Landmark breast cancer study paves way for tailored treatments

Researchers have identified 10 different types of the disease, laying groundwork for more effective, targeted treatment plans.

A new study could revolutionise the way women with breast cancer will be diagnosed and treated in the future by reclassifying the disease into 10 completely new categories based on the genetic fingerprint of the tumour.

The study suggests that doctors could one day predict survival more accurately in women with breast cancer based on these new categories (or subtypes) and better tailor treatment to the individual patient.

The research, published today (18 April) in the journal Nature, is the largest global gene study of breast cancer tissue ever performed – the culmination of decades of research into the disease.

The team at Cancer Research UK’s Cambridge Research Institute, in collaboration with the BC Cancer Agency Vancouver Canada, analysed the DNA and RNA of 2,000 tumour samples taken from women diagnosed with breast cancer between five and 10 years ago.

In the study, the scientists:

• Classified breast cancer into at least 10 subtypes grouped by common genetic features that correlate with survival. This new classification could change the way drugs are tailored to treat women with breast cancer.

• Discovered several completely new breast cancer genes that drive the disease. They are all potential targets for the development of new types of drugs. This information will be available to scientists worldwide to boost drug discovery and development.

• Revealed the relationship between these genes and known cell signalling pathways – networks that control cell growth and division. This could pinpoint how these gene faults cause cancer by disrupting important cell processes.

Study co-lead, Professor Carlos Caldas, senior group leader at Cancer Research UK’s Cambridge Research Institute and Professor of Cancer Medicine at the Department of Oncology, University of Cambridge (as well as Honorary Consultant Medical Oncologist, Addenbrooke’s Hospital), said: “Our results will pave the way for doctors in the future to diagnose the type of breast cancer a woman has, the types of drugs that will work, and those that won’t, in a much more precise way than is currently possible.

“This research won’t affect women diagnosed with breast cancer today. But in the future breast cancer patients will receive treatment targeted to the genetic fingerprint of their tumour.

“We’ve drilled down into the fundamental detail of the biological causes of breast cancer in a comprehensive genetic study. Based on our results, we’ve reclassified breast cancer into 10 types – making breast cancer an umbrella term for an even greater number of diseases.

“Essentially we’ve moved from knowing what a breast tumour looks like under a microscope to pinpointing its molecular anatomy – and eventually we’ll know which drugs it will respond to.

“The next stage is to discover how tumours in each subgroup behave – for example, do they grow or spread quickly? And we need to carry out more research in the laboratory and in patients to confirm the most effective treatment plan for each of the 10 types of breast cancer.”

Professor Samuel Aparicio, co-lead author of the study based at the BC Cancer Agency in Vancouver, Canada, said: “Breast cancer is a global problem and it’s exciting to see a new framework for the understanding of breast cancer emerge from our partnership with colleagues in the UK.

“The new molecular map of breast cancer points us to new drug targets for treating breast cancer and also defines the groups of patients who would benefit most.”

He added: “The size of this study is unprecedented and provides insights into the disease such as the role of immune response, which will stimulate other avenues of research.”

Dr Harpal Kumar, chief executive of Cancer Research UK, said: “This landmark study will completely change the way we look at breast cancer. It’s the result of decades of research by our scientists to identify the causes and drivers of the disease, which included a pivotal role in decoding the well-known BRCA genes.

“We’re entirely funded by the generosity of the public and this incredible support has put us at the heart of progress that’s underpinned the dramatic increase in the number of women surviving from breast cancer in the UK. This new study will enable us to make a further step-change for patients with breast cancer.

“These latest results demonstrate again how solid scientific research is the foundation for translation into patient benefit and ultimately improving breast cancer survival.”