Prioritizing Research Questions In Breast Cancer

A team led by Professor Mitch Dowsett, Head of Biochemistry at The Royal Marsden NHS Foundation Trust, based in London and Surrey, together with colleagues from the USA, Switzerland and Italy carried out an international, web-based consultation to identify the most pressing issues that could be tackled by translational research. Translational research - which is concerned with the transfer of findings from the lab to the clinic - holds huge promise for the individualisation of cancer treatment.

In this study, a database of over 4000 potential participants (breast cancer professionals, including clinicians, research scientists, academics and pathologists) was created using attendee details from two major breast cancer conferences, one held in the USA and one in Europe. Participants were asked to register online and then log the most important questions that they felt the research community should tackle.

A steering committee reduced the 409 questions registered to 70 unique issues, from which participants were asked to vote for their 'top six'. In all, 420 participants from 48 countries voted; around half of voters classed themselves as clinicians.

The top research priority found was the identification of molecular signatures to select patients who could be spared chemotherapy. The second most pressing issue also involved chemotherapy, namely the identification of features to help clinicians choose the optimal chemotherapy regimen for individual patients.

While translational research in breast cancer has increased greatly over recent years, individual projects often reflect the immediate interests of the research group, rather than attempting to answer a specific question with potential to alter patient management. Identifying issues deemed important by the research community could help focus translational research resources, ensuring that opportunities for important clinical advances aren't missed.

"This appears to be a novel way to identify the most important challenges for improving breast cancer treatment and prevention" explains Professor Dowsett. "The work will allow investigators globally to select the most relevant clinical research questions in their efforts to translate the major advances in basic science to improvements in the clinical management of this common malignancy. I am grateful to the participants from 48 countries who made this possible."