Onco Actu du 13 septembre 2018

	1. Biologie
Appendix Cancers Are Genetically Distinct from Other Gastrointestinal Cancers, Study Shows [NCI] In a group of 76 patients who were treated at UCSD, those with GNAS mutations had a life expectancy of 10 years after diagnosis, whereas patients with TP53 mutations had a life expectancy of 3 years. Patients whose tumors had neither mutation had a life expectancy of 6 years.
	1.4 Biologie - Technos
New Technique Limits CRISPR-Cas9 Off-Target Mutations [The Scientist] In a study published in Nature today (September 12), researchers describe a strategy to predict these off-target mutations throughout the genome and show in mice that a carefully designed guide RNA strand does not produce any detectable slip-ups.
	2. Etiologie
Pilot study identifies strain of bacteria as chief risk factor for stomach cancer [Fred Hutch] Collaborating with researchers at Zhengzhou University, the Fred Hutch team ran tests on 49 patients’ stomach endoscopy and stool samples, looking for H. pylori with a variant of the cagA gene, known as EPIYA D. They found 91 percent of the patients with the EPIYA D strain also had cancer.
After valsartan recall, study offers 'modest reassurance' on short-term cancer risk [CNN] Dr. Erin Michos, an associate professor and associate director of preventive cardiology at Johns Hopkins Medicine, called the study "well-done" but noted that more research is needed over a longer period of time to substantially evaluate true cancer risk.
	2.6 Etiologie - Environnement
Despite continued public debate, weed killer glyphosate is safe, EPA says [Genetic Literacy Project] “ [T]he agency doesn’t feel that there’s any meaningful risk to human health based on exposure to glyphosate,” Michael Goodis, director of registration division in EPA’s Office of Pesticides, said at a conference hosted by the National Association of Departments of Agriculture. “This is consistent with determinations from other countries and regulatory authorities.”
	3.1.1 Prévention - Tabac - e-cigs
Statement from FDA Commissioner Scott Gottlieb, M.D., on new steps to address epidemic of youth e-cigarette use [FDA] We’re announcing the largest ever coordinated initiative against violative sales in the history of the FDA. This is the largest single enforcement action in agency history. It’s aimed at retail and online sales of e-cigarettes to minors.
If It Wanted To, The FDA Could Destroy E-Cigarette Makers [Forbes] The FDA says it's more than willing to limit the sale of e-cigarettes to adult smokers if it has to.
FDA Launches Crackdown on Juul, Other E-Cigarettes [Wired] The agency cites risks of nicotine, particularly on young brains. “The FDA won’t tolerate a whole generation of young people becoming addicted to nicotine," Commissioner Scott Gottlieb says.
FDA proposed crackdown on flavored e-cigs puts Juul on notice [Reuters] The FDA is giving the five top-selling e-cigarette brands - Juul, Vuse, MarkTen XL, Blu and Logic - 60 days to provide plans for how they will mitigate sales to minors.
	4. Dépistage, diagnostic et pronostic
Problematic PR releases: Costs are hidden in cancer testing news [HealthNewsReview] The National Cancer Institute isn’t the only US agency that sidesteps cost implications. The FDA consistently omits discussion of cost when sending out its announcements on new approvals.
	4.11 Dép., diag. & prono. - Ovaire
Simple urine test for ovarian cancer which could radically improve survival rates on the horizon [The Telegraph] In tissues the new biomarker, dubbed ‘ovarian cancer protein’ was detectable in 18 per cent of stage one cancers and 36 per cent of stage two cancers which could potentially save thousands of lives. The team is currently testing the biomarker in urine samples of women with ovarian cancer to find out if they also contain the protein and are due to publish their results shortly.
	4.2 Dép., diag. & prono. - Génome
Study cracks open the secrets of the cancer-causing BRCA1 gene [STAT] The NCI’s Chanock was more cautious. “It might be tempting to make immediate use” of the information to interpret puzzling variants found when women undergo BRCA tests, he wrote, but it “should not be used as the basis for medical advice — at least until the approach has been clinically validated.”
Huge genetic-screening effort helps pinpoint roots of breast cancer [Nature] “These variants are nightmarish,” says Alvaro Monteiro, a geneticist at the Moffitt Cancer Center in Tampa, Florida. “The result becomes: ‘Well, you have something, but we just don’t know exactly what it is.’”
	5.10 Traitements - Essais
Universities are worse than drug companies at reporting clinical trial results [Science] The European Union’s 2014 Clinical Trial Regulation, which comes into effect next year, will tighten requirements for reporting results. The regulation provides a clear legal obligation, rather than mere guidance, and allows member states to lay down rules for penalties in case of infringements.
Half of Europe's clinical trials fail to report results despite EU rule [Reuters] 32 major sponsors have not published results for any of their due trials on the register. All 32 are European hospitals, universities and research institutions. The researchers defined major sponsors as those with 50 or more trials on the EU Clinical Trial Register.
	5.12 Immunothérapies
Predicting response to immunotherapy [NIH] Three independent research teams recently reported developing ways to predict which melanoma patients are most likely to respond to checkpoint therapy. The work was funded in part by several NIH components. Two papers were published in Nature Medicine on August 20, 2018, and another in Nature on August 8, 2018.
	5.12.5 Immunothérapies - Pharma
FDA Grants Priority Review to Merck’s Application for KEYTRUDA® (pembrolizumab) Monotherapy for First-Line Treatment of Locally Advanced or Metastatic Non-Small Cell Lung Cancer in Patients Whose Tumors Express PD-L1 (TPS ≥1%) [Merck] Application Based on Overall Survival Data from Pivotal Phase 3 KEYNOTE-042 Trial.
	5.2.3 Pharma - économie
Atreca bags $125M as solid tumor trial comes into view [FierceBiotech] “Instead of starting with a target and then companies rushing into figure out the best way to drug that target, we start with the responding patients and what the immune system revealed to us.”
Atreca banks a $125M mega-round as it builds a pipeline of antibodies for cancer and ponders IPO timing [EndPoints] The work at Atreca centers on a platform tech that takes tissue samples from cancer patients to explore for ideal antibodies, using B cells as their sounding board.
	5.3 Traitements - FDA, EMA, NICE...
More and More, New Drugs Clear the FDA With ‘Accelerated Approval’ [Undark] “The whole game of saying ‘This is statistically significant’ is grossly misleading. This is done again and again and again in oncology.” This is also what happened in the case of Avastin.
	5.4 Traitements - Economie
The Curious Case Of Gleevec Pricing [Forbes] What is atypical is the fact that generic imatinib's list price has remained stubbornly high. In late 2017, almost two years after its patent expiration a month’s supply of branded Gleevec was priced at around $9,000, while the cost of generic imatinib was about $8,000. This is both puzzling and troubling, and appears to suggest that the pricing model for specialty generics differs from traditional generics.
	5.9 AACR
AACR Releases Annual Cancer Progress Report [AACR] Strong bipartisan commitment from Congress to invest in biomedical science is fueling innovation in cancer research leading to advances in prevention and treatment.
	6. Lutte contre les cancers
To The Last Drop [Journal of Clinical Oncology] For most of us, at some point in our careers, our job can be dangerous. There is danger when the weight of our words threatens to crush us as they fill the room. There is threat when the situational burdens become too entrenched and the existential crisis too wide to cross without a net. It is not a job for the faint of heart, the frail of spirit, or the fragile of psyche.
	6.1 Observation
Cancer will kill 9.6m people this year, experts predict [The Guardian] International Agency for Research on Cancer says a third of new cases are likely to be caused by smoking and obesity.
Cancer deaths rise to 9.6 million as populations grow and age [Reuters] Europe accounts for 23.4 percent of global cancer cases and 20.3 percent of cancer deaths, although it has only 9 percent of the global population.
Latest global cancer data: Cancer burden rises to 18.1 million new cases and 9.6 million cancer deaths in 2018 [IARC] The GLOBOCAN 2018 database, accessible online as part of the IARC Global Cancer Observatory, provides estimates of incidence and mortality in 185 countries for 36 types of cancer and for all cancer sites combined.
	6.10 Politiques
Sixteen EU Member States Sign the Genomics Declaration [ESMO] The Declaration on linking genomic databases across borders was originally launched on 10 April 2018. It has been signed since then by Bulgaria, the Czech Republic, Cyprus, Estonia, Finland, Italy, Lithuania, Luxembourg, Malta, Portugal, Slovenia, Spain, Sweden and the UK. Croatia has also committed to join this list.
	6.5 Médecines alternatives/complémentaires
Is cancer fundraising fuelling quackery? [BMJ] Crowdfunding sites are helping people with advanced cancer spend thousands of pounds on unproved and alternative treatments. Melanie Newman examines calls to help ensure patients and their donors are not being exploited.
	6.6 Publications
Scientific publishing: How much is too much? [Stanford Medicine] It's important to be fair and transparent with how credit and rewards are allocated. We want to reward the most energetic and the most creative, not the most manipulative, politically savvy or coercive. I trust that these hyperprolific authors include some of the best scientists in the world — but they may also include some that passed this threshold for reasons other than excellence.
Scientific publishing is a rip-off. We fund the research – it should be free [The Guardian] Those who take on the global industry that traps research behind paywalls are heroes, not thieves.
Some scientists publish more than 70 papers a year. Here’s how—and why—they do it [Science] There are two main reasons we have authorship: credit and responsibility. I think both are in danger.
Thousands of scientists publish a paper every five days [Nature] To highlight uncertain norms in authorship, John P. A. Ioannidis, Richard Klavans and Kevin W. Boyack identified the most prolific scientists of recent years.
	6.7 DMP, Big Data & applis
With OneOncology, Flatiron and Cancer Docs Aim to Boost Community Care [Xconomy] The company brings together doctors and patients from these three practices, and connects them with the help of the cancer-specific electronic health record software developed by Flatiron Health. For Flatiron, a high-flying New York startup that Roche bought for $1.9 billion in February, OneOncology represents a way to acquire more patient data and customers for its EHR system.