Thanks to research, breast cancer survival has improved dramatically. But there are still hundreds of thousands of people dying from the disease each year. So, what do we need to do to find new cures for breast cancer? We asked three expert cancer researchers what they think is the most important area of breast cancer research that needs addressing right now.
Dr Greta Varchi, National Research Council, Italy:
Breast cancer makes me think of Hydra, the gigantic mythical monster with nine heads. Each time a discovery seems to be the key to curing patients, new evidence indicates that we are still far from the solution.
In the past decades, enormous progress has been made regarding early diagnosis and enhancing breast cancer patient care, leading to reduced morbidity and mortality. Nonetheless, several critical challenges remain.
For example, conventional chemotherapy is almost ineffective against dormant cancer cells, which are responsible for the spread of cancer and the cause of death for so many. The development of resistance to systemic therapies also remains an unsolved issue. And triple-negative breast cancer, the most aggressive tumour subtype, is still lacking targeted therapies.
In my opinion, one of the essential areas of research that still needs to be addressed and deepened is the development of concrete, personalized and targeted therapies able to simultaneously tackle primary tumour cells and dormant cancer cells while teaching the immune cells of the microenvironment, how to attack the tumour.
Professor Neta Erez, Tel Aviv University, Israel:
Mortality from breast cancer is almost exclusively a result of tumor metastasis – the spread of cancer to other organs.
Since advanced metastatic cancers are incurable, understanding the biology of tumor metastasis is the most significant challenge in cancer research today.
Metastasis is a complex multistep process. The early stages of metastasis, between the resection of primary tumor and diagnosis of clinically evident metastasis are currently a “black box” in patients, limiting our ability to predict or prevent metastatic relapse.
Reaching a comprehensive understanding of the mechanisms underlying the early stages of the metastatic process is the most significant and urgent quest in cancer research today.
This research is also essential for the discovery of novel therapeutic targets that aim to prevent metastatic relapse, rather than trying to treat advanced metastatic disease.
Dr Manuel Valiente, CNIO, Spain:
Cancers are not solely depending on cancer cells proliferating, but also on the tumour microenvironment. The microenvironment is the normal organ that in principle is doing its normal function.
But when the cancer is there, these normal functions are changed so that the microenvironment is no longer serving the person, but serving the cancer. I think this is going to open a new area for developing therapies.
Another exciting area of cancer research is one we are working on, and that is personalized therapies for cancer applied to metastasis. If you have a metastasis in the bone, we know that there is a survival mechanism that cancer cells need to colonise the bone.
And that may be different to how these cells colonise the brain. So in the future, we are going to start seeing therapies that are applied according to where the metastasis is located. The hope is that by developing these new therapies we will be better able to fight cancer.
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