Can a Pill Replace Mammograms?

Researchers at the University of Michigan are working to develop a pill designed to make tumors light up under infrared light. The goal of their research is to help eliminate unnecessary procedures for breast cancer patients.

Nearly one in eight women in the United States will develop invasive breast cancer, according to statistics from BreastCancer.org, a nonprofit organization dedicated to providing the most reliable, complete and up-to-date information about breast cancer for patients and their families.

The organization anticipates 266,120 women in the U.S. will be diagnosed with a form of invasive breast cancer this year. Another 63,960 women will be diagnosed with non-invasive.

Once they are diagnosed, as many as one in three women treated for breast cancer will undergo unnecessary procedures to determine if their tumors are benign or malignant.

While the pill has not yet been tested in humans, the researchers have successfully proven that their concept works in mice.

The study authors were prompted to perform their research after a 2017 study from Denmark showed that nearly a third of breast cancer patients who are treated through surgery or chemotherapy have tumors that are very slow growing or are benign and would never become life-threatening. Other women who have very dense breast tissue are at a disadvantage because mammograms and other imaging do not reveal their deadly tumors.

Hence, the need for imaging on a molecular level.

The researchers hope that the move from mammograms to molecular imaging will help identify cancers that could go undetected.

The visible light used by mammograms does not penetrate the body easily compared to infrared light, which can reach all depths of the breast.

Additionally, infrared light is safer than the radiation of X-ray imaging.

The research team created a specific dye that responds to infrared light when in the presence of a cancerous tumor cell, which would allow researchers to be able to distinguish a malignant tumor from a benign one.

The dye is delivered orally versus through IV -- a step researchers took out of caution over allergic reactions.

The premise of the pill sounded great, but creating the pill was not easy.

Researchers on the project had to create infrared light-responsive molecules that could be absorbed into the bloodstream without negatively affecting their light-responsive properties.

To get what they needed, the study authors teamed up with pharmaceutical company Merck, which also happened to be working on a new drug for cancer and related conditions. Merck's efforts even reached phase II clinical trials showing safety, but they failed to demonstrate effectiveness.

Merck's failure was precisely what the Michigan researchers needed and became their targeting molecule.

They combined it with a molecule that fluoresces under infrared light and tested the combination in lab mice. They saw it travel through both the stomach and the liver unscathed and into the bloodstream.

The researchers then watched the molecule combination light up when they found a tumor in the mice with breast cancer.

In addition to being able to distinguish between the types of tumors, better testing can help get patients into treatment faster.

"There is a lot of testing in the diagnosis of breast cancer. If that time can be shortened and patients can go quickly into treatment, the odds of their survival increase," said Dr. Mona Alqulali, a Bettendorf, Iowa, OB-GYN.

According to Cancer.net, the five-year survival rate of people with cancer in one breast is 99 percent, and 61 percent of cases are diagnosed at this stage. If the cancer has spread to nearby lymph nodes, the five-year survival rate drops to 85 percent.

 

Sources:

Cancer.net. Breast Cancer: Statistics. 20 April 2017.

BreastCancer.org U.S. Breast Cancer Statistics 9 January 2018.

University of Michigan. "Pill for breast cancer diagnosis may outperform mammograms." ScienceDaily. ScienceDaily, 30 April 2018.

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