RESEARCHERS DISCOVER NEW GENETIC ANOMALIES IN LUNG CANCER

ANN ARBOR, Mich. -- Developing effective treatments for lung cancer has been challenging, in part because so many genetic mutations play a role in the disease.

By analyzing the DNA and RNA of lung cancers, researchers at the University of Michigan Comprehensive Cancer Center found that patients whose tumors contained a large number of gene fusions had worse outcomes than patients with fewer gene fusions. Gene fusions are a type of genetic anomaly found in cancers that occurs when genes get rearranged and fuse together.

In addition, the researchers identified several new genetic anomalies that occur in lung cancer, including in patients with a history of smoking.

"Lung cancer is quite a complex disease with many causes. Our deep sequencing analysis found new gene fusions in lung cancers that were negative for the most commonly known fusions. These new anomalies could potentially be targets for developing new treatments," says study author Arul Chinnaiyan, M.D., Ph.D., director of the Michigan Center for Translational Pathology and S.P. Hicks Professor of Pathology at the University of Michigan Medical School.

The study looked at 753 lung cancer samples that represented both smokers and non-smokers. The first 153 samples came from the University of Michigan and were combined with 521 samples from a report published by The Cancer Genome Atlas.

The researchers found 6,348 unique fusions with an average of 13 fusions per tumor sample. Anomalies in two gene pathways were most prevalent: the Hippo pathway, which has previously been linked to some rare cancers, and NRG1, which has not previously been seen in cancer.

The study appears in Nature Communications.

Researchers know that three common gene fusions - involving ALK, RET and ROS - play a role in about 5 percent of lung cancers, but primarily in non-smokers. The new anomalies were found only in patients who did not have ALK, RET or ROS fusions.

"Our results indicate that in the more genomically complex smoking-related lung cancers, gene fusion events appear to be frequent," says study author David G. Beer, Ph.D., John and Carla Klein Professor of Thoracic Surgery and professor of Radiation Oncology at the University of Michigan Medical School and co-director of Cancer Genetics at the U-M Comprehensive Cancer Center.

Drug companies are already investigating drugs that could target the Hippo pathway and NRG1. The research team suggests exploring these inhibitors as potential therapeutics in lung cancer.

In addition, the finding that the number of gene fusions was tied to prognosis suggests that a screen could be developed to help doctors determine how aggressive a patient's tumor is likely to be - and to tailor treatment accordingly.

The study identified many different gene fusions that comprise the landscape of lung cancer, with most occurring in only a small number of individual tumor samples. The Hippo pathway fusions were present in 3 percent of patients and NRG1 fusions in 4 percent. The researchers suggest expanding lung cancer subtypes based on these molecular characteristics.

"We've previously had success in targeting therapies against low-recurrence gene fusions. Large-scale genome analyses like this allow us to identify more of the key drivers of each patient's tumor so that we can match the most appropriate therapies," Chinnaiyan says.

Source: EurekAlert

PANCREATIC CANCER MAY BECOME THE SECOND DEADLIEST CANCER BY 2013. IS THERE A CHANCE TO CHANGE THIS AWFUL PREDICTION?

By 2030, the top cancer killers in the United States will be lung, pancreas and liver, according to a new report published in the American Association for Cancer Research's journal.

Lung cancer is already the top killer overall, but pancreatic and liver cancer will surpass the cancers currently considered the second and third leading causes of death. Right now, second most dangerous is breast cancer for women and prostate cancer for men; and third is colorectal cancer for both men and women.

Researchers looked at trends in cancer incidence and death rates between 2006 and 2010, and used that data -- combined with expected U.S. demographic changes -- to predict numbers for 2030.

The rate of pancreatic cancer has been slowly increasing for the past 15 years. Some of that rise can be attributed to the prevalence of obesity and diabetes.

Many Americans are not aware that the combination of obesity, high-caloric intake and lack of physical activity is the second-leading cause of cancer in the U.S., Indeed, It is linked to at least 12 types of cancer, including pancreatic cancer.  This is an American problem ... If we want to change bad projection of the death rate for pancreatic cancer, it is necessary to increase the investment in education of the population about the importance of changing eating habits and the physical activities to prevent cancer.

You can learn more about how you can prevent the cancer, read my Manual about “Cancer Prevention” 

http://www.amazon.com/Cancer-Prevention-Luis-Mendoza-ebook/dp/B00AXX965Y

Luis Mendoza, MD, PhD

THE COST OF NEW DRUGS FOR BREAST CANCER PATIENTS

The newest recommendation of the American Society of Clinical Oncology (ASCO) 2014 for HER2+ metastatic breast cancer patients recommends the use of new drugs like pertuzumab and T-DM1 for first and second line, respectively.  The Perjecta costs is 6.000 USD a month and for trastuzumab is 4500 USD a month. Thus, the costs for first line (without including the costs for taxotere) will be over 10000 USD a month!. For the T-DM1 (recommended second line), the drug will cost 9800 USD a month! … it is clear that but the costs of such new medicines for uninsured patients or 99% of patients from countries in development will be impossible to afford! I strongly disagree with this!

© Luis Mendoza

RAMUCIRUMAB STEAM AHEAD: NOW LUNG CANCER TRIAL SUCCEEDS

The investigational drug ramucirumab (Lilly) is steaming ahead through clinical development. The company has just announced positive top-line results from a phase 3 trial in non-small cell lung cancer (NSCLC).

This is the third successful pivotal trial for the drug; the other 2 were in gastric cancer. In all of the 3 trials reported so far, it has shown a significant improvement in both overall and progression-free survival.

Two more pivotal trials, in hepatocellular and in colorectal cancer, are in progress, with results expected in 2014. But a large trial in breast cancer has failed.

Ramucirumab is an angiogenesis inhibitor, a targeted antibody that specifically blocks VEGF-2. It is seen as a successor to bevacizumab (Genentech/Avastin), and is predicted by analysts to have similar blockbuster sales potential.

Success in NSCLC Trial

The latest trial, known as REVEL, was a global phase 3 trial in more than 1200 patients with NSCLC (both squamous and nonsquamous) who had progressed after failure of platinum-based chemotherapy. Patients were randomized to received docetaxel alone or docetaxel with ramucirumab.

"REVEL is the first positive phase 3 study of a biologic in combination with chemotherapy to demonstrate improved overall survival compared to chemotherapy alone in second-line NSCLC," the company said.

Full results of this study are due to be presented at an upcoming meeting, and the company plans to submit these data to regulatory authorities in 2014.

Success Also in Gastric Cancer

Ramucirumab is already awaiting approval for use in gastric cancer in both the United States and Europe. That application was based on the just-published REGARD trial, conducted in patients with advanced gastric cancer who had progressed after chemotherapy ( Lancet. 2014;383:31-39). Monotherapy with ramucirumab showed an improvement in overall survival (5.2 vs 3.8 months with placebo), and was hailed by experts as a " new standard of care" when the results were presented at a meeting.

A second trial in gastric cancer, known as RAINBOW, involved a similar patient population and showed that the combination of ramucirumab with paclitaxel was superior to paclitaxel used alone as second-line therapy.

The company says that it plans to also submit these data for approval.

Failed in Breast Cancer

However, a phase 3 trial in breast cancer was not successful. Known as ROSE, this trial compared ramucirumab and docetaxel with placebo and docetaxel as a first-line treatment in 1144 patients with unresectable, locally recurrent, or metastatic HER2-negative breast cancer. It found no improvement in progression-free survival.

Source: medspace

SCIENTISTS QUERY HEALTH RISK OF FOOD PACKAGE CHEMICALS

The health risks of chemicals in plastic bottles are the subject of some debate 

Scientists say "far too little" is known about the health risks of chemicals used in food packaging, and some could cause cancer. 

Research is needed to understand the effect on the human body and embryonic development of at least 4,000 chemicals used in packaging, they said. 

Links between packaging and obesity, diabetes and neurological diseases need to be explored, scientists warned.

But critics have said that the call is alarmist. 

Scientists Jane Muncke, John Peterson Myers, Martin Scheringer and Miquel Porta called for an investigation into the health risks of food packaging in a commentary piece published in the Journal of Epidemiology and Community Health.

'Lifelong exposure' 

They noted that chemicals such as formaldehyde, which they said can cause cancer, were used in many materials, such as plastics used for fizzy-drink bottles and tableware. 

Substances could leach into food, and they added that the risks of "lifelong exposure" to such chemicals were not documented, said the researchers. 

"Whereas the science for some of these substances is being debated and policymakers struggle to satisfy the needs of stakeholders, consumers remain exposed to these chemicals daily, mostly unknowingly," they said. 

But carrying out analysis would not be easy, they said, as there are no unexposed populations for comparison. 

The call for research has attracted criticism. 

Dr Ian Musgrave, senior lecturer in pharmacology at the University of Adelaide, said it was "very hard to take seriously" the claims that formaldehyde in plastic bottles could cause cancer. 

He said it was present in many foods naturally, and to consume as much formaldehyde as that in an apple someone would have to drink "at least" 20 litres of plastic-bottled water. 

Dr Musgrave added: "Obviously the concern about formaldehyde from food packaging is significantly overrated, unless we are willing to place 'potential cancer hazard' stickers on fresh fruit and vegetables."

'High levels of fat' 

Jon Ayres, Professor of Environmental and Respiratory Medicine at the University of Birmingham, said the scientists painted an "alarmist" picture. 

He said there was "no denying" that ingesting lower doses of some substances could "in principle" be harmful, but the issue was how to recognise and quantify any effect. 

Prof Ayres added: "But can these effects really be anything other than modest at worst when few have been recognised to date?"

He said that simply calling for a different approach to the chemicals "does not really help". 

Dr Oliver Jones, lecturer at the RMIT University in Melbourne, Australia, said: "More research is always welcome from a scientist's point of view.

"But I would hazard a guess that the high levels of fat, sugar and salt in a lot of today's processed food are more of a health concern than any migration of chemicals from the packaging."

Source: bbc

iKNIFE DETECTS CANCER CELLS IN TUMOR OPERATIONS

When surgeons remove tumor tissue they try to leave a "margin" of healthy tissue to ensure all the cancer is removed. Sometimes this means the patient has to remain under general anaesthetic for another 30 minutes or so while tissue samples are sent for analysis to check if the margin is clear. Even then, it is still possible that some cancerous tissue remains, and the patient has to undergo further surgery to remove it.

Now, a new technique based on an "intelligent knife," called the "iKnife," promises to remove the need for lab analysis and the accompanying delay, and it also helps avoid repeat surgeries.

The iKnife sniffs the "smoke" created by the electrosurgical removal of cancerous tissue and tells the surgeon almost immediately if the tissue it has come from is healthy or cancerous.

This first study appears online this week in Science Translational Medicine, in which the iKnife is tested in the operating room.

In tissue samples from 91 patients, researchers at Imperial College London using the iKnife achieved 100% accuracy in diagnosing whether the samples were cancerous or not.

Study author Dr. Zoltan Takats is the inventor of the iKnife. Asked if his new surgical tool would be confined to use in only certain types of cancer, he told Medical News Today:

"It is a generally applicable tool, we believe it will be useful for many different types of cancer surgeries."

On the question of cost-effectiveness, Dr. Takats told us:

"We believe that it will be a cost-saver - due to elimination of intraoperative histology, shorter intervention times and lower rate of re-operations."

iKnife combines electrosurgery with new mass spectrometry techniques

The iKnife is a combination of an established technology called electrosurgery that was invented in the 1920s and a new technology that is still emerging, called rapid evaporative ionization mass spectrometry (REIMS).

In electrosurgery, the surgeon's knife delivers an electric current that heats the target tissue and cuts through it while causing minimum loss of blood.

The heat from the current vaporizes the tissue, which gives off a smoke that is normally sucked away with an extractor.

The mass spectrometer technology behind REIMS almost instantly identifies the chemicals present in human tissue by analyzing the smoke that is released during electrosurgery.

Cells produce thousands of metabolites in various concentrations, depeding on their cell type. So once the REIMS technology is primed with the profiles of healthy and cancerous cells, it can rapidly use these to screen the sample of smoke and inform the surgeon whether it is from a tumor or healthy tissue.

Results delivered in under 3 seconds

By comparing the chemical profile of the tissue it is sampling to the reference library, the iKnife can deliver a result in under 3 seconds, say the researchers.

But for this study, the surgeons carrying out the procedures were not allowed to see the nearly instant readings from the iKnife.

The researchers now hope to run a clinical trial that tests whether giving surgeons access to iKnife readings during operations improves outcomes for patients.

Dr. Takats says in a statement:

"These results provide compelling evidence that the iKnife can be applied in a wide range of cancer surgery procedures."

As the technology delivers almost instant results, it allows "surgeons to carry out procedures with a level of accuracy that hasn't been possible before", he adds, noting that they "believe it has the potential to reduce tumor recurrence rates and enable more patients to survive."

Source: Medical News Today