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Building consensus for a new approach to breast cancer prevention in women with a BRCA1 mutation

Project description

Exploring preventive treatments for BRCA1 mutation carriers

Women with BRCA1 gene mutations face a 40-fold increased risk of developing breast and ovarian cancers, leading many to opt for drastic preventive surgery while still young. Current drugs like tamoxifen do not prevent aggressive cancers, such as triple-negative breast cancer, which are particularly challenging. This creates a significant unmet need for effective preventive measures. The ERC-funded BRCA-PREVENT project aims to address this gap by exploring progesterone receptor antagonists, such as mifepristone, as potential preventive treatments. The project will also develop DNA methylation markers to monitor treatment efficacy and seek consensus on trial design within the scientific and ethical communities.

Objective

Women with germline mutations in the BRCA1 genes face a 40-fold increased risk of developing breast and ovarian cancer. As a result, and due to a lack of other options, many women with a BRCA1 mutation choose to undergo drastic risk reducing surgery (removal of both breasts, ovaries and Fallopian Tubes) when they are still very young. Drugs currently recommended for prevention of breast cancer, such as tamoxifen or aromatase inhibitors, do not prevent those cancers with the poorest prognosis, such as triple negative breast cancer. Methods to prevent breast and ovarian cancers in these women are therefore a critical unmet medical need.

We and others have identified progesterone as one of the key drivers for triple negative breast cancer development. We have shown that progesterone is consistently elevated during the luteal phase of the menstrual cycle in BRCA1 mutation carriers compared to women without such a mutation, and preliminary data point to progesterone receptor antagonists, such as mifepristone, as a promising class of drugs for primary prevention.

Clinical trials of primary cancer prevention are extremely challenging due to the time-gap between the start of the cancer-preventive treatment and the primary endpoints (i.e. cancer incidence and cancer death). Current tools do not predict the likelihood of future cancer development with sufficient accuracy to be used to determine the preventive efficacy of a new treatment. We have developed DNA methylation markers reflecting tissue age and cell type that are increased in cancer tissue as well as in normal tissue from women with a BRCA1 mutation and could be used to monitor preventive efficacy.

Clinical trials are now required to further investigate the use of antiprogestins for the prevention of breast and ovarian cancer. This ERC Proof of Concept grant aims to bring consensus among the scientific, patient and regulatory/ethical communities regarding the design and conduct of an initial clinical trial.

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Topic(s)

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Funding Scheme

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HORIZON-ERC-POC - HORIZON ERC Proof of Concept Grants

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Call for proposal

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(opens in new window) ERC-2022-POC2

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Host institution

UNIVERSITAET INNSBRUCK
Net EU contribution

Net EU financial contribution. The sum of money that the participant receives, deducted by the EU contribution to its linked third party. It considers the distribution of the EU financial contribution between direct beneficiaries of the project and other types of participants, like third-party participants.

€ 150 000,00
Address
INNRAIN 52
6020 Innsbruck
Austria

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Region
Westösterreich Tirol Innsbruck
Activity type
Higher or Secondary Education Establishments
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Total cost

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Beneficiaries (1)

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