Molecular oncology team

When breast cancer spreads to other parts of the body, it’s called secondary (metastatic) breast cancer. Secondary breast cancer often develops years after treatment for primary breast cancer. By the time it can be detected with current methods, the disease is incurable. Around 1,000 people die from secondary breast cancer every month in the UK.

What makes secondary breast cancer difficult to treat is the fact that cancer cells can become resistant to drugs. Treatments that were effective at first can stop working over time.

Professor Nicholas Turner and his team want to tailor breast cancer treatments to each patient, and make them more effective. They’re developing ways to find tiny traces of cancer cells in the body that remain after initial treatment.

1. Treating trace amounts of breast cancer in the body
   
   Nicholas and his team are analysing trace amounts of cancer DNA in the blood of people with breast cancer. They want to see if these blood tests could help to guide their treatment.
   
   These blood tests, also called liquid biopsies, could help to identify who is going to develop secondary breast cancer. If we could start additional treatment for secondary breast cancer sooner, when it’s only developing, it could be easier to treat or even cure.
   
   The researchers hope to make blood tests better at identifying who is likely to develop secondary breast cancer earlier by using data from an ongoing clinical trial. They’ll also investigate how treating cancer at this early point may improve outcomes.
   
   

2. Treating genetically diverse tumours
   
   A growing number of changes in the DNA of secondary breast cancer can make it more resistant to treatment. Cancer cells within a tumour, or across secondary tumours in the body, can also change, and become resistant to treatment in different ways.

   Nicholas and his team want to discover how breast cancer changes with treatment, and what drives the changes that lead to recurrence. They’ll do this using tissue samples donated by people with breast cancer, at different stages of their treatment.
   
   

3. Finding new ways to treat breast cancer that is resistant to CDK4/6 inhibitor drugs
   
   Secondary oestrogen receptor positive breast cancer can be treated with drugs called CDK4/6 inhibitors, such as palbociclib. But breast cancer cells can become resistant to this treatment over time.

   Nicholas’s team are searching for new treatments for breast cancer that has become resistant to CDK4/6 inhibitors. The researchers are looking for changes in genes that make breast cancer resistant to palbociclib. Then, they will use drugs targeting these changes to test how effective they are. To do this work, the team will use 3D mini tumours that are grown in the lab. These tumours are created using tissue samples donated by people with resistant breast cancer tumours. Drugs found through this research could then be tested in clinical trials.
   
   

4. Understanding how breast cancer becomes resistant to new drugs
   
   Drugs called AKT inhibitors are being tested in clinical trials to treat breast cancer. The researchers want to understand whether breast cancer can become resistant to these drugs, and if so, how.

   Nicholas and his team are studying tumour and blood samples from patients being treated with AKT inhibitors. They’re also carrying out experiments in the lab using patient-derived 3D mini-tumours that have changes to the AKT gene. They hope this research will help develop new ways to prevent breast cancer becoming resistant to this new treatment.

This research could revolutionise the way breast cancer is treated. In the future, blood tests could help determine the best treatment for each person. They could also help detect breast cancer coming back at the earliest stage, when it could be treated successfully. This research could not only increase people’s quality of life, but ultimately save lives.

Breast Cancer Now thanks the Mary-Jean Mitchell Green Foundation for their generous support of Professor Turner’s research.