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New breast cancer test to predict spread of the disease
The test works by identifying the presence of two proteins in cells of the original cancer
A new breast cancer test, which may be able to accurately predict those at risk of their cancer spreading, is to be trialled in the UK.
The test, which will be trialled at the University of Bradford’s Institute of Cancer Therapeutics, could mean those at low risk could avoid undergoing follow-on treatment as well as potentially save the NHS millions of pounds a year.
In pilot studies, the test has proved 98 per cent accurate in predicting which patients are at low risk of their cancer spreading or returning, referred to as metastasis, after their initial treatment.
Now, a trial funded by Innovate UK is being conducted to test whether Ran Diagnostics works in practice.
Professor Chris Twelves, clinical director of the Institute of Cancer Therapeutics, University of Bradford, who is leading the study, said: “When people are first diagnosed with breast cancer, their oncologist will want to discuss whether they may benefit from extra drug treatment to reduce the risk of the cancer returning and spreading.
“One of the ways we do that now is through a genetic test on the cancer, but that test is expensive and can be slow.
“If, as we hope, Ran Diagnostics is as good at identifying who may benefit from such extra treatment, it will be quicker and less expensive, helping us to better personalise cancer treatment for our patients.”
Dr Mohammad Isreb, associate professor in medicine development at the University of Bradford, said: “The Ran Diagnostics test has the potential to accurately predict the likelihood of someone newly diagnosed with breast cancer developing metastasis in the future more quickly and economically than current tests.
“It may help indicate who may benefit from extra treatment, and those at low risk, who may be able to be spared extra treatment and avoid its painful and unpleasant side effects.”
The test is designed for people with the most common type of breast cancer – hormone receptor positive, HER2, receptor negative. It works by identifying the presence of two proteins in cells of the original cancer, Ran GTPAse (Ran) and MMP-2.
In laboratory tests of 181 tumour samples from patients diagnosed with breast cancer in the 1990s and whose medical histories are known, the Ran Diagnostics test showed 98 per cent accuracy.
Dr Mohammad Isreb, associate professor in medicine development at the University of Bradford and Professor Sherif El-Khamisy, director of the Institute for Cancer Therapeutics at the University of Bradford
Dr Jason Jones, commercial manager, faculty of life sciences, University of Bradford, said: “We measured levels of the two biomarkers in those samples then we looked at their medical histories to see which ones later developed metastatic disease.
“There is a clear correlation between high levels of Ran and MMP-2 and patient outcomes. Tests showed 98 per cent of patients with low levels did not go on to develop secondary cancer and therefore may have been spared chemotherapy. We have not seen anything with such a strong relationship as this before.”
The trial will be conducted in collaboration with Leeds Teaching Hospitals NHS Trust and the University of Leeds.
Breast cancer is the most commonly diagnosed cancer globally. Metastatic breast cancer – also known as secondary or stage four breast cancer – can be treated but not cured.
The NHS has committed to improving cancer care in its Long Term Plan and NICE recommends tumour profiling for some people with breast cancer to guide clinicians and patients decisions on the best treatment for patients.
Ran Diagnostics could be carried out within a hospital’s own pathology lab, with results potentially available within hours.
The team has been awarded an £897,000 Innovate Biomedical Catalyst grant to test a further 600 samples with known tumour profiling results to see if Ran Diagnostics gives equivalent results.
Ran Diagnostics will comprise of two elements: the physical testing kit used to stain the biomarkers along with AI-enabled software to analyse the data.
The grant also includes funding for Carmen Diagnostic Technologies Ltd, a spin-out company of the University of Bradford that owns the Intellectual Property (IP), to develop Ran Diagnostics into a commercial product. If the new test is successful, Carmen Diagnostic Technologies could have the product available to use in clinic within two to three years.
Professor Krzysztof Poterlowicz, director of research for computational and data-driven science at the University of Bradford and co-investigator in the project, commented: “This groundbreaking project provides a unique opportunity to leverage the latest advancements in AI and data science to develop software that optimises the results of the Ran Diagnostics test.”
Everard Mascarenhas, director of Carmen Diagnostics Technology, based in Southport, Merseyside, said: “Ran Diagnostics utilises equipment and pathology expertise that already exists in the hospital and can be adopted very quickly in hospitals around the world.
“Furthermore, as the cancer tumours can be tested by the hospital, unlike genetic tests where samples have to be transported internationally, Ran Diagnostics is closely aligned to helping the NHS achieve its net zero climate change objectives.”
He added: “A further limitation of existing genetic tests is that they only work for around 70 per cent of breast cancers.
“The science behind Ran Diagnostics means it can work for all breast cancer. In the future, there is the potential for a similar test to be used on other forms of breast cancer as well as other cancers.”
Professor Sherif El-Khamisy, director of the Institute for Cancer Therapeutics at the University of Bradford, said: “Our mission at the Institute of Cancer Therapeutics is developing smarter and personalised ways to diagnose, predict and treat cancer.
“Ran Diagnostics is an important step towards achieving our aspirations by providing a cost-effective, rapid and potentially point-of care test that informs more personalised cancer treatments that help reducing the risk of the cancer coming back or spreading to other parts of the body.”
Small bowel microbiome differences between women and men may help explain why some conditions are more common in women, a study suggests.
The small bowel microbiome is the community of microorganisms living in this part of the digestive tract, where they play vital roles in immune function, metabolism and hormonal regulation.
Researchers found differences between women and men in the composition and organisation of these microbial communities. One bacterial community containing Granulicatella was found only in women.
The study was conducted by investigators at Cedars-Sinai Health Sciences University.
Ruchi Mathur, director of clinical research and clinical operations for the Medically Associated Science and Technology (MAST) Program at Cedars-Sinai and corresponding author of the study, said: “One intriguing finding was a bacterial community containing Granulicatella, which we found only in women.
“Bacteria in this community appear at increased levels in women with polyendocrine metabolic ovarian syndrome, formerly known as polycystic ovary syndrome.”
The researchers also identified differences between women and men in how microbes in the small bowel produce fructans, complex carbohydrates known to trigger digestive symptoms in irritable bowel syndrome (IBS).
IBS is far more common in women than men.
Mathur, who is also a professor of medicine, said: “Our findings show that biological sex is a critical variable in the small bowel microbiome.
“We must consider it as we move toward more personalised approaches to understanding and treating disease.”
An experimental cancer drug reduced bone loss and body fat in mice modelling post-menopausal changes, early research suggests.
The compound, CADD522, appeared to strengthen bones and help the animals stay leaner after surgery designed to mimic hormonal changes seen after menopause.
The treatment remains at an early experimental stage and has so far only been tested in animals.
The study, led by the University of East Anglia, investigated CADD522, which was originally developed to block a protein involved in the growth and spread of several cancers.
Mice treated with the compound for eight weeks showed significant improvements in bone health. Scans found increased bone volume and better preservation of the honeycomb-like structures inside bones that are crucial for strength and resilience.
Blood tests suggested the treatment stimulated new bone growth without interfering with the body’s normal process of breaking down and rebuilding bone.
Dr Darrell Green, lead researcher from UEA’s Norwich Medical School, said: “Osteoporosis affects around one in three women over the age of 50, leaving sufferers vulnerable to painful fractures that can seriously impact quality of life.
“Current treatments exist, but many are plagued by side effects, safety concerns or inconvenient dosing schedules that make long-term use difficult.”
The researchers also found that mice receiving CADD522 weighed less than untreated mice despite eating the same amount of food.
They had less body fat and fewer fat deposits in their bone marrow, a process commonly seen after menopause and linked to declining bone health.
The team also examined brain tissue and found that the drug appeared to reverse several menopause-related changes in fatty acids.
Levels of omega-3 fats including DHA remained largely intact, while several other lipid abnormalities shifted back towards healthier patterns.
Green said: “We didn’t directly test for memory or thinking ability, but our work raises questions about whether this drug could one day help address wider menopause-related health problems.”
Safety experiments in mice, rats and dogs found that CADD522 could be taken orally and was well tolerated.
The compound also appeared to be metabolised more slowly in human tissue than in rodents, potentially improving its performance in people.
“This is still in the early stages and has so far only been tested in animals but we hope that the benefits will translate to humans to ultimately reduce fracture rates,” added Green.
The research was led by UEA in collaboration with the University of Maryland, the Scintillon Research Institute in San Diego and the University of Stirling.
Safety testing was funded by The Sir William Coxen Trust as part of the development of CADD522 as a childhood cancer treatment.
Weight loss surgery was linked to more regular periods and fewer polyendocrine metabolic ovarian syndrome (PMOS) symptoms in women aged 18 to 45 living with obesity in a recent study.
The researchers recommend that women undergoing the procedure have access to preconception care and reproductive counselling to support their reproductive health.
Researchers at the University of Surrey analysed data over 24 months from 84 women who underwent bariatric surgery and 18 women living with obesity who did not have surgery.
Of those who underwent surgery, 49 had gastric bypass procedures and 35 had gastric sleeve surgery.
Women who underwent metabolic bariatric surgery lost more than 30kg on average at 12 and 24 months after the procedure.
Among women with polycystic ovaries, the condition persisted in only 10 per cent after 24 months.
Women also reported a resolution of clinical hirsutism, or excess body hair, by 12 months.
Women who had previously experienced irregular periods reported more regular menstrual cycles after surgery.
Professor Martin Whyte, co-author of the study and professor of metabolic medicine at the University of Surrey, said: “A large proportion of those undergoing bariatric surgery are women of reproductive age, who may be planning a pregnancy in the coming years.
“So much remains unknown about the impact of this type of surgery on women who are planning to have children.
“This raises the question of when the ideal time after surgery is to conceive.”
Women have a higher prevalence of obesity than men, with 57 per cent of women in the UK classified as overweight and 27 per cent living with obesity, which can affect fertility and the health of an unborn baby.
The researchers said 17 women had healthy pregnancies following surgery.
Although this was not specifically examined in the study, no difference in birth weight was observed between babies conceived within or after the first year.
Dr Kathryn Hart, co-author of the study and associate professor in nutrition and dietetics at the University of Surrey, said: “What we have found is that bariatric surgery positively affects the reproductive health of women living with obesity and can improve the likelihood of them having a healthy pregnancy after surgery.
“Dysregulated hormone levels, irregular periods and conditions such as polycystic ovaries are affected by obesity.
“By reducing this, what we have seen is that it can lead to improvements without the need for medication.
“We would suggest that clinicians consider medical intervention for obesity to treat irregularities in the menstrual cycle and issues with fertility.”
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