Newly Identified Cellular Markers Improve Targets for Chemotherapy in Breast Cancer Patients

New markers found in cancer-associated cells could make it easier for doctors to treat breast cancer, results of a new study published in Cancer Cell suggest. These new types of identifiers will help target chemotherapy by allowing doctors to better differentiate between healthy/normal tissue and cells contributing to cancer.

“The ideal treatment of cancer would allow healthy cells to stay alive and well, and cancer cells to be targeted selectively and killed,” says Columbia University breast surgeon and study co-author Lisa S. Wiechmann, MD. “Any time we find a difference between normal tissue and cancer tissue – which includes not only cancer cells, but also the tumor microenvironment that affects their growth – we have the opportunity to discover a new targeted therapy.”

In this study, published in April 2019, the investigators identified a 37-gene tumor-associated macrophage (TAM) signature that is found in the most aggressive breast cancer subtypes. TAMs are associated with shorter disease-specific survival, more aggressive tumors, and in general poorer clinical outcomes, explains Dr. Wiechmann. 

These results, along with recent evidence of the role of TAMs in chemo- and immunotherapy resistance, highlight the need to study TAMs in human cancers and to identify markers for TAM-specific targeting. Larger sample sizes would improve the sensitivity and specificity of the targeted analysis and improve its translation capability to the clinic, note the researchers.

“Cancer is not just a group of cells, it is an evolving  and ever changing landscape where many actors take the stage and play an important part,” says Dr. Wiechmann. “The lead, of course, is the cancer cell, but the supporting actors can make or break the performance.” 

‘As we learn how these different parts interact and how relationships hinder or promote the lead’s success, we can intervene accordingly by bolstering the players that interfere with cancer’s success, and suppressing those who help. And we can do this as the healthy cells, the audience, just sit and watch unperturbed - this is the goal of targeted therapy,” explains Dr. Wiechmann.

Understanding more differences in the cellular makeup of cancer has shifted cancer research already, says Dr. Wiechmann. Immunotherapy, for instance, has mostly focused on lymphocytes, but now researchers are looking at other parts of the immune response, including both normal and cancer-associated macrophages because they are just as likely to play an important role in facilitating or blocking cancer growth. This shift in research allows for more targeted therapy in the future.

Learn more about the Surgical Breast Cancer Program at Columbia.

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