Cancer cells in the blood could be the key to personalized breast cancer treatment, according to groundbreaking research. The study, led by the University of Kansas Medical Center and the University of Michigan, suggests that analyzing cancer cells in blood could help doctors make more informed decisions about treatment options for breast cancer patients. This approach could potentially spare patients from unnecessary aggressive treatments, such as surgery, radiation, and anti-hormonal therapy, which are often recommended for early-stage breast cancer.
The research, published in Science Advances, focuses on identifying biomarkers that can distinguish patients who would benefit from aggressive interventions from those who may only require surgery or no treatment at all. Fariba Behbod, Pharm.D., Ph.D., a professor at KU Medical Center, emphasizes the importance of this distinction, as it can significantly impact a patient's quality of life and treatment outcomes.
Of the 2.3 million women diagnosed with breast cancer annually, around a quarter have ductal carcinoma in situ (DCIS), an early-stage cancer that hasn't spread. While DCIS patients typically have a good prognosis, the cancer can become invasive in a significant percentage of untreated cases. This uncertainty in treatment outcomes has led to the recommendation that all women with DCIS undergo treatment, which can include lumpectomy or mastectomy, followed by radiation therapy and anti-hormonal therapy for hormone receptor-positive cases.
However, the study highlights a critical issue: some patients may receive aggressive treatments when their cancer hasn't spread, while others might not receive enough treatment. The research suggests that around 10% of cases treated with surgery alone experience cancer recurrence within 10 years. This discrepancy underscores the need for more personalized treatment approaches.
To address this challenge, the researchers developed a 'labyrinth chip' in 2017, in collaboration with Max Wicha, a professor of oncology and internal medicine. This innovative device separates cancer and white blood cells from smaller blood cells, allowing for the collection of cancer cells in a few milliliters of blood. By analyzing the genes expressed in these cancer cells, the researchers can identify subtypes associated with disease progression, chemotherapy resistance, and immune evasion.
The study revealed that six Black patients had more cancer cells in their blood and higher levels of immune suppression compared to white patients, which aligns with higher breast cancer mortality rates in Black individuals. This finding highlights the importance of considering environmental factors in cancer development and treatment.
Moving forward, the researchers plan to investigate which cell types and biomarkers are capable of reaching and remaining at secondary sites. They are achieving this by transplanting cancer cells from study participants into mice and monitoring their blood for elevated cancer cells. This approach will provide valuable insights into disease progression and help refine personalized treatment strategies for breast cancer patients.
