Ulipristal Acetate May Prevent Aggressive Breast Cancer, UK Study Suggests
TL/DR –
A study from the UK suggests that progesterone receptor antagonism with ulipristal acetate could help to prevent aggressive breast cancer in high-risk premenopausal women. The research revealed that ulipristal acetate decreased fibroglandular volume and epithelial cell density, thereby reducing the proportion, proliferation, and activity of the luminal progenitor/luminal adaptive secretory precursor (LASP) population. The findings also suggested that women with an increased breast density could benefit most from preventive treatment with an anti-progestin drug.
Ulipristal Acetate: Potential Preventative Treatment for Aggressive Breast Cancer
Aggressive breast cancer prevention in premenopausal women who are at high risk might be possible through progesterone receptor antagonism with ulipristal acetate, according to a UK study published in Nature.
Breast cancer remains the foremost cause of cancer-related death for women worldwide, with the highest mortality rate in the UK. Earlier research indicated basal triple-negative breast cancer’s origination in luminal progenitor cells, suggesting progesterone inhibition could restrict these cells.
In this study, researchers utilised paired vacuum-assisted breast biopsy tissues, blood tests, and MRI scans to evaluate if a 12-week ulipristal acetate treatment could reduce surrogate breast cancer risk markers in 24 premenopausal women with a breast cancer history.
The researchers observed changes in breast tissue, concluding that progesterone indirectly affects breast cancer development through luminal progenitor/luminal adaptive secretory precursor (LASP) cell fraction. The study found that ulipristal acetate lowered fibroglandular volume and epithelial cell density, reducing the luminal progenitor/LASP population’s proportion, proliferation, and activity.
It was inferred that progesterone receptor antagonism remodels the extracellular matrix (ECM), lessening collagen organisation and tissue stiffness. This discovery illuminates the significance of stromal–epithelial interactions in both luminal progenitor/LASP cell maintenance and breast density.
The study also revealed collagen VI, a protein that connects epithelial cells with the ECM, to be significantly downregulated. Moreover, researchers found premenopausal women with dense breasts were more likely to respond to progesterone receptor antagonism.
Progesterone’s Role in Breast Cancer Prevention
The research, led by clinical senior lecturer Dr Sacha Howell from The University of Manchester, suggests that progesterone plays a critical role in breast cancer development, especially in high-risk individuals. The combination of clinical imaging and biological analysis could provide a potent tool against breast cancer. This study paves the way for larger trials to validate the potential of anti-progestins in reducing breast cancer risk.
The team was captivated by how anti-progestins restructure the breast tissue environment at the molecular level, thereby decreasing the number of tumour-initiating cells. Preventive treatment with anti-progestin drugs might benefit women with increased breast density, a known risk factor for breast cancer, the most.
Charities Support Potential of Ulipristal Acetate
The research received funding from charities Breast Cancer Now and Prevent Breast Cancer. Dr Simon Vincent, Breast Cancer Now’s chief scientific officer, stated that high-risk women currently only have options for surgery or long-term hormone therapy to decrease their risk. However, this study on ulipristal acetate signifies an important advancement towards discovering preventative treatments. While the potential of this drug to prevent breast cancer development is clear, he calls for larger, longer-term studies for a comprehensive understanding.
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