TOGETHER with the University of Cambridge and Subang Jaya Medical Centre, Cancer Research Malaysia has built the largest genetic and genomic database of Asian breast cancers to date.
Previously, the majority of characterised genomes (the sum total of an organism's DNA) used in breast cancer research were from Caucasian women – less than 5 per cent came from Asians, even though Asians make up more than half of the world's population.
"Genomic information enables us to be more precise in diagnosis, as well as choosing the right treatment for the right patient. It is critical for us to close the gap in Asian genomic research, otherwise we may miss important genetic information that may be rare in Caucasians, but common in Asians," says Cancer Research Malaysia, chief scientific officer, Professor Datin Paduka Dr Teo Soo Hwang.
Through their study, they discovered that Asians are at higher risk of an aggressive type of breast cancer, are more likely to have a mutated TP53 gene, and have an enriched immune tumour profile.
This information opens the door to improving precision medicine for Asian breast cancer patients.
The study published in the prestigious Nature Communications science journal, was a collaboration between Cancer Research Malaysia, Professor Carlos Caldas and Dr Suet-Feung Chin from the Cancer Research UK Cambridge Institute, University of Cambridge and Professor Pathmanathan Rajadurai and Professor Emeritus Datuk Dr Yip Cheng Har from Subang Jaya Medical Centre.
The genomic sequences of 560 breast cancer tumour samples were analysed and it was discovered that the aggressive subtype that expresses the HER2 protein is more common in Asian women compared to Caucasians.
"The HER2 subtype of breast cancer is one of the most aggressive, and it is becoming clear that the risk factors may be different from other types of breast cancer. Our study highlights that Asians have a higher risk of this type of aggressive disease and underscores the need to do more research on Asians so we can save more lives," says Dr Yip.
The research also showed that the TP53 gene - often called the "guardian of the genome" because it protects normal cells from becoming cancer cells - is more commonly altered in Asian breast cancers compared to that of Caucasians.
This genomics map has enabled new thinking about the treatment of breast cancer in Asians. For example, a new clinical trial to test immunotherapy in Asian breast cancer patients already started in July 2020, led by Cancer Research Malaysia, in partnership with oncologists at Universiti Malaya and the National University Hospital Singapore. But more can and should be done.