Among women, breast cancer is the most common global cancer, with 2.3 million cases diagnosed annually. Despite significant advances in early diagnosis and treatments for breast cancer, 670,000 women still die around the world every year*.
In the era of personalised medicine, specific targeted therapies now exist for the different types of breast cancer. Despite these tremendous successes, there are several tumours that remain difficult to treat.
Historically, it’s been very difficult to understand how well some patients’ tumours will respond to the treatments that are available. This means some patients go through unpleasant treatments that sadly don’t work.
Developing a more accurate method of testing samples in the lab helps doctors to improve clinical outcomes.
In Leicester, researchers are doing just this – implementing cutting-edge digital pathology and multi-immunofluorescent techniques to investigate changes in samples of patient tumours in a laboratory. This is known as patient derived explants (PDEs).
In their previous work on non-small cell lung cancer and endometrial cancer patient derived explants (PDEs) the Cancer theme of the NIHR Leicester BRC observed a significant relationship with explant responses to chemotherapy drugs and patient outcomes. This paved the way for the latest research.
In the latest study, the team measured the stability of 55 breast cancer patients’ tumour ‘explants’ over time. They ‘treated’ the tumour explant with either chemotherapy or HER2 antibody therapy trastuzumab in the lab.
Importantly, their data showed that, using this method, the architecture of the tumour was maintained for up to 72 hours during testing and the immune microenvironment was preserved. This is highly encouraging as it’s something that other testing techniques have struggled with providing confidence that this testing was meaningful.
The team then compared observations of the tumour explant as it underwent ‘treatment’ in the lab to what we knew about each breast cancer patient’s progression as they underwent their clinical treatment. They found a similar pattern in responsiveness in the patient’s explant to their clinical progression.
This was particularly encouraging as it suggests the tumour explant in the lab was responding in the same way the tumour did in the patient. Suggesting that the patient derived explant technique could be a suitable preclinical testing platform for some breast cancer patients.
It could provide a more accurate method to predict how they may respond to particular treatments. Doctors can avoid giving ineffective treatments, saving time and ultimately improving a patient’s clinical outcome.
The BRC provided critical support for this project on breast cancer PDEs in the form of infrastructure support for staff salaries and consumables. Without this infrastructure support they would not have gained access to the patient samples required to undertake the study.
This work has benefitted from the work of the NIHR Leicester BRC’s dedicated public involvement team and their activity within the city’s many ethnic communities.
The meaningful community activities and connections has meant that more patients from diverse backgrounds have been willing to take part in shaping our studies, and in and the studies themselves