Heart Health After Cancer: A Growing Concern

“Nearly 15 million people are living after a cancer diagnosis in the United States. This number represent over 4 percent of the population, an astonishing figure. And a growing one, as reported last year by the ACS and outlined by the NCI’s Office of Cancer Survivorship.

“As cancer patients survive longer they face additional health problems. Radiation to the chest, chemotherapy, antibody therapy and hormone changes can affect blood vessels and heart function in the short term and long, during treatment or years later. But millions affected – and their physicians – remain insufficiently mindful about the risk of heart disease.

“It’s the kind of problem a person who’s had cancer, or a doctor who’s prescribed generally helpful treatment, may not want to think about.

“Years ago, heart complications of cancer treatment didn’t garner so much attention says, Dr. Javid Moslehi, a cardiologist who leads a program in cardio-oncology at the Vanderbilt University School of Medicine in Nashville, TN. The emerging field involves cardiologists, oncologists, scientists and others who study the long-term effects of cancer treatment on the heart.”


ASCO: Antibody Adds 6 Weeks to Squamous NSCLC Survival

“The novel anti-EGFR monoclonal antibody necitumumab modestly improved survival in squamous non-small cell lung cancer (NSCLC) in a pivotal trial, but many called the effect too small to count.

“Adding the drug to a standard chemotherapy regimen improved overall survival by 16% (P=0.012), Nick Thatcher, MD, of Christie Hospital in Manchester, England, and colleagues found in the SQUIRE trial.

“While only about a 6-week gain over chemotherapy alone (median 11.5 versus 9.9 months), Thatcher called the findings an important advance.”

Editor’s note: Necitumumab is a drug that may hold promise for some patients with squamous non-small cell lung cancer (NSCLC). In a clinical trial to test the drug on volunteer patients, researchers found that necitumumab can increase survival by 6 weeks, compared to standard chemotherapy treatment. Some researchers say a 6 week increase in survival time is not terribly meaningful, and may be setting the bar too low for treatment of squamous NSCLC.


Cyramza Yields a Modest Survival Benefit in Second-line NSCLC

“Cyramza™ (ramucirumab, IMC-1121B; Eli Lilly) is a human IgG1 monoclonal antibody directed against the extracellular domain of VEGFR-2. It was recently approved by the Food and Drug Administration (FDA) for advanced gastric cancer or gastroesophageal junction adenocarcinoma. On February 19, 2014, Lilly announced via press release that the REVEL trial was positive for both overall survival (OS) and progression-free survival (PFS) benefit. Results from the randomized, double-blind, placebo-controlled Phase III REVEL trial (NCT01168973) were reported at the 2014 annual meeting of the American Society of Clinical Oncology (ASCO). The trial evaluated docetaxel with or without Cyramza in squamous or non-squamous Stage IV non-small cell lung cancer (NSCLC) patients following disease progression after one prior platinum-based therapy.”

Editor’s note: A new targeted drug called Cyramza (aka ramucirumab) shows promise as a potential treatment for people with advanced non-small cell lung cancer (NSCLC). In a clinical trial, scientists tested the drug on volunteer patients with stage IV NSCLC. Compared to standard chemotherapy alone, patients who were treated with chemo plus Cyramza lived longer and had more time pass before their cancer worsened.

Update 6/9/14: According to Dr. Jack West of GRACE, the benefit of Cyramza is very minimal in the above-mentioned clinical trial, and is therefore not so promising.


AVEO Oncology Announces Presentation of AV-203 Phase 1 Results at 2014 American Society of Clinical Oncology Annual Meeting

“AVEO Oncology (NASDAQ:AVEO) today announced the presentation of results from a first-in-human Phase 1 study of AV-203, AVEO’s ErbB3 (HER3) inhibitory antibody candidate. Among the results, the study established a recommended Phase 2 dose of AV-203, demonstrated good tolerability and promising early signs of activity, and reached the maximum planned dose of AV-203 monotherapy. The results were presented in a poster, entitled “First-in-human Phase 1 dose-escalation study of AV-203, a monoclonal antibody against ErbB3 in patients with metastatic or advanced solid tumors” (Abstract #11113, Poster #395, S Hall A2), at the Tumor Biology General Poster Session of the American Society of Clinical Oncology 2014 Annual Meeting, taking place May 30 – June 3, 2014, in Chicago.”

Editor’s note: This story is about a promising new drug called AV-203. In a clinical trial to test the drug in volunteer patients, AV-203 showed promise for treating several cancer types, including lung cancer.


AstraZeneca Launches Phase 3 Study of NSCLC Immunotherapy

“On the heels of rebuking merger offers from Pfizer, AstraZeneca announced in a press release it is moving forward with the phase 3 PACIFIC trial of a lung cancer immunotherapy drug.

“The drug, MEDI4736, is a human monoclonal antibody directed against programmed death ligand 1 (PD-L1). The drug, still in development, targets the PD-L1/PD-1 pathway for the treatment of non–small cell lung cancer (NSCLC) by blocking signals which allow PD-L1 to escape detection by the immune system.”

Editor’s note: MEDI4736 is an immunotherapy drug that is meant to boost a patient’s own immune system to fight cancer. Learn more about immunotherapy and clinical trials here.


New Cancer Vaccine Approach Directly Targets Dendritic Cells

“Celldex Therapeutics announced today that final data from its Phase 1 study of CDX-1401 in solid tumors, including long-term patient follow-up, have been published inScience Translational Medicine. The data demonstrate robust antibody and T cell responses and evidence of clinical benefit in patients with very advanced cancers and suggest that CDX-1401 may predispose patients to better outcomes on subsequent therapy with checkpoint inhibitors. CDX-1401 is an off-the-shelf vaccine consisting of a fully human monoclonal antibody with specificity for the dendritic cell receptor DEC-205 linked to the NY-ESO-1 tumor antigen. The vaccine is designed to activate the patient’s immune system against cancers that express the tumor marker NY-ESO-1. While the function of NY-ESO-1 continues to be explored, references in the literature suggest that its expression might reflect the acquisition of properties that cancers find useful, such as immortality, self-renewal, migratory ability and the capacity to invade.”

Editor’s note: Cancer vaccines like CDX-1401 are a type of immunotherapy, meaning that they boost a patient’s own immune system to fight cancer. CDX-1401 is able to attack tumor cells because the tumor cells have a molecule called NY-ESO-1 that CDX-1401 recognizes. We recently published a story about another treatment that is meant for patients whose tumors have NY-ESO-1. To learn more about how patients can use molecular testing to see if particular treatments might work for them, click here.


New Cancer Vaccine Approach Directly Targets Dendritic Cells

“Celldex Therapeutics announced today that final data from its Phase 1 study of CDX-1401 in solid tumors, including long-term patient follow-up, have been published inScience Translational Medicine. The data demonstrate robust antibody and T cell responses and evidence of clinical benefit in patients with very advanced cancers and suggest that CDX-1401 may predispose patients to better outcomes on subsequent therapy with checkpoint inhibitors. CDX-1401 is an off-the-shelf vaccine consisting of a fully human monoclonal antibody with specificity for the dendritic cell receptor DEC-205 linked to the NY-ESO-1 tumor antigen. The vaccine is designed to activate the patient’s immune system against cancers that express the tumor marker NY-ESO-1. While the function of NY-ESO-1 continues to be explored, references in the literature suggest that its expression might reflect the acquisition of properties that cancers find useful, such as immortality, self-renewal, migratory ability and the capacity to invade.”

Editor’s note: Cancer vaccines like CDX-1401 are a type of immunotherapy, meaning that they boost a patient’s own immune system to fight cancer. CDX-1401 is able to attack tumor cells because the tumor cells have a molecule called NY-ESO-1 that CDX-1401 recognizes. We recently published a story about another treatment that is meant for patients whose tumors have NY-ESO-1. To learn more about how patients can use molecular testing to see if particular treatments might work for them, click here.


New Antibody-drug Conjugate Shows Early Promise Against All Forms of Melanoma

“The investigational drug DEDN6526A, which is a new member of a class of drugs called antibody-drug conjugates, was safe, tolerable, and showed hints of activity against different forms of melanoma—cutaneous, mucosal, and ocular—according to results of a first-in-human phase I clinical trial presented here at the AACR Annual Meeting 2014, April 5-9.

“Antibody-drug conjugates consist of an antibody attached to a toxic chemotherapy by a special linker that keeps the chemotherapy inactive. In the case of DEDN6526A, the antibody recognizes the protein endothelin B receptor (ETBR) and the toxic chemotherapy is monomethyl auristatin (MMAE). Infante explained that when administered to the patient, the antibody portion of DEDN6526A recognizes and attaches to ETBR, which is often present at elevated levels on the surface of tumor cells in patients with melanoma. The whole antibody-drug conjugate is then taken up by the cells and MMAE is released from the linker to become active, killing the melanoma cells.”


Deploying the Body's Army

“More than a century ago, American bone surgeon William Coley came across the case of Fred Stein, whose aggressive cheek sarcoma had disappeared after he suffered a Streptococcus pyogenesinfection following surgery to remove part of the large tumor. Seven years later, Coley tracked Stein down and found him alive, with no evidence of cancer. Amazed, Coley speculated that the immune response to the bacterial infection had played an integral role in fighting the disease, and the doctor went on to inoculate more than 10 other patients suffering from inoperable tumors with Streptococcus bacteria. Sure enough, several of those who survived the infection—and one who did not—experienced tumor reduction.”

Editor’s note: This article is a great overview of immunotherapy for treating cancer. Immunotherapy drugs boost a patient’s own immune system to fight cancer. Learn more.