News from Around the Globe

Research is constant.  Every day we are learning more about how to fight cancer in all of its forms.  Here are the latest news articles from some of the leading cancer organizations.  Check back often to stay up to date.

news from around the world

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Stronger Than Cancer has shared these news articles for information purposes only.  It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

 

Possible causes of a lump on the back of the neck hairline

4 days 6 hours ago
Lumps on the back of the neck hairline can be the result of skin irritation or acne or may be a sign of a new mole. Other possible causes include muscle knots, cysts, boils, and swollen lymph nodes. Learn more about these causes and when to see a doctor here.

Alternative therapies for cancer: Do they do more harm than good?

4 days 9 hours ago
How many people with cancer use complementary and alternative therapies? And do these interfere with conventional treatments? A new study investigates.

Where Vitamin D Supplements Fail

4 days 12 hours ago
As I discuss in my video Do Vitamin Supplements Help with Diabetes, Weight Loss, and Blood Pressure?, review articles continue to be published touting vitamin […]

News digest – cancer ‘vaccine factories’, cataloguing DNA weaknesses, NHS drug decisions and cancer sniffing canines

1 week ago

Science blog

Scientists use CRISPR to catalogue cancer’s weaknesses

BBC News covered some fascinating new findings from the Wellcome Sanger Institute in Cambridge, where scientists are building a list of the most promising potential cancer drug targets. The team are using the DNA-editing tool CRISPR to switch off every gene, one-by-one, in over 300 different types of lab-grown cancer cells. So far they’ve ranked 600 promising drug targets, which could help to prioritise drug development in the future. Our news report has a breakdown of the research.

A fresh batch of NHS drug decisions
  • Breast cancer: a new drug combo won’t be made available for patients with a certain type of advanced breast on the NHS in England. The combination of ribociclib (Kisqali) and fulvestrant (Faslodex) could give patients more time before their disease gets worse, but the combo hasn’t been compared to patients’ current treatment, making it hard to judge if it’s a cost-effective option. Find out more in our news report.
  • Lung cancer: two targeted drugs got an initial ‘no’ for some NHS patients with non small cell lung cancer in England. The decision came down to uncertainties over the long-term benefits and a lack of data comparing the drugs to the current standard of care. Our news report has the details.
  • Liver cancer: a targeted cancer drug has been approved for some patients with advanced liver cancer that cannot be removed surgically on the NHS in Scotland, reports the BBC. It was one of three cancer drug decisions for NHS Scotland this week, with the other two decisions extending access to existing treatments to children with certain types of leukaemia. More on these decisions on the Scottish Medicines Consortium website.
Immune-boosting combo could help create cancer ‘vaccine factories’

Scientists are testing new, experimental treatment combinations to help teach the immune system to attack cancer cells. The Express picked up the latest results from the US, which we also covered, showing that injecting immune cell stimulants directly into a tumour could help the immune system spot and kill cancer cells in mice. It’s an exciting new immunotherapy approach, but it’s a long way from being an effective treatment for people with cancer.

Boys in Northern Ireland will be offered HPV vaccine

Important news this week as it was announced that boys aged 12-13 in Northern Ireland will be offered the human papillomavirus (HPV) vaccine from September this year. This brings Northern Ireland in line with the rest of the UK, where the roll-out of the vaccine programme was announced in 2018. The vaccine protects against HPV infection, which can increase the risk of 7 types of cancer, including mouth and throat cancer, as our blog post explains.

Northern Ireland also announced it would introduce a more effective bowel cancer screening test in 2020. BBC News has more.

Space scientists tasked with improving cancer imaging

In a week that was dominated by the first stunning photos of a black hole, the UK Space Agency and NHS England announced that scientists would be turning star gazing technology on cancer cells. They’ve tasked experts with developing a portable 3D x-ray machine, with the hope that a more complete picture of growing tumours could aid early diagnosis. Watch this space.

1 in 3 US cancer patients report using complementary and alternative medicines

The Independent covered research into the self-reported use of complementary and alternative medicines among US cancer patients, with a third saying they used one of these remedies. And of those that had tried alternative medicines, 1 in 3 hadn’t told their doctor. While the study was based across the pond, experts say it’s not just a US phenomenon. We’ve written about complementary and alternative medicines, and their potential impact in cancer survival, before.

Chilli compound slows cancer spread in lab tests

Scientists in the US are investigating the potential benefits of a highly purified version of the chilli compound capsaicin in slowing cancer spread. They found that in lab tests, the molecule, which gives chillies their heat, could block some of the steps cancer cells take before spreading, as the Evening Standard explains. It’s not the first time this fiery compound has been linked to cancer, but most research has looked at if it can promote or prevent cancer developing. The jury’s still out.

Making genetic studies more representative

An interesting article in the journal Nature this week covered the effort to make DNA data used in research more diverse. Most large genetic studies so far have mainly included people of European descent, but the tide is starting to turn, as Nature reporter Heidi Ledford explains.

And finally

A trio of beagles made headlines this week, as the dogs were trained to ‘sniff out cancer’ with remarkable accuracy, according to a press release. Our canine companions have smell receptors 10,000 times more accurate than ours, which has led to some interest in their ability to detect cancer and other conditions by using their keen sense of smell to detect smelly molecules given off by faulty cells. In lab tests, the dogs were trained to pick out samples from patients with lung cancer that had spread to other parts of the body, which they did 96.7% of the time. It’s unlikely that research like this will result in a dog in every GP practice, but the ideas behind the research are already being exploited to develop a reliable and reproducible test to detect cancer early. You can read more about one example of this in our blog post about a breath test clinical trial.

Katie

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Is it better to get nutrients from food or supplements?

1 week 1 day ago
New research has found that nutrients obtained from food, not supplements, correlate with lower risks of all-cause mortality and cancer.

Two targeted lung cancer drugs get initial ‘no’ for NHS in England

1 week 1 day ago

News report

Patients with a certain type of lung cancer will not have access to two targeted cancer drugs on the NHS in England.

The two drugs – dacomitinib (Vizimpro) and osimertinib (Tagrisso) – were each being considered as initial treatments for patients whose non small cell lung cancer had begun to spread to other parts of the body. Patients’ cancers cells would also need to test positive for a certain molecule, called EGFR

But due to uncertainties around long-term outcomes and comparisons with existing drugs, the National Institute for Health and Care Excellence (NICE) judged neither drug offers good value for money for the NHS. 

Rose Gray, policy manager at Cancer Research UK, said the decisions will be disappointing for people with this type of non small cell lung cancer. 

“In both cases, clinical trial evidence suggests these drugs could offer patients more time before their disease gets worse compared to some existing treatment options, and potentially even extend their lives – though NICE felt there wasn’t enough evidence to be confident about any possible survival benefit.” 

A tale of two drugs

Dacomitinib and osimertinib are both targeted cancer drugs that block the growth signals delivered to cells via a molecule called EGFR. By blocking these signals the drugs are designed to stop cancer cells from growing and dividing so quickly. 

Both drugs target the same molecule as existing treatments for patients whose lung cancer cells test positive for EGFR, afatinib (Giotrif), erlotinib (Tarceva) or gefitinib (Iressa)

And the treatments have been tested in clinical trials involving patients whose cancer has at least one fault in the EGFR molecule. 

In a trial involving 452 patients with non small cell lung cancer that had spread to other parts of the body, taking dacomitinib increased the time before patient’s cancer got worse compared to those taking gefitinib.

Patients taking dacomitinib were alive for an average of 14.7 months without their cancer getting worse, compared to 9.2 months for those taking gefinitib. Dacomitinib also increased overall survival, with patients taking the drug living for an average of 34.1 months, compared to 26.8 months for those taking gefitinib. 

But serious side effects were more common in the group taking the new targeted drug, with 9 in 100 patients taking dacomitinib experiencing severe side effects compared with 4 in 100 patients taking gefinitib.

Osimertinib was tested in a trial involving 556 patients with advanced non small cell lung cancer. Taking osimertinib was found to extend the time before patient’s cancer got worse compared to those taking gefitinib or elotinib. 

Patients taking osimertinib were alive for an average of 18.9 months without their cancer getting worse, compared to 10.2 months for those taking existing treatments. But the trial has not been running for long enough to know how much the drug will improve long-term survival for these patients.

Unlike with dacomitinib, serious side effects were less common for those taking osimertinib than those taking the existing standard-of-care drugs.

The lowdown on the latest decisions

While the drugs are being developed for the same group of patients, the reasons the NICE committee gave for the draft rejections differed for each of the two treatments.

For dacomitinib, clinical trials have not compared it to afatanib, which the committee felt was the most suitable and widely-used alternative. And based on the data provided, NICE concluded that patients taking dacomitinib wouldn’t see significant additional benefits compared with afatanib in either the short or the long-run. 

The committee therefore concluded that the price of dacomitinib put it above the threshold for cost-effectiveness and couldn’t be approved for routine use on the NHS. 

Osimertinib is already available on the NHS to treat some patients with non small cell lung cancer if initial treatments have failed, but only if their cancer carries a specific fault in the EGFR molecule. This week’s decision was looking at whether all patients whose disease tests positive for the EGFR molecule should be able to have it as the first treatment they receive.

The committee concluded there wasn’t enough evidence around the long-term benefits the drug offers patients to make the treatment cost effective. And, like dacomitinib, trials of osimertinib have not compared it to the standard-of-care drug afatanib.

NICE also noted that trials testing osimertinib included patients who are likely to be in better health than the patients who would be treated in the NHS. Considering all these factors together, they concluded that the treatment would not be cost-effective on the NHS. 

Gray urged NICE, NHS England and the drugs’ manufacturers to work together before NICE reviews these decisions next month to explore how the drugs can be made available to NHS patients.

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Tailoring breast cancer screening to individual patient risk

1 week 2 days ago

Research Feature

Professor Fiona Gilbert is using funding from our Early Detection Programme Award to assess the most effective approaches for breast screening. In this story, Fiona tells us how she hopes to develop prediction models to tailor breast screening programmes to individual patient risk.

Fiona, who is Head of Department of Radiology at the University of Cambridge, is working together with Professor Paul Pharoah, from the Centre for Cancer Genetic Epidemiology. Their research is focusing on women with particularly dense breast tissue, a population whose mammograms have reduced sensitivity and who may be at increased risk of developing breast cancer.

“Mammography has been considered the gold standard for breast cancer screening, however it’s well known to be less sensitive in women with dense breast tissue.

Studies have shown that dense breast tissue can mask cancers, making mammograms more difficult to read. Cancers when they are found in these women tend to be larger.

We wish to test a range of imaging techniques to assess their feasibility for women who may be at increased risk due to dense breasts, in addition to standard mammography in a screening setting.

The screening technologies we will be exploring include Abbreviated Magnetic Resonance Imaging, a more rapid test with the key MRI images; Contrast Enhanced Mammography, which combines iodinated contrast agents with conventional mammography to identify areas of increased blood supply, which can be an indicator of cancer;  and Whole Breast Ultrasound, which involves a large curved transducer that fits comfortably over the breast to allow the entire breast to be scanned by ultrasound.

Our study is exploring whether Abbreviated Magnetic Resonance Imaging, Contrast Enhanced Mammography, or Whole Breast Ultrasound is better as a supplemental breast cancer screening test to mammography for women with dense breasts. 

Women have a wide range of breast densities – those with the densest breasts have a higher proportion of glandular and fibrous tissue, whilst those with the least dense breasts have higher relative proportions of fat.

There are two problems connected with dense breasts: dense tissue can mask or hide cancers reducing the likelihood of detection by mammographic screening, and may also increase the risk of developing breast cancer.

We want to use an integrated approach to identify which of these women would benefit from additional imaging and to try and establish the amount of density where women would benefit from additional imaging.

Study to involve six screening centres across the UK

With our recent funds from CRUK’s Early Detection Committee, we will first randomly assign upfront women undergoing breast screening at six UK centres to one of four screening arms - Abbreviated Magnetic Resonance Imaging, Contrast Enhanced Spectral Mammography, Whole Breast Ultrasound, and standard mammography.

We will then invite women found to have particularly dense breasts to take part in the study and we’ll allocate them to their upfront screening arm.

We hope to start enrolment in the summer and altogether plan to recruit 12,000 women with dense breasts over two years, with 3,000 in each arm. So far, the breast screening centres signed up for the study include Cambridge, Leeds, Manchester, Nottingham, and Cheltenham, with a sixth centre yet to be identified.

We aim to discover which of the four modalities identifies the greatest number of breast cancers in women with dense breasts.

As well as the number of cancers identified, it will also be important to take into consideration the stage of cancers found, since, to have an impact, screening tools need to identify cancers when they can be effectively treated.

As part of the study, we’ll also be testing a range of automated tools for assessing breast density to determine what the most appropriate might be for incorporating into breast screening programmes.

Since it isn’t known at which numerical score women might actually benefit from additional imaging, we want to establish which density score would serve as the cut off at which it could be effective to offer additional imaging tests.

Helping predict breast cancer risk by validating the BOADICEA prediction model

Working with joint lead Professor Paul Pharoah from the Centre for Cancer Genetic Epidemiology at the University of Cambridge, we also plan to use a subset of women from our study to validate the BOADICEA model (Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm).

The University of Cambridge developed the computer programme to calculate the risks of breast and ovarian cancer, analysing single letter variations in DNA sequence, lifestyle and hormonal risk factors, and breast density.

For a group of women in the study we’ll calculate their risk of cancer using the BOADICEA model and then validate it against the actual number of cancers detected. Ultimately, if we can show that a prediction tool works, we could use it to stratify the population to decide which women should be invited for screening.

Advice to applicants: budget carefully upfront and get policy makers on board

My advice to anyone applying for these awards is to plan your work and think upfront about your costings really carefully as you will not have the chance to amend them in the second stage of the application process.

One of the strengths of our proposal was that we’d already had the support from the NHS Breast Screening Programme who agreed to allow us to use their centres for recruiting patients.

We did lots of groundwork to make sure screening policy makers believed the modalities we were investigating could be of value. Such preparation is critical because without their support and the possibility of introducing new approaches to screening in clinical practice, it would be a complete waste of charitable money to undertake the research.

I would also recommend getting in touch with CRUK regardless of whether your research involves discovery, pre-clinical or translational science. When the CRUK early detection funding team made contact to say that they were interested in funding research in our area, it came as a bit of a surprise as we were under the impression they only funded basic science. We have since discovered that they are really supportive of clinical work. ”

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