Study suggests that breast cancer stem cells reveal information not seen in whole tumors.

Stanford University School of Medicine researchers found 186 genes that together can predict the risk of recurrence in breast cancer patients. The same genes predict the recurrence of prostate cancer, lung cancer, and medulloblastoma.

“These data suggest that there are some fundamental properties of the malignancy that are shared between many types of tumors,” points out Michael Clarke, M.D., the Karel H. and Avice N. Beekhuis professor in cancer biology. The study will be published in the January 18 issue of the New England Journal of Medicine.

Dr. Clarke and his colleagues also found they could predict aggressive cancers with even greater accuracy when they combined the 186-gene signature with another previously identified group of genes in the cells surrounding the tumor.

Stanford scientists say the findings are a significant step toward using insights from cancer stem cell research to develop better tools for diagnosing and treating the disease. “This paper demonstrates, for the first time, the clinical value of isolating pure human cancer stem cells,” notes Irving Weissman, M.D., director of the Stanford Institute for Stem Cell Biology and Medicine. “Mike Clarke and his colleagues have now shown that the human breast cancer stem cell reveals information not evident when the whole tumor is analyzed. We plan to incorporate these findings in our approaches to the care of cancer patients, starting here at Stanford.”

Dr. Clarke has already begun working with surgeons to help translate these findings into tools that will help doctors zero in on the best treatment for individual cancer patients. For instance, he hopes that within five years a surgeon would be able to leave more breast tissue intact in a patient whose genetic profile showed that her tumor was unlikely to return. Likewise, a woman at high risk of relapse would get more aggressive treatment.

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