Onco Actu du 15 janvier 2019

	1. BIOLOGIE
Tumor Hypoxia Associated With Cancer Driver Mutation Signatures in 19 Tumor Types [Genome Web] The tumor microenvironment is peppered with subregions of hypoxia in approximately half of all solid tumors, and these regions can vary in their size and extent, the researchers noted in a study published today in Nature Genetics.
	4.10 DÉP., DIAG. & PRONO. - POUMON
Lung cancer screening complications may be higher than expected [Reuters] Overall, about 22 percent of patients under 65 in the study had complications, as did almost 24 percent of the older people in the study. These complication rates are more than twice as high as those reported in the pivotal 2011 LDCT lung cancer screening study responsible for current screening recommendations, researchers report in JAMA Internal Medicine.
	4.9 DÉP., DIAG. & PRONO. - SEIN
GPs could use breast cancer 'calculator' to predict risk to women [The Guardian] Scientists devise method using genetic data and lifestyle to work out who should be screened.
Researchers develop comprehensive new way to predict breast cancer risk [Cancer Research UK] They have a developed a way of calculating the risk of developing the disease by combining information on family history and genetics with other factors such as weight, age at menopause, alcohol consumption and use of hormone replacement therapy.
	5.10 TRAITEMENTS - ESSAIS
ASLAN Pharmaceuticals announces study results from phase 2 study of varlitinib in first-line gastric cancer [Aslan] Based on independent central review, patients treated with varlitinib plus mFOLFOX6 had an average tumour shrinkage of 22.0% after 12 weeks compared to 12.5% for patients treated with mFOLFOX6 alone. This difference did not reach statistical significance.
Aslan fails to roar as lead drug flunks phase 2 trial [Fierce Biotech] The Singapore biotech says its phase 2 study of varlitinib as a first-line therapy for patients with HER1/HER2 co-expressing advanced or metastatic gastric cancer showed that the drug provided no additional benefit when added to standard chemotherapy when it came to shrinking tumors.
Aslan turns focus to biliary tract cancer as lead drug flops in PhII gastric cancer study [EndPoints] Originally developed by Array, the drug is also known as ASLAN001 and is an oral, small molecule that inhibits the activity of epidermal growth factor receptors HER1, HER2 and HER4 — which are mutated or overexpressed in many tumors and typically cause uncontrolled growth.
	5.12 IMMUNOTHÉRAPIES
Researchers Uncover Major Clue In Predicting Response To Immunotherapy [Forbes] Researchers don't exactly know why high numbers of mutations make cancers more susceptible to immunotherapy, but they do have a very plausible theory. They think that the more mutated a cell is, the more likely it is to produce incorrect, mangled proteins.
Parker-backed cancer scientists shine a light on an emerging pathway in pancreatic cancer [EndPoints] “In melanoma, you have a large area of malignant cells surrounded by a thin layer of stroma,” noted Sharma. “With pancreatic cancer, it’s more like cancer cells, stroma, cancer cells, stroma ― blended.”
Highly mutated cancers respond better to immune therapy [Nature] Ultimately, Shibutani suspects that it will take a combination of characteristics, including mutation counts and information about the concentration of a given protein to select patients for immunotherapy. “This is the exact opposite of ‘keep it simple, stupid’,” he says. “Naturally, there’s more work to be done."
	5.12.5 IMMUNOTHÉRAPIES - PHARMA
Merck's Keytruda slashes death risk by 31% in esophageal cancer victory [Fierce Pharma] That result could also make it the first in its class to score an approval. Esophageal cancer is the seventh most commonly diagnosed cancer worldwide, and it’s projected to affect 17,650 U.S. adults this year.
Merck’s KEYTRUDA® (pembrolizumab) Reduced Risk of Death by 31 Percent Compared to Chemotherapy in Previously Treated Patients with Advanced Esophageal or Esophagogastric Junction Carcinoma Whose Tumors Expressed PD-L1 (CPS ≥10) [Merck] Results from Phase 3 KEYNOTE-181 Trial to be Presented at 2019 Gastrointestinal Cancers Symposium (ASCO GI).
	5.12.6 IMMUNOTHÉRAPIES - AMM
European Commission Approves Opdivo (nivolumab) Plus Low-Dose Yervoy (ipilimumab) for First-Line Treatment of Patients with Intermediate- and Poor-Risk Advanced Renal Cell Carcinoma [BMS] Approval based on results from Phase 3 CheckMate -214 trial.
	5.12.8 IMMUNOTHÉRAPIES - ECONOMIE
Top product forecasts for 2019 [Nature Reviews Drug Discovery] Of the newer products in the list, PD1-blocking cancer immunotherapies feature prominently, with Keytruda outpacing Opdivo following a string of clinical and regulatory successes ahead of its rival.
	5.2 PHARMA
Sean Bohen to leave AstraZeneca as exodus continues [Fierce Biotech] This comes amid a mixed time for AstraZeneca, with its CEO Pascal Soriot also endlessly speculated to be heading for the exit, something however he continuously denies, and a plethora of trial setbacks over the years, with cancer becoming a brighter spot but still being hit by some late-stage failures.
	5.3 TRAITEMENTS - FDA, EMA, NICE...
If the shutdown drags on at FDA, it will put anticipated new treatments in jeopardy [STAT] Any full interruption in work will likely lead to a backlog of drug applications to review, meaning approval decisions set for later this year could also slip, even after the government reopens.
EMA to lose 25% of staff as hard Brexit approaches [EndPoints] In addition to the staffing losses, EMA said it will further temporarily reduce or suspend activities in the first half of 2019 as it moves into the final phase of its physical relocation.
	5.3.4 TRAITEMENTS - AMM (FDA, EMA,...)
Exelixis Announces U.S. FDA Approval of CABOMETYX® (cabozantinib) Tablets for Previously Treated Hepatocellular Carcinoma [Exelixis] Approval based on statistically significant and clinically meaningful overall survival benefit demonstrated in the CELESTIAL phase 3 pivotal trial.
	5.4 TRAITEMENTS - ECONOMIE
Think Generics Will Lower the Cost of Chemo? Think Again [Forbes] From the time it entered the market in 2001, until its last year of exclusivity, the price of Gleevec more than doubled. After a decade and a half of generating profits, Gleevec finally faced generic competition in 2016. But here is the rub: the price of the generic medicine was barely lower than the brand drug.
	6.1 OBSERVATION
You’re Not Getting Much Taller, America. But You Are Getting Bigger. [NY Times] Meet the average American man. He weighs 198 pounds and stands 5 feet 9 inches tall. He has a 40-inch waist, and his body mass index is 29, at the high end of the “overweight” category. The picture for the average woman? She is roughly 5 feet 4 inches tall, and weighs 171 pounds, with a 39-inch waist. Her B.M.I. is close to 30.
	6.10.1 POLITIQUES (USA)
House Democrats launch drug pricing investigation into 12 major companies [STAT] Many of the drugs included are among the most-cited examples of alleged price-gouging — including Revlimid, Celgene’s multiple myeloma drug, and Humira, an arthritis medicine manufactured by AbbVie.
	6.5 MÉDECINES ALTERNATIVES/COMPLÉMENTAIRES
How online crowdfunding supports cancer quacks (part 2) [Respectful Insolence] In response to The Good Thinking Society’s report, GoFundMe claimed that it was already “taking proactive steps” in the US to make sure users of its site are better informed and will be doing the same globally over the coming months. However, I’ve seen no evidence thus far that GoFundMe has done a thing since September.
	6.6 PUBLICATIONS
Plan S: What About Researchers? [The Scholarly Kitchen] The problem here for researchers is that they are being asked not just to make their article OA, but also to withdraw support for anything that may be connected to a subscription model – this is an authoritarian move, and restricts author choice.
	6.7.3 DMP
Early research on Apple's Health Records service suggests patients generally like it [CNBC] For its research, the hospital sent an anonymous online survey to 425 patients who activated the app in 2018. Of the respondents, 96 percent said they could easily connect their data, 78 percent were satisfied with the service, and 90 percent said it improved the process of sharing their personal health information with friends and family.