@RaceOncology I am wondering if there is potential for Bisantrene to be used as a risk-reducing medication for women at increased risk of breast cancer? I'm assuming that Bisantrene will have to be available orally or through some other efficient mechanism other than intravenously, although I do not know if that is possible.
My thoughts are as follows:
FTO expression & breast cancer riskThere has been a lot of research done to date that has demonstrated the relationship between FTO and breast cancer. FTO is considered a 'powerful' predictor of breast cancer risk, which is likely to do with its expression accross a wide range of different molecular subtypes (ER+, PR+, TNBC, and HER2+)[1].
1.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4680493/#b18
ChemopreventionCurrently in Australia, tamoxifen and raloxifene may be prescribed for women who are at increased risk of breast cancer based on family history of breast cancer and/or presence of the BRCA1/2 genes. Tamoxifen and Raloxifene are also commonly used in the USA for chemoprevention.
Potential MarketTamoxifen and raloxifene are estrogen receptor modulators, which basically means that they ocupy the space of the receptor so circulating estrogen cannot bind to the receptors. Notably, tamoxifen and raloxifene are FDA approved for estrogen receptor (ER) positive cancers. Makes sense, right? If a cancer cell expresses estrogen receptors, then using a drug that occupies the receptor space and stops the binding of estrogen makes sense. Importantly, roughly 60% of people fall into the ER+ category, which leaves approximately 30% of people without a preventative medication for use, since FTO overexpression has been linked with all molecular subtypes (above).
Additional comments
In addition to preventative treatment, an FTO inhibitor could be delivered for years after cancer therapy to prevent the reccurance of breast cancer through suppressing the activity of the FTO protein. The World Health Organisation states that tamoxifen is currently used in the same way for ER+ patients.
Interested to know if this is a possibility.
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