Pioneering strategy may keep breast cancer from coming back
A clinical trial led by scientists from the Abramson Cancer Center and the Perelman School of Medicine offers proof-of-concept for a treatment approach to prevent breast cancer recurrence.
2 min. read
A first-of-its-kind, federally funded clinical trial has shown it’s possible to identify breast cancer survivors who are at higher risk of their cancer coming back due to the presence of dormant cancer cells and to effectively treat these cells with repurposed, existing drugs. The research, led by scientists from the Abramson Cancer Center and Penn’s Perelman School of Medicine is published in Nature Medicine.
Angela DeMichele and Lewis Chodosh have collaborated for years to translate biological discoveries about dormant tumor cells made in his lab, to clinical trials that she leads for breast cancer patients.
(Image: Courtesy of Penn Medicine News)
While breast cancer survival continues to improve thanks to advances in detection and treatment, when breast cancer relapses—or returns after initial treatment—it is still incurable. For the 30% of women and men who do relapse, the only option is continuous and indefinite treatment which cannot eliminate the cancer completely. Some breast cancers, like triple negative and HER2+, recur within a few years, and others like ER+ can recur decades later. Until now, there has not been a way to identify those breast cancer survivors who harbor the dormant cells that lead to recurrence in real time and to intervene with a treatment that can prevent incurable relapse.
“The lingering fear of cancer returning is something that hangs over many breast cancer survivors after they celebrate the end of treatment,” says principal investigator Angela DeMichele, the Mariann T. and Robert J. MacDonald Professor in Breast Cancer Research.
The study builds on previousresearch that showed how dormant tumor cells continue to lay in wait in some patients after breast cancer treatment. Because they are not “active” cancer cells and can be scattered throughout the body, they do not show up on standard imaging tests that are used to watch for breast cancer recurrence. Once the sleeper cells begin to expand and circulate in the bloodstream, it can lead to the spread of metastatic breast cancer.
Lewis Chodosh, chair of cancer biology and senior author of the study, previously led research to identify the pathways that allow dormant tumor cells to survive in patients for decades.
“Our research shows that this sleeper phase represents an opportunity to intervene and eradicate the dormant tumor cells before they have the chance to come back as aggressive, metastatic disease,” says Chodosh. “Surprisingly, we’ve found that certain drugs that don’t work against actively growing cancers can be very effective against these sleeper cells. This tells us that the biology of dormant tumor cells is very different from active cancer cells.”
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