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A network is created to bring precision medicine to the treatment of breast cancer, taking into account the genetic and social diversity of the disease in the country | Cyta Agency

The ambitious proposal it proposes joint work between health and science areas and involves institutions and hospitals from Jujuy, Salta, Misiones and Buenos Aires. It seeks to determine, specifically, if certain naturally more aggressive breast tumors are associated with the percentage of Amerindian ancestry typical of the Argentine population and to analyze how to improve access to existing therapies for these tumors. This is one of the winning initiatives of the call for “High Impact Federal Network Projects” of the Ministry of Science of the Nation.

(CyTA-Leloir Agency).- With the aim of generating a scientific-medical structure for cancer research that takes into account the genetic diversity of the Argentine population and that combines clinical research with the social determinants of health, a group of more than 30 researchers, doctors and Technicians from four provinces of the country came together to create the Network for the Study of Diversity in Breast Cancer (REDICAM). The initiative seeks to improve the results and access to treatment for one of the most aggressive subtypes of the tumor that sickens 20,000 women in the country every year and represents the second cause of cancer death in this population.

The proposal, which was one of the winners of the call for “High Impact Federal Network Projects” from the Ministry of Science of the Nation, will obtain the equivalent in pesos of US$ 250,000 per year for four years and is specifically focused on the study of the HER2+ subtype of breast cancer from the perspective of precision medicine applied to public health .

One of REDICAM’s goals is to confirm whether, indeed, women in the north of the country are more likely to develop this type of aggressive tumor than other subtypes, a hypothesis that arises from studies that showed higher rates of HER2+ cases in populations with higher proportion of American Indian ancestry from Colombia and Peru. If that were the case, it is also proposed to analyze how to improve access to existing therapies, in order to correct current inequities.

HER2+ breast cancer is one of the most aggressive and is associated with a worse prognosis. However, it also has a specific treatment, directed against the HER2 protein, which results in a high response rate and improved survival. Although the Argentine health system provides it, the reality is that sometimes it is not administered in a timely manner.

“Precision medicine is not only about generating high-cost drugs designed for certain individuals, but also about developing health policies that take into account the determinants of health, the circumstances in which people live. For that, it is first necessary to know them comprehensively. At present there is a very important vacancy regarding those of our population, and it is something that Argentine science is the only one that can solve”, said the doctor in biochemistry Andrea Llera, a CONICET researcher at the Laboratory of Molecular and Cellular Therapy of the Leloir Institute Foundation (FIL) and general coordinator of the initiative.

“The data and results of this project will be an essential input for the Argentine health system, which will have concrete and solid information to better plan the needs for molecular diagnosis and access to targeted treatment in this subtype of breast cancer and also to include it in the design of policies for the prevention of breast cancer in general,” said Carina Argüelles, a doctor in molecular biology, a researcher at the Catholic University of Misiones (UCAMI), in Posadas, and coordinator of the NEA node of the REDICAM.

The initiative also involves researchers from the Center for the Study of State and Society (CEDES) and the Genomics and Bioinformatics Unit of the Anlis-Malbrán Institute, in Buenos Aires; the Foundation for the Progress of Medicine, in Córdoba; and the Institute of Andean Ecoregions (INECOA) of CONICET, in San Salvador de Jujuy, plus doctors and specialists from the Arturo Oñativia hospital in Salta and Madariaga hospital in Misiones, as well as other health centers in northwest Argentina.

Unlike other regions of the world, Latin America is characterized by a massively mixed population where the ancestral genetic and sociocultural characteristics of the original peoples and migrants converge. “Today it is known that the genetic variability provided by ancestry has a strong impact on health issues, particularly in conferring more or less risk of developing certain diseases. Cancer is one of them. The genetic heterogeneity of our region would indicate that not all the solutions provided by studies in other countries are applicable to ours,” added Llera, who recognized that there are other determinants that modulate genetic risks and influence the appearance and evolution of pathologies. , such as the circumstances in which people are born, grow, work, live and age.

“Assuming that in the regions of our country with the highest prevalence of Indo-American ancestry there would be a higher relative proportion of the HER2+ subtype, our hypothesis is that this would constitute a particularly vulnerable population, since it is more likely to encounter barriers to correct treatment: tumors more aggressive, more expensive specific medication and that requires the determination of the HER2 associated marker in advanced pathology centers, added to the usual difficulties of access to health that this population of Argentina presents”, the authors described in the drafting of the project.

As a first step, REDICAM will carry out a pilot project, which arises from the previous experience of many of its members in the Latin American Cancer Research Network (LACRN). For two years, a cohort of some 900 patients who attend the aforementioned hospitals will be created, to whom a questionnaire will be applied to reveal lifestyles, employment status, socioeconomic and educational level, among other social determinants of health. and a blood sample will be taken from them that will be frozen until processing. A sample of the remaining tumor from the one used for diagnosis will also be taken.

“If the association between Indo-American ancestry and the higher relative proportion of the HER2+ subtype is confirmed, we would be facing a discovery that would modify the vision of breast cancer as of sporadic origin,” concluded Argüelles.

(Left to right) Melisa Paolino, Carina Argüelles, Andrea Llera, Emma Alfaro and Elmer Fernández, part of the group that makes up REDICAM.

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