Aleix Prat, oncologist at Hospital Clínic and head of the Idibaps group.
The advanced metastatic breast cancer represents one of the diseases lethal today and your current classification does not always reflect the reality of the patients. The use of genomics to go deeper into your categorization is the path from a research project to five years view led by Aleix Pratoncologist at Hospital Clínic and head of the group Idibaps. Within these tumors, which a priori are believed to be hormonosensiblesgenomics dictates the opposite: “A part of this 70 percent of tumors, 20-30 percent, are really aggressive y no son hormonosensibles. From here, we started a project whose objective is to discover new ways of diagnosing the hormone positive breast canceras well as new treatments”, explains the oncologist in Medical Writing.
understand and better understand the tumor molecular subtype It is one of the answers that the research group hopes to discover over the five years that the project lasts. Although today the method to identify it is known, Prat goes one step further: “We must understand its heterogeneity, DNA level, your immune system, etc. We treat the HER2-enriched pool as if it were a pool, but there are subgroups And we have to name them. We have agreements with other hospitals such as Hebron Valley or the October 12 °and we hope to reach thousand samples”.
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“There are subgroups within HER2 and we have to give them surnames” |
Thanks to an academic scholarship from the Cris Foundationwhich seeks to promote the development of clinical programs with the potential to achieve a real impact in the treatment of patients, the project, which will last a total of five years, has been marked as the first step biologically characterize the patient. “We want to understand what biological characteristics the tumor has in order to create a genomic atlas of this molecular subtype”, details the oncologist.
Another goal that the Clínic researchers hope to achieve during the duration of the project is identify therapies that might work for this group of cancer patients. “In the laboratory we have already developed models preclinical in tumors of mouse and we are testing treatments that use chemotherapydifferent antibodies, immunotherapy, etc. In these five years we hope to find a combination of therapies to design a study in patients and test it”, Prat details.
Blood, a possible way to identify breast cancer
Identifying this group of patients is not easy today, since it is necessary to resort to metastatic biopsy already the genomic analyzes. The sangre is, for Prat, “a way that we try to promote to identify this subtype in a less invasive. There are many metastases and biopsies can be risky. In addition, the tissue that we obtain from the tumor is so small that we can’t do genomics. We have to find alternative ways, to carry out faster studies.”
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“Blood can help us identify this subtype of cancer in a less invasive way” |
Within immunotherapy, right now the group led by Prat is not closing any doors and is open to all kinds of therapies. “So far we have managed to two proofs of concept in groups of small patients, testing the classical immunotherapy y inhibiting the HER2 receptor in a small molecule. From now on, we will continue testing different therapies”, confirms the oncologist at Hospital Clínic.
Trastuzumab, potential treatment in the future
This past Sunday was published in the New England Journal of Medicine a phase 3 clinical trial in metastatic breast cancer, led by Javier Cortes, director of the International Breast Cancer Center (Ibcc), and in which Prat has also participated. Researchers demonstrated the efficacy of a new drug for metastatic breast cancer with low HER2 expression, trastuzumab deruxtecan. In addition, the experts have shown that, among all patients, “the median progression free survival it was of 9.9 months in the trastuzumab deruxtecan group and 5.1 months in the selection group doctorand overall survival was 23.4 months and 16.8 months, respectively.”
Regarding this aspect, Prat does not rule out that this research could become a “potential treatment for hormone positive breast cancer in the future. Thanks to this new drug, which combines 7-8 molecules of a very powerful chemotherapy with the antibody trastuzumab, the survival of the patients is prolonged”.
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