Let sleeping cells die: Understanding dormant breast cancer cells

When breast cancer is diagnosed early or when the tumour is contained to the breast or nearby lymph nodes, patients have a high chance that their cancer will be curable. Nonetheless, cancer cells can spread from the breast and cause secondary tumours in organs such as bone, liver and lung in a process called metastasis. The patient can still be treated to slow cancer growth; however, currently the disease is incurable.

Metastasis in breast cancer, and a few other types of cancer such as prostate cancer, is unusual in that it can take a long time before secondary disease develops. Breast cancer cells lodged in other tissues can survive there for many years without growing, in a so-called dormant state. In roughly one out of five breast cancer patients, these dormant cells wake up and start growing, forming secondary tumours.

Professor Robin Anderson, along with Associate Professor Sarah Ellis and postdoctoral fellow Dr. Charlotte Roelofs, has received a large four-year grant from the National Health & Medical Research Council. With this grant they will investigate how these dormant cancer cells can survive in the body for so long and what drives them to wake up after many years.

Unfortunately, conventional chemotherapy does not kill dormant cancer cells because they do not actively grow.  Therefore, there is a need for new treatments that specifically target dormant cancer cells. The aim of this research is to investigate how to develop a therapy that can either prevent dormant cells from waking up, or better still, identify a therapy that can kill the dormant cancer cells altogether.

The grant will enable the research team to directly image dormant tumour cells in tissues using high-end new microscopy equipment recently installed at ONJCRI. They will also be able to isolate these dormant cells and the surrounding host cells that form the niche that enables the cancer cell to survive for years. The isolated tumour and host cells will be subjected to gene profiling to understand the mechanisms that control dormancy. These studies should lead to the identification of new genes that can be targeted with treatments to improve the outcome for cancer patients.

Breast cancer treatment has come a long way in a relatively short period of time with five-year survival rates now at 90%. Still, in Australia alone, over 3,100 women died from breast cancer in 2021. Their cause of death was nearly always metastases that grew into uncontrollable secondary tumours.

“Once we understand why some cancer cells lie dormant and how they can re-awaken, we can identify new genes to target and either keep dormant cells asleep permanently or even kill them,” explained Prof Anderson.

“The cause of death of patients who are initially diagnosed with breast cancer is nearly always metastases that grow into uncontrollable secondary tumours. Our research will be critical to improving the outcome for patients with advanced breast cancer.”

“As our Founding Champion Olivia Newton-John herself died from a very late recurrence of breast cancer, we hope she would be proud of our current research aiming to find new therapies for this disease,” she said.

This research investigates one of the last unmet clinical needs of breast cancer patients. Understanding how cancer cells become dormant, and more importantly, how dormancy is broken has the potential to improve the outcome for thousands of patients around the globe.

World-class Radiochemistry Lab to open at Olivia Newton-John Cancer Research Institute - giving Australian cancer patients access to new therapies

Olivia Newton-John’s legacy continues to inspire with a cutting-edge radiochemistry laboratory to be established at the cancer research institute bearing the beloved entertainer’s name in Victoria.

Australian Cancer Research Foundation (ACRF) has awarded a $2.1 million grant to establish the state-of-the-art ACRF Centre for Precision Medicine at the Olivia Newton-John Cancer Research Institute.

Precision oncology can benefit up to 50% of cancer patients by determining the most effective treatment based on their cancer’s profile, rather than a one size fits all approach.

The ACRF Centre for Precision Medicine will utilise a “theranostic” approach of combined imaging and treatment with novel drugs to enhance therapeutic responses and exploit new technology for tumour treatment. Theranostics is an exciting new area of cancer treatment – a form of precision medicine in which radioisotopes are combined to diagnose and treat a tumour.

For example, Lu-PSMA-617 is under consideration in Australia after recently being approved to treat prostate cancer in the US and Europe. New theranostic targets will be developed and validated at the ACRF Centre for Precision Medicine for use across several cancer types.

The radiochemistry lab at the heart of the ACRF Centre for Precision Medicine will support the supply of radiopharmaceuticals for theranostic trials – meaning Australian cancer patients can access new diagnostics and therapies as they are developed.

Chief Investigator, Olivia Newton-John Cancer Research Institute’s Professor Andrew Scott AM, said: “Precision medicine has been described as the future for cancer treatment, whereby identifying key targets in a patient’s cancer and individualising treatments based on appropriate treatment selection can result in improved outcomes.”

“The ACRF Centre for Precision Medicine will establish a unique and exciting capability for translation of discoveries into the clinic and provide a key technology for theranostics for multi-centre clinical trials across Australia.”

“This will link outstanding researchers in cancer biology, drug development, radiochemistry and molecular imaging of cancer, leading to novel therapeutic approaches and clinical trials.”

Australian Cancer Research Foundation CEO Kerry Strydom, said ACRF is proud to enable transformative research that will be conducted at the ACRF Centre for Precision Medicine, accelerating translation of discoveries into the clinic to ensure optimal outcomes for cancer patients.

“ACRF supports innovation that leads to better ways to prevent, detect and treat all cancers. With precision medicine and theranostics, in particular, regarded as the way forward for effective cancer treatment, we anticipate lifesaving impact from the ACRF Centre for Precision Medicine,” Kerry added.

ACRF formally awarded the $2.1 million grant to the Olivia Newton-John Cancer Research Institute at the Sydney Opera House on Tuesday 6th December, 2022. The event – Celebrating Brilliance – also showcased remarkable support for cancer research in Australia.

Among the attendees were ACRF Medical Research Advisory Committee members Professor Doug Hilton AO, Emeritus Professor Ian Frazer AC and Professor Roger Reddel AO. The grant was awarded by Her Excellency The Honourable Margaret Beazley AC KC.

ACRF’s $2.1M investment has the potential to result in a return of $8.19M with $5.49M in health gains and $2.7M in wider economic gains.

The Ovarian Cancer Research Foundation has also committed $300,000, over three years, for technical project personnel to drive new theranostic ovarian cancer treatments.

It’s fitting for the ACRF Centre for Precision Medicine to reside at the Olivia Newton-John Cancer Research Institute given the late Olivia Newton-John’s tireless quest to improve cancer treatment amid her ongoing journey with the disease.

For further information, visit: www.acrf.com.au

About ACRF
Australian Cancer Research Foundation (ACRF) is a leading independent charity. ACRF focuses on funding the technology, equipment and infrastructure researchers need to progress the prevention, detection and treatment of all cancers.
ACRF is uniquely positioned to bring together outstanding expertise from medical research organisations across Australia and initiate pioneering cancer research programs, revolutionising outcomes for patients.
ACRF receives no government funding, relying on donations and fundraising from individuals, corporates, and community groups. Applications for grant funding are assessed by an outstanding panel of Australian and international cancer experts.

About Olivia Newton-John Cancer Research Institute
The Olivia Newton-John Cancer Research Institute is a leader in the development of innovative and breakthrough cancer treatments.
Based at the Austin Hospital in Melbourne, the Olivia Newton-John Cancer Research Institute’s world-class laboratories are located just metres from hospital beds, allowing researchers and clinicians to work closely together and translate scientific discoveries into clinical trials to improve treatment options for patients.
Our researchers bring observations from the clinic back to the laboratory bench to create a continual cycle of learning and improvement between scientific research and clinical applications.
Our research is primarily focused on investigating and developing treatments for cancers of gastrointestinal tract, brain, breast, lung, skin and rare cancers. We also undertake research in understudied rare cancers and proactively look for opportunities to extend our efforts to other cancers and diseases. For more information visit www.onjcri.org.au.
The Olivia Newton-John Cancer Research Institute is part of the La Trobe University, as the La Trobe University School of Cancer Medicine.