Better diagnosis: Laura van ’t Veer
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Away from the laboratory, Laura van ’t Veer finds her focus on the water.

The inventor of a gene-based test for breast cancer that can save almost a third of breast cancer patients from unnecessary chemotherapy has rowed her way through more than 25 years of research and development.

“It helps me to relax, to focus,” says Prof van ’t Veer, shortly after finishing a 30km tournament around all of Venice’s islands. “The Vogalonga [tournament] is not about who finishes first, it’s about the fun and the joy and the craziness.”

Professor van ’t Veer’s choice of sport requires the same kind of discipline and perseverance that has marked her out in science.

The co-founder and chief research officer of Agendia, the 14th biggest molecular diagnostic company in the world by revenue, first started working on the molecular diagnostics of breast cancer at the Netherlands Cancer Institute in the late 1980s.

In 2001, Prof van ’t Veer and her team at the Institute identified 70 genes that were key to determining whether a breast cancer was likely to recur.

“My discovery has changed the way diagnostics of breast cancer is done, by not only relying on vectors such as age of a patient and diameter of a tumour, but by looking into the biology of the tumour, the biology of the genes to really understand whether the cancer is aggressive or slow-growing,” Prof van ’t Veer says.

Her work also determined that chemotherapy is not required for slow-growing tumours.

“Depending on the country, a first-diagnosis breast cancer is treated with chemotherapy in 40 per cent to 90 per cent of cases,” she says. “Whereas, with first diagnosis breast cancer, we know it only returns in 23 per cent to 30 per cent of patients . . . You are overtreating the majority.”

But in a minority of cases, doctors were undertreating aggressive cancers because they were judging tumours by size, she adds. “Some of the small tumours were the aggressive type.”

Prof van ’t Veer and her research partner René Bernards co-founded Agendia with the patent for the MammaPrint test, and took it to market in the US in 2004. The test measures the activity of cancer-specific genes in a tissue sample with the help of a microchip. Within 10 days, it predicts how aggressive the cancer will be.

Prof van ’t Veer and her team recently went back to the original sample of 78 women who determined the 70 key genes and found that, even after 25 years, the low risk cancer group had an extremely low recurrence rate.

More than 40,000 women in Europe, the US and parts of South America have now received the test. Breast cancer is the most common form of cancer in women, according to the World Health Organisation, with some 1.7m women diagnosed each year.

Prof van ’t Veer is now focused on finding a way to determine the best treatments for the 30 per cent to 40 per cent of patients who have an aggressive form. The work has led to her team being this year’s recipient of the European Patent Office’s small and medium-sized enterprise inventor award.

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