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Given the abundance of new research, it can be challenging to stay current on the latest advancements and findings. Oncology Times is here to help with summaries of the newest studies to ensure you are up-to-date on the latest innovations in oncology practice.

 

CANCER SURVIVORS

Blood pressure status in adult survivors of childhood cancer: a report from the St. Jude lifetime cohort study

New data suggests people who survived childhood cancer were more than twice as likely as the general population to have hypertension as adults (Cancer Epidemiol Biomarkers Prev 2017;26(12):1705-1713). Researchers examined 3,016 adults who were part of the St. Jude Lifetime Cohort Study, which provides ongoing medical assessments of childhood cancer survivors. Data showed that the prevalence of hypertension was 2.6 times higher among childhood cancer survivors than expected, based on age-, sex-, race-, and body mass index-specific rates in the general population. Additionally, researchers found that the prevalence of hypertension increased over time. At age 30, 13 percent of the survivors had hypertension; at age 40, 37 percent had hypertension, and by age 50, more than 70 percent of the survivors had hypertension. Certain groups of survivors were the most likely to have hypertension, including men, non-Hispanic blacks, older survivors, and those who were overweight or obese, according to study results.

 

ESOPHAGEAL CANCER

Oral microbiome composition reflects prospective risk for esophageal cancers

An analysis of bacteria present in the mouth showed that some types of bacteria that lead to periodontal disease were associated with higher risk of esophageal cancer (Can Res 2017; doi:10.1158/0008-5472.CAN-17-1296). Researchers collected oral wash samples from 122,000 participants in two large health studies: the NCI Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial and the American Cancer Society Cancer Prevention Study II Nutrition cohort. In 10 years of follow-up, 106 participants developed esophageal cancer. In a prospective case-control study, the researchers extracted DNA and sequenced oral wash samples, allowing researchers to compare the oral microbiomes of the esophageal cancer cases and the cancer-free cases. Certain bacteria types were associated with higher risk of esophageal cancer, according to researchers. For example, higher levels of the Tannerella forsythia bacteria were associated with a 21 percent increased risk of esophageal adenocarcinoma. The bacteria Porphyromonas gingivalis was associated with a higher risk of esophageal squamous cell carcinoma. The study showed that a few types of oral bacteria were associated with lower risk of esophageal cancer. For instance, the Neisseria bacteria was associated with lower risk of esophageal adenocarcinoma. "Overall, our findings have potential implications for the early detection and prevention of esophageal adenocarcinoma and esophageal squamous cell carcinoma," researchers wrote.

 

CANCER DETECTION

Mutation detection in patients with advanced cancer by universal sequencing of cancer-related genes in tumor and normal DNA vs guideline-based germline testing

A recent study found that more than half of inherited cancer gene mutations in people with advanced cancer are not detected using traditional methods based on family history (JAMA 2017; doi:10.1001/jama.2017.11137). Researchers analyzed DNA samples from 1,040 patients and found that 182 (17.5%) had mutations indicating cancer susceptibility. Of these 182 patients, 101 (55%) would not have had these mutations detected using traditional guidelines based on family history, age, and tumor type. Germline findings led to discussion or initiation of change to targeted therapy in 38 patients and predictive testing in the families of 13, including six for whom genetic evaluation would not have been initiated by guideline-based testing, according to investigators. These findings show that the current guidelines for genetic testing based on family history may not detect all clinically actionable genetic mutations. They also demonstrate that universal sequencing can create an opportunity for precision prevention to preemptively treat cancer in the next generation through increased surveillance or risk-reducing surgical procedures. Research suggests that in select populations of people with advanced cancer, universal tumor-normal sequencing may detect more potentially clinically significant heritable mutations than a targeted approach based on current clinical guidelines.

 

LUNG CANCER

Epigenetic therapy ties MYC depletion to reversing immune evasion and treating lung cancer

Researchers have identified a novel drug combination therapy that could prime non-small cell lung cancers to respond better to immunotherapy. These so-called epigenetic therapy drugs, used together, achieved robust anti-tumor responses in human cancer cell lines and mice (Cell 2017; doi:10.1016/j.cell.2017.10.022). Investigators combined a demethylating drug called 5-azacytidine that chemically reignites some cancer suppressor genes' ability to operate, with one of three histone deacetylase inhibitor drugs (HDACis). The combination therapy triggered a chemical cascade that increased the attraction of immune cells to fight tumors and diminished the work of the cancer gene MYC, according to investigators. In a series of experiments, researchers studied the combination of 5-azacytidine with the HDACis entinostat, mocetinostat, or givinostat in human cancer cell lines and in mouse models of non-small cell lung cancers. The treatments were found to alter the tumor microenvironment. In cancer cell lines, 5-azacytidine worked against the cancer gene MYC, causing down regulation of the entire MYC signaling program. Adding the HDACis further depleted MYC, and together the drugs subsequently caused actions that prevented cancer cell proliferation, simultaneously attracted more immune system T cells to the area of the tumor, and activated these cells for tumor recognition.

 

OVARIAN CANCER

Dose-response association of CD8+ tumor-infiltrating lymphocytes and survival time in high-grade serous ovarian cancer

A recent study showed that women with high-grade serous ovarian cancer and high levels of cytotoxic CD8 have a longer overall survival than those with low or no CD8, which suggests the presence of the cells may be a prognostic factor for patients (JAMA Oncol 2017; doi:10.1001/jamaoncol.2017.3290). Researchers analyzed tumor samples from 7,377 women with a primary diagnosis of epithelial ovarian, peritoneal, or fallopian tube cancer. Immunohistochemical analysis included 5,577 patients, 3,196 of whom had high-grade serous ovarian carcinomas, according to investigators. Patients were grouped based on the estimated number of CD8+ tumor-infiltrating lymphocytes (TILs) per high-powered field: negative (none), low (1-2), moderate (3-19), and high (>=20). The association between CD8 and survival was the primary objective of the trial. Findings showed patients with high-grade serous ovarian carcinomas showed the most infiltration compared with other histotypes. Median survival was 2.8 years for patients without CD8-positive TILs compared with 3 years for patients with low levels, 3.8 years for patients with moderate levels, and 5.1 years for patients with high levels. "This study demonstrates the histotype-specific nature of immune infiltration and provides definitive evidence for a dose-response relationship between CD8+ TILs and high-grade serous ovarian cancer survival," researchers concluded.

 

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