For every case of breast cancer we can't prevent, we must stop it from taking lives. But that’s not an easy task.

We need to diagnose breast cancer early and effectively, make sure that everyone is given the treatment that works best for them, and understand how secondary breast cancer develops and how we can treat it or stop it from developing in the first place.

Is this the right treatment for you?

There are many different types of breast cancers, and not all treatments work equally well for all of them. We don’t want to be wasting precious time on treatments that bring no benefits, so it’s key we find ways to give everyone the most suitable treatment for them.

Our researchers have developed a simple, low-cost test called IHC4 that predicts which patients, with a certain type of breast tumour, will benefit from or can safely avoid chemotherapy after surgery. IHC4 is currently undergoing broader testing in the NHS to assess how well it works in routine use.

Developing blood tests to see how well a treatment is working is another area our researchers are working hard at. They have found that a blood test for cancer DNA could be used to assess early on if a cancer is responding to the secondary breast cancer drug palbociclib, so that in future patients can get the most appropriate treatment as early as possible.

A similar blood test could help identify patients with secondary breast cancer who could benefit from a change of treatment.

New drugs on the block

In 2005, our scientists published a landmark research paper that showed a new class of drugs – called PARP inhibitors – could be used to treat breast and ovarian cancers caused by faulty BRCA genes. These drugs were moved into clinical trials at unparalleled speed and low cost, offering new hope to patients.

In June 2017, results from a clinical trial showed that the PARP inhibitor olaparib could slow progression of secondary breast cancer in patients with BRCA mutations.

Olaparib is already being used to treat patients with ovarian cancer, and at the start of 2018 it has been approved to treat advanced BRCA-mutated breast cancer in the USA. We now look forward to olaparib being approved for use in Europe and the UK.

Teaching old drugs new tricks

Sometimes drugs developed to treat one condition can also work really well to treat a different disease. This approach is cheaper and faster than developing new drugs from scratch.

Our researchers found that crizotinib – a drug already used to treat lung cancer – could help thousands of breast cancer patients. The discovery showed that it can kill breast cancer cells with a particular genetic defect, commonly found in lobular breast cancer – which accounts for around 13% of all breast cancers.

To make this discovery available to breast cancer patients as soon as possible we are now funding a clinical trial of crizotinib in patients with advanced lobular breast cancer.

New tricks against aggressive breast cancer

Triple negative breast cancer is a subtype of the disease which can be more aggressive, affects younger women, and has limited treatment options. To try and tackle this tricky form of the disease, our researchers conducted the Triple Negative Trial to understand what chemotherapy drugs are best for patients with this type of the disease.

It found that women who have advanced triple negative breast cancer and faults in their BRCA genes do much better receiving a chemotherapy drug called carboplatin than standard treatment.

As a direct result of this study, the European Society of Medical Oncology made two changes to their guidelines to doctors: firstly, that BRCA-mutated triple negative secondary breast cancer is treated with a platinum chemotherapy like carboplatin, and crucially, that women with triple negative secondary breast cancer are offered BRCA gene testing, so that more women could benefit from more suitable treatments.

In an effort to bring us one step closer to a targeted treatment for triple negative breast cancer, our scientists investigated its ‘addiction genes’ – genes that cancer cells highly depend on to survive. They identified that a ‘cancer addiction gene’ called KIFC1 could be a promising target for triple negative breast cancer.

Our researchers have also discovered that blocking the production of a molecule called PIM1 could also be used to treat this type of the disease. PIM1 is overproduced in triple negative breast cancer, and the researchers found that stopping this slows the growth of cancer cells and makes the chemotherapy drug eribulin more effective.

Stopping secondary breast cancer

As secondary breast cancer is the main cause of the nearly 1,000 deaths a month of breast cancer in the UK, our researchers are working hard to unravel how and why breast cancer spreads to other parts in the body and becomes incurable.

One of the key areas of work is understanding how healthy cells can be tricked into helping cancer to spread. Our researchers have uncovered that breast cancer cells release a specific protein that helps the cancer cells to invade the surrounding tissue and spread throughout the body.

Separate studies have also shown how cancer cells can enter the bloodstream – a crucial step in enabling the tumour to spread. Our researchers have found that a type of cell called a pericyte, which is found wrapped around the outside of blood vessels, makes a molecule called endosialin which enables cancer cells to travel through the blood vessel wall and into the blood stream.

Next steps for researchers are to figure out how we can use this new knowledge to stop secondary breast cancer in its tracks.

With further investment in this vital research, we want to see everyone offered a treatment that works best for them. We want to find new and more effective treatments that would mean breast cancer doesn’t have a chance to return, spread, and become incurable. We want to have new tools to understand who is most likely to see their breast cancer come back and have ways to prevent it.

And ultimately, we want to stop people dying from breast cancer.