OnCo
ideasIdea

A bone drug to prevent breast cancer in BRCA1 carriers

BRCA1 breast cancers seem to grow from cells driven by the RANK signal. Denosumab blocks it and is already used for bone. A trial is testing whether it prevents these cancers.

RANKL signalling drives progenitor expansion in BRCA1 breast tissue; the BRCA-P trial (ABCSG) randomises BRCA1 carriers to denosumab versus placebo with breast cancer incidence as the endpoint. Propose supporting completion and preparing implementation pathways for a positive result.

Hypothesis
Denosumab reduces breast cancer incidence in BRCA1 carriers by at least 40%.
Rationale
Preclinical and window-of-opportunity data show reduced proliferation in carrier breast tissue.
What would test it
BRCA-P readout; if positive, an implementation study with uptake and adherence endpoints.
Maturity
being tested at scale
Who has to act
research
Cost to try
Large (over $50M)
Years to first evidence
5
Bottlenecks it attacks

Key papers

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