The Trans-EndoNET study will examine the relationship between insulin levels and response to aromatise inhibitors in women with oestrogen receptor-positive, HER2-negative (ER+HER2-) breast cancer. Torbay Hospital and Southampton General Hospital have now opened the study, with a further 30 hospitals expected to begin recruiting patients in the coming months. The study has been funded by a partnership between the UKRI Medical Research Council (MRC) and the National Institute for Health and Care Research (NIHR).
ER+HER2- breast cancer accounts for the majority of breast cancer diagnoses, particularly among post-menopausal women. In these tumours, oestrogen is a key driver of cancer growth, binding to cancer cells and promoting their proliferation. Aromatase inhibitors, such as letrozole, tackle this by lowering oestrogen levels and are given as a standard of care treatment for 5-10 years following surgery for early-stage breast cancer to reduce the risk of recurrence.
However, growing evidence suggests that metabolic factors, including insulin levels, may influence how well patients respond to hormone therapies such as aromatase inhibitors. Type 2 diabetes and elevated insulin levels have been associated with a higher incidence of breast cancer and increased breast cancer-related mortality. Laboratory studies have also shown that high insulin levels can activate a key biological pathway known to drive resistance to hormone treatments, while lowering insulin levels appears to inhibit this pathway and improve treatment response.
“Insulin resistance and metabolic syndrome are increasingly common, particularly in older adults,” said Dr Simon Lord, Director of Oxford Cancer Trials within the Department of Oncology, and Consultant Medical Oncologist at Oxford University Hospitals NHS Foundation Trust.
Read the full story on the Department of Oncology website.