Onco Actu du 21 août 2018

	4. Dépistage, diagnostic et pronostic
Helen Macdonald: Overdiagnosis and the fear of being “normal” [BMJ] “Why we are so afraid to be normal?” Iona Heath asked, as she opened the 2018 Preventing Overdiagnosis conference in Copenhagen. It was a typically thought provoking opening from the retired GP, who is a core member of the scientific committee for the conference.
	4.12 Biopsies liquides
Liquid Biopsy May Predict Risk of Breast Cancer Returning Years Later [NCI] “This [finding] is not something that should change practice now,” said lead investigator Kathy Miller, M.D., of Indiana University Melvin and Bren Simon Cancer Center. “But it gives us the potential for future clinical trials that identify patients at higher risk [of late recurrence] and study whether having that information could change treatment and improve outcomes.”
	4.2 Dép., diag. & prono. - Génome
New ESMO tumour DNA scale helps match patients with cancer to optimal targeted medicines [ESMO Press Release] As ESMO disseminates ESCAT into clinical practice, it is hoped that cancer centres and laboratories will start to routinely include Tier I-V grading of genomic mutations in patients’ clinical and laboratory reports and discuss results at tumour boards and clinics.
	5.12 Immunothérapies
NCI-led research team develops predictor for immunotherapy response in melanoma [NCI] Dr. Ruppin said that while the results obtained are encouraging, they will need to be carefully evaluated in additional patient datasets. The authors also wrote that further study of this kind of predictor is now warranted in other cancer types for which checkpoint inhibitors have been approved.
	5.12.5 Immunothérapies - Pharma
Harbour BioMed jumps into the crowded PD-1/L1 race, looking to take a Chinese asset global as checkpoint pipeline bulges [EndPoints] Can two Chinese biotechs vault a homegrown PD-L1 agent to frontrunner status in the crowded global checkpoint race? Harbour BioMed thinks the answer is yes, and it’s willing to spend a total of $350 million to make that a reality.
	5.12.6 Immunothérapies - AMM
FDA Approves Expanded Label for Merck’s KEYTRUDA® (pembrolizumab) in Combination with Pemetrexed (ALIMTA®) and Platinum Chemotherapy for First-Line Treatment of Patients with Metastatic Nonsquamous NSCLC, with No EGFR or ALK Genomic Tumor Aberrations [Merck] Approval Based on Results of KEYNOTE-189, Where KEYTRUDA in Combination with Pemetrexed and Platinum Chemotherapy Reduced the Risk of Death by Half Compared to Chemotherapy Alone.
FDA grants regular approval for pembrolizumab in combination with chemotherapy for first-line treatment of metastatic nonsquamous NSCLC [FDA] This is the second FDA approval using the Real Time Oncology Review pilot program that enabled the FDA review team to begin analyzing data before the application submission.
FDA grants nivolumab accelerated approval for third-line treatment of metastatic small cell lung cancer [FDA] Responses were durable for 6 months or longer in 77%, 12 months or longer in 62%, and 18 months or longer in 39% of the 13 responding patients. PD-L1 tumor status did not appear to be predictive of response.
	5.2.1 Pharma - Partenariats
AbbVie, Tolero team up to test Venclexta combo in AML [FierceBiotech] Alvocidib inhibits CDK9, which controls the expression of the survival factor MCL-1, which, along with BCL-2, is co-opted by cancer cells to avoid cell death. Tolero and AbbVie reckon that Venclexta and alvocidib might complement each other as previous studies have shown that cancer cells can resist BCL-2 inhibition by using MCL-1 to prevent cell death.
	5.3.4 Traitements - AMM (FDA, EMA,...)
Tagrisso approved in Japan for 1st-line treatment of EGFR-mutated non-small cell lung cancer [AstraZeneca] The approval is based on results from the global Phase III FLAURA trial which included Japanese patients and which were published in the New England Journal of Medicine.
Targeted Drug Approved for Acute Myeloid Leukemia with IDH1 Gene Mutations [NCI] Physicians will have to become familiar with the side effects of this drug, such as differentiation syndrome, noted Dr. Walter. “There is still much to learn about ivosidenib and enasidenib, including how best to combine these drugs with others,” he added.
Ribociclib Approval Expanded for Some Women with Advanced Breast Cancer [NCI] The new approvals for ribociclib were the first granted through a new FDA pilot program launched earlier this year called Real-Time Oncology Review. The program allows FDA to begin reviewing a drug after results from trials are first available but before a company has officially submitted an approval application.
	5.4 Traitements - Economie
NICE stands firm on 'no' vote for Roche's Perjeta in postsurgery breast cancer [FiercePharma] That opinion isn’t the one the Swiss pharma giant was hoping for. It’s counting on Perjeta and other newer meds—such as multiple sclerosis-fighter Ocrevus and immuno-oncology product Tecentriq—to step up as biosimilars move in to challenge Roche’s older moneymakers, including Herceptin and Avastin.
	6.1 Observation
Airline crew don’t have significantly elevated risk of thyroid cancer, new study finds [Stanford Medicine] Stanford researchers addressed this question with a meta-analysis of published data on thyroid cancer rates in airline crew, as recently reported in Cancers of the Head and Neck. They analyzed eight studies with a total of almost 250,000 crew members from 11 countries. They found no evidence of increased thyroid cancer risk in airline crew.
Why Are Black And Latino Kids More Likely To Die Of Certain Cancers? [NPR] For epidemiologist Rebecca Kehm, the answer could lie not in a test tube or even a patient's race, but in their place in society. In a paper published Monday in the journal Cancer, Kehm and her coauthors pinpoint socioeconomic status as a factor in childhood cancer survival.
	6.10.1 Politiques (USA)
Companies report no signs of drugmakers cutting prices, despite Trump pledge [The Hill] Several companies that manage prescription drug benefits for insurers say they have not received any commitments from drugmakers to lower list prices.
	6.4 Médico-éco
A Chinese Pharmacist Found Out He Had Cancer. Then He Vanished. [NY Times] Nearly a decade after the rollout of an ambitious $130 billion health care reform plan, millions of people cannot afford the treatments they need for serious illnesses. Insurance coverage of major illnesses like cancer is low, and many cancer-related drugs are not covered at all. Local governments, lacking cash, sometimes fail to reimburse patients.
	6.5 Médecines alternatives
Is it likely that alternative medicine works? The importance of prior probability [The Logic of Science] Finally, I can foresee those who believe in alternative medicines responding to this with the comment, “but [insert anecdotes].” So let me forestall that. Anecdotes simply are not good evidence of causation and, as such, don’t help you much with prior probability.
	6.7 DMP, Big Data & applis
Blockchain Startup Shivom Aims High With Precision Medicine Ecosystem [Genome Web] "In a few years it will be normal for human beings to be sequenced," he said. Someone will need to store all this data, but not necessarily in one place. For this reason, Shivom is developing a blockchain-based system for decentralized genomic data storage.
	6.7.1 IA/bioinformatique
Dilemma over AI and drug patenting already under debate [Nature] For example, Heuer foresees problems over whether to designate the algorithm or its programmer as the inventor, and whether a drug discovered through machine-learning methods would be patentable.
	6.7.2 Applis
Witty Health Announces Launch of Oncology Provider Registration on OncoPower, a Blockchain-based Digital Health Platform [Witty Health] OncoPower helps oncologists build a complete patient treatment history, rewards patients for reporting data and content, facilitates peer to peer virtual consultations, and enables smart-contracts between payers and providers, patients, and pharmaceutical brands to improve medication adherence or report cancer treatment and genetic data.