Critical Breast Cancer Research Gaps and Priorities

From the UK:

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

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.