Despite numerous efforts, breast cancer continues to represent a significant burden on society. In 2021, breast cancer accounted for 12% of all cancer cases globally making it the world’s most prevalent cancer, according to the World Health Organization (WHO). It is therefore no surprise that so many entities continue to actively seek novel screening, diagnostics, and treatment advances to help fight breast cancer.
Early detection and treatment have proven successful, achieving survival probabilities of 90% or higher when resources are available. This sets 2 clear goals for breast cancer research: Improve early detection and uncover treatments for the remaining resistant breast cancer types. Here, we highlight 10 breast cancer advances in 2022 that we believe are or will play a key role in improving patient outcomes.
1. A drug that inhibits tumor expansion in HER2-low patients:
A clinical trial, sponsored by Daiichi Sankyo and AstraZeneca and led by Dr. Shanu Modi of Memorial Sloan Kettering Cancer Center, has been very effective in treating HER2-low breast cancer patients, or those with only a few HER2 cells. The drug, trastuzumab deruxtecan, showed no tumor growth in two-thirds of a total of 557 HER2-low patients with metastatic breast cancer for about 10 months, as compared with 5 months for those with standard chemotherapy.
Although trastuzumab deruxtecan was already approved for patients with HER2-positive breast cancer, few expected it to work because other drugs for such cancers had failed in HER2-low patients. According to Dr. Eric Winer, director of the Yale Cancer Center and head of ASCO, using trastuzumab deruxtecan for cancer treatment affects a huge number of patients, thus it may be a new standard of care.
2. Differentiation therapy transforms cancer cells into less harmful cell types:
Researchers at the University of Basel and the University Hospital Basel have tested a therapeutic strategy called differentiation—converting breast cancer cells to less harmful cells that stop growing. This way, cancer cells lose their high adaptability to different environments in the body and to drug treatments and stop growing uncontrollably and spreading to other organs in the body.
Lead author, Dr. Milica Vulin, notes that the initial idea of the study was to induce estrogen receptor expression in order to convert triple-negative breast cancer into estrogen-receptor-positive breast cancer because of the more effective treatment options available for this subtype.
Within the research, which was done in vivo, more than 9500 compounds were tested for their efficacy in reaching this goal, demonstrating inhibition of an essential cell cycle protein called polo-like kinase 1 (PLK1) and providing the most promising results. Inhibiting this protein resulted in an increased expression of the estrogen receptor which then converted the triple-negative breast cancer cells into cells similar to normal ones. Researchers hope that therapy with the compounds used in this research will be tested in cancer clinics in the future. Additionally, this suggests that differentiation therapy and immunotherapy can be used together in the future to make more progress in treating cancer.
3. An advanced device for breast cancer treatment:
Zeiss Medical Technology in India launched the INTRABEAM 600 device that offers a more manageable treatment method for early-stage breast cancer patients via Intraoperative Radiation Therapy (IORT). Compared to conventional breast radiotherapy, a single dose of IORT given after the removal of the tumor gives remarkable results without the possible risk of affecting the heart and lungs. It also reduces the total duration of treatment from 30 days to 30 minutes.
The key to reducing the duration of the treatment is that IORT is applied immediately after the removal of the tumor, in contrast to classical radiotherapy, which waits for several weeks before starting the therapy. The first model of the INTRABEAM received clearance from the US Food and Drug Administration (FDA) in 1997.
4. Detection of breast cancer with a simple blood draw:
Drawbacks to diagnosing breast cancer via the industry standard of mammograms and tissue biopsies inspired researchers at the USC Michelson Convergent Science Institute in Cancer to develop a new methodology for early-stage cancer detection, the liquid biopsy. For the purposes of this research, blood samples from 100 breast cancer patients and 30 healthy donors were tested for 5 biomarkers in order to stratify late-stage and early-stage breast cancer patients and healthy donors.
The results show that it is possible to perform a robust and reproducible detection of rare circulating events in order to separate the relevant groups of cancer vs. normal control. Furthermore, detecting circulating tumor cells (CTCs) can find cancer even in its early stages, before it grows and spreads, making the treatment much more likely to work, and increasing survival chances.
Since liquid biopsies can be used to detect different types of biomarkers, if proven in larger clinical trials, this method for early cancer detection with a simple blood draw may become a diagnostic tool not only for breast cancer but also for other types of cancer.
5. Portable Atusa ultrasound system for 3D visualization of the breast tissue:
It is well known that early diagnosis of cancer is one of the key factors for successful treatment. Additionally, accessible and complementary imaging modalities and tools play a critical role in proper diagnosis and the continuum of care. The iSono Health company recently presented an innovative ultrasound system designed for personalized breast imaging. Their vision was to offer a compact, automated whole breast ultrasound system in order to provide quality breast imaging without the assistance of expert operators.
This system will provide an ultrasound scan of breast tissue in 3D and offers machine learning capabilities, providing physicians with insightful data to make more informed clinical decisions in the future. Maryam Ziaei, Ph.D., co-founder, and CEO of iSono Health, hopes this system will enable earlier diagnosis and treatment, ultimately saving more lives.
6. New screening technique for breast cancer detection:
Dense breast tissue makes detection of cancerous breast lesions in mammography more challenging. Additionally, breast density itself represents a significant cancer risk factor as dense tissue obscures visualization. Researchers from the National Physical Laboratory (NPL), UK, are optimistic about an advanced breast screening program that will allow clinicians to have a better visualization into the structure of the breast tissue with the help of a non-invasive breast density assessment.
This screening uses a new type of sensor which detects ultrasonic waves transmitted through the breast tissue. It is a completely safe technique, tried and tested by the NPL, and it provides maps of breast composition without the risk of exposure to ionizing radiation. Although it is still in the research phase, the new screening technology is expected to lead to a better diagnosis of the disease as well as monitoring of the course of therapy.
7. A vaccine capable of destroying cancer cells:
One of the important achievements that emerged from the science behind the COVID-19 vaccines is a potential new breast cancer treatment. Scientists at Queen’s University Belfast will use messenger RNA (mRNA) to tackle breast cancer cells with high levels of protein p53, which tend to mutate and cause triple-negative breast cancer. This type of breast cancer is more likely to return or spread during the first years following successful treatment. The p53 protein can also be found in many other types of cancer, which leads to the conclusion that the current discovery could be applied to the treatment of a wider range of cancer types.
8. A “guardian” protein against breast cancer growth:
A new protein, GIT1, that affects the formation and growth of breast cancer have been identified. The results of experiments at the Karolinska Institutet in Sweden show that high levels of GIT1 inhibited tumor growth and low levels of this protein facilitated tumor growth. Researchers also concluded that patients with high levels of GIT1 have a better prognosis than those with low levels, and studies in mice carrying human-derived tumors confirmed that overexpression of this protein substantially reduces tumor formation.
Researchers hope that the discovery of GIT1, which could possibly serve as a biomarker in ER(-) breast cancer, will lead to the development of new therapies for patients with difficult-to-treat breast cancer.
9. ERX-41 – a synthetic compound kills triple-negative breast cancer cells:
Triple-negative breast cancer is a true challenge for most treatment methods that fight the disease because it lacks receptors for estrogen, progesterone, and human epidermal growth factor 2. Therefore, it is necessary to find an effective therapy that targets and kills tumor cells regardless of whether they have those receptors.
Dr. Jung-Mo Ahn and his colleagues synthesized a new molecule called ERX-41 that was shown to be successful in treating this type of cancer because of its ability to bind to a cellular protein called lysosomal acid lipase (LIPA). LIPA is found in a cell structure called the endoplasmic reticulum, an organelle that processes and folds proteins, which are necessary for a tumor cell to grow quickly, which is why it is found to a much greater extent in cancer cells than in normal cells. Furthermore, researchers discovered that the ERX-41 compound is effective against other cancer types, including hard-to-treat pancreatic and ovarian cancers and glioblastoma.
10. A targeted immunotoxin for stage 0 breast cancer treatment:
Researchers at the Johns Hopkins Kimmel Cancer Center have tested injecting the immunotoxin drug through the breast duct, in order to clean out stage 0 breast cancer, also known as ductal carcinoma in situ (DCIS). Using a targeted immunotoxin HB21(Fv)-PE40 in a test on mice, strong cancer-killing effects were observed in all four cell lines of different molecular subtypes of breast cancer. The most surprising thing was that 30 minutes after the toxin was injected, there were no toxins circulating in the bloodstream of the mice.
These “dramatic results,” according to senior study author Saraswati Sukumar, Ph.D., could save many women from having breast removal surgery and radiation treatments, chemotherapy, or hormone therapies for these very early cancers.
