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As our name suggests, Breast Cancer Research Centre-WA conducts research into breast cancer treatment and care. Our research informs and underpins the treatment we provide to our patients. BCRC-WA was founded in 2009 with a vision to provide high quality care to breast cancer patients while conducting trials into the next generation of cancer drugs. This would ensure patients have access to the most advanced treatments.
What would you like to learn more about?
There are many reasons why a clinical trial is performed. These include questions relating to improving the quality of life for patients whilst on treatment, the impact of a cancer diagnosis on patients and family members, understanding the biological behaviour of cancer so we can better eliminate it, and most commonly to assess new treatments which improve the cure rate and cancer control for an individual.
To read more about the Breast Clinical Trials Unit and our current pharmaceutical trials, head to the Clinical Trials page.
As well as collaborations with pharmaceutical companies or other research groups, BCRC-WA also designs and performs our own research projects. These are called Investigator Initiated Research (IIR) and are funded by BCRC-WA.
By designing and funding our own studies, we can focus directly on the needs of our own patients seen through the Perth Breast Cancer Institute. For example, the BCOS study (Breast Cancer Offspring Study) was designed by Prof Arlene Chan to investigate the needs of children whose mother had been given a diagnosis of breast cancer after she saw many of her patients were concerned about the effects of their breast cancer experience on their children.
Specialists within PBCI design research projects and these frequently involve experts in other areas of medicine including pathology, psychology and biotechnology. The focus of these studies generally arise from the need to understand an aspect of breast cancer which is identified in the patients we treat and in which there is insufficient accurate information available at that time in the medical literature. Many of our past and current studies focus on areas such as social, emotional and other impacts of breast cancer outside of drug treatment specifically.
Our current IIR research includes collaborations with Curtin University, pathologists and radiation oncologists among others and include areas such as:
By carefully selecting which pharmaceutical clinical trials we will be involved in and by designing our own research to investigate the needs and experiences of our own patients seen here at BCRC-WA, we can see the positive impact our research has for patients with breast cancer and their families here in Western Australia. Here are just a few examples of clinical trials we have conducted which have provided direct benefits for our patients
Minimising the Impact of Side Effects
One of the most common side effects of certain breast cancer treatments is hair loss (alopecia). This can be very distressing for patients and may lead to negative self-image and feelings of depression or anxiety. A study designed and performed by BCRC-WA looked at the use of scalp cooling technology to decrease the likelihood and severity of this very unwelcome side effect. Scalp cooling can alter the growth rate of hair follicles during chemotherapy and lead to a reduction in hair loss. At the time of the study, access to cold cap machines was very limited in WA so the study provided access to technology they would not otherwise have had. The majority of patients involved in the study were satisfied with the use of the technology and were pleased to have been offered an option for treatment of hair loss. The results of our study enabled us to learn what the likelihood of success with use of the cold cap is, based on which specific chemotherapy drugs are administered to women. This now allows us to inform new patients about the cold cap, and the level of success when used with the treatment(s) they will receive so that they can make an informed decision as to whether to use the cap or not. As a direct result of performing this study, there are now two scalp cooling machines available for patients of BCRC-WA being treated at Hollywood Private Hospital.
Another study designed to minimize side effects was the G-CSF Study. To ensure the best outcomes from chemotherapy in the early breast cancer setting, patients should receive at least 85% of the planned dose of chemotherapy. However, one of the most common reasons why a patient may not receive the optimal dose is the side effect of low neutrophils in the blood; neutropaenia. The management of this side effect includes treatment reduction, treatment delay or minimisation of neutropenia with the use of G-CSF, a type of drug called a growth factor which increases the number of neutrophils in the blood. G-CSF can be given preventatively for use only with certain chemotherapy regimens known to increase the risk of neutropoenia. If dose reductions and delay are done unnecessarily, this will contribute to some patients not receiving the optimal amount of treatment.
Prof Chan designed this study to show that using G-CSF with other approved chemotherapies in the early breast cancer setting could reduce the risk and severity of neutropoenia, indicating that patients were more likely to receive the optimal treatment and thus the best long term likelihood of cure.
Between 1999 and 2010, information about the frequency of this side effect was collected on 1655 patients treated with chemotherapy regimens approved for patients with early breast cancer. The patients’ neutrophil levels were tested during the first cycle of treatment which showed the likelihood of severe neutropoenia with ongoing chemotherapy. These patients could then be given G-CSF preventatively for the rest of their chemotherapy, leading to optimal treatment being given and better outcomes overall.
Improving Longterm Outcomes
Professor Chan was the lead author and chairperson of the steering committee on a study of neratinib given to patients with early stage, HER2-positive breast cancer after chemotherapy and trastuzumab (Herceptin). The study aimed to show that adding neratinib in this setting would reduce the risk of breast cancer recurring in other parts of the body in the two years following chemotherapy and trastuzumab. More than 40 patients participated in the study at BCTU out of more than 2,800 participants across 495 locations worldwide. The study found that 12 months of neratinib given after chemotherapy and trastuzumab did significantly improve the outcome for these patients. Neratinib is now approved for use in Australia in this setting and this trial led to the drug’s approval in the USA and Europe. To watch an interview with Prof Chan and patient Shereen Jolly as they discuss the trial, head to 10 News with Professor Arlene Chan and Shereen Jolly on Neratinib.
Avoiding Unnecessary Procedures
Epiphora (excessive tears) is a symptom often reported by patients receiving adjuvant chemotherapy particularly with docetaxel. The Epiphora study, the first to evaluate the incidence of tearing and other eye symptoms in the early breast cancer setting, sought to show whether underlying blockage of the tear ducts (lacrimal duct obstruction) was a major contributor to this side effect. A blockage of the tear duct can be treated by insertion of a stent, a tiny tube, into the lacrimal duct.
The study was conducted by BCRC-WA at two different centres in Australia and employed two different methods to assess for an association between obstruction of the tear duct and excess tearing. Up to 18% of patients had a tear duct obstruction with no symptoms prior to receiving any chemotherapy, however patients developed excess tearing regardless of whether or not they had lacrimal obstruction. The study, therefore, did not support the need for preventative lacrimal stenting prior to commencing on chemotherapy. Knowing when invasive interventions are not required is of great benefit to our patients.
A Consistent Approach to Locally Advanced Breast Cancer
Prior to 2005, there was no standard approach to the clinical management of women with locally advanced breast cancer in WA. Prof Chan collaborated with a multidisciplinary team of surgeons, radiologists, nuclear medicine specialists, radiation oncologists and other medical oncologists to develop and test a uniform approach for these patients. In the study, all patients received the same chemotherapy regimen of docetaxel, doxorubicin and cyclophosphamide. Breast imaging, to determine how much invasive cancer was left after chemotherapy, was performed with MRI and PET. Breast surgery was then followed by radiotherapy according to the protocol. Most patients involved in the study were able to complete the standardised management plan. MRI was shown to be the most accurate method for assessing how much invasive cancer remained after chemotherapy.
This standardised approach became the treatment of choice in Western Australia for treating patients with locally advanced breast cancer and improved outcomes for our patients through optimising multidisciplinary care.
Named in honour of generous benefactor, Helen Sewell. BCRC-WA started the first breast cancer specific tumour bank in Western Australia in conjunction with Western Diagnostic Pathology.
A breast tumour bank is a storage site for small samples of breast tumour and surrounding tissues which have already been removed at the time of breast cancer surgery. Patients are not requested to undergo further procedures for their tissue to be stored in the tumour bank.
Patients provide written consent to their tissue being included in the tumour bank. To date, we have collected more than 3000 breast cancer samples – a reflection of the keen support our patients have in supporting the understanding of the disease. More research is needed into predictive biomarkers for breast cancer and the collection and study of tissue samples is vital for this to occur.
A unique feature of our tumour bank is that the samples we collect are linked to patient demographic information and treatments given to the patient, in a confidential manner. It is vitally important to be able to link the biology of the breast cancer to what happens to that patient. The EMT study is just one example of the important research made possible by the availability of these tumour samples and the information about treatments linked together with them.
If you are a patient of PBCI and have not previously been asked about whether you are willing for your tissue to be stored in the bank, ask your specialist for more information.