Posts Tagged ‘professor’

New blood test could offer more tailored treatment of ovarian cancer

Researchers from The University of Manchester and The Christie NHS Foundation Trust — both part of Manchester Cancer Research Centre — say the test could be developed and used in hospitals within the next few years.

It would mean medics could see which patients could benefit from blood vessel-targeting drugs — such as bevacizumab — in addition to conventional therapy. Meanwhilehile others who are not going to benefit would be spared the time and side effects associated with having the drug.

The test would also help to reduce the cost to the NHS. Ovarian cancer has seen little increase in survival rates over the last few decades and scientists are seeking new treatment strategies to improve the standard approach of surgery and chemotherapy.

A recent advance has been to target the development of new blood vessels within the tumor — preventing the cancer from receiving the nutrients it needs to grow. Bevacizumab, one of the blood vessel-targeting drugs, has shown significant but modest improvements in patient survival so doctors are seeking ways to predict which patients are most likely to gain an advantage from this type of drug.

The research team looked at blood samples from patients enrolled in an international trial of bevacizumab. These patients received either standard chemotherapy treatment alone or chemotherapy plus the blood vessel-targeting drug.

Professor Gordon Jayson, Professor of Medical Oncology at The University of Manchester and Honorary Consultant at The Christie who jointly led the study, said: “We are keen to identify predictive biomarkers — measures that can indicate how well a patient will respond to treatment — so we can better target these drugs to patients most likely to benefit.”We investigated levels of a range of proteins in patients’ pre-treatment blood samples to see if any were associated with improved survival.”

The findings, published recently in the journal Clinical Cancer Research, show that two particular proteins — Ang1 and Tie2 — could be used in combination to predict patient response. Patients with high levels of Ang1 and low levels of Tie2 were most likely to benefit from bevacizumab.

Both these proteins are involved in controlling the formation of new blood vessels. Conversely, they found that patients with high levels of both proteins did not benefit from the additional drug.

Study co-author Professor Caroline Dive, from the Cancer Research UK Manchester Institute based at The University of Manchester, added: “We will now look to further explore the potential of using a blood test to personalise treatment for ovarian cancer patients.

Moving towards a more individualized treatment plan specific for each patient and their particular tumor is key to improving outcomes for patients while sparing those unlikely to benefit from potential side effects of therapy.”

source : http://www.sciencedaily.com/releases/2014/09/140905090419.htm

Novel immunotherapy vaccine decreases recurrence in HER2 positive breast cancer patients

One of only a few vaccines of its kind in development, GP2 has been shown to be safe and effective for breast cancer patients, reducing recurrence rates by 57%. Further, women with the highest overexpression of HER2 (known as HER2 +3) had no cancer recurrences when they were administered the vaccine after completing trastuzumab (Herceptin), a type of immunotherapy drug known as a monoclonal antibody. HER2 is an oncoprotein that promotes tumor growth and is expressed to some extent in 75-80% of breast cancers.

“This is an important and different avenue in immunotherapy research, in that we are investigating ways to prevent cancer recurrence by stimulating the immune system to treat cancer,” says principal investigator Elizabeth Mittendorf, M.D., Ph.D., associate professor of Surgical Oncology. “The ultimate goal is to develop a preventative tool that will minimize the risk of recurrence in women who have already had breast cancer and for whom standard therapies have failed.”

The findings are the result of a phase II randomized trial that paired the GP2 vaccine, designed to stimulate the CD8+ cells, commonly known as “killer” or “toxic” T cells, with an immune stimulant known as granulocyte/macrophage colony stimulating factor (GM-CSF). The trial included 190 patients with varying levels of HER2; 89 women received the GP2 vaccine with a GM-CSF adjuvant and a control group of 91 patients received GM-CSF alone. Eight patients experienced early recurrence or developed a second malignancy and did not complete the vaccine trial. The vaccine is injected subcutaneously and the initial series consisted of monthly inoculations for six months, followed by four cycles of booster shots administered every six months thereafter. The patients were monitored for nearly three years.

For all 190 patients, including those who did not complete the trial, the disease-free survival (DFS) rate was 88% among those who received the vaccine and 81% in the control group — representing a 37% reduction in recurrence. Excluding the patients who did not complete the vaccine series, the results are higher — 94% DFS rate versus 85% who did not get GP2 — a 57% risk reduction.

Women with HER2 +3 who were administered trastuzumab as part of the standard of care prior to receiving the vaccine experienced no cases of cancer recurrence. According to Mittendorf, trastuzumab may act like a primer for the vaccine. Trastuzumab stimulates CD4+ T cells to release substances that fight cancer cells and initiates an antibody response. Thus, it may prepare the immune system, making the vaccine even more effective. MD Anderson is now testing this combination of immunotherapies in other clinical trials.

Personalized Immunotherapy

The GP2 study supports previous MD Anderson research on similar breast cancer vaccines, such as AE37, which showed a significant immune response and improved recurrence rates in triple-negative breast cancer patients. Another candidate, E75, known as NeuVax or nelipepimut-S, showed a 50% recurrence decrease in high-risk patients. Currently, NeuVax is being tested internationally in a phase III clinical trial.

“We believe many more patients will benefit in some way from immunotherapy,” says Mittendorf. “The challenge will be identifying the right immunotherapeutic approach for each individual patient. When doctors are able to do that, cancer therapy, and immunotherapy specifically, will follow a more personalized approach.”

source : http://www.sciencedaily.com/releases/2014/09/140905122717.htm

Minimally invasive, high-performance intervention for staging lung cancer

Endoscopic biopsy of the lymph nodes is a minimally invasive, non-surgical intervention that has recently begun to be used to stage lung cancer. The study conducted by Dr. Liberman’s team involved 166 patients with confirmed or suspected non small cell lung cancer, and was designed to compare the new approach to surgical staging under general anesthesia, as prescribed in current guidelines for this type of cancer. The findings, which were recently published in CHEST Journal, the official publication of the American College of Chest Physicians, show that the endoscopy approach is not only sensitive and accurate, but also leads to improved staging compared to surgical staging due to its ability to biopsy lymph nodes and metastases not attainable with surgical techniques.

Research protocol

All patients underwent endobronchial ultrasound (EBUS), endoscopic ultrasound (EUS) and surgical mediastinal staging (SMS) during a single procedure. Each subject served as his or her own control. The results of the EBUS, EUS and combined EBUS/EUS were compared to SMS (gold standard) results and, in patients with negative lymph node staging, to lymph node sampling at pulmonary resection.

source : http://www.sciencedaily.com/releases/2014/09/140904141807.htm