A round-up of the news from Google Alerts for Breast Cancer and Cancer, for the week ending 21 March 2014.
This week’s lead is a study proving that exercise prevents breast cancer which is stating the obvious and still doesn’t answer the question of “why”. It’s all very well having stats so that GPs can use them to nag patients, but I want to know what physiogical changes occur during exercise that increase a person’s ability to prevent breast cancer.
At the integrative conference in Fulda in December 2013, a link was made between exercise and its effect on a transcription factor, hypoxia-inducible factor-1 (HIF-1). HIF-1 activity mediates hypoxia (the state of low oxygen concentration) by downregulating mitochondrial oxygen consumption in the cell. Hypoxia often keeps cells from differentiating [sounds familiar? Remember, cancer cells are poorly-differentiated cells] and also promotes the formation of blood vessels [angiogenesis oh-oh], and is important for the formation of a vascular system in embryos, and cancer tumors. So that’s my explanation for why exercise helps to prevent not just breast cancer but any cancer by oxygenating the body and rendering it less hypoxic.
According to the scientists of the study, it doesn’t have to be doing bench-presses at the gym, exercise can include playing with the children or carrying the shopping, as long as it adds up to at least an hour a day.
The second article is about another miracle drug that has transformed the lives of terminally-ill leukaemia and lymphoma patients. I know it’s not about breast cancer, but it offers us hope, and that’s good news. We need more hope.
1. Being slim will not prevent breast cancer – you need to exercise as well: Study finds those who did least activity were 40% more likely to develop the disease
- Leading obesity conference told basic tasks like carrying shopping help
- Encouraged women ‘it is never too late’ to become more active
- Exercise lowers levels of immune system compounds linked to disease
2. ‘Astonishing’ new cancer drug could extend the lives of terminally-ill patients and eliminate their symptoms overnight….with virtually no side effects
- The new drug is a new class of Bruton’s Tyrosine Kinase (BTK) inhibiting drugs.
- The Bruton’s Tyrosine Kinase (BTK) drug is built around a protein which plays a role in the signals that cause growth in cancerous cells. The pill blocks this protein causing the cancerous cells to die but leaves normal cells unaffected.
- It is taken orally in a single dose every morning and effectively switches off the mechanisms of leukaemia and lymphoma.
- Patients at Derriford Hospital in Plymouth, Devon, first in the world to try it
- Terminally ill man ‘fighting fit’ a year after he was told he had months to live
For more information: Bruton Tyrosine Kinase inhibitor Ibrutinib (pci-32765)
3. Radiotherapy after mastectomy benefits women with breast cancer in 1-3 lymph nodes
- Women whose breast cancer has spread to just a few lymph nodes under their arm are less likely to have their disease recur or to die from it if they have radiotherapy after mastectomy.
- Results were analysed from 3786 women in 14 randomised trials starting between 1964-1982, who had been given mastectomies along with the surgical removal of lymph nodes under the arm (axillary dissection) and who were then randomised to receive either radiotherapy to the chest wall and surrounding regions or to no radiotherapy.
- The women fell into three categories: those with no cancer in the lymph nodes, those with cancer in one, two or three lymph nodes, and those with cancer in four or more lymph nodes.
- The women were followed up for an average of just over 11 years, and data on the number of recurrences and deaths were available up to 2009.
- In 700 women in whom the pathologists could find no sign that the nodes were affected, radiotherapy did not reduce the risk of recurrence or of dying from breast cancer.
- However, in the 1314 women who had between one and three positive nodes, radiotherapy reduced the recurrence rate by nearly a third (32%) and the breast cancer death rate by a fifth (20%). Giving radiotherapy to these women led to nearly 12 fewer recurrences of breast cancer per 100 women after ten years, and eight fewer deaths per 100 women after 20 years.
- For the 1772 women with four or more positive nodes, radiotherapy also reduced the recurrence rate (by 21%) and the breast cancer death rate (by 13%). Here, radiotherapy for these women led to nine fewer recurrences of breast cancer after ten years and nine fewer deaths after 20 years per 100 women.
- This research is to be presented at the European Breast Cancer Conference (EBCC-9) on Thursday and published in The Lancet.
For more information: “Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials”, by EBCTCG (Early Breast Cancer Trialists’ Collaborative Group). Published online in The Lancet, March 19, 2014, dx.doi.org/10.1016/S0140-6736(14)60488-8
4. Blocking ADAM8 can help beat triple-negative and other aggressive breast cancers
- Tufts researchers have identified a new target for treating particularly aggressive forms of breast cancer that could potentially save thousands of lives each year.
- Gail Sonenshein, a professor of developmental, molecular and chemical biology at the School of Medicine, and her research team found that when they injected antibodies to a protein called ADAM8—essentially turning the protein off—tumors in mice from what are called “triple-negative” types of breast cancer stopped growing and did not spread to other parts of their bodies.
- Their studies have now shown that ADAM8 has two roles. Once tumors start to grow and reach a critical mass, they stop growing, if they don’t have adequate access to nutrients or oxygen. ADAM8 sends signals that help recruit new blood vessels to the tumor, a process called angiogenesis. The blood vessels then feed the tumor with the nutrients and oxygen required for its growth.
- In addition, ADAM8 is necessary to activate proteins on the surface of the cancer cells that allow the cancer cells to interact with the blood vessels. This gives them the means to enter and exit blood vessels, essentially promoting metastasis.
- When Irene Georgakoudi, Sonenshein’s collaborator in the Tufts Department of Biomedical Engineering, and her colleagues tested the blood from the mice with tumors lacking ADAM8, there were very few tumor cells in circulation.
- The research, which was funded by the National Institutes of Health and other sources, was published in January in EMBO Molecular Medicine.
For more information: EMBO Molecular Medicine, DOI: 10.1002/emmm.201303373, ADAM8 expression in invasive breast cancer promotes tumor dissemination and metastasis
5. Genetic testing may help select women with ER+ breast cancer for extended hormone therapy
- Genetic analyses of results from 1125 postmenopausal women being treated for oestrogen responsive breast cancer have shown that some of them are more likely than others to have a late recurrence of their cancer and might benefit from ten years of hormone therapy rather than five.
- The findings are the latest to come from the ATAC trial (Arimidex, Tamoxifen Alone or in Combination), a double-blinded phase III clinical trial that randomly assigned postmenopausal women with early, oestrogen receptor positive (ER+) breast cancer to receive the hormone therapies anastrozole or tamoxifen, or a combination of the two.
- Prof Dowsett and his colleagues at The Royal Marsden, The Institute of Cancer Research and Queen Mary University of London used data from the OncotypeDx® 21-gene Recurrence Score that are not usually available from this test in order to analyse the genetic make-up and to predict the likelihood of cancer recurring within ten years in these women.
- “The OncotypeDx result is reported as a single score but it is made up of 16 informative genes and five control or “housekeeper” genes that we have studied in detail. Some of the 16 are considered as groups rather than individual genes, and one of these is the E-module, which consists of four genes that are related to oestrogen signalling, including the oestrogen receptor itself,” he explained.
- “Importantly, HER2- tumours that are very sensitive to oestrogen are usually considered to be relatively low risk, yet these were the tumours that showed an increase in recurrence after five years, which coincided with the cessation of adjuvant hormonal therapy,” said Prof Dowsett.
- “It is commonly thought that the reduction in recurrence achieved by five years of endocrine therapy ‘carries-over’ into the next five years. Our results suggest this effect may differ markedly between different groups of ER+ tumours. We need to do more detailed analyses on large numbers of tumours to find out if this is the case.”
- The findings could change clinical practice: women with HER2-, high oestrogen signalling breast cancer might be considered for adjuvant hormone therapy that is extended to ten years. However, the results need to be confirmed in other sets of tumours first. “This should be done by testing the tumours of patients that are participating in ongoing trials of extended versus no extended adjuvant therapy,” said Prof Dowsett.
For more information: ECCO-the European CanCer Organisation
6. BRCA1 gene affects brain development
- The BRCA1 gene, known for its role in suppressing the growth of breast and ovarian tumors, could be necessary for brain development.
- In a study appearing in the Proceedings of the National Academy of Sciences, Inder Verma and his colleagues at the Salk Institute for Biological Studies in La Jolla, California created a strain of mice lacking BRCA1 in neuronal stem cells.
- These mice had smaller than normal brains with numerous defects.
- The researchers think BRCA1 played an important role in the evolution of the mammalian brain.
- BRCA1 helps repair DNA damage in dividing cells. Women with mutated copies of this gene have a high risk of developing ovarian and breast cancer.
- However, BRCA1 is most highly expressed in the embryonic neuroepithelium, cells in the embryo that will later form the nervous system.