Nice, the National Institute for Health and Care Excellence, has recommended the use of ribociclib, also known as Kisqali for routine use by the NHS in England and Wales, after it was originally made available through the Cancer Drugs Fund.  Their draft guidance recommends ribociclib plus fulvestrant as an option for treating hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative, locally advanced or metastatic breast cancer.  The combination is recommended for adults who have had previous endocrine therapy and where exemestane plus everolimus is the most appropriate alternative treatment.  Ribociclib is to be taken once a day as a pill and is a type of drug called a cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor. These work by inhibiting proteins in cancer cells, and so prevent the cells from dividing and growing.   It is believed that the different side effects of each of the CDK4/6 inhibitors, which are generally less toxic than the combination of exemestane and everolimus, mean that people would like to have a range of treatment options available to them.  Subject to appeal, NICE’s final guidance will be published in March 2021.

Dr Coffelt and his team at the Beatson Institute of the University of Glasgow are investigating the role of a type of immune cell called gamma delta T cells in helping breast cancer spread through the body and received grants from Secondary1st in 2019 and 2020.

Dr Pors and his team at the Institute of Cancer Therapeutics at the University of Bradford received a grant from Secondary1st in October 2019, but the lab was closed for a large part of 2020.  To mark World Cancer Day on February 4^th he tweeted “We are developing tumour-targeted prodrugs & training the next generation of #canceresearch scientists. This is only possible via financial support from @BreastCancerNow, @2ndary1st & Kidscan (https://kidscan.orguk). So grateful.”

NHS England has announced that it is rolling out a new blood test which aims to detect whether some cancer patients are genetically prone to experience more serious effects from some chemotherapy treatments.  These treatments can then be tailored more closely to the patients’ genetic makeup and so avoid the most serious side effects.

Drugs called Fluoropyramidines (including 5-fluorouracil, capecitabine and tegafur), which are used to treat some breast cancers, help to kill cancer cells and are usually broken down quickly by the liver and excreted.  However, some people whose livers do not produce enough of the enzyme DPD (dihydropyrimidine dehydrogenase) to break down these drugs in the body can suffer more serious side effects which can include diarrhoea, vomiting, breathlessness, nausea or extreme skin reactions.  The new genetic test will show if a patient is DPD deficient and so should receive a lower dose or even be given a different drug.  This marks another move towards the development of more personalised cancer treatments.

Sharon was 45 when she was diagnosed with stage 3 breast cancer. She was immediately booked in for a single mastectomy, followed by a course of chemo sessions and radiotherapy. On the day of her surgery when she came round from the general anaesthetic, the first thing she asked for was her lip gloss and a mirror. She was so strong that she got up and changed her clothes. She did not experience sickness and every day she got up as normal and carried on with her life as best she could; she even managed to collect her grandsons from school.

A few months later she and her family got the fantastic news that the cancer had officially gone. However, this soon changed as she began to suffer unusual pain and fatigue. After some scans, she received a diagnosis of secondary breast cancer, but she refused to be fazed. She began to take daily chemo tablets and had a course of radiotherapy on her spine as the cancer was close to her spinal cord. She spent many happy hours doing the things she enjoyed and even walked her daughter down the aisle on her wedding day. She built many lovely memories with her three children and three grandchildren.

In winter 2020 a scan showed up some abnormalities and her chemo was stopped. She began sleeping much more than before. During a home visit, her G.P. decided that she needed to be admitted to hospital. Her family wanted to make sure that she stayed safe there and asked for her to be kept isolated because of the danger of Covid. After a week of treatment, she had regained her strength and was about to be discharged when there was an outbreak of Covid on the ward and she tested positive for the virus. Her consultants told her family that they could not help her if her symptoms got worse, so her family decided to take her home.

She felt well when she got home and even did some online Christmas shopping from her bed. She had five fantastic days laughing and making plans with her family in the run-up to Christmas. She passed away on the sixth day from Covid, leaving her family heartbroken but full of memories of her strength, determination and happiness.

Sharon’s family want to share her story to show that she was able to enjoy a full life while living with secondary breast cancer. They have generously raised money for Secondary1st to help in the search for more effective treatments.

Thanks to our wonderful Donors and Fundraisers Secondary1st has been able to make a second grant of  £65,000 to the research project led by Dr Seth Coffelt at the Beatson Institute at the University of Glasgow.   Dr Coffelt and his team are investigating the role of a type of immune cell called gamma delta T cells in helping breast cancer to spread through the body.  These gamma delta T cells can suppress the immune system and prevent it from destroying cancer cells.  The immune system protects the body  against illness and infection but a tumour can sometimes trick it into ignoring it or even promoting its growth.  The aim of Dr Coffelt’s team is to understand how these gamma delta T cells and other immune cells take part in metastasis or the spread of cancer cells and so develop new immunotherapies that counteract metastatic lesions.

At Secondary1st we appreciate that a great deal of attention has had to be concentrated on the pandemic and the development of effective vaccines to deal with Covid-19, but we also know that it is vital for research into secondary breast cancer to continue.  Secondary1st remains in a stable financial position and ready to continue our mission to increase awareness of and raise more money for research into secondary breast cancer.  We hope that before long life will return to a more normal pattern and that 2021 will be a much better year for everyone.

In these unusual times more and more people are turning to online shopping.  Amazon Smile has the same range of products and costs no more to use than the original Amazon site, but it donates a percentage of the money it receives to charities, so it is an easy way to help Secondary1st .