This finding, if validated in further studies could be vital in helping patients get the most effective therapy as early as possible.
8. There could be a more effective treatment option for people with triple negative breast cancer
In April results were announced from the ‘Triple Negative Trial’ - a major trial co-funded by Breast Cancer Now searching for the best treatment options for those with triple negative breast cancer. This form of the disease is often more aggressive, and can’t currently be treated with targeted treatments, meaning chemotherapy is the main treatment option.
The researchers studied 376 patients with triple negative breast cancer that had spread, and found that for those with a mutation in one of their BRCA genes, a ‘platinum’ chemotherapy drug called carboplatin performed better than standard chemotherapy docetaxel. Carboplatin delayed the disease’s progression by an average of 2.4 months more than docetaxel, as well as shrinking the tumours in twice as many women. Carboplatin also had fewer side effects than the standard chemotherapy.
These exciting results are a long-awaited step forward for women with this form of the disease, and will hopefully reach patients as soon as possible, ensuring they can be given more time to live well.
9. There are 72 more clues helping us predict someone’s risk of developing breast cancer
All of us have millions of tiny variations in our genetic code that mostly have no effect, but can occasionally influence factors such as your likelihood of developing diseases like breast cancer. The more we know about these genetic variations, the bigger picture we can build about someone’s risk.
At the end of Breast Cancer Awareness Month last year, the results of a big international collaboration including the Generations Study were published, announcing the discovery of 72 variations in our genetic code that contribute to the chances of developing breast cancer. This takes the total number known to around 180, and will help scientists understand why some women are more likely to develop the disease than others, allowing us to identify those at high risk and provide them with the best ways to reduce that risk, or monitor them more closely to ensure that if breast cancer develops we can find it as early as possible when it is most treatable.
10. There’s yet another reason to stop smoking
Smoking has been linked to 15 different types of cancer, and it has been thought for some time that it could increase your risk of breast cancer as well. However, the evidence for a link between the two has previously been inconsistent. To bring some strong evidence to the conversation, the Breast Cancer Now Generations Study analysed information from over 102,000 of its participants, to unpick the link between breast cancer and smoking. In November last year, they shared their results that those who had smoked in their lives were 14% more likely to develop breast cancer than those who had not. The study also found that this effect was even stronger in women who had begun smoking at a young age, and those who already had a family history of the disease. There are already many reasons to stop smoking, but this information now adds a further factor, especially for young women, to consider.
We are so proud of the work our researchers have done, which has only been made possible by the incredible efforts of people like you, fundraising, wearing pink, and getting involved throughout Breast Cancer Awareness Month and beyond.
But we are not stopping here. We are excited about the possibilities for the future, and are currently funding around £25 million worth of ground-breaking research projects, supporting almost 380 of the world’s brightest researchers. With all of this, we believe that by 2050, everybody who develops breast cancer will live – and live well. Your support has helped us to achieve so much already – please stay with us on the journey to making this 2050 vision a reality.