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Breast cancer is a commonly occurring illness, primarily in women. The clinical picture is heterogeneous. Aimed at increasing the chances of therapeutic success (including the success of chemotherapy and hormone therapy), this project involves research into gene profiles which can predict the efficacy of these therapies. This can, for example, prevent overtreatment: there can be a precise prior estimation of how a patient will react to various treatments. In this study, there is a subdivision of the various groups/tumor types based on genetic characteristics; each of these groups requires its own specific treatment.
Scientists involved in this project had previously developed the first usable gene test in the world, which can be used to estimate/predict the risk of metastasis. This project is a logical continuation of that work and is focused on making the test more widely usable. However, new predictive tests are being developed, as well as other tests to analyze cell material stabilized with the aid of paraffin. Cell material which has not been frozen is also suitable for this, and many more hospitals can participate using this diagnostic technique.
Full project title: Predicting drug responses in breast cancer
Project category: Oncology
Start date: July 2007
End date: January 2012
Goal: To improve the prediction of response to breast cancer treatment
Principal investigators: Laura van 't Veer (The Netherlands Cancer Institute) and Els Berns (Erasmus Medical Center)
Project size: 10 FTEs
Partners: Erasmus Medical Center, The Netherlands Cancer Institute, Agendia BV
Approximately 1 million new cases of breast cancer are diagnosed worldwide each year. On average, one in every seven to eight women in Western Europe will develop breast cancer at some time in her life. This percentage has increased sharply in recent decades, which is a result of better screening, but possibly also due to the fact that women are having children later in life. Existing hormonal therapies often do not have the desired effect: half of the patients with breast cancer do not respond to them (within the required time frame).
In order to better anticipate how cancer cells will react to a treatment, research is being done with gene profiles, which has already resulted in the so-called “MammaPrint.” This is a test which indicates whether a tumor will metastasize and how aggressive a breast tumor is. Using the result of the test, treatment can be customized for the patient. Based on international consensus criteria, in 90 percent of cases a decision is made to undertake additional chemotherapy, which is a severe and taxing treatment; this exercise is performed even when the additional chemotherapy might not even be necessary. Patient use of the test, which has been developed by molecular cancer diagnostics company Agendia, is reimbursed by various Dutch health insurance providers. The test has also been approved by the American Food and Drug Administration (FDA).
Stella Mook (project T3-108)
Prognostic factors in breast cancer