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Gene could guide better treatment of most common breast cancer

Scientists have identified a gene which if present in certain breast cancer patients indicates how they will respond to specific therapies.

Breast cancer
The study involved analysing the tissue and treatment history of almost 13,000 patients

The work – involving a team from Nottingham Trent University and Nottingham University Hospitals NHS Trust – could help to ensure that patients are spared ineffective drugs and therefore unnecessary side effects.

The study looked at patients with oestrogen receptor positive breast cancer, which accounts for about two-thirds of all cases globally.

The work is particularly significant as there is currently no proven test that can accurately predict response to endocrine therapy or chemotherapy for these breast cancer patients.

It involved analysing the tissue and treatment history of almost 13,000 patients with oestrogen receptor positive breast cancer, and the presence and role of the protein ‘sperm associated antigen 5’, or SPAG5.

Writing in the Journal of the American Medical Association (JAMA) Network Open the team found that there were worse outcomes for patients who showed an increased expression of SPAG5, who underwent endocrine therapy alone.

A subgroup of patients with the more aggressive ‘luminal B’ tumours responded well and survived longer, however, if they received endocrine therapy along with anthracycline-based combination chemotherapy.

Dr Tarek Abdel-Fatah, the Clinical Senior Scientist at NUH and scientific lead of the study said: “SPAG5 is found in 30% of oestrogen receptor positive luminal B subclass of breast cancers which constitutes 40% of all breast cancer patients and we have found that 80% of those patients will benefit from adding chemotherapy to endocrine therapy. Our work will help to guide clinicians to the optimal treatment for these patients.”

Graham Ball, Professor of Informatics in Nottingham Trent University’s John van Geest Cancer Research Centre, said: “There is an urgent need for an improved method of determining how these patients will respond to therapy.

“Although endocrine therapy has extended survival for patients with oestrogen receptor positive breast cancer, resistance to it is common and reported in up to half of patients. We need to prevent the time and distress of patients receiving needless chemotherapy and suffering unnecessary side-effects.

“We have been studying this particular molecule and its important role in breast cancer for some time. We believe it will be a significant biomarker in helping to get the most effective treatment to patients as quickly as possible.”

Professor Stephen Chan, consultant oncologist at Nottingham University Hospitals NHS Trust and a visiting professor at Nottingham Trent University, said: “This important discovery will add to our ongoing project of predictive markers, which optimise treatment options for the individual patient.”

The work is funded by the National Institute for Health Research's Invention for Innovation programme.

  • Notes for editors

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    The full paper: Association of Sperm-Associated Antigen 5 and Treatment Response in Patients With Estrogen Receptor–Positive Breast Cancer

    The current phase of the three year National Institute for Health Research funded project is scheduled to end in June 2021.

    The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:

    • Funds, supports and delivers high quality research that benefits the NHS, public health and social care
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    The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR supports applied health research for the direct and primary benefit of people in low- and middle-income countries, using UK aid from the UK government.

    NTU was named University of the Year 2019 in the Guardian University Awards. The award was based on performance and improvement in the Guardian University Guide, retention of students from low-participation areas and attainment of BME students. NTU was also the Times Higher Education University of the Year 2017, and The Times and Sunday Times Modern University of the Year 2018. These awards recognise NTU for its high levels of student satisfaction, its quality of teaching, its engagement with employers, and its overall student experience. The university has been rated Gold in the Government’s Teaching Excellence Framework – the highest ranking available.

    It is one of the largest UK universities. With nearly 32,000 students and more than 4,000 staff located across four campuses, the University contributes £900m to the UK economy every year. With an international student population of more than 3,000 from around 100 countries, the University prides itself on its global outlook. The university is passionate about creating opportunities and its extensive outreach programme is designed to enable NTU to be a vehicle for social mobility. NTU is among the UK’s top five recruiters of students from disadvantaged backgrounds and was awarded University of the Year in the UK Social Mobility Awards 2019.

    A total of 82% of its graduates go on to graduate entry employment or graduate entry education or training within six months of leaving. Student satisfaction is high: NTU achieved an 87% satisfaction score in the 2020 National Student Survey, above the sector average of 83%.

Gene could guide better treatment of most common breast cancer

Published on 5 August 2020
  • Subject area: Sciences including sport sciences
  • Category: Press office; Research; School of Science and Technology

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