Cancer Genetics

Cancer genetics

Research developing Predicting Risk Of Cancer At Screening (PROCAS) methods in breast cancer

Outline

In the UK 46,000 people are diagnosed with breast cancer per year as well as causing 12,000 deaths.

Our researchers are working on both predicting an individual’s risk of developing breast cancer and developing targeted treatments aimed at inherited cancer conditions.

Knowing one’s risks of developing a cancer and when, will allow an individual to be empowered to potentially prevent or at least detect that cancer at an earlier more curable stage.

Genetic tests are being developed that incorporate 20 genes which will not only predict the risk of an individual carrying the breast cancer type 2 protein (BRCA2), but also the risk for all women with or without a family history. Such tests will also be developed for other common cancers such as bowel and ovarian cancer.

Problem

Although breast cancer deaths have decreased in many Western countries, the incidence of the disease is continuing to rise. Understandably there is increasing interest in disease prevention to spare the trauma of diagnosis and increasingly aggressive treatment. There is a need, not only to predict which women will develop the disease, but also to apply drug and lifestyle measures in order to prevent the disease.

Current risk prediction models are reasonably good at predicting the proportion of women who will develop breast cancer but are weak at predicting which particular women will develop the disease.

What we have achieved to date

Our researchers will develop Predicting Risk Of Cancer At Screening (PROCAS) methods from examination of a range of genes recently identified as increasing breast cancer risk. This will be combined in a prediction program with other known risk factors to provide women with more accurate individual prediction. The risks will be calculated by using the Tyrer-Cuzick risk model, which takes into account family history, lifestyle and hormonal risk factors. In addition breast density scores are also being used to assess breast cancer risk.

Greater accuracy in breat cancer risk prediction will mean that high risk screening interventions such as MRIs and prevenetative strategies like tamoxifen can be focused on those at appropriate risk levels.

What we aim to achieve

We are also using next generation sequencing to identify the genetic cause of as yet unidentified cancer causing conditions, as well as rare non-cancer genetic disorders. This will hopefully lead to targeted treatments.

We anticipate the development of highly predictive models for breast cancer risk prediction within five years and to have developed validated prevention and screening programmes appropriately targeted at risk.

It is hoped that the results of the PROCAS study will result in changes to the length of time women are recalled for breast screening, based on their individual risk of developing breast cancer. This also means that women at increased risk of breast cancer will have the opportunity to access information about the choices available to them, and ways of reducing their risk.

In addition to PROCAS we are undertaking new treatments for the tumour conditions neurofibromatosis types 1 and 2 (NF1 and NF2) we are undertaking new treatments involving drugs to improve the outcomes of these sometimes devastating disorders. Drugs such as an antibody to a blood vessel growth factor called bevacizumab and cancer drugs including sorafenib and nilotinib are being used for the first time in the UK on NF2 patients in Manchester. A drug trial of statins is due to start on our NF1 patients.