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Transforming Metastatic Breast Cancer Treatment: The Critical Role of Independent Research

Metastatic breast cancer (MBC) is a serious and complex form of cancer that continues to challenge researchers and clinicians. While there have been advancements in treating early-stage breast cancer, MBC remains difficult to manage and treat effectively. Independent scientific research is crucial in finding new ways to understand and combat this disease.

This article explores the latest discoveries in MBC research, focusing on how independent studies make a real difference in patient care.

Introduction

Metastatic breast cancer (MBC), or stage IV breast cancer, occurs when cancer spreads from the breast to other parts of the body like bones, liver, lungs, or brain. Unlike early-stage breast cancer, MBC isn’t curable and needs lifelong treatment. However, advancements in research are crucial for improving patient outcomes and quality of life.

Importance of Advancements in MBC Research

  • Improving Survival Rates: New treatments can help patients live longer.
  • Enhancing Quality of Life: Research leads to therapies that manage symptoms and reduce side effects.
  • Personalized Medicine: Discoveries enable tailored treatments based on individual genetics, improving effectiveness and reducing unnecessary treatments.
  • Understanding Metastasis: Insights into how and why cancer spreads can lead to new preventative measures and treatments.

The Current State of Metastatic Breast Cancer

MBC affects many individuals worldwide. In the United States, it is estimated more than 168,000 women will be living with metastatic breast cancer in 2020. Despite advances in detection and treatment, MBC remains a leading cause of cancer-related deaths among women, with a median survival of about three years after diagnosis.

Challenges in Treating MBC Compared to Early-Stage Breast Cancer

  • Complex Treatment: Early-stage breast cancer can often be treated with surgery and localized therapies. MBC requires systemic treatments like targeted therapy and immunotherapy to address cancer cells throughout the body.
  • Treatment Resistance: Metastatic cancer cells can develop resistance to treatments, reducing their effectiveness and necessitating new therapies and combinations.
  • Tumor Diversity: MBC tumors often contain different types of cancer cells, making it difficult to find a one-size-fits-all treatment. Different cells may respond differently to the same therapy.
  • Quality of Life: Managing MBC involves not only controlling cancer spread but also addressing symptoms and side effects, such as pain, fatigue, and emotional distress, which impact the patient’s quality of life.

The Role of Independent Scientific Research

Independent scientific research is conducted by researchers or organizations not directly affiliated with major institutions or government bodies. It is often funded by private foundations, non-profits, or individual donors, allowing for greater flexibility and innovation.

It is important for the following reasons:

  • Innovation and Flexibility: Independent researchers can explore new ideas and approaches that larger institutions might overlook.
  • Filling Knowledge Gaps: They can study areas that are often underfunded, contributing to a more complete understanding of MBC.
  • Collaboration and Cross-Disciplinary Work: Independent groups often work with other researchers, patients, and advocacy groups, fostering a comprehensive approach to finding solutions.
  • Rapid Response to Emerging Data: These researchers can quickly adapt to new findings, ensuring the latest discoveries are promptly investigated and translated into treatments.

Recent Breakthroughs in MBC Research

In the relentless pursuit of combating metastatic breast cancer (MBC), recent years have seen remarkable breakthroughs that are reshaping the landscape of treatment options and patient outcomes. These breakthroughs result from tireless efforts from independent researchers dedicated to unraveling the complexities of MBC.

Here’s a closer look at some of the most significant advancements:

On/Off Switch for MBC

In a recent study, researchers led by Lingyin Li, a Stanford biochemistry professor, found that the protein ENPP1 plays a key role in breast cancer’s resistance to immunotherapy and its spread. ENPP1 is found in both cancerous and healthy cells and is linked to immunotherapy resistance and metastasis in breast cancer patients.

Collaborating with UCSF professors, the team confirmed ENPP1’s predictive value in patient outcomes. Mouse studies showed that blocking ENPP1 reduced tumor growth and metastasis by suppressing the immune response. Dr Li suggested that ENPP1 acts like a “dam,” blocking immune signals and allowing cancer cells to hide.

These findings could help guide treatment decisions and improve therapies for breast cancer and other cancers that evade the immune system.

Two-pronged Immunotherapy for Metastatic Breast Cancer

Researchers at Washington University School of Medicine have found a way to make metastatic breast tumors in bone susceptible to the body’s immune system. By boosting certain immune cells, they cleared breast tumors in mice and prevented them from returning.

Blocking a molecule called p38 MAPK made the tumor area more vulnerable while combining it with an immune therapy called OX40 agonist supercharged T cells, effectively eliminating metastatic tumors.

This approach shows promise for treating metastatic breast cancer and protecting against bone loss. Clinical trials are ongoing for the therapies involved.

Targeting SMYD2 Protein to Prevent MBC

In a study published in Cell Discovery, researchers led by a biologist at CNRS have uncovered a potential breakthrough in understanding metastatic breast cancer. They found that a protein abundant in aggressive breast cancers, SMYD2, might play a pivotal role in promoting metastasis. This protein appears to activate BCAR3, another protein known for aiding cancer cell adhesion and migration.

Through experiments on mice with early-stage breast cancer, inhibiting SMYD2 prevented metastasis, suggesting a promising avenue for early treatment strategies that could potentially improve patient outcomes.

Translating Research into Patient Care

Recent progress in metastatic breast cancer (MBC) research is bringing hope to patients. Turning research into practical treatments follows a step-by-step process:

  • Lab Testing: New treatments are first tested in labs to make sure they’re safe and effective.
  • Clinical Trials: Promising treatments move to human trials, starting small to check safety and dosage, then expanding to see how well they work.
  • Regulatory Approval: Once proven safe and effective, treatments get approval from organizations like the FDA.
  • Guidelines and Monitoring: Approved treatments become part of official guidelines for doctors. They’re also watched closely to make sure they keep working well and are safe in the long run.

Bottom Line

Independent research is vital for advancing our understanding and treatment of metastatic breast cancer (MBC). Despite challenges, researchers have made significant breakthroughs, improving patient care. To sustain progress, we must support independent research efforts through funding and advocacy.

Looking ahead, personalized medicine offers hope for better outcomes. Let’s continue prioritizing and investing in independent research to provide hope and better solutions for MBC patients.

Cancer blog-min

The Importance of Early Detection and Prevention of Cancer

Introduction

Health is indeed the greatest wealth one can have.  Being vigilant towards the health of yourself and your loved ones is a top priority. This involves routine health check-ups and regular monitoring required as per physician’s advice relevant to an individual’s medical history. Any disturbance found in the body’s normal rhythm can hence be caught at an early stage and appropriate measures can be taken for its treatment and/or management. Amongst other ailments, cancer diagnosis can be most terrifying. Since there is no definite cure for Cancer, early stage diagnosis can greatly help in better treatment outcome and improved Quality of life.

Role of early diagnosis & screening-

The two main components of early detection of cancer are, i) early diagnosis and ii) screening. Early diagnosis focuses on detecting symptomatic patients as early as possible, while screening refers to the use of tests performed to detect cancer early on healthy individuals who have not yet shown symptoms of disease and are asymptomatic. The aim of screening is to reduce ailments and mortality caused by cancer. It is an effective method which is widely accepted and beneficial to people who are at risk with regards to cancer. This is crucial as it is one of the first actions taken to prevent disease. Furthermore, patients whose cancer is detected at an early stage possess a higher chance of cured disease, complete recovery, increased quality of life and longevity. Efforts to improve the selection of candidates for cancer screening, in order to understand the biological basis of carcinogenesis, and the development of new technologies for cancer screening will allow for improvements in the field over time.

Goals of early detection- 

The goal of cancer screening and early detection is to cure cancer by detecting the malignancy, or its precursor lesion, at an early stage prior to the onset of symptoms, when treatment of cancer is most effective. Indeed, overall cancer mortality has decreased by 25% from 1990 to 2015 for the United States U.S.), with even greater declines in the mortality rates for colorectal cancer (47% among men and 44% among women) and breast cancer (39% among women). A portion of this decrease can be attributed to the introduction of high-quality cancer screening for colorectal and breast cancer. The most successful cancer screening programs lead to the identification of precursor lesions (e.g., cervical intraepithelial neoplasia (CIN) with cervical cancer screening and colonic polyps with colorectal cancer screening) where the treatment of the precursor lesion leads to a decrease in the incidence of invasive and lethally spreading cancer over a period of time.

Application of various Imaging techniques-

Imaging tests used in diagnosing cancer may include Computed tomography (CT) scan, Magnetic resonance imaging (MRI) scan, Breast MRI, X-rays and other radiographic tests, Mammography, Nuclear medicine scans (bone scans, PET scans, Thyroid scans, MUGA scans, gallium scans), Ultrasound. Imaging tests are only part of cancer diagnosis and treatment. A complete cancer work-up includes assessment of medical history by a certified health care professional, a thorough physical exam, blood work and other lab tests.

Biopsy & its types-

Biopsy is another method that aids in detection of Cancer. It is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a disease. The most common types of biopsy includes: (1) Incisional biopsy, in which only a sample, part of affected tissue is removed; (2) Excisional biopsy, in which an entire lump or suspicious area is removed; and (3) Needle biopsy, in which a sample of tissue or fluid is removed through a needle aspiration. Depending on the type of needle used, the procedure is called a core biopsy when performed with a wide needle, and fine-needle aspiration biopsy when a thin needle is used.

Genetic & DNA testing-

Genetic testing is another effective method in Screening for Cancers. It helps in discovering certain mutations (changes) in genetic make-up of an individual, which are more prone to getting certain cancers. The most commonly mutated gene in people with cancer is p53 or TP53. More than 50% of cancers involve a missing or damaged p53 gene. Most p53 gene mutations are acquired. Germ line p53 mutations are rare, but patients who carry them are at a higher risk of developing many different types of cancer.

Routine examinations required to check for warning signs that may lead to Cancer-

There are few warning signs and symptoms that should not be neglected for better health. They are as follows:

-A sore that does not heal, delayed or slow healing

-Unusual bleeding or discharge.

-Thickening or lump in breast or elsewhere.

-Indigestion or difficulty in swallowing.

-Obvious change in wart or mole.

-Nagging cough or hoarseness.

 -A change in bowel habits, including diarrhoea, constipation or consistency of your stool.

-Persistent abdominal discomfort such as cramps, gas or pain.

-Rectal bleeding or blood in your stool.

-Unexplained weight loss.

-Weakness or fatigue, which does not get better after adequate rest.

Importance of early diagnosis and its comparison with late stage diagnosis; along with their respective prognosis-

Lack of early screening leads to late stage diagnosis. In most cases, patients who are diagnosed with cancer at earlier stages show improved survival, clinical outcomes and better quality of life. However, screening for earlier cancer detection remains limited. As of year 2021, broad-based cancer screenings for asymptomatic patients are recommended in the US for just 5 cancer types (breast, cervical, colorectal, lung for a high-risk subset of the population, and prostate).Statistically, 71% of all cancer mortality is from cancers that lack broad-based screenings for asymptomatic patients. Thus, earlier cancer diagnosis results in improved survival. Patients diagnosed with earlier stages of cancer (stage I-II) generally have a higher likelihood of recovery than those diagnosed at a later stage (stage III-IV). For non-small cell lung cancer (NSCLC), stomach, and pancreatic cancers, between 36% and 53% of patients are diagnosed with stage IV cancer, where the cancer has spread to other parts of the body, decreasing survival chances. The 5-year survival rate for non-small-cell lung cancer (NSCLC), stomach, and pancreatic cancers, doubles in all cases when detected at earlier stages. These differences in survival rates emphasize the opportunity to make progress in beating cancer by decreasing late-stage diagnoses with improved and expanded screenings.

Suffering patients progress through more extensive treatment demanded by later stage diagnosis. Quality of life goes down including through physical, emotional, and social functioning. Late-stage diagnosis often requires more intensive and more invasive interventions that result in sometimes difficult and lasting side effects. For example, patients with late-stage NSCLC diagnosis often suffer from dyspnoea, or laboured breathing, after their treatment is complete. Similarly, stomach cancer patients recovering from a partial or full gastrectomy followed by other treatments such as chemotherapy, radiation, and immunotherapy in late stages may suffer from chronic fatigue, difficulty eating, and challenges performing everyday activities.

Conclusion-

A plan for early diagnosis is a key component in controlling and preventing cancer. Main goal is to cure cancer patients, prolong their life considerably while ensuring a good quality of life. Treatment plans need to be integrated with a palliative care programme, so that patients with advanced cancers, who can no longer benefit from treatment, will get adequate relief from their physical, psychosocial and spiritual suffering. Additionally, programmes should include an awareness-raising component, to encourage and educate patients, family and community members about the cancer risk factors and the need for taking preventive measures to avoid contracting cancer.