Researching better treatments for secondary breast cancer
Podcast: researching better treatments for secondary breast cancer
We fund vital research and clinical trials of global relevance, enabling our medical professionals to understand and treat cancer better, in a way that changes and saves lives. So, as part of breast cancer awareness month, we spoke to Dr Penelope Ottewell to find out how her research, funded by Weston Park Cancer Charity, is studying new ways to treat secondary breast cancer.
Dr Ruby Osborn, our grant officer, finds out more…
Breast cancer is the most common cancer in the UK, and while we have good treatment options for primary breast cancer, if the tumour spreads, then treatment becomes much more limited.
When breast cancer spreads, it often grows new tumours in the bones, and this creates holes in the bones and makes them more fragile. Patients who have secondary bone tumours, or bone metastases, are given a type of drug called a bisphosphonate to help slow the damage to the bones. “Now this treatment strategy is incredibly important,” says Dr Ottewell of the University of Sheffield, “because it increases the quality of life for the patient, however it’s not curative, so we really need to do something better for this patient population.”
Previous research done by Dr Ottewell’s team in collaboration with other researchers, supported by a grant from Weston Park Cancer Charity, showed that the drugs could be used more effectively. “If we gave these same treatments but we gave them earlier, so when the tumours were very small or before they’d spread, this might actually be able to stop the tumours from spreading at all.”
This discovery in the lab led to clinical trials, which showed two very different results. In postmenopausal patients, giving the bisphosphonates early did lead to less secondary tumour growth, both in their bones and around the rest of the body.
“However, patients who were premenopausal when they got the same treatment did worse, so although they got less tumour their bone they got more tumour growing in other sites. The research that we’re doing in the laboratory at the moment is focusing on why these bisphosphonates appear to have anti-tumour effects when given to women who are postmenopausal, but pro-tumour effects when given to women who are premenopausal.”
If Dr Ottewell and her team can work out what’s causing the different responses between pre- and postmenopausal patients, then it might be possible to develop another drug to give alongside the bisphosphonates to correct for this, and so allow everyone to get the benefits of the treatment.
Levels of the hormone oestrogen differ before and after menopause, and oestrogen affects the immune system, so with funding from Weston Park Cancer Charity, the team are exploring if immunotherapy drugs given with the bisphosphonates would be able to overcome this difference.
Another of Dr Ottewell’s research projects, that the charity has supported, found that breast cancer tumours make a molecule called IL-1β to help them spread around the body. IL-1β is also involved in inflammatory diseases like arthritis, “and because things like arthritis are so frequent there are drugs available in the clinic that target this particular molecule.” A clinical trial is being developed between Weston Park Cancer Centre and the Christie in Manchester, to test if these arthritis drugs can help to treat secondary bone cancer.
And this finding could be used in another way. “At the moment when a patient presents in a clinic we don’t know which of those patients are going to develop tumour growth in bone and which ones aren’t,” says Dr Ottewell, “and this is actually quite important because we don’t want to over-treat people so we only want to be targeting treatment for those people who are likely to develop tumour growth in bone.”
Because IL-1β is only produced by breast cancer cells that spread, and not those that don’t, clinics might be able to check patient samples for IL-1β and use the results to predict which patients are at higher risk of bone metastases, and then treat them accordingly.
“We’re hoping that in the future our research can lead to patients either not developing metastases at all or not developing tumours spread to the bone, or indeed to any other site,” says Dr Ottewell. “What we need to do now is we need to basically have the revolution that we’ve had for primary breast cancer, where we’ve got really good targeted treatments for that, so we can have good targeted treatments for tumour growth at other sites, so that patients can live a normal life expectancy and a normal healthy life expectancy.”
Right now, we have over £1.5 million committed to 21 research projects; investing in medical, scientific and care-related research to enable people to live longer or better lives with cancer.