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.
Two linked papers in The BMJ this week shed new light on the relation of alcohol and diet with breast cancer and heart disease.
The first study reports that high fruit consumption during adolescence may be associated with lower breast cancer risk, while the second study finds that increasing alcohol intake in later life is associated with an increased risk of breast cancer.
Fruit and vegetables are thought to protect against breast cancer, but the evidence is conflicting. Most studies have assessed intakes during midlife and later, which may be after the period when breast tissue is most vulnerable to carcinogenic influences.
So a team of US researchers wanted to see whether fruit and vegetable consumption might affect subsequent breast cancer risk. They followed 90,000 nurses for over 20 years who reported their diet in early adulthood, of whom half also recalled their usual diet during adolescence.
They found that high fruit consumption during adolescence (2.9 v 0.5 servings per day) was associated with a roughly 25% lower risk of breast cancer diagnosed in middle age.
Mohile, S. G. et al. Cancer. Published online: 12 May 2016
In May 2015, the Cancer and Aging Research Group, in collaboration with the National Cancer Institute and the National Institute on Aging through a U13 grant, convened a conference to identify research priorities to help design and implement intervention studies to improve the quality of life and survivorship of older, frailer adults with cancer. Conference attendees included researchers with multidisciplinary expertise and advocates. It was concluded that future intervention trials for older adults with cancer should:
1) rigorously test interventions to prevent the decline of or improve health status, especially interventions focused on optimizing physical performance, nutritional status, and cognition while undergoing cancer treatment;
2) use standardized care plans based on geriatric assessment findings to guide targeted interventions; and
3) incorporate the principles of geriatrics into survivorship care plans.
Also highlighted was the need to integrate the expertise of interdisciplinary team members into geriatric oncology research, improve funding mechanisms to support geriatric oncology research, and disseminate high-impact results to the research and clinical community. In conjunction with the 2 prior U13 meetings, this conference provided the framework for future research to improve the evidence base for the clinical care of older adults with cancer.
NHS pushes forward with ambition to create world class cancer services
The NHS in England has set out its plans to deliver world class cancer services, which includes a fund to find new ways of speeding up diagnosis with the potential to save thousands more lives every year.
The National Cancer Transformation Board has published a wide ranging plan designed to increase prevention, speed up diagnosis, improve the experience of patients and help people living with and beyond cancer.
Scientists have unearthed crucial new genetic information about how breast cancer develops and the genetic changes which can be linked to survival. via Science Daily
The Cancer Research UK funded researchers, from the University of Cambridge, analysed tumour samples from the METABRIC study — which revealed breast cancer can be classified as 10 different diseases — to get a deeper understanding of the genetic faults of these 10 subtypes.
They found 40 mutated genes that cause breast cancer to progress. Only a fraction of these genes were previously known to be involved in breast cancer development. They also discovered that one of the more commonly mutated genes, called PIK3CA, is linked to lower chances of survival for three of the 10 breast cancer subgroups. Crucially, this might help explain why drugs targeting PIK3CA work for some women but not for others.
And the researchers think the results could in the future help find drugs to target these genetic faults, stopping the disease from progressing. The research could also provide vital information to help design breast cancer trials and improved tests for the disease.