一种被称为NR2F1的特殊蛋白质可以改善乳腺癌的治疗，并使患者免于不必要的治疗(来源:Syda_Productions/Depositphotos)

    在一项重大突破中，一个国际科学家团队发现了一种蛋白质生物标志物，可以预测转移的乳腺癌患者是处于休眠状态，还是即将走向死亡。这项研究不仅将帮助医生更好地治疗乳腺癌患者，而且还将为在癌细胞转移前刺激其休眠的新疗法指明方向。
乳腺癌仍然是女性中最常见的癌症，虽然早期发现可以有效治疗，但如果允许转移，也会致命。骨髓是乳腺癌扩散过程中最常见的第一个转移点。
目前，医生可以检测患者的骨髓中是否存在残留的播散性肿瘤细胞(DTCs)，但这些标记物并不是判断疾病活动性的最可靠指标。大约60%的可识别的DTCs患者被发现在长达五年或更长时间内没有复发。
这项新的研究开始调查是什么导致这些转移性DTCs休眠多年。令人兴奋的发现是，一种名为NR2F1的特殊蛋白似乎是调节癌细胞活性的关键。当在骨髓癌细胞中发现大量NR2F1时，患者存活时间更长，肿瘤处于休眠状态，但如果在转移癌细胞中发现没有或极少NR2F1，则癌细胞扩散速度更快，患者死亡时间更早。
“这项研究表明，这些患者的生存优势是由于高水平的这种蛋白质，”首席研究员胡里奥·阿吉瑞-高依说。“使用这种蛋白质标记物的测试可以进一步改善乳腺癌的治疗效果，使患者免于不必要的治疗。”识别尚未出现症状的播散性疾病患者，并将其定性为潜在的休眠或转移性复发是一项重大改变。
简单地通过骨髓检测就能有效地鉴别出或多或少具有侵袭性转移特征的病人，这无疑是非常重要的。但是，也许更令人兴奋的是，利用这一过程和诱导睡眠的潜力。其他针对前列腺癌的研究已经表明，增加NR2F1的水平可能会导致该癌症的休眠，并且已经在研究可以上调NR2F1抑制癌症转移的药物。
Aguirre-Ghiso在未来可能的研究方向上说:“这为通过诱导休眠或根除尚未开始转移生长的休眠播散性癌细胞来预防转移的新疗法的试验开辟了道路。”
在短期内，这一生物标志物的发现可以迅速帮助医生评估乳腺癌一旦转移到骨骼的潜在侵袭性。虽然转移性乳腺癌目前没有有效的治疗方法，但这一发现是朝着更好地控制该病迈出的令人兴奋的一步。

该报道发表在《乳腺癌研究》杂志上。

In an outstanding breakthrough, an international team of scientists has discovered a protein biomarker than can predict whether a patient's metastasized breast cancer is dormant or about to turn deadly. The research will not only help doctors better treat patients suffering from breast cancer, but also points to new treatments that may be able to stimulate dormancy in cancer cells before they metastasize.

Breast cancer is still the most frequently appearing cancer seen in women, and while it can be treated effectively if caught early, it is also incredibly deadly if it is allowed to metastasize. Bone marrow is the most common first metastatic point in the spread of breast cancer.

Doctors can currently test a patient's bone marrow for residual disseminated tumor cells (DTCs), but these markers are not the most reliable signifier of how active the disease is. Around 60 percent of patients with identifiable DTCs have been found to remain relapse-free for up to five years or more.

The new study set out to investigate what could be causing these metastatic DTCs to lay dormant for many years. The exciting revelation was that a specific protein, called NR2F1, seemed to be the key to modulating the activity of cancer cells. When a high volume of NR2F1 was found in the bone marrow cancer cells, the patients lived longer and the cancer remained dormant, but if no, or very little, NR2F1 was found in the metastasized cancer cells then the cancer spread faster and the patient died sooner.

"This research shows that the survival advantage in these patients is due to high levels of this protein," says lead researcher Julio Aguirre-Ghiso. "Tests using this protein marker could further improve curative treatment of breast cancer, sparing patients from unnecessary treatments. Identifying patients with disseminated disease that is not yet symptomatic and characterizing it for potential dormancy or metastatic recurrence is a game changer."

The benefits of being able to effectively identify patients with more or less aggressive metastatic characteristics simply through a bone marrow test are undeniably significant. But, perhaps ever more exciting, is the potential for harnessing this process and inducing dormancy. Other studies targeting prostate cancer have already revealed that increasing levels of NR2F1 may induce dormancy in that cancer, and research is already underway into drugs that can upregulate NR2F1 to potentially stifle cancer metastasis.

"This opens the way for testing new treatments that prevent metastasis by inducing dormancy or eradicating the dormant disseminated cancer cells that have not yet initiated metastatic growth," says Aguirre-Ghiso on possible future research directions.

In the short term though, this biomarker discovery can rapidly assist doctors in evaluating the potential aggressiveness of breast cancer once it has metastasized to the bone. While metastatic breast cancer currently has no effective cure, this discovery is an exciting step towards better managing the disease.

The story is published in the journal Breast Cancer Research.

来源:明日情报