Metastatic breast cancer: advanced diagnostics for monitoring treatment

Extending the survival and improving the quality of life of patients with metastatic breast cancer. These are the key objectives of PREMIO COLLAB (Personalised response monitoring in oncology: co-creating clinical trials in advanced breast cancer), a new €8 million international research project funded by Horizon Europe Cancer Mission and UK Research and Innovation. The initiative, led by the University of Odense (Denmark), involves thirteen partners from seven European countries, including the University of Bologna. Diagnostic imaging, particularly in relation to monitoring the response to treatment is at the centre of the work.

"Although molecular imaging has emerged as a highly accurate method, the standard for assessing response to treatment in patients with metastatic breast cancer, it has not been updated for decades: this has a profound impact on treatment options and chances of survival", explains Stefano Fanti, the scientific supervisor of the project and professor at the Department of Medical and Surgical Sciences at the University of Bologna and Director of Nuclear Medicine at the IRCCS Policlinico di Sant'Orsola. "In addition, the patient’s perspective is rarely taken into account, but it is very important for their daily lives to be able to continuously monitor the response to treatment of the disease".

Internationally, there are no specific recommendations for assessing response to treatment in metastatic breast cancer or for the overall management of this important part of care. Even the possibility of reimbursement by national health systems is not consistent across Europe.

To help address this issue, PREMIO COLLAB scientists will conduct a randomised clinical trial comparing two treatment monitoring systems: computed tomography (CT), a conventional imaging technique, and positron emission tomography/computed tomography (FDG-PET/CT), one of the most innovative nuclear medicine tests for diagnosing and monitoring tumours.

The results will enable new participatory research studies to be launched to develop better ways of treating patients. In parallel, solutions based on artificial intelligence in imaging and liquid biopsies will open up new horizons.

"Our work will combine patients' preferences and data on their wellbeing with clinical evidence and economic feasibility," explains Professor Elisabetta Lalumera, Head of the Research Group in the Department for Life Quality Studies. "In this way it will be possible to formulate recommendations for communicating diagnostic choices, for clinicians, and guidelines for reimbursement policies for imaging modalities, for national policy makers".