Combination of new drug and chemotherapy used to treat patients with advanced ovarian and lung cancer

ICR | August 2018 | Drug combination gives ‘exciting’ results in ovarian and lung cancer in early trial

The results of an early clinical trial suggest that a combination of chemotherapy and a new drug could be used to provide treatment for patients with advanced ovarian and lung cancer, where other treatments had failed. 

Scientists from The Institute of Cancer Research, London (ICR), and The Royal Marsden NHS Foundation Trust, decided to test vistusertib, which inhibits the activation of a specific molecule in ovarian cancer cells, to determine if the drug combination was safe for patients, the dosage and its efficacy.  The combination of targeted drug vistusertib along with paclitaxel chemotherapy caused tumours of over 50 per cent of patients with ovarian cancer and over 33 % with lung cancer to shrink, and stopped patients’ cancers from growing for almost six months.

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This far exceeds what is expected with standard treatments in patients with advanced disease who have already had, and have now become resistant to, standard treatment (Source: ICR).

Read the full news release from The Institute for Cancer Research Drug combination gives ‘exciting’ results in ovarian and lung cancer in early trial

In the news:

BBC News Drug cocktail can ‘shrink cancer tumours’

The Times Cancer drug Vistusertib gives hope for terminal patients

NHS70: spotlight on cancer

NHS England |August 2018 |NHS70: spotlight on cancer

More people are surviving cancer than ever before. As we continue to celebrate 70 years of the NHS, we shine the spotlight on some of the key milestones that improved cancer diagnosis, treatment and care over the decades, as well as looking to the future on NHS cancer care.

NHS England will also explore some of the work of the National Cancer Programme, as the NHS implements an ambitious. They have produced a timeline of cancer care improvements in cancer prevention, treatment and care (Source: NHS England).

You can watch the video here:

 

The NHS has played a major role in advancing cancer treatment and care locally, nationally and globally. In this video, we acknowledge some of the key milestones that marked huge improvements in cancer prevention, treatment and care.

 

Full details are available from NHS England 

Data shows that patients diagnosed through screening, GP referral or 2-week referrals are more likely to have more treatment options

Public Health England | August 2018 | New data links route to cancer diagnosis and treatment

 Public Health England (PHE) have released new data which  illustrates how the way that cancer patients are diagnosed may affect their treatment options.

The national data links individual patients’ route to diagnosis, including screening, GP referrals, and emergency presentations, with the treatment patients go on to receive.

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Those diagnosed through screening were likely to have the most treatment options available and receive treatments aimed at curing the cancer, in particular surgery to completely remove the tumour. This strongly supports the benefits of screening as a way of diagnosing cancer early, which evidence suggests leads to better patient outcomes, ultimately saving lives (Source: PHE).

Full news story at PHE

Advancing Care, Advancing Years: Improving Cancer Treatment and Care for an Ageing Population 

Cancer Research UK | June 2018 | Advancing Care, Advancing Years: Improving Cancer Treatment and Care for an Ageing Population 

A new report presents the findings of  research commissioned by Cancer Research UK (CRUK) and conducted by the University of Birmingham’s Health Services Management Centre and ICF International, which sought to understand the specific needs of older patients, and to explore the process of clinical decision-making for older people with cancer across the UK.

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This research involved a literature review, clinical observations at eight case study sites, interviews with 15 national decision-makers and 80 health professionals, and three UK-wide surveys (of primary care professionals, secondary care professionals and older people affected by cancer). The direction of the research was also informed by engagement with a group of older people affected by cancer, and by extensive engagement and interviews with national policymakers.

This research involved a literature review, clinical observations at eight case study sites, interviews with 15 national decision-makers and 80 health professionals, and three UK-wide surveys (of primary care professionals, secondary care professionals and older people affected by cancer). The direction of the research was also informed by engagement with a group of older people affected by cancer, and by extensive engagement and interviews with national policymakers.

The report is available from CRUK 

Prostate cancer ultrasound treatment as effective as surgery or radiotherapy

Using high energy ultrasound beams to destroy prostate cancer tumours may be as effective as surgery or radiotherapy, but with fewer side effects | European Urology | via ScienceDaily

A new study, carried out at six hospitals across the UK, tracked 625 men with prostate cancer who received a type of treatment called high-intensity focused ultrasound (HIFU).

The research, published in the journal European Urology, is the largest ever study of HIFU treatment used to target prostate tumours. The treatment is similar to a ‘lumpectomy’ for other cancers — where doctors remove only tumour cells, leaving as much healthy tissue as possible.

The findings, from a number of institutions including Imperial College London and University College London, found that after five years the cancer survival rate from HIFU was 100 per cent. Approximately, 1 in 10 men needed further treatment. The cancer survival rate from surgery and radiotherapy is also 100 per cent at five years.

The research also showed the risk of side effects of HIFU, such as urinary incontinence and erectile dysfunction, were lower than other treatment options, at 2 per cent and 15 per cent respectively.

Full story at ScienceDaily

Journal reference: Guillaumier, S. et al. | A Multicentre Study of 5-year Outcomes Following Focal Therapy in Treating Clinically Significant Nonmetastatic Prostate Cancer |European Urology, 2018

Hypnosis may help reduce distress of cancer treatment in children

University of Exeter | June 2018 | Hypnosis may help reduce distress of cancer treatment in children

A team at the University of Exeter have worked alongside Devon Integrated Children’s Service to explore ways of  reducing anxiety in children having treatment for cancer without using drugs. According to the authors of the study almost fifty per cent of children with cancer experience clinically significant emotional distress. This can cause additional anguish for the child and for their families and have a long-lasting impact on mental health. As well as looking at the evidence available on hypnosis, the team also reviewed evidence on listening to music, virtual reality and cognitive behavioural therapy. They found much of the research about whether or not these strategies reduced children’s distress to be  contradictory.

Now, the team report  that hypnosis can reduce the distress associated with injections and other needle procedures, such as extracting bone marrow and giving chemotherapy. Earlier research had found that procedures like these are often more anxiety-inducing for children and young people than the cancer itself.
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Tamsin Ford, Professor of Child and Adolescent Psychiatry at the University of Exeter Medical School, said: “Hypnosis is inexpensive to deliver, and our research found that it was the technique that was most studied, and showed promise in reducing children’s anxiety about the many medical procedures they have to endure. We now need high quality trials to be sure whether hypnosis should be adopted in clinics.”(Source: University of Exeter)

An article based on the research’s findings has been published in the journal Psychooncology

Abstract

OBJECTIVE:

Children and young people (CYP) with cancer undergo painful and distressing procedures. We aimed to systematically review the effectiveness of nonpharmacological interventions to reduce procedural anxiety in CYP.

METHODS:

Extensive literature searches sought randomised controlled trials that quantified the effect of any nonpharmacological intervention for procedural anxiety in CYP with cancer aged 0 to 25. Study selection involved independent title and abstract screening and full text screening by two reviewers. Anxiety, distress, fear, and pain outcomes were extracted from included studies. Where similar intervention, comparator, and outcomes presented, meta-analysis was performed, producing pooled effect sizes (Cohen’s d) and 95% confidence intervals. All other data were narratively described. Quality and risk of bias appraisal was performed, based on the Cochrane risk of bias tool.

RESULTS:

Screening of 11 727 records yielded 56 relevant full texts. There were 15 included studies, eight trialling hypnosis, and seven nonhypnosis interventions. There were large, statistically significant reductions in anxiety and pain for hypnosis, particularly compared with treatment as usual . Evidence from nonhypnosis interventions was equivocal, with some promising individual studies. There was high risk of bias across included studies limiting confidence in some positive effects.

CONCLUSIONS:

Evidence suggests promise for hypnosis interventions to reduce procedural anxiety in CYP undergoing cancer treatment. These results largely emerge from one research group, therefore wider research is required. Promising evidence for individual nonhypnosis interventions must be evaluated through rigorously conducted randomised controlled trials.

Full reference:

Nunns, M., Mayhew, D., Ford, T, Rogers, M., Curle, C., Logan, S., Moore, D.|2018| Effectiveness of nonpharmacological interventions to reduce procedural anxiety in children and adolescents undergoing treatment for cancer: A systematic review and meta-analysis| Psychooncology2018 Apr 30|  doi: 10.1002/pon.4749. [Epub ahead of print]

 

Research supports less chemotherapy after bowel cancer surgery

NIHR | June 2018 | Research supports less chemotherapy after bowel cancer surgery

New research funded by the NIHR shows that patients with bowel cancer may only need half of the number of sessions of chemotherapy than they currently receive. The international clinical research trial indicates that people with bowel cancer who are currently given 6 months of chemotherapy may only need three months of treatment (Source: NIHR).
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The full story is available at NIHR 

Background

6 months of oxaliplatin-containing chemotherapy is usually given as adjuvant treatment for stage 3 colorectal cancer. We investigated whether 3 months of oxaliplatin-containing chemotherapy would be non-inferior to the usual 6 months of treatment.

Methods

The SCOT study was an international, randomised, phase 3, non-inferiority trial done at 244 centres. Patients aged 18 years or older with high-risk stage II and stage III colorectal cancer underwent central randomisation with minimisation for centre, choice of regimen, sex, disease site, N stage, T stage, and the starting dose of capecitabine. Patients were assigned (1:1) to receive 3 months or 6 months of adjuvant oxaliplatin-containing chemotherapy. The chemotherapy regimens could consist of CAPOX (capecitabine and oxaliplatin) or FOLFOX (bolus and infused fluorouracil with oxaliplatin). The regimen was selected before randomisation in accordance with choices of the patient and treating physician. The primary study endpoint was disease-free survival and the non-inferiority margin was a hazard ratio of 1·13. The primary analysis was done in the intention-to-treat population and safety was assessed in patients who started study treatment. This trial is registered with ISRCTN, number ISRCTN59757862, and follow-up is continuing.

Findings

6088 patients underwent randomisation between March 27, 2008, and Nov 29, 2013. The intended treatment was FOLFOX in 1981 patients and CAPOX in 4107 patients. 3044 patients were assigned to 3 month group and 3044 were assigned to 6 month group. Nine patients in the 3 month group and 14 patients in the 6 month group did not consent for their data to be used, leaving 3035 patients in the 3 month group and 3030 patients in the 6 month group for the intention-to-treat analyses. At the cutoff date for analysis, there had been 1482 disease-free survival events, with 740 in the 3 month group and 742 in the 6 month group. 3 year disease-free survival was 76·7%  for the 3 month group and 77·1%  for the 6 month group, giving a hazard ratio of 1·006 (0·909–1·114, test for non-inferiority p=0·012), significantly below the non-inferiority margin. Peripheral neuropathy of grade 2 or worse was more common in the 6 month group (237 [58%] of 409 patients for the subset with safety data) than in the 3 month group (103 [25%] of 420) and was long-lasting and associated with worse quality of life. 1098 serious adverse events were reported (492 reports in the 3 month group and 606 reports in the 6 month group) and 32 treatment-related deaths occurred (16 in each group).

Interpretation

In the whole study population, 3 months of oxaliplatin-containing adjuvant chemotherapy was non-inferior to 6 months of the same therapy for patients with high-risk stage II and stage III colorectal cancer and was associated with reduced toxicity and improved quality of life. Despite the fact the study was underpowered, these data suggest that a shorter duration leads to similar survival outcomes with better quality of life and thus might represent a new standard of care.

The findings have now been published in the journal Lancet Oncology where the article can now be downloaded

Full reference:

Iveson, Timothy J et al.| 2018| 3 versus 6 months of adjuvant oxaliplatin-fluoropyrimidine combination therapy for colorectal cancer (SCOT): an international, randomised, phase 3, non-inferiority trial|The Lancet Oncology | Vol. 19| Issue 4| P.  562 – 578