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Latest breast cancer treatment advances presented at NCRI conference

Understanding variation in radiotherapy sensitivity

Professor John Yarnold told the National Cancer Research Institute conference in Liverpool about changes in how radiotherapy is scheduled, which are improving the quality of life for breast cancer patients.

Professor Yarnold, who is Professor of Clinical Oncology at The Institute of Cancer Research (ICR) and Honorary Consultant at the Royal Marsden NHS Foundation Trust, delivered the prestigious 2013 George Edelstyn Lecture.

His lecture looked at the 10-year follow-up of the UK START trials, which compared a traditional radiotherapy schedule of many small doses of radiation, with a regimen of fewer, larger doses. The trials showed that in addition to being more convenient for patients, reducing the number of doses led to a reduction in both short- and long-term side effects, without being any less effective than the traditional schedule.

Standard care for early stage breast cancer local-regional radiotherapy in the UK has already switched from a five-week schedule of 25 fractions of 2Gy to the three-week schedule delivering 15 fractions of 2.7 Gy. But Professor Yarnold said that 15-fraction regimens are unlikely to represent the lower limit of effective radiotherapy.

It is now important to determine the extent of variation between breast cancers in their sensitivity to different levels of radiation. If there is a lot of variation between cancers, it highlights the need to identify tests to exploit this variation in order to tailor the treatment of future patients.

By the end of this decade, research could bring about a regimen of local-regional radiotherapy with as few as five fractions for women with early breast cancer.

Emerging targeted therapies

Dr Nicholas Turner, Team Leader in Molecular Oncology at the ICR, delivered his lecture on emerging targeted therapies for advanced breast cancer.

Dr Turner called upon researchers to meet the challenge of tackling triple negative breast cancer, the most hard-to-treat type with the worst outlook for women, by combining traditional research approaches with more focus on a deeper understanding of the genetic profiles of individual cancers. Current approaches, he argued, have failed to lead to any significant improvement in outlook over the last five years and there are currently no treatments in late-stage clinical trials for triple negative breast cancer.

Recent advances in next generation genetic sequencing, gene expression profiling and bioinformatics, have opened up new avenues for research into treatments for the disease. Dr Turner described recent advances that have allowed researchers to separate triple negative cancers into at least six different types, all of which could be targeted by different treatments.

Dr Turner is optimistic about finding new treatments, arguing that these advances in technology and our growing understanding of the genetic diversity of triple negative breast cancers put us in a position to design smarter clinical trials for new targeted treatments, in which the most appropriate therapies are picked out for each individual patient.

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