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    Critical research gaps and translational priorities for the successful prevention and treatment of breast cancer

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    Authors
    Eccles, Suzanne A
    Aboagye, Eric O
    Ali, Simak
    Anderson, Annie S
    Armes, Jo
    Berditchevski, Fedor
    Blaydes, Jeremy P
    Brennan, Keith
    Brown, Nicola J
    Bryant, Helen E
    Bundred, Nigel J
    Burchell, Joy M
    Campbell, Anna M
    Carroll, Jason S
    Clarke, Robert B
    Coles, Charlotte E
    Cook, Gary JR
    Cox, Angela
    Curtin, Nicola J
    Dekker, Lodewijk V
    dos Santos Silva, Isabel
    Duffy, Stephen W
    Easton, Douglas F
    Eccles, Diana M
    Edwards, Dylan R
    Edwards, Joanne
    Evans, D G
    Fenlon, Deborah F
    Flanagan, James M
    Foster, Claire
    Gallagher, William M
    Garcia-Closas, Montserrat
    Gee, Julia M W
    Gescher, Andy J
    Goh, Vicky
    Groves, Ashley M
    Harvey, Amanda J
    Harvie, Michelle
    Hennessy, Bryan T
    Hiscox, Stephen
    Holen, Ingunn
    Howell, Sacha J
    Howell, Anthony
    Hubbard, Gill
    Hulbert-Williams, Nick
    Hunter, Myra S
    Jasani, Bharat
    Jones, Louise J
    Key, Timothy J
    Kirwan, Cliona C
    Kong, Anthony
    Kunkler, Ian H
    Langdon, Simon P
    Leach, Martin O
    Mann, David J
    Marshall, John F
    Martin, Lesley A
    Martin, Stewart G
    Macdougall, Jennifer E
    Miles, David W
    Miller, William R
    Morris, Joanna R
    Moss, Sue M
    Mullan, Paul
    Natrajan, Rachel
    O’Connor, James PB
    O’Connor, Rosemary
    Palmieri, Carlo
    Pharoah, Paul D P
    Rakha, Emad A
    Reed, Elizabeth
    Robinson, Simon P
    Sahai, Erik
    Saxton, John M
    Schmid, Peter
    Smalley, Matthew J
    Speirs, Valerie
    Stein, Robert
    Stingl, John
    Streuli, Charles H
    Tutt, Andrew N J
    Velikova, Galina
    Walker, Rosemary A
    Watson, Christine J
    Williams, Kaye J
    Young, Leonie S
    Thompson, Alastair M
    Show allShow less
    Issue Date
    2013-10-01
    Keywords
    CANCER
    RESEARCH
    BREAST CANCER
    
    Metadata
    Show full item record
    Citation
    Breast Cancer Research. 2013 Oct 01;15(5):R92
    URI
    http://dx.doi.org/10.1186/bcr3493
    http://hdl.handle.net/10147/305319
    Abstract
    Abstract 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. 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. 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. 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.
    Item Type
    Article
    Language
    en
    Sponsors
    SAE acknowledges support from the NIHR RM/ICR Biomedical Research Centre, ICR and Cancer Research UK. AMT acknowledges support from Breast Cancer Campaign, Breakthrough Breast Cancer and CR-UK.
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