Patient Group Releases Cancer Innovation ‘Blueprint’

“The National Patient Advocate Foundation has released what it calls a ‘blueprint to accelerate the delivery of promising new treatments’ through a grassroots effort called Project Innovation.

“The group issued a report after consulting with biomedical researchers, patient advocates, medical developers, clinicians and policymakers to identify obstacles which may slow the pace of innovation in cancer research and the implementation of new treatments. The report outlines ‘logistical, bureaucratic, institutional and regulatory obstacles’ and ‘inefficiencies’ in clinical trials along with other factors that impede discover [sic] and the development of new drugs.

“ ‘This report represents a wakeup call for all Americans and is intended to spark a national movement to make cancer innovation a national priority,’ Nancy Davenport-Ennis, NPAF’s founder and chairman, said in a press release. ‘Cancer kills 1,600 Americans every day and this number will only increase in the years ahead unless we commit as a nation to hasten the pace of medical discovery. It is time to put cancer innovation on the national agenda and press for solutions that will save lives instead of continuing a one-sided conversation on the cost of treatment.’ ”

Study Identifies Irinotecan Dosing Levels Based on UGT1A1 Genotype

Editor’s note: Molecular testing can sometimes give clues as to how well a particular treatment will work for a particular cancer patient, helping patients make treatment decisions with their oncologists. For example, patients treated with the drug irinotecan may experience severe neutropenia as a side effect if they have a particular version of the gene UGT1A1 known as UGT1A1*28. Now, researchers have worked with volunteer patients in a clinical trial to figure out the best doses of irinotecan to give to patients with UGT1A1*28.

“Risk of severe irinotecan-associated neutropenia is related in part to presence of the UGT1A1*28 variant, which is linked to reduced elimination of the irinotecan active metabolite SN-38. In a study reported in the Journal of Clinical Oncology, Innocenti et al identified appropriate irinotecan dosing levels according to UGT1A1*28  genotype.

“In the study, 46 patients with advanced solid tumors received a flat dose of IV irinotecan every 3 weeks; 46% had the *1/*1 genotype, 41% had the *1/*28 genotype, and 13% had the*28/*28 genotype. Starting doses of irinotecan were 700 mg in patients with the *1/*1 and *1/*28 genotypes and 500 mg in patients with the *28/*28 genotype.”

Living With Cancer: Parting Gifts

Editor’s note: This piece from The New York Times was written by an ovarian cancer patient and explores the loss of a support group friend to cancer. 

“Being in a cancer support group eventually means losing a friend. On the first day of November, Leslie informed the six of us that she would not attend our next meeting: ‘I am so tired and I think all the tricks and treats are done.’

“A private person in her early 60s, Leslie had contacted me a year and a half earlier when she saw a notice in the local paper about my memoir, about dealing with ovarian cancer treatments. She could not bear to read it, but might we correspond?

“We did. And despite her qualms about support groups, when one started to coalesce she joined and relished the camaraderie of our twice-a-month lunches. She named us ‘The Ladies.’ ”

How Antioxidants Can Accelerate Cancers, and Why They Don't Protect Against Them

“Two cancer researchers have proposed why antioxidant supplements might not be working to reduce cancer development, and why they may actually do more harm than good. Their insights are based on recent advances in the understanding of the system in our cells that establishes a natural balance between oxidizing and anti-oxidizing compounds. These compounds are involved in so-called redox (reduction and oxidation) reactions essential to cellular chemistry.”

Patient Navigation Improves Time to Diagnosis Resolution and Treatment Initiation

Editor’s note: According the the NCI, “Patient Navigators are trained, culturally sensitive health care workers who provide support and guidance throughout the cancer care continuum. They help people ‘navigate’ through the maze of doctors’ offices, clinics, hospitals, outpatient centers, insurance and payment systems, patient-support organizations, and other components of the health care system. Services are designed to support timely delivery of quality standard cancer care and ensure that patients, survivors, and families are satisfied with their encounters with the cancer care system.” This article from the ASCO Post describes research that found specific benefits for cancer patients who received help from patient navigators.


“In the Patient Navigation Research Program study reported in the Journal of the National Cancer Institute, Freund et al found that a patient navigation intervention improved diagnostic resolution and timely treatment initiation in a clinical population comprising predominantly racial/ethnic minorities and publicly insured or uninsured patients.

“Study Details: The study compared patient navigation with usual care in 10,521 patients with abnormal breast, cervical, colorectal, or prostate screening tests and 2,105 with cancer or precancer diagnosis seen at nine centers between 2007 and 2010. The centers recruited patients from care sites that were predominantly community health centers.

“Patient navigators developed individual strategies to address barriers to care and track patients through medical evaluation with a focus on timely diagnostic resolution and initiation of therapy. Navigation was started after a clinician informed the patient of the abnormal test result.”

Variations in Key Gene Predict Cancer Patients’ Risk for Radiation-Induced Toxicity

“Key genetic variants may affect how cancer patients respond to radiation treatments, according to a study published this week in Nature Genetics. The research team, which included researchers at the Icahn School of Medicine at Mount Sinai, found that variations in the TANC1 gene are associated with a greater risk for radiation-driven side effects in prostate cancer patients, which include incontinence, impotence and diarrhea.

“The current results are based on a genome-wide association study, a type of study in which researchers examine numerous genetic variants to see if any of them are associated with a certain type of complication, which could sometimes emerge years after treatment was completed.

“ ‘Our findings, which were replicated in two additional patient groups, represent a significant step towards developing personalized treatment plans for prostate cancer patients,’ said Barry S. Rosenstein, PhD, Professor, Radiation Oncology, Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, the lead Mount Sinai investigator on the study. ‘Within five years, through the use of a predictive genomic test that will be created using the data obtained in the recent study, it may be possible to optimize treatment for a large number of cancer patients.’ ”

Editor’s note: When making treatment decisions, it can be very useful to know how a patient might respond to certain treatments. A recent study involving prostate cancer patients found genetic markers that were associated with a greater risk of side effects from radiation treatment. The finding could lead to the development of a genetic test to help doctors personalize treatment plans for prostate cancer patients.

Support Team Aiding Caregivers of Cancer Patients Shows Success, Researchers Report

“Many caregivers of terminal cancer patients suffer depression and report regret and guilt from feeling they could have done more to eliminate side effects and relieve the pain. So researchers devised and tested an intervention that quickly integrates a cancer support team to guide caregivers and their patients through difficult end-of-life treatment and decisions.”

Agenus Brain Cancer Vaccine Nearly Doubles Survival Rate in Study

“Agenus Inc said its experimental cancer vaccine helped brain tumor patients live nearly twice as long compared with those who received standard of care treatment…

“The drug, when given in addition to standard treatment, extended median overall survival in 50 percent of newly-diagnosed glioblastoma multiforme (GBM) patients to two years in a mid-stage study.

“GBM patients, who tend to succumb to the disease within one year, are usually treated with a combination of radiation and the chemotherapy drug temozolomide.”

Editor’s note: Prophage is a new “cancer vaccine” that might boost a patient’s own immune system to help fight cancer. Cells from each patient’s tumor are used to personalize Prophage specifically for the patient. This article discusses results from a clinical trial testing Prophage in volunteer patients with glioblastoma multiforme (GBM). Some of the patients in the trial were treated with Prophage in combination with standard radiation and chemotherapy treatment, while for comparison, others were treated only with standard radiation and chemo. The results showed that adding Prophage to standard treatment can help some patients live longer.

Planned Clinical Phase I Trial to Examine the Safety of Vaccine Against Gliomas Based on Mutant IDH1 in Human Patients

“Astrocytomas and oligodendrogliomas are subtypes of a brain cancer called ‘glioma’. These incurable brain tumors arise from glial cells, a type of support cell found in the central nervous system. ‘Low-grade gliomas’, which grow comparatively slowly, spread in a diffuse manner across the brain and are very difficult to completely eliminate through surgery. In many cases, the effectiveness of treatments with chemotherapy and radiotherapy is very limited. Gliomas can develop into extremely aggressive glioblastomas.

“Low-grade gliomas have a particular feature in common: more than 70% of the cases exhibit the same gene mutation in tumor cells. An identical ‘typo’ in the DNA causes the exchange of a single, specific protein building block (amino acid) in an enzyme called isocitrate dehydrogenase 1 (IDH1). As a result, most cancer cells do not follow the original building plan for the protein; at the 132nd position in the molecule’s sequence, they insert the amino acid histidine instead of arginine…

” ‘…we might be able to use a vaccine to alert the patient’s immune system to mutant IDH1, fighting the tumor without damaging healthy cells,’ [Prof. Dr. Michael Platten at the German Consortium for Translational Cancer Research] explains.

“In collaboration with a team of physicians and scientists from Heidelberg University Hospital, DKFZ and the Universities of Mainz, Tübingen and Hamburg, Platten and his co-workers have now made the first successful step toward a vaccine that specifically targets the mutation in the tumor.

“In a clinical trial scheduled to start early next year, with the support of the German Consortium for Translational Cancer Research (DKTK), they plan to examine the safety of the vaccine against gliomas based on mutant IDH1 in human patients, for the first time.”

Editor’s note: Early next year, oncologists will begin testing a newly developed cancer vaccine in a clinical trial with volunteer patients, in the hopes that it will help treat low-grade gliomas. Cancer vaccines are a type of immunotherapy treatment; they boost a patient’s own immune system to fight cancer. The new vaccine takes advantage of a dysfunctional protein that is found in 70% of low-grade gliomas. The protein is called IDH1, and the vaccine is designed to alert the patient’s immune system to attack cells with mutant IDH1, potentially shrinking the brain tumor. So far, the vaccine has only been tested in mice, but the results were promising.