DOCTOR MENDOZA CANCER NEWS : Chronic stress may promoteresistance to lung canc...

DOCTOR MENDOZA CANCER NEWS :
Chronic stress may promoteresistance to lung canc...: Chronic stress may promote resistance to lung cancer therapy Elevated levels of chronic stress hormones, such as those produced by ps...

DOCTOR MENDOZA CANCER NEWS : Symptomsof ovarian cancerIf you regularly experi...

DOCTOR MENDOZA CANCER NEWS :
Symptomsof ovarian cancer
If you regularly experi...: Symptoms of ovarian cancer If you regularly experience any of these symptoms, which are not normal for you, it is important that you ...

The prevention is worth than a cure. Avoid the cancer risks!

 

New hope: Nivolumab Approved for metastatic and unresectable Liver Cancer.

Nivolumab (Opdivo, Bristol-Myers Squibb) has been approved by the US Food and Drug Administration (FDA) for use in the treatment of hepatocellular carcinoma (HCC) in patients who have previously been treated with sorafenib (Nexavar, Bayer).
The immunotherapy is already approved for use in many different cancer types, including melanoma, lung and kidney cancer, and Hodgkin's lymphoma.
This latest indication is an accelerated approval based on tumor response rates and durability of response, as seen in the CheckMate-040 trial, a single-arm phase1/2 trial.
Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials, the company noted.
The trial was conducted in 154 patients with HCC who had progressed on, or were intolerant of, sorafenib.  All patients received nivolumab 3 mg/kg administered intravenously every 2 weeks.

The overall response rate was 14.3% (22 of 154 patients), with 3 patients (1.9%) showing a complete response and 19 patients (12.3%) a partial response. The duration of the responses ranged from 3.2 to 38.2+ months; 91% of those patients had responses of 6 months or longer and 55% had responses of 12 months or longer, the manufacturer noted in a press release.

Gut Microbes May Shape Response to Cancer Immunotherapy

 

New studies indicate that the composition of gut bacteria can influence the effectiveness of certain cancer immunotherapy drugs and that manipulating the gut microbiome may potentially expand the numbers of patients who benefit from cancer immunotherapies.

Programmed cell death protein 1 (PD-1) inhibitors, or so-called immune checkpoint inhibitors, unleash T lymphocyte–mediated immune responses by suppressing the interaction of T inhibitory receptors with ligands on tumor cells. They are highly effective against advanced melanoma, non–small cell lung cancer, and renal cell carcinoma—but only in a minority of patients. Two recent research studies in Science, which examined how patients’ gut microbiomes correlate with their cancers’ response to PD-1 inhibitors, suggest that the gut microbiome may in part account for individual differences in drug efficacy.

Investigators from the Gustave Roussy Cancer Campus in France and their colleagues explored how antibiotics, which can transiently change the composition of the gut microbiome, might affect the outcomes of patients receiving PD-1 inhibitors for the treatment of lung, kidney, or urothelial cancer. In the study. patients who had taken antibiotics for other conditions within 2 months before or 1 month after the first administration of anti–PD-1 therapy had reduced progression-free and overall survival compared with patients who had not taken antibiotics during that time.

The investigators also found that an abundance of the bacterium Akkermansia muciniphila in the gut was associated with the best clinical response to treatment. The species was detectable in 69% and 58% of patients exhibiting a partial response or stable disease, respectively, but only in 34% of patients who progressed or died. In support of these findings, in mice treated with antibiotics, fecal transplants from patients whose cancers responded to anti–PD-1 therapy improved the effectiveness of the therapy after a subsequent tumor challenge. Scientists suspect that the cytokine IL-12, which is released in response to A muciniphila, may help rally T cells to combat cancer.

In a separate study, a team led by researchers at the University of Texas MD Anderson Cancer Center in Houston found that patients whose melanoma responded better to PD-1 inhibitors had greater gut microbe diversity. Furthermore, patients whose microbiomes were enriched with bacteria in the Faecalibacterium genus and the Clostridiales order were more likely to respond to treatment and to experience longer progression-free survival compared with patients whose microbiomes were more enriched with bacteria of the Bacteroidales order.

The former patients tended to have more CD8+ T cells, with enhanced systemic and antitumor immunity, whereas the latter had higher levels of circulating regulatory T cells, myeloid-derived suppressor cells, and a blunted cytokine response, resulting in dampening of antitumor immunity. In addition, a favorable microbiome was associated with increased antigen processing and presentation by immune cells at cancer sites.

 “Though some data were available linking diversity and composition of the gut microbiome to other forms of cancer treatment, these papers are the first to demonstrate that diversity and signatures within the gut microbiome may modulate responses to immune checkpoint blockade in patients across cancer types.

Additional research is needed to uncover the precise mechanisms by which bacterial strains exert such profound immunomodulatory effects in the body. The studies’ results also raise a number of questions: should physicians profile the gut microbiome of patients before initiating immunotherapy, and should these patients avoid the use of antibiotics or certain foods that might have a detrimental effect on healthy gut bacteria? “These questions beg to be answered, and we need to work together as a global community to answer them.

https://jamanetwork.com/journals/jama/fullarticle/2671442?utm_source=TWITTER&utm_medium=social_jn&utm_term=1346066374&utm_content=content_engagement|article_engagement&utm_campaign=article_alert&linkId=48142387