Breast Cancer Metastatis Risk Markers and Treatment Developments

PJ Hamel Health Guide
  • Two stories that broke online last week may have long-reaching benefits for women with breast cancer.  

    First, Science Daily reported on March 27 that researchers at New York-Presbyterian Hospital/Weill Cornell Medical Center have discovered a new marker that may identify, at the time of diagnosis, which of us are most likely to have a distant recurrence: in other words, a metastasis. Complete results of the study, funded by the National Cancer Institute, were detailed March 24 in the online journal Clinical Cancer Research.

    Called TMEM (Tumor Microenvironment of Metastasis), this marker differs from other cancer markers with which you might be familiar. Most markers (a kind of cellular-level footprint) indicate that cancer is spreading or growing; TMEM predicts whether it will spread in the future, as it eventually does with about 40% of women diagnosed with breast cancer.

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    Obviously, this prediction gives you and your doctor a huge heads-up as you develop a treatment plan. 

    "Currently, anyone with a breast cancer diagnosis fears the worst—that the cancer will spread and threaten their lives,” said the study’s senior author, Dr. Joan C. Jones. “A tissue test for metastatic risk could alleviate those worries, and prevent toxic and costly measures like radiation and chemotherapy." 

    How does TMEM work? Without getting too detailed, it’s been discovered that when cancer cells develop a link with two types of normal cells—white blood cells, and the cells lining the walls of your blood vessels—it encourages cancer to spread. Scientists found that “TMEM density”—the number of cancer cells that form that link—was a good indicator of future metastatic disease.

    "Traditionally, the likelihood of breast cancer metastasis is estimated based on tumor size, tumor differentiation—how similar or dissimilar the tumor is compared to normal breast tissue—and whether it has spread to the lymph nodes. While these are useful measures, TMEM density… may prove to be more specific and directly relevant," said Dr. Jones.

    Will a TMEM density test become a regular part of future breast cancer pathology reports? Will it eventually help women decide on lumpectomy vs. mastectomy, and whether or not to have chemo? More research needs to be done, but this first study is an encouraging start.

    Double-Duty Bisphosphonate?
    Scientists around the world are collaborating on development of a powerful new bisphosphonate that might someday prevent osteoporosis, AND destroy breast cancer tumors.

    If you’re post-menopausal, you’ve probably heard of the bisphosphonate drugs Fosamax and Boniva, right? Another, newer bisphosphonate, Reclast (zoledronate), has been shown to inhibit enzymes that feed cancer cells, thus killing those cells.

    Problem is, Reclast has been designed to go right to your bones, bonding tight to prevent them from shedding and becoming porous. Sure, it kills a few cancer cells along the way, but Reclast knows its job is to build bone, not fight cancer.

  • Last week’s issue of the Journal of the American Chemical Society reports that a bisphosphonate “200 times better at killing tumor cells” is being developed by an international team of scientists from Illinois, Iowa, China, Japan, and the Netherlands. Currently in compound form, BPH-715 binds to cancer-feeding enzymes, not to bone. It also activates the body’s T-cells, our natural cancer-fighters.

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    While much testing remains to be done, BPH-715 might just be the first bisphosphonate that’s equally effective at fighting osteoporosis and breast cancer. And for all of us battling both of those afflictions, that one-two punch would be a dream come true.

Published On: April 01, 2009