Using the Principles of Evolution to Treat and Prevent Cancer

Excerpt:

“Cancer has been called malevolent. Devious. Even ingenious. It’s actually none of these. Cancer has no purpose or direction. As these wayward cells arise, they simply adapt to the environmental conditions of the tissues in which they exist. That concept, which springs from Charles Darwin’s theory of evolution, is guiding new approaches to fighting this common and deadly disease.

“In Darwinian evolution, organisms that are well-adapted to their environments flourish and crowd out those that aren’t. My colleagues and I believe that much the same thing happens with cancer in a process we call adaptive oncogenesis.”

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Long-Term Results of Adjuvant Endocrine Therapy in Premenopausal Breast Cancer

Excerpt:

“In an analysis of long-term outcomes in the SOFT and TEXT trials reported at the 2018 ASCO Annual Meeting and in The New England Journal of Medicine, Francis et al found that the addition of ovarian suppression to adjuvant tamoxifen significantly improved 8-year rates of disease-free and overall survival vs tamoxifen alone among premenopausal women with breast cancer; risk of recurrence was further reduced with exemestane plus ovarian suppression.

“Initial reports showed that 5-year rates of recurrence were significantly lower among premenopausal women who received the aromatase inhibitor exemestane plus ovarian suppression vs tamoxifen plus ovarian suppression, with the addition of ovarian suppression to tamoxifen not significantly improving recurrence risk vs tamoxifen alone.”

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FDA Expands Approval of Pembrolizumab for First-Line Treatment of NSCLC

Excerpt:

“The U.S. Food and Drug Administration (FDA) recently granted accelerated approval to the immune checkpoint inhibitor pembrolizumab (Keytruda) for use in combination with chemotherapy as a first-line treatment for patients with metastatic non–small cell lung cancer (NSCLC).

“This new approval of pembrolizumab was based on the results of the phase II KEYNOTE-021 clinical trial of 123 patients with advanced or metastatic nonsquamous NSCLC without mutations in the EGFR gene or alterations in the ALK gene, for which there are existing targeted therapies. Patients in the trial had not been treated previously and were randomly assigned to receive either pembrolizumab plus chemotherapy or chemotherapy alone.”

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Selective AXL Inhibitor Bemcentinib Meets Pre-specified Efficacy Endpoint in Stage 1 of NSCLC Phase II Combination Trial With KEYTRUDA

Excerpt:

“BerGenBio ASA (OSE:BGBIO) announces today that on a top-line, preliminary basis, the first efficacy endpoint has been met in its Phase II clinical trial (BGBC008) evaluating bemcentinib, a first-in-class oral selective AXL inhibitor, in combination with the Merck & Co., Inc., Kenilworth, N.J., USA[1] anti-PD-1 therapy KEYTRUDA® (pembrolizumab) as a potential new treatment regimen for advanced non-small cell lung cancer (NSCLC). The primary efficacy endpoint requires at least four patients (out of the first 22 treated patients) to achieve clinical responses when treated with the novel drug combination, defined as either complete or partial response, as measured by Response Evaluation Criteria in Solid Tumors (RECIST).”

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Early Treatment of Advanced Prostate Cancer with PSMA-Targeted Radioligand Therapy Prolongs Life

Excerpt:

“Research presented at the 2018 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) demonstrates for the first time the benefit of providing earlier lutetium-177 (177Lu) prostate-specific membrane antigen (PSMA) radioligand therapy to patients with metastatic prostate cancer. Until now, this therapy has only been used in patients with end-stage disease.”

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Doctors Try Genetically Modified Poliovirus As Experimental Brain Cancer Treatment

Excerpt:

“A genetically modified poliovirus may help some patients fight a deadly form of brain cancer, researchers report.

“The experimental treatment seems to have extended survival in a small group of patients with glioblastoma who faced a grim prognosis because standard treatments had failed, Duke University researchers say.

” ‘I’ve been doing this for 50 years and I’ve never seen results like this,’ says Dr. Darell Bigner, the director emeritus of the The Preston Robert Tisch Brain Tumor Center at the Duke Cancer Institute, who is helping develop the treatment.”

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FDA Accepts Application for Frontline Nivolumab/Ipilimumab in TMB-High NSCLC

Excerpt:

“The FDA has accepted a supplemental biologics license application (sBLA) for the combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) for the frontline treatment of patients with advanced non–small cell lung cancer (NSCLC) with tumor mutational burden (TMB) ≥10 mutations per megabase (mut/Mb), according to Bristol-Myers Squibb (BMS), the manufacturer of both immune checkpoint inhibitors.

“The sBLA is based on findings from the phase III CheckMate-227 trial presented at the 2018 AACR Annual Meeting and published in the New England Journal of Medicine, in which the 1-year progression-free survival (PFS) rate was 43% for patients with high TMB (≥10 mut/Mb) assigned to the immunotherapy combination compared with 13% for those assigned to platinum-doublet chemotherapy. The median PFS was 7.2 months versus 5.5 months, respectively, representing a 42% reduction in risk of disease progression or death (HR, 0.58; 97.5% CI, 0.41-0.81; P <.001).”

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Lethal Prostate Cancer Treatment May Benefit from Combination Immunotherapy

Excerpt:

“Researchers at the Johns Hopkins Kimmel Cancer Center and the Bloomberg~Kimmel Institute for Cancer Immunotherapy (BKI) released a study investigating the use of combination checkpoint immunotherapy in the treatment of a lethal form of advanced prostate cancer. The study suggested a genetic subset of prostate cancer may benefit from this form of immunotherapy.

“The study targeted AR-V7+ prostate cancer with a combination of two checkpoint blockers, ipilimumab and nivolumab, in 15 patients with this aggressive variant, first discovered at Johns Hopkins in 2014.”

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Neratinib/T-DM1 Combo Shows Promise in HER2-Positive Breast Cancer

Excerpt:

“The combination of neratinib (Nerlynx) and T-DM1 (ado-trastuzumab emtansine; Kadcyla) induced an overall response rate of 60% in previously-treated women with HER2-positive metastatic breast cancer, according to results from the phase Ib NSABP FB-10 study presented at the 2018 ASCO Annual Meeting.

“Among 12 of 20 evaluable patients with objective responses, 3 had a complete response and 9 had a partial response. An additional 2 patients had stable disease, and 6 patients had progressive disease.”

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