In most cases where tumors are discovered in time, patients survive five years after diagnosis. However, in about 30% of cases, breast cancer returns, sometimes even years or decades later, and the recurrence is almost always fatal.
Doctors cannot provide an accurate prediction of the recurrence of breast cancer in a patient or the exact timing of this event. However, researchers at the University of Pennsylvania are focusing on identifying and eliminating dormant breast cancer cells left in the body after treatment, before they have the opportunity to reactivate and spread.
In an advanced clinical trial, all but two of the 51 treated patients were declared cancer-free after four years.
These initial results, presented at a European oncology conference in October, offer hope that such a treatment could reduce the fatal outlook for breast cancer recurrence.
Angela DeMichele, co-director of the breast cancer research program at Penn’s Abramson Cancer Center, initiated this research to address lingering uncertainties about breast cancer recurrence after treatment.
Specialists compare dormant cancer cells to hibernating bears, entering a state of rest without multiplying. They can then return to activity and multiply rapidly, months, years or even decades after treatment.
Doctors know that these dormant cells are often found in the bone marrow, where blood cells are made.
Recurrent breast cancer is difficult to get rid of once it reaches the bone marrow and blood because it spreads quickly to other parts of the body (metastasizes).
The Penn team investigated whether they could detect these dormant cells by periodically testing the bone marrow, and whether a certain set of oral drugs could eliminate these cells when they are dormant.
In the clinical trial, samples of the patients’ pelvic bone were taken to be tested for latent cancer cells. If the test was positive, patients received oral treatment.
Nearly 200 people were tested for latent cancer cells in their bone marrow, and 51 were ultimately treated.
About half of these had an aggressive, triple-negative type of breast cancer. After four years, all but two of them showed no signs of cancer.
The next step for the Penn research team is to enroll larger numbers of patients with diverse backgrounds and continue testing people who have already participated in the study.
Expanding the study is crucial to confirm whether the method can successfully detect and eliminate latent cancer cells before they become a threat to patients.
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