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Cutting-Edge Breast Cancer Therapy

Tailor-Made Treatments
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Search and Destroy

One of the most promising areas of breast cancer research is targeted therapeutics. These treatments send toxic cancer-killing agents directly to tumor cells, avoiding the "fallout" damage to healthy cells that happens with broad-range chemotherapies and radiation. The more that's known about the differences in genetic makeup among cancers, the more targets can be identified.

Researchers at the University of California San Francisco's Comprehensive Cancer Center are in clinical trials with a new technology called immunoliposomes, developed by researchers John Park, MD, and Christopher Benz, MD.

"It's a molecule comprised of a lipid [fat] ball containing a therapeutic agent, such as a chemotherapy drug," explains study leader Joe Gray, PhD, professor of laboratory medicine. According to Gray, the approach will use an antibody that seeks out a specific protein found only on the surface of cancer cells. The antibody will deliver the lipid ball into the cancer cell, where it will release its toxic contents -- the drug -- and kill the cancer.

The first trial of the immunoliposome approach focuses on the HER2 protein. "But that's just a prototype," says Gray. "You can change the antibody and target different tumor types depending on what cancer protein is present, and you can also change the toxin. Within five years, we're hoping to generate half a dozen different therapeutics that target different subtypes of breast tumors."

Duke researchers are taking the liposome approach in a different direction. In a recent trial, 21 women with especially hard-to-treat breast cancers received a treatment the women jokingly refer to as the "booby Jacuzzi." The affected breast is immersed in salt water for an hour while radio frequency energy warms the tumor to 104 degrees Fahrenheit. At this temperature, the liposomes melt, releasing their potent drugs directly into the tumor. Not only did all the women see some degree of improvement, none experienced the typical side effects of chemotherapy.

Cell Signaling

Cells are constantly sending and receiving messages to and from other cells. Some signals stimulate the cell to grow and reproduce; others direct it to stop growing. The signaling process involves proteins on the surface of cells as well as genes within the cells. When the signaling process goes awry, cell growth can spin out of control, leading to tumors -- a process called deregulation.

Scientists are working to identify -- and stop -- the genes that cause deregulation in breast tissue. Though they've "already generated a long list of candidate targets," it's particularly challenging to intervene in the cell-signaling process, says Gray. "If a protein is on the surface of a cell, it's easy to get therapeutics to it. But if we're targeting [something within the cell, such as a gene], it's much harder to attack that." His team is looking at how the faulty genes affect cell function, in hopes of finding "a target either upstream or downstream of the signaling process to attack with therapeutics."

And these are just a few of the many new approaches being investigated right now. According to Winer, "Breast cancer treatment is already more than 'one size fits all.' We don't treat all patients with the same therapies." Now, that individualized approach needs to be taken to the next level, especially among women with early-stage disease. With continued research, he says, "we'll understand how each treatment works, and be much more selective picking and combining them for different patients."

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