DNA ‘barcoding’ project to transform breast cancer care

A groundbreaking breast cancer treatment programme, funded by Cancer Research UK, that could potentially save thousands of lives has opened at our hospital.

Patients who join the Personalised Breast Cancer Programme (PBCP) will have their DNA read like a barcode, with the whole genome of their tumour sequenced and the results returned to inform treatment planning.

The news – which comes during Breast Cancer Awareness Month – means now more people in the East are set to benefit from personalised treatment, as the ground-breaking breast cancer study is expanded.

Our hospital is the fourth site in the East and the fifth site to be opened nationally following on from the implementation of the programme in Cambridge, Ipswich, Colchester and Oxford.

The first patient was seen at Norfolk and Norwich University Hospital on 25 September.

So far over 1,500 patients have been enrolled in the study. Results are returned within six to 12 weeks, enabling patients to have a more precise and personalised cancer treatment.

For many, results have confirmed they were receiving the best treatment available for their disease, whilst over a third have had a change in clinical management.

Dr Clare Hannon and Dr David Maskell are overseeing the study at NNUH.

Dr Hannon said: “It is very exciting to be able to bring the programme to NNUH as part of a national drive for better cancer treatments and personalised medicine. Recruiting started at the end of September. For the patients on the programme, DNA and RNA readouts from their tumour cells are compared with those of their healthy cells to study which genetic mistakes are causing the disease, and which weaknesses could be targeted with cancer drugs.

“The results also identify whether the patient has any inherited genetic faults that increase the risk of breast cancer or could cause toxic side effects to chemotherapy.

“In a small subset of patients the DNA will be analysed from additional biopsy and blood samples taken at the time of other routine appointments, meaning that there are no more appointments than usual and no delays in starting treatment. The results are discussed by a team of geneticist and clinicians, with a report prepared for the patient.”

“Longer term, this study will help us to predict which patients will or won’t benefit from a particular treatment.  It leads us to much more effective and personalised care which increases survival rates and reduces the side effects of treatments.”

Cancer Research UK’s Professor Jean Abraham, who leads the PBCP from Cambridge University Hospitals NHS Foundation Trust, said that for every patient on the programme DNA and RNA readouts from their tumour cells are compared with those of their healthy cells to study which genetic mistakes are causing the disease, and which weaknesses could be targeted with cancer drugs.

She said: “The beauty of this sequencing project is we get the data faster and can act on it. The benefits are various and depend on the stage of the cancer. If it’s at an advanced stage, the genetic information we get from the whole genome might push us towards a different treatment or you might find a specific mutation that means the patient could take part in a certain clinical trial. Ultimately, these findings can help direct clinicians to using more novel and targeted drugs that have the best chance of helping individual patients.”

Every year, around 5,700 women – as well as a small number of men- are diagnosed with breast cancer in the East of England, whilst around 1,100 women in the region die from the disease.

Professor Abraham added: “A lot of patients won’t see their treatment plan change, but it might offer hope and faster access to the most appropriate treatment if there’s a relapse. Having the genetic information of the tumour will give us a better idea of what to do should a patient relapse. It becomes an armoury of knowledge, and it could reveal weakness we can target. That can be very reassuring to patients. In addition, establishing an individual doesn’t carry any high-risk hereditary genes is a relief to both the patient and their family.”