Breast cancer research

Led by Prof Christobel Saunders, the Breast Cancer Research Unit covers four major aspects to assist and guide patient care, including:

• translational research driven by our Biobank in collaboration with national and international researchers 
• medical and surgical oncology clinical trials from prevention through to survivorship. They cover all aspects of cancer, including prevention, diagnosis, treatments, post treatment, survivorship, fertility, end-of-life care, development of drugs and translation of research practice
• supportive care research, such as exercise intervention and enabling young breast cancer survivors to start a family health services research that can help deliver more equitable and effective cancer care to Western Australians 

BRCA-P clinical trial is the first clinical trial in prevention of breast cancer, which was launched in April 2020. So far, we have three active participants on this trial and a few potential patients have expressed their interest to participate.

The BRCA-P study is looking at a new cancer prevention option involving a study medication injection (Denosumab or placebo) every six months for five years. In addition, participants will have a visit with their study doctor every six months, and will have their bone health and quality of life assessed every 12 months while receiving the study medication. These assessments are not typically part of standard medical care for women carrying a BRCA1 mutation. Participants will also continue to be checked by their study team every 12 months for a further five years (total of 10 years).

Denosumab is approved in Australia for the treatment of osteoporosis (60mg, Prolia®) and for the prevention of bone-related problems in adults with bone metastases from cancers (120 mg, XGEVA®). It has not been approved as a prevention medication for people with a mutation in the BRCA1 gene. Its use in this study is experimental.

Eligibility:

• Women with a confirmed BRCA1 gene mutation
• Aged 25-55 years, no evidence of breast cancer clinically and imaging (MRI, mammogram)
• No history of mastectomy
• No history of ovarian cancer

1. Juraskova, I., Laidsaar-Powell, R., Keast, R., Schofield, P., Costa, D. S., Kay, J., ... & Butow, P. (2021). eTRIO trial: study protocol of a randomised controlled trial of online education modules to facilitate effective family caregiver involvement in oncology. BMJ open, 11(5), e043224. doi.org/10.1136/bmjopen-2020-043224

2. Vaidya, J. S., Bulsara, M., Baum, M., Wenz, F., Massarut, S., Pigorsch, Saunders, C. et al (2021). New clinical and biological insights from the international TARGIT-A randomised trial of targeted intraoperative radiotherapy during lumpectomy for breast cancer. British journal of cancer, 1-10. doi.org/10.1038/s41416-021-01440-8

3. Wright, C. M., Moorin, R. E., Saunders, C., Marinovich, M. L., Taylor, D. B., Bourke, A. G., ... & ROLLIS study group. (2021). Cost-effectiveness of radioguided occult lesion localization using 125I seeds versus hookwire localization before breast-conserving surgery for nonpalpable breast cancer. British Journal of Surgery. doi.org/10.1093/bjs/znaa160

4. Taylor, D. B., Bourke, A. G., Westcott, E. J., Marinovich, M. L., Chong, C. Y. L., Liang, R., ... & Saunders, C. M. (2021). Surgical outcomes after radioactive 125I seed versus hookwire localization of non-palpable breast cancer: a multicentre randomised clinical trial. British Journal of Surgery, 108(1), 40-48. doi.org/10.1093/bjs/znaa008

5. Vaidya, J. S., Bulsara, M., Baum, M., Wenz, F., Massarut, S., Pigorsch, S., ... & Tobias, J. S. (2020). Long term survival and local control outcomes from single dose targeted intraoperative radiotherapy during lumpectomy (TARGITIORT) for early breast cancer: TARGIT-A randomised clinical trial. bmj, 370. doi.org/10.1136/bmj.m2836