Onco Actu du 11 octobre 2016

	2. Etiologie
'No link' between night shifts and breast cancer risk [NHS Choices] The evidence we have – both from these three UK studies and international studies – suggests night shift work won't increase your breast cancer risk.
	4. Dépistage, diagnostic et pronostic
A Noninvasive Approach May Identify Glioblastoma Patients Suitable for Antiangiogenic Therapy [AACR] Radiomics, an approach that combines imaging and computation, can stratify patients with recurrent glioblastoma into those who are likely to benefit from the antiangiogenic therapy bevacizumab (Avastin) and those who do not, according to a study published in Clinical Cancer Research.
Computers still aren't close to replacing doctors for diagnosing disease [Vox] In the first such head-to-head study, researchers from Harvard Medical School and Brigham and Women’s Hospital in Boston decided to put humans and machines to the test, comparing the diagnostic accuracy of physicians with that of 23 different medical diagnostic software tools.
	5. Traitements
A new strategy for choosing cancer drugs [MIT News] Device can predict tumor responses by measuring cell growth after drug exposure.
	5.12 Immunothérapies
Immuno-oncology: AACR Partners with FDA to Accelerate the Pace of Progress [Cancer Researh Catalyst] This week, the American Association for Cancer Research (AACR) is partnering with the FDA to co-sponsor a two-day public workshop in Washington, D.C., that will bring together individuals representing many of the stakeholders in the immuno-oncology drug development community with the goal of enhancing the immuno-oncology drug development process.
	5.2 Pharma
Clovis' Drug Data Deja Vu [Bloomberg] Friday's news highlights underlying problems for the drug. PARP inhibitors are a crowded class. If approved, rucaparib will have to make up ground on Lynparza, while also being pressured by Tesaro's drug, which has had better results. If Clovis can't prove its drug is substantially different than competing drugs, its acquisition hopes will be dimmer.
Bristol's Failure of Leadership [Bloomberg] If Bristol loses more of its lead in single-drug treatment and can't find a way win in the combo game, then it may be in real trouble. Analyst estimates for Opdivo's sales in 2019 have fallen by more than $2 billion since August and may have further to go.
Ziopharm Breast Cancer Gene Therapy Tied to 'Higher Than Expected' Toxicity [The Street] Six of nine breast cancer patients treated with an experimental gene therapy from Ziopharm Oncology ZIOP experienced a potentially dangerous immune system-related toxicity known as cytokine release syndrome.
	5.2.1 Pharma - Partenariats
In the midst of an R&D shift, Takeda inks $790M cancer collab with Crescendo [FierceBiotech] Under the pact, Crescendo will use its transgenic platform to discover and mould its Humabody candidates (that are drug conjugates and I/O modulators) against “multiple targets” selected by the Japanese pharma.
	5.2.3 Pharma - économie
Even High-Flying Tesaro and Its Ovarian Cancer Drug Has a Bear Thesis. Here It Is, Explained [The Street] Tesaro is soaring, but the company is overvalued if regulators decide to grant marketing clearance for niraparib only in a smaller, more restricted population of ovarian cancer patients.
	5.3 Traitements - FDA, EMA,...
The Sarepta dilemma: Bioethics expert Arthur Caplan says it’s time to rethink how to regulate compassion [EndPoints] “The FDA should be thinking hard about this,” says Caplan. “This is the first in what will be a long parade of diseases that affects small numbers of patients.
How the FDA Manipulates the Media [Scientific American] The U.S. Food and Drug Administration has been arm-twisting journalists into relinquishing their reportorial independence, our investigation reveals. Other institutions are following suit.
	5.4 Traitements - Economie
This federal drug discount program is actually boosting cancer care costs [STAT] Because this program has been so profitable for so many hospital systems, outpatient hospital-based cancer services have grown dramatically. Pharmaceutical companies have naturally tried to offset giving so many discounts to hospital systems by increasing the prices of their drugs.
What outrage? Ariad raises price of its leukemia drug four times so far this year [STAT] In explaining the rising prices, an Ariad spokeswoman sent us a statement saying the company assesses “pricing based on a range of factors, including efforts to make sure that pricing appropriately reflects the benefit the therapy delivers to patients and to the healthcare system.
	5.6 ESMO
Checkpoints In Lung Cancer, and Other Oncology News From Europe [Xconomy] The European Society for Medical Oncology’s annual conference wraps up in Copenhagen today. We’ve seen updates on heavyweight immunotherapy programs, potential options for patients with advanced breast cancer, and more. Here’s a quick roundup of the major news.
	5.6.11 ESMO- Rein
Pfizer Presents Promising New Immunotherapy Combination Data With INLYTA® (axitinib) In Advanced Renal Cell Carcinoma (RCC) [Pfizer] Data From a Trial of INLYTA With Pembrolizumab Provides Additional Support for Novel Immunotherapy Combinations in RCC.
	5.6.14 ESMO - Ovaire
Superlative data from NOVA: A Star is Born [OBR] These data were received extremely positively by the crowd in attendance. During the discussion, the strong data in this “BRCA-like” group were considered particularly exciting and could change the landscape of treatment in ovarian cancer.
	5.6.15 ESMO - VADS
Meta-Analysis Confirms Superiority of Concomitant Over Induction Chemotherapy in Non-Metastatic HNSCC [ESMO] Adding concommitant chemotherapy to loco-regional treatment or radiotherapy significantly improved overall survival.
	5.6.2 ESMO - Divers
The NETwork! Translational Programme Facilitates Genomic Analysis of Neuroendocrine Tumours [ESMO] Large-scale analyses reveal genomic alteration is more abundant than genetic mutation in pancreatic NETs.
Metformin Significantly Lowers the Risk of Cancer Progression in Patients with Diabetes and Advanced pNETs [ESMO] A retrospective evaluation of patients receiving treatment for pancreatic neuroendocrine tumours (pNETs) showed that patients with diabetes had longer progression-free survival (PFS) than non-diabetic (normoglycaemic) patients.
	5.6.4 ESMO - Poumon
A Very Long Ovation for Keytruda and a Polite One for Opdivo at ESMO 2016 Is Not “the End of the Story” in NSCLC [OBR] Although these data appear somewhat similar at first glance, Dr. Soria also noted that the Kaplan-Meier PFS curves for KEYNOTE-021 separated at about the one month time point while the KEYNOTE-026 curves separated after three months, suggesting gently that the future may lie in combinations of checkpoint inhibitors with chemotherapy or other immunotherapies.
OAK Bears Fruit: Roche’s Tecentriq Enters the Heavily Played Lung Cancer Field [OBR] The entrance of Tecentriq will expand the competitive set in second-line, while other presentations during this ESMO session look to the future as these immuno-oncology agents move into earlier treatment settings.
ARIAD Presents Updated Long-Term Follow-up Results from the Phase 1/2 Trial on Investigational Drug Brigatinib at 2016 ESMO Meeting [Ariad] In ALK+ NSCLC patients with prior crizotinib treatment, the confirmed ORR was 62% and median PFS was 12.9 months.
Keytruda vs. Opdivo: No Contest [In the Pipeline] You don’t always get to see a head-to-head showdown like this one: Merck’s Keytruda (pembrolizumab) and Bristol Myers-Squibb’s Opdivo (nivolumab) were both the subject of presentations at the European Society of Medical Oncology conference, reporting on non-small cell lung cancer trials, and there doesn’t seem to be any doubt that Keytruda looked better.
Clinical Benefit Demonstrated with Everolimus and Pasireotide LAR Alone or in Combination in the First Randomised, Prospective Study Entirely Dedicated to Advanced Lung and Thymic Carcinoids [ESMO] Efficacy was observed in all 3 treatment arms.
Bristol lung-cancer setback puts rival Merck drug in driver seat [Reuters] "Merck will completely 'own' the segment of first-line lung cancer patients who have high PD-L1 expression levels, and Bristol Myers will capture nothing really," Anderson said.
Doctors grapple with best use of potent new cancer drugs [Reuters] Despite immunotherapy successes and the prospect of a potential market worth up to $40 billion in sales, veteran cancer experts urge caution. "In oncology, we see these kind of waves from cosmic pessimism to over-optimism, so we have to be cautious," ESMO President Fortunato Ciardiello said.
	5.6.5 ESMO - Mélanome & Peau
Baseline Genetic Features Elucidated in Responding and Non-Responding Patients with BRAFV600-Mutated Melanoma [ESMO] Melanomas from patients who respond best to BRAF -/+ MEK inhibition have genomic features of higher levels of immune features compared with patients having progressive disease.
PD-L1 Expression as a Biomarker for Checkpoint Inhibitors Response in Patients with Advanced Melanoma [ESMO] Results from a pooled analysis from studies in patients treated with nivolumab or nivolumab plus ipilimumab.
	5.6.6 ESMO - Sein
MONALEESA-2: Smiles Abound as First Line Ribociclib plus Letrozole Significantly Improves Progression-Free Survival [OBR] To help differentiate ribociclib from Ibrance, Novartis has initiated two additional Phase III studies, MONALEESA-3, to evaluate the combination of ribociclib plus fulvestrant in first or second line (similar in design to the PALOMA-3 trial for Ibrance4), and MONALEESA-7, to evaluate ribociclib plus tamoxifen plus goserelin in pre/perimenopausal women with advanced breast cancer (a unique indication from any of the other CDK inhibitors in development).
	6.1 Observation
Rise in Oropharyngeal Cancer Incidence Not Solely Driven by HPV [AACR] “This is different to trends reported elsewhere in the developed world, which illustrates that we cannot generalize the causes underlying the rise in OPSCC incidence between populations; they must be analyzed in a population-specific manner.”
Take a Number: Cancer in Retreat on One Front: Fewer Children Are Dying [NY Times] “Many hope for cancer breakthroughs, or cancer moonshots,” she said. “But it’s a series of well-conceived trials where we’ve studied minor changes in standards of care which add up over decades to substantial gains in survival.”
	6.4 Médico-éco
Breast cancer chemo costs vary despite similar effectiveness [Reuters] “We found that patients had high out-of-pocket costs related to their breast cancer treatment, particularly those patients who were insured through high deductible health plans,” said lead study author Dr. Sharon Giordano, a researcher at the University of Texas MD Anderson Cancer Center in Houston.
	6.6 Publications
Cancer biologist says Nature journal “censored” his News & Views, retracts it [Retraction Watch] A cancer biologist has retracted a 2016 News & Views article in a Nature journal, alleging that the journal tried to censor his writing by asking him to remove passages that criticized another journal (Cell).
	6.9 Controverses
Evidence-based medicine guidelines versus patient wishes [Respectful Insolence] Our job is to give the best evidence-based recommendation that will fit in with the patient’s values. However, in this age where we cannot just ignore cost, a very uncomfortable question always rears its ugly head: How much more are we willing to pay to deviate from evidence-based guidelines to accommodate a patient’s values? If physicians and patients together don’t answer that question, we can be sure that third party payers will.