Best of Breast: news for week ending 26 September 2014

The main highlights for breast cancer and cancer from Google Alerts, for the week ending 26 September 2014.

At the risk of being known as the cancer blog devoted to dogs sniffing out cancer, item 1 this week is about a labrador who detected his owner’s breast cancer.  I think this must make the fourth time I’ve seen this reported in the news this year, and I think it is remarkable that there is this amazing resource out there which is under-utilised.  I wish I had one of these dogs.  It would make it so much easier to know what’s going on without scans or blood tests.

Item 9 is about a researcher who is crowd-funding to develop a patent-free cancer drug.  This has significant implications for the US, where there is no central body that regulates or negotiates with the drug companies to get the best deal for cancer patients.  It is a travesty that drug companies can charge what they want.

A case in point is a recent expose by the CBS news reportage programme, 60 minutes, of the high-cost of cancer drug pricing in the US and how the doctors at Memorial Sloan-Kettering refused to prescribe a drug that they considered overpriced and more toxic than a competitor drug.  Watch the recording here:  http://www.cbsnews.com/news/the-eye-popping-cost-of-cancer-drugs/

Dog-detected-breast-cancer

Missy the Labrador, who detected his owner’s breast cancer. Image credit: expressnewspaper.

1.  Woman’s breast friend: Dog saves owner’s life by detecting her cancer

http://www.express.co.uk/life-style/life/514695/Breast-cancer-symptoms-detected-by-dog

  • Allison Powell lived alone with her two dogs when her Labrador Missy started acting bizarrely.
  • The once bubbly dog became noticeably depressed and would not eat. She would nudge Allison’s chest with her nose and paw at her left breast.
  • Allison, 48, said: “It was so strange how her behaviour just changed one day. She became really depressed and would spend hours on end staring blankly out of the window.
  • “Then she kept nuzzling me and pawing at my breast. I just thought she was trying to get attention.”
  • Allison took her dog to the vets who said there was nothing wrong with her and advised her to keep an eye.
  • After months of pestering the mum of one decided to go for a check and doctors found a small lump.
  • “When I found the small lump in my left breast it all made sense, that’s where Missy had been nuzzling.
  • “I couldn’t believe it when I found out she was right. She saved my life.”
  • “Missy alerted me to it just in time and I had a double mastectomy. I was in hospital for ten days and when I came home she was back to her normal self.
  • “Her tail was whizzing round like a helicopter and she wasn’t depressed anymore. Now every morning she comes and sniffs me head to toe.”

2.  Stanford researchers create ‘evolved’ protein that may stop cancer from spreading

http://www.eurekalert.org/pub_releases/2014-09/ssoe-src091914.php

  • A team of Stanford researchers has developed a protein therapy that disrupts the process that causes cancer cells to break away from original tumor sites, travel through the blood stream and start aggressive new growths elsewhere in the body.
  • Today doctors try to slow or stop metastasis with chemotherapy, but these treatments are unfortunately not very effective and have severe side effects.
  • The Stanford team seeks to stop metastasis, without side effects, by preventing two proteins – Axl and Gas6 – from interacting to initiate the spread of cancer.
  • Axl proteins stand like bristles on the surface of cancer cells, poised to receive biochemical signals from Gas6 proteins.
  • When two Gas6 proteins link with two Axls, the signals that are generated enable cancer cells to leave the original tumor site, migrate to other parts of the body and form new cancer nodules.
  • To stop this process Cochran used protein engineering to create a harmless version of Axl that acts like a decoy.
  • This decoy Axl latches on to Gas6 proteins in the blood stream and prevents them from linking with and activating the Axls present on cancer cells.
  • Mice in the breast cancer treatment group had 78 percent fewer metastatic nodules than untreated mice.
  • Mice with ovarian cancer had a 90 percent reduction in metastatic nodules when treated with the engineered decoy protein.

For more information:   Nature Chemical Biology (2014) doi:10.1038/nchembio.1636, An engineered ​Axl ‘decoy receptor’ effectively silences the ​Gas6-​Axl signaling axis

3.  New tool to get cleaner margins in breast cancer surgery

http://medicalxpress.com/news/2014-09-fine-line-breast-cancer-tissues.html

  • Up to 40 percent of patients undergoing breast cancer surgery require additional operations because surgeons may fail to remove all the cancerous tissue in the initial operation.
  • However, researchers at Brigham and Women’s Hospital (BWH) have successfully tested a tool they developed that will help surgeons better distinguish cancerous breast tissue from normal tissue, thereby decreasing the chances for repeat operations.
  • The tool, known as DESI mass spectrometry imaging (or Desorption ElectroSpray Ionization mass spectrometry imaging), works by turning molecules into electrically charged versions of themselves, called ions, so that they can be identified by their mass.
  • By analyzing the mass of the ions, the contents of a tissue sample can then be identified.
  • The tool sprays a microscopic stream of charged solvent onto the tissue surface to gather information about its molecular makeup and produces a color-coded image revealing the nature and concentration of tumor cells.
  • The researchers used DESI mass spectrometry imaging to look at the distribution and amounts of fatty acid substances, called lipids, within breast tissue and normal tissue from 61 samples obtained from 14 breast cancer patients that underwent mastectomy.
  • A software program was used to characterize the breast cancer tumors and detect boundaries between healthy and cancerous tissue.
  • The researchers found that several fatty acids, such as oleic acid, were more abundant in breast cancer tissue compared to normal tissue.
  • The results were also confirmed using traditional pathology methods to test for accuracy.
  • Researchers plan to continue to work toward validating the identified biomarkers—the fatty acid substances—to provide tumor margin information during breast cancer surgery.

For more information:  PNAS, doi: 10.1073/pnas.1408129111, Application of desorption electrospray ionization mass spectrometry imaging in breast cancer margin analysis

4. Compounds in Apple Peel and Fish Oil may fight triple-negative breast cancer

http://www.dailynews.lk/?q=features/breast-cancer-research-no-longer-dream-sri-lanka-s-wasu#sthash.kZhlnInP.dpuf

  • Triple negative breast cancer is a form of breast cancer that tests negative for estrogen receptors, progesterone receptors and human epidermal growth factor receptors.
  • Nearly 15 per cent of all types of invasive breast cancer are triple negative.
  • Certain flavonoids found in apple peels and fish oil may have potential anti-cancer effects on TNBC.
  • Phloridzin (PZ), a compound found in apple peels, has poor bioavailability, while docosahexaenoic (DHA), an omega-3 fatty acid in fish oil, is unsaturated. making it unstable and highly vulnerable to a reaction with oxygen.
  • When combined, the bioavailability of PZ is enhanced and DHA becomes more stable which then acts against triple negative breast cancer cell lines.

For more information:  Dalhousie University:  Breast cancer research no longer just a dream for Agriculture master’s student

Also see:  http://www.lef.org/magazine/2012/4/Apple-Polyphenols-Longevity/Page-01

5.  Roche Says Avastin Prolongs Life In Breast Cancer Study

  • Roche said its cancer drug Avastin helped women with a common form of breast cancer live longer without their disease worsening, when used in combination with chemotherapy drug Xeloda (capecitabine).
  • Results of a Phase III study involving 185 patients with HER2-negative metastatic breast cancer found those treated with both drugs saw an almost threefold improvement in how long they lived without their disease getting worse compared with those taking Avastin alone.
  • A second late-stage trial with 494 patients who continued treatment with Avastin and standard chemotherapy after their disease had progressed showed patients lived significantly longer without the disease getting worse compared with those treated only with chemotherapy.

For more information:  European Society of Medical Oncology congress 2014, Bevacizumab Maintenance in HER2-Negative Metastatic Breast Cancer

6.  Benefits of Endocrine Therapy in Breast Cancer Patients Questioned in New Study

http://radiationtherapynews.com/2014/09/22/benefits-endocrine-therapy-breast-cancer-patients-questioned-new-study/

  • A new study on breast cancer challenges the current medical treatment guideline for women with hormone-receptor positive (HR+) invasive breast cancer by showing that combination treatment with endocrine and radiation therapy as part of breast conservation surgery may not be necessary for all patient populations with this type of cancer.
  • The results of this study suggest that low-risk patients over 65 years old with small tumors after treatment only with adjuvant radiation therapy, without taking endocrine therapy, and patients taking the combination therapy, endocrine and radiation, may have similar survival rates.
  • “When they’re treated with adjuvant radiation therapy alone, elderly women with small, low risk tumors may have acceptable results.  Once their tumors start to get bigger, however, we identified an increasing risk for metastasis, and those people likely need to be on endocrine therapy.”
  • The conclusions from a recent phase III clinical trial suggested that older women with low risk, early stage HR+ breast cancer treated with endocrine therapy only, without radiation, can have satisfactory results.
  • However, outcomes due to the treatment with radiation only, without endocrine therapy, on this type of cancer patients have not been addressed yet.

For more information:  American Society for Radiation Oncology’s 56th Annual Meeting, ASTRO: Benefit of endocrine therapy in elderly women with low risk hormone receptor positive breast cancer

7.  Lactation reduces breast cancer risk

http://www.figo.org/news/lactation-reduces-breast-cancer-risk-0014726

  • Lactation could be linked to a lower risk of developing aggressive forms of breast cancer that are harder to treat.
  • The study analysed data from four large studies and found that women who had had children, or parous women, were 33 per cent more likely than those who had not given birth to develop oestrogen receptor negative breast cancer, a subtype that has a much higher mortality rate.
  • What’s more, women who had never breastfed and had four children or more were 68 per cent more likely to develop the condition than those who had just one child and had breastfed them.
  • The researchers say that the link between childbirth and higher risk of this subtype of breast cancer is largely limited to women who have not breastfed, which could imply that lactating is connected to reduced risk.

For more information:  The Journal of the National Institute of Cancer, (2014) 106 (10): dju281doi: 10.1093/jnci/dju281, Breastfeeding and Triple-Negative Breast Cancer: Potential Implications for Racial/Ethnic Disparities

8.  Cell tower radiation increases risk of brain cancer

http://www.dnaindia.com/mumbai/report-cell-tower-radiation-increases-risk-of-brain-cancer-2020015

http://www.bgr.in/news/mobile-phones-impact-human-cells-finnish-scientist/

  • Finnish scientist Dariusz Leszczynski says that long-term exposure to cellphone and cell tower radiation, on an average of thirty minutes a day over ten years, causes an increased risk of brain cancer.
  • However, he could not conclude whether it is harmful or not because funding for the study stopped.
  • The scientist said that he was working on a research for which funding was promised by a Finnish organisation Tekes, where about 70 per cent fund for research is public money and rest comes from industry.
  • ”When we found that cell phone effects human body the funding stopped because cell phone manufacturers Nokia and Teliasonnera said they don’t like it. The scientific advisory board has industry partners as members.
  • If industry partners doesn’t likes a research, it is often not funded by Tekes.
  • There is effect of cell phone radiation emitted at present levels of safety standards. Protein structure in human skin changes. We could not conclude whether it is harmful or not because our funding stopped.”
  • Apart from brain cancer, three definitive studies showed that exposure of radiation to the skin and brain caused changes in cell structure.
  • “Changes were induced in skin cells and metabolism of glucose in the brain was affected.” It is also known to cause hearing loss, infertility, polycystic ovary syndrome (PCOD) in women.

9.  San Diego Researcher Crowdfunding Patent-Free Cancer Drug

http://timesofsandiego.com/tech/2014/09/20/san-diego-researcher-crowdfunding-patent-free-cancer-drug/

  • Dr. Isaac Yonemoto founded IndySci as a crowdfunding platform for Project Marilyn— a campaign that seeks to develop a patent-free cancer drug based on an open-source ideology.
  • The drug, known as 9DS, was found to be most effective against kidney cancer, melanoma, and triple negative breast cancer in an NCI-60 study, which pits potential cancer drugs against 60 different kinds of cancer cells.
  • The goal of the crowdfunding campaign is to finance an initial xenograft study— that is, studying the drug in mice.
  • Due the drug’s patent status, the threat of competition is likely to keep the price of 9DS low, regardless of a partnership with a for-profit company. Currently, when a drug loses its patent status, the price can come down ten-fold, according to Yonemoto.

10.  HER-2 positive breast cancer is associated with an increased risk of positive cavity margins after initial lumpectomy

  • The effect of breast cancer subtype on margin status after lumpectomy remains unclear.
  • This study aims to determine whether approximated breast cancer subtype is associated with positive margins after lumpectomy, which could be used to determine if there is an increased risk of developing local recurrence (LR) following breast-conserving surgery.
  • The HER-2 subtype was the predictive factor most associated with positive CMs and an independent prognostic factor for LR.
  • This result suggests that the increased risk of LR in HER-2 breast cancer is due to an increased microscopic invasive tumor burden, which is indicated by margin status after lumpectomy.

For more information:  World Journal of Surgical Oncology 2014, 12:289 doi:10.1186/1477-7819-12-289, HER-2 positive breast cancer is associated with an increased risk of positive cavity margins after initial lumpectomy

11.  Immunotherapy Trials Offering Promise in Hard-to-Treat Pancreatic Cancer

http://www.ajmc.com/publications/evidence-based-oncology/2014/September-2014/Immunotherapy-Trials-Offering-Promise-in-Hard-to-Treat-Pancreatic-Cancer

  • In pancreatic ductal adenocarcinoma (PDAC), which accounts for 90% of all cases, tumors are notoriously resistant to chemotherapy; they are characterized by dense stroma with few blood vessels, inhibiting drug delivery.
  • Once pancreatic cancer is found, the location of the pancreas itself makes removing the tumor difficult and for most patients, impossible.
  • For some time, researchers have understood that KRAS is a driver of PDAC progression.
  • According to the National Cancer Institute (NCI), KRAS is mutated in approximately 95% of all cases of PDAC, the highest percentage of all solid malignancies.  
  • Much important work involves understanding the qualities of the collagen-rich fibrosis around the tumor, which not only acts as a barrier to therapy, but may also be the body’s way of containing cancer cells.
  • Throughout, clinical trials are informed by an important lesson: when fighting pancreatic cancer, the battle isn’t just against the tumor; it’s against the tumor in a setting hardwired to resist treatment. This makes the central premise of immunotherapy—to train the body to use its own immune system to battle cancer— even more challenging than usual.
  • Whole Cell Vaccines
  • Treating a difficult disease like pancreatic cancer with whole cell vaccines delivers multiple antigens, avoiding “the difficulty of picking the optimal tumor antigen to target.”
  • Two such vaccines advancing in clinical trials are algenpentucel-L and GVAX, an acronym for granulocytemacrophage colony-stimulating factor (GM-CSF) gene-transfected tumor cell vaccine.
  • GVAX is made from irradiated pancreatic cell lines that secrete GM-CSF.  GVAX has been studied as a monotherapy, but its most promising results have involved its use in combination therapy. Work on this vaccine stems from the many efforts to target KRAS directly, and the realization that a different approach was needed,
  • Algenpentucel-L, which is being developed by NewLink Genetics, follows years of work to understand the responses to alpha-gal, a carbohydrate to which humans have a preexisting immunity. The vaccine uses alpha-gal–modified human cancer cells, which are designed to jump-start the immune system.
  • In effect, when the body attacks the vaccine, the battle against the cancer escalates, too.
  • PANVAC: Injecting the Tumor Directly:  In the first phase, researchers directly injected a live form of the Fowlpox vaccine, which cannot multiply, into tumors for patients who were not candidates for surgery, seeking to shrink tumors without allowing fragments to spread elsewhere. Then patients received a booster, a live but weakened form of smallpox vaccine that can still multiply, injected into the arm. In the second phase, patients received a higher dose of the Fowlpox-derived vaccine into the tumor.

For more information:  1. A scientific framework for pancreatic ductal adenocarcinoma. National Cancer Institute. http://www.cancer.gov/cancertopics/types/pancreatic. Published February 2014. Accessed August 19, 2014.

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