Not every breast cancer tumour follows the same path to grow.

Some tumours have the assistance of myeloid-derived suppressor cells (MDSCs), a diverse type of immune cell involved in the suppression of the body's response against tumours.

How breast cancer cells recruit MDSCs is not completely understood, but in a paper released in Nature Cell Biology, Baylor College of Medicine researchers report a new mechanism that helps cancer cells engage MDSCs.

"There are alternative paths a tumour may take without the MDSCs, but those cancer cells that take the mTOR path of activity tend to have more MDSCs through the production of granulocyte-colony stimulating factor (G-CSF), which drives the accumulation of MDSCs," said corresponding author Dr Xiang Zhang, a McNair Scholar and assistant professor of molecular and cellular biology at Baylor College of Medicine.

Knowing how cancer cells and MDSCs interact with each other helps researchers understand the events that may lead to tumour growth and metastasis and identify potential therapeutic targets.

For instance, "determining that a patient's tumour is using the mTOR pathway would indicate that the cancer cells are more likely to depend on MDSCs for progression," said Zhang, who also is with the Lester and Sue Smith Breast Center at Baylor.

"This information suggests that, in this case, available therapies for mTOR combined with therapies for MDSCs represent potential therapeutic strategies."

Tumours that do not use the mTOR signalling pathway would not be expected to respond as well to the same therapies.

The discovery of Zhang and colleagues is much in line with the concept of personalised medicine.

"People talk about the specific mutations one patient's tumour has that are not in another patient's tumour. The same type of tumours having different mutations may warrant different treatments; that is personalised medicine," explained Zhang.

"We are trying to come from a different angle. We are trying to enrich this concept by saying that not only tumour-intrinsic characteristics are different from patient to patient, but, related to that, there is also diversity in terms of the immune components. Different tumours may evolve via different characteristics of the tumour and the immune response."

MDCSs are just one type of aberrant immune cell associated with the tumour.

"In addition, there are other immune cells associated with the tumour - monocytes, macrophages, different subsets of T cells - that can either attack or help the tumour. All those cells may vary from patient to patient, and we don't really understand that yet," said Zhang.

In addition, MDSCs also play a role in non-cancer situations.

For instance, in chronic inflammation, these cells try to suppress the inflammation; in this case, they play a pro-health role. So, "simply eliminating all MDSCs to treat cancer may likely result in negative side effects, such as auto-immune disease.

That's why it's necessary to further characterise the diversity, to find the specific subsets of MDSCs that are tumour specific," said Zhang.