Israeli research suggests new path to predict and prevent cancer relapses

Specific signs in lung may give early warning of breast cancer relapse, Tel Aviv scholars say, hoping to use the knowledge to avert repeat illness

Nathan Jeffay is The Times of Israel's health and science correspondent

Illustration of metastasis, or metastatic disease, which is the spread of a cancer or other disease from one organ or part of the body to another not directly connected with it. (7activestudio  via iStock by Getty Images)
Illustration of metastasis, or metastatic disease, which is the spread of a cancer or other disease from one organ or part of the body to another not directly connected with it. (7activestudio via iStock by Getty Images)

Israeli scientists say they may have found a new way to predict when cancer patients are poised for a relapse, and develop treatments to avert it.

Tel Aviv University researchers identified a specific pattern of changes in lung tissue that tends to appear before breast cancer patients in remission see the disease metastasize, or spread, to another part of the body.

“We’ve recorded the earliest changes ever seen in the body that enable breast cancer cells to bring about metastasis,” lead researcher Prof. Neta Erez, head of pathology at Tel Aviv University, told The Times of Israel, explaining that she believes the changes set off a domino effect that causes the metastasis.

“We hope to use this research to pave the way for therapeutic interventions that may prevent the changes and therefore prevent metastasis.”

She said that if her research pans out it will allow very early intervention, before metastasis, “which is akin to fighting a fire when it’s just a small spark instead of big flames.”

Erez said that while her study focused on breast cancer, she expects that the changes in the body would be found across cancers, and plans to explore this.

Explaining the background to her research, which has been peer-reviewed and published in the journal eLife, Erez said: “When a woman has breast cancer, the primary tumor is removed and she’s treated with radiotherapy or chemotherapy to remove cells that may have been missed by the surgeon. She will come for follow-up, but it can happen that, say, a couple of years later, there is recurrent disease caused by cells that were in the body for two years.

A woman receiving radiation therapy (iStock)

“This time period is a ‘black box,’ in the sense that any cells that will cause harm are undetectable until they cause metastasis, which is already late for treatment,” she said, “We’re trying to open this black box and understand what happens between the removal of the tumor and the discovery of metastasis.”

Erez and her colleagues Dr. Ophir Shani and Dr. Yael Raz have explored the topic using mice that were modified to mimic the body of recovered breast cancer patients. The mice that had a relapse of cancer experienced specific changes, discernible in the lungs, that take place in fibroblasts, a type of connective tissue.

The researchers validated the findings by analyzing lung tissue of human breast cancer patients who had metastasis.

Professor Neta Erez of Tel Aviv University (courtesy of Tel Aviv University)

Erez said that as she advances her research and achieves a detailed picture of what the changes look like in humans, doctors may be able to look for them and intervene earlier. “Identifying the preparatory processes for the reception of metastases at an early stage may save millions of lives,” she said.

But her biggest hope is that the emerging insights into processes that take place in the body before metastasis will enable her to interfere with the cell changes that prompt these processes.

“We are starting to understand early changes that happen before metastasis, and our hope is that by doing so we can stop the changes from happening, with targeted therapies the likes of which already exist, such as antibodies or small molecules,” she said.

“If we find the protein that is very important in facilitating and enabling tumor cells in their forming of metastasis, the scientific community already has the capability to develop the right therapies. If we block these metastasis-supporting processes, we’re hopefully going to stop the tumor cells from growing.”

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