Breast cancer: The treatments of tomorrow
Research needs to address the future challenges in oncology, and this is what Sergio Roman-Roman, head of the translational research department, is doing. Surrounded by physicians, physician-researchers and researchers, he is doing all he can to improve treatment of the most aggressive forms of cancer.
Anticipating the response to treatments
Physicians have several therapeutic options at their disposal to treat women suffering from breast cancer. However, in a certain number of cases there is resistance to treatment, and we do not yet know why. One of the major challenges in improving the treatment of breast cancer is, he believes, fighting the resistance of tumors.
One of the most commonly mentioned explanations for this resistance is the wide variety of tumors. There are multiple types of breast cancer: HER2, triple negative, luminal A or B, but the complexity doesn’t end there: within these different sub-types there are also differences. “Take for example luminal B cancers, which represent 20 to 25% of breast cancers. Although they express estrogen receptors, resistance is observed in some women treated, and to date there is no alternative therapy or way to identify which patients will develop resistance.”
For several years the researchers at Institut Curie have been developing animal models based on tumor samples from patients. These models reproduce all aspects of the developments of the tumor, but over a much shorter time period. Use of these models for each form of aggressive breast tumor would allow the tumor’s reactions, relapse or recurrence to be anticipated, but also, and above all, would allow us to test sensitivity to a particular treatment. It would then be possible to study the various therapeutic combinations, but also the sequence of treatments. An essential tool when we consider that depending on the order in which treatments are administered, their effectiveness is not the same and these data appear to vary from one patient to another.
Animal models with xenografts derived from patients constitute one of the most useful preclinical models for understanding the mechanisms of tumor resistance to treatments and for anticipating them. In the long term, before treating a patient it may be possible to test the effectiveness of the treatment on a model of this type, thus limiting ineffective treatments and reducing relapses.
In parallel, one of the translational research department teams, that of the surgeon Fabien Reyal, is studying cell lines from triple negative breast cancer to try and understand the biological characteristics of these very aggressive tumors, and assess the response to medications on the market. As for Cécile Vallot, she is focusing on cellular plasticity. This phenomenon, increasingly considered to be one of the loopholes developed by tumor cells to resist treatments, is based on the implementation of epigenetic markers, in which she specializes.