Five Minutes with Associate Professor Elgene Lim
NBCF funded researcher Associate Professor Elgene Lim, researcher at the Garvan Institute of Medical Research, The Kinghorn Cancer Centre and medical oncologist at St Vincent’s Hospital shares the latest updates on breast cancer prevention, diagnosis and treatment.
What are some of the latest advancements in breast cancer research?
The Garvan Institute of Medical Research has one of the biggest breast cancer research programs in Australia. Some significant advancements in breast cancer research from Garvan date back to 1986 when Garvan researchers demonstrated the effect of tamoxifen on breast cancer growth. In 1993, they discovered the role of cyclins in breast cancer (one of the top 20 advances in breast cancer in a decade). This has contributed to the development of one of the latest block buster therapies, CDK4/6 inhibitors, in breast cancer.
More recently, Garvan breast cancer researchers have:
Identified how some ‘oestrogen receptor positive’ breast cancers become resistant to hormone therapy
Discovered that ‘triple-negative breast cancers’ (the most aggressive form of breast cancer) are two distinct diseases that are likely to original from different cell types. They also found a gene that drives the aggressive disease, and are working now to find a way to switch it off.
Uncovered a new way to decrease the spread of breast cancer which could lead to a new combination therapy with the anti-metastasis drug dasatinib.
Discovered a way to sensitise triple negative breast cancers to PARP inhibitors, which have been shown previously only to work on BRCA mutation associated cancers.
In my own work, my team and I have established a biobank of living breast cancer tissue, taken from patients, who we consider vital partners in our research endeavour. It allows us to evaluate new therapies and to explore new ways to overcome resistance to common treatments. A major focus of my team is to better understand the mechanisms of treatment resistance, with a focus on endocrine resistance, and identifying new therapeutic strategies to overcome this.
What are some of the most exciting recent breakthroughs in breast cancer prevention / detection or treatment worldwide?
In terms of screening, the identification of inherited genes (e.g. BRCA1 and BRCA2) that predispose patients to breast cancer which we can now routinely test for has led to a personalised tailoring of screening approaches to these patients. It has also given these patients the option of risk reducing surgery.
There have been many therapeutic breakthroughs in breast cancer that stem from fundamental discoveries in the laboratories in the last decade. These have led to a significant prolongation of life in women with breast cancer. Even in the setting of advanced breast cancer, survival has increased to many years in many patients.
What current clinical trials are running at Garvan? What do they hope to achieve?
As an oncologist and researcher, I’m passionate about getting patients involved in the research process. They can do so by partnering with us through our protocols which allow them to share their valuable breast cancer tissue with researchers. We also have an increasing number of breast cancer trials at St Vincent’s hospital which we encourage our patients to participate in. These offer them another line of therapy they would not otherwise have access to. One of these builds on the Garvan Institute’s infrastructure of being able to genomically characterise the tumour in order to guide therapy.
What role does genomics have in treating breast cancer?
Breast cancer, like all diseases, is a disease of the DNA. Genomics is the study of genes and other information encoded in a person’s DNA. It plays a pivotal role in helping us understand why some people get breast cancer and different responses to therapy. It also help us in our search for novel therapies for people with breast cancer, and Garvan’s ultimate goal of improving patient outcomes.