- Cancer experts from around the globe met up for a major conference in Chicago
- Clinicians shared the results of pioneering new treatments for the disease
- Among those to benefit from new techniques is Mike Brandon from Bristol
- He underwent therapy in the US for a form of leukaemia untreatable in the UK
Cancer experts from around the world unveiled a raft of discoveries last week that will, they hope, transform treatment for millions of patients.
Thousands of specialists got together at the American Society of Clinical Oncology’s annual meeting in Chicago to share the latest game-changing research findings.
It is at the conference every year that cutting-edge therapies are announced, with many making dramatic front-page headlines.
Cancer experts from around the world have been meeting up to discuss the latest developments in detecting and treating the disease
This year I was lucky enough to attend the meeting, alongside scores of specialist medical writers who report on the latest innovations in the field.
The buzz-term at the event was precision medicine: bespoke protocols involving tests that help doctors understand the genetic make-up of a patient’s specific disease, helping them attack tumours with pinpoint accuracy while minimising side effects.
There has been much talk about this in theory, but now years of hard work and scientific study are producing breakthroughs that mean the outlook is truly one of optimism.
But what does it all mean for British cancer patients today, and how can the average person benefit?
I put that very question to the UK’s leading cancer specialists to find out…
NO MORE CHEMO FOR EARLY BREAST CANCER
WHAT’S IT ALL ABOUT?
The announcement that the majority of women with early-stage breast cancer, of the most common type, can safely forgo chemotherapy generated huge excitement.
All women will still be offered surgery to remove the cancer. However, after being given a genetic test, a decision can be made as to whether this is followed by chemotherapy and hormone-blocking drugs, or the latter alone, said researchers.
WHAT DOES IT MEAN FOR ME?
Consultant oncologist Dr Hendrik-Tobias Arkenau, Medical Director at Sarah Cannon Research UK, said: ‘The type of breast cancer looked at in the study was hormone-receptor positive, HER2-negative, and node negative – if you have this, you’ll recognise the terms – which represents roughly half of all diagnoses.
The American Society of Clinical Oncology held the conference in Chicago, pictured
‘About 70 per cent of these women may be able to avoid chemo, without any raised risk of their cancer returning.
‘The key is the genetic test, the Oncotype DX test, which is widely used in the NHS. This looks for genetic signatures on a tumour that indicate whether there is a low, medium or high risk of the cancer coming back.
‘We can now reassure post-menopausal women who score with a low or medium risk of recurrence that they do not need chemotherapy and they will have surgery and hormone drugs only.
‘Younger women with a low risk can also safely forgo chemo. The study authors indicated that this may further broaden to include even more patients. The way we treat women with early-stage breast cancer will change overnight thanks to this study.’
GREAT LEAPS FORWARD TO BEAT BIGGEST KILLER
WHAT’S IT ALL ABOUT?
It was good news, for once, for sufferers of lung cancer, which causes 100 deaths a day in Britain. First, immunotherapy drug pembrolizumab was shown to be more effective than chemotherapy for patients with advanced, incurable cases of the most common type of lung cancer. It gave the majority of them about four to eight months more life, with fewer side effects, when compared to chemo.
The surface of the cancer cells were studied for the presence of markers that indicate whether it will be sensitive to the drug.
And there was hope for better screening for those at high risk of lung cancer – such as smokers – as early-stage trials showed DNA blood tests could accurately detect the disease at an early stage, before it causes symptoms.
WHAT DOES IT MEAN FOR ME?
Consultant oncologist Professor Siow-Ming Lee, an expert in lung cancer at University College Hospital London, said: ‘The immune system should attack anything that shouldn’t be in the body, such as a tumour.
‘But many cancers seem to evade detection by giving off signals that interfere with the way immune cells recognise an “invader”.
‘Pembrolizumab, which is a type of immunotherapy, works by blocking those signals. This allows the immune system to “see” it and attack it, clearing the cancer from the body.
‘Today, we can test tumour biopsies to find out whether pembrolizumab will have an effect. In about a third of cases it may do.
‘For those patients who we think it will benefit, we will apply to the Cancer Drugs Fund for them to be given the treatment. In those patients, we know it will extend life.
‘However, it won’t work for everyone. Immunotherapy isn’t recommended for patients who suffer from an autoimmune disease such as Crohn’s or colitis, because it can worsen those conditions, or who have taken immune-suppressing drugs such as steroids, because the two medications cancel each other out.’
Prof Lee added: ‘More research is needed before we can recommend DNA blood tests to screen for early lung cancer. It will be at least five more years before we see a reliable test like this.’
BACK FROM THE BRINK… THANKS TO ‘LAZARUS’ DRUG
WHAT’S IT ALL ABOUT?
As first revealed in The Mail on Sunday last week, men with terminal prostate cancer could be thrown a lifeline thanks to the ‘Lazarus drug’ pembrolizumab. The patients were those who had undergone chemotherapy and other treatments to no avail. But the effect of pembrolizumab in one in ten men was dramatic. At the start of the trial, some were being ‘eaten alive’ by the disease – but thanks to the treatment they were clear of cancer up to two years later.
WHAT DOES IT MEAN FOR ME?
Consultant oncologist Dr Peter Harper, of Guy’s and St Thomas’ Hospital NHS Foundation Trust and co-founder of the London Oncology Clinic, said: ‘A large number of men with prostate cancer are diagnosed at a late stage. Once the disease has spread outside of the prostate, it’s likely to keep coming back – and the problem really isn’t the gland itself any more. So they may well not be offered surgery.
‘Instead, men are given hormone drugs and chemotherapy and this does usually help keep things at bay. But some men don’t respond and we’ve had few options for them. It is this group who would be ideal candidates for pembrolizumab.
‘However, it is not licensed in Europe for treating prostate cancer, so we can’t offer it even privately. Even if we could, it’s very expensive – just under £8,000 per injection, and it needs to be given every three weeks. If you live for as long as some on this trial, it could get quite costly.
‘The best bet is getting involved in a clinical trial. Visit the National Clinical Trials Gateway website [ukctg.nihr.ac.uk], and search for metastatic castrate resistant prostate cancer.’
KIDNEY PATIENTS MAY NOT NEED SURGERY
WHAT’S IT ALL ABOUT?
Until now, for all kidney cancer patients, removal of the affected organ was standard treatment. But research carried out in France has demonstrated that the operation does not boost survival in those with advanced, incurable cancer.
A key factor is that surgery delays the patient receiving other treatments, including medication, for weeks – by which time the cancer could have worsened.
Surgery is still the gold-standard treatment for patients who do not have advanced disease, noted the researchers from the Hopital Europeen Georges-Pompidou in Paris.
WHAT DOES IT MEAN FOR ME?
Mike Brandon, pictured with his wife Kate following his recovery from a type of leukaemia – which had previously been considered incurable
Dr Peter Harper said: ‘Although we can’t cure many patients with advanced kidney cancer, we now have quite an armament of drugs – including sunitinib, or Sutent, and new targeted antibody treatments – that help us control the disease.
‘Kidney cancer typically spreads to the bones, liver and lungs, and also the brain.
‘When it does pop up, these medicines are good at zapping it.
‘Patients can survive for five years or more, and stay relatively well, living a normal life for that time.
‘Now we know it’s not necessary to put them through a big operation – even if it is a keyhole procedure these days, there are still risks and it means recovery time that could be far better spent doing other things.’
LOWERING THE RISK – WITH A DAILY ASPIRIN
WHAT’S IT ALL ABOUT?
A daily dose of aspirin lowers the risk of oesophageal cancer in patients with a common digestive condition, according to a major British study. The 2,500 volunteers involved in the trial also took the over-the-counter medication omeprazole, which reduces stomach acid. All the patients involved had Barrett’s oesophagus, a ‘pre-cancerous’ condition in which low-level acid reflux causes cell changes in the lower part of the gullet.
Sufferers are 50 times more likely than those without the condition to develop oesophageal cancer.
Those who took the two daily pills in combination were found to have a 20 per cent lower chance of developing oesophageal cancer than if they had been untreated.
While the anti-acid drugs reduce the damage caused by stomach acid, the aspirin is thought to have a dampening effect on the cell division that leads to cancer.
About 9,000 Britons develop oesophageal cancer and the disease causes 7,900 deaths each year.
WHAT DOES IT MEAN FOR ME?
Dr Hendrik-Tobias Arkenau said: ‘I would encourage anyone with Barrett’s oesophagus to see their GP or gastroenterologist and discuss the results of this trial.
‘These drugs cost pennies and will help prevent oesophageal cancer. It’s important not to self-prescribe, even though the medicines are available over the counter.
‘Aspirin in particular can cause stomach upsets, so the regime needs to be properly monitored.
‘The peak age for developing oesophageal cancer is in the mid-60s, so starting on this course of medication as early as possible is advisable.’
Breakthrough therapy saves Mike’s life
One man to have already benefited from the advances in precision medicine is leukaemia sufferer Mike Brandon.
Mike Brandon was suffering from chronic lymphocytic leukaemia (CLL), which is not considered curable in Britain, but he underwent pioneering therapy in Philadelphia in 2016 which has saved his life
The 34-year-old from Bristol was desperately ill when he underwent pioneering CAR T therapy in the US city of Philadelphia in 2016.
Mike was suffering from chronic lymphocytic leukaemia (CLL), which is not considered to be curable. He underwent a successful bone marrow transplant in 2014 after first being diagnosed but suffered a full-blown relapse two years later.
His wife Kate spearheaded a crowdfunding drive when they discovered that the experimental treatment was not yet licensed in Europe and raised more than £400,000 in just nine days.
CAR T works by taking some of a patient’s own immune cells via a blood sample and genetically modifying them so they seek out and destroy cancer cells. The modified cells are grown in the lab and then re-infused into the patient.
In the small trial at the University of Pennsylvania’s Abramson Cancer Center, which Mike was part of, CAR T was combined with another targeted drug, ibrutinib, which works by blocking signals within cancer cells that make them grow and divide.
An incredible 89 per cent of patients on the trial went into complete remission. Experts welcomed the result, although more research is needed to better understand the therapy.
Mike began treatment in May 2016, and by October that year he was clear of cancer.
The couple have now started a campaign called #Donate4TCells to help others who are facing a terminal diagnosis. Mike, who works for a music rehearsal studio, said: ‘My energy levels are excellent today. They returned super quick after the treatment.
‘By that autumn, Kate and I were walking in the Lake District. I’m quietly starting to train for the Bristol Half Marathon. I’m feeling good, and blood tests suggest I’m still in remission. So I’m optimistic.’
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