Research conducted by the BREAST-PREDICT cancer research team has yielded exciting new insights about the resistance of some breast cancers to a commonly used breast cancer drug. 

The research also identified frequent changes in a ‘druggable’ gene in a difficult-to-treat type of breast cancer, and how levels of a certain protein can be used to predict outcome for some breast cancer patients. 

Led by Prof William Gallagher, an associate professor of cancer biology at University College Dublin, BREAST-PREDICT (www.breastpredict.com) is the Irish Cancer Society’s first Collaborative Cancer Research Centre (CCRC) initiative, which is aimed at improving integration of cancer research and cancer care in Ireland and internationally.

This countrywide collaboration involves a 50-strong team of expert Irish researchers, including most of the leading names in breast cancer research, and will run for a period of five years, with an investment of €7.5 million from the Irish Cancer Society. 

 (click to enlarge)

Biobank and database

At the heart of the study is the development of a National Breast Cancer Biobank and Database that includes tumour tissue, blood samples and patient information collected, with permission, from almost every breast cancer patient in the country.  

BREAST-PREDICT is using these valuable resources to improve understanding of how the disease can spread and become resistant to treatment, and find ways to combat this with new and better therapies, with the overall aim of delivering a more personalised approach to breast cancer treatment.

Breast cancer patients who test positive for high levels of the HER2 protein are usually treated with Herceptin, which has vastly improved the outlook for this group of patients. However, BREAST-PREDICT researchers have found that many patients whose tumours were positive for the oestrogen receptor in addition to the HER2 protein, were more likely to develop resistance to the commonly used Herceptin therapy.  

This research finding may aid clinicians to identify, in advance, breast cancer patients who are likely to respond poorly to Herceptin, which could then inform the clinical decision to prescribe alternative or additional treatments. 

Research into the role of the AKT-3 gene in triple-negative breast cancer (TNBC) has also been undertaken. BREAST-PREDICT found that approximately 10% of TNBCs have high levels of AKT-3, and these tumours were more likely to recur after initial treatment. This discovery paves the way for future studies investigating the benefit of therapies targeting AKT-3 for this difficult-to-treat type of breast cancer.

Oestrogen receptor-positive breast cancer, which accounts for 70% of all breast cancers, is generally very treatable and has an excellent prognosis. However, some patients develop resistance to the more common therapies over time, leading to recurrence of the primary tumour, and in some cases, metastasis and eventual death. BREAST-PREDICT researchers have discovered that patients whose primary tumours express a protein called peroxiredoxin 1 (PRDX1) are more likely to develop a recurrence in the future. This finding may have implications for future breast cancer care, where it could be used to help guide treatment decisions in these patients.

Virtual laboratory

Launched in October 2013, BREAST-PREDICT is effectively a ‘virtual centre’ that brings together researchers from six academic institutions across Ireland: UCD, TCD, RCSI, DCU, NUIG and UCC, and the nationwide oncology clinical trials group, ICORG. These experts are sharing their resources and expertise in a project designed to predict the best treatment options for breast cancer.

“We now have a significant opportunity to unify the efforts of our national oncology clinical trials network with leading computational biologists, breast cancer clinicians, population scientists and translational researchers, in order to make a real and lasting impact on the lives of Irish breast cancer patients,” remarked Prof Gallagher, director, BREAST-PREDICT.

The research team is examining the changes that take place in breast cancer that determine, for instance, whether patients respond to a particular drug, how their cancers change over time while they are being treated and whether drugs that they may have been taking prior to their diagnosis have any effect on the outcome of their cancer treatment.

The Centre is also testing ways to find new treatment strategies, either by using existing drugs for the correct patient or by identifying new combinations of drugs that will help patients to beat their disease more effectively. It is also investigating new tools for improved prediction of patient outcome and response to treatment.