Postponing the start of adjuvant chemotherapy for more than 90 days following surgery may significantly increase risk of death for breast cancer patients, particularly those with triple-negative breast cancer (TNBC), according to a new study from The University of Texas MD Anderson Cancer Center. Further, the researchers found that factors such as socio-economic status, insurance coverage and ethnicity were associated with delayed treatment.
According to the study, published in JAMA Oncology, patients who start chemotherapy more than 90 days after surgery are 34 percent more likely to die within five years. Patients with TNBC who delay treatment have a 53 percent increased risk of death.
Adjuvant chemotherapy, which is given after primary surgery, has been demonstrated to benefit patients by decreasing the risk of recurrence and death, explained Mariana Chavez Mac Gregor, M.D., assistant professor, Health Services Research and Breast Medical Oncology. However, delaying the start of adjuvant chemotherapy may allow small remnants of the tumor to grow or become drug-resistant.
Currently, there are no guidelines recommending the optimal time to initiation of adjuvant chemotherapy. The Centers for Medicare & Medicaid Services (CMS) considers the administration of adjuvant chemotherapy within 120 days of diagnosis for certain patients as a quality metric. Eleven cancer hospitals, including MD Anderson, are now reporting on this metric.
Scientists at Princess Margaret Cancer Centre have discovered that blocking the master regulator of bone renewal stops osteosarcoma – the most common primary bone cancer in children and teens, and the malignant disease that was fatal for Canadian icon Terry Fox.
The proof-of-concept findings, published online today in Science Translational Medicine, establish the importance and function of the bone master regulator, a protein known as RANKL, in bone cancer and set the stage to develop rationalized targeted therapy for patients, says principal investigator Dr. Rama Khokha, Senior Scientist at the Princess Margaret Cancer Centre. Dr. Khokha is also a Professor in the departments of Medical Biophysics and Laboratory Medicine and Pathobiology at the University of Toronto.
"We now understand the molecular basis of how RANKL drives osteosarcoma and believe this new information could potentially be rapidly translated into the clinic as a new therapy for patients," says Dr. Khokha.
"There is already a clinically-approved RANKL-blocking drug currently being used to treat other bone diseases. The next step is to determine whether this particular drug could be adapted to treat osteosarcoma and improve outcomes for these patients. As there has been little improvement in treating this type of bone cancer for the past 20 years, we are eager to find out."
She adds that in the U.S., the National Cancer Institute has recently approved a Phase 2 clinical trial to test the drug in osteosarcoma patients whose cancer either recurs or resists treatment.
It’s known as the most common cancer-causing protein, directly responsible for 30 per cent of all cancers and indirectly involved in virtually all cancers. For over 30 years, scientists have failed to successfully target it, but now researchers from U of T can turn this protein off with an experimental drug.
“For several decades, scientists have tried to turn off a protein called Ras,” said Michael Ohh, a professor in the Faculty of Medicine’s Department of Laboratory Medicine and Pathobiology. “But despite their efforts, we ultimately haven’t seen much progress. In fact, it’s been coined the ‘undruggable’ protein.”
Study in Science Translational Medicine identifies drug target and genetic pathway for graft-versus-host disease, a dangerous and common complication of bone marrow transplants. Study in Science Translational Medicine identifies drug target and genetic pathway for graft-versus-host disease, a dangerous and common complication of bone marrow transplants.
The paper — co-written by John Rossmeisl, Virginia-Maryland College of Veterinary Medicine associate professor of internal medicine and neurology; Michael Sano, postdoctoral researcher at Stanford; and Virginia Tech Department of Biomedical Engineering and Mechanics Ph.D. students Jill Ivey of Fayetteville, Arkansas and Eduardo Latouche of Valencia, Venezuela, — describes the researchers’ work on developing a new type of treatment for glioblastoma multiforme (GBM), the most common and deadly malignant primary brain tumor.
Patients with glioblastoma have a five-year survival rate of less than 10 percent, Verbridge said.
“This statistic has not improved significantly in decades, and there is still no treatment option to preferentially target the glioma stem cells or diffuse infiltrative cells that lead to tumor recurrence after surgery, chemo, or radiotherapy,” Verbridge said.
The paper, “Targeted cellular ablation based on the morphology of malignant cells,” describes research into a new treatment option involving pulsed electric fields (PEFs) that is better at targeting and killing malignant cells while leaving healthy cells alive.