Data Shows Disconnect Between Healthcare Professionals and Patient Perceptions of Impact of Chemotherapy and Radiotherapy-Induced Nausea and Vomiting

“Norgine B.V. has presented new data highlighting a perceptual gap between healthcare professionals and patients in terms of the incidence and impact on patients’ daily life of chemotherapy and radiotherapy induced nausea and vomiting (CINV/RINV).

“These data were sponsored by Norgine and presented at the joint Multinational Association of Supportive Care in Cancer (MASCC) / International Society of Oral Oncology (ISOO) 2015 Annual Meeting.

“The data demonstrate that physicians and oncology nurses overestimate the incidence of CINV/RINV, but underestimate the impact of the condition on patients’ daily lives (p1

“In addition, just 38% of patients reported full compliance with physicians’/nurses’ guidelines when self-administering anti-emetic medication, compared with 60% estimated by physicians and nurses. Leading factors given for poor patient compliance included reluctance to add to a pill burden and fear that swallowing itself would induce nausea/vomiting.”


Rates of Breast-Conserving Therapy for Early-Stage Breast Cancer Have Increased, Study Finds

“The number of women in the US undergoing breast-conserving therapy following a diagnosis of early-stage breast cancer has risen during the past 2 decades, according to a new study published in JAMA Surgery, though the authors reveal there are still barriers preventing women from receiving the treatment.

“After skin cancer, breast cancer is the most common cancer among American women, estimated to affect around 1 in 8 at some point in their lives.

“The majority of women diagnosed with breast cancer undergo some form of surgery, particularly if the cancer is diagnosed in the early stages. The surgical options available include mastectomy and breast-conserving therapy (BCT), or lumpectomy.

“While mastectomy involves full or partial removal of the breast tissue, BCT involves only the removal of the part of the breast containing the cancer.

“There are pros and cons with each procedure. With a mastectomy, a woman may lose an entire breast, while women who undergo BCT may be able to retain the majority of their breast tissue – making it a preferable option for many. However, women who have BCT often need to undergo radiation therapy for around 5-6 weeks following the surgery to ensure any remaining cancer cells are destroyed.”


Tumor Sequencing Study Highlights Benefits of Profiling Healthy Tissue as Well

“As the practice of genetically profiling patient tumors for clinical treatment decision making becomes more commonplace, a recent study from The University of Texas MD Anderson Cancer Center suggests that profiling normal DNA also provides an important opportunity to identify inherited mutations that could be critical for patients and their families.

“Preliminary findings from this ongoing study will be presented by Funda Meric-Bernstam, M.D., professor and chair, Investigational Cancer Therapeutics, on June 1 at the American Society for Clinical Oncology 2015 Annual Meeting in Chicago.

“The MD Anderson research team sequenced tumor and normal DNA from patients with advanced cancer, with the goal of sharing results with patients to better educate them going forward. Sequencing normal tissue is not routinely done in the research environment, but comparing tumor versus normal DNA can distinguish between germline, or inherited, mutations and those found only in the tumor.”


New Immune System-Boosting Cancer Drug to Begin Testing in Patients

The gist: A new immunotherapy drug called CM-24 will soon be tested in patients with various types of advanced or recurrent cancer, including melanoma and non-small cell lung cancer (NSCLC). CM-24 is meant to boost a patient’s own immune system to fight cancer. It works by targeting an immune system protein called CEACAM1.

“cCAM Biotherapeutics, a biopharmaceutical company focused on the discovery and development of novel cancer immunotherapies, has announced that it has received approval form the US Food and Drug Administration to commence a Phase 1 trial for CM-24, a first-in-class immunomodulatory monoclonal antibody (mAb) for the treatment of various types of cancers. The study is expected to commence during the first quarter of 2015.

“CM-24 is directed against CEACAM1, a novel immune checkpoint protein that is expressed on activated effector lymphocytes and a variety of cancer cells. CEACAM1 belongs to the Human CEA protein family, and preclinical data show that inhibition of CEACAM1-CEACAM1 homophilic interactions by CM-24 leads to enhanced activation of tumor specific immune cells.

“The Phase 1 trial is a first-in-human, open-label, multicenter, dose escalation study assessing the effect of the CM-24 mAb in cancer patients with selected advanced or recurrent malignancies, including melanoma, non-small cell lung adenocarcinoma (NSCLC) and bladder, gastric, colorectal or ovarian cancer. Primary objectives of the study are to assess the safety and tolerability of escalating multiple doses of CM-24 and to determine the recommended dose for Phase 2 trials with CM-24. Secondary objectives include characterization of the pharmacokinetic profile and immunogenicity of CM-24, and the evaluation of the preliminary efficacy of the drug on the basis of objective tumor response and duration of response in subjects treated with CM-24. The trial will be conducted at four sites including Yale and UCLA, and will be composed of a dose escalation stage and an expansion stage. The expansion stage will focus on subjects with cutaneous melanoma or additional malignancies that responded to treatment in the first stage of the study.”


Death Rates from Cancer in the US Continue to Drop

“The latest annual report from the American Cancer Society shows that death rates from cancer in the US are continuing to fall, ‘giving reasons to celebrate but not to stop,’ according to the voluntary health organization whose goal is the eradication of cancer.

“In figures to be published in CA: A Cancer Journal for Clinicians, the American Cancer Society (ACS) show how the death rate from cancer in the US has dropped by 22% since its peak in 1991.

“They say this means about 1.5 million deaths from cancer have been avoided in the last 20 years.

“The ACS estimate that in 2015, the US will see a total of 1,658,370 new cancer cases and 589,430 deaths due to the disease.

“Cancer was responsible for nearly 1 in 4 deaths in the US in 2011, making it the second leading cause of death overall -close behind heart disease.”


New Data Shows Popular Alternative Medicines Can Pose a Risk to Cancer Patients

“The ten most commonly asked about complementary medicines all interact with conventional treatments, potentially posing a threat to patient health and reaffirming the need for complementary or alternative therapies to be discussed between patients and their healthcare provider.

“The new research, being presented on December 3rd at the Clinical Oncology Society of Australia’s (COSA’s) Annual Scientific Meeting, reveals the 10 most commonly inquired about complementary medicines at Melbourne’s Peter MacCallum Cancer Centre all have predicted or actual drug interactions when taken with chemotherapy, radiation therapy or before surgery.

“The research involved an audit of inquiries to the hospital’s Medicines Information Centre from health providers and patients, over two years.

“The 10 most commonly inquired about products or supplements (excluding vitamins and minerals) were: fish oil, turmeric, coenzyme Q10, milk thistle, green tea, ginger, lactobacillus, licorice, astragalus and reishi mushroom.

“Lead researcher and Senior Pharmacist at Peter MacCallum’s Medicines Information Centre, Sally Brooks, said while levels of these substances found in a healthy diet were unlikely to cause contraindications, larger amounts in complementary medicines could.”


Cancer Patients Benefit from Isavuconazole, a New Antifungal

The gist: This article describes the results of a clinical trial—a research study with volunteer patients. The goal of the study was to test a new treatment for fungal infections in cancer patients. The researchers found that the new drug, isavuconazole, is just as effective as the existing drug voriconazole, and it has fewer bad side effects,

“A newly developed antifungal, isavuconazole, is as effective as an existing drug, voriconazole, against invasive mold disease in cancer patients with less adverse effects, according to phase 3 clinical data presented at the 54th Interscience Conference on Antimicrobial Agents and Chemotherapy, an infectious disease meeting of the American Society for Microbiology.

” ‘There is a growing need for new antifungal therapies like isavuconazole because serious fungal infections caused by Aspergillus and other molds are on the rise due to the increasing numbers of immunosuppressed patients, including those with active cancer. These infections are associated with high morbidity and mortality. If approved, isavuconazole has the potential to be an important new option for the treatment of these life-threatening fungal infections,’ says Andrew Ullman of Julius Maximilians University in Wuerzburg, Germany, one of the researchers presenting data.

“Invasive fungal infections are important causes of morbidity and death for patients with hematological malignancies. Many leukemia and lymphoma patients receive high-dose chemotherapy, sometimes followed by stem cell transplantation, compromising their immune systems. The genus Aspergillus comprises several hundred species of mold that are ubiquitous in the environment but pose little threat to people with healthy immune systems. Immunocompromised patients, however, are more vulnerable to infection.”


Lung Cancer Study Reveals New Drug Combination Targets

Editor’s note: Oncologists often prescribe lung cancer treatments based on specific proteins found in patients’ tumors. These treatments are known as targeted therapies. This article describes how a patient with an unexpected response to treatment contributed to new research into targeted therapies. This patient responded exceptionally well to a drug that targets a protein called IGF-1R. She was found to have a mutation in the ALK protein, and was then successfully treated with the ALK-targeted drug crizotinib. Based on her success, researchers hope that combining an IGF-1R-targeted drug with crizotinib could help treat other patients with ALK mutations.

“A Vanderbilt lung cancer patient’s exceptional response to different types of therapies spurred research that suggests lung cancer patients with specific gene alterations may benefit from combination therapy that targets two different cancer pathways.

The study, led by Christine Lovly, M.D., Ph.D., assistant professor of Medicine and Cancer Biology, was published online in Nature Medicine.

The work was based on an intriguing clinical observation of a female patient with advanced lung cancer who had an unexpected response to a monoclonal antibody that targets the insulin-like growth factor receptor (IGF-1R). IGF-1R helps cancer cells survive and evade anti-cancer therapies.

Remarkably, the patient remained on the IGF-1R therapy for 17 months – far longer than any other patient on the clinical trial. The Vanderbilt researchers, led by Lovly, became interested in why this particular patient’stumor responded to the experimental therapy so dramatically. Investigators decided to test for gene mutations and found an unexpected result – the patient’s tumor was positive for an ALK gene fusion. Only about 5 percent of lung cancer patients have this gene fusion in their tumor.


New Ways to Treat Solid Tumours

Editor’s note: Recent research has uncovered a potential new way to fight some cancer types. The key is a protein called Eph3A, which is made by the cells of blood cancers and solid tumors. Researchers made a new drug called KB004 to target and kill cells with Eph3A. The drug is currently being tested in a clinical trial with volunteer leukemia patients.

“An international team of scientists has shown that an antibody against the protein EphA3, found in the micro-environment of solid cancers, has anti-tumour effects.

“As EphA3 is present in normal organs only during embryonic development but is expressed in blood cancers and in solid tumours, this antibody-based approach may be a suitable candidate treatment for solid tumours…

“Currently, KaloBios Pharmaceuticals is testing the anti-EphA3 antibody KB004 in a multi-centre Phase I/II clinical trial in Melbourne and the US in patients with EphA3 expressing blood malignancies: AML, MDS and myelofibrosis.”