Onco Actu du 14 février 2018

	1. Biologie
Classification can lead to new ways to diagnose, treat cancer [Baylor College of Medicine] The researchers applied a different computational approach to subtract all tissue-specific differences and identify what pathways remained. They analyzed about 10,000 human cancers of 32 different types and were able to define 10 major cancer groups that they call classes.
	4.11 Dép., diag. & prono. - Ovaire
The Yet Unrealized Promise of Ovarian Cancer Screening [JAMA Oncology] Ovarian cancer mortality has remained largely unchanged over the last 5 decades. Early detection may yet prove to be effective, but the mortality reduction is likely to be modest. For now, the USPSTF has provided sound clinical and public health recommendations against screening for average-risk, asymptomatic women.
	4.12 Biopsies liquides
Liquid Biopsies: Past, Present, and Future [ACS] But it’s one thing, Lichtenfeld says, to use a liquid biopsy to test a patient who you know already has cancer, as they did for their study. “It’s completely different to translate that into a situation when you’re screening millions of people who have no evidence of cancer,” he says.
New cancer test isn't ready for prime time [CNN] Liquid biopsies are a recipe for more health anxiety, more procedures, more complications and more overdiagnoses. Not to mention, more out-of-pocket costs for our patients.
	4.9 Dép., diag. & prono. - Sein
Family history increases breast cancer risk even for older women [Reuters] “Breast cancer is actually more common in women as they age, and some older women who are healthy and have a life expectancy of at least five to seven years perhaps should be screened and followed more closely with annual mammograms.”
	5. Traitements
Precision Medicine: Hope or Hype? [The ASCO Post] “At the end of the day, biology is still messy and science is still hard,” Dr. Sledge continued. “Precision medicine is not a panacea; it’s a tool. And like all tools, it needs to be used appropriately. If not, it will not work.”
	5.1 Traitements - Pré-clinique
New Cancer Treatment Approach Targets Circadian Clock [NCI] Two compounds that target components of the circadian clock killed several types of cancer cells in the lab and slowed the growth of brain tumors in mice without harming healthy cells, the study investigators reported. The NCI-funded study was published January 18 in Nature.
Molecule Found in Huntington’s Patients Kills Cancer Cells [The Scientist] Small interfering RNAs (siRNAs) responsible for brain damage in Huntington’s patients are also toxic to cancer cells, according to researchers at Northwestern University. The findings, published in EMBO Reports, could provide a novel approach to cancer therapy.
Study opens up new way of treating rare cancer of arms and legs [Institute of Cancer Research] The new research found that drugs called ATR inhibitors could be effective against synovial sarcoma even though it is a ‘quiet’ cancer caused predominantly by a single genetic change.
KRAS Targeted Cancer Strategy Shows Early Promise [NIH Director's Blog] Those small molecules work by forming covalent chemical bonds with inactive KRASG12C proteins. They trap KRAS in that non-functional state before it can get stuck in the “on” position to fuel a tumor’s abnormal growth.
	5.10 Traitements - Essais
Data sharing and reanalysis of randomized controlled trials in leading biomedical journals with a full data sharing policy: survey of studies published in The BMJ and PLOS Medicine [BMJ] Data availability was not optimal in two journals with a strong policy for data sharing.
	5.12 Immunothérapies
Researchers develop novel immunotherapy to target colorectal cancer [Yale News] “We found that this Wnt inhibitor, DKK2, which was thought to inhibit tumor formation, promoted tumors through suppression of tumor immunity,” Wu said. Additionally, they learned “if you inactivate, or neutralize, or blockade this inhibitor, it causes reduction of tumor formation through activation of the host’s immune system.”
	5.12.2 Immunothérapies - CAR-T
Toxicity management after chimeric antigen receptor T cell therapy: one size does not fit 'ALL' [Nature Reviews Clinical Oncology] We believe that many of the recommendations should not be applied universally to all CAR T cell products and all patients, and that more studies and a consensus conference are needed to develop standard practice guidelines that will be applicable to the two currently approved CAR T cell therapies.
	5.12.5 Immunothérapies - Pharma
Advaxis Submits Conditional Marketing Authorization Application For Axalimogene Filolisbac For The Second-Line Treatment Of Metastatic Cervical Cancer In European Union [Advaxis] The MAA submission is built around data from the GOG-0265 study which examined overall survival rates in 50 women and showed a 12-month overall survival rate (primary efficacy endpoint) of 38% (n=19/50) in women with PRmCC, representing a 55% improvement over an expected, model-predicted,12-month survival rate of 24.5%.
	5.2 Pharma
Exelixis Announces Results from a Phase 2 Investigator-Sponsored Trial of Cabozantinib in the First-Line Treatment of Metastatic Radioiodine-Refractory Differentiated Thyroid Carcinoma [Exelixis] Exelixis plans to initiate a pivotal phase 3 trial later this year.
Erytech Selects Triple Negative Breast Cancer As Next Indication For Eryaspase [Erytech] Set-up activities for Phase 2 clinical study ongoing and patient enrollment expected to start Q3 2018.
Erytech doubles down on solid tumor trials for red cell drug therapy [FierceBiotech] After disappointing data in leukemia, France’s Erytech is refocusing its red blood cell-encapsulated drug therapy to solid tumors—and will target triple-negative breast cancer in its next trial.
	5.2.3 Pharma - économie
Drug copies ready to take next bite out of Roche's cancer sales [Reuters] European oncologists will soon get their hands on cut-price copies of breast cancer drug Herceptin, turning the screws on maker Roche and giving another boost to a new breed of companies focused on so-called biosimilars.
	5.3 Traitements - FDA, EMA, NICE...
Statement from FDA Commissioner Scott Gottlieb, M.D., on Administration’s request for new FDA funding to promote innovation and broaden patient access through competition [FDA] Additional resources will help advance initiatives to support novel medical technology and public health priorities such as generic drug development, pharmacy outsourcing and novel domestic manufacturing capabilities.
	5.4 Traitements - Economie
Trump's Budget Proposal Swings At Drug Prices But May Land Only A Glancing Blow [NPR] Trump entered office with blustering promises to bring drug prices "way down." But critics have charged that the White Househas failed to engage Congress on cost-cutting ideas, and that a leaked draft of an executive order last summer read like a wish list for the industry.
$100B in NIH-funded research played an important role in all 210 new drugs approved over 7 years — study [EndPoints] The authors in particular wanted to expand the scope of their research to make sure they were accounting for NIH-funded studies that were essential to a drug target, which doesn’t always factor into the patents used to protect the commercial value of each drug — a standard that had been used in earlier attempts to highlight the role of the NIH in drug development.
	5.5.3 ASCO (prostate)
Richard Lehman’s journal reviews—12 February 2018 - Et tu, apalutamide [BMJ] Apalutamide is a me-too drug and as such needs to prove its superiority over others in the class: but in this manufacturer funded study, it was compared with placebo rather than bicalutamide. I searched for a justification in the accompanying review article on the management of prostate cancer but I couldn’t find any. But ethics approval was obtained in 26 countries, so I must be missing something.
	6. Lutte contre les cancers
Precision Medicine for Everyone [NEJM Catalyst] Fully realizing the promises of precision medicine for everyone will require cultural humility, a process of self-reflection and honesty to build trustworthy relationships, and precision engagement.
	6.1 Observation
Obesity Tied to Survival in Men With Melanoma [NY Times] “The magnitude of the effect and the dose-response relationship point to there being a biological underpinning to this,” she said. “But we need to emphasize that obesity is still a risk factor for many diseases, including 13 different types of cancer. The most important thing is still preventing obesity.”
	6.11 Patients
'My sister died of lung cancer but never smoked' [BBC News] Paula Chadwick, chief executive of the Roy Castle Lung Cancer Foundation, paints a stark picture of why research and treatment is so poorly funded. She argues that it is almost a "Cinderella" disease, because of the stigma that comes with the idea that it might be self-inflicted.
	6.4 Médico-éco
Lives hang in the balance as health insurers drag their feet on coverage appeals [STAT] Dr. Jay Ken Iinuma, the former medical director of Aetna for Southern California, admitted in a deposition that he routinely did not review patients’ medical records before denying appeals for insurance coverage.
High cancer-related expenses take a toll on quality of life [Reuters] Park and co-author Dr. Kevin Look, a pharmacy professor at UW-Madison, analyzed 2010-2014 data from the national Medical Expenditure Panel Survey, including responses from nearly 6,800 patients with cancer.
	6.6 Publications
Q&A John Ioannidis: Biomedicine warms to preprints [Nature] It’s wrong to dismiss preprint repositories as the junkyards of science, warns Ioannidis.