Over 30 years ago, researchers at the University developed the globally recognised tool, Nottingham Prognostic Index (NPI), for use by clinicians to decide on the risk of breast cancer returning. Following the success of NPI, a new study has led to the development of an enhanced clinical test for breast cancer treatment, available to patients by 2016.

The Nottingham Prognostic Index Plus (NPI+) could significantly improve the way in which patients are treated by giving clinicians more detailed information about a patient’s breast cancer type and its likely behaviour, which will help them create a more personalised treatment plan. As breast cancer is now known to be a biologically complex disease and its various forms can have very different outcomes, the new test has been developed from the existing NPI and incorporates the measurement of 10 proteins (biomarkers) found in breast cancer cells.

The research, funded by the Medical Research Council, was led by Professor Ian Ellis in the University’s Division of Cancer and Stem Cells, in collaboration with colleagues at Nottingham University Hospitals NHS Trust and Nottingham Trent University’s John van Geest Cancer Research Centre.

Professor Ellis said: “Using a panel of 10 biomarkers and other clinical information, we are able to categorise women with breast cancer into one of seven treatment-specific classes based on their personal cancer biology. We believe the categorisation of women with breast cancer into more specific risk classes will deliver better targeting of relevant therapies, which will result in improved outcomes with reduced costs and less anxiety for the patient.

“In addition the ability to give survival prediction will be welcomed by concerned patients. Decisions can be made more quickly reducing waiting times and unnecessary consultation time.”

The NPI+ test was developed using over 1,000 breast cancer samples and was shown to predict both patient survival and patients at risk of treatment failure. This can help doctors to consider additional forms of treatment to improve survival.

Importantly, the technology required to measure protein biomarkers in tumour samples is already in place in most pathology laboratories across the UK, whereas newly developed genetic profiling tests need to be sent to specialist laboratories, which brings additional costs and time delays