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.