A report published in the journal Nature has energized the field of breast cancer research and generated a lot of excitement among folks reading the news today. Researchers say an effort to do detailed molecular analyses of breast cancer is yielding a comprehensive catalogue of likely genomic drivers of the most common breast cancer subtypes. Why is that notable? They say the findings significantly extend the knowledge about breast cancer, and could lead to new treatments with new or already existing drugs.
Their new observation is that many diverse genetic alterations line up generally into four main breast cancer classes. Experts agree though that as exciting as the findings are, any changes in treatment would take many years to come to fruition, as a wide array of approaches would need to be fully tested to determine which could lead to improved outcomes. The study is part of a large federally-funded project, called the Cancer Genome Atlas, which aims to build maps of the genetic irregularities in common cancers, including breast, lung, and colon cancer.
We asked Dr. Len Lichtenfeld what he made of these findings.
The paper published this week in Nature reports the most detailed analysis to date of the various genetic mutations found in a significant number of breast cancers. The implications of the research are substantial, and while opening the door to new understandings of the genetic and molecular basis of breast cancer it also points out the incredible complexity of the disease.
More important to patients, their families and physicians, it highlights new understandings of how different breast cancers work, and new opportunities that may prove very useful in approaching the diseases we call breast cancer with new and existing treatment approaches.
But while of those concerned about or affected by breast cancer are likely going to flock to their doctor to get the most out of this potentially remarkable finding, it’s just as important to take action on another front to make sure this type of research continues.
The research is incredibly complex, much more than the typical cancer specialist or other physician can understand. The researchers used several different approaches to analyzing the breast cancers, and were able to do complex analyses across these various platforms to glean information that heretofore has been beyond our abilities to either examine or understand. It is these analyses that open the doors to new understandings and treatment approaches, while bringing closer the promise of being able to make this information available in the clinical treatment of patients in a timely and meaningful way. In other words, this research takes us one major step from theory to actual practice.
As we have watched the science of genomics—which is basically our understanding of the genetic makeup of cancer—advance, there have been questions raised when and even whether this research is going to be applicable in the clinic anytime soon. Meanwhile, our ability to analyze the human genome with speed and accuracy has been advancing dramatically while at the same time the costs of such analyses have decreased considerably. How we can harness this new science and how we can separate the real signals from the background “chatter” has been a question raised by many scientists and others, particularly recently.
It appears from this current research that the scientists have been able to move in a direction to resolve some of those questions.
It is important to recall that despite the fact this is incredibly sophisticated and difficult work, it is still reasonably early in our ability to perform the analyses, interpret the data, and determine the best way to apply it to the clinic. We still have a long way to go, and we must always remember that cancer has a way of being more complicated at every turn that we might otherwise anticipate as our research and our knowledge advances. But research such as this also puts more of the pieces of the puzzle of breast cancer together in a way that a solution to the dilemma of understanding breast cancer and how we can apply the best treatment does appear to be more readily at hand.
What is the most important message from this research?
Unfortunately, it is not going to change lives immediately. Your doctor isn’t going to give you a different treatment for your breast cancer today, tomorrow, or next week because of this research. There is no question that doctors involved in breast cancer treatment are going to take a very careful look at this research and determine the best way to apply this information to new approaches to breast cancer as quickly as they can, but that will still take time.
To me, the most important message from this research is to confirm what many of us have been thinking for some time now: we are seeing the fruits of decades—yes, decades—of hard work in the laboratory taking us to a point we are going to have a significant impact on patient care and the outcomes of treatment for cancer. At the same time, the very support for that research is in jeopardy due to decreases in government funding, business investment, and private philanthropy. We cannot, in my opinion and in the opinion of others like the American Cancer Society, allow that to happen.
So perhaps the most important thing you can do is not only consult with your doctor—understanding they probably won’t do anything hurriedly for you because of this report—but to also be certain to let your legislators know that they hold the future progress of this exciting work in their hands as they deliberate on how government should be spending our money. Without that support, we will not be able to take this forward to the next steps that are so obvious from the success of this study.