Breast cancer is the most common form of cancer in the UK and affects one in eight women at some point in their lives.
Nearly 60,000 people are diagnosed with breast cancer in the UK each year. While modern treatments are helping women survive the disease, some forms of breast cancer are more difficult to treat than others.
Despite the considerable success that doctors have had in treating many breast cancers, nearly 12,000 women die each year. In part this is due to the aggressive nature of some forms of the disease, but many women can also relapse years or even decades later, even with the most advanced breast cancer drugs available.
Professor Judith Bliss is Director of the Clinical Trials and Statistics Unit (ICR-CTSU) at The Institute of Cancer Research, London, and she is leading trials for breast cancer drugs with scientists at the ICR which could make a huge difference to people with the disease.
Current breast cancer drug trials
One drug currently undergoing testing at the ICR is palbociclib, which is a type of biological therapy that targets and blocks proteins that help cancer cells to divide and grow. It targets two proteins called CDK4 and CDK6 — key regulators of cell cycle machinery that are often found mutated in breast cancer.
Around 70–80% of all women with breast cancer have a form of the disease that is sensitive to the female hormone oestrogen, known as ER+ breast cancer.
PALLET is an international trial being led in the UK with the ICR’s Professor Mitch Dowsett and Professor Stephen Johnston at The Royal Marsden NHS Foundation Trust, assessing the effects of palbociclib combined with the hormone treatment letrozole in post-menopausal women newly diagnosed with ER+ breast cancer which is negative for the protein HER2.
Doctors sometimes treat breast cancer before surgery with chemotherapy or with hormone therapies like letrozole, which can help to shrink cancers to make it easier to operate and limit the amount of breast tissue that needs to be removed.
PALLET will find out if palbociclib may be useful alongside letrozole to improve treatment, compared with using letrozole on its own.
And a new trial being led by the ICR-CTSU with the ICR’s Dr Nick Turner and The Royal Marsden’s Dr Alistair Ring called plasmaMATCH is testing a number of other drugs for breast cancer.
plasmaMATCH trial video by Stand Up to Cancer UK
This trial is important because it will use blood tests to match breast cancer patients to treatments that will have the greatest impact on their disease, based on genetic mutations picked up in blood samples from their tumours that can be targeted with drugs.
The ICR have been at the forefront of developing liquid biopsies to identify targetable mutations from blood samples, which could help breast cancer patients use more effective drugs earlier in their treatment. If the trial is successful, liquid biopsies could be used more widely to match breast cancer patients to targeted treatments - and for other types of cancer too.
Committed to ongoing drug development
The ICR has also helped to develop a promising breast cancer drug called AZD5363, which is a type of drug known as an AKT inhibitor.
AKT is a key part of the PI3K/AKT/mTOR signalling network that regulates processes such as cell division and resistance to cell death, and it can be mutated in a wide range of cancers. PI3K/AKT signalling can be hijacked by mutations in genes that cause normal cells to behave like cancer.
The ICR’s Dr Udai Banerji presented data from an early stage clinical trial for AZD5363 last year. It showed the drug was safe to use in breast cancer patients with mutations to the gene PIK3CA, which is frequently found mutated in breast cancer.
This drug is currently being tested in combination with other drugs, but the new plasmaMATCH trial will also test AZD5363 in breast cancer patients with mutations to AKT.
We will have to wait for the clinical trial results to see what impact these new drugs may have on treatment for patients with breast cancer, but the ICR is committed to finding ways to improving breast cancer treatments so that women live longer, healthier lives.
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