Research Priorities

A considerable amount of background data supported the selection of each breast cancer research priority. This included stakeholder input obtained before and during the National Breast Cancer Research Summit held in May 2008 and the identification and collation of internationally determined priorities, as well as current and emerging funded research projects in Canada and internationally.

Research priorities were selected through a rigorous, consultative process to ensure agreement that each of these research advances would benefit Canadians and improve Canada’s global competitiveness in cancer research. Suggested areas for investment are presented in two linked ways: as broader overarching themes and as more focused individual research priorities.

The six overarching research themes are:
1. Mechanisms of Cancer Development 4. Cancer Progression and Dissemination
2. Molecular Detection and Prediction 5. Psychosocial, Survivorship and Health Services
3. Personalized Medicine 6. Transferring Knowledge into Practice

The 17 high-impact research priorities, listed here, are itemized by CSO category* and are described in terms of their CSO code.

NOTE: for complete details, refer to Chapter 6 of the National Framework document.

*The Common Scientific Outline is a system used by most research granting agencies to classify and categorize research.

Research Priorities

Description

Cancer is a disease of the genes. This research area will focus on identifying the gene-altering changes underlying cancer initiation and progression. A better understanding of the role played by genetic and epigenetic changes implicated in breast cancer and the discovery of new breast cancer susceptibility genes could lead to better strategies for cancer prevention and treatment.

Cancer initiation is thought to result from alterations to the molecular machinery regulating the normal functioning of cells. This research priority will study these alterations and the factors influencing them, and the consequences of these alterations on breast cancer initiation. The results of this research could be highly clinically relevant through the identification of molecular pathways that could be targeted by new therapeutic interventions to block cancer initiation.

Metastatic breast cancer results in mortality and is still poorly understood. Therefore, gaining a better understanding of the process of invasion of cancer cells throughout the body is critical and should result in the development of new strategies for treatment of metastatic breast cancer.

Research in this priority area will attempt to identify modifiable risk factors implicated in the development of breast cancer. This could lead to the development of new prevention strategies and interventions.

Certain genes or hormonal factors have been linked to the development of breast cancer in some groups of individuals. This research priority explores this link in more detail, and could lead to the development of new interventions  Lumieres ambrees, ambiance zen, atmosphere musicale dont les compilations ont fait le tour du monde, le Buddha-Bar made in Monte-Carlo est un bain regenerant a deux pas du tumulte de la Place du meilleur-casino-en-ligne.info . or treatments to reduce the risk of breast cancer in certain populations.

The interaction of genes with lifestyle factors (gene-environment interaction) could play an important role in breast cancer risk. Research in this priority area will study the interaction of different factors, such as genetic predisposition or exposure to a certain environment, on the risk of developing breast cancer. The results of this research could have an important impact in the development of new breast cancer prevention interventions

Specific factors continue to be identified as influencing the risk of developing breast cancer, particularly in some subpopulations. Research in this priority area will aim to develop new population-based interventions that could be introduced to reduce breast cancer incidence.

This research priority will focus on the development of new approaches to breast cancer screening and on the discovery of new tools leading to more accurate diagnoses and to more personalized treatment of the disease.

Research in this priority will lead to the discovery and validation of new biomarkers. New diagnostic biomarkers will provide critical information for more accurate disease characterization. Predictive biomarkers will forecast patient response to therapy and could lead to the development of new treatment targets.

  1. Subtypes of breast cancer
  2. Predictive markers of response to therapy

Following the discovery of new biomarkers, clinical trials will be required to assess their use in a clinical setting, particularly for some specific subtypes of breast cancer. The results of these trials will have an important impact on the development of new personalized therapeutic strategies by providing predictive information on response to therapy for specific groups of breast cancer patients.

More specific and effective therapies are required for breast cancer patients. This research priority area will focus on the development of better treatments, particularly for some specific subtypes of breast cancer.

Following the discovery of new promising therapies, clinical trials and related companion studies test these new agents on breast cancer patients. Clinical testing and applications of new breast cancer therapies and the assessment of side effects, toxicity and pharmacodynamics is a critical step in the implementation of these therapies.

Research in cancer survivorship covers the range of research domains from basic biomedical (e.g., to understand the underlying mechanisms leading to late effects of treatment modalities); clinical (e.g., to test interventions to ameliorate late effects; health service interventions to improve the quality of survivorship care; randomized trial to improve the evidentiary basis for elements of follow-up care during survivorship); and population studies (e.g., to understand the impact of public health interventions to improve lifestyle factors on the outcomes for cancer survivors).

Research in quality of life could lead to the development of new interventions for improving the quality of life of breast cancer patients across the course of the disease, and promoting psychological adjustment to the diagnosis of breast cancer and to treatment effects.

This area of research examines quality of care, access to care (including timeliness and equity), and factors associated with variations in quality and access. Studies examine the health system requirements to provide optimum quality of care throughout the cancer continuum (from health system requirements to improved screening, reduced wait times for diagnosis, and improved end-of-life care). This research also studies patients’ preferences and needs through the cancer continuum.

In addition, individuals affected by breast cancer and their family/caregivers face economic challenges. Research in this area could focus on the financial implications of a breast cancer diagnosis; it could include an evaluation of the long-term economic and employment implications for breast cancer patients and their families. The results of this research could have an important impact on the development of new health services and care delivery policies.

New initiatives in this area will aim to improve the application of research findings into policy and practice and identify which KT interventions are most effective for breast cancer. An understanding of the barriers to and supports for the successful application of research results to breast cancer is needed. Research will also identify the most effective strategies to implement best practices in breast cancer care. This could include the development of new communication approaches, tools and methods to facilitate, for example, communicating therapeutic options to patients. This research could also have an important impact on breast cancer patients through significant improvement in the translation of research findings into new policies.

Linking data collected during clinical trials with administrative health databases enables long-term studies on survivorship and quality of life issues related to breast cancer treatment. This form of linkage is potentially powerful because data from clinical trials (where patients have been randomly assigned to treatments and where the precise treatment regimens are known) may be linked with administrative health databases providing information about long-term outcomes. For example, a clinical trial conducted in 1990, if linked with administrative health databases running to 2005, could provide 15-year, patient-specific information on outcomes compared to population controls. Research in this area will provide critical information for the development of future therapeutic strategies and better understanding of late effects of treatments.

New animal and cellular models are required to study specific subtypes of breast cancer and their response to treatment as well as breast cancer development and invasion.