Decent article in today’s Age.
This article is from the February 10 issue of The Age Digital Edition. To subscribe, visit https://theage.digitaleditions.com.au/. Kate Aubusson An Australian scientist is working to unleash the power of immunotherapy to kill off one the most aggressive types of breast cancer. Dr Fatima Valdes Mora at the Garvan Institute of Medical Research in Sydney has secured a share in $10.4 million from the NSW government and the Cancer Institute NSW to find a way of killing off triple negative breast cancers with epigenetic drugs and immunotherapy. Almost one in four women with triple negative breast cancer will die within five years of being diagnosed, compared with 7 per cent of women with other breast cancer types. The aggressive tumours account for about 15 per cent of all breast cancers and do not have any of the three receptors – oestrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 (HER2) – that can be treated with targeted therapies. The first line treatment for triple negative breast cancer is chemotherapy that indiscriminately kills cancerous and healthy cells. If Dr Valdes Mora succeeds, it will be the first step towards personalised medicine for these patients. Checkpoint inhibitor immunotherapies have been the superstars of cancer treatment in the past decade, effectively treating some subtypes of melanoma and lung cancer by turbo-charging the body’s immune system. Immunotherapies “release the handbrake” of a patient’s T-cells to recognised cancer cells and attack them. So far immunotherapies haven’t worked for triple negative breast cancer because these cancer cells have their own handbrake: Myeloid-derive suppressor cells (MDSCs). MDSCs infiltrate tumours, shielding the cancer cells from T-cell attacks, allowing the cancer to spread. “Think of MDSCs like evil immune cells, protecting cancer cells,” Dr Valdes Mora said. “We know now that breast cancers have a lot of MDSCs, especially highly metastatic breast cancers.” Dr Valdes Mora is trying to find a way of modify MDSCs using epigenetic drugs so that they can no longer seal off cancer cells from T-cell attacks. The problem is MDSCs are not all the same and probably have different functions. “We don’t know which MDSCs are the bad guys and how to target them to get the results we want” Dr Valdes Mora said. “We need to understand the complexities of MDSCs and the genes that express these cells.” Over the next three year, Dr Valdes Mora will use single cell RNA-sequencing to study MDSCs cell-by-cell to discover which are the “evil” immune cells in triple negative breast cancers. The next step is finding the right epigenetic drugs and immunotherapies to target these MDSCs and ultimately kill off the cancer. “It’s very exciting,” Dr Valdes Mora said. “In the field of immunotherapy it would be amazing.” Her research team has begun testing four immunotherapy drugs that have already be proven to work on some MDSCs and will trial as many immunotherapies as they can, starting with drugs being tested in clinical trials before moving to newer, untested immunotherapies. Copyright © 2019 The Age
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