Mental health
Research roundup: Overcoming EGFR-targeted therapy resistance in breast cancer, and more
Femtech World explores the latest developments in women’s health research – from overcoming EGFR-targeted therapy resistance in breast cancer to understanding obesity’s role in triple-negative breast cancer, and more.
EGFR-targeted therapy resistance in breast cancer
Researchers have reviewed current research on why Epidermal Growth Factor Receptor (EGFR)-targeted therapies often fail in breast and head and neck cancers.
The article explores how cancer cells evade these treatments by activating alternative survival pathways and offers an in-depth look at the molecular barriers to EGFR inhibition, providing insights that could inform the development of more effective and durable treatments.
EGFR is a critical protein that regulates cell growth and survival, and it is frequently overexpressed in breast and head and neck cancers. Although therapies targeting EGFR showed early promise, resistance has become a significant challenge.
In breast cancer, resistance mechanisms include the movement of EGFR from the cell surface into the nucleus, where it promotes DNA repair, as well as ligand-dependent activation that helps tumour growth despite therapy.
The review describes how tumour cells in these cancers commonly activate other receptor tyrosine kinases (RTKs), such as MET, AXL, and RON, to continue growing even when EGFR is blocked.
By analysing these resistance mechanisms, the authors highlight combination therapies from current research that target EGFR and other key molecular pathways.
Strategies such as dual inhibition of EGFR and MET or blocking inflammation-driven survival signals may enhance treatment outcomes.
Several clinical trials are evaluating these approaches in patients.
For example, in breast cancer, combinations of EGFR inhibitors with chemotherapy and immune checkpoint inhibitors are being tested to improve responses, particularly in triple-negative breast cancer.
These efforts aim to overcome resistance and provide more effective treatment options for patients with EGFR-driven tumours.
The review also emphasises the necessity of identifying biomarkers to predict which patients are most likely to benefit from EGFR-based therapies.
Screening women with diabetes for intent to conceive at every doctor visit
Adverse pregnancy outcomes such as miscarriages or birth defects are common in individuals with pre-existing diabetes and are often related to modifiable factors such as maternal high blood sugar and body mass index (BMI).
With this in mind, a new, joint guideline released by the Endocrine Society and the European Society of Endocrinology (ESE) has recommended that women with diabetes receive proper preconception care.
This includes access to emerging diabetes technology and therapeutics to manage their blood sugar before, during and after pregnancy.
Screening women of reproductive age who have diabetes for intent to conceive at every reproductive, diabetes and primary care visit helps ensure they get the appropriate preconception care and reduces health risks.
Care suggestions from the guidelines include screening by asking all women with diabetes of reproductive age about intent to conceive at every reproductive, diabetes and primary care visit; timing delivery before 39 weeks for pregnant individuals with diabetes as the risks associated with continued pregnancy may outweigh those of early delivery; discontinuing anti-obesity medications called GLP-1s prior to pregnancy; and, avoiding prescribing metformin in pregnant individuals with preexisting diabetes already on insulin.
Further suggestions include using diabetes technology, recommending hybrid closed loop systems for pregnant individuals with type 1 diabetes; and suggesting that women with diabetes use contraception until they are ready to become pregnant.
Premenstrual symptoms linked to increased risk of cardiovascular disease
A new study has revealed that women diagnosed with premenstrual symptoms have a slightly increased risk of developing cardiovascular disease later in life.
Premenstrual symptoms include premenstrual syndrome (PMS) and the more severe form, premenstrual dysphoric disorder (PMDD).
The study followed more than 99,000 women with premenstrual symptoms for up to 22 years, comparing their health with women without these symptoms – both in the general population and by comparing them with their own sisters to take into account hereditary factors and upbringing.
The results show that women with premenstrual symptoms had about a 10 per cent higher risk of developing cardiovascular disease.
When the researchers also looked at different types of cardiovascular disease, they found that the link was particularly strong for heart rhythm disorders (arrhythmias), where the risk was 31 per cent higher, and for stroke caused by a blood clot, where the risk was 27 per cent higher.
Even after the researchers took into account other factors such as smoking, BMI and mental health, the link between premenstrual symptoms and increased disease risk remained.
Research has not yet identified the cause of this link, but the researchers behind the study suggest three possible explanations.
One is that women with premenstrual symptoms may have a disrupted regulation of the renin-angiotensin-aldosterone system (RAAS), which controls blood pressure and fluid balance in the body, among other things.
The second is that these women have increased levels of inflammation in the body, which is a known risk factor for atherosclerosis and other heart problems.
Finally, it may be because women with premenstrual symptoms may have metabolic abnormalities, which are linked to an increased risk of both stroke and heart attack.
Obesity’s role in triple-negative breast cancer
Among the various subtypes of breast cancer, triple-negative breast cancer (TNBC) stands out due to its aggressive nature and poor prognosis.
It is characterised by the absence of three critical hormone receptors: oestrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2, which are common targets for breast cancer therapies.
Consequently, TNBC lacks targeted treatment options, relying primarily on conventional cytotoxic therapies, often referred to as chemotherapy in which drugs kill or damage cancer cells.
This limitation contributes to the subtype’s high recurrence rates and significantly lower survival rates compared to other forms of breast cancer.
Researchers have now discovered that exosomes, messenger nanovesicles that carry proteins, RNA, and other molecules to other cells, that are released into the blood by different organs and tissues in obese, insulin-resistant models, carry signals that turn otherwise slow-moving TNBC cells into highly mobile, invasive cells.
This is the first time a study has shown that exosomes from an obese, diabetic environment directly cause this aggressive change in TNBC, and that Rho-proteins (molecular switches that turn “on” or turn “off” signal transduction pathways) play a key role in driving the change.
According to the researchers, by revealing how obesity-driven exosomes push aggressive breast cancer to spread, they hope to unlock new blood tests and drug targets, like Rho-protein inhibitors that stop this deadly process.
“These findings support the development of clinical tests to quantify obesity-derived exosomes in patient plasma as noninvasive biomarkers of metastatic risk, allowing earlier identification and tailored management of aggressive TNBC,” said corresponding author Gerald Denis, Shipley Prostate Cancer Research professor and professor of pharmacology, physiology and biophysics.
“Ultimately, our goal is to improve survival and quality of life for patients facing both metabolic disease and hard-to-treat cancers.”
A £50m maternity consortium will bring together UK clinicians, researchers and communities to tackle the most critical gaps in maternal care.
Funding from the National Institute for Health and Care Research has established the NIHR Inequalities Challenge: Maternity Disparities Consortium under the leadership of the University of Birmingham and Newcastle University.
Higher education bodies, NHS organisations, community groups and voluntary organisations from across the UK will work together through the programme.
The NIHR has committed £50m over five years to support research led by clinicians, researchers and communities across the consortium.
Professor Joht Singh Chandan, consortium co-lead for research at the University of Birmingham, said: “National attention on maternity safety and equity has never been greater, but ambition must now be matched by evidence and implementation.
“Through this consortium, we will work across the UK to understand what works, for whom and in what contexts, and to ensure that research leads to practical changes in care for the women, babies and families who need them most.”
The launch comes at a pivotal moment for UK maternity care, with growing national attention on improving safety, equity and women’s experiences of care.
The government’s renewed Women’s Health Strategy highlights the need to improve care before and between pregnancies for underserved communities.
Against that backdrop, the consortium will generate the evidence, interventions and research capacity needed to help turn national ambition into practical improvements for women, babies and families.
University of Birmingham is leading work to improve maternity care pathways across the antenatal, intrapartum and postnatal periods.
Antenatal care covers pregnancy before labour, while intrapartum care refers to care during labour and birth.
The consortium will examine how women and families can be better supported before pregnancy and between pregnancies.
This includes improving access to advice and care that can help people prepare for pregnancy, manage existing health conditions and reduce risks before they build up.
Other research will focus on improving care during pregnancy, birth and the early weeks after birth.
This will include work on major causes of poor maternal health, such as high blood pressure, diabetes in pregnancy, obesity, perinatal mental health and complications during recovery after birth.
Professor Judith Rankin OBE, consortium co-lead for research and capacity development at Newcastle University, said: “This funding represents a critical opportunity to make the step change we need to improve outcomes for women and their babies.
“Alongside the research, the Consortium will be investing in tomorrow’s research leaders today to ensure we have the capacity to deliver on improving pregnancy outcomes, access to, and experience of, care.”
A four-week Pilates programme may improve heart, metabolic and stress measures in previously sedentary women, a small study suggests.
Pilates is a mind-body form of exercise that has been linked to better fitness, balance, posture, muscular endurance, mental wellbeing and quality of life in different groups.
Built around breathing, concentration, control, precision, centring and flow, Pilates is already used in physiotherapy, rehabilitation and preventive health. The new study looked at whether a structured four-week programme could affect cardiovascular, metabolic, body and stress-related measures in sedentary adult women.
The longitudinal study included 30 sedentary women split into two age groups, 30 to 40 and 50 to 60.
All participants completed a standardised, supervised Pilates programme lasting four weeks, with three sessions a week lasting 50 to 60 minutes.
Researchers measured resting heart rate, systolic and diastolic blood pressure, body mass index, abdominal circumference, fasting blood glucose and serum cortisol at the start and end of the programme.
Systolic and diastolic blood pressure are the top and bottom readings in a blood pressure test. Cortisol is a hormone linked to the body’s stress response.
The four-week Pilates programme was linked to improvements in cardiovascular, metabolic, body and neuroendocrine measures, although not every change reached statistical significance within each age group.
In the younger group, significant reductions were seen in heart rate, blood pressure, body mass index and fasting blood glucose after the intervention.
The reduction in blood pressure after the programme was significantly greater in the older group than in the younger group.
Older participants also showed a greater reduction in glucose and cortisol levels after the intervention than younger participants.
Analysis also found significant links between cardiovascular, metabolic and neuroendocrine changes.
In the younger group, this was particularly seen between heart rate and blood pressure responses.
In the older group, it was particularly seen between changes in body mass index and fasting glucose.
The findings suggest Pilates could be a useful multidimensional exercise approach for cardiometabolic health and stress regulation in previously sedentary women.
The researchers said the larger reduction in blood pressure seen in the older group may reflect a higher cardiometabolic burden at the start, leaving more room for improvement after the programme.
The greater reduction in fasting glucose and cortisol in older participants may similarly suggest that people with higher baseline metabolic and neuroendocrine dysfunction could benefit more from structured exercise such as Pilates.
Although Pilates is known to improve body composition through energy use, neuromuscular activation and support for healthier habits, the researchers said the fall in body mass index over four weeks is unlikely to be explained by Pilates alone.
They noted that participants were also told to avoid alcohol, sugar-containing products and sugar-sweetened drinks during the intervention, which may have contributed to the change.
In the younger group, the link between heart rate and blood pressure suggested coordinated cardiovascular responses after Pilates.
The researchers also found that cortisol appeared to be linked to blood pressure and body mass index, suggesting stress-related changes may be tied to cardiovascular and body regulation after the intervention.
In the older group, the link between body mass index and fasting glucose highlighted the relationship between body fat and metabolic regulation.
A positive link between blood pressure and body mass index in this group also suggested that improvements in vascular regulation may be associated with reductions in body mass.
Overall, the findings suggest Pilates-related physiological changes may involve interconnected cardiovascular, body, metabolic and neuroendocrine mechanisms, with different response patterns by age.
The study has important limits. It did not include a non-exercise control group, so it cannot prove Pilates directly caused the changes.
The sample size was also small, which limits how far the findings can be applied more widely.
The authors also noted that cortisol was measured using a single fasting morning sample, which limits conclusions about broader hypothalamic-pituitary-adrenal axis regulation, the system involved in the body’s stress response.
They said larger studies with longer follow-up will be needed to confirm whether Pilates causes these physiological changes over time.
British women are among the angriest in Europe, a global health survey has revealed.
More than 20 per cent of women in Britain said they had experienced feelings of rage for much of the previous day.
British women were also 47 per cent more likely to say they felt angry than a year earlier.
The findings were published in the Hologic Global Women’s Health Index, a yearly league table based on polling of more than 76,000 women and girls aged over 15 worldwide.
Anna O’Sullivan, co-founder of women’s health awareness group CensHERship and founder of the FutureFemHealth news platform, told the Daily Mail: “These figures reflect years of long waiting lists, delayed diagnoses and women’s health being treated as an afterthought.
“We’ve seen a significant increase in awareness and discussion about women’s health over the last few years, but access to care has not kept up with that.
“These findings should be a wake-up call that it’s time for long-term, sustainable investment to ensure women can access timely healthcare, trusted information and earlier diagnosis before conditions become more complex and costly to treat.”
The data suggested anger levels among British women have risen sharply.
Rates across the rest of Europe, however, remained broadly the same.
The survey, which involved more than 140 countries, found three in 10 UK women said they felt sadness, compared with the EU average of 25 per cent.
The data, collected in February 2024 and released this week, also showed that around four in 10 women in both the UK and EU felt worry.
A third of women in the UK reported being in pain, up 10 per cent on the previous year.
Three in 10 women also said they lived with chronic health problems, up seven per cent on the year before.
Chronic health problems are long-term conditions that may need ongoing care or management.
Health experts said women in the UK were increasingly frustrated by the gap between the NHS care they expected and the care they received.
The report took a snapshot of the national mood, with participants asked about the emotions they had experienced “during a lot of the day yesterday”.
The UK placed sixth among 37 European countries for anger.
The highest levels were recorded in Malta, where 26 per cent of women reported feelings of rage, followed by Greece at 25 per cent, the Czech Republic and Albania at 23 per cent, and Spain at 22 per cent.
Ireland ranked at 18 per cent, while Germany, France and Switzerland each reported 17 per cent.
Britain has also slipped in Hologic’s overall global rankings for women’s health.
The UK is now 48th, close to dropping out of the top third of countries worldwide, after ranking 40th out of 142 countries last year.
Taiwan ranked first, followed by Latvia, Japan, Vietnam and Poland. Singapore, Germany and Austria were also among the leading countries.
Tim Simpson, a senior manager at Hologic, said: “Women are telling us they want earlier diagnosis and faster access to care.
“Improving women’s health will take continued commitment from policymakers, the NHS, clinicians and industry working together to deliver the changes women are asking for.”
A separate Hologic survey carried out last month found that almost 70 per cent of women had faced delays seeking NHS care in the past five years.
Two in five said difficulties accessing healthcare had left them feeling frustrated or anxious.
The survey’s findings reinforced official figures showing that Britain has become more anxious since before the pandemic.
The Office for National Statistics said 22.5 per cent of UK adults reported “high anxiety yesterday” between July and September 2024, up from 20.4 per cent in the same period in 2019.
Among women, the figure was 26.3 per cent, compared with 18.5 per cent among men.
A Department of Health and Social Care spokesperson said: “It is unacceptable that the UK continues to lag behind other countries when it comes to women’s health.”
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