A SIMPLE TECHNIQUE MAY BE MOST EFFECTIVE IN PREVENTING HEART DISEASE AFTER RADIATION THERAPY FOR BREAST CANCER

 Women who have breast cancer on their left side present a particular challenge to radiation oncologists. Studies have shown that the risk of heart disease is higher in this group of women after radiation treatment because it can be difficult to ensure that a sufficient dose of radiation is delivered to the left breast while adequately shielding the heart from exposure. New research shows a woman who holds her breath during radiation pulses can greatly reduce radiation exposure to the heart.

"Radiation therapy is commonly prescribed to patients with breast cancer following surgery as a component of first-line therapy," said first author Harriet Eldredge-Hindy, M.D., a Chief Resident and researcher in the Department of Radiation Oncology at Thomas Jefferson University "We wanted to determine how effective breath-hold could be in shielding the heart from extraneous radiation exposure during treatment of the left breast."

Recent studies have shown women with cancer in the left breast are at higher risk of heart disease, and that the risk increases proportionately with the dose of radiation the heart is exposed to during treatment. A number of techniques have been developed to reduce exposure to the heart including prone positioning (lying flat on the belly on a bed that only exposes the left breast), intensity-modulated radiation therapy (IMRT), and accelerated partial breast irradiation. The breath-hold technique allows doctors to monitor a patient's breath for the position that shifts the heart out of the range of the radiation beam.

In the largest prospective study to date, following women for 8 years post treatment, 81 women were asked to hold their breath during radiation treatment for breast cancer- a process that was repeated until therapeutic dose was reached. The researchers found that patients capable of holding their breath over the course of treatment had a 90 percent disease-free survival, and a 96 percent overall survival, with a median reduction in radiation dose to the heart of 62 percent. The findings were published online this week in the journal Practical Radiation Oncology.

"Given that this technique helps to shield the heart during radiation treatment for breast cancer," said Rani Anne, M.D., Associate Professor of Radiation Oncology at Thomas Jefferson University and senior author on the study, "we routinely offer breast cancer treatment with the breath hold technique at Jefferson."

Source: EurekAlert

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