A leading Manchester scientist has been awarded a grant of over £195,000 by research charity Breast Cancer Now to investigate whether certain drugs could stop breast cancer spreading to the bone.
The news comes on Secondary Breast Cancer Awareness Day (Friday 13 October 2017), as Breast Cancer Now announces more than £700,000 of funding across the UK for research specifically targeting secondary breast cancer – where the disease has spread to another part of the body.
If breast cancer spreads – known as secondary or metastatic breast cancer – it becomes incurable, and almost all of the 11,500 women that die as a result of breast cancer each year in the UK will have seen their cancer spread. More than 2,000 women in Greater Manchester are diagnosed with breast cancer every year, and over 400 women in the region die from the disease each year.1
The bone is one of the most common and least treatable places for breast cancer to spread to. Secondary tumours in the bone can cause joint pain as well as debilitating fractures that often require surgery at a time that is already difficult for patients.
Special types of cells, called breast cancer stem cells (BCSCs), are thought to be responsible for breast cancer coming back after treatment. These cells are able to travel to distant locations – such as the bone – where they can remain inactive, not being affected by therapy, for long periods of time.
Dr Robert Clarke and Dr Rachel Eyre's work
Dr Robert Clarke, based at the Breast Cancer Now Research Unit at the University of Manchester, has been investigating why BCSCs so often spread to the bone, and how the bone environment allows them to survive and grow to form secondary tumours. His previous studies revealed that a molecule inside bones called interleukin 1-beta (IL-1β) triggers a survival mechanism within BCSCs.
Dr Clarke and researcher Dr Rachel Eyre will investigate how IL-1β helps BCSCs migrate to the bone and survive once there. Using BCSCs grown in the lab and in mice, the team of scientists will explore whether drugs that block IL-1β – and the survival mechanism it triggers – could be used to stop secondary tumours forming in the bone.
Next, the team will cultivate BCSCs in bone samples donated by hip replacement patients from the Manchester Royal Infirmary, to replicate what happens when breast cancer spreads to the bones. They will investigate how BCSCs are able to colonise the bone environment, and whether blocking IL-1β could affect their ability to do so.
Kathleen Moss, 61, from Oldham, initially underwent treatment for primary breast cancer in 2011, but last year, she sadly learned that her cancer had spread, when a painful hip alerted her to metastases in her bones and liver.
Kathleen is currently taking Herceptin and Perjeta, which she will continue to take until her breast cancer progresses. She said:
“Hearing the diagnosis of ‘secondary’ was a real game-changer for me. When my aggressive breast cancer came back after four years, I went from happily "cancer free" to living with cancer on a daily basis: morphine tablets to contain bone pain twice a day, chemotherapy every three weeks, and three-monthly CT and MRI scans.
“Side effects make my feet and fingers permanently numb, my nose bleeds, my hair thins and my fingernails break and fatigue is crippling. Almost as hard to bear is the effect on my outgoing and happy husband, who has battled with depression since my diagnosis. Our plans for the future have telescoped into three month segments, always mindful that my secondary breast cancer is incurable, only contained with treatment.
“The first place my cancer spread was to my bones. It was scary going from a lively 58 year old to someone who had trouble walking. Knowing that Dr Clarke and his team are working on a way to stop this spread in other breast cancer patients gives me hope. Although his research won't help me, I hope it can help thousands of others. I wouldn't wish this pain and uncertainty on other families.”
Dr Robert Clarke, Reader in Breast Biology at the University of Manchester, said:
“Rachel and I are very excited to be starting this Breast Cancer Now-funded project. We believe that we have discovered a key factor promoting spread to the bone marrow, which is very common in breast cancer. This funding from Breast Cancer Now will enable us to discover whether we can use drugs to target and prevent breast cancer spread in experimental systems, which is an important step to gather sufficient supporting evidence for clinical trials to take place.”
Dr Richard Berks, Senior Research Communications Officer at Breast Cancer Now, said:
“Drugs that block IL-1β are already used to treat rheumatoid arthritis, and so if this approach is shown to be effective in breast cancer, it could allow patients with secondary breast cancer in the bone to access these drugs much more quickly.
“Our ambition is that by 2050, everyone who develops breast cancer will live. But if we are to achieve this, we desperately need to raise funds for research to find ways to stop the disease spreading.
“This project could help bring us one step closer to our 2050 vision, and we’d like to thank our supporters in Manchester who continue to help make potentially life-saving research like this possible.”
1. Source of information: Local incidence and mortality survival statistics were provided on request by Public Health England, April 2017 – similar data are available from cancerdata.nhs.uk Figures are based upon averages for 2012-2014.