Category Archives: Oncology

This Is Why Red Peppers Could Reduce Lung Cancer Risk In Smokers

In a new study, researchers from Tufts University in Massachusetts have uncovered the molecular reasoning for beta-cryptoxanthin pigment’s powerful cancer-fighting skills.

red-bell-peppers-1836560_1920-by-pexels-pixabay-free-cc0-lic

Red Bell Peppers — Image courtesy Pexels PIXABAY CC0 Lic

Researchers discovered in 2004 that beta-cryptoxanthin (BCX), a natural pigment which gives many fruits and vegetables their bright red and orange colorings, was able to reduce smokers’ risk of developing lung cancer — although exactly why remained unclear.

Tufts cancer researcher Xiang-Dong Wang and his team found that BCX has the opposite effect of nicotine on lung cells in mice and is able to decrease erratic cell growth in the lung and limit the cancer from spreading. While more research is needed, Wang predicts that understanding BCX’s effect on lung cells could lead to new chemoprevention techniques and could be implemented in dietary recommendations for patients undergoing lung cancer treatment, and for lung cancer survivors.

Read More:  3 Reasons Why Non-Smokers Get Lung Cancer

“For smokers, tobacco product users or individuals at higher risk for tobacco smoke exposure, our results provide experimental evidence that eating foods high in BCX may have a beneficial effect on lung cancer risk,” said Wang in a statement.

Nicotine binds to lung cells, triggering a biochemical response that may lead to erratic cell growth, and new blood vessel development — the perfect storm for lung cancer. However, Wang and his team discovered that BCX is able to counteract this response by inhibiting lung cell growth and preventing cancer cells from spreading to different parts of the body.

In the study, the team observed that mice that had purposely been given a nicotine-derived carcinogen, and which were treated with BCX had fewer lung tumors than those who were not given BCX. According to Wang, the greatest benefit in mice was equivalent to a daily human dose of about 870 micrograms, or the amount contained in one sweet red pepper or a couple of tangerines a day. Also, human lung cancer cells in a petri dish treated with BCX migrated less than those that were not.

The researchers emphasized that their study does not show that BCX has the ability to prevent or cure lung cancer in humans. Still, the results are promising and the team hope to take their research further to better understand the cancer-killing capabilities of red and orange fruits and veggies.

Source: WAng XD, Iskandar AR, Miao B, et al. β-Cryptoxanthin Reduced Lung Tumor Multiplicity and Inhibited Lung Cancer Cell Motility by Downregulating Nicotinic Acetylcholine Receptor α7 Signaling.  Cancer Prevention Research .2016

By Dana Dovey; Displayed with permission from Medical Daily via RePubHub

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Most Women Are Confused About Cancer Screenings

A new survey courtesy of Planned Parenthood finds that many women are unfortunately in the dark about the basics of breast and cervical cancer screenings.
FREE PIXABAY question banner-1090830_1280 CC0 LICThe nonprofit organization teamed up with an independent research institution, NORC at the University of Chicago, to survey over 1,000 adult women across the country this past March. Among other questions, the women were asked about the age they should first get screened for either type of cancer and how often they should return for a follow-up. When it came to cervical cancer, around 70 percent of women said they knew the correct answer to each question, but only nine percent actually got it right for either. For breast cancer, it was even worse, with more than 80 percent saying they understood the correct time frames, but only four percent getting the first question right and 10 percent the second.

For both breast and cervical cancer, the age that an average woman should get their first screening is 21. With cervical cancer, follow-up screenings should happen every three years for women in their 20s, and every three to five years for women ages 30 to 64; with breast cancer, the rate of screenings should be every one to three years, depending on your family history. In particular for breast cancer, women often confused mammograms as the primary form of screening rather than physical breast exams. Thirty percent guessed the first screening should happen at age 40, which is actually the recommended age of the first mammogram, and 55 percent guessed that women under the age of 40 should receive both types of screenings.

“The survey shows that not enough women have accurate information about their recommended cancer screenings,” said Dr. Raegan McDonald-Mosley, Chief Medical Officer for Planned Parenthood Federation of America, in a statement. The survey is the first of its kind commissioned by the organization, which wanted to understand how much women understood about cancer screenings given the updated recommendations issued by health agencies in recent years, according to Planned Parenthood spokesperson, Catherina Lozada.

Additionally, the survey demonstrated that a significant chunk of women haven’t gotten screened at all. Nineteen percent said they hadn’t been checked for cervical cancer, compared to 16 percent who said the same about breast cancer. And 39 percent and 23 percent of women said they weren’t sure when they should next get screened for cervical and breast cancer, respectively. These gaps were especially pronounced among Black and Hispanic women, who were not only less likely to get screened, but expressed facing more barriers to proper health care.

For instance, 42 percent of Hispanic women and 32 percent of Black women said that financial cost made them wary of cervical cancer screenings, compared to only 18 percent of white women. Similarly, these women felt more fearful of the test and of the potential results than their white counterparts. The findings only reaffirm a steady stream of research showing the disparities of cancer care experienced by people of color.

“The unfortunate reality is that women of color in the U.S. face more barriers to accessing health care than white women, and so are less likely to get preventive screenings, more likely to be diagnosed at later stages, and more likely to experience worse health outcomes when it comes to breast and cervical cancer,” explained McDonald-Mosley. Sadly, less than half of the women were aware that the Affordable Care Act has now made all insurance policies cover both types of screening completely free of charge.

“The survey revealed that almost half of women have never encouraged other women in their lives to get screened for cervical cancer, one of the most preventable cancers when caught early,” said McDonald-Mosley. “We hope more women will talk with their loved ones — mother, siblings, aunts, cousins, partners, and friends — about the importance of getting screened for breast and cervical cancer. You can simply ask when the last time they had a check-up was — and if they aren’t going in for screenings, ask what’s preventing them from getting care.”

Read More:  For Cancer Screenings, When Do The Benefits Outweigh The Risks? Read here
Ovarian Cancer Screening May Soon Be Conducted With A Simple Blood Test. Read here

Source:  National Survey of Women’s Knowledge of Recommended Screenings for Breast and Cervical Cancer. Planned Parenthood. 2016.

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IMMUNO-ONCOLOGY: Targeting the immune system, not the tumor

Immuno-oncology is based on the concept of harnessing the body’s own immune system to fight cancer.

One of the most exciting areas of cancer research today is immuno-oncology, and while it’s an approach that scientists first considered more than 100 years ago, recent scientific discoveries and clinical advances have ushered in a truly historical time in cancer research.

Immuno-oncology Video Capture

Image Courtesy of PhRMA (Video Capture)

Recently, PhRMA released a new video highlighting immuno-oncology, which is currently being researched and developed by Bristol-Myers Squibb and several other bio-pharmaceutical companies.

Cancer is clever and has found ways to outwit the immune system. Rather than killing these cancer cells directly with traditional tools like radiation or chemotherapy, immunotherapy seeks to intensify the immune system’s power to eliminate them. Immuno-oncology is already improving outcomes and survival rates for some patients, including melanoma, kidney and lung cancer, and researchers are urgently working to gain new insights into the complex interactions between patients’ immune systems and the cancer cells growing in their bodies with the goal of markedly improving outcomes in many more tumor types.

While the science has advanced rapidly in recent years, there is more work to do. Researchers hope to replace chemotherapy as the first line treatment for many cancers and help as many patients as possible achieve long-term survival. This new treatment approach has the potential to help patients live longer, healthier lives.

Learn more about advancements in science at From Hope to Cures.

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For Cancer Patients, The Possibility Of DNA-Tailored Care

Holly Boehle looked at the expression on the face of her radiologist and knew something was wrong. Boehle had felt a lump just before the holidays and had decided to schedule a mammogram, even though she wasn’t due to start standard screening for another eight years. The mammogram was followed up with an ultrasound, and then a biopsy. Finally, she was given the formal diagnosis: invasive ductal carcinoma, the most common type of breast cancer.

The next week she traveled to Mayo Clinic’s oncology office in Rochester, Minn., where she met with clinical breast surgeon Dr. Judy Boughey who suggested Boehle consider participating in a new, ongoing study. She quickly agreed and became one of 140 women to take part in the Breast Cancer Genome-Guided Therapy Study, affectionately called “BEAUTY.”

By the end of the month, the first phase of the study was underway. Tumor tissue was taken from Boehle, and promptly brought into a lab where the sample was injected into mice with compromised immune systems. With her tumor tissue growing inside of them, the avatar mice are given different chemotherapy drugs in order to test the efficacy of treatment before they try it out on human Boehle.

BEAUTY’s Beginnings

Each patient in BEAUTY was given a biopsy, imaging, and chemotherapy treatment, followed by a second round of biopsy and imaging before they headed into the operating room. This gave researchers information on each patient’s blood and genetic makeup, and the sequencing information for their tumor before, during, and after chemotherapy treatment. The mouse avatars, known as patient xenografts, took up the patient’s individualized tumor 40 percent of the time, ultimately serving as a preview into the patient’s treatment outcome.

DNA Strand Free CCLicenseA class of chemo drug called taxanes are the standard of treatment for breast cancer, but doctors currently don’t have a genetic marker to indicate who will respond to taxane therapy and who won’t. That’s why anthracyclines and cyclophosphamide, a separate chemotherapy drug regimen, are typically given in conjunction as the first step in treatment followed by taxane therapy. However, Boughey’s team reversed the sequence for BEAUTY patients whose mice reacted well to the taxane treatment first. It turned out that those patients who responded best to the flipped treatment sequence also shared the same gene in their genetic makeup.

Based on how her mice reacted to treatment, Boehle was one of those patients who were treated with a reverse chemotherapy schedule than what the typical patient with invasive ductal carcinoma is treated with. Within six months of her diagnosis, Boehle’s tumor shrank considerably as a reaction to the chemotherapy.

Being part of the trial has long-term implications for Boehle, too. If the cancer were to recur, she says, “we would already know…what works for me and what doesn’t. It really opens up a whole new world for me and other breast cancer patients in terms of individualized medicine and knowing that I don’t need to be the person who they experiment on and say, ‘Let’s try this medication or chemotherapy and see if it works and we hope that it does.’”

Four years ago, when Boughey and her team began setting up the BEAUTY study, they wanted to be able to design a treatment plan with a relatively accessible patient population. Because breast cancer is so common among women, the research team chose to start work on individualized medicine with those patients with plans to eventually work their way to other solid tumor cancers such as prostate.

By sequencing the genome for both the tumor and the patient’s inheritable DNA, researchers are able to pull the curtain back and see what’s driving the tumor to grow, why it’s different from another tumor, and how the tumor might react to drug treatments. Harnessing the genetic sequence of a tumor in conjunction with a person’s DNA will allow doctors to expand personalized cancer treatments beyond breast cancer.

Standard of Care Tumor Sequencing

Sequencing a tumor for its complete genetic information can take as little as a few days, and as long as several weeks, depending upon the stage of cancer. Once they have the results, researchers then compare them to a patient’s individual germline cells, which contain hereditary mutations that occur during conception. Patients born with germline mutations can pass on to future generations. Somatic mutations can be caused by a number of different environmental factors and can occur spontaneously. As researchers unravel which gene mutations are responsible for causing each corresponding disease, it sets the foundation for creating individualized treatments through trial-and-error.

“From there potential drugs can be identified that act on genes and/or pathways,” Boughey and her colleague Dr. Matthew Goetz, a clinical oncologist at the Mayo Clinic, told Medical Daily in an email. “One novel aspect of the BEAUTY clinical trial is our ability to link drug response in the patients with both germline and somatic genomic information and validate using the patient derived xenografts [mouse avatars].”

Mayo Clinic’s research team is currently writing the protocol for BEAUTY 2 based on the types of tumors they identified, and the drug resistance and successes discovered in BEAUTY 1. Because they were able to prove mouse avatars, when administered the same drug that patients were treated with, mirror the drug response seen in patients, pharmaceutical companies will be involved with this next stage by designing medications based on study participants’ response to treatment.

BEAUTY, Boughey says, will “drive forward breast cancer treatments for the future.”

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‘Second Cancers’ Are On The Rise, But It’s Kind Of A Good Thing

The number of “second cancer” patients, or individuals who develop two unrelated forms of cancer at different times in their lives, is on the rise. Although the news may sound grim, doctors say the increase is not due to patients’ poor health, but rather a sign that we’re getting better at detecting and beating cancer.

In the United States, nearly one in five new cases of cancer occur in individuals who have already had the disease. That’s a 300 percent increase since the 1970s, The Associated Press reported. While this figure may be startling, the fact remains that no matter what type of cancer a person has had, it’s possible to develop a new, unrelated cancer. According to the American Calab-test-tubes_227ncer Society, increasing numbers of second cancer cases are a sign that advances in early detection and treatment are saving an unprecedented amount of lives. In other words, people getting second cases of cancer means that more people than ever are actually surviving their first case.

Cancer is caused by mutations within the DNA that cause cells to no longer function correctly. These cells may eventually become cancerous. For some, the same mutations that led to the first cancer inevitably spur a second or even third case. This can occur even after the patient has made a full recovery. For example, doctors know women who have the BRCA1 mutation and have already experienced breast cancer are at a higher risk of developing an unrelated type of cancer, such as colon cancer. Because of this genetic risk, these patients will need to be monitored and screened for signs of other cancers for the remainder of their lives.

For others, the treatment that saved their life ends up being the reason their life is once again at risk. For example, although cancer treatments have become effective at destroying cancer without compromising the patient’s health, some treatments, such as radiation treatment, can actually give rise to new mutations and therefore new cancers.

Translational Science ResearchBattling cancer the second time can be trickier than the first because many treatments are ineffective or even deadly when given over a longer period of time.  Along with the medical limitations, experts agree that a second bout of cancer can be mentally difficult for patients to deal with. “I think it’s a lot tougher” for most people, Julia Rowland, director of the federal Office of Cancer Survivorship, told AP. “The first time you’re diagnosed, its fear of the unknown. When you have your next diagnosis, it’s fear of the known.”

Those who have survived past bouts of cancer need to be hypervigilant about cancer screening throughout their lives in order to ensure that if they do develop the disease again, they are able to detect it at the earliest possible stage. Although it may be daunting, patients should remember that cancer treatments are advancing on nearly a daily basis.

By Dana Dovey, Displayed with permission from Medical Daily
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2015: Lung Cancer Research Outside the USA

Female Lung Cancer Deaths to Surpass Breast Cancer in Europe

In January 2015, a study by researchers from Switzerland and Italy revealed that lung cancer deaths among women in Europe would overtake those from breast cancer in 2015.[1] Lung cancer is the most common type of cancer, accounting for 13% of all cancer deaths worldwide. That represents a death toll of 1.6 million people, over 80% of who are tobacco users.[2]  While European men have been more afflicted by the disease due to higher smoking rates, the rates among men have been on the decline in the recent past. Meanwhile, the rates among women have been on an upward trend. This year, the prevalence of lung cancer among women in Europe is expected to rise by 9% over 2009 levels to reach 14.24 per 100,000 of population. Meanwhile, the death rate from breast cancer over the same period will fall by 10.2% to 14.22 deaths per 100,000 of population.[3]

The rise is attributed to the delayed effect of the surge in smoking among European women during the period after the 2nd World War and extending to the late 1960s.[4] The UK is one of the main drivers of this trend. Of all the countries surveyed independently, the UK had the highest level of lung cancer deaths, 21 per 100,000 of population.[5] Professor Carlo La Vecchia of the University of Milan, who is also the lead researcher attributed this to the fact that, “…British women started smoking during the second world war, while in most other EU countries women started after 1968.”

Research Shows Personalized Treatments are Underutilized

An international survey conducted between December and January 2015 revealed that the rates of patients receiving personalized treatment for advanced non-small cell lung cancer (NSCLC) remains low despite a large proportion of them (81%) having been tested for EGFR mutations. The results of the study were released in April in Ingelheim Germany, the seat of the Boehringer Ingelheim Pharmaceutical group which is the main sponsor of the study. The results were collected from 562 oncologists from 10 developed countries across Asia, Europe and North America. In Europe, 30% of advanced NSCLC patients were put on first-line treatment before their test results were ready, displaying a huge disparity with Asia (12%). The average global rates were 25%. The main reasons cited by oncologists for non-testing were insufficient tissue, poor patient fitness and protracted process of acquiring results once samples had been taken. Additionally 51% of all oncologists involved in the study stated that their treatment decisions were not dependent on EGFR mutation subtype of their patients. EGFR mutations are present in 40% of East Asian and 10-15% of white NSCLC patients.[6] ESMO clinical practice guidelines[7] recommend the use of EFGR mutation testing results to guide treatment decisions according to each patient’s specific cancer type as this has been shown to improve survival rates at least with the Del 19 mutation[8], the most common type of mutation.[9]

Sources:
[1] http://annonc.oxfordjournals.org/content/early/2015/01/24/annonc.mdv001.full
[2] http://www.cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-cancer/smoking-facts-and-evidence#smoking_facts0
[3] http://annonc.oxfordjournals.org/content/early/2015/01/24/annonc.mdv001.full
[4] http://www.theguardian.com/society/2014/oct/07/smoking-falls-lowest-level-uk-recording-started-1940s
[5] http://annonc.oxfordjournals.org/content/early/2015/01/24/annonc.mdv001.full
[6] https://www.boehringer-ingelheim.com/news/news_releases/press_releases/2015/17_april_2015_oncology.html

[7] http://annonc.oxfordjournals.org/content/early/2014/08/11/annonc.mdu199.full.pdf+html
[8] Afatinib versus cisplatin-based chemotherapy for EGFR mutation-positive lung adenocarcinoma (LUX-Lung 3 and LUX-Lung 6): analysis of overall survival data from two randomised, phase 3 trials
    Yang, James Chih-Hsin et al., The Lancet Oncology , Volume 16 , Issue 2 , 141 – 151
[9] http://link.springer.com/article/10.1007/s00330-015-3697-0/fulltext.html

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Other Gene Tests for Cancer

Other than the BRCA1 and BRCA2 gene mutation test for breast and ovarian cancer, there are other gene-related tests available for cancer.

As an example, one such test that is available is for Lynch syndrome, a hereditary condition which comes with a family history of colon cancer and other types of cancer at a younger age. Those with the syndrome have a higher risk of colorectal and uterine (womb) cancers.

Like BRCA screening, the genetic screening test for Lynch is expensive and is recommended only for high-risk individuals with a strong family history of such cancers.

Trying to find the Lynch syndrome in the general population would be rather costly and not necessarily helpful, said Dr Lim Sheow Lei, a senior consultant at the department of gynaecological oncology at KK Women’s and Children’s Hospital.

BLOG CTA ButtonRead more about how targeted treatments and translational science research methods are creating better outcomes for patients with cancer

The field of cancer genetics is a rapidly evolving area.   But things are changing quickly.  As genomic technology advances, the cost of sequencing the human genome is plunging, said Dr Lim. Just two weeks ago, a US company announced it was offering a much cheaper and easier way for women to get tested for the BRCA1 and BRCA2 genetic mutations.

Color Genomics* has begun selling a test (USD $249) that it said could accurately analyze a saliva sample for the mutations, as well as check for 17 other genetic variants that have been associated with a somewhat increased risk for cancer of the breast or ovaries.

Cancer can sometimes appear to “run in families” even if it is not caused by an inherited mutation.  Acquired mutations are the most common cause of cancer. These mutations occur from genes damaged during a person’s life. Smoking, viruses, and aging can damage genes and cause these mutations.

One such cancer caused by an acquired mutation is cervical cancFREE MS Art - Cancer Biology Ribboner, which stem from the human papilloma virus (HPV). Last year, the US Food and Drug Administration approved the HPV DNA test, manufactured by Roche, as a first-line primary screening test in women 25 and older. The geno-typing test detects DNA from 14 high-risk HPV types and specifically identifies HPV 16 and HPV 18, which carry the highest risk of cervical cancer. It can be used to help a healthcare professional assess the need for the woman to undergo additional diagnostic testing for cervical cancer. The test can also provide information about the patient’s risk for developing cervical cancer in the future.

Women who test positive for HPV 16 or HPV 18 should have a colposcopy, an examination using a device that illuminates and magnifies the cervix so a doctor can directly observe the cervical cells. Those who test positive for one or more of the 12 other high-risk HPV types should have a PAP smear to determine the need for a colposcopy. In a United States study of more than 47,000 women that compared HPV DNA tests with PAP smear tests, up to one in three women with cervical cancer had a normal PAP smear result.

Scientists and researchers are uncovering more genetic markers for other cancers.  The challenge is to know what to do with these pieces of information, how to interpret the multitude of newly uncovered mutations, work out the associated cancer risks and to manage the risks, said Dr Lim.

(Reprinted with license and permission from The Straits Times by Ng Wan Ching)
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*Information and link for Color Genomics does not constitute our endorsement of or any liability associated with the product, company or service.  Please consult a physician in case you believe you or someone you know may have cancer.

Halozyme: Update Following Type B FDA Meeting

Recent FDA meeting allows for potential marketing application based on progression free survival in pivotal Phase 3 pancreatic cancer study

Halozyme Therapeutics, Inc.,a biotechnology company developing novel oncology and drug-delivery therapies, today announced it plans to proceed with a Phase 3 clinical study (Study 301) of its investigational new drug PEGPH20 in patients with metastatic pancreatic cancer, using a design allowing for potential marketing application based on either progression free survival (PFS) or overall survival. The use of PFS as the basis for marketing approval will be subject to the overall benefit and risk associated with PEGPH20 combined with nab-paclitaxel (ABRAXANE ®) and gemcitabine therapy, including the:

  • Magnitude of the PFS treatment effect observed;
  • Toxicity profile; and
  • Interim overall survival data.

The study will enroll patients whose tumors accumulate high levels of hyaluronan (HA) – a sugar that is sometimes more prevalent in the areas surrounding cancer cells. Halozyme recently discussed the study as part of a planned Type B meeting with the U.S. Food and Drug Administration (FDA).

bullseyeData discussed at the meeting focused on interim results from the company’s randomized Phase 2 study in pancreatic cancer, Study 202, which showed a doubling in median PFS in metastatic pancreatic cancer patients with high levels of HA who were treated with Halozyme’s investigational new drug PEGPH20 combined with nab-paclitaxel (ABRAXANE ®) and gemcitabine (9.2 months vs. 4.3 months in patients treated with nab-paclitaxel ABRAXANE ® and gemcitabine alone). The potential risk profile, including rate of thromboembolic events, was also discussed.  Additional takeaways from the meeting include:

  • Halozyme affirmed plans to enroll and evaluate high-HA patients using a companion diagnostic test; and
  • FDA provided feedback on the current companion diagnostic approach and confirmed that an approved companion diagnostic strategy is required prior to Phase 3 study initiation.

“We are encouraged by the FDA’s feedback and their willingness to consider a novel primary endpoint such as PFS given the high unmet medical need in high-HA metastatic pancreatic cancer,” said Dr. Helen Torley, President and Chief Executive Officer. “We are committed to rapidly finalizing the Phase 3 protocol and developing the companion diagnostic regulatory filings required to initiate Study 301.” Based on this FDA feedback, the company is targeting the end of first quarter 2016 to initiate the Phase 3 study.

About Study 202 & PEGPH20microscope in laboratory
Study 202 (Halo 109-202) is a Phase 2 multi-center, randomized clinical trial evaluating investigational new drug PEGPH20 as a first-line therapy for treatment of patients with stage 4 metastatic pancreatic cancer. The primary outcome of the trial is to measure improvement in progression-free survival in patients receiving investigational new drug PEGPH20 in combination with gemcitabine and nab-paclitaxel compared to gemcitabine and nab-paclitaxel alone. A second primary endpoint will assess the thromboembolic event rate in the PEGPH20 treatment arm. Secondary endpoints also include objective response rate and overall survival. More information may be found at: http://oncologytrials.halozyme.com/pancreatic/.

PEGPH20 is an investigational PEGylated form of Halozyme’s proprietary recombinant human hyaluronidase under clinical development for the systemic treatment of tumors that accumulate hyaluronan. FDA granted orphan drug designation to PEGPH20 for treatment of pancreatic cancer and fast track for PEGPH20 in combination with gemcitabine and nab-paclitaxel for the treatment of metastatic pancreatic cancer. Additionally, the European Commission, acting on the recommendation from the Committee for Orphan Medicinal Products of the European Medicines Agency, designated investigational drug PEGPH20 an orphan medicinal product for the treatment of pancreatic cancer.

About Halozyme
Halozyme Therapeutics is a biotechnology company focused on developing and commercializing novel oncology therapies that target the tumor microenvironment. Halozyme’s lead proprietary program, investigational drug PEGPH20, applies a unique approach to targeting solid tumors, allowing increased access of co-administered cancer drug therapies to the tumor.  PEGPH20 is currently in development for metastatic pancreatic cancer and non-small cell lung cancer and has potential across additional cancers in combination with different types of cancer therapies. For more information, visit www.halozyme.com.

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The Top 5 Recent Breakthroughs in Advanced Lung Cancer Treatment

Ross Camidge MD PHD ATOMICWe might need to look at our back catalogues for treatments we could retrospectively explore for effective predictive biomarkers with our more modern approaches. —D. Ross Camidge, MD, PhD

A countdown of the top 5 breakthrough therapies in the treatment of advanced lung cancer was presented by D. Ross Camidge, MD, PhD, at the 2014 Chicago Multidisciplinary Symposium in Thoracic Oncology. Dr. Camidge is Director, Thoracic Oncology Clinical and Clinical Research Programs, and Associate Director for Clinical Research, University of Colorado Comprehensive Cancer Center, Aurora. He is also the Director for the newly minted ATOMIC Lung Cancer Consortium. He chose the following molecular therapies as his top choices for illustrating what the future of Lung cancer treatment will involve:

#5. Crizotinib

Dr. Camidge chose crizotinib(Xalkori) as a breakthrough therapy “because of how it has exemplified the philosophy of one size does not fit all,” he said.

#4. Second-Generation ALK Inhibitors

The second-generation ALK inhibitors werechosen “not because of their impressive activity post-crizotinib, but because of their progress in accurately defining how we capture data on benefit in central nervous system (CNS) disease,” Dr. Camidge explained.

#3. Third-Generation EGFR Inhibitors

Dr. Camidge identified the third-generation EGFR inhibitors “because of what they are teaching us about understanding acquired resistance in order to effectively treat it,” he said.

#2. PD-1/PD-L1 Antagonists

Dr. Camidge singled out the inhibitors of programmed death receptor 1 (PD-1) and its ligand (PD-L1) as opening the door to immunotherapy but with the open question of whether they will really be a panacea or whether they have the potential to become a truly personalized medicine.

#1. Three Possible Future Breakthroughs

The number 1 spot was shared by three “mini-fantasies” about what future breakthroughs might be, based on the concepts of mining the past, intraoncogene heterogeneity, and affordable incremental benefit.

Explaining his interest in mining the past, Dr. Camidge said, “We have walked away from a large number of targeted agents because they didn’t work when given to otherwise unselected lung cancer populations. However, in almost all of these cases, no attempt at robustly exploring predictive biomarkers was conducted,” he noted.

“Consequently, the classes of drugs may not truly be ineffective, and there may have been evidence of hypersensitive subpopulations ripe for re-exploration,” he continued. “We might need to look at our back catalogues for treatments we could retrospectively explore for effective predictive biomarkers with our more modern approaches.”

As an example, he cited the class of drugs known as death receptor agonists. These drugs “which directly stimulate apoptosis and worked exceptionally well in various preclinical models, were all dropped when a series of randomized phase II studies adding these agents to first-line chemotherapy failed to show an advantage.” But the nonprogressors in the experimental arms approached 15% of the population in several of the studies, he said. “Unfortunately little or no tissue was collected in these studies so no predictive biomarkers could really be explored at the time.”

Dr. Camidge used KRAS as an example of intraoncogene heterogeneity. The most common mutation among adenocarcinomas of the lung, KRAS has been shown in preclinical and clinical studies to have tremendous heterogeneity. The trial design for the FAK inhibitor VS-6063 in KRAS-mutant lung cancer is “at least starting to address this heterogeneity by exploring its benefit in four KRAS-mutant cohorts that have also been characterized with regard to their INK4a and p53 status to see if these contexts alter the response to the drug, based on relevant preclinical data,” Dr. Camidge said.

To explain affordable incremental benefit, he cited the REVEL study, which looked at the addition of ramucirumab (Cyramza), an antibody against VEGFR2, to standard second-line docetaxel. “The addition of ramucirumab increased the response rate from 14% to 30% and the disease control rate from 53% to 64%, increased the progression free survival from 3.0 to 4.5 months, and increased the overall survival from 9.1 to 10.5 months,” Dr. Camidge reported.

“So with an unequivocally positive phase III study, adding a little to all major endpoints, we might want to be using this drug. But only if it, and drugs like it, are affordable, as one recurring problem has been in pricing a breakthrough as if it’s a game-changer and not just a way of offering a little incremental benefit to everyone.” If not affordable, “these minor breakthroughs will never be practical to use in the real world,” he said.

Disclosures: Dr. Camidge has received honoraria from Pfizer, Genentech/Roche, Clovis, Aria, and Eli Lilly.

Reference
Camidge DR: The top five most promising molecular therapies on the horizon. Chicago Multidisciplinary Symposium in Thoracic Oncology. Presented October 31, 2014.

Source/Complete article by Charlotte Bath (The ASCO Post) is available at: http://www.ascopost.com/issues/december-1,-2014/top-5-breakthroughs-in-the-treatment-of-advanced-lung-cancer.aspx

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There May Soon Be A Vaccine For Breast Cancer

A study on a new breast cancer vaccine developed at Washington University School of Medicine in St. Louis has found the treatment to be safe in patients with metastatic breast cancer. According to the press release, the vaccine helped patients’ immune systems attack breast tumor cells and also slowed the cancer’s progression.

By Dana Dovey  Release date: December 1, 2014

Breast cancer is the second most common cancer among American women, surpassed by only skin cancer. It’s estimated that around one in eight American women will develop some form of breast cancer during their lifetime, and sadly, the American Cancer Society estimates that around 40,000 women will succumb to the disease every year. Breast cancer detection and treatment is constantly improving, but with the possibility of a new vaccine, the day we beat breast cancer may be sooner than imagined.

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The vaccine works by helping a patient’s own body fight off breast cancer cells by pushing the immune system to target proteins called mammaglobin-A. These proteins are only found in breast tissue, and express themselves at abnormally high levels when there’s a tumor.  The vaccine prompts the immune system to target and destroy these proteins, which significantly slows breast cancer’s progression.

“Most physician scientists believe that breast cancer vaccines will be most successful for the treatment of patients with early-stage breast cancer, or for prevention of breast cancer in patients who are at high risk for developing breast cancer,” breast cancer surgeon and senior author of the study Dr. William E. Gillanders told Medical Daily in an email. Mammaglobin-A is found in as many as 80 percent of breast cancer cases, he said. “In theory, this means we could treat a large number of breast cancer patients with potentially fewer side effects.”

The phase 1 trial was conducted to test the vaccine’s safety, and researchers were pleased to find that it passed with flying colors. Rash, tenderness at the vaccination site, and mild-flu like symptoms were the worst reactions recorded. “Despite the weakened immune systems in these patients, we did observe a biologic response to the vaccine while analyzing immune cells in their blood samples,” said Gillanders.

It’s important to note that this vaccine did not “cure” the patient’s cancer or cause them to go into remission. “Cancer vaccines are not currently used as a substitute for other therapies — they are typically given in addition to other effective treatments,” Gillanders told Medical Daily.

Now that the vaccine has been shown to be safe for human use, the team will move on to a larger clinical trial. This time, they will use volunteers who were only recently diagnosed with breast cancer, and therefore would have much stronger immune systems. It’s believed that the stronger immune systems may provide even more impressive results.

“If we give the vaccine to patients at the beginning of treatment, the immune systems should not be compromised like in patients with metastatic disease,” Gillanders said. “We also will be able to do more informative immune monitoring than we did in this preliminary trial.”

Still, of the 14 volunteers in this most recent trial, about half showed no cancer progression one year after receiving the vaccine, which Gillanders says suggests “that the cancer growth was slowed — i.e. the progression-free survival was prolonged.”

The team now has the funding needed for the second phase of their study and will soon begin their new trial.

For more information on translational research in breast cancer please visit the ABRCC website.
(Reprinted with license and permission from Medical Daily)RePubHub Banner

 

 

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