Project details

Researcher: Dr Stephen John Sammut

Team: Cancer dynamics

Where: Breast Cancer Now Toby Robins Research Centre, London

The challenge

Some people with breast cancer may have additional treatment, such as chemotherapy, before their surgery. It can help to shrink the tumour so that it’s easier to remove. Or it can reduce the risk of breast cancer spreading to other parts of the body.

This additional treatment can work really well for some. Around 30% of patients have no visible tumour remaining at the time of surgery. But for others, their breast tumours don’t respond as well. These people are more likely to see their disease come back or spread. But at the moment, we can’t reliably predict whether the tumour will respond to this treatment or not.

The science behind the project

Dr Stephen John Sammut’s team wants to improve breast cancer treatments that are given before surgery. And the key is knowing in advance whether the treatment will work.

Being able to predict how cancer responds can help make sure that every patient gets the most suitable drug for them. And looking at how the tumour responds to therapy over time lets us know whether it’s becoming resistant to treatment, and whether a new drug should be used.

“Clinical trials have shown a clear relationship between cancer’s response to therapy given before surgery and patient survival. If we can understand what factors influence this treatment response, we can find ways to predict how different tumours will react to different treatments. That’s why we’re developing tools to help make these treatment decisions, so that every person with breast cancer can receive the most suitable treatment for them.” – Dr Stephen John Sammut

Stephen and his team are focusing on 2 areas:

1) Understanding the treatment response and predicting how tumours will respond to therapy

How effective therapy is depends on the biological features of the tumour and the surrounding environment. Modern lab techniques and complex computer-based methods can help to visualise this. So Stephen’s team have been using these methods to predict cancer’s response to treatment given before surgery. They’ve been looking at changes in gene activity in breast cancer cells, and the function of the immune system, and using artificial intelligence to understand how the tumour may react to treatment.

Stephen hopes this research will give doctors the tools to more accurately predict cancer’s response before starting treatment.

2) Developing more accurate ways to predict how cancer responds to therapy

Tracking how a breast tumour responds to treatment can help us understand how the tumour adapts and evolves over time. To see how well a tumour responds, it’s usually not enough to look at its features before treatment. Changes in cancer cells and their surroundings that happen during the treatment could give some additional insight.

Stephen’s team is using sophisticated genetic and imaging methods and combining them using artificial intelligence to analyse cancer tumours. They’ll look at how the tumours and their environment change over time in response to treatment. This could help us better understand how cancer can become resistant to treatment. And it could help us find new vulnerabilities in breast cancer cells that can be treated with new drugs.

What difference will this project make?

Stephen’s hope is that his work will show how breast cancer cells adapt and change to resist treatment. By predicting these changes, we could personalise treatments and help more people to live well with and beyond breast cancer.