Professor Therese Becker Metastatic Breast Cancer Research Interview

Professor Therese Becker Metastatic Breast Cancer Research Interview

The National Breast Cancer Foundation (NBCF) is calling on the community to partner with them to raise vital funds for breast cancer research by hosting a Pink Ribbon Breakfast in October.

Every day in 2017, 48 Australian women will be diagnosed with breast cancer and 8 women will die from the disease, leaving countless families devastated.

This year marks the 15th anniversary of the Pink Ribbon Breakfast campaign held in October for International Breast Cancer Awareness Month. The campaign will focus on research that will have the biggest impact and save lives. This includes metastatic breast cancer, which is breast cancer which has spread beyond the breast. With the five-year survival rate of metastatic breast cancer much lower than early stage diagnosis, it is crucial for the community to come together to fund research that will improve outcomes in this area.

Funds raised through a Pink Ribbon Breakfast will directly support NBCF researchers including Associate Professor Claudine Bonder from the University of South Australia. Professor Bonder and her team of researchers are searching for a treatment for metastatic breast cancer by repurposing an available drug that blocks blood vessel development and potentially prevents further tumor growth due to breast cancer.

'Our research can result in a new treatment option for patients with the most difficult to treat breast cancer. Continuous support from the Australian community is so important to ensure we achieve the necessary advancements in treating metastatic breast cancer," Professor Bonder said.

In developed countries like Australia, up to one-third of women who have been diagnosed with early stage breast cancer will go on to develop metastatic breast cancer.2 This can occur more than 10-15 years after the original diagnosis.

NBCF Speakers Network member Tracey Ryan, 54, knows all too well the impact that breast cancer has. Both a mother and a grandmother, Tracey was diagnosed in 2010 when she was 47. She has undergone multiple surgeries and several courses of chemotherapy and faces an ongoing breast cancer journey.

'My diagnosis was shocking and devastating but knowing that NBCF is funding the best possible research gives me great hope and comfort knowing that becoming involved with helping others probably also helps me to better cope with the disease," said Tracey.

Professor Sarah Hosking, Chief Executive Officer of NBCF, said 'we know research is the only way to stop deaths from breast cancer and create a better tomorrow for those affected. Our researchers have come a long way but there is still so much to be done to reach our goal of zero deaths from breast cancer by 2030."

There are many ways to get involved. Whether you host a Pink Ribbon Breakfast at your workplace, at school or even at your home, all funds will contribute to NBCF's goal of raising $2 million for breast cancer research.

Register to host a Pink Ribbon Breakfast at www.pinkribbonbreakfast.org.au

Interview with Professor Therese Becker, Chief Investigator for Ingham Institute for Applied Medical Research

Question: What is Metastatic Breast Cancer?

Professor Therese Becker : Cancer can start in many tissues of the body such as the lung, skin, prostate or breast. It will commonly be first recognized as a lump of tissue called a tumour. A tumour consists of many cells which are still a similar to the neighbouring cells in the tissue of origin but have changed in a way that they divide very often, producing more and more cells causing tumour growth these cells also do not die like normal cells eventually would allowing more tumour growth. Tumour cells can also become more mobile. Some tumour cells can enter blood vessels and take a ride as so called circulating tumour cells (CTCs) in the blood stream. These cells may be relatively harmless (we call those cells dormant) but other CTCs may be quite aggressive and leave the blood stream again to settle down in other organs where they again divide and form daughter tumours, which are called 'metastases". When this happens in breast cancer the patient will be diagnosed with 'metastatic breast cancer" as soon as these tumours reach a size that causes symptoms. Some times cancer cells are especially attracted to certain organs. For example breast cancer often forms daughter tumours in the bone. Cancer enters a dangerous state once it becomes metastatic and it is usually the metastatic disease that causes cancer deaths.

Question: Can you tell us about the metastatic breast cancer blood test you and your team are working on?

Professor Therese Becker : At the Centre for Circulating Tumour Cell Diagnostics and Research (CCDR) at the Ingham Institute we can isolate these CTCs although they are very rare cells within a common blood sample. Once isolated, they are like a sample of the tumour which we can analyse for important characteristics of the disease that might be important for best therapy.

We have received funding from the National Breast Cancer Foundation to analyse how breast cancer CTCs change from relatively harmless dormant CTCs to aggressive CTCs that can invade other tissue and form metastases. It is very important to fully understand how CTCs become metastatic to early detect it happening and to possibly prevent it.

For this study we isolate CTCS from a) patients before removal of early localised breast cancer (most of these will move on to become survivors), b) of long term breast cancer survivors (about a third continue to have mostly dormant CTCs in their blood) and c) from metastatic breast cancer patients. We are able to analyse these CTCs at a molecular level down to examining which genes a cell has switched on or off. It is almost certain that we will find a range of genes that is used (switched on) in dormant CTCs predictably they will be 'sleepy genes" that keep these cells alive but not doing a great deal more. We expect a quite different set of genes used in CTCs from metastatic breast cancer patients, these will be 'aggressive genes" that allow cells to invade other tissue, divide frequently and cause tumour growth. Importantly, once we have identified these genes using high tech experimental approaches we can develop more cost effective routine assays that we can use to detect selected dormant and aggressive gene signatures in CTCs. Once we have these assays, expected within the next year or two we can screen large numbers of breast cancer patients to make sure our assays are able to distinguish dormant from aggressive CTCs. Once confirmed these assays could be used to screen breast cancer survivors on a regular basis to help monitoring any signs of the cancer reoccurring. So far all data from CTC analysis indicate that CTCs are far better to predict disease relapse earlier than common clinical imaging technology.


Question: How long until we'll be able to use this blood test instead of tissue samples?

Professor Therese Becker : We believe to have assays within 1-2 years and confirmation of utility to detect dormant and aggressive disease within the next 5 years.


Question: What are the advantages of this blood test over tissue samples?

Professor Therese Becker : Our test is not only non invasive (simple blood draw) and more economic than undergoing surgical tissue biopsies, often biopsy tissue in advanced breast cancer cannot (easily) be obtained for example when metastases localise to the bone. Our test can be done even when common clinical measurements cannot detect tumour tissue and we will find CTCs in about a third of patients clinically considered disease free. One obvious advantage in countries like Australia with remote communities is that we can do these tests from patient blood samples that get shipped to us within about 24hrs, possible from most areas.


Interview by Brooke Hunter