Critical gaps discovered in breast cancer research

CRITICAL gaps have been identified in breast cancer research. In an article in BioMed Central’s open access journal Breast Cancer Research, leading scientists in the field report on a gap analysis that critically assessed issues and new challenges emerging from recent breast cancer research, and propose strategies for translating solutions into practice.

It is estimated that around 570,000 people are living with, or after, a diagnosis of breast cancer in the UK, and this number is expected to double by 2030. Breast cancer, therefore, remains a significant challenge. Over 100 specialist breast cancer scientists, clinicians and heath care professionals reviewed a wide range of issues and challenges involved in breast cancer research, prevention and treatment. Through facilitated discussions and consultation, including appraisal from experts and patients, they produced an account outlining ten major gaps and five strategic solutions.
The 10 major gaps identified were: (1) understanding the functions and contextual interactions of genetic and epigenetic changes in normal breast development and during malignant transformation; (2) how to implement sustainable lifestyle changes (diet, exercise and weight) and chemopreventive strategies; (3) the need for tailored screening approaches including clinically actionable tests; (4) enhancing knowledge of molecular drivers behind breast cancer subtypes, progression and metastasis; (5) understanding the molecular mechanisms of tumour heterogeneity, dormancy, de novo or acquired resistance and how to target key nodes in these dynamic processes; (6) developing validated markers for chemosensitivity and radiosensitivity; (7) understanding the optimal duration, sequencing and rational combinations of treatment for improved personalised therapy; (8) validating multimodality imaging biomarkers for minimally invasive diagnosis and monitoring of responses in primary and metastatic disease; (9) developing interventions and support to improve the survivorship experience; (10) a continuing need for clinical material for translational research derived from normal breast, blood, primary, relapsed, metastatic and drug-resistant cancers with expert bioinformatics support to maximise its utility.
In order to make significant progress in addressing these gaps the group put forward some strategic solutions. These include improving clinical trial methodologies including patient involvement, and developing a fully cohesive and collaborative infrastructure to support breast cancer research.
A previous review of gaps in research, published in 2008, helped to shape the direction of breast cancer research and the establishment of the UK’s first multi-centre, breast-specific tissue bank. It is hoped the outcomes of this review will have a similar effect on filling the current gaps in research and practice.
Corresponding author, Professor Sue Eccles, The Institute of Cancer Research said: “We’ve known for some time that breast cancer is not just one disease but our understanding has increased enormously in the five years since the first Gap Analysis in 2008. We now know that breast cancer cells can have different characteristics, even within the same tumour, and these can also change over time. This makes it much more complex to research and is why we need greater collaboration between multi-disciplinary teams and an improved infrastructure, to ensure we are getting the data and tissue samples needed to advance ourNEW BALANCE