Investigation and characterisation of breast cancer, from both a genomic and a microbial perspective - towards precision treatment.

Dr Emer Lynch

Dr Emer Lynch has received a two-year Breakthrough Cancer Clinical Research Fellowship.

Breast cancer is the most common cancer amongst women in Ireland, and is the second most common cause of cancer related deaths for women. In recent years, the treatment landscape for such patients has evolved and mortality has improved considerably, with better survival for those patients diagnosed with advanced cancers, largely due to improved systemic treatment options. However, these therapies have potential toxicities, and even still, will be ineffective for some patients. Oncology as a discipline is moving increasingly towards ‘precision oncology’, treatments tailored for a particular patient at a particular time, to maximise efficacy and minimise toxicity and breast cancer treatments are no different. In order to deliver such targeted treatment, there is a need to better understand both the disease itself and also how it responds to treatment.

There are now numerous targeted therapy options for those with metastatic breast cancer with actionable genetic and tumour-related mutations, however there is minimal specific research on the incidence and sensitivity of such mutations within the Irish population. There has been an expansion of the use of tumour based next generation sequencing (NGS) platforms in this setting, with in-house capabilities available now at the CUH/UCC Cancer Centre. As new treatments are being approved internationally over the last few years based also on liquid-based NGS platforms, there is a need to integrate this approach now into the Irish setting.

With these limitations of current practice in Ireland in mind and supported by the promise of ongoing local research, the focus of Emer’s research will be to further investigate and characterise breast cancer, from both a genomic and a microbial perspective. This will be achieved by collaborating with other centres to collate and interrogate a dataset of the existing genomic information on advanced breast cancer in Ireland, and by developing a prospective clinical trial to establish a liquid biopsy platform for patients with advanced breast cancer, with considerations for cost-efficacy, concordance with tissue-based assays, patient perception of such a process and assessment of the inter-familial microbiome in advanced breast cancer.