Oral drug treatment helps protect cancer patients from potentially deadly DVT and pulmonary embolism

University of Warwick| May 2018 |Oral drug treatment helps protect cancer patients from potentially deadly DVT and pulmonary embolism

Patients with a diagnosis of cancer are at high risk of developing blood clots. 20 per cent of cancer patients will develop venous thromboembolism (VTE) – either deep vein thrombosis (DVT) or pulmonary embolism (PE). This is due to a number of factors including immobility (if in bed poorly), pancreatic and gastric tumours, and chemotherapy. Because VTE can be life-threatening, blood thinners are used to shrink existing clots and prevent others from forming.

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Currently, international guidelines recommend cancer patients are injected with an anticoagulant (a low molecular weight heparin) to treat and prevent recurrence of VTE. Now scientists from the University of Warwick suggest that taking a tablet a day can help treat cancer patients for a potentially deadly condition.  The results of a large trial run at the University’s  Medical School called ‘select-d’ indicate that a daily tablet could be a beneficial alternative for treating VTE in selected patients, and  that prescribing the oral drug rivaroxaban (Xarelto) significantly reduced venous thromboembolism recurrence among patients with cancer and VTE

 

Lead researcher Professor Annie Young said,

“Clinicians were already adopting the oral drug into practice for non-cancer patients and now they have data from this study to indicate that this form of treatment is an alternative option for many cancer patients who have a clot.” ( Source: University of Warwick).

The full, unedited press release is available from University of Warwick 

6 in 7 women offered Tamoxifen choose not to take it

University of Leeds | April 2018 |Women at increased cancer risk shun preventative tamoxifen therapy

A study published in Breast Cancer Research and Treatment  shows that only 1 in 7 women who were offered Tamoxifen due to a familial history of cancer decided to take it. This new research sought to highlight that women eligible to take the drug were electing not to, it also aimed to explore the reasons behind such decisions. Researchers also found that patients consulted informal networks such as friends and family before making a decision about whether to take Tamoxifen (via University of Leeds) .

Whether the participants had children also had an impact on the decision, the scientists found those with children were more likely to take the drug. One participant explained that taking the drug might affect her ability to care for her children and parents, so decided not to take it.

The study was conducted in collaboration with scientists at the University Hospitals Southampton, University College London, Queen Mary University, University of Leeds and Northwestern University. The research was funded by Cancer Research UK and Yorkshire Cancer Research.

 

Abstract

Purpose Uptake of preventive therapy for women at increased breast cancer risk in England is unknown following the introduction of UK clinical guidelines in 2013. Preventive therapy could create socioeconomic inequalities in cancer incidence if it is more readily accepted by particular socio-demographic groups. In this multicentre study, we investigated uptake of tamoxifen and evaluated socio-demographic and clinical factors associated with initiation. We explored women’s experiences of treatment decision-making using qualitative interview data.
Methods Between September 2015 and December 2016, women (n=732) attending an appointment at one of 20 centres in England to discuss breast cancer risk were approached to complete a survey containing socio-demographic details and nul-
liparity. Of the baseline survey respondents (n equal to 408/732, 55.7% response rate), self-reported uptake of tamoxifen at 3-month follow-up was reported in 258 (63.2%). Sixteen women participated in semi-structured interviews.
Results One in seven (38/258=14.7%) women initiated tamoxifen. Women who had children were more likely to report use of tamoxifen than those without children (OR=5.26; 95%CI: 1.13–24.49, p=0.035). Interview data suggested that women weigh up risks and benefits of tamoxifen within the context of familial commitments, with exposure to significant other’s beliefs and experiences of cancer and medication a basis for their decision.

Conclusions Uptake of tamoxifen is low in clinical practice. There were no socio-demographic differences in uptake, suggesting that the introduction of breast cancer preventive therapy is unlikely to create socioeconomic inequalities in cancer incidence. Women’s decision-making was influenced by familial priorities, particularly having children.

The full article can be downloaded here 

Unexpected weight loss associated with cancer in 10 cancer sites, finds new study

Oxford University | April 2018 | Weight loss is an important predictor of cancer

A team of scientists from  Oxford and Essex Universities conducted a systematic review and meta- analysis to examine all the literature on the association between weight loss and cancer in primary care. This robust study, the first of its kind in this area, demonstrates that unintentional weight loss is the second highest risk factor for colorectal, lung, pancreatic and renal cancers (via Oxford University).

Their analysis of 25 studies,  over 11.5 million patients  -predominantly in primary care 22 of the studies or 92% – used data coded by clinicians in primary care. Four-fifths of these data defined weight loss as a physician’s coding of the symptom; the remainder collected data directly.  An association was  identified with weight loss linked with 10 cancer sites: prostate, colorectal, lung, gastro-oesophageal, pancreatic, non-Hodgkin’s lymphoma, ovarian, myeloma, renal tract, and biliary tree.
This also showed that people aged over 60 with unexpected weight loss have more than 3% chance of having cancer in one of the 10 cancer sites. In females in this age group, the average risk across all sites involved was estimated to be up to 6.7%, and in males up to 14.2%.

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The authors of the study conclude that a a primary care clinician’s decision to code for weight loss is highly predictive of cancer.
The article has been published in the British Journal of General Practice online ahead of print.

Cancers should be recategorised based on tumour types, not location, say American researchers

Liu, J.,  et al | 2018 | An Integrated TCGA Pan-Cancer Clinical Data Resource to Drive High-Quality Survival Outcome Analytics | Cell | 73 | Vol. 2| P. 400-416| e11 | Doi: 10.1016/j.cell.2018.02.052. 

Researchers in the US argue that based on the findings of a study that looked at 33 cancer types in more than 10,000 patients, cancers should in future be categorised according to similarities in tumour types; rather than where they are first formed. The researchers suggest they could reclassified into clusters that shared molecules.

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Abstract

For a decade, The Cancer Genome Atlas (TCGA) program collected clinicopathologic annotation data along with multi-platform molecular profiles of more than 11,000 human tumors across 33 different cancer types. TCGA clinical data contain key features representing the democratized nature of the data collection process. To ensure proper use of this large clinical dataset associated with genomic features, we developed a standardized dataset named the TCGA Pan-Cancer Clinical Data Resource (TCGA-CDR), which includes four major clinical outcome endpoints. In addition to detailing major challenges and statistical limitations encountered during the effort of integrating the acquired clinical data, we present a summary that includes endpoint usage recommendations for each cancer type. These TCGA-CDR findings appear to be consistent with cancer genomics studies independent of the TCGA effort and provide opportunities for investigating cancer biology using clinical correlates at an unprecedented scale.

Highlights:

  • Generation of TCGA Clinical Data Resource for 11,160 patients over 33 cancer types
  • Analysis of clinical outcome endpoints with usage recommendations for each cancer
  • Demonstration of data validity and utility for large-scale translational research

 

In the media: BBC News  Reclassify cancers to improve treatment, researchers say

The full article is available from The Cell 

Brain tumour research: task and finish working group report

Department of Health and Social Care | 2018| Report of the Task and Finish
Working Group on Brain Tumour Research

The conclusions of the Department of Health and Social Care (DHSC) task and finish working group on brain tumour research have been published. The working group comprised clinicians, charities, a patient carer and officials to discuss how to increase the level and impact of research into brain tumours, removing barriers to research and how to generate high-quality research.  It is the first time that research funders have joined together to look at how this area can be developed (DHSC).

 

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Following such a prolonged period of under-funding, the Working Group identified the  of fundable research applications currently being received as a principal issue,
which occurs for many reasons and needs to be tackled systematically.  Therefore, they focused on identifying opportunities for removing barriers and generating  additional high quality research applications. (DHSC)

The full report can be read here 

A new way to slow cancer cell growth

A new way to slow cancer cell growth. | University of Rochester Medical Center | ScienceDaily

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Researchers have identified a new way to potentially slow the fast-growing cells that characterize all types of cancer. By removing a specific protein from cells, they were able to slow the cell cycle, which is out of control in cancer.

The findings, reported in the journal Science were made in kidney and cervical cancer cells and are a long way from being applied in people, but could be the basis of a treatment option in the future.

Researchers identified a protein called Tudor-SN that is important in the “preparatory” phase of the cell cycle – the period when the cell gets ready to divide. When scientists eliminated this protein from cells, using the gene editing technology CRISPR-Cas9, cells took longer to gear up for division. The loss of Tudor-SN slowed the cell cycle.

More on this story:     ScienceDaily

University of Rochester Medical Center

Tracking cancers signaling pathways

Scientists investigate how and why brown pigmented moles turn into malignant melanoma | via ScienceDaily

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Malignant melanoma is one of the most common and dangerous types of cancer. Researchers have investigated how and why brown pigmented moles turn into malignant melanoma using innovative robot technology. The insights gained can simplify methods of diagnosis in the future; furthermore, they suggest that certain cosmetic products and creams should be avoided.

Until now, researchers only knew which genetic mutations were responsible for triggering the transformation of benign pigmented moles into malignant tumours. But little was known about what happens to proteins and signalling pathways when a malignant melanoma develops.

The research group have now discovered that the ADAM10 signalling pathway is activated during the transformation. This pathway is a protein chain that passes the signal from one protein to the next, similar to chasing LED lights. This protein chain is normally inactive in healthy skin and is only activated in an immune response. It is known for its role in psoriasis, rosacea and inflammation, i.e. when the immune system is activated but is also key in the development of malignant melanoma.

Read more at Science Daily

Full reference: Christian Ostalecki, et al. Multiepitope tissue analysis reveals SPPL3-mediated ADAM10 activation as a key step in the transformation of melanocytes. Science Signaling, 2017; 10 (470)