Gene Tests Identify Breast Cancer Patients Who Can Skip Chemotherapy, Study Says

Excerpt:

“When is it safe for a woman with breast cancer to skip chemotherapy?

“A new study helps answer that question, based on a test of gene activity in tumors. It found that nearly half of women with early-stage breast cancer who would traditionally receive chemo can avoid it, with little risk of the cancer coming back or spreading in the next five years.

“The so-called genomic test measures the activity of genes that control the growth and spread of cancer, and can identify women with a low risk of recurrence and therefore little to gain from chemo.”

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Liquid Biopsies for Identification of EGFR Mutations and Prediction of Recurrence

Excerpt:

“Three manuscripts published in the recent issue of the Journal of Thoracic Oncology, the official journal of the International Association for the Study of Lung Cancer (IASLC), explored the versatility of liquid biopsies by identifying EGFR mutations using circulating tumor DNA (ctDNA) in urine and plasma and examining circulating tumor cells (CTCs) in plasma to predict the risk of lung cancer recurrence after surgical resection. Collectively, these findings illustrate the potential and reach of liquid biopsies in both identifying patients suitable for targeted treatment as well as predicting cancer recurrence.

“Lung cancer is the most common type of cancer with the highest cancer-related mortality worldwide. Non-small cell lung cancer (NSCLC) accounts for roughly 85% of lung cancer and most patients present with advanced disease at diagnosis. Surgical resection is the preferred treatment option for patients with medically operable tumors. However, disease recurrence occurs in approximately 50% of cases. Patients with advanced disease are often not candidates for surgical resection and commonly harbor driver mutations that can be targeted by drugs. A major challenge for assessing driver mutations, such as epidermal growth factor receptor (EGFR) mutations, in advanced disease is the scarcity of suitable biopsy tissue for molecular testing. A minimally invasive alternative to invasive tissue biopsy is the use of liquid biopsy, which analyzes ctDNA or CTCs in a liquid biological sample (i.e. urine, blood, or serum).”

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Can Big Data Help Cure Cancer?

Excerpt:

“Curing cancer seems like something that would happen at hospitals and not in computer rooms. But applying analytics to human DNA and the DNA of cancer cells is a promising frontier of cancer research that can help patients get the best treatment for the type of cancer they have, minimize the negative impact of that treatment on them, and ultimately save lives.

“For Intel’s Bryce Olson, it’s a personal mission.

“Olson is a prostate cancer patient and global marketing director of the Health and Life Sciences Group at chipmaker Intel. Together with the Knight Cancer Center Institute at Oregon Health & Science University, Intel is the company that has been driving the Collaborative Cancer Cloud project.”

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Study Finds Incidence of Mutations in DNA-Repair Genes Significantly Higher in Men With Metastatic Prostate Cancer

Excerpt:

“The incidence of mutations in DNA-repair genes was significantly higher among men with metastatic prostate cancer than among men with localized disease (11.8% vs 4.6%), according to a study by Pritchard et al reported in The New England Journal of Medicine. In addition, the frequency of germline mutations in DNA-repair genes among men with metastatic prostate cancer did not differ significantly according to age at diagnosis or family history of prostate cancer. ”

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Study Suggests Men with Metastatic Prostate Cancer Should Be Tested for Inherited Mutations

Excerpt:

“Inherited mutations in DNA-repair genes, such as the BRCA genes, can increase cancer risk. A new study shows that DNA-repair mutations are significantly more common in men with metastatic prostate cancer compared with men whose prostate cancer hasn’t spread. This suggests all men with advanced prostate cancer should be tested for inherited DNA-repair mutations to help select the most effective therapies and provide information on family risk.”

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Mutation Status May Guide Endocrine Therapy for Advanced Breast Cancer

Excerpt:

“Plasma analysis of ESR1 mutations may aid in the identification of appropriate endocrine therapy for patients with advanced breast cancer who progress after treatment with aromatase inhibitors, according to study results published in Journal of Clinical Oncology.

“ ‘Although diverse mechanisms of resistance to endocrine therapy have been described, recent evidence identified mutations in the ER gene (ESR1),’ Nicholas C. Turner, MA, MRCP, PhD, consultant medical oncologist at The Royal Marsden NHS Foundation Trust and team leader at the Breakthrough Breast Cancer Research Centre at Institute for Cancer Research, London, and colleagues wrote. ‘ESR1 mutations occur rarely in primary breast cancer, but have a high prevalence in advanced breast cancers previously treated with aromatase inhibitors, implying evolution through selective treatment pressure.’ ”

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Should We Sequence the DNA of Every Cancer Patient?

Excerpt:

“A startup called Strata Oncology says it plans to give away advanced genetic tests to 100,000 patients struggling with cancer. But there’s a profit motive: it hopes to identify patients with specific rare DNA errors and steer them to drug companies.

“Strata, which was founded last year and has raised $12 million from investors, says it is set up to run 50,000 next-generation sequencing tests a year. Such tests probe the DNA of tumor tissue, searching for mutations in hundreds of genes at once, hoping to surface clues about what drug a patient should be taking.

“Similar tests are already offered commercially to doctors by several companies, including Foundation Medicine of Cambridge, Massachusetts, and can cost $5,000 each.”

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Can Liquid Biopsies and Tumor Biomarkers Personalize Prostate Cancer Treatment?

Excerpt:

“Experimental, minimally invasive ‘liquid biopsy’ blood tests might soon help to personalize prostate cancer treatment by predicting androgen resistance and survival benefits from particular treatments, researchers announced at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting, held June 3–7 in Chicago.

“Liquid biopsies detect circulating tumor cells (CTCs) or bits of tumor DNA (ctDNA). Not all tumors shed cells or DNA into a patient’s bloodstreams, but most do. And when they do, they can reveal a lot about themselves—including molecular signatures that can be targeted with specific treatments.

“Recent years have seen an explosion of candidate biomarkers for prostate cancer and other malignancies, including both liquid biopsies and tumor-sample gene panels. Most candidate biomarkers have been prognostic gene-mutation signatures that can estimate patient survival regardless of what treatment strategies are attempted. These prognostic tests can be useful for risk-stratifying patients who are participating in clinical studies, or in communicating prognosis to a patient and his loved ones.”

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Black Women Less Likely to Pursue BRCA Testing and Cancer Risk Reduction Measures

Excerpt:

“Findings from a population-based study reported at the 2016 ASCO Annual Meeting revealed that young black women with breast cancer are much less likely to undergo testing for the BRCA gene than other women. Or, if they do carry a BRCA mutation, they are less likely to get a prophylactic mastectomy or salpingo-oophorectomy to reduce the risk of developing cancer.

“The research identified disparities in recipients of BRCA testing between non-Hispanic white women, Hispanic, and black women, with the latter being the least likely to undergo testing. Likewise, black women who were BRCA carriers were less likely to undergo risk-management practices compared with their white and Hispanic counterparts.

“ ‘We need to understand the reasons for these findings,’ said lead study author Tuya Pal, MD, a clinical geneticist at the Moffitt Cancer Center in Tampa, Florida. Ultimately, it’s the patient who must decide whether to have genetic testing and take prophylactic measures for risk management, Pal said.”

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