There’s a possible breakthrough in understanding a rare, difficult to detect form of breast cancer called Invasive Lobular Carcinoma. 180,000 American women will be diagnosed with it this year, according to the American Cancer Society. 200 researchers all over the world collaborated to identify the genetic features that define it. The molecular profile that researchers came up with could lead to better treatments. The study’s co-lead author is Rutgers Cancer Institute Dr. Michael Gatza.
“Lobular breast cancer is a less frequently identified form,” said Dr. Gatza. “Instead of forming the characteristic lump that we find in ductal carcinoma, it tends to be a thickening of the tissue. The tumor tends to grow in more finger-like projections, so it’s often more difficult to find on a mammogram or by self-examination,” he said.
Through their research, he said they were able to identify the genetic alterations using hundreds of different patients and thousands of different molecular data points. “We identified a couple of different interesting findings. Different oncogenic pathways that we could use for potential therapeutic targets. We found that within lobular carcinoma itself it’s not a single disease, it’s actually three unique molecular diseases. So we really think that these findings, looking at the genetic alterations that drive this tumor type will allow us to personalize therapy where every patient gets a unique combination of therapies based on the molecular features of her tumor,” Dr. Gatza said.
The research allows for more a personalized kind of care. “The idea is that we can look at Ms. Jones’ tumor, identify the genetic alterations that drive her tumor, develop a cocktail of therapies that specifically target those genetic alterations and hopefully get the best treatment for her. Whereas in Ms. Smith we might identify a different set of alterations and develop a different cocktail of therapies that would be personalized for her specific tumor,” he said.
The cancer genome atlas project is a project that’s been funded by the National Institute of Health. The goal is to genomically profile cancer, with one of those tumors being breast cancer. “We have more than 800 breast cancer patients, over 200 of those were lobular patients. We did use six different analytical technologies to look at the mutations and alterations that were present within those patients’ tumors,” Dr. Gatza said. “This included some proteomics, so looking at the protein that’s being generated by the gene. We generated more than 100,000 data points for each patient, and we were able to look at these in a very concerted, global fashion to understand what was actually altering the tumor, or what was causing the tumor to develop.”
The doctor says that it’ll take some time to develop the findings from this study into something that will be immediately available to patients. However, he says there’s “tests that are happening at Rutgers Cancer Institute and other institutions around the country that are using precision medicine where they’re actually sequencing a handful of genes that we know are important for cancer and using that to help guide therapies. This study will allow us to expand that set of genes and sort of lay the foundation for looking at more genes in a very targeted fashion.”
He says this kind of research is essential. “If we don’t know what the genes are that are important for cancer, we don’t know where to look. We don’t know how to develop new therapies for that cancer. We don’t know how to personalize therapy. We just have to sort of guess and that takes the scientific method out of treating cancer patients, or patients in general,” Dr. Gatza said. “So if we can go back to this basic research and really understand the mechanisms and the genetic alterations, then that’s going to give us a road map to identify Achilles heels in breast cancer, or cancers in general.”