lundi 25 juillet 2016

Onco Actu du 25 juillet 2016

NB: en raison d'un problème informatique, ce numéro est publié sous une forme simplifiée.

Biologie
A laboratory study has revealed an entirely unexpected process for acquiring drug resistance that bypasses the need to re-establish DNA damage repair in breast cancers that have mutant BRCA1 or BRCA2 genes. 

The images released this week by the National Cancer Institute as part of its “Cancer Close Up” project show the genesis of cancer cells and their migration through the body, the blood vessels they sprout to stay alive, and the molecular “skeletons” that help them spread.

One cell line involved are the so-called HeLa cells. These cancerous cervical cells — named for Henrietta Lacks, from whom they were first cultured in the early 1950s — are ubiquitous in labs, proliferate wildly — and, it turns out, contaminate all manner of cells with which they come into contact. 

Etiologie
The huge study not only found no increased risk among women receiving I.V.F., but also found no greater risk among women who had various types of less intensive treatments to improve fertility.

The biggest limitation of this review is that it doesn't appear to be systematic. The author provided no methods for how they identified and appraised the research they drew on.
Analysis implicates alcohol in development of breast, liver and other types of cancer and says even moderate consumption is a risk.

Prévention
Updated Guideline Recommends Vaccinating Males and Females at Ages 11 to 12.

Dépistage, diagnostic et pronostic
Despite the excitement I feel about the potential of ctDNA cancer screening, I can’t help but feel skepticism also. If these tests are to be applied for routine screening in the general population, they can’t just be good—they have to be nearly perfect.

Researchers reporting in Annals of Internal Medicine Monday found that density assessments varied widely from one radiologist to another. That means you shouldn't let one finding freak you out too much, nor should you assume something's wrong if your reported density changes from year to year.

Traitements
Engineers program E. coli to destroy tumor cells.

Therapies could combat the disease’s 'ability to adapt and evade treatment'.
The new vision represents the first major research strategy to place at its heart the need to overcome cancer evolution and drug resistance. 

Gene-editing technique to treat lung cancer is due to be tested in people in August.

Immunothérapies
Given these promising findings, it is hoped that continued immunotherapy research and development will produce better cancer treatments that improve patient outcomes. With this promise, however, there is also recognition that the clinical and biological landscape for immunotherapies is novel and not yet well understood.


Traitements - économie
More than two-thirds of the 20 largest​ pharmaceutical companies said price increases boosted sales of some or most of their biggest ​products in the first quarter, according to a Wall Street Journal review of corporate filings and conference-call transcripts. ​​

Anson renewed a call for the government to reform NICE, growing the chorus of displeasure among AZ’s pharma peers who have seen effective new drugs turned down on price concerns.

Pharma
Amgen Inc and Allergan Plc said their copycat version of Roche Holding AG's blockbuster cancer treatment, Herceptin, was found as effective as the original in a late-stage study.

AstraZeneca said Tagrisso (osimertinib) showed superior progression-free survival compared to standard platinum-based chemotherapy.

Gazyva did not significantly reduce the risk of disease worsening or death for people with previously untreated diffuse large B-cell lymphoma, over current drug Rituxan in a phase III GOYA study.
GOYA study did not meet its primary endpoint of improvement in progression-free survival with Gazyva/Gazyvaro plus CHOP chemotherapy versus MabThera/Rituxan plus CHOP chemotherapy.

The drug, Ad-RTS-hIL-12, is being developed in collaboration with Intrexon Corp, and is injected directly into the patient's tumor to elicit a cancer-killing immune response. Ziopharm also reported two other deaths of patients in trial but said they were unrelated to the drug.

Regulatory submissions based on CheckMate -141, in which Opdivo met its primary endpoint of overall survival, compared to investigator’s choice of therapy.

Serious questions about the XBiotech colon cancer drug were raised after the Xylonix presentation at an ESMO cancer meeting on July 2.

Pharma - économie
Schwan warned that if up-to-date therapies were not generally available in the UK then it would not be possible to conduct clinical trials in the country, since researchers needed to compare test drugs to the best existing standard of care.

Tuesday, the German drugmaker announced it was breaking ground on a $115 million life science campus in Burlington, MA, about 13 miles from where many of its peers have set up shop in Cambridge.

FDA, EMA...
Cabometyx (cabozantinib) and Kisplyx (lenvatinib) are indicated for the treatment of adult patients with advanced renal cell carcinoma who have been previously treated with a vascular endothelial growth factor (VEGF)-inhibitor; Cabometyx is to be used as monotherapy while Kisplyx is for use in combination with everolimus.
Cabometyx led to a statistically significant improvement in progression-free survival (PFS) compared with everolimus: PFS was 7.4 months with Cabometyx versus 3.8 months with everolimus.

All patients treated with Zydelig should be given preventive medication against the lung infection Pneumocystis jirovecii pneumonia during treatment and this should be continued for up to 6 months after treatment with Zydelig has stopped.

The EC decision was based on data from MCL-002, a phase II, multicenter, randomized open-label study to determine the efficacy and safety of REVLIMID® versus the investigator's choice (IC), in 254 patients who were refractory to their last treatment or had relapsed one to three times. In the study, REVLIMID® showed a significant improvement in progression-free survival (PFS) of 8.7 months vs. 5.2 in the control arm.

Bioequivalence studies performed at the site cannot be used to support medicines approval in the EU.
The move comes three months after the US Food and Drug Administration alerted an untold number of drug makers of problems at the Semler Research Center, which is located in Bangalore. An inspection last fall found “significant instances of misconduct and violations of federal regulations, including the substitution and manipulation of study subject samples.”

Comments invited on a concept paper on changes intended to support best practices.

Lutte contre les cancers
Cancer Research UK has tripled its investment in pancreatic cancer, one of the hardest cancers to treat, since launching its research strategy in 2014 according to new figures published today.

If you look at survival figures by cancer type, four types of cancer stand out in which survival has barely improved: lung, pancreatic and oesophageal cancers, and brain tumours.

Despite working out a huge amount of biology, particularly of children’s brain tumours – understanding that allows us to classify these tumours accurately into distinct diseases – this knowledge hasn’t yet made its way into routine use. And it needs to.

Lutte contre les cancers - politiques
We’ve tried to cure cancer before. Will this time be different?

For starters, it’s too expensive and the science isn’t advanced enough.

The US vice-president, Joe Biden, says there is a need for a new “Manhattan Project” against cancer as he announced a deal to share data from Australian patients with researchers around the world.

Failure to act swiftly could generate waves of uncertainty over UK researchers’ future involvement in major European science projects following last month’s Brexit vote, he said.

Observation
The claim of an increase in advanced cases does not hold up, according to the American Cancer Society, which posted a statement on its website challenging the findings. The main concern is that the study’s methods do not pass muster with statistics experts, so the increase may not be real.
Given this substantial flaw, why did so many news outlets blast off on the “skyrocketing” disease angle? Brawley notes that the framing bears a suspicious resemblance to that of a Northwestern University news release, which just happens to be home base for that “believer” in prostate cancer screening.

Pathologists at a dozen hospitals in the state are part of a pilot project — the first of its kind in the United States — in which they are reporting cancer diagnoses in close to real time to the California Cancer Registry. And they are using standardized electronic forms to make their reporting more consistent and accurate.