Breast Cancer Trials International Clinical Fellowship Support aims to financially assist promising junior researchers to gain international experience and connections. Dr Julia Dixon-Douglas has been awarded support in the first year of the program and is heading to France to study novel therapies for breast cancer.
Her research may help to improve our understanding of which patients will have the greatest benefit from these treatments and how they’re best administered to patients.
What is the focus of your research?
“I’m a Medical Oncologist at the Peter MacCallum Cancer Centre, and I work with the breast cancer unit. For the last two years I’ve been working as a clinical trials fellow, so mostly recruiting patients to clinical trials and looking after patients on clinical trials who are being treated with new therapies.”
“At the moment I am starting to delve a bit further into working in the lab. So rather than seeing patients and dealing with patients every day, I’m doing a bit of work in the lab to actually look at tumour and blood samples from patients under the microscope to understand which patients are benefiting from these treatments the most, and how we can use that information to better implement these treatments in the future.”
“Our response to new cancer treatments is really quite complicated and I guess determined by a number of different things. One component of it is how the tumor cells respond to the treatment that you’re giving. But another component, which sort of overlays with that, is how that interacts with the patient’s immune system and how that either allows or prevents the immune system from coming in and providing protection against cancer cells.”
“So, what this research is looking at is how the new treatments affect the tumor biology, both in terms of tumor cells, but also how they affect patients’ immune systems and how that information can be used to select patients for treatments better, or sequence treatments better, or combine treatments better.”
Listen to the Podcast
Listen to our conversation with Dr Julia Dixon-Douglas as she discusses her international fellowship grant with Breast Cancer Trials, and her research project looking into Novel Breast Cancer Treatments.
Why is going to France an important element of this research?
“Cancer research is really resource intensive, so it’s important that we share expertise and knowledge globally. So, an important part of that is international collaboration, which is why I’ve decided to go to the Institute Gustav Roussy, which is just outside Paris in France.”
“This is a leading European cancer centre that sees over 2000 new breast cancer patients a year. I’ll be working with a team who have world-leading expertise in translational research. So, looking at these patient samples of patients who’ve been on clinical trials with these new treatments, and they also run an active clinical trials unit, which is an amazing resource in terms of seeing patients on clinical trials and also collecting samples from patients on clinical trials.”
How will research from this project impact breast cancer treatments today?
“Every patient’s tumour is unique. At the moment, the way we treat breast cancer is pretty general, whilst we try and tailor treatments, it really is very general and many patients within a subtype of breast cancer will have similar treatments.”
“What this research is trying to do is identify biomarkers, so that we can implement these treatments in a more precise, individualized way so that patients can achieve the best outcomes with the least treatment, which will avoid unnecessary side effects and financial toxicity.”
“The overall aim is to uncover biomarkers to enable or to inform clinical trial development. So, coming up with new combinations of treatment, selecting patients for these new treatments, and developing clinical trials that involve selecting patients for new combinations of treatments, essentially to improve the chance of cure with fewer side effects.”
The role of novel therapies in treating breast cancer
In recent years, novel therapies including immune checkpoint inhibitors, antibody drug conjugates, and oral small molecule inhibitors, have been approved for the treatment of breast cancer. Can you explain what these are and their role in treating breast cancer?
“So, these are all examples of some of the new treatments that have been developed for the treatment of breast cancer, and there’s some really exciting research from clinical trials to show that they are effective.”
“But I think we’re really at the start line in terms of understanding how well they could work if they were implemented in a way that is optimized. And by that, I mean selecting the patients who are most likely to respond to those treatments, and understanding how they impact on the tumor biology and how that might inform how we could combine these treatments together.”
“So for example, immunotherapy is treatment that harnesses a patient’s immune system to help overcome cancer. Whereas a treatment like an antibody drug conjugate is a treatment that directly kills cancer cells. So, we need to learn how to be able to combine these treatments effectively so that not only are we killing cancer cells, but we’re also priming and harnessing the immune system to add long-term control to that as well.”
Why are novel therapies so important?
“I think this has the potential to affect all patients with breast cancer, by shifting their paradigm from a very general approach to cancer treatment, to a precise biomarker informed, directed approach to treating breast cancer, it has the potential to change how every patient with breast cancer is treated.”
“The treatment that we refer to when we think about traditional anti-cancer treatment is really chemotherapy. And chemotherapy does work well for some types of breast cancer, but it has a lot of side effects, including long-term side effects like heart problems, and the risk of secondary blood cancers. And we know that some patients, despite maximum chemotherapy, still will not be cured from their breast cancer.”
“So novel treatments that either target the machinery that tells a cancer cell to grow, or that harness the immune system to provide more longer-term control of cancer, are really the key to improving long-term cure rates.”
How will data from this study be used?
“This study will be looking at samples that have been taken from patients on clinical trials who’ve received these novel treatments on clinical trials. So, we’ll be looking at patient blood samples, to look at their circulating immune cells and we will also be looking at their tumour samples to look at tumour cells, and also immune cells that are embedded within the tumour.”
“We will be looking at how these immune cells, tumour cells, and genes change in response to treatment in patients who have both responded to the treatment, or have not responded to the treatment, or who have responded for a period of time, but then progressed, to understand these markers of response and resistance.”
Dr. Dixon-Douglas’ hopes for the future
“Breast cancer is a really diverse field. It’s really one of the few cancer types where we have the opportunity to use all of these different treatment modalities, and it’s a really heterogeneous field as well, meaning that every patient’s tumor is unique. So, what excites me about this research is moving from a very general treatment paradigm to a very specific, individualized precision medicine approach.”
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