Implanted Device Could Slow Metastatic Breast Cancer

A small implantable scaffold device was found to effectively capture metastatic cancer cells in mice with breast cancer during a recent study. Also, undergoing surgery prior to the first signs of metastatic disease improved survival, according to a study published in Cancer Research.

The analysis builds on earlier findings from this team showing the efficacy of the device. The scaffold is made of FDA-approved material commonly used in sutures and wound dressings.

“Currently, early signs of metastasis can be difficult to detect,” said study author Jacqueline S. Jeruss, MD, PhD. “Imaging may be done once a patient experiences symptoms, but that implies the burden of disease may already be substantial. Improved detection methods are needed to identify metastasis at a point when targeted treatments can have a significant beneficial impact on slowing disease progression.”

The scaffold is designed to mimic the environment in other organs before the cancer cells have the chance to migrate there. The device attracts the body’s immune cells while the immune cells draw in the cancer cells, limiting the immune cells from migrating to the brain, liver, or lung.

“Typically, immune cells initially colonize a metastatic site and then pave the way for cancer cells to spread to that organ,” said study author Lonnie D. Shea, PhD. “Our results suggest that bringing immune cells into the scaffold limits the ability of those immune cells to prepare the metastatic sites for the cancer cells. Having more immune cells in the scaffold, attracts more cancer cells to this engineered environment.”

On day 5 after tumor initiation in the mice, researchers found a detectable percentage of tumor cells within the scaffold, while none were found in the brain, liver, or lung. The results suggest that the cancer cells hit the scaffold first.

By day 15 after tumor initiation, the results showed 64% fewer cancer cells in the liver, and 75% fewer cancer cells in the brains of mice with scaffolds, compared with mice without scaffolds. Authors noted that these findings suggest that the presence of scaffolds slows the progression of metastatic cancer.

At day 10, the tumors were removed, which was after detection but before substantial spreading. It was found that mice with the scaffold survived longer than the mice without the scaffold. Although surgery was the primary intervention of the study, researchers suggest that additional medical treatments may also be tested as early interventions.

“This study shows that in the metastatic setting, early detection combined with a therapeutic intervention can improve outcomes,” Shea said. “Early detection of a primary tumor is generally associated with improved outcomes. But that’s not necessarily been tested in metastatic cancer.”

Researchers hope that by removing the scaffold and examining the cancer cells within the device, they can use precision medicine techniques to target the treatment most likely to have an impact, according to the study. The authors emphasized that the system is for early detection to initiate treatment, and is not a cure. They added that the scaffold device won’t prevent metastatic disease, or reverse disease progression for patients with established metastatic cancer.

Currently, the researchers are testing the scaffold device in other types of cancer, and plan to develop a clinical trial protocol with the device to monitor metastasis in early-stage breast cancer patients. They hope that eventually, the scaffold could be used to monitor breast cancer in high-risk individuals.