Trastuzumab (also known as Herceptin) and other breast cancer treatments targeting the HER2 protein have saved numerous lives, but the therapy doesn’t benefit all patients equally.
Further, because treatments are expensive — Herceptin for a year costs approximately $54,000 — and come with serious side effects, clinicians are looking for ways to identify breast cancers that are most likely to respond to the drug.
The answer may lie in positron emission tomography (PET) scans, according to City of Hope research being presented at the American Society of Clinical Oncology annual meeting in Chicago.
In the study, researchers administered a dose of trastuzumab to patients followed by another dose of trastuzumab modified with a tracing agent. The idea is that, although tumor and normal tissues alike will take up the normal trastuzumab, only the cancer cells will take up the tracing agent-modified trastuzumab, allowing for better visualization of the tumor.
Joanne Mortimer, M.D., director of the Women’s Cancers Program at City of Hope and lead author of the study, said that, in addition to identifying tumors that were responsive to HER2 treatments, the study also found that some tumors classified as HER2-negative took in the tracer-linked trastuzumab as well. That finding implies a possible benefit for anti-HER2 treatments for this group, as well, and is worth further investigation, she said.
Mortimer discussed the findings in the video above.
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If doubts remained about immunotherapy’s potential as a cancer fighter, a new study should help ease them.
City of Hope researchers administered a vaccine known as MVA-p53 to 11 patients with metastatic colon, gastric or pancreas cancer whom standard treatments had failed to help. Each received three different doses of the vaccine, designed to prompt the immune system to fight cancer.
In announcing the results of their first-in-human trials, City of Hope researchers report that their vaccine is well-tolerated – in other words, it’s safe. None were cured, but for phase 1 trials, that isn’t the goal.
“Considering the advanced disease and pretreatment with chemotherapy that is the requirement to enter the trial, we were not anticipating major responses,” said Don Diamond, Ph.D., the Tim Nesvig Lymphoma Research Fellow at City of Hope and one of the study authors. “However, the completion of this trial sets up a series of new proposals to enhance the efficacy of the vaccine.”
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Adolescent and young adult cancer survivors between 15 and 39 years of age have unique health care needs, from difficulty accessing care to cognitive problems that linger long after treatment. Yet, communication barriers sometimes prevent them from getting the care they need in a timely way.
Using technology that this population already embraces, Jonathan Espenschied, M.D., director of Graduate Medical Education & Clinical Training, and his colleagues are trying to dissolve those barriers.
They created a tailored touchscreen tool for cancer patients and survivors in an effort to foster better communication between them and their health care team – and enable more timely intervention. Through this screening/assessment tool, called AYATT (for Adolescents and Young Adults Touchscreen Tool), clinicians will know sooner about patients’ possible cognitive issues, such as impaired motor skills or memory deficits. Those problems can then be further addressed using more in-depth clinical tools, Espenschied said. » Continue Reading
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Patients with transformed non-Hodgkin lymphoma (NHL) – in which low-grade lymphoma mutates into diffuse large cell lymphoma – have a poor prognosis, generally surviving only about seven to 20 months.
Those odds now look considerably more promising thanks to a novel conditioning regimen combining radioimmunotherapy (which uses monoclonal antibodies to deliver radiation to the tumor), high-dose chemotherapy and autologous stem cell transplantation, in which the patient’s own stem cells are removed, cleansed and reinfused.
City of Hope has collaborated with a center in the Netherlands and a center in Israel to combine the results of such a treatment approach for transformed NHL; their findings are being presented at a poster session at the American Society of Clinical Oncology meeting in Chicago, May 31 through June 4.
Previous studies demonstrated that patients with transformed non-Hodgkin lymphoma were helped by high-dose chemotherapy and autologous stem cell transplantation.
“In this study we looked at our outcomes with patients with transformed lymphoma getting Zevalin Beam conditioning. It was well tolerated, there was low toxicity and they had good overall survival – 90 percent at two years,” said first author Amrita Krishnan, M.D., director of the Multiple Myeloma Program at City of Hope. » Continue Reading
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Metastatic colorectal cancer generally comes with a grim prognosis; only 6 percent of patients will survive five years past their diagnosis. But research unveiled at the 2013 American Society of Clinical Oncology (ASCO) annual meeting offers some positive news for these patients.
The findings come from the Germany-based “FIRE-3” study. In the trial, 592 people with metastatic colorectal cancer took either cetuximab (Erbitux), which slows the growth of cancer cells, or bevacizumab (Avastin), which stops the formation of blood vessels that feed the tumors. Both drugs were given in addition to a chemotherapy combo.
The authors found that, although progression-free survival was identical for both drugs, the patients taking cetuximab showed a significant improvement in overall survival (28.7 months versus 25 months). Additionally, among the 526 those who had undergone post-benchmark imaging, the cetuximab group had a better response to the therapy as well.
“We suspected that cetuximab would produce a better response, but we didn’t know this would translate into better survival,” said lead author Volker Heinemann, M.D., Ph.D., reporting the results at an ASCO briefing and in a subsequent press release.
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Put simply, National Cancer Survivors Day is a celebration of life. But when it comes to surviving cancer, nothing is simple. Every survivor is special, every moment is a victory and every story is unique.
“Finally, just when it seems you can’t take anymore ‘medicine,’ when the cure is worse than the disease, when you have no veins left to offer the nurses and their sharp sticks, when you can’t take the smell of the hospital one more time or the sight of your sickly self anymore – you finish your treatment and go home. Free forever.
It’s really that simple. Of course it will take you a while to regain your strength and to get over the mental trauma of what you’ve been through. Don’t underestimate that.
But you are done with the pain. You are done with the nausea. You are done being a patient. In fact, you are just you again and really, what a wonderful thing to be.”
Some survivors will spend today, National Cancer Survivors Day, relishing that “wonderful thing” and celebrating an existence that doesn’t involve “being a patient.” Some will spend it in quiet reflection. And some will simply be too busy living their lives to pay any attention at all. » Continue Reading
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National Cancer Institute-designated comprehensive cancer center isn’t just a long, fancy name. For some young cancer patients, treatment at one of these centers could be the key to survival, a City of Hope study has found.
The study compared 746 adolescents and young adults diagnosed with brain tumors in Los Angeles County, and analyzed their survival rates based on the facilities where they received care. The outcomes of patients from one of the county’s three NCI-designated centers were compared with those of patients who received care at other facilities in Los Angeles County.
“The reason why we wanted to do this particular study was we knew adolescents and young adults were less likely to have a favorable outcome – they haven’t kept up compared to patients under 14 years of age,” said Smita Bhatia, M.D., M.P.H., professor and Ruth Ziegler Chair in Population Sciences. “We wanted to see if their care had any role in it.”
For adolescents and young adults with very early stage brain tumors, the outcomes were good regardless of where they received treatment. Likewise, for those with very high-risk tumors, the outcomes were poor no matter where they were diagnosed and treated.
But for those in the middle, treatment location mattered. The gap between survival for young children versus adolescents and young adults disappeared when the adolescents and young adults were treated at an NCI-designated comprehensive cancer center.
For that group, it’s important that care be obtained at an NCI center, Bhatia said.
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Anthracyclines have successfully treated many childhood cancers, including leukemia and lymphoma. But although the drugs have led to a growing number of childhood cancer survivors, patients treated with these drugs face a high risk of developing heart failure.
Of the 350,000 childhood cancer survivors in the U.S., about two-thirds were treated with anthracyclines. Of those, two-thirds have developed heart abnormalities that could progress to heart failure. The common method for screening these patients is with an echocardiogram, but by the time the damage can be picked up by this test, it’s irreversible.
Two City of Hope studies seek to mitigate the risk of heart failure in such patients. One has identified a potential gene variant that could indicate which children are more susceptible to developing heart failure if treated with anthracyclines; another identifies methods to catch heart problems early, when intervention is still an option.
Gene variant linked to risk of cardiomyopathy
Because cardiomyopathy – a deterioration in the function of the heart muscle – occurs only in some patients treated with anthracylines, researchers suspected the existence of a genetic link. After examining 10,000 genetic variations in 2,100 genes, researchers homed in on variations in the HAS3 gene.
Childhood cancer survivors from 121 institutions participated in the study. During routine clinic visits, 93 patients with cardiomyopathy and 194 with healthy hearts were asked to donate blood samples. Researchers found that for individuals with one variant of the HAS3 gene, exposure to anthracyclines at any dose was not associated with cardiomyopathy risk. However, those with a different variant had an 8.5-fold increased risk for developing heart deterioration. » Continue Reading
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The American Society of Clinical Oncology’s (ASCO) annual meeting will include numerous significant – even breakthrough – findings for the prevention, diagnosis and treatment of cancer. Many of them would not have been possible without public funding.
That was the focus of the meeting’s opening day briefing on May 31. At the event, the panel noted that current National Cancer Institute (NCI) funding has been decreasing for the past decade and is currently stagnating at 1998 levels, after adjusting for inflation. And that was before the sequestration’s automatic cut of 5 percent from the budget.
“Our federally funded clinical trials system has achieved remarkable advances that have improved survival and quality of life for millions of people with cancer, but this progress is occurring under the cloud of federal budget slashing,” said ASCO President Sandra M. Swain, M.D., during the briefing and in a press release.
Some may argue that private and corporate sources can pick up the slack. However, Joanne Mortimer, M.D., director of City of Hope’s Women’s Cancers Program, explained in the video above that these sources may not have the same goals as a researcher. » Continue Reading
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