Image shows photomicrograph (magnification X400) of fine needle aspiration from breast in metastatic malignant melanoma.
Oncologists at the Fred Hutchinson Cancer Research Center have successfully treated a patient with metastatic melanoma by combining two different types of immunotherapy. Cassian Yee and colleagues describe their approach in a paper, “Combined IL-21-primed polyclonal CTL plus CTLA4 blockade controls refractory metastatic melanoma in a patient,” that will be published online May 30 in The Journal of Experimental Medicine.
The researchers tested their idea on a 53-year-old patient with multiple metastases who had previously shown little response to either T cell transfers or ipilimumab treatment. The patient now received an infusion of his own antitumor T cells that had been treated with an immune signaling protein, called interleukin-21, that promotes T cell survival. Immediately afterward, the patient received a dose of ipilimumab. Within weeks, the patient’s tumors began to shrink, and they eventually disappeared completely. Yee and colleagues report that, over five years later, the patient remains disease free.
The researchers found that their combined approach boosted the number of antitumor T cells circulating in the patient’s blood in both the short and long term. Moreover, the enhanced immune response induced by this treatment allowed the patient to develop new types of T cells that attacked the melanoma in additional ways, a phenomenon known as epitope spreading.
In this study, painkiller requirements were examined after patients received opiate anaesthesia and non-opiate anaesthesia. A randomised controlled trial was conducted, containing two groups each containing 33 breast cancer patients undergoing a mastectomy or lumpectomy. The study took place between September 2014 and July 2015 at the Jules Bordet Institute, Brussels.
Perioperative non-opiate analgesia was obtained by combining clonidine (0.2 mcg/kg), ketamine (0.3 mg/kg) and lidocaine (1.5 mg/kg). An extra bolus of ketamine (0.2mg/kg) was given if necessary. Opiate analgesia was obtained via a combination of remifentanil infusion, ketamine (0.3 mg/kg) and lidocaine (1.5 mg/kg). Both groups received intravenous paracetamol (1000mg/6h) and intravenous diclofenac (75 mg/12h). Patients received a PCA (patient-controlled analgesia) pump for breakthrough pain during the first 24 hours post-operatively.
Clinical characteristics and post-operative piritramide painkiller consumption (through the patient controlled pump) were assessed during the first 24 hours post-operatively. Data were not complete for two patients in the non-opiate group, and thus a total of 64 patients were included in the study. The total mean piritramide usage 24 hours post-operatively was 8.1 mg (range 2.0-14.5) in the non-opiate group and 13.1 mg (range 6.0-16.0) in the opioid group. The difference observed was statistically significant.
Hundreds of thousands of patients in England are waiting more than a month for radiology test results
A report into NHS services in England by the Royal College of Radiologists (RCR) found three-quarters of hospitals have a backlog for radiology, which includes CT and MRI scans.
Some 126 out of 155 NHS trusts responded to enquiries from the RCR about the state of radiology services.
The report found that on one particular day in February 2016, 230,000 patients had been waiting more than a month for test results. These included at least 12,000 who were waiting for the result of CT or MRI scans, which are often used to diagnose or monitor cancer.
This statistical report presents a range of information on smoking which is drawn together from a variety of sources. The report aims to present a broad picture of health issues relating to smoking in England and covers topics such as smoking prevalence, habits, behaviours and attitudes among adults and school children, smoking-related ill health and mortality and smoking-related costs.
The topics covered include:
Part 1: Smoking patterns in adults
Part 2: Smoking patterns in children
Part 3: Availability and affordability of tobacco
Part 4: Behaviour and attitudes to smoking
Part 5: Smoking-related costs, ill health and mortality
Each part provides an overview of the key findings on these topics, as well as providing links to sources of further information and relevant documents.
The UK Lung cancer screening trial has demonstrated that patients with a high risk of developing lung cancer can be identified with early stage disease and have up to a 73 percent chance of surviving for five years or more. | via Science Daily
The UK Lung cancer screening trial (UKLS) has been successfully completed and demonstrated that patients with a high risk of developing lung cancer can be identified with early stage disease and have up to a 73% chance of surviving for five years or more. The UKLS trial was conducted by experts in the University of Liverpool.
The UKLS was undertaken in partnership with Liverpool Heart & Chest Hospital, Papworth Hospital and the Royal Brompton & Harefield Hospital with the aim of highlighting the need for a screening programme to help benefit people who are at risk of developing lung cancer.
The results of the UKLS trial provide further evidence for the UK National Screening Committee (UKNSC) to consider when making a decision whether to implement a national screening programme in the UK in the future.
Funded by the NIHR Health Technology Assessment programme the trial was the first and only lung cancer screening trial to take place in the UK and has provided in depth information on how to set up a national lung cancer CT screening programme, including using a risk prediction model to identify high risk individuals in the population.
A majority of oncology professionals believe that writing condolence letters to the families of deceased patients is an important component of cancer palliative care, the results of a new survey indicate. | Story via Science Daily
The results of a new survey published in ecancermedicalscience indicate that a majority of oncology professionals believe that writing condolence letters to the families of deceased patients is an important component of cancer palliative care.
The study explored whether institutions should consider changing policies to raise condolence letters to a more official standing.
But because this practice is a personal grace note, it has rarely been studied or discussed. In particular, this issue hasn’t been researched in the UK, where cultural practices surrounding grief are often private.
The sharing of genetic information from millions of cancer patients around the world could be key to revolutionising cancer prevention and care, according to a leading cancer expert from Queen’s University Belfast.
Professor Mark Lawler, from Queen’s University’s Centre for Cancer Research and Cell Biology is corresponding author of a paper published today in the journal Nature Medicine. The paper highlights the potential of ‘big data’ to unlock the secrets inside cancer cells and enable the development of more effective personalised treatments.
Professor Lawler is also Co-Chair of the Cancer Task Team of the Global Alliance for Genomics and Health (GA4GH), which was established in 2013 to create a common framework for the responsible, voluntary and secure sharing of patients’ clinical and genomic data.
GA4GH is a partnership between scientists, clinicians, patients and the IT and Life Sciences industry involving more than 400 organisations in over 40 countries, and has published today’s paper as a blueprint to enable the sharing of patient data to improve patient outcomes.
Gallagher, J. BBC News. Published online: 16 May 2016
In a letter to the prime minister, the charities said many drugs would “now struggle to gain approval”. The medicines regulator has rejected this and said drugs would be approved faster than anywhere else in Europe.
The dispute is over planned changes to the Cancer Drugs Fund – a special pot of money just for cancer medicines. It currently pays for innovative drugs that have been deemed too expensive for the NHS as a whole. It includes medicines such as Kadcyla, which initially cost £90,000 per patient, and extends the lives of women with breast cancer by six months on average. However, the fund was a victim of its own success and has been greatly overspent. Its costs have risen to £340m in 2015-16 from an initial annual budget of £200m when it was set up in 2011.
Diessner, J. et al. BMC Cancer. Published online: 12 May 2016
Image of photomicrograph (magnification X25) showing bone metastases from carcinoma of the breast.
Background: The development of metastases is a negative prognostic parameter for the clinical outcome of breast cancer. Bone constitutes the first site of distant metastases for many affected women. The purpose of this retrospective multicentre study was to evaluate if and how different variables such as primary tumour stage, biological and histological subtype, age at primary diagnosis, tumour size, the number of affected lymph nodes as well as grading influence the development of bone-only metastases.
Methods: This retrospective German multicentre study is based on the BRENDA collective and included 9625 patients with primary breast cancer recruited from 1992 to 2008. In this analysis, we investigated a subgroup of 226 patients with bone-only metastases. Association between bone-only relapse and clinico-pathological risk factors was assessed in multivariate models using the tree-building algorithms “exhausted CHAID (Chi-square Automatic Interaction Detectors)” and CART(Classification and Regression Tree), as well as radial basis function networks (RBF-net), feedforward multilayer perceptron networks (MLP) and logistic regression.
Results: Multivariate analysis demonstrated that breast cancer subtypes have the strongest influence on the development of bone-only metastases (χ2 = 28). 29.9 % of patients with luminal A or luminal B (ABC-patients) and 11.4 % with triple negative BC (TNBC) or HER2-overexpressing tumours had bone-only metastases (p < 0.001). Five different mathematical models confirmed this correlation. The second important risk factor is the age at primary diagnosis. Moreover, BC subcategories influence the overall survival from date of metastatic disease of patients with bone-only metastases. Patients with bone-only metastases and TNBC (p < 0.001; HR = 7.47 (95 % CI: 3.52–15.87) or HER2 overexpressing BC (p = 0.007; HR = 3.04 (95 % CI: 1.36–6.80) have the worst outcome compared to patients with luminal A or luminal B tumours and bone-only metastases.
Conclusion: The bottom line of different mathematical models is the prior importance of subcategories of breast cancer and the age at primary diagnosis for the appearance of osseous metastases. The primary tumour stage, histological subtype, tumour size, the number of affected lymph nodes, grading and NPI seem to have only a minor influence on the development of bone-only metastases.