Intra-tumoural Heterogeneity in Primary Breast cancer
Research type
Research Study
Full title
The detection of genetic Intra-tumoural heterogeneity in Primary Breast Cancer patients and correlation with lymph node metastasis and tumour-derived plasma DNA: an exploratory study.
IRAS ID
126873
Contact name
Peter Barry
Contact email
Sponsor organisation
The Royal Marsden NHS Foundation Trust
Research summary
Diagnosis and treatment of primary breast cancer with medical therapies are based on a single biopsy of the tumour. Its molecular features determine which treatment(s) it is sensitive to. For example, the expression of the HER2 protein receptor on the cell surface predicts response to Trastuzumab, a therapy that targets those cells.
Unfortunately, cells can become unresponsive or resistant to such treatments due to changes in their characteristics during treatment. In some cases, several different cell populations present within the cancer at the time of diagnosis can be the cause of tumour regrowth or recurrence after such treatments. Whilst the cells which responded to the treatment ultimately die, resistant cells, already present in smaller numbers can now dominate and are responsible for further cancer growth and development.
This study aims to characterise the different cell types present within the cancer at the time of diagnosis or following a short course of treatment given before surgical removal of the cancer. This may require one or several biopsies from different parts of the primary breast lump. DNA analysis determines the exact changes (mutations) that have rendered it cancerous. By characterising these different cellular populations (or clones) it may be possible to predict not only treatment resistance but also which treatments a cancer may respond to afterwards.
The study also aims to check if the findings within the primary lump may predict the cell type which has spread to armpit lymph glands as well as tumour-derived DNA detected in the bloodstream.
If such characteristics of the breast lump can be determined with only a single (or few biopsies) it may be useful eventually to incorporate this into routine clinical practice, predicting those patients becoming resistant to a particular treatment and the alternatives which may assist them thereafter.REC name
London - Queen Square Research Ethics Committee
REC reference
13/LO/1015
Date of REC Opinion
23 Aug 2013
REC opinion
Further Information Favourable Opinion