New Test Could Sharply Reduce Risky, Costly Lung Cancer Biopsies

“When a suspicious lesion shows up in the lungs on a CT scan, the first thing your doctor wants to know is whether it’s cancerous. A specialist will pass a long, thin bronchoscope into your airway in the hope of grabbing a few cells of the growth so they can be examined under a microscope.

“But some of these lesions or nodules are deep in the small branches of the lungs, out of reach of the bronchoscope, which is about the diameter of a pen. Other times, the results are inconclusive. That has left only two ways to determine whether the abnormality is cancerous: inserting a needle through the chest wall and into the tumor, or surgically opening a patient’s chest to find it (and remove it if necessary).

“The first procedure carries a 15 percent risk of collapsing a lung (pneumothorax), as well as infection. The second is serious surgery that requires general anesthesia and results in the loss of lung tissue. Both are in-patient procedures that carry the cost and other risks of hospitalizations. In about a third of the surgeries, the growth turns out to be benign, meaning the surgery was unnecessary.

“But now, according to a study published Sunday in the New England Journal of Medicine, there appears to be a new, much less invasive way of determining whether a growth is malignant.”


Myriad Adds to Clinical Utility Data Backing Use of Melanoma Dx to Discern Malignant, Benign Lesions

The gist: Doctors sometimes perform molecular testing on patients’ tumors to identify certain characteristics that can inform treatment decisions. This article describes a molecular test called myPath Melanoma. It helps doctors determine is a patient’s skin lesion is malignant melanoma or benign. Recent research showed that myPath Melanoma helped doctors change their treatment decisions. In particular, many doctors opted for less intensive treatments for their patients based on myPath results.

Myriad Genetics this week presented data showing that its multi-gene myPath Melanoma test helped doctors change their treatment decisions, often lowering the intensity of the treatment strategy, for 35 percent of nearly 700 cases of pigmented skin lesions.

“Myriad presented the data, from a second clinical utility study for myPath Melanoma, at the College of American Pathologists’ annual meeting this week. The results of the prospective analysis aligned with findings from a retrospective clinical utility study presented earlier this year, which showed that doctors changed their decisions for 33 percent of cases using myPath Melanoma results.

“Myriad is marketing the 23-gene panel test, list priced at $1,500, as a tool that doctors can use to determine if a patient’s skin lesion is malignant melanoma or benign. Late last year the company provided early access to the test to dermatopathologists in the US through ‘The melEval Program.’ The test, according to Myriad, is one that pathologists can use to arrive at a more definitive diagnosis for suspicious, difficult-to-assess skin lesions. To date, approximately 120 dermatopathologists have submitted samples for testing with myPath through the early access program, according to the firm.

“In the latest prospective clinical utility study, 42 dermatopathologists answered questions about their treatment decisions for 687 cases of pigmented skin lesions, before and after performing the myPath Melanoma test. Myriad researchers asked these doctors to document their level of confidence about their diagnosis (is the skin lesion benign, malignant, or indeterminate) and their treatment recommendations before and after the test was performed.”


Tight Coordination of Protein Translation and HSF1 Activation Supports the Anabolic Malignant State

“Ribosome biogenesis is commonly up-regulated to satisfy the increased anabolic demands associated with malignant transformation and tumor growth. Many different oncogenic signaling pathways converge on the ribosome to increase translational flux. Despite the detailed understanding of ribosome regulation in cancer, it is not clear whethethe net translational activity of the ribosome can itself regulate transcriptional programs that support and promote the malignant state.”


Tight Coordination of Protein Translation and HSF1 Activation Supports the Anabolic Malignant State

“Ribosome biogenesis is commonly up-regulated to satisfy the increased anabolic demands associated with malignant transformation and tumor growth. Many different oncogenic signaling pathways converge on the ribosome to increase translational flux. Despite the detailed understanding of ribosome regulation in cancer, it is not clear whethethe net translational activity of the ribosome can itself regulate transcriptional programs that support and promote the malignant state.”


Tight Coordination of Protein Translation and HSF1 Activation Supports the Anabolic Malignant State

“Ribosome biogenesis is commonly up-regulated to satisfy the increased anabolic demands associated with malignant transformation and tumor growth. Many different oncogenic signaling pathways converge on the ribosome to increase translational flux. Despite the detailed understanding of ribosome regulation in cancer, it is not clear whethethe net translational activity of the ribosome can itself regulate transcriptional programs that support and promote the malignant state.”