Critical research gaps and translational priorities for the successful prevention and treatment of breast cancer.
Suzanne A Eccles
Eric O. Aboagye
Simak Ali
Annie S. Anderson
Jo Armes
Fedor Berditchevski
Jeremy P. Blaydes
Keith Brennan
Nicola J. Brown
Helen E. Bryant
Nigel J. Bundred
Joy M. Burchell
Anna M. Campbell
Jason S. Carroll
Robert B. Clarke
Charlotte E. Coles
Gary Jr Cook
Angela Cox
Nicola J. Curtin
Lodewijk V V. Dekker
Isabel Dos Santos Silva
Stephen W. Duffy
Douglas F. Easton
Diana M. Eccles
Dylan R. Edwards
Joanne Edwards
D Gareth Evans
Deborah F. Fenlon
James M. Flanagan
Claire Foster
William M. Gallagher
Montserrat Garcia-Closas
Julia MW Gee
Andy J. Gescher
Vicky Goh
Ashley M. Groves
Amanda J. Harvey
Michelle Harvie
Bryan T. Hennessy
Stephen Hiscox
Ingunn Holen
Sacha J. Howell
Anthony Howell
Gill Hubbard
Nick Hulbert-Williams
Myra S. Hunter
Bharat Jasani
Louise J. Jones
Timothy J. Key
Cliona C. Kirwan
Anthony Kong
Ian H. Kunkler
Simon P. Langdon
Martin O. Leach
David J. Mann
John F. Marshall
Lesley A. Martin
Stewart G. Martin
Jennifer E. Macdougall
David W. Miles
William R. Miller
Joanna R. Morris
Sue M. Moss
Paul Mullan
Rachel Natrajan
James PB O'Connor
Rosemary O'Connor
Carlo Palmieri
Paul DP Pharoah
Emad A. Rakha
Elizabeth Reed
Simon P. Robinson
Erik Sahai
John M. Saxton
Peter Schmid
Matthew J. Smalley
Valerie Speirs
Robert Stein
John Stingl
Charles H. Streuli
Andrew NJ Tutt
Galina Velikova
Rosemary A. Walker
Christine J. Watson
Kaye J. Williams
Leonie S. Young
Alastair M. Thompson
10779/rcsi.10800605.v1
https://repository.rcsi.com/articles/journal_contribution/Critical_research_gaps_and_translational_priorities_for_the_successful_prevention_and_treatment_of_breast_cancer_/10800605
<p>INTRODUCTION: Breast cancer remains a significant scientific, clinical and societal challenge. This gap analysis has reviewed and critically assessed enduring issues and new challenges emerging from recent research, and proposes strategies for translating solutions into practice.</p>
<p>METHODS: More than 100 internationally recognised specialist breast cancer scientists, clinicians and healthcare professionals collaborated to address nine thematic areas: genetics, epigenetics and epidemiology; molecular pathology and cell biology; hormonal influences and endocrine therapy; imaging, detection and screening; current/novel therapies and biomarkers; drug resistance; metastasis, angiogenesis, circulating tumour cells, cancer 'stem' cells; risk and prevention; living with and managing breast cancer and its treatment. The groups developed summary papers through an iterative process which, following further appraisal from experts and patients, were melded into this summary account.</p>
<p>RESULTS: The 10 major gaps identified were: (1) understanding the functions and contextual interactions of genetic and epigenetic changes in normal breast development and during malignant transformation; (2) how to implement sustainable lifestyle changes (diet, exercise and weight) and chemopreventive strategies; (3) the need for tailored screening approaches including clinically actionable tests; (4) enhancing knowledge of molecular drivers behind breast cancer subtypes, progression and metastasis; (5) understanding the molecular mechanisms of tumour heterogeneity, dormancy, de novo or acquired resistance and how to target key nodes in these dynamic processes; (6) developing validated markers for chemosensitivity and radiosensitivity; (7) understanding the optimal duration, sequencing and rational combinations of treatment for improved personalised therapy; (8) validating multimodality imaging biomarkers for minimally invasive diagnosis and monitoring of responses in primary and metastatic disease; (9) developing interventions and support to improve the survivorship experience; (10) a continuing need for clinical material for translational research derived from normal breast, blood, primary, relapsed, metastatic and drug-resistant cancers with expert bioinformatics support to maximise its utility. The proposed infrastructural enablers include enhanced resources to support clinically relevant in vitro and in vivo tumour models; improved access to appropriate, fully annotated clinical samples; extended biomarker discovery, validation and standardisation; and facilitated cross-discipline working.</p>
<p>CONCLUSIONS: With resources to conduct further high-quality targeted research focusing on the gaps identified, increased knowledge translating into improved clinical care should be achievable within five years.</p>
2019-11-22 17:30:56
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