Noak-Le Bar Floréal/Institut Curie
Breast cancer research: recent breakthroughs
Oncology research is very active and has evolved a great deal in recent years, in particular with the arrival of precision medicine. Below is a review of the most promising avenues.
- Precision medicine, based on the molecular characteristics of the tumor, is making rapid progress. The principle is a simple one: for some types of cancer, the characteristic biomarkers of the tumor are known. By systematically identifying them, the patient can be offered the treatment, if one exists, that corresponds precisely to the nature of her tumor. For breast cancer, four biomarkers (HER2, ER, PR, Ki67) are already routinely looked for. Other biomarkers should be validated via clinical trials. “We have high expectations of the molecular characterization of triple-negative tumors, which are very diverse," explains Dr Véronique Diéras, head of the clinical research department at Institut Curie.
- Targeted therapies represent the majority of the research. That is because they present many advantages: unlike chemotherapy, which attacks all the rapidly dividing cells in the organism, whether healthy or cancerous, targeted therapies block tumor cells more specifically.
- The development of new diagnostic methods is also at the heart of our concerns. Imaging techniques are being perfected.
- By the same token, the detection of circulating tumor cells (cancerous cells which detach from the tumor and circulate within the organism before installing themselves on another organ in order to develop) can be accomplished via a simple blood test. This should allow for better monitoring of the disease’s evolution in its metastatic phase so that the treatment can be adapted. This method is faster and less invasive than biopsies.
- Circulating tumor DNA is also becoming more significant, and may some day become “the equivalent of a liquid biopsy,” comments Professor Jean-Yves Pierga. Cancerous cells, just like any cell, break down naturally over time. As this occurs, they release part of their genetic material into the blood. If we can identify this circulating tumor DNA we can confirm that a cancerous tumor is present somewhere in the body. This may also help us to track the development of the tumor mass or to search for treatment-resistance markers. The difficulty lies in identifying this circulating DNA as tumorous. To do so, we need to identify the genetic anomalies typical of the tumor.
- Reducing treatments and their side effects as far as possible is a priority for researchers and caregivers.Limiting the use of chemotherapy while still providing optimal care is certainly a desirable goal. To this end, institute specialists have just proven the efficacy of a treatment based solely on hormone therapy.
- Triple-negative breast cancers often have a poor prognosis. Today, few weapons are available to fight this aggressive form of cancer. Fortunately, research is making progress, and a new test has just been launched at Institut Curie combining radiotherapy with PARP inhibitors.