‘By 2050, we want to ensure no one dies from cancer’

TechWatch editor Emily McDaid spoke with Dr Niamh Buckley about her research into triple-negative breast cancer and her mission to ensure the disease does not become a life sentence.

Many of us with a cursory knowledge of breast cancer have heard of the susceptibility genes known as BRCA1 and BRCA2. We may also have heard of targeted therapies that exploit specific genetic defects to combat the disease.

But you may not know that researcher Dr Niamh Buckley of Queen’s University Belfast School of Pharmacy has been instrumental in helping a subset of patients who miss out on targeted therapies and face a bleak prognosis. Buckley is undertaking a fellowship funded by Breast Cancer Now to study triple-negative breast cancer.

The BRCA genes hit the headlines in recent years when actor Angelina Jolie opted for a double mastectomy after learning she had the mutation. Some studies show that 45-65pc of women with mutations in BRCA1 or BRCA2 will develop breast cancer.

Cancers that arise in women with a BRCA1 mutation tend to be triple negative and even those without the mutation often behave like they do, highlighting the importance of BRCA1 biology. However, triple-negative breast cancer is defined, as Buckley said, “because it lacks something. What’s worse is, this is an aggressive form of cancer than often hits younger women.”

Whitla Medical Building, QUB, the site of Dr Niamh Buckley’s study. Image: TechWatch

Triple-negative study

Without the three ‘positives’ (progesterone-receptor positive, oestrogen-receptor positive or HER2 positive), triple-negative patients are offered broad-spectrum chemotherapy instead of targeted medicine. It’s a gruelling regimen made up of three different drugs. “Two-thirds of triple-negative patients will do well but one-third will relapse,” Buckley said.

Buckley’s study is trying to predict which triple-negative patients will respond to treatment, identifying a new biomarker that, if found, could forever change the clinical strategy for this disease. She has discovered that an activity within cells, known as NF-kB signalling, could be important in these cancers.

It’s a retrospective study, for which she’s mining reams of data held by Belfast City Hospital and collated by the Breast Cancer Focus Group about past patient outcomes.

‘We engage earlier with clinicians to ensure the research impacts clinically. It’s not science for science’s sake’
^{– DR NIAMH BUCKLEY}

“Initially, the study involves 60 patients, treated between the years of 2009 and 2012, using their information, transcriptional levels and some indication of their gene signatures. We map this data against their outcomes to find predictive factors,” Buckley explained.

She discussed how precision medicine changes researchers’ outlook: “Before, any scientists’ work had to be a huge breakthrough but now, with smaller groups of patients involved, it’s more about asking a clinically relevant question for a subset of patients. We engage earlier with clinicians to ensure the research impacts clinically. It’s not science for science’s sake, in other words.”

She went on: “It can still take 10 years from laboratory bench to bedside, but technology is improving.”

Animal studies

“Infinite cell lines are useful and have offered great advancements in oncology, but it’s critical to study tumours in an environment with an active immune system, not just in a petri dish,” said Buckley.

“Also, using mice, there’s a concept of mouse avatars. Grow the same tumour you have in a mouse, and let it go through the same clinical trials that you are. That’s available right now, but not many people can afford that,” she said.

A company called Champions Oncology is offering these advancements now. Buckley also mentioned a Belfast-based biotech called MitraBiotech with a “tumour microenvironment” offering. With this service, patients would have a replica tumour grown in a lab, subjected to various treatment regimens.

Buckley’s study, on the other hand, is using the past to inform the future.

“Cancer will always find a way around,” she said.

“But, by 2050, we want to ensure no one dies from it. It will be a manageable disease, not a life sentence,” she concluded.

By Emily McDaid, editor, TechWatch

A version of this article originally appeared on TechWatch