05 June 2018
TUESDAY, June 5, 2018 (HealthDay News) — Judy Perkins was 49 and battling breast cancer that had spread, but chemotherapy and hormone treatments had failed to rein in her disease. So, her doctors tried a highly sophisticated, but experimental, immunotherapy. It worked beyond their wildest expectations: Her body was cleared of all signs of cancer. And the research team that tried the cutting edge treatment hope the case will herald a major breakthrough in cancer treatment. The immunotherapy was tailored to the particular genetic mutations of Perkins’ tumor. In the end, the medical team identified 197 mutations. Of those, 196 were characterized as “unique” to Perkins. The researchers then deployed a relatively novel intervention called adoptive cell transfer (ACT). ACT is a type of immunotherapy that essentially enlists and enhances a patient’s own immune system, activating an army of T-cells to launch a highly specific attack on those cancerous mutations. The result: Perkins remains cancer-free more than two years after her treatment ended. When Perkins, a retired engineer from Port St. Lucie, Fla., was first diagnosed and treated for breast cancer in 2003, she thought she’d beaten it, according to NPR. “I thought I was done with it,” she told the radio network. But she felt a new lump almost 10 years later, and her physicians discovered the cancer had spread throughout her chest. “I became a metastatic cancer patient,” Perkins said. “That was hard.” And although the treatment was grueling, Perkins is grateful. “”I’m one of the lucky ones,” Perkins said. “We got the right T-cells in the right place at the right time. And they went in and ate up all my cancer. And I’m cured. It’s freaking unreal.” Her doctors are just as thrilled. “The message in this paper is twofold,” explained study author Dr. Steven Rosenberg, chief of the surgery branch at the U.S. National Cancer Institute’s Center for Cancer Research. “One, that it is now clear that for multiple cancer types that are [resistant] to all known chemotherapies and immunotherapies, attacking the unique mutations in a patient’s cancer can result in dramatic durable cancer regressions,” he noted. The second message, he added, is that “we need a new paradigm for cancer therapy.” By that, Rosenberg said he means that “highly personalized treatments are likely to be necessary if we are to make progress in treating common cancers.” The researchers emphasized that while Perkins’ case revolved around breast cancer, the basis for treatment centered on mutation identification, rather than on cancer type. And that likely means there’s every reason to believe that her case can serve as a template for tackling a wide array of other cancers that have also proven impervious to standard treatments. Rosenberg goes so far as to suggest that “the development of this approach holds the best opportunities for finding effective immunotherapies for patients with the solid cancers that last year caused over 500,000 deaths in this country.” The research team noted that ACT has actually already been used to treat melanoma. However, while melanoma typically gives rise to a lot of cell abnormalities, that’s not the case with the sort of cancers that first take root in the lining of organs. Such so-called “epithelial cancers” include stomach, esophageal and ovarian cancer, as well as breast cancer, all of which are solid cancers with relatively low levels of mutations. In this latest case, published June 4 in the journal Nature Medicine, Perkins’ team was able to sift through her immune system to find those T-cells best equipped to wage war on her disease. Those T-cells were then extracted, multiplied exponentially in a lab setting, and put back into Perkins to supercharge the desired immune response. Besides demonstrating an ability to eliminate breast cancer, Rosenberg and his team already have additional preliminary results suggesting that the technique is similarly effective against both liver cancer and colon cancer. “The complexity of the treatment scares away many oncologists who think that this is not practical,” acknowledged Rosenberg. But he suggested the ACT approach is exactly the “drastic change [that] is needed if we are to make substantial progress in curing patients with cancer.” More information There’s more on immunotherapy at U.S. National Cancer Institute.
26 April 2018
THURSDAY, April 26, 2018 (HealthDay News) — Few American men are screened for gene mutations that can greatly increase their risk of breast and other types of cancers, a new study reveals. BRCA1 and BRCA2 gene mutations put women at high risk for breast and ovarian cancers, but these mutations also increase men’s risk for certain cancers. “If a male has a BRCA mutation, their risk of breast cancer increases 100-fold,” said senior study author Dr. Christopher Childers. He is a resident physician in the department of surgery at the University of California, Los Angeles School of Medicine. “But it’s not just breast cancer — BRCA mutations put men at higher risk for often aggressive prostate cancers that occur at younger ages,” Childers added in a university news release. “These mutations have also been associated with other cancers, such as pancreatic cancer and melanoma [skin cancer],” he noted. “It is therefore very important that men at risk of a BRCA mutation get genetic testing, as it can potentially help them detect future cancers and help physicians tailor cancer treatment if they do.” For the new study, Childers and his colleagues analyzed data from the 2015 U.S. National Health Interview Survey. The investigators found that nearly 2.5 million people had received cancer genetic testing. Of those people, nearly three times as many women had testing compared to men — 73 percent versus 27 percent, respectively. Further analysis revealed that the rate of testing for BRCA gene mutations in men was one-tenth that of women. There was no gender disparity in other types of cancer gene tests, the findings showed. The study was published April 26 in the journal JAMA Oncology. Further research is needed to learn why so few men get tested for BRCA gene mutations and how to increase their rates, said study lead author Kimberly Childers. She is a genetic counselor and regional manager of the Providence Health and Services Southern California’s clinical genetics and genomics program. “Previous studies have shown that men don’t necessarily understand the importance of a breast/ovarian cancer gene mutation — that it is more of a ‘feminine’ issue — but this couldn’t be further from the truth,” she said. “We hope this study will spur broad national educational efforts.” More information The U.S. National Cancer Institute has more on male breast cancer.
26 February 2018
MONDAY, Feb. 26, 2018 (HealthDay News) — Many breast cancer patients say they’ve heard scary stories about radiation therapy, but their actual experience is usually better, new research finds. The study of more than 300 women who underwent breast radiation found that almost half had heard “frightening” stories going into treatment. But only 2 percent ultimately agreed that the stories were true. And over 80 percent of all patients said their experience with radiation therapy was actually “less scary” than they’d expected. Researchers said the findings show that the public still has misconceptions about “modern” radiation therapy. “The word ‘radiation’ itself sounds frightening, and it’s associated with many negative news stories,” said senior study author Dr. Susan McCloskey. But over the past 20 years, there have been key advances in how breast radiation is given, explained McCloskey, an assistant professor of radiation oncology at the University of California, Los Angeles. It’s more precise and shorter in duration — which has helped limit short-term side effects like skin burning and breast pain. Doctors can also now create individualized radiation plans for each patient, and give the treatment in “more convenient” schedules, McCloskey noted. Dr. Beryl McCormick is a radiation oncologist at Memorial Sloan Kettering Cancer Center in New York City. She said that in her experience, it’s “extremely common” for patients to go into treatment having heard scary stories. The side effects of any cancer treatment will vary from one person to another. But McCormick said it’s possible to predict what women can typically expect. For example, skin symptoms vary based on whether a woman had only the breast tumor removed (a lumpectomy), or breast-removal surgery (a mastectomy). With lumpectomy patients, McCormick said she usually tells them the skin effects will be similar to what would happen if they were out in the sun for two hours without sunscreen. Those skin symptoms typically go away a few weeks after treatment ends, she noted. With mastectomy patients, the effects would typically be more pronounced and lasting, because the radiation therapy is actually, in part, targeting the skin, McCormick said. What’s important, she added, is that women have a thorough discussion of the benefits and risks of radiation therapy when making treatment decisions. “That discussion should start with their surgeon, who is usually the first [doctor] a woman will see,” McCormick said. If a woman finds the surgeon cannot answer all her questions, she can ask to talk to a radiation oncologist, McCormick suggested. The study findings were based on 327 women who’d been treated for breast cancer within the past several years. They’d had surgery, followed by radiation — usually a lumpectomy, though 17 percent had undergone a mastectomy. Overall, 47 percent said that before starting treatment, they’d read or heard “scary” stories about the effects of breast radiation. And many went into treatment worried about risks like skin burning and damage to the internal organs. In hindsight, though, few women felt their experience matched the stories they’d heard. Instead, 84 percent said their side effects — including skin symptoms, pain and fatigue — had been less serious than they’d expected. Similar percentages also said their treatment had been less disruptive to their work and family life than they’d feared. The long-term outlook was better than most women had thought, too. Of women who’d gotten a lumpectomy, 89 percent said the appearance of their irradiated breast was better than they’d expected. Similarly, 67 percent of mastectomy patients said the appearance of the radiation-treated area was better than they’d anticipated, according to the report. Finally, the vast majority of women agreed with the statement, “If future patients knew the real truth about radiation therapy, they would be less scared about treatment.” The study was published Feb. 26 in the journal Cancer. McCloskey said she hopes the findings will offer future patients a “better idea of the breast radiation experience when making treatment decisions.” McCormick agreed. “Almost everyone in the study went through [radiation] therapy and said it wasn’t as scary as they’d thought,” she said. “I think that’s pretty powerful.” In the longer term, chest radiation carries a risk of heart or lung disease, since it can damage those organs. But recent research shows that among nonsmoking women who receive breast radiation, less than 1 percent ultimately die of heart disease or lung cancer, according to McCloskey’s team. More information The U.S. National Cancer Institute has more on radiation therapy.