We held our seventh Breast Health Forum, presented by our Main Partner, National Bank, on May 6, 2023.
Specialists held lectures, roundtables and workshops on the latest advances in breast cancer research. The Foundation also launched a new free support service. Read on for a summary of the five key takeaways from this event.
1. Cancer Cell Dormancy – Reducing the Metastatic Loa
The majority of breast-cancer-related deaths are due to metastases. Metastatic cascade is the process whereby cells detach from the breast tumour and migrate via the blood or lymphatic circulation to distant organs where they develop into metastases. Dr. Jean-François Côté’s team is closely studying this process, with a particular focus on cancer-cell dormancy. Certain aggressive cancer cells quickly form metastases when they reach a distant region, while others enter a state of dormancy for a time before awaking to in turn form new metastases. Dr. Côté’s team is trying to discover what distinguishes the dormant cells from more aggressive cells. Their work has revealed the role of the phosphoinositide 3-kinase (PI3K) pathway in this metastatic process. When tested in mice, pharmacological inhibition of PI3K reduces the metastatic load, particularly pulmonary metastases. This discovery opens up new avenues for therapy.
2. HER2-low – New Category, New Therapy, New Hope
Until recently, breast cancers were classified according to two HER2 protein criteria: overexpressed (HER2-positive) or not (HER2-negative). Anti-HER2 targeted therapy could be offered to people with HER2-positive cancer, but not to people with HER2-negative cancer. However, the characterization of HER2 protein expression has changed with the emergence of a new category: HER2-low. Some breast cancers previously considered HER2-negative could now be considered HER2-low. This discovery paved the way for a new treatment: Enhertu antibody-drug conjugate (anti-HER2 antibody combined with deruxtecan). Conjugated antibodies combine the targeting capacities of monoclonal antibodies and the cancer-destroying capacity of cytotoxic drugs (chemotherapies). The antibody binds to the target and generates a signal that inserts the chemotherapy into cancerous cells like a Trojan horse. Studies have shown that Enhertu administered in second-line treatment of HER2-low, hormone-receptor-positive (HR+) metastatic breast cancer almost doubles median progression-free survival and increases overall survival compared to chemotherapy. Further study is needed to determine if this discovery and conjugated drug might have other clinical applications.
3. Genomic Analysis – Towards Precision Medicine
At the roundtable on tumour genomics, Dr. Mark Basik and Nathalie Bolduc brought us up to speed on the use of genetic tests and genomic analysis. What are they? When and for whom are they indicated? We learned that using tests such as Oncotype DX to identify certain known genetic mutations or the expression of certain genes can be useful in guiding treatment choices. Nonetheless, although advances in genomics knowledge are shaping the future of breast cancer management, a complete genomic analysis (all genetic material) is not yet recommended nor relevant. Why? Because although current technology makes it possible to perform genomic analyses and identify genes or gene mutations involved in the development and growth of breast cancer or in treatment resistance, we are not yet able to interpret these results, nor make the appropriate clinical recommendations. Hope lies in the research. Accordingly, for several years the Foundation has financed the Cancer Research Network’s eight breast cancer tissue banks containing tissues from patients in 32 research projects. Clinical tests seek to validate the effectiveness of certain drugs based on genomic activation
4. My Active Health™ – Nutrition Component
Studies show that a healthy lifestyle has a significant effect on life and quality of life for people affected by breast cancer throughout their treatment journey. The Quebec Breast Cancer Foundation is offering the free My Active Health™ program, which helps people living with breast cancer maintain active daily lives. And nutrition is a critical part of a healthy lifestyle. What does it mean to eat well with breast cancer? How can people maintain a balanced diet despite the side effects of cancer and treatments? To answer these questions, the Foundation is launching the nutrition component of the My Active Health program. Video clips featuring nutritionist Hélène Laurendeau and educational information are designed to help you adopt and maintain a healthy and adapted diet before, during and after treatment.
5. Endocrine Disruptors – Proceed With Caution
Substances known as “endocrine disruptors” are seeping into our homes and on to our plates. Caution is required, whether the effects of these substances on health, particularly on hormone system functioning, are proven or just suspected. Karelle Trottier, from the Réseau des femmes en environnement, shared a number of tips for limiting your daily exposure to these harmful substances. These tips include reducing the number of cosmetics used and paying attention to their ingredients. With regard to food, fatty, acidic, hot or microwave-heated foods do not mix well with plastic containers. Lastly, non-stick coatings, particularly on frying pans, should be avoided. More information is available in the brochure on hormone sabotage (available in French only).