“Back-to-back discoveries from Cleveland Clinic demonstrate for the first time how a testosterone-related genetic abnormality can help predict individual patient responses to specific prostate cancer therapies.
“The studies, published in the October 12 issue of JAMA Oncology, suggest that men who inherit this variant would benefit from a personalized treatment plan that targets specific hormonal pathways.”
“A novel class of personalised cancer vaccines, tailored to the tumours of individual patients, kept disease in check in two early-stage clinical trials, pointing to a new way to help the immune system fight back.
“Although so-called immunotherapy drugs from the likes of Merck & Co, Bristol-Myers Squibb and Roche are starting to revolutionise cancer care, they still only work for a limited number of patients.
“By adding a personalised cancer vaccine, scientists believe it should be possible to improve substantially the effectiveness of such immune-boosting medicines.”
“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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“Amsterdam, The Netherlands: Approximately a quarter of women with HER2 positive breast cancer, who were treated with a combination of the targeted drugs lapatinib and trastuzumab before surgery and chemotherapy, saw their tumours shrink significantly or even disappear, according to results from a clinical trial.
“Professor Nigel Bundred told the 10th European Breast Cancer Conference (EBCC-10) today (Thursday): ‘This has ground-breaking potential because it allows us to identify a group of patients who, within 11 days, have had their tumours disappear with anti-HER2 therapy alone and who potentially may not require subsequent chemotherapy. This offers the opportunity to tailor treatment for each individual woman.’
“Prof Bundred, who is Professor of Surgical Oncology at The University of Manchester and the University Hospital of South Manchester NHS Foundation Trust (UK), was presenting results from the UK EPHOS-B multi-centre, clinical trial, in which 257 women with newly-diagnosed, operable, HER2 positive disease were recruited between November 2010 and September 2015.”
“A huge federal trial of personalized cancer medicine has run into an unexpected roadblock: Many of the tumor samples aren’t robust enough to be put through genetic analysis.
“The samples, taken from patients with advanced cancer, were collected by doctors in hundreds of clinics nationwide. When researchers checked them, they found as many as 1 in 5 didn’t have enough malignant cells to analyze, in most cases because the biopsy had been poorly done.
“The glitch raises troubling questions about the new era of precision medicine.”
“African American men are more likely to develop prostate cancer than European American men, and are also more than twice as likely to die from it. Although there are many reasons that contribute to this health disparity, new research shows that African American men may have a distinctly different type of prostate cancer than European American men, according to new genomic fingerprinting results.
“ ‘This study, this line of research, is about finding better and more appropriate therapies for African American men,’ says corresponding author of the study, Kosj Yamoah, M.D., Ph.D., Chief Resident in the Department of Radiation Oncology, Sidney Kimmel Cancer Center at Thomas Jefferson University. ‘The first step is to figure out how prostate cancer is different and more aggressive at the genomic level.’ In research published in the Journal of Clinical Oncology on July 20th, Dr. Yamoah and colleagues identify a subset of genes known as biomarkers that define a genomic subtype of prostate cancer that is more common in African American men, and which signals a more aggressive disease.”
“Though molecularly targeted drugs are not yet available for most cancer patients, they account for the majority of the 45 new cancer drugs launched since 2010, a report by IMS Health found.
“Personalized cancer therapy is no longer just an exciting prospect, and better survival rates — as well as escalating spending — are proving it.
“ ‘It’s here. It’s definitely here,’ said Pasi Janne, an oncologist at the Dana-Farber Cancer Institute in Boston. ‘Today, it’s the most effective way to treat patients: Figure out the genetic fingerprint of an individual’s cancer and tailor the therapies to it.’ ”
“This year, President Obama announced an initiative focused on ‘precision medicine.’
“The FDA today granted breakthrough therapy designation for CTL019, an investigational personalized immunotherapy, for the treatment of relapsed and refractory adult and pediatric acute lymphoblastic leukemia, according to a press release issued by Penn Medicine.
“CTL019 (Novartis), developed by the University of Pennsylvania, is the first personalized cellular therapy for the treatment of cancer to receive this classification.
“In early-stage clinical trials conducted at the Hospital of the University of Pennsylvania and Children’s Hospital of Philadelphia, 89% of patients with ALL who were not responding to conventional therapies achieved complete remission after treatment with CTL019.
“ ‘Our early findings reveal tremendous promise for a desperate group of patients, many of whom have been able to return to their normal lives at school and work after receiving this new, personalized immunotherapy,’ Carl H. June, MD, director of translational research in the Abramson Cancer Center of the University of Pennsylvania. ‘Receiving the FDA’s Breakthrough Designation is an essential step in our work with Novartis to expand this therapy to patients across the world who desperately need new options to help them fight this disease.’ ”
Editor’s note: This story describes a new leukemia treatment called CTL019, which boosts a patient’s own immune system to fight cancer. CTL019 treatment is personalized for each patient, since it involves altering a patient’s immune system cells to attack tumor cells. It has been tested in volunteer patients in clinical trials, and has shown promising results for adults and children with relapsed or refractory acute lymphoblastic leukemia (ALL). The U.S. Food and Drug Administration (FDA) has now granted breakthrough therapy designation for CTL019, meaning that review and approval will be accelerated so that the drug can more quickly reach patients outside of clinical trials.
“The immunotherapy ipilimumab (Yervoy, Bristol-Myers Squibb Company) works amazingly well in some patients, hardly at all in others. A groundbreaking study that used deep sequencing techniques offers some clues as to why.
“Ipilimumab, which is marketed for melanoma but is being explored in several other cancer types, including prostate cancer, acts as a checkpoint blocker by inhibiting cytotoxic T lymphocyte– associated antigen–4 (CTLA-4).
“Immune repertoire sequencing has confirmed that blocking CTLA-4 increased turnover and diversity of the T-cell repertoire in some patients with advanced prostate cancer or metastatic melanoma, but also showed that patients who survived longest maintained clones of high-frequency T-cells they had developed before starting treatment.”
Editor’s note: Ipilimumab is a drug that boosts a patient’s own immune system to fight cancer. It works by activating immune system cells called T cells, some subtypes of which may then attack tumors. Ipilimumab works very well for some patients, but not for others. This study found that patients who had certain tumor-fighting T cell subtypes already present before ipilimumab treatment were more likely to respond well and survive longer, possibly because these cells were readily available to fight cancer upon activation. The study also found that ipilimumab may prompt the immune system to “re-shuffle” the body’s T cell subtypes, allowing patients with only a small amount of tumor-fighting T cells to generate more. (This may explain why some patients take longer to respond to ipilimumab than others; their immune systems need more time to build up the right T cells.) Based on the results, doctors may be able to monitor a patient’s T cell subtypes (“immune repertoire sequencing”) to determine whether ipilimumab will work, or to keep tabs on the effectiveness of ongoing ipilimumab treatment.