First children with cancer to begin treatment with revolutionary CAR-T therapy

The first children to receive a game-changing personalised therapy for cancer will start treatment at Great Ormond Street Hospital in London this week | via NHS England

CAR-T is a highly complex new type of immunotherapy which involves collecting and using the patients’ own immune cells to target their cancer in a process which is completed over a number of weeks.

The start of this treatment marks the beginning of a new era of personalised medicine, and forms part of the upgrade in cancer services which will be set out shortly NHS’s long term plan.

In September, NHS England struck the first full access deal in Europe on tisagenlecleucel, which can potentially cure some children with B cell acute lymphoblastic leukaemia (ALL) where other treatments have failed, enabling NICE to recommend the treatment for entry into the reformed NHS Cancer Drugs Fund last week.

The landmark deal with Novartis came less than 10 days after the treatment was granted its European marketing licence and represents one of the fastest funding approvals in the 70 year history of the NHS.

Full story at NHS England

Personalised cancer care

This report considers how a better collection and use of data can significantly improve cancer outcomes | Reform

This report finds that a more effective use of data could bring about much-needed improvements in cancer care. The new model of cancer care proposed in this paper looks at how data could be examined and used at every stage of the treatment journey, from prevention and diagnosis through to treatment and recovery. Making better use of data will not only improve cancer outcomes but will also enable the NHS to manage the disease far more effectively, now, and in the future.

The cancer dashboard, currently run by Public Health England, is an online interface for all cancer related information. Going forward, the authors recommend the dashboard  be extended to become the single point of access for cancer outcomes data in England.

Alongside an improved cancer dashboard, the report also recommends data must be shared effectively and promptly between different stakeholders to ensure patients have the best possible care experience. This is especially important in cancer care as a patient normally interacts with many different parts of the health service.

Full report: A data-driven approach to personalised cancer care | Reform

Discovery in fight against bowel cancer

New research has discovered how a genomic approach to understanding bowel (colorectal) cancer could improve the prognosis and quality of life for patients.

Bowel cancer is the fourth most common cancer in the UK, with 41,200 people newly diagnosed each year. A number of treatment options are available but mortality rates remain high, with bowel cancer the second most common cause of cancer death in the UK.

Researchers at Queen’s University Belfast, in collaboration with the University of Oxford and the University of Leeds have made a significant advance in the treatment of bowel cancer. The study, which has been published in the journal Nature Communications, has shown how defining precise gene signatures within bowel cancer cells can allow us to develop novel prognostic and predictive markers for bowel cancer and help to drive personalised medicine approaches.

Full story via ScienceDaily

Link to the research:  Dunne, P.D. et al. Cancer-cell intrinsic gene expression signatures overcome intratumoural heterogeneity bias in colorectal cancer patient classification. Nature Communications, 2017

Precision medicine trial first of its kind to show benefit to patients

ScienceDaily | Published online: September 23 2016

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A clinical trial for types of advanced cancer is the first of its kind to show that precision medicine — or tailoring treatment for individual people — can slow down the time it takes for a tumor to grow back, according to research presented at the Molecular Analysis for Personalized Therapy (MAP) conference.

Results from the trial, which took place at the Gustave Roussy Cancer Campus in Paris, found that 199 out of 1110 patients with advanced cancer, who had their genes mapped and their treatment tailored, had around 30 per cent longer before their cancer started growing again compared to any of the previous therapies the patients had tried. This ranged from between five and 32 months.

This trial involved patients who had no other treatment options left and who had already tried three or more cancer therapies. The team found potential faulty molecules to target for 411 of these patients and experimental drugs to hit the targets for 199 of these patients.

Read the full commentary here

Pancreatic cancer resists personalized medicine: What researchers are doing to fight back

ScienceDaily. Published online: 4 August 2016

B0007659 Pancreatic cancer cells
Image source: Anne Weston, LRI, CRUK – Wellcome Images // CC BY-NC-ND 4.0

Image shows false colour scanning electron micrograph of pancreatic cancers cells grown in culture.

Researchers are taking a new, patient-directed approach to treating pancreatic cancer. Rather than relying on conventional cell lines that have defined effective drug targets for other types of cancers, they are creating and sequencing cell lines from a cancer patient’s own tissue. Their results reveal that pancreatic tumors are more varied than previously thought and that drug sensitivity is unique to each patient.

In the study, the team turned to a library of cancer drugs, representative of what’s available to patients, and tested each individually against a panel of different cell lines: either conventional pancreatic cell lines, which are often used by researchers and pharmaceuticals, or cell lines that the team developed directly from cancer patients. While conventional pancreatic cell lines were more sensitive to standard drugs used in pancreatic cancer treatment, cell lines from patients were not, with only a “handful” responding to any single-agent treatment.

Read the full commentary here

Read the research abstract here

Relevance of internal time and circadian robustness for cancer patients

Ortiz-Tudela, E. et al. BMC Cancer2016. 16:285

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Image source: Rowena Dugdale, Wellcome Images // CC-BY-NC-ND 4.0

Background: Adequate circadian timing of cancer treatment schedules (chronotherapy) can enhance tolerance and efficacy several-fold in experimental and clinical situations. However, the optimal timing varies according to sex, genetic background and lifestyle. Here, we compute the individual phase of the Circadian Timing System to decipher the internal timing of each patient and find the optimal treatment timing.

Methods: Twenty-four patients (11 male; 13 female), aged 36 to 77 years, with advanced or metastatic gastro-intestinal cancer were recruited. Inner wrist surface Temperature, arm Activity and Position (TAP) were recorded every 10 min for 12 days, divided into three 4-day spans before, during and after a course of a set chronotherapy schedule. Pertinent indexes, I < O and a new biomarker, DI (degree of temporal internal order maintenance), were computed for each patient and period.

Results: Three circadian rhythms and the TAP rhythm grew less stable and more fragmented in response to treatment. Furthermore, large inter- and intra-individual changes were found for T, A, P and TAP patterns, with phase differences of up to 12 hours among patients. A moderate perturbation of temporal internal order was observed, but the administration of fixed chronomodulated chemotherapy partially resynchronized temperature and activity rhythms by the end of the study.

Conclusions: The integrated variable TAP, together with the asynchrony among rhythms revealed by the new biomarker DI, would help in the personalization of cancer chronotherapy, taking into account individual circadian phase markers.

Read the full article here

Cancer tumour genetics reveal possible treatment revolution

Ian Sample. The Guardian Healthcare. Published online: 4th March 2016.

A landmark discovery into the genetic makeup of tumours has the potential to open a new front in the war on cancer, delivering potent therapies that are tailored to individual patients, scientists have said.

The breakthrough comes from research into the genetic complexity of lung and skin cancers which found that even as tumours grow and spread around the body, they carry with them a number of biological “flags” that the immune system can be primed to attack.

Because the flags, which appear as surface proteins, are found only on cancer cells, they provide what scientists described as “exquisite targets” for new therapies that draw on the power of the immune system to combat cancer.

Treatments that harness the immune system have shown great promise against some forms of cancer, such as melanoma, but they do not work in everyone. One approach releases the brakes on the immune system, unleashing the full force of killer T cells, which are otherwise dampened down by cancer cells. But to work, the patient’s immune system must first recognise the cancer as the enemy.

Read the full news article here