Arthritis drugs could be repurposed to help prevent breast cancer spreading to bone

GSK initiates phase III start for otilimab in rheumatoid arthritis
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Drugs commonly used to treat arthritis may help to prevent breast cancer spreading to the bone, where it is incurable, new research suggests.

In a study published in Nature Communications, scientists from the Universities of Sheffield and Manchester in the UK propose that NHS arthritis drugs anakinra, canakinumab and sulfasalazine could in future be repurposed to help treat breast cancer, following the discovery of the role of bone marrow in the spread of the disease to the bone.

Largely funded by research and care charity Breast Cancer Now, the study found that bone marrow releases a protein called interleukin 1-beta (IL-1β) which encourages breast cancer cells to form secondary tumours once they reach the bone.

The study established that the process started by this molecule can be blocked by drugs already used in treating arthritis, with anakinra found to be able to prevent breast cancer forming secondary tumours in the bone.

“Discovering that a molecule, known as IL-1β, is responsible for growth of breast cancer in the skeleton is very exciting,” said Dr Penelope D Ottewell, Senior Lecturer in Bone Biology at the University of Sheffield’s Department of Oncology and Metabolism.

“Drugs currently available on the NHS to treat rheumatoid arthritis, including anakinra and canakinumab inhibit activity of IL-1β.

“Our findings indicate that these drugs could be rapidly repurposed to provide benefit to late stage breast cancer patients whose tumours are likely to spread to the bone.”

The growth of breast cancer cells was investigated in the lab and in mice to establish what helps the disease settle and grow in a new location.

They discovered that the molecule IL-1β (which is released by bone marrow) was responsible for helping breast cancer stem cells grow into tumours and these findings were supported using data from patients with secondary breast cancer.

Drugs that can inhibit the action of IL-1β already exist and are used in treating other conditions on the NHS. Research is now ongoing to understand how blocking the action of IL-1β to stop breast cancer spreading may affect the immune system, and whether the drugs currently available could work with existing therapies – including bisphosphonates – to prevent the spread of the disease to the bone.

Lead author Dr Rachel Eyre, from the University of Manchester, said: “We are very excited by our results in the lab showing that breast cancer in bone can be prevented using drugs that are already approved for other diseases.

“We hope it can soon be established whether these drugs can be used for breast cancer patients following successful testing in clinical trials.

“We will now look to see if similar processes are also involved in breast cancer growing in other organs, such as the liver and lungs.

“We hope that by continuing this work, we could in future identify those at high risk of their breast cancer spreading, and where possible use drugs already available to prevent this from happening.”