Showing posts with label treatment for triple negative breast cancer. Show all posts
Showing posts with label treatment for triple negative breast cancer. Show all posts

Saturday, May 4, 2013

HMGA1 Turns TNBC Cells Back to More Normal and Slows Their Growth

From a News Release from the Johns Hopkins University School of Medicine

Researchers at Johns Hopkins have identified a gene that, when repressed in tumor cells, puts a halt to cell growth and a range of processes needed for tumors to enlarge and spread to distant sites. The researchers hope that this so-called “master regulator” gene may be the key to developing a new treatment for tumors resistant to current drugs.

“This master regulator is normally turned off in adult cells, but it is very active during embryonic development and in all highly aggressive tumors studied to date,” says Linda Resar, M.D., an associate professor of medicine, oncology and pediatrics, and affiliate in the Institute for Cell Engineering at the Johns Hopkins University School of Medicine. “Our work shows for the first time that switching this gene off in aggressive cancer cells dramatically changes their appearance and behavior.” A description of the experiments appears in the May 2 issue of the journal PLOS ONE.

Resar has been investigating genes in the master regulator’s family, known as high mobility groupor HMG genes, for two decades. In addition to their role in cancer, these genes are essential for giving stem cells their special powers, and that’s no coincidence, she says. “Many investigators consider cancer cells to be the evil twin of stem cells, because like stem cells, cancer cells must acquire special properties to enable the tumor to grow and metastasize or spread to different sites,” she explains.

In a previous study, she and her team devised techniques to block the HMGA1 gene in stem cells in order to study its role in those cells. In their prior work, they discovered that HMGA1 is essential for reprogramming adult cells, like blood or skin cells, into stem cells that share most, if not all, properties of embryonic stem cells.

In the newly reported study, the Resar team applied the same techniques to several strains of human breast cancer cells in the laboratory, including the so-called triple negative cells — those that lack hormone receptors or HER2 gene amplification. The Resar team blocked HMGA1 expression in breast cancer cells and followed their appearance and growth patterns.

"Remarkably, within a few days of blocking HMGA1 expression, they appeared rounder and much more like normal breast cells growing in culture,” says Resar. The team also found that the cells with suppressed HMGA1 grow very slowly and fail to migrate or invade new territory like their HMGA1-expressing cousins.

The team next implanted tumor cells into mice to see how the cells would behave. The tumors withHMGA1 grew and spread to other areas, such as the lungs, while those with blocked HMGA1 did not grow well in the breast tissue or spread to distant sites.

“From previous work, we know that HMGA1 turns on many different genes needed during very early development, but it’s normally turned off by the time we’re born,” says postdoctoral fellow Sandeep Shah, Ph.D., who led the study. “Flipping that master regulator back on seems to be necessary for a cancer to become highly aggressive, and now we’ve seen that flipping HMGA1 off again can reverse that aggressive behavior.”

The next step, Resar says, is to try to develop a therapy based on that principle. The team is working with other researchers at Johns Hopkins to see whether HMGA1-blocking molecules could be delivered to tumors inside nanoparticles. Another possible approach, she says, would be to block not HMGA1 itself, but one of the pathways or processes that it affects.


• Read more about TNBC in my book, Surviving Triple-Negative Breast Cancer.

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Saturday, March 21, 2009

Choosing the Best Doc for You.

Doctors are a mixed bag and some are better than others.  That's just natural.  As the old joke goes:  What do you call the person who graduated last in his medical school class?  Doctor.

But you want the best person for you because cancer is a big deal and getting the right treatment is literally a case of life and death.  How to find the right healthcare team to walk this walk with you?  Here are some tips.

1. Trust your gut. If you don’t like the doc, he just might feel the same way, and that could affect your treatment.
2. Get the best care you can afford. If this means heading out of town, do it. Cancer is a big deal; it deserves the best docs. US News and World Report lists the top 50 cancer centers
here.
3. Do your research. On the left, I have listed some top websites for breast cancer information. Spend some time with these excellent resources--you'll learn a great deal.

4. Ask questions. A good doctor will take time to answer them. My radiation oncologist even drew a picture for me, explaining how radiation works. More evidence that she was good. She spent more than an hour talking about all types of treatment with me and my husband. And she treated me like a smart adult who could understand her.
5. Write down the answers. I still consult my treatment notebook, in which I wrote what the doctor said—direct quotes in quote marks, journalist that I am. This comes in handy for follow-up research.
6. Call back with questions. This is your life. If things aren’t making sense the way they should, ask.
7. Respect even the worst doctors. First, respect breeds respect. Second, these folks spend their lives around cancer, so they deserve a break. That said, if they are not serving you well, go elsewhere.
8. Find a patient advocate. If you cannot wrap your head around this information, don’t try to go it alone. Better yet, go to a center that has a Nurse Navigator program—these people are trained to help you make sense of treatment. They ask the questions you don’t know to ask, and they understand the answers.
9. Get copies of all your reports, especially your pathology reports. This is how I found out what doctors said about me.

Wednesday, January 7, 2009

Triple Negative Breast Cancer: Research Review

Triple negative breast cancer, an especially aggressive form of the disease, is prevalent among young women and African-American women. Researchers Carey Anders, M.D., and Lisa A. Carey, M.D., published a thorough research review of triple negative in the journal Oncology October 1, 2008. The entire article is available online.

Key points:

• Triple negative breast cancer is a breast cancer subtype in which all hormone receptors are negative. That is, it is estrogen-negative (ER-), progesterone-negative (PR-) and negative for the human growth factor receptor Her2-neu.

• Estimates are that 172,000 women will have been diagnosed with triple-negative breast cancer in 2008.

• Most, but not all, BRCA1 breast cancers are triple negative.

• Triple negative responds well to chemotherapy, especially anthracycline and anthracycline/taxane.

• Triple negative does not respond to tamoxifen or aromatase inhibitors like Arimidex, so there is no standard follow-up treatment.

• Research on new treatments shows promise. These include epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), and poly (ADP-ribose) polymerase (PARP) inhibitors, which are currently in clinical trials.

Source: C. Anders and L. A. Carey, “Understanding and Treating Triple-Negative Breast Cancer,” Oncology, Vol. 22, No. 11, October 1, 2008.