More evidence that beta blockers help stop cancers from spreading

Wednesday 30 January 2013

US researchers have taken a step forward in understanding how beta blockers may slow the spread of cancer.

The study is the latest in a series of findings that suggest the drugs, commonly used to treat conditions such as heart disease, high blood pressure, glaucoma and migraines, might also have a role to play in cancer treatment.

Previous studies have shown lower rates of death from various cancers among people who take beta blockers for long periods for other conditions, leading researchers to speculate that the drugs could help treat patients.

The new research, published in Nature Communications and led by Professor Anil Sood at the MD Anderson Cancer Center in Texas, focused on a molecule on the surface of cells, known as the beta-adrenergic receptor, or ADRB - the target of beta blocker drugs.

Working in a mouse model of ovarian cancer, the researchers showed that signals sent from ADRB into the cell’s interior activated a key cancer protein called Src.

This in turn switched on a variety of processes linked to the spread of the disease.

The effect was counteracted by giving the mice propanolol, a commonly used beta blocker, and this also appeared to slow the growth of the cancers.

“This is a major step forward in understanding [beta blockers’] biology and impact,” said Professor Sood. “It opens the door to study drugs that could inhibit this unique signalling pathway".

To add further weight to their findings, the researchers looked at medical records from a large database called the Adverse Event Reporting System. They found that patients’ chances of dying from cancer were reduced by 17 per cent if they were also taking beta blockers for other conditions.  

This echoed the findings of recent studies into lung cancer and ovarian cancer.

Dr Des Powe, a Nottingham-based researcher running a Cancer Research UK-funded study into beta blockers and breast cancer, agreed the evidence was becoming more and more compelling.

“Evidence has been building for several years that beta blockers could be used to help treat certain cancers – notably some forms of breast, bowel, lung, melanoma and ovarian cancer, and possibly prostate cancer.

“These cancers seem to have a more favourable prognosis in people who regularly take beta blockers, and trials are underway to find out more. On top of this, labs around the world have begun to work out exactly why and how this may be happening.”

But he cautioned that there was still a way to go before beta blockers – prescription drugs with known side effects – were proven safe and suitable for patients undergoing cancer treatment.

“This is an idea that needs to be fully tested in the clinic to be sure,” he warned.

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Late ovarian cancer diagnoses 'are costing lives'

Wednesday 23 January 2013

Delays in diagnosis are cutting short the lives of women with ovarian cancer, according to a UK charity.

Women putting off visiting their GP and subsequent delays in getting the correct diagnosis are highlighted as "areas of concern" by Target Ovarian Cancer.

The charity's latest Pathfinder Study, launched today at the House of Commons, also says that delays in diagnosis could be down to GPs requests for tests for their patients being refused.

Dr Claire Knight, health information manager at Cancer Research UK, said the report was a "timely reminder" that urgent attention must be given to ovarian cancer, and added that treatment - not just early diagnosis - needs to be improved.

Women diagnosed with ovarian cancer at the earliest stage have a five-year survival rate of 92 per cent.

But the overall survival rate in the UK is just 43 per cent - among the worst in Europe.

Previous studies have suggested that late diagnosis could be one reason why the UK lags behind other countries, but recent research  suggests that the UK may be worse at treating late-stage ovarian cancer.

The latest study found that, over the last five years, one in four women diagnosed with ovarian cancer took more than three months to visit their GP after they started having symptoms. Around half took more than a month.

Three per cent of these women said they "knew a lot" about the disease prior to their diagnosis. And more than half said they had "heard of the disease but knew nothing about it".

Once at the GPs, the report found that women still faced problems getting a correct diagnosis. A third of women were diagnosed more than six months after they first went to see their doctor.

The report also showed that 30 per cent of women were misdiagnosed as having irritable bowel syndrome, 15 per cent as having ovarian cysts and 13 per cent as having a urinary infection.

On top of this, one in ten GPs reported having diagnostic tests for their patients, such as abdominal scans, refused in the past year.

Cancer Research UKs Dr Knight said: "Nearly a third of women with the disease are diagnosed as an emergency and survival rates in the UK are worse compared to other countries. We urgently need to do more to improve both the way the disease is diagnosed and treated.

"Symptoms of ovarian cancer include pelvic or tummy pain, bloating, difficulty eating or feeling full.

"If you experience any of these, they are new for you and happen on most days, see your GP. And if your symptoms persist, keep going back to your doctor."

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Israeli researchers developing BRCA 'radiation' test

Tuesday 22 January 2013

A new blood test that measures cells’ response to radiation could detect inherited faults in a person’s BRCA genes, according to Israeli researchers.

Rather than directly analysing an individual’s DNA, the scientists propose the new test could identify at-risk people with mutations that current methods find hard to spot.

But others cautioned that the method, while promising, would need significant development and testing before it could replace existing methods, which rely on DNA sequencing.

Discovered in the 1980s, the BRCA1 and BRCA2 genes are found in all human cells, and normally make proteins that are involved in cell division and DNA repair - two processes that go wrong in cancer.

As a result, people who inherit faulty copies of either gene have a significantly increased risk of breast, ovarian and prostate cancers, and these cancers often run in their families. About five in every hundred breast cancers are thought to be caused by an inherited BRCA gene.

At the moment, DNA samples from members of affected families can be tested, and carriers offered extra monitoring or treatment.

But the test relies on being able to predict whether a fault is likely to be harmful, by comparing the DNA analysis against previously known mutations.

This has disadvantages, says study author Dr Asher Salmon, from the the Hadassah Hebrew University Medical Center in Jerusalem.

"The current tool for mutation detection is gene sequencing, which is expensive, time-consuming and, in many cases, lacking clear and decisive clinical decision making information," he said.

"In many cases, [it] identifies a mutation, but we do not know if the mutation is neutral or harmful."

Since they are unable to repair damaged DNA, cells that contain faulty BRCA genes are more sensitive to radiation. So Salmon's team tested whether this response could be used as a marker for faulty BRCA genes.

Initially analysing blood samples from nine healthy women with a mutated BRCA1 gene and eight healthy women with a mutated BRCA2 gene, they developed a 'signature' of the cells' response to radiation, made up of a number of genes that were switched on or off in response to radiation.

They then confirmed this signature's presence in radiation-treated blood samples from an independent group of 40 women who were carriers of mutated BRCA1 and/or BRCA2, but absent from 17 non-carrier women.

The test correctly identified 95 percent of BRCA carriers, and 88 percent of non-carriers.

According to Salmon, the test can show whether an individual carries a cancer-linked fault, regardless of the specific mutation they carry. In addition, it could be extremely useful across the developing world, where expensive gene-sequencing equipment may not be accessible.

However, Cancer Research UK’s Dr Julie Sharp urged caution.

"This is a very preliminary finding. The current test - DNA sequencing - is easy to standardise across different labs, whereas this new method would require substantial expertise and training to make sure its results were as consistent between labs.

"And we don't currently know whether there are indeed significant numbers of families out there who are unidentified carriers of BRCA mutations, who would not be picked up by existing methods."  

"That said, if further development goes as planned, this could be a useful technique to spot BRCA mutation carriers under certain circumstances."

The research is published in the journal Cancer Prevention Research

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Cervical smear tests 'could also detect ovarian and womb cancer'

Thursday 10 January 2013

DNA from cervical screening samples could also be used to detect ovarian and womb (endometrial) cancers, according to preliminary US research.

Cervical screening uses a test called cytology, which most people know as the 'smear test'. Cytology involves taking a sample of cells from the cervix with a small brush.

Scientists from John Hopkins Medical Institutes extended the DNA testing already used as part of the screening programme to look for changes relating specifically to womb and ovarian cancer from cells that had trickled down to the cervix.

The test identified all of 24 women who had subsequently developed womb cancer, and nine out of 22 women who had gone on to develop ovarian cancer.

Despite the lower detection rate, the researchers propose that such a test could be most useful for women with ovarian cancer, since the disease is difficult to diagnose early and so is often harder to treat.

And womb cancer already tends to be detected earlier than ovarian cancer as a result of more obvious symptoms such as vaginal bleeding.

Importantly, no healthy samples were wrongly identified as having cancer- so called 'false-positive' results.

Dr Jacqui Shaw, a Cancer Research UK grant holder from the University of Leicester, said: "This is an exciting early study. It suggests that the national cervical screening programme could one day be expanded to test for ovarian and womb cancers too.

"The idea of testing women's cervical screening samples for DNA from ovarian and womb cancers is clever, and this small study shows this may be possible in the future.

But she cautioned further research is needed: "The next step is to carry out larger studies that can better measure how accurately such DNA tests could detect these cancers".

"It will also be interesting to see whether expanding the number of genes analysed could make the test more accurate, especially for detecting ovarian cancer, which is notoriously difficult to diagnose early, " she added.

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Blood cell gene fault linked to breast and ovarian cancer

Monday 17 December 2012

Scientists have linked a rare genetic fault in the immune system to an increased risk of breast and ovarian cancers.

The research from a team at The Institute of Cancer Research suggests an entirely new way tumours develop.

The lead researcher on the study, Professor Nazneen Rahman, said it was one of her lab's "most interesting and exciting discoveries".

According to the study, published in the journal Nature, women with faults in a gene called PPM1D in their blood cells were 20 per cent more likely to develop breast or ovarian cancer.

That is twice the average breast cancer risk and more than 10 times the ovarian cancer risk of women in the general population.

The discovery could have implications for future genetic testing and targeted prevention, especially in the case of ovarian cancer.

Dr Emma Smith, Cancer Research UK's senior science information officer said: "This exciting discovery could help doctors identify women at higher risk of developing breast and ovarian cancer in the future.

"This may have a particular impact on ovarian cancer, which is often diagnosed at a late stage.

"Understanding the genetic mistakes that drive these cancers may also lead to new ways to treat these diseases."

The researchers speculate that they have uncovered a new cancer-causing process, since the PPM1D gene appears to operate differently to other genes known to increase the risk of breast and ovarian cancer, such as BRCA1 and BRCA2.

The team found that changes in PPM1D were not inherited and rather than being present in every cell - as in most inherited cancer-causing genes - they were only present in immune cells known as lymphocytes.

Even more surprisingly, the PPM1D gene was not altered in women's cancer cells, nor in their normal breast or ovarian cells, the study discovered.

The changes make the PPM1D gene overactive, reducing the action of a gene called TP53, one of the most frequently altered genes in cancer cells.

The ICR's Professor Nazneen Rahman, who led the study, said: "This is one of our most interesting and exciting discoveries. At every stage the results were different from the accepted theories.

"We don't yet know exactly how PPM1D mutations are linked to breast and ovarian cancer, but this finding is stimulating radical new thoughts about the way genes and cancer can be related."

Professor Rahman said the findings could also help inform women's decisions about future medical treatments.

A woman might, for example, consider keyhole surgery to remove her ovaries after completing her family if she knew she had PPM1D changes and had a one in five chance of developing ovarian cancer.

The study was funded by Cancer Research UK, the ICR, the Wellcome Trust and Breakthrough Breast Cancer.

Researchers analysed 507 genes involved in DNA repair in 1,150 women with breast or ovarian cancer, identifying PPM1D gene changes in five women.

They then sequenced the PPM1D gene in 7,781 women with breast or ovarian cancer and 5,861 people from the general population.

25 of the women with cancer had faults in PPM1D, compared with only one in the general population, a highly statistically significant difference, the researchers said.

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High-risk women may need more frequent ovarian cancer screening

Friday 7 December 2012

Cancer Research UK Press Release

Screening women at high risk of ovarian cancer once a year may not be effective enough to spot the disease in its earlier stages, and more frequent screening may be needed for this group of women, according to new research published in the Journal of Clinical Oncology.

The UK Familial Ovarian Cancer Screening Study (UKFOCSS) looked at the results of annual screening in over 3,500 women aged 35+ between 2002 and 2008. During this period, 26 women developed ovarian or fallopian tube cancers.

The research, funded by Cancer Research UK and The Eve Appeal, aimed to see how good a yearly screening programme (involving ultrasound and blood tests) would be at picking up ovarian and fallopian tube cancers in women who were thought to be at high risk of the disease*.

The study found that annual ovarian screening did pick up the majority of cancers, but by the time cancers had been diagnosed, most of them had already started to spread. Women who had been screened within the previous year were less likely to be diagnosed with the most advanced stages of ovarian cancer, compared to women who had not been screened for over a year.  But screening did not increase the proportion of women diagnosed with stage I cancers, leaving the question of whether even more frequent screening would be necessary to increase the number of cancers detected earlier.

The authors from UCL’s Institute for Women’s Health suggest that screening high-risk women more frequently, coupled with swift surgery where necessary, might improve the chances of finding these cancers at an earlier stage. They are now assessing the results of the second phase of the study, which will show the impact of screening high-risk women every four months, and the findings are to be presented next year.

Dr Adam Rosenthal, senior lecturer and consultant gynaecological oncologist at Barts Cancer Institute and lead author of the study, said: “These results support a possible role for screening women at high risk of ovarian cancer, but only if they have decided not to have surgery to remove their ovaries and fallopian tubes.

“The study shows that screening is picking up most cases of ovarian cancer before they reach the most advanced stages. But, by the time they are detected, the majority have still spread and the outlook for these patients is likely to be poorer than for women whose cancers have not spread. At this time, annual screening cannot be considered to be such a safe bet as risk-reducing surgery and it’s important that high-risk women know the options and outlooks available to them.”

Professor Ian Jacobs, principal investigator of UKFOCSS said “I am delighted that the results of this first phase are now published and that the findings are encouraging. We await further information from this trial and from the large study of screening in women without a family history, the UK Collaborative trial of Ovarian Cancer Screening, UKCTOCS, to establish whether or not screening with a blood test or ultrasound saves lives.”

Jessica Harris, health information manager at Cancer Research UK, said: “Until we have the results from two other key studies into ovarian cancer screening, it’s too soon to know whether any type of screening could be effective for high-risk women. So women with a strong family history of ovarian or other cancers should talk to their doctors about the options and whether they could be referred for genetic testing.

“Cancer Research UK has been at the heart of research that has helped make women diagnosed with ovarian cancer now twice as likely to survive compared to back in the 1970s. When ovarian cancer is diagnosed at an early stage, treatment is more likely to be successful and many more women survive. So if you experience tummy pain, bloating or a lasting sense of feeling full that won’t go away, then you should visit your doctor.”

Robert Marsh, CEO of The Eve Appeal, said: “It’s encouraging to receive meaningful and helpful information for high-risk women from the first phase of this trial. While we await the results of phase II of this, and the larger UKCTOCS trial for women without a history of ovarian cancer, our message to all women is to be aware of the signs and symptoms of ovarian cancer and to visit your GP if you have any concerns at all.”

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Death rates from ovarian cancer have fallen by 20 per cent over last decade

Tuesday 20 November 2012

Cancer Research UK Press Release

The rates of women dying from ovarian cancer in England have fallen from 11.2 women in every 100,000 (3,820 cases) in 2001 to 8.8 per 100,000 (3,453 cases) in 2010 – a drop of around 20 per cent, according to a new report by the National Cancer Intelligence Network published today.

And the most notable drop in deaths over the last 10 years has been among women aged 40-69 years old.

The report also showed that survival for ovarian cancer has increased since the mid-1980s – women surviving their disease for at least a year has risen from 57 to 73 per cent and five year survival has increased from 33 to 44 per cent.

But the report found the chance of surviving the disease varies widely between ages, becoming increasingly worse with age, even after adjusting for the higher background mortality in the older population generally. For women aged 15-39 diagnosed with ovarian cancer, 84 per cent survived their disease for at least five years compared with just 14 per cent of those aged over 85 years at diagnosis.

In 2009 almost half of women diagnosed with ovarian cancer were in their 60s or 70s – and over 80 per cent of deaths were in women aged 60 or over.

Dr Andy Nordin, gynaecological oncologist at East Kent Hospitals University NHS Foundation Trust and study author, said: “Our new report is very encouraging and shows a fall in the rates of women dying from ovarian cancer – a type of cancer that has always been notoriously hard to treat. This is because ovarian cancer is a group of different disease types, which is difficult to diagnose and commonly presents as advanced disease. This drop in deaths may reflect improvements in detecting and treating the disease, such as improvements in scanning, surgery and chemotherapy treatments.  Additionally, over the past decade, ovarian cancer patients throughout the UK have experienced better management due to organisation of ovarian cancer care in specialist gynaecological cancer centres, planning of care by teams of cancer experts and specialist surgery by specially trained and accredited gynaecological oncologists.”

The report also highlights that the incidence rates for developing the disease have remained fairly stable since the late 1980s although they have dropped slightly in the last few years.

Dr Nordin, added: “We know the risk of developing some types of ovarian cancer may be related to the number of times a women ovulates during her lifetime. And anytime that she stops ovulating such as during pregnancy and breast feeding, early menopause and taking the contraceptive pill all help to protect against the disease developing.  The fall in incidence could therefore partially reflect the widespread use of hormonal contraceptives since the ‘60s.”

Chris Carrigan, head of the National Cancer Intelligence Network (NCIN), said: “As  ovarian cancer can be very hard to diagnose and treat this report was important to help us learn as much as we can about the numbers of women who develop the disease, how many survive and how many die.”

Ovarian cancer is the fifth most common cancer in women in the UK with around 7,000 cases diagnosed each year.

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First figures help set the standard for gynaecological cancer surgery

Monday 5 November 2012

Cancer Research UK Press Release

The first UK multicentre figures showing that one in five women having major gynaecological cancer surgery have some sort of complication will help set standards in the NHS, according to research presented at the NCRI Cancer Conference today.

The initial findings of the UK Gynaecological Oncology Surgical Outcomes and Complications (UKGOSOC) audit also reveal that one in 30 women experience a serious complication, which may need another operation or procedure.

The detailed and verified figures come from an interim analysis of more than 1,600 operations carried out across 10 centres in the UK between April 2010 and July 2011. The final results from the full audit, covering the outcomes of around 3,000 operations, will be released later this year.

Surgeons entered details about each patient’s general health, the complexity of their operation and any complications encountered into online computer records. This meant that information about complications could be entered directly from the operating theatre or from the wards if they occurred after surgery. The UKGOSOC audit also sent patients a follow up card 6-8 weeks after surgery.

Understanding the complication rates will help set NHS benchmarking standards, allowing nationwide performance in this area of cancer treatment to be better understood. It will also help doctors to better advise patients on the full risks involved in their treatment decisions.

Professor Usha Menon, head of the Gynaecological Cancer Research Centre at UCL and lead author of the audit, said: “In contrast to the wealth of data regarding complication rates following chemotherapy and radiotherapy, there have been no multicentre figures on complication rates following surgery for gynaecological cancers. This has meant that we have been unable to properly counsel our patients in preparation for surgery.

“It’s hugely satisfying that we now have robust figures and, while complication rates of one in five may seem high, it’s similar to the only other comparable figure available from an Australian study. These numbers also need to be evaluated alongside the survival rates, which should be available in the near future.”

Dr Andy Nordin, a consultant gynaecological oncologist and co-author of the audit, said: “This work is giving us a complete picture of each patient’s treatment, from the operating theatre to eight weeks after they’ve been discharged. In addition to the complication rates, it provides other key information, including details of patients' medical history along with the complexity of their operation.

“We hope to see this electronic data collection process brought into routine practice to improve the information collected by the NHS and to help us to continue to improve surgical outcomes in the UK. The findings, along with the hard work involved in data collection, may well prove useful in other countries too.”

Dr Jane Cope, director of the NCRI, said: “All surgery carries risks and it’s important that patients know that there may be complications during and after their operations. Setting nationwide benchmarks will be an important step in helping doctors and patients better understand the effectiveness of current treatment. Doctors and surgeons can then go on to develop improvements, which will give better outcomes for the patients of the future.”

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Differences in treatment for advanced ovarian cancer could explain why UK survival lags behind other countries

Wednesday 3 October 2012

Cancer Research UK Press Release

The main reason women are less likely to survive ovarian cancer in the UK than in other comparable countries appears to be due to very low survival in those with more advanced stages of the disease, shows new research published in the journal Gynecologic Oncology.

This research is part of the International Cancer Benchmarking Partnership (ICBP) - a unique global collaboration funded by the Department of Health.

Overall, the UK had similar proportions of women diagnosed at each stage of the disease as in the other participating countries (Australia, Canada, Denmark and Norway). This indicates that differences in access to treatment, or in the quality of care, could play the largest role in the UK’s lower survival for ovarian cancer, along with other factors such as having another illness which may prevent some women from receiving or completing a specific treatment.

Researchers from Cancer Research UK’s Cancer Survival Group at the London School of Hygiene and Tropical Medicine examined the records of 20,073 women diagnosed with ovarian cancer between 2004 and 2007 to see how many survived for at least one year, and how this compared with the other four countries.

They found that in the UK, 69 per cent survived for at least a year compared to 72 per cent in Denmark and 74-75 per cent in Australia, Canada and Norway.

Survival in the UK was lower among women whose ovarian cancer was diagnosed at a late stage, and for those whose disease stage had not been recorded. This difference for late-stage cancer was greatest for women diagnosed at age 70 years or more, among whom just 35 per cent survived for at least a year, compared to 45 per cent in Canada.

The UK was also much worse at actually recording the stage at diagnosis.

Dr Bernard Rachet, lead author from the Cancer Survival Group at the London School of Hygiene and Tropical Medicine, said: “Our research is the first population-based study to examine whether low ovarian cancer survival in the UK is due to more women being diagnosed with advanced disease, or to the outcome of treatment in the UK being inferior at each stage. The results show that the proportion of women with advanced disease is similar to that in other countries, but that survival for women with advanced disease is much lower. This suggests that the success of treatment is lower in the UK, and more effort should be made to ensure that UK women with ovarian cancer have the same access to the best treatments.”

Dr John Butler, study author and Cancer Research UK clinical advisor for the ICBP project from the Royal Marsden Hospital, said: “Ovarian cancer can be very difficult to treat, because it’s not just one disease but several different diseases, depending on the type of the tumour. The most common form, high grade serous ovarian cancer, is thought to develop in the fallopian tube, rather than the ovary, and it often spreads rapidly before a woman notices any symptoms. This is why many ovarian cancers are not detected until they are more advanced. But in order for us to understand why we have lower ovarian cancer survival and how we can focus on improving treatment for later stage disease, the UK must get better at recording the stage of disease at diagnosis.”

Sara Hiom, director of information at Cancer Research UK, said: “This disturbing research advances our knowledge about what needs to be done to tackle lower ovarian cancer survival in the UK. The results show that achieving earlier diagnosis remains vital for improving overall survival. If women are diagnosed when the cancer is still in its early stages, before it has spread to other parts of the body, it is far more likely that treatment will be successful. In addition treatment must be improved for advanced stage cancers.”

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Gene helps predict which women with ovarian cancer will benefit most from chemotherapy

Wednesday 19 September 2012

Cancer Research UK Press Release

Measuring how active a gene is in women with ovarian cancer could predict who will benefit from platinum-based chemotherapy drugs – a common treatment for the disease.

For the first time, researchers have found that a gene called FGF1 is highly active in aggressive, advanced ovarian cancers, and it is found at higher levels in cancer cells that are resistant to platinum chemotherapy treatments, such as carboplatin and cisplatin.

So women with high levels of FGF1 are less likely to respond to these drugs and have a poorer prognosis.  

The research, funded by Cancer Research UK and the Scottish Funding Council, is published online in the British Journal of Cancer today1.

The researchers also found that FGF1 activity increases after ovarian cancer cells become drug resistant. By blocking FGF1 in ovarian cancer cells resistant to platinum drugs, the scientists were able to make them sensitive to chemotherapy again.

Dr Gillian Smith, one of the researchers based at the University of Dundee, said: “We’re excited by these results because they identify potential ways that ovarian cancer builds resistance to common chemotherapy drugs over time. Our study paves the way for the development of new tests to determine if chemotherapy will work and suggests that drugs targeting FGF1 could be effective new treatments for a group of women with a type of ovarian cancer that is difficult to treat successfully.”

The researchers measured amounts of a variety of genes in 187 ovarian cancer patients and found each cancer had a unique range of active genes. But, FGF1 appeared to playing the greatest role in determining how cancers behave.

The FGF1 gene encourages cancers to grow a blood supply, helping to fuel the tumour’s growth.

Dr Julie Sharp, senior science information manager at Cancer Research UK, said: “Ovarian cancer is frequently diagnosed at an advanced stage where surgery is difficult and the disease has spread. The current approaches to treatment are limited - not all women respond to chemotherapy and there is no way of telling who will benefit most. This research is a step towards addressing the urgent need to develop tests that can tell us more about each woman’s ovarian cancer and help personalise treatment to save more lives.”  

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Cancer Research UK initiative attracts innovative targeted cancer trials to the UK

Thursday 31 May 2012

Cancer Research UK Press Release

A Cancer Research UK initiative to improve cancer gene testing has prompted two pharmaceutical companies to plan pioneering international trials into targeted cancer treatments in the UK.

Cancer Research UK’s Stratified Medicine Programme launched last year in a bid to test tumour samples from 9,000 UK patients across six different tumour types to help further research into new targeted therapies.

Each tumour sample is being tested for a range of gene faults linked to cancer, and the information entered into a database that will allow researchers to compare the results of treatment to specific faults within cancer cells.

As a result of the programme, Roche and Bristol-Myers Squibb are working with Cancer Research UK to run trials in the UK that rely on this testing. The Roche trial will look at whether patients with a range of cancers could benefit from the targeted skin cancer drug vemurafenib. The Bristol-Myers Squibb trial is seeking health authority and ethics approval.

Doctors will be able to use the Stratified Medicine testing to see if any of their patients have the specific faults in their tumour, which would make them suitable to join these trials.

Michelle Rashford, medical director, Roche UK said: “The stratified medicines programme run by Cancer Research UK is an exciting initiative, as the opportunity to test tumour samples for a range of biomarkers is an important step in the continued development of personalised medicines.  Our VE-Basket study of vemurafenib in patients with V600 mutation positive cancers across different disease areas will allow us to identify patients that may benefit from treatment, and get closer to the goal of truly targeted medicines that provide better patient outcomes, reduce unnecessary side effects and ultimately deliver life-saving and life-prolonging treatments.”  

Oracle has also signed an agreement with Cancer Research UK to provide Oracle Health Sciences Translational Research Center software that will allow such information to be integrated and analysed much more efficiently, helping drive forward research into targeted cancer treatments.

Neil de Crescenzo, senior vice president and general manager at Oracle Health Sciences, said: “As we move toward the next generation of care, the ability to integrate and meaningfully analyse data will be a critical component in the ability to deliver more targeted, personalised therapies.

“We are delighted to work with Cancer Research UK to provide the analytical foundation needed to unlock real value from their data to support new insights at the molecular level, as they seek to expand on the genetic testing of tumours to enable more advanced, targeted and effective treatments for cancer patients.”

Cancer Research UK’s programme is a partnership with AstraZeneca, Pfizer, the Technology Strategy Board (TSB), and a range of other universities, hospitals and companies in six collaborations funded by the TSB: a total investment of £18 million. More than 2600 patients have so far enrolled, putting the programme on target to finish recruiting at the end of next summer.

David Willetts, Minister for Universities and Science, said: “This is an excellent example of collaboration between the research base and industry. It shows how Cancer Research UK is driving forward the delivery of significant benefits for patients. Two further pharmaceutical companies have got onboard and decided to carry out clinical trials - this is evidence of the attractiveness of the UK as a location for science and innovation."

James Peach, director of Cancer Research UK’s stratified medicine programme, said: “We’re delighted that our programme has helped bring these two highly innovative cancer trials to the UK, where we hope they will be of benefit to patients.

“Being able to quickly and efficiently identify patients on the basis of the faults within their tumour is a key step in developing targeted cancer treatments. This will be particularly important in relation to rare cancer types, where the target gene faults may only be present in a relatively small number of patients making it more difficult to do research.

“Patients are the heart of this work, so I’d like to thank the thousands of them who have volunteered, as well as the donors who enable this vital work to take place, and the dedicated teams in the 21 hospitals and three genetics labs across the UK that make it happen every day.”

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Blood test gives 'real-time' picture of cancer

Wednesday 30 May 2012

Cancer Research UK Press Release

A simple and cost-effective blood test could be used to monitor how a patient is responding to treatment and detect genetic faults in their cancer as they happen, according to a Cancer Research UK study.

The test accurately measures the levels of ‘faulty’ DNA fragments that are shed into the bloodstream by cancer cells as they die1. By tracking these levels, scientists at Cancer Research UK’s Cambridge Research Institute were able to detect genetic faults involved in tumour growth in blood samples taken from twenty women with ovarian cancer.

The researchers were also able to build a ‘real-time’ picture of how one woman’s breast cancer was responding to treatment over more than a year.

As treatments become more targeted towards genetic mutations, this approach could mean that a patient is given certain treatments based on the results of a quick blood test, sparing them from an invasive biopsy.

Study author Dr Nitzan Rosenfeld, based at the Cancer Research UK Cambridge Research Institute, said: “This type of blood test has the potential to revolutionise the way we diagnose and treat cancer. The great advantage is that it can be used to identify cancer mutations without surgery or a biopsy, making it safer and cheaper.”

The test also overcomes one of the main limitations of tumour biopsies, where a sample may only give a limited snapshot of the mutations that are present in cancer. It’s also difficult to take samples from secondary cancers throughout the body, once the disease has spread.

Because DNA is shed from all tumours into the bloodstream, this test gives a fuller picture of the disease’s progress.  

This is the first time scientists have been able to screen entire genes in a blood test to identify mutations that have arisen in the cancer, and it could transform how cancers are monitored and treated in the future.

The research, published today in Science Translational Medicine2, used DNA sequencing to look for nearly 20,000 possible mutations in 6 cancer-related genes and was able to identify rare DNA molecules containing cancer-specific genetic faults.

The researchers identified mutations in blood samples from twenty ovarian cancer patients treated at Addenbrooke’s Hospital in Cambridge. They were also able to measure changes in the amounts of cancer DNA in the blood stream in several ovarian and breast cancer patients.

Dr James Brenton, a Cancer Research UK ovarian cancer clinician and study author, said: “Our technique is much more comprehensive and practical than others that have been used to measure DNA in the blood. More than two per cent of the DNA we found in plasma of advanced cancer patients came from the tumour. This tumour specific DNA offers us an opportunity to follow the disease in ‘real-time’ as it changes, helping us to respond and change the treatments we use against the disease.”

In one of the ovarian samples studied, the test was able to detect a new genetic fault not found in the original biopsy. After further examination, they found that this mutation was present in a small minority of cells in one part of the tumour, but could not be identified in most areas tested.

The researchers believe that implementing the test could be done at a similar cost to others used to detect and monitor cancer and a single technician could carry out several hundred tests a week.  

Dr Rosenfeld added: “We need to confirm its accuracy in more patients, and in additional cancer types, but this test could be adapted to look for mutations in different cancers and updated to include new genetic faults as research uncovers them.”

Professor Peter Johnson, Cancer Research UK’s chief clinician, said: “These initial results hold out the promise of a new way to monitor cancer and how it can change as patients undergo treatment.  In the future we will be using many more treatments aimed at molecular changes in cancer cells, and this gives us a system that could allow us to respond and modify treatments as we see new gene changes occurring."

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Study uncovers types of ovarian cancer linked to endometriosis

Wednesday 22 February 2012

The link between endometriosis and a slightly increased risk of ovarian cancer has been confirmed in a US study.

The study, published in the Lancet Oncology, is the first to show which types of ovarian cancer are linked to the condition, which affects the womb.

About one women in every 20 will develop endometriosis. But, commenting on the finding, UK experts pointed out that the number of women with the condition who would go on to develop ovarian cancer was small.

Dr Paul Pharoah, a Cancer Research UK-funded researcher at the University of Cambridge, said that about one woman in 50 in the general population will develop ovarian cancer - about 2 per cent.

He added that previous research has shown that this risk increases to around one in 40 (2.5 per cent) for women with endometriosis.

The new study was carried out by the Ovarian Cancer Association Consortium, led by Professor Celeste Leigh Pearce from the University of Southern California, Los Angeles.

It looked at the overall results of 13 previous studies, including data from more than 23,000 women, over 9,800 of whom had cancer.

Three types of ovarian cancer were slightly more common in women with endometriosis: clear cell, endometrioid, and low-grade serous ovarian cancer.

But the most common form of the disease - high-grade serous ovarian cancer - and other less-common types were not linked with the condition.

In endometriosis, the lining of the womb (the endometrium) begins to grow on the outside of the womb and on the nearby organs.

It can be painful and sometimes affect a woman's fertility. It is usually treated with surgery or hormone therapy.

Lead author Prof Pearce said the research could lead to better prevention and early detection approaches, such as risk-reducing surgery and screening.

But Dr Pharoah said that the research had limited immediate relevance for women or their doctors: "While these finding are of some biological interest they have limited immediate clinical implications, as the increase in risk to women with endometriosis is small.

"The only well-established intervention to reduce ovarian cancer risk is surgical removal of the ovaries, and this would only be offered to women at much higher risks," he said.

He also pointed out that, in absolute terms, it showed lifetime risk of developing clear cell cancer - about 1 in 500, or 0.2 per cent - increased to 1 in 180 (or 0.55 per cent) for women with endometriosis.

"The lifetime risk of both endometriod and low-grade serous ovarian cancer are each about 1 in 400 and these also increases to 1 in 180 in women with endometriosis," he added - an increase from 0.25 per cent to 0.55 per cent.

Dr Emily Power, health information manager at Cancer Research UK, said that women should be aware of the disease's symptoms.

"Ovarian cancer can be difficult to detect at an early stage, so identifying women who are at higher risk could help doctors to develop more targeted monitoring in the future," she said.

"All women should be aware of the signs of ovarian cancer, like pain in the lower tummy, bloating, increased tummy size, difficulty eating or feeling full."

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Scientists reveal best imaging technique for ovarian cancer

Tuesday 14 February 2012

Cancer Research UK Press Release

Cancer Research UK-funded scientists have determined that a magnetic resonance imaging (MRI) technique, which measures the movement of water molecules within the tumour, may be the best way to monitor how women with late-stage ovarian cancer are responding to treatment. The study is published in the journal Radiology today.

Researchers from Cancer Research UK’s Cambridge Experimental Cancer Medicine Centre at the University of Cambridge compared three different MRI techniques and showed that a type called ‘diffusion-weighted MRI’ is the most effective at indicating response to treatment and also at distinguishing when tumours that had spread from the ovaries into surrounding tissues were not responding.

CT scans are routinely used to help assess whether ovarian cancer patients should continue having chemotherapy after their first round of treatment, but can only detect differences in the size of the tumour as opposed to a change in its structure.

Study leader Dr Evis Sala from the department of radiology at the University of Cambridge, said: “At the moment we rely on CT scans and blood tests to tell us what’s going on inside a patient’s tumour. But it’s difficult to judge how effective treatment has been from these alone, particularly when the cancer has spread to other tissues where it may behave differently to the primary tumour.

“We’ve shown that diffusion-weighted MRI can give a much better idea of the density of tumours, in addition to their size, making it easier to determine which patients are benefitting most from the treatment. We are now collaborating on a nationwide study to see if this type of imaging could be an effective way of predicting treatment response in a much larger group of patients with advanced ovarian cancer.”

Daphne Tustian is one of 21 women who took part in the study. She was diagnosed with advanced ovarian cancer in May 2009. Her participation in the study meant that various MRI techniques were used to monitor her throughout her chemotherapy to help inform doctors how her treatment was going. Her cancer went into remission in November 2009, but returned just over a year later.

She said: “I know that at present doctors are trying to prolong my life – they are unable to cure the cancer in my body, but if they can give me more time with my family I am very happy with that.

“When I enrolled on the trial nurses explained to me that it may not benefit me directly but certainly would help others in the future.  I do feel that I have benefited from the trial, however, as I was closely monitored and knew at each stage how my cancer was responding to treatment. It saved me from having unnecessary chemotherapy and it can save others too.”

Each patient underwent an MRI of the abdomen and pelvis, including three additional MRI techniques on top of the standard scans. The different imaging techniques were compared using various parameters - one which was called the Apparent Diffusion Coefficient (ADC), which measures the movement of water molecules in tumours.

The researchers compared the ADC measurements in the primary tumour and in cancer cells that had spread from the ovaries into lining of the abdomen. They found there was a larger increase in the ADC of the primary tumour among those who responded to treatment compared to those who didn’t, while in the sites of cancer spread there was no change.

Senior author Dr James Brenton from Cancer Research UK’s Cambridge Research Institute, added: “Understanding which patients aren’t benefiting from treatment is, in many ways, just as important as being able to distinguish those who are, because it means that patients can avoid the unpleasant side effects of ineffective treatments. This type of information will become increasingly important as we seek to tailor treatments to individual patients.”

Dr Joanna Reynolds, Cancer Research UK’s director of centres, said: “An important aim of Cancer Research UK’s Experimental Cancer Medicine Network is to support the development of tests that can help doctors to quickly spot treatment resistant cells in the tumour, so therapy can be tailored appropriately. Advanced ovarian cancer can be very difficult to treat, meaning it’s vital that patients are monitored closely to ensure they are benefiting from treatment. We’re excited to be funding the next stage of this research, which will look at the potential benefits of this test in a much larger group of patients. ”

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Women with faulty BRCA genes more likely to survive ovarian cancer

Tuesday 24 January 2012

Cancer Research UK Press Release

Ovarian cancer patients who carry BRCA1 or BRCA2 mutations are significantly more likely to survive the disease than women without these faulty genes, according to research published in the Journal of the American Medical Association.  

The study, which combined the results of 26 international trials, showed 44 per cent of women with BRCA1 faults and 52 per cent of women with BRCA2 faults were alive five years after they were diagnosed with epithelial ovarian cancer.

This compares with 36 per cent of women without a fault in one of these genes who were alive five years after their diagnosis.

The researchers say having a faulty BRCA gene could alter the biology of a tumour, making it more responsive to treatment.

It could also be because the normal role of a BRCA gene is to repair damage to DNA. Having a faulty BRCA gene could leave the tumour less able to repair damaged DNA and so more vulnerable to chemotherapy.

Cancer Research UK’s Dr Paul Pharoah, lead author based at the University of Cambridge, said: “Our study is the largest on this topic to date, looking at just over 900 ovarian cancer patients with faulty BRCA1 genes and just over 300 with faulty BRCA2 genes.

“Our results could change the way ovarian cancer is treated. Women with BRCA faults respond better than we thought to current treatments but it’s important that researchers now look at what treatment approaches work best for women without those genetic faults.

“We also need to consider how our results affect research. Clinical trials should be designed to take this difference in survival into account. Otherwise trial results may not be an accurate reflection of what’s really going on.”

Around 6,800 women are diagnosed with ovarian cancer in the UK each year and up to 90 per cent of these cases are epithelial ovarian cancer. Around 10 per cent of women with epithelial ovarian cancer carry BRCA1 or BRCA2 faults.

Ovarian cancer is often diagnosed at a late stage and it is the fourth biggest cause of cancer death in women, with around 4,400 ovarian cancer deaths in the UK each year.

Dr Julie Sharp, senior science information manager at Cancer Research UK, said: “This is an intriguing study with important implications for the treatment of ovarian cancer. Women with faulty BRCA genes have up to a 40 per cent chance of developing ovarian cancer by the age of 70, but now we know that they are also more likely to survive the disease.

“Interestingly, this difference in survival isn’t seen in women with breast cancer who have faulty BRCA genes, so understanding why we’re seeing this in ovarian cancer could reveal some clues on how to improve treatment for the disease.”

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Cancer Research UK launches 'outpatients' trial of breast and ovarian cancer drug

Wednesday 11 January 2012

Cancer Research UK Press Release

Cancer Research UK’s Drug Development Office has re-launched a trial of a promising drug to treat inherited breast and ovarian cancer – but this time taken as a tablet by outpatients.

The Phase II clinical trial is led by The Sir Bobby Robson Cancer Trials Research Centre, Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, and also runs across The Beatson West of Scotland Cancer Centre, UCL, Plymouth Oncology Centre, University of Birmingham Hospital, Christie Hospital, Manchester; and St James’ University Hospital, Leeds.

Women with advanced breast or ovarian cancer with faults in the known high-risk BRCA1 or BRCA2 genes will receive the drug called Rucaparib (CO-338; formerly called AG-014699 or PF-01367338) – which belongs to a promising class of drugs called PARP inhibitors. The trial is also open to women with advanced serous ovarian cancer but unknown BRCA status.

When both copies of the BRCA1 or BRCA2 genes are faulty, the cells rely on the alternative PARP pathway to repair damaged DNA – preventing cancer-causing mistakes being passed on to daughter cells. By also blocking PARP with drugs, cancer cells which have lost BRCA1 or BRCA2 can no longer repair DNA damage at all, causing these cancer cells to die. Serous ovarian cancer patients are also included in the study as they may have DNA repair deficits that could make them sensitive to treatment with a PARP inhibitor.

Patients take the drug as a daily tablet at home over a period of 21 days, only coming to hospital for check-ups and tests. This treatment plan replaces an earlier version of the trial of the drug where it was delivered intra-venously to patients on five days over the same period.

The trial will initially establish the dosing schedule for the drug and evaluate whether it is effective for these patients.

Professor Ruth Plummer, the trial’s chief investigator, at the Northern Institute for Cancer Research, at Newcastle University, said: “We’re seeing encouraging results in women with breast or ovarian cancer treated with PARP inhibitors. It’s great news that we’re able to run a trial of this exciting drug as a tablet which will be a much more convenient and comfortable way to receive the treatment.

“Patients will be able to take a tablet at home – which will mean they can go to work or stay at home with their families, instead of spending long periods of time at hospital with the discomfort of receiving the drug through a drip.”

Faults in the BRCA1 or BRCA2 genes account for around five per cent of the 44,000 women in the UK with breast cancer and for more than five percent of the 6,600 women with ovarian cancer.

PARP inhibitors are being used alone in clinical trials to treat patients with specific types of breast, ovarian and prostate cancers. They can also be combined with existing cancer treatments – including chemotherapy and radiotherapy.

This latest trial is being funded and managed by the charity’s Drug Development Office (DDO).
Dr Nigel Blackburn, director of drug development at Cancer Research UK’s Drug Development Office, said: “It’s incredibly encouraging to launch a trial of this promising drug which is personalised to target the different genetic make-up of patients with breast and ovarian cancer. Providing the drug as a tablet will give patients a much improved quality of life.

“This drug was developed through work led by Cancer Research UK scientists and we’re continuing to invest further in targeted drugs like this. We hope that this new treatment approach will help extend the lives of women with breast and ovarian cancer. We look forward to the results with great interest.”

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Evolving ovarian cancer cells 'dodge' treatment with chemotherapy

Monday 19 December 2011

Cancer Research UK Press Release

Cancer Research UK scientists have discovered that the commonest type of ovarian cancer evolves at a startling rate, which may allow cancer cells to ‘dodge’ the current standard treatment, reveals research in The Journal of Pathology today.

The researchers at Cancer Research UK’s Cambridge Research Institute examined cells from high-grade serous ovarian cancer that had returned after initial platinum chemotherapy, and were resistant to further treatment with these drugs.

They compared these cells with those taken from the original tissue, before treatment.  

The team discovered that the resistant cells continued to evolve, acquiring many genetic mistakes, some of which may have caused the cells to stop responding to chemotherapy.

Resistance to platinum therapy is the greatest clinical problem in managing this type of ovarian cancer. Some 80 per cent of patients with the disease initially benefit from therapy but cancer returns in the majority of cases.

The reasons cells stop responding is poorly understood. There are no tests to predict how patients will respond, nor which patients may relapse after treatment.

Lead author, Dr James Brenton, a research clinician at Cancer Research UK’s Cambridge Research Institute, said: “These intriguing results show for the first time how some ovarian cancer cells evolve quickly and acquire changes in their genetic makeup, which may help them evade treatment with platinum chemotherapy.

“In effect, drugs that would normally home in on and attack a distinct genetic weak spot in cells are now presented with a constantly changing target – so cancer cells become resistant to this treatment.

“Unravelling the secrets of how these ovarian cancer cells accumulate these genetic errors may allow scientists to target these vulnerabilities with new drugs. The next stage is to investigate if drugs can be developed to target these genetic faults.”

There are more than 6,500 new cases of ovarian cancer diagnosed each year in the UK - around 126 women every week. Of these about 70 per cent are high-grade serous ovarian cancer.

Dr Julie Sharp, Cancer Research UK’s senior science information manager, said: “Thanks to the generosity of our supporters we’ve been at the heart of research that has played a vital role in transforming treatment for ovarian cancer and improving survival. A third of women diagnosed with ovarian cancer are now likely to survive their disease for at least 10 years. But relapse is a very real problem.

“This exciting research shines light onto why the most common type of ovarian cancer can become resistant to standard treatment – providing new avenues of research to benefit patients and ultimately increasing survival from this disease.”

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First patients enrolled in project to improve NHS cancer gene testing

Monday 21 November 2011

Cancer Research UK Press Release

Cancer Research UK has started recruiting patients for a pioneering initiative to demonstrate how genetic tests could be used within the NHS to help match cancer patients to the most appropriate treatment, while building a database of information for research into new targeted therapies.

The charity’s multi-million pound Stratified Medicine Programme ultimately aims to establish a world-class NHS genetic testing service for cancer patients in the UK. This means that, as and when new targeted treatments become available, doctors will have access to the tests they need to help them decide which drugs are best for their patients.

Medical staff in seven of Cancer Research UK’s existing Experimental Cancer Medicine Centres (ECMCs) will be asking up to 9,000 patients to participate in the first phase of the Programme, which covers six different tumour types: breast, bowel, lung, prostate, ovarian and melanoma skin cancer.

The ECMCs are: The Institute of Cancer Research (ICR) in London, Leeds, Edinburgh, Cambridge, Cardiff, Glasgow and Manchester, collectively covering more than 20 hospitals across the UK.

Patients will be asked to give consent for a small sample of their tumour to be sent to one of three leading NHS genetic testing labs – based at The Institute for Cancer Research in London, Cardiff All Wales Regional Molecular Genetics Laboratory and the West Midlands Regional Genetics Laboratory in Birmingham – where DNA will be extracted and analysed for a range of molecular faults linked to cancer.

This information will be stored alongside other relevant clinical information to allow researchers to compare the success of different treatments in relation to specific faults within cancer cells.

So although the Programme will not alter patients’ treatment at this stage, it’s hoped it could help scientists design better targeted treatments in the future.

Wendy Payne, 55, who is being treated at Addenbrooke's Hospital in Cambridge, is one of 240 patients who are so far taking part in the programme. She was diagnosed with ovarian cancer in March 2011 after a CT scan.

Mrs Payne said: “I was very keen to take part in the Stratified Medicine Programme because I think much more can and should be done to help patients get the right drugs in future.

“Finding out I had cancer was terrifying but it’s incredible to think that the tumour which could have killed me can now be used to develop more targeted drugs in future. Even though I won’t benefit from that research, it’s comforting to think that my experience with cancer will be helping others who are diagnosed in future.”

Cancer Research UK, AstraZeneca and Pfizer are funding the £5.5 million programme. The charity’s share is being funded through its Catalyst Club - a pioneering venture to raise £10 million to propel forward the use of personalised cancer treatment, including Cancer Research UK’s Stratified Medicine Programme.

The initiative is closely aligned with the government’s Technology Strategy Board (TSB)’s £6 million investment in the development of tests for analysing a tumour’s genetic profile and secure software that can link this information to relevant clinical information.

James Peach, director of Cancer Research UK’s Stratified Medicine Programme, said: “In the ten years since the Human Genome Project was completed we’ve made huge progress in unraveling the genetic basis of cancer and understanding what drives it at a molecular level. We know that prescribing certain drugs according to the genetic basis of the tumour can improve the chances of successful treatment. And by hardwiring research into the day-to-day care of cancer patients, we can harness the power of the NHS to bring personalised medicine a step closer to reality.

“This programme marks the beginning of the journey, and there is much to be done before we can bring the benefits of personalised medicine to every cancer patient. But I’m confident that within the next few years we’ll see personalised medicine changing the face of cancer treatment and saving many more lives from cancer.”

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Ovarian cancer 'is not detectable' in the blood for years

Wednesday 16 November 2011

A mathematical model designed by scientists in the US indicates that ovarian cancer may not be detectable in the blood using current technology until 10 years after the disease first starts to develop.

The researchers say their work could make future efforts to develop diagnostic blood tests more efficient.

The study by experts from Stanford University School of Medicine used models originally developed to predict the concentration of drugs injected into the blood as they move in and out of the bloodstream. The investigators linked these to other models of tumour cell growth.

They looked at a known ovarian cancer 'biomarker' called CA-125, and modelled how large a tumour needs to grow before it begins to shed CA-125 into the bloodstream.

A biomarker is a biological molecule found in the blood or other tissues that can be used to measure the activity of a cancer. Similar to how looking out the window for people with umbrellas is an indirect way of detecting rain, looking for cancer biomarkers can help doctors detect disease and plan treatment.

Lead researchers Sharon Hori and Sanjiv Gambhir believe the model used to calculate this 10-year gap from when ovarian cancer starts to develop and when it is detected is broadly applicable across all solid tumour types.

It has been known for some time that cancer patients have a better chance of survival the earlier a tumour is detected. But this research, published in the Science Translational Medicine journal, is the first study to mathematically model the size of a tumour and its related blood biomarker levels.

Many biomarkers for different cancers have been identified, but testing their accuracy as an early diagnostic tool can be a long and costly process. The new model could be used to speed up this process, and prompt new and accurate ways to detect ovarian and other cancers before they have a chance to spread to other parts of the body.

Dr Gambhir said: "This model could take some of the guesswork out of it. It can be applied to all kinds of solid cancers and prospective biomarkers as long as we have enough data on, for instance, how much of it a tumour cell secretes per hour, how long the biomarker can circulate before it's degraded and how quickly tumour cells divide."

He adds that identifying biomarkers that are made exclusively by tumour cells will also speed up the detection process.

Dr Laura McCallum, Cancer Research UK's science communications officer, said: "Detecting cancer at an early stage when treatment is more likely to be successful is one of the most promising ways to reduce deaths from the disease. Biomarkers have the potential to offer a simple, non-invasive way to detect cancer early and scientists, including our own, are working hard to find ones that can do this reliably.

"Mathematical models like this, designed to predict the most effective biomarkers, could help improve the bench to bedside success of such tests in the future."

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Clue to spread of ovarian cancer

Monday 31 October 2011

Laboratory-based research by US scientists has given a clue to the role that a pad of fat cells inside the abdomen, called the omentum, plays in fuelling the spread of ovarian cancer.

Researchers from the University of Chicago believe the fat cells that make up the omentum provide nutrients which promote the growth and spread of ovarian cancer, the fourth leading cause of cancer deaths in women in the UK.

This fatty tissue, which extends from the stomach and covers the intestines, acts as a "launching pad" for the cancer to spread, according to the report published online in the journal Nature Medicine.

By the time ovarian cancer is diagnosed in 80 per cent of women it has spread to the omentum.

Study author Dr Ernst Lengyel said: "This fatty tissue, which is extraordinarily rich in energy-dense lipids, acts as a launching pad and energy source".

"The cells that make up the omentum contain the biological equivalent of jet fuel. They feed the cancer cells, enabling them to multiply rapidly. Gaining a better understanding of this process could help us learn how to disrupt it."

The Chicago team found that ovarian cancer cells injected into the abdomen of healthy mice found their way to the omentum within 20 minutes - and protein signals emitted by the omentum can attract the tumour cells. This attraction was at least halved by inhibitors which disturbed these signals.

Ovarian cancer can rapidly convert the entire omentum into a solid mass of cancer cells, a mechanism which may not be limited to ovarian cancer cells, the authors noted. Fat metabolism may also contribute to cancer development in other environments where fat cells are abundant, such as breast cancer.

They said a protein known as fatty acid binding protein (FABP4), who's role appears to be to carry fat around within cells, may be crucial to this process and could be a target for treatment.

Dr Kat Arney, science information manager at Cancer Research UK said: Ovarian cancer can be difficult to treat because the disease is often only diagnosed once it has spread.

"These are important results because they suggest that fat cells in the abdomen can fuel the spread of ovarian cancer, and point towards potential targets for the development of new treatments for the disease.

"But at the moment these are still early experiments using mice and cells grown in the lab, so there's still a lot of work to be done to turn this knowledge into a treatment that could help women with ovarian cancer."

Copyright Press Association 2011

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Pill and pregnancy have biggest effects on ovarian cancer risk

Wednesday 26 October 2011

Cancer Research UK Press Release

Taking the Pill for 10 years can reduce the risk of ovarian cancer by almost half (45 per cent), new research part-funded by Cancer Research UK shows today.

Overall, women who took the Pill for any length of time had an approximately 15 per cent lower risk of ovarian cancer than those who never took it at all - and the risk reduced further in women taking it for longer.

The study, published in the British Journal of Cancer1, looked at how various reproductive factors affected the risk of ovarian cancer.

Taking the Pill for more than 10 years had the biggest impact on reducing the risk of the disease, followed by getting pregnant and having more than one child.2

Among women who used the pill for a year or less, the risk of developing ovarian cancer was around 28 per 100,000 per year. For women who took the pill for at least 10 years, this risk fell by about half to around 15 per 100,000 per year.3

Women who had ever been through a full-term pregnancy had a 29 per cent lower ovarian cancer risk compared with women who had never been pregnant.

Among women who had never been pregnant, the risk of developing ovarian cancer was 34 per 100,000 per year. For women who had at least one full-term pregnancy, this risk fell to around 24 per 100,000 per year.

And the bigger the family, the greater the benefit – among women who have children, each additional child lowered the risk of ovarian cancer by a further eight per cent.

The research is part of ongoing work by the European Prospective Investigation of Cancer (EPIC) – a Cancer Research UK co-funded study and one of the largest studies into the links between diet, lifestyle and cancer.

Naomi Allen, a Cancer Research UK epidemiologist, based at the University of Oxford who works on the EPIC study, said: “Ovarian cancer is difficult to detect and so prevention is key to saving women suffering from this disease. These results are important because most women don’t know that taking the Pill or getting pregnant can help reduce their risk of ovarian cancer later on in life.”

Research has not yet established how factors like the Pill and pregnancy reduce ovarian cancer risk. One theory is that taking the Pill or getting pregnant changes the level of hormones that can affect a woman’s risk of the disease.

While the Pill has a protective effect against ovarian cancer, women taking the Pill have an increased risk of breast cancer while using it, but which disappears after use has stopped.

Ovarian cancer is the fifth most common cancer in women in the UK with over 6,500 cases diagnosed each year.
The link between ovarian cancer and pregnancy and using oral contraceptives is already well established - this study adds weight to the evidence.

Dr Richard Edmondson, a Cancer Research UK women's cancer expert based at the University of Newcastle, said: "Women may be reassured to know that the oral contraceptive is not only an effective contraceptive but can have the added benefit of reducing their risk of ovarian cancer.

“This is however balanced against a slightly increased risk of developing breast cancer. To put this in context, it is estimated that if 100,000 women use the pill for ten years or more there will be 50 more breast cancers than would have otherwise occurred, but 12 fewer ovarian cancers.

“This may be particularly important for women with an increased risk of ovarian cancer in their family.”

Sara Hiom, director of health information at Cancer Research UK, said: “These days it is not uncommon for women to have fewer children or none at all. Women tend to be unaware that these reproductive factors have a protective effect on their risk of ovarian cancer.

“Nobody can expect women to start living like their Victorian counterparts to reduce their risk of the disease. But there are other things that can be done to lower the risk of ovarian cancer like stopping smoking and maintaining a healthy weight.

“As with most cancers, the risk of developing ovarian cancer increases with age - most cases are in women who are past their menopause. Inherited faulty genes can also play a significant role, and women who think they may have a family history should discuss this with their doctor.

“Treatment for ovarian cancer is better if the disease is caught as early as possible. So all women should be aware of the signs of ovarian cancer like pain in the lower tummy, bloating, increased tummy size, difficulty eating or feeling full. If these symptoms are new and happen on most days then it’s worth getting checked out by your doctor without delay.”

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Scientists find first ever 'gene fusion' in ovarian cancer

Wednesday 21 September 2011

In a world's first, US researchers have found a particular gene fault - called a gene fusion - is present in a significant proportion of difficult-to-treat ovarian cancers.

The discovery by Stanford University researchers could eventually help with the earlier detection of this type of cancer, called high grade serous ovarian cancer (HGSOC), and lead to new ways to treat the disease.

Scientists studying HGSOCs found that a gene known as ESRRA was fused to the nearby C11orf20 gene in nearly one in six (15 per cent) of samples studied.

Serous ovarian cancer, the most common form of the disease, is particularly hard to treat as it is normally only identified at a late stage of the illness.

If further research shows that the protein made as a result of the gene fusion circulates in the blood, it may be possible to detect it in the early stages of the cancer, when treatment is more likely to be effective. Also, if the protein is found to contribute to cancer progression, it could be a target for future therapies.

Patrick O. Brown, senior author of the study published in PLoS Biology, said: "Although this is the first time that a rearrangement of neighbouring genes has been found to occur repeatedly in a cancer, we suspect that these local rearrangements may be more common and important that we had realised."

"More study will reveal if this gene fusion contributes to the tumour's aggressive growth and spread," he continued.

The researchers, identified the very specific genetic change by using 'deep sequencing' techniques.

The relatively new technology combines tools from genetics, statistics and computer science and was used during research at Stanford University School of Medicine.

Simon Gayther, a Cancer Research UK ovarian cancer expert, said: "The problem we've had in the past is that these types of tumour usually have a disordered mess of genetic changes. This makes finding individual changes that drive the disease extremely difficult. So this discovery of the first ever gene fusion in ovarian cancer is exciting on several levels.

"Firstly, it raises the possibility that several similar genetic faults in ovarian cancers could be uncovered using a similar approach. Secondly, and perhaps more significantly, this could represent a new, tumour-specific therapeutic target for ovarian cancer, similar to treatment for some breast cancers using Herceptin, which targets the HER2 protein. But further work will need to be done to evaluate this.

"Finally, more broadly speaking, this finding represents a shift in what's possible in the field of cancer genetics, driven by more advanced DNA sequencing technologies, which could bring more benefits to patients in years to come."

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Glowing cells guide ovarian cancer surgery

Monday 19 September 2011

Dutch surgeons have performed the first ever surgical procedures on ovarian cancer patients using new technology that illuminates ovarian cancer cells, making it easier to detect and remove tumours.

It is hoped the technique will improve the results of surgery as it allows doctors to spot tiny tumours that may not otherwise be visible.

The flourescent technology involves a cancer cell 'homing device' and a fluorescent imaging agent, created by Professor Philip Low and colleagues at Purdue University in the US.

Professor Low says the method could help surgeons to remove more cancerous tissue, giving patients a better prospect of successful chemotherapy or immunotherapy.

The first surgery to be performed using the technique was carried out at the University of Groningen in The Netherlands on a patient as part of a clinical trial. The patient was injected with a combination of the fluorescent imaging agent and a form of folic acid two hours before surgery.

The substance attaches itself to ovarian cancer cells, allowing a special device called a multispectral fluorescence camera to illuminate the cells on a screen during surgery.

Surgeons reported finding an average of 34 tumour deposits using this technique, compared with an average of seven tumour deposits using traditional methods.

The findings have been published in the journal Nature Medicine.

Prof Low said: "Ovarian cancer is notoriously difficult to see, and this technique allowed surgeons to spot a tumour 30 times smaller than the smallest they could detect using standard techniques."

He added: "With ovarian cancer it is clear that the more cancer you can remove, the better the prognosis for the patient.

"This is why we chose to begin with ovarian cancer. It seemed like the best place to start to make a difference in people&aposs lives."

Professor Peter Johnson, Cancer Research UK's chief clinician, said: "We know that one of the most important things for people with ovarian cancer is that as much of it as possible should be removed by an operation, and that the better this can be done, the higher the chances of survival.

"This is one reason why it is so important for women to see their doctor quickly if they have suspicious symptoms. This new technique for detecting tiny amounts of cancer during the course of an operation may be a promising way to improve the results of surgery in the future."

Oliver Childs, senior science information officer at Cancer Research UK, said: "Surgery can be a hugely important part of cancer treatment, and it's great to see work to try to make it more effective. It's important to say that this is an early, proof-of-concept trial, and not every tumour was detected using this technology, so larger studies are needed before this technique will be used more widely"

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Blocking key proteins could improve response to common chemotherapy drug

Thursday 1 September 2011

Cancer Research UK Press Release

SCIENTISTS have discovered how blocking key cell signalling proteins could help boost the success rate of the tumour-shrinking drug paclitaxel, according to a study published in the journal Cancer Research today.

Paclitaxel is one of a family of drugs originally derived from yew trees that block the growth of cancer by interfering with microtubules – structures that help chromosomes to separate during cell division. It’s commonly used to treat breast and ovarian cancer, but some tumours can become resistant over time and start growing again.

The international team of researchers, - funded by Cancer Research UK, the University of Oxford and, the Camilla Samuel Fund, and the University of Texas M.D. Anderson Cancer Center - found that blocking certain proteins stabilised the microtubules and made ovarian cancer cells more sensitive to paclitaxel.

Lead researcher Dr Ahmed Ahmed, based at the University of Oxford, said: “Our work provides further evidence for the important link between the stability of microtubules, the backbone of the cell, and sensitivity to paclitaxel. And because the proteins we’ve identified share the same target as paclitaxel, it raises the prospect of developing more specific drugs that sensitise cancer cells to paclitaxel without damaging the surrounding tissues.”

Previous research by Dr Ahmed and colleagues found that the loss of a protein called TGFBI – which sends messages that stabilise the microtubules – caused paclitaxel to fail.

So to test the theory that microtubule stability may be essential for paclitaxel response, the researchers systematically blocked other signalling proteins in ovarian cancer cells growing in the lab, to see which might alter paclitaxel response.

Senior Author Dr Robert Bast, vice president of translational research at the University of Texas MD Anderson Cancer Centre, said: “Our study has revealed several new proteins involved in microtubule stability that could be potential targets for drugs to improve the sensitivity of cancer cells to paclitaxel, without damaging healthy cells.”

Dr Julie Sharp, senior science information manager at Cancer Research UK, said: “Overcoming drug resistance is a key challenge for our researchers. Unravelling the genetic basis of cancer to find out what determines whether a patient will respond to treatment will help us take a more targeted approach to tackle this problem. This approach could lead to fewer side effects and provide a lifeline for patients who have stopped responding to conventional treatments.”

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'Targeted' breast and ovarian cancer drug could have far wider application

Tuesday 23 August 2011

Canadian researchers have shown that the 'targeted' cancer drug olaparib, which was developed to treat cancers caused by inherited faulty versions of the BRCA1 or BRCA2 genes, can also reduce the size of tumours in a substantial minority of ovarian cancer patients who do not carry these gene faults.

The study, published in Lancet Oncology, seems to suggest that the drug can be used to treat certain women with the more common 'sporadic' (non-inherited) form of ovarian cancer. In total, the disease affects about 6,500 women in the UK every year.

The drug blocks the activity of a protein called Poly (ADP-ribose) polymerase, or PARP, which along with the proteins made by the BRCA genes is involved in DNA repair.

Inhibiting PARP in a tumour cell that already lacks a BRCA gene prevents cancer cells from repairing their DNA, which boosts the effectiveness of chemotherapy and causes them to die.

The phase 2 drug trial was designed to find out how effective it is in treating those breast and ovarian cancer patients who do not carry the BRCA gene fault.

A total of 65 ovarian cancer and 26 breast cancer patients were prescribed 400mg of olaparib twice daily for four weeks. They were also sub-divided according to whether their tumours had faulty BRCA genes.

Approximately 41 per cent of ovarian cancer patients with BRCA faults experienced a significant reduction in the size of their tumour. This compared with 24 per cent of patients who&aposs cancers did not contain BRCA faults.

None of the breast cancer patients whose tumours had intact BRCA genes showed any response to the drug.

Henry Scowcroft, Cancer Research UK's science communication manager, said: "Since they were first developed, PARP inhibitors have shown increasing and expanding potential to treat cancer. These results suggest they may be useful as a treatment for women with ovarian cancer - but this was just an early-phase trial involving a relatively small number of patients so there&aposs still work to do.

"Thanks to the generous support of the public, Cancer Research UK scientists are playing a key role in the development of PARP inhibitors, and we're extremely encouraged to see them chalk up more experimental successes."

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London researchers pioneer MRI technique to detect ovarian chemo benefits

Thursday 18 August 2011

Researchers in London have used a magnetic resonance imaging (MRI) technique - called 'diffusion-weighted' MRI - to determine whether women with late-stage ovarian cancer are benefitting from chemotherapy after their first round of treatment.

The finding, although preliminary, could lead to a way to avoid treating patients unnecessarily if they are not benefitting from chemotherapy.

At the moment, judging whether treatments are still effective isn't possible until a standard CT scan, or blood marker measurements prove conclusive. By this time, patients will have been treated for many months.

Writing in the journal Radiology, scientists from The Institute of Cancer Research (ICR) and The Royal Marsden Hospital in Chelsea - funded by Cancer Research UK, Marie Curie Actions and the ESPRC - explained how diffusion-weighted MRI can detect changes in tumours following a 21 or 28-day cycle of chemotherapy.

Over the course of nearly two years, 42 women with ovarian cancer were given diffusion-weighted MRI scans before and after their first and third cycles of chemotherapy. The measurement of water within the tissue was calculated and represented in a figure known as an Apparent Diffusion Coefficient (ADC).

Among those women who responded to drug treatment, ADCs were found to have risen, while in the group who did not benefit from their regimen, ADCs remained the same.

The ICR's Professor Nandita de Souza and colleagues at the ICR and The Royal Marsden wrote: "This test could allow us to predict after just one month whether a patient will benefit from the full six month course of chemotherapy.

"This would help make decisions on treatment and mean that patients could avoid the unpleasant side-effects of ineffective treatments."

The technique was also able to detect cancer that had spread from the ovaries into the peritoneal region, helping determine the extent of the cancer.

The test can be done on standard MRI machines found nationwide. A larger trial involving four hospitals, to be funded by Cancer Research UK, will begin later this year.

Dr Julie Sharp, senior science information manager at Cancer Research UK, said: "We hope that this new approach will allow doctors to monitor tumours much more closely in the future and make quicker decisions if treatments aren't working.

"Advanced ovarian cancer is difficult to treat and we're pleased to be funding the next stage of this research that will develop this test further."

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Researchers trial new drug for women with hereditary breast and ovarian cancer

Wednesday 17 August 2011

Cancer Research UK Press Release

A CANCER RESEARCH UK-funded trial of a new drug for patients with advanced breast or ovarian cancer due to inherited gene faults has been launched at the Oxford Experimental Cancer Medicine Centre (ECMC) at the University of Oxford.

The trial, led by a team based at the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, is looking at a drug called 6MP, which is already used to treat leukaemia and is often given alongside another chemotherapy drug called methotrexate.

Earlier studies involving cells grown in the laboratory suggest that a class of drugs called thiopurines, which includes 6MP, are effective at killing cancer cells lacking BRCA - a gene which significantly increases risk of breast and ovarian cancer - even after they have developed resistance to treatments like PARP inhibitors and cisplatin.

This trial is one of a growing number looking at matching patients to the most appropriate treatment based on their genetic makeup and that of their cancer – an approach known as personalised medicine.

If successful the results will pave the way for a larger phase III trial, which could in future lead to an important extra treatment option for the 15 out of every 100 women with breast and ovarian cancers caused by faults in BRCA1 or BRCA2 genes.

Trial leader Dr Shibani Nicum, a gynaecology specialist based at the Oxford ECMC, and a researcher in Oxford University’s Department of Oncology, said: “PARP inhibitors are a powerful new class of drugs developed specifically to target tumours caused by BRCA 1 and BRCA2 faults, but drug resistance remains a problem. We hope that the very encouraging results we have seen in early laboratory studies involving 6MP will lead to increased treatment options for these patients in the future.”

Trial participant Suzanne Cole, 54, from Newbury, has a strong history of ovarian cancer in her family, with her sister, mother and grandmother all having been diagnosed with suspected cases of the disease at a relatively young age. But it wasn’t until many years later, after she herself was diagnosed with cancer, that doctors were able to trace the cause of this back to a BRCA1 mutation in her family.

She said: “I was diagnosed in 2009 and initially had surgery then chemotherapy. I was then told about the trial and I went away and studied the information. The doctors were able to answer all my questions and then I agreed to sign up. I’m happy to be a part of this work as it could help others by moving treatments forward."

Professor Mark Middleton, director of the Oxford ECMC at Oxford University, said: “It’s exciting to see drugs being developed for specific groups of patients who share the same underlying genetic faults in their cancer. Targeted treatments are at the cutting edge of cancer care and we’re proud to be involved in bringing such drugs a step closer to the clinic.”

Dr Sally Burtles, Cancer Research UK’s director of the ECMC Network, said: “This study helps demonstrate the value of being able to pool subsets of patients who share specific rare faults in their tumour from a UK-wide network of Experimental Cancer Medicine Centres. This will be crucial as we move towards a new era of personalised medicine with treatments targeted according to the individual biological profile of a patient’s cancer.”

For more information on the trial, please visit www.cancerhelp.org.uk or call the Cancer Research UK cancer information nurses on 0808 800 4040.

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Landmark ovarian cancer discovery as scientists unveil high risk gene

Sunday 7 August 2011

Cancer Research UK Press Release

Cancer Research UK-funded scientists have discovered that women who carry a faulty copy of a gene called RAD51D have almost a one in 11 chance of developing ovarian cancer, the most significant ovarian cancer gene discovery for more than a decade, reveals a study in Nature Genetics1 today (Sunday).

The team at The Institute of Cancer Research (ICR) examined DNA from women from 911 families with ovarian and breast cancer and compared differences in DNA with a control group of 1060 people from the general population.

The team discovered eight gene faults in the RAD51D gene in women with cancer, compared with one in the control group.

Ovarian cancer is the fifth most common cancer in women - around 6,500 cases are diagnosed annually in the UK. The researchers estimate that RAD51D gene faults are present in almost one per cent of women with ovarian cancer - around 50 UK women each year.

Around one woman in 70 in the general population is at risk of developing ovarian cancer, but for those with a RAD51D gene fault this risk is increased to one in 11 – making these women six times more likely to develop the disease.

The RAD51D gene is important for repairing damaged DNA. When the RAD51D gene is faulty, a key repair pathway fails. This means DNA damage is not fixed and DNA faults build up in cells which make them more likely to turn into cancer.

The team also showed that cells with faulty RAD51D can be selectively destroyed by a relatively new class of cancer drugs called PARP inhibitors. These drugs are showing great promise in clinical trials for the treatment of breast and ovarian cancers with faults in the BRCA1 and BRCA2 genes, which are also important for repairing damaged DNA.

Cancer Research UK-funded scientist and study author Professor Nazneen Rahman, head of the Division of Genetics and Epidemiology at The Institute of Cancer Research and The Royal Marsden, said:

“Women with a fault in RAD51D gene have a one in 11 chance of developing ovarian cancer. At this level of risk, women may wish to consider having their ovaries removed after having children, to prevent ovarian cancer occurring.”

“There is also real hope on the horizon that drugs specifically targeted to the gene will be available.”

Ovarian cancer often develops without any clear symptoms and many women only discover they have it once it has spread.2

Professor Nic Jones, Cancer Research UK’s chief scientist, said: “It’s incredibly exciting to discover this high risk gene for ovarian cancer.

“It’s further evidence that a range of different high risk genes are causing the development of breast and ovarian cancer and we hope there are more waiting to be discovered in different cancers.

“We believe the results of this research will help inform personalised treatment approaches and give doctors better information about risks of cancer to tell patients.”

Harpal Kumar, Cancer Research UK’s chief executive, said: “Survival from ovarian cancer has almost doubled in the last 30 years. This landmark discovery is another piece of the jigsaw deepening our understanding of the disease. We hope this will have a significant impact in providing more personalised treatments for patients based on their genetic make-up, saving more lives from ovarian cancer.

“All of our research is generously funded by the public. This support has allowed us to invest heavily in the identification of DNA changes which paint a picture of which parts of a person’s gene set are linked to cancer. This life-changing discovery exemplifies the importance of this research and the importance of ongoing public support.”

Cancer Research UK is the largest single funder of ovarian cancer research in the UK – last year it spent more than £12 million of public donations on tackling the disease.

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Detailed 'genetic landscape' of ovarian cancer revealed

Friday 1 July 2011

US scientists have published the most detailed genetic analysis of ovarian cancer to date, following a large-scale analysis of tumour samples. Although the researchers did not identify new genes involved in the disease, the work revealed a "remarkable degree" of DNA disorder in ovarian cancer, according to the authors.

The Cancer Genome Atlas (TCGA) Research Network carried out the study, which examined samples from 500 patients with an aggressive form of ovarian cancer called high-grade serous adenocarcinoma.

The detailed analysis revealed that around 96 per cent of all tumour samples had faults in a gene called TP53, which carries the genetic code needed to make a tumour suppressor protein that normally prevents the formation of cancer. This confirms earlier work by Cancer Research UK scientists, which first showed the link between TP53 and this type of ovarian cancer.

When TP53 is faulty, the resulting protein is unable to function properly and ovarian cancer cells are allowed to grow uncontrollably.

The researchers, whose findings are published in the journal Nature, also confirmed a number of less common faults in other genes.

Dr Francis Collins, director of the National Institutes of Health, said: "This landmark study is producing impressive insights into the biology of this type of cancer. It will significantly empower the cancer research community to make additional discoveries that will help us treat women with this deadly disease."

The researchers also believe that their findings could lead to new ways to assess a patient's chances of surviving this type of ovarian cancer, which accounts for about 70 per cent of all ovarian cancer deaths.

They identified patterns for 108 genes which were associated with poor survival, as well as 85 genes linked to better survival.

Patients whose tumours had gene patterns associated with poor survival lived for 23 per cent less time than those whose tumours did not have these patterns.

The study also confirmed the role of the BRCA1 and BRCA2 genes in ovarian cancer.

Approximately 22 per cent of the tumour samples had faults in these genes. The analysis also revealed that ovarian cancer patients with BRCA1 or BRCA2 faults were more likely to survive for longer than patients with other faults in their DNA.

The exception was in patients whose BRCA genes had a DNA alteration called methylation, as opposed to a specific fault in the code of DNA. Women with this alteration to their BRCA genes did not survive any longer than patients with other faults in their DNA. This suggests that survival depends on the type of change in the BRCA genes.

Dr Harold Varmus, director of the National Cancer Institute, which jointly funds and manages the project alongside the National Human Genome Research Institute (NHGRI), said: "Cancer researchers can use this comprehensive body of information to better understand the biology of ovarian cancer and improve the diagnosis and treatment of this dreaded disease."

The study also suggests that around half of women may benefit from taking a new type of targeted treatment called a PARP inhibitor. These drugs are designed to target specific gene faults by preventing the tumour cells' DNA repair machinery from working effectively and causing the cells to die.

Dr Eric Green, director of the NHGRI, explained: "Like all cancers, ovarian cancer results from genomic derangements. The efforts of TCGA are confirming that the more we learn about genomic changes in tumour cells, the more we will be able to care for the people affected by cancer."

Cancer Research UK scientist Dr James Brenton first showed that TP53 faults are present in almost all cases of this type of cancer. Of this new research, he said: "This work adds a lot of extra detail to the genetic survey of ovarian cancer. While we already knew about many of the genes highlighted in this study, this is the most comprehensive map yet, and will help towards future progress in diagnosing and treating this disease.

"It confirms that - aside from a few common faults - the DNA in ovarian tumours is remarkably variable. The TCGA project is not finished and there are more important data still to come from DNA sequencing of most of the cancers. As more advanced DNA sequencing technologies get cheaper, we will see much more genetic detail emerge about ovarian cancer. This will help us work out the specific DNA faults in each woman's tumour and allow us to treat them individually."

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Annual ovarian cancer screening fails to prevent deaths in US study

Tuesday 7 June 2011

Annual screening for ovarian cancer with a blood test combined with an ultrasound scan did not reduce the risk of dying from the disease, but did increase the likelihood of invasive medical procedures, a US study has found. But these tests could yet be beneficial if they are used in an alternative way being assessed in a UK study.

Researchers at the University of Utah Health Sciences Centre examined data on ovarian cancer death rates from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial.

This trial measured the results of annual screening using ultrasound examinations, and a blood test to measure levels of a protein called CA-125, which is often increased in women with ovarian cancer.

Almost 80,000 women, aged 55 to 74 years, took part between November 1993 and July 2001. Half were screened annually and the other half received usual medical care with no interventions.

Those screened were offered a CA-125 test every year for six years, as well as an annual ultrasound exam every year for four years.

Participants were followed up for up to 13 years to see whether they developed ovarian cancer or died from the disease.

The researchers found that women who attended screening appointments were not significantly less likely to die from ovarian cancer than those who received standard care.

The research revealed that 212 women were diagnosed with ovarian cancer in the screening group, and 176 in the control group.

There were 118 deaths from ovarian cancer in the screening group and 100 in the control group - a difference that was not found to be statistically important.

The researchers also showed that women who attended screening were more likely to undergo invasive medical procedures and develop complications associated with surgery.

The results were presented at the annual meeting of the American Society of Clinical Oncology and will be published in the Journal of the American Medical Association.

Despite not finding any benefit from screening in this way, the study authors noted that CA-125 testing and ultrasound exams may still be beneficial if used in a different way - something that is currently being investigated in the UKCTOCS trial, which is being co-funded by Cancer Research UK, the Medical Research Council and the NHS.

Dr James Brenton, Cancer Research UK's ovarian cancer clinician, said: "This important research suggests that having a yearly ultrasound test along with a blood test which provides a snapshot of the levels of a protein associated with ovarian cancer - the serum CA125 test - is not going to cure more women of ovarian cancer. Ovarian cancer is very hard to detect at an early stage before it has spread.

"Ongoing research funded by Cancer Research UK is testing whether smaller rises in CA125 over time can be a better predictor of early ovarian cancer and is working with international groups to identify common genes that might slightly increase the risk of ovarian cancer. Combining genetic tests with ultrasound and serum markers will provide a more accurate way of detecting those women who have a greater chance of developing ovarian cancer, and curing them." 

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Gene fault could predict ovarian cancer drug success

Monday 6 June 2011

Cancer Research UK Press Release

FAULTS in a gene commonly inactivated in many different types of cancer could be used to predict which drug combination ovarian cancer patients are most likely to benefit from, according to results presented at the American Society for Clinical Oncology today (Saturday).

The study – funded by Cancer Research UK and the Medical Research Council (MRC) and led by researchers from Newcastle University, the UCL Cancer Institute and the MRC - found that women with faults in a gene known as p53 were 50 per cent less likely to survive following treatment with carboplatin alone, but tended to be more likely to show survival benefit from the addition of the drug paclitaxel to the standard treatment of carboplatin.

Those without such mutations had better survival rates but did not benefit from having paclitaxel added to their treatment, meaning patients like this could be spared unnecessary side effects in the future.

Professor Hilary Calvert, who led the study, said: “These results show that ovarian cancer patients whose tumour had a faulty p53 gene survive longer if given paclitaxel in addition to carboplatin. Although survival rates have improved dramatically in recent years, ovarian cancer remains a deadly cancer in women and efforts to improve survival by targeting treatments at those most likely to benefit are urgently needed.”

The researchers examined tumour samples from 265 patients who had taken part in the MRC’s ICON 3 study, which had found no significant benefit in giving patients paclitaxel in addition to the standard treatment of carboplatin.

But this contradicted earlier studies, which showed that adding paxlitaxel to treatment improved survival, leading to this drug combination being adopted as a standard treatment for ovarian cancer.

The researchers believed that this difference in response to paxlitaxel could be related to the genetic makeup of the tumour which varies between patients and suspected that p53 faults may be behind this.

So to put their theory to the test they sequenced the DNA of all the tumour samples to see which had p53 faults. This revealed that p53 was inactive or faulty in around half of the samples (130/265) and also that patients only benefited from paxlitaxel if p53 was faulty in their tumour.

Dr Lesley Walker, Cancer Research UK’s director of cancer information, said: “Our scientists discovered p53 over thirty years ago and it’s good to see this now being used as a biomarker to improve treatment for patients.

“There’s no such thing as a one-size-fits-all drug and increasingly scientists are developing ways to identify groups of patients that are most likely to respond to a particular drug. This approach is called stratified medicine and many scientists now believe it could transform cancer treatment in the future.”

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Trial suggests PARP inhibitor drugs may help to prevent ovarian cancer from coming back

Thursday 19 May 2011

Treating women with olaparib, a new type of experimental drug called a PARP inhibitor, after their initial cancer treatment, may help prevent their ovarian cancer from coming back, according to a phase-II clinical trial led by UK scientists.

The finding applies to women with the most common form of ovarian cancer - 'high-grade serous' ovarian cancer.

Olaparib, taken in pill form, was designed to target cancers containing faulty BRCA1 and BRCA2 genes, while leaving healthy cells unharmed. But it also appears to be effective in targeting cancers with related genetic defects, which appear to be common in women with high-grade serous ovarian cancer.

An international research team, led by University College London's Professor Jonathan Ledermann, carried out a trial to see whether olaparib could have a role to play in preventing ovarian cancer from coming back in this group of patients.

It is thought that the treatment may help to 'mop up' any cancer cells that are left behind after chemotherapy.

A total of 265 women took part in the trial, all of whom had high-grade serous ovarian cancer and had recently completed a course of platinum-based chemotherapy which had achieved a complete or partial response.

Within eight weeks of finishing their chemotherapy, trial participants started to take olaparib or a placebo (dummy pill).

The researchers found that women who took olaparib had a median of 8.4 months before their cancer came back, compared to 4.8 months for those on the placebo.

Overall survival data are not yet available, as half of olaparib users had not relapsed at the time of data analysis.

Larger clinical trials are now needed but, if the results of this phase-II trial are confirmed in future, maintenance therapy with olaparib could form a new treatment approach to prevent recurrences or prolong remission in women who have recently undergone chemotherapy for ovarian cancer.

Lead author Professor Ledermann, professor of medical oncology at the UCL Cancer Institute and a Cancer Research UK grantee, said: "A well-tolerated anti-tumour agent that could be used for months or perhaps years as maintenance therapy after standard chemotherapy could be a big step forward and ultimately extend survival.

"This study demonstrates proof of principle for the concept of maintenance therapy in ovarian cancer using a PARP inhibitor. Our progression-free survival difference was very impressive and better than we anticipated."

Professor Ledermann carried out this trial with support from AstraZeneca. Cancer Research UK, who did not fund the trial but have played an important role in the development of PARP inhibitors like olaparib, said the results highlighted their potential.

Henry Scowcroft, Cancer Research UK's science information manager, said: "PARP inhibitors were initially designed to treat people whose cancers are caused by rare inherited gene faults. But it's starting to look as though they might be effective in a much wider range of cancers, including this particular type of ovarian cancer.

"Although we need to wait for the long-term results of this trial, it's an important 'proof-of-concept', and hints that there are exciting times ahead for these drugs, which Cancer Research UK played a key role in researching and developing."

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New NICE guidance aims to improve ovarian cancer detection

Wednesday 27 April 2011

The National Institute for Health and Clinical Excellence (NICE) has published new guidance that advises GPs and other primary care professionals to offer more blood tests to women with possible symptoms of ovarian cancer.

In its first clinical guidance on the disease, NICE says that women - particularly those over the age of 50 - who visit their doctor with regular bloating, feeling full quickly, lower abdominal pain and the need to urinate urgently or frequently should be offered a blood test to measure a protein called CA125.

Patients whose CA125 raises concerns should then be offered an ultrasound scan of their abdomen and pelvis, and referred to a hospital specialist within two weeks if the ultrasound shows signs of ovarian cancer.

In addition, NICE is advising doctors to test women aged 50 or above who have been experiencing symptoms that suggest irritable bowel syndrome (IBS) within the previous 12 months. This is because IBS rarely develops for the first time in women over the age of 50, whereas the symptoms of ovarian cancer - which are similar to those of IBS - tend to become apparent in this age group.

According to NICE, more initial investigations in primary care settings could enable women to be referred to hospital specialists sooner, thereby improving their chances of surviving if they are diagnosed with the disease.

Early treatment can improve a woman's chances of surviving ovarian cancer, which is the fifth most common form of cancer among women.

But the CA125 isn't fool proof and GPs do need to be careful. It may be that a woman does have ovarian cancer even if their serum CA125 definitely isn't raised. For these women - and those who have high levels of CA125 but an ultrasound doesn't show anything - the guidance says that if there's no other apparent cause of the symptoms they should come back to their GP if their symptoms become more frequent and/or persistent.

Dr Fergus Macbeth, director of NICE's Centre for Clinical Practice, said: "Ovarian cancer is commonly referred to as the 'silent killer' as its symptoms are considered vague, and so can be confused with other conditions, like irritable bowel syndrome.

"This misconception can lead to many women being referred to inappropriate care pathways or being diagnosed once the cancer is at an advanced stage. The stage of the disease at diagnosis is the most important factor in predicting survival."

Dr Macbeth explained that persistent symptoms can be an "important indicator" of ovarian cancer, and that the new guidance recommends effective initial tests that can be undertaken by GPs and other healthcare professionals in such cases.

"In particular we recommend a specific blood test as a useful early way of determining if the disease is likely to be present. This test is already available on the NHS, but by offering it sooner and in primary care, we hope that it will lead to earlier diagnoses and treatment," he added.

Linda Facey, a guideline developer with personal experience of ovarian cancer, reiterated the importance of an early diagnosis of ovarian cancer, the symptoms of which can be "confusing".

She revealed: "I found that I was eating much less as I felt full very quickly during meals, but instead of losing weight, I constantly felt bloated and in pain.

"It's very easy for women to put their bodies on a backburner as they deal with busy family and working lives, but they should never ignore the possible symptoms. If the symptoms have been present for some time, women should go to see their GP and ask for the blood test. This will either help identify the cause early on, or give women the reassurance they may need."

The guidance has been welcomed by the Royal College of Obstetricians and Gynaecologists, whose president Dr Tony Falconer said that diagnosing ovarian cancer at the earliest possible stage is a "fundamental issue" for healthcare providers.

He said: "We support the NICE recommendation for GPs to offer the blood test (CA125) to women with suspected symptoms with the follow-up of an ultrasound scan.

"This approach will help detect problems at the earlier stages with more rapid referral to gynaecological oncologists. Early therapeutic intervention with surgery and chemotherapy should improve the prognosis for women."

Professor Jonathan Lederman, Cancer Research UK's ovarian cancer expert, said: "It's encouraging to see the early diagnosis of ovarian cancer being taken so seriously and we welcome any steps to help doctors diagnose women at the earliest stage.

"Cancer Research UK is helping to fund a trial developing screening for ovarian cancer using this blood test and ultrasound scans, which could make an even bigger impact on the number of women who survive the disease."
 

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Ovarian cancer survival doubles in 30 years

Wednesday 9 March 2011

Cancer Research UK Press Release

Survival from ovarian cancer has almost doubled over the last 30 years according to new figures from Cancer Research UK released today.

The overall five year survival rate for ovarian cancer has increased from 21 per cent in the early 1970s to 41 per cent today. Over 1,000 more women per year in England and Wales are now surviving ovarian cancer for at least 5 years due to improved survival rates1.

But more work is needed to see the same improvements in women diagnosed with advanced ovarian cancer.

Based on data from the East of England Cancer Registry (ECRIC), survival rates for women diagnosed with stage III ovarian cancer – the majority (45 per cent) of women - still lag behind with just over 20 per cent surviving five years. And this falls to less than six per cent of women with stage IV disease2.

Ovarian cancer often develops without any clear symptoms and many women only discover they have it once it has spread.

Dr James Brenton, based at Cancer Research UK’s Cambridge Research Institute and an ovarian cancer clinician at Addenbrooke’s hospital, said: “These latest figures show improvements in treatment, such as centralisation of ovarian cancer surgery and uniform access to chemotherapy, are making a difference in helping more women survive ovarian cancer, particularly those who are diagnosed earlier. But we face a real challenge in translating these improvements in survival to women whose ovarian cancer has already spread.”

In the 1980s Cancer Research UK scientists discovered a chemotherapy drug called carboplatin, now the ‘gold standard’ treatment for ovarian cancer. This not only treated women more successfully when they were first diagnosed with ovarian cancer, but offered new options to treat recurrences of the disease.

To tackle the issue of late diagnosis Cancer Research UK are helping to fund a pivotal trial of ovarian cancer screening. More than 200,000 women are participating in this nationwide trial testing whether ultrasound scanning and a blood test can save lives.

The early results have been promising, and if the final findings, expected in 2015, show this is successful it could lead to a national screening programme that will help to detect the disease earlier and save many more lives.

Researchers are also looking at developing more targeted treatments that are aimed at the particular characteristics of a woman’s ovarian cancer. Cancer Research UK scientists are playing a key role in developing this new generation of drugs including PARP inhibitors, which could help women with ovarian cancer who also have faulty BRCA genes. They are already showing promising results in clinical trials and could make a big difference for many women with ovarian cancer in the future.

Dr Brenton added: “Ovarian cancer is starting to become a more controllable chronic disease but a cure remains elusive in most cases. We need to investigate the full potential of targeted treatments such as PARP inhibitors as they may also benefit women who don’t have faulty BRCA genes. Hopefully through these new treatments and, importantly, with better ways to screen and detect the cancer earlier, we will help more women beat the disease.”

Ovarian cancer is the fifth most common cancer in women, each year around 6,500 women are diagnosed with the disease, with most cases diagnosed in women over 50.
Around 4,400 women died of ovarian cancer in 2008 though mortality rates have fallen by 14 per cent over the last decade.

Cancer Research UK is the largest single funder of ovarian cancer research in the UK, last year spending over £12 million of public donations on tackling the disease.

Dr Lesley Walker, Cancer Research UK’s director of cancer information, said: “These figures show that we’re making steady progress against ovarian cancer but much more needs to be done. Cancer Research UK is committed to finding new ways to treat and detect the disease. In the coming years we could really see some of the benefits of this work, particularly a potential nationwide screening programme that finds women with the disease earlier.

“New treatments are also in the pipeline that could help keep the disease under control for longer, meaning that ovarian cancer becomes a disease that women can live with for many years."

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AstraZeneca and Pfizer join Cancer Research UK's Stratified Medicine Programme

Tuesday 1 February 2011

Cancer Research UK Press Release

CANCER RESEARCH UK will be supported by AstraZeneca and Pfizer in a multimillion pound initiative to examine how genetic tests to improve cancer diagnosis can be best rolled out across the NHS.

Cancer Research UK’s pioneering Stratified Medicine Programme will also promote research into new targeted treatments by building a database of genetic information about tumours, treatments and survival rates that will enable researchers to design more effective cancer treatments in future.

Cancer Research UK will now select six hospitals and three labs to collect tumour samples from 9,000 cancer patients around the UK, and test them for a set of gene faults specifically linked to cancer – an approach called ‘molecular diagnosis’.

Molecular diagnosis of tumours is not yet available for all patients on the NHS and currently only possible using a single test for each mutation.

But the programme aims to develop a multi-gene panel that can test for genetic markers for drugs already used in the clinic - such as EGFR for gefitinib - as well as those for promising new drugs in late-stage trials.

So as and when new targeted cancer treatments become available, doctors will have access to the tests needed to help them match the right drug to the right patient.

The programme will deliver a clear set of standards and processes for molecular diagnosis of NHS patients’ tumours, which can be scaled up to provide a national service.

This will help ensure that the hospitals and labs can deliver high quality, efficient molecular diagnosis of tumours, so all cancer patients across the NHS can get access to the tests that they need.

The £5.5m programme will be led by Cancer Research UK, with funding from AstraZeneca and Pfizer.

It is closely aligned with the Technology Strategy Board’s £5.6 million investment in tumour profiling and data capture to improve cancer care and the new cancer strategy recently launched by the coalition government.

Rob Day, Head of Pfizer Oncology, UK, said: “Pfizer is delighted to partner with Cancer Research UK on the Stratified Medicine programme to advance the role of genetic testing in cancer diagnosis and treatment selection. Personalised medicines are likely to transform the way cancer is treated in the future. As a company dedicated to advancing oncology research, Pfizer Oncology is focused on discovering gene-specific targeted medicines to improve outcomes for patients with cancer.”

Dr Susan Galbraith, Vice President and Head of Oncology, Innovative Medicines, at AstraZeneca, said: “We are delighted to be involved in this collaboration. AstraZeneca has spent over fifty years at the forefront of cancer research and it is our view that better understanding of which patients will benefit from treatment with currently available and new therapies is the way forward in fighting this disease.’

“This collaboration is particularly exciting as by building a database of tumour genetic information, treatments and outcomes, we can better understand which targets for new drugs occur in which patients. The information currently available on this is often incomplete. This kind of testing will mean better selection of patients for clinical trials with drugs which are more likely to make an impact on their disease. Ultimately this will help us develop drugs which improve the survival of patients with cancer.”

Paul Mason, Head of Development at the Technology Strategy Board, said: “We are delighted to be working with Cancer Research UK in this exciting area. The alignment of our activities to build a national programme, and their contribution to the Stratified Medicines Innovation Platform, will go a long way to help generate the critical mass the UK needs.”

James Peach, director of Cancer Research UK’s stratified medicine programme, said: “Cancer Research UK recognises the huge potential of personalised medicine to save lives from cancer. Such an ambitious vision could not be realised without partnership and we know that the support of AstraZeneca and Pfizer will be invaluable in facing the many challenges that lie ahead.”

“It’s important that NHS cancer patient have access to these kinds of tests to make sure they get the right treatment at the right time. And by acting now we can ensure patients benefit from personalised cancer medicines as soon as they become available.

“Cancer Research UK is proud to be leading this coordinated national effort – including the Government, NHS and pharmaceutical and diagnostic companies – that will bring us a step closer to tailored treatments becoming a routine part of NHS cancer care.”

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UK survival for major cancers improves, but still lags behind other countries

Wednesday 22 December 2010

Despite gaining ground, survival figures for newly diagnosed breast, ovarian, bowel and lung cancers were still lower in the UK than in Australia, Canada and Sweden between 1995 and 2007, a new study in the Lancet medical journal shows.

The research looked at one, five-year and five-year 'conditional' survival for these four major cancers between 1995 and 2007 in Australia, Canada, Sweden, the UK (excluding Scotland), Denmark and Norway.

Among other things, one-year survival figures can give information about how late cancers are being diagnosed, as the later cancer is diagnosed the lower the proportion of patients who survive one year.

Five-year 'conditional' survival looks at five-year survival rates among people who survive at least one year, and is thought to be an indication of the quality of care and treatment received.

Survival figures over this period were found to be better for patients in Australia, Canada or Sweden than for those in the UK or Denmark, while Norway's survival rates were intermediate.

For example, five-year bowel cancer survival for 2005-07 was 54 per cent in the UK compared to 66 per cent in Australia, while one-year survival for lung cancer was around 30 per cent in the UK, compared to 43 per cent in Australia and 44 per cent in Sweden.

Experts say that late diagnosis or differences in treatment are likely to be behind the lower survival rates in Denmark and the UK.

But the study also shows that, while the UK's survival rates are not as high as those in other countries, relative survival did improve for all four cancers between 1995 and 2007.

One-year and five-year breast cancer survival rates improved more in the UK and Denmark than in the other countries between 1995 and 2007, indicating that the UK's cancer plans, which were introduced in England in 2000, Northern Ireland in 1996 and Wales in 2004, may have made a difference.

The study authors wrote: "Differences in individual, health-system and clinical factors - such as public awareness of cancer, diagnostic delay, stage [of cancer at diagnosis], comorbidity [other serious illnesses at time of cancer diagnosis] and access to optimum treatment - are all potential explanations for the overall differences in relative survival.

"The patterns are consistent with late diagnosis or differences in treatment, particularly in Denmark and the UK, and in patients aged 65 years and older."

The research was carried out as part of the International Cancer Benchmarking Partnership, a collaboration aimed at understanding the reasons for differences in cancer outcomes between countries. The new paper is the first to emerge from 'module one' of the partnership's work, which aims to generate quality data to base future analyses on.

Other modules will attempt to unpick the reasons for these discrepancies.

Sara Hiom, director of health information at Cancer Research UK, which helped to fund the study, said: "It's encouraging to see that survival for breast, bowel, lung and ovarian cancers has improved across the board and this study shows how far survival has improved for some of the most common cancers in the UK. But we still have work to do. Now we know how we currently compare to other countries, we must look at exactly why these differences in survival exist.

"When the government refreshes its cancer strategy, it's vital to retain a focus on early diagnosis and on improving equitable access to treatment. We also urge the government to continue to collect good quality information. Reliable data - which are consistent across the country - are crucial to understanding the extent of the problem and identifying the causes of the survival gap within the UK and compared to other countries."

Sir Mike Richards, England's national director for cancer, said: "These data will be crucial in helping all the partners involved improve their cancer outcomes.

"In England we have already started work on improving early diagnosis, including a new campaign starting next month to alert people to the early signs and symptoms of bowel, lung and breast cancer, and plans to give GPs more direct access to key diagnostic tests. Full details of our future plans will follow when the coalition government launches its new cancer strategy in the new year."

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Deprived cancer patients face fatal health problems

Wednesday 24 November 2010

Cancer Research UK Press Release

CANCER patients from deprived backgrounds are more likely to develop life-threatening health problems, research published today (Wednesday) in the British Journal of Cancer* shows.

The study** found that less affluent patients are 50 per cent more likely to develop at least one serious illness like heart disease, tuberculosis, dementia or diabetes, which could reduce their chance of recovering from cancer.

The research looked at over 72,000 patients with 14 different types of cancer*** between 1997 and 2006. The results showed that the likelihood of one-year survival for poorer patients was significantly worse than those who were well-off.

Scientists claimed this was the first large study to show how a cancer patient's background affected their chances of developing other illnesses and could impact their survival.

Dr Marieke WJ Louwman, one of the study authors based at the Eindhoven Cancer Registry in The Netherlands, said: "Remarkably, we found that additional health disorders were common in patients from a lower socioeconomic background for every cancer type."

The study outlined possible explanations for increased health problems among poorer cancer patients. Previous research has shown that smoking is a likely cause for the higher risk of heart disease.

This was confirmed by the high number of cases of the disease among patients with smoking-related cancers like lung, stomach, bladder and kidney.

Cancers like pancreatic, breast, womb and bowel have been linked to diabetes which can be triggered by obesity. Previous evidence has shown that obesity is more common among those from a low socioeconomic background.

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: "It's worrying to see that survival is considerably worse for deprived patients - this research stresses the need to close the gap between rich and poor in health.

"The results of this study suggest that the causes of the types of cancer and the health problems common among poorer cancer patients are likely to be down to lifestyle.

"More work needs to be done to raise awareness in economically-deprived areas about the risks of smoking and obesity and the benefits of a healthy diet and exercise."

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Test selects the 60 per cent of women with inherited ovarian cancer who could benefit from 'smart' drug

Monday 8 November 2010

Cancer Research UK Press Release

Scientists have developed a new test to select which patients with ovarian cancer will benefit from new drugs called PARP inhibitors, according to research presented at the NCRI Cancer Conference in Liverpool today.

PARP inhibitors are the first targeted treatment to be developed for women with inherited forms of breast and ovarian cancer carrying faults in a BRCA gene. Early results from clinical trials are showing promise for patients with the rare inherited forms of these cancers.

But this new test shows that even more patients - 60 per cent of all patients with ovarian cancer - may benefit from PARP inhibitors.

Inherited ovarian cancer accounts for up to 15 per cent of all cases of the disease. Ovarian cancer is the fifth most common cancer in females in the UK. There are around 6,850 new cases of ovarian cancer diagnosed each year in the UK - around 130 women every week.

Dr Asima Mukhopadhyay*, presenting the results, said: “Our results show that this new test is almost 100 per cent effective in identifying which ovarian cancer patients could benefit from these promising new drugs.

“We have only been able to carry out this work because of the great team we have here which includes both doctors and scientists.”

The team based at Queen Elizabeth Hospital, Gateshead and the Newcastle Cancer Centre at the Northern Institute for Cancer Research, Newcastle University collaborated with Pfizer Inc to develop the new assay to test tumour samples taken from ovarian cancer patients when they had surgery.

The test, called the RAD51 assay, scans the cancer cells and identifies which tumour samples contain defective DNA repair that can be targeted by the PARP inhibitor. The PARP inhibitor studied, PF-01367338 - formerly known as AG-14699 - was found to selectively block the spread of tumour cells with low RAD51 expression.

The test has been used to examine tumour samples in the laboratory and is not yet suitable for routine clinical practice but the team hope to refine it for use in patients.

Dr Mukhopadhyay added: “Now we hope to hone the test to be used directly with patients and then carry out clinical trials. If the trials are successful we hope it will help doctors treat patients in a personalised and targeted way based on their individual tumour.”

It is also now hoped that PARP inhibitors will be useful for a broad range of cancers and we hope this test can be extended to other cancer types.

Dr Lesley Walker, Cancer Research UK’s director of cancer information, said: “It’s exciting to see the development of promising new ‘smart’ drugs such as PARP inhibitors. But equally important is the need to identify exactly which sub groups of patients will benefit from these new treatments.

“Tests like this will become invaluable in helping doctors get the most effective treatments quickly to patients, sparing them from unnecessary treatments and side effects.”

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Scientists discover first DNA region to alter breast cancer risk in women with BRCA1 faults

Sunday 19 September 2010

Cancer Research UK Press Release

Cancer Research UK scientists have identified a DNA region which can increase or decrease the high breast cancer risk associated with the BRCA1 gene. The region is particularly involved in oestrogen receptor negative breast cancer and has also been linked to an increased risk of ovarian cancer in the general population.

The research is published in Nature Genetics today (Sunday) alongside two other independent studies linking this region and four others to ovarian cancer.

Two independent research groups identified the same region after carrying out genome-wide association studies*. Researchers led by Dr Antonis Antoniou based at the Cancer Research UK Centre for Cancer Genetic Epidemiology at the University of Cambridge, identified the region after searching through the genomes of more than 2,300 women with faults in the BRCA1 gene, to find other sections of DNA which could alter breast cancer risk.

Meanwhile researchers led by Dr Simon Gayther, based at the Cancer Research UK Genetic Epidemiology Unit, at the University of Cambridge and UCL (University College London), pinpointed the same region after carrying out a similar study looking at nearly 9,000 women with ovarian cancer from the general population.

On average, around 65 per cent of women carrying a faulty BRCA1 gene will develop breast cancer - and around 40 per cent ovarian cancer - by the age of 70.

These studies reveal that if a woman with a BRCA1 fault also carries the risk ‘version’ of the 19p13 region, her breast cancer risk may be higher still.

Dr Antonis Antoniou, lead author on the breast cancer study and scientist at the Cancer Research UK Centre for Cancer Genetic Epidemiology, University of Cambridge, said: “We’ve found a DNA region that acts like a volume control – to turn up or down the risk of developing breast cancer from faults in the BRCA1 gene.

“Our discovery is the first step in a much larger study to identify genetic factors that modify breast cancer risk in women carrying BRCA1 mutations, and ultimately could help assess the risk for each woman and monitor for the disease.”

The same DNA stretch was also associated with the risk of developing oestrogen receptor negative breast cancer in women without a faulty BRCA1 gene, and also associated with the risk of developing triple negative breast cancer – oestrogen, progesterone and HER2-negative breast cancer.

In a separate study in Nature Genetics today, the same region was also shown to increase the risk, to a lesser degree, of ovarian cancer in women who don’t carry a BRCA1 fault.

Dr Simon Gayther at UCL, who is lead author on this study and whose work is supported by Cancer Research UK and the Eve Appeal, said: “Our study showed that the same genetic region also plays a role in ovarian cancer, suggesting that it is involved in the same faulty pathway.

”This is important because it suggests that women who carry certain versions of this DNA stretch could benefit from closer monitoring for both breast and ovarian cancers.”

Dr Andrew Berchuck, head of the international Ovarian Cancer Association Consortium (OCAC) steering committee and an author on the study, said: "The critical validation of these findings was performed by large consortia of investigators from around the world, and this research represents a triumph of science without borders for the benefit of all women."

A third study, led by Dr Paul Pharoah, also at the Cancer Research UK, Centre for Cancer Genetic Epidemiology at the University of Cambridge and UCL, and published in the same journal today, reveals four other separate genetic regions also associated with ovarian cancer risk in the general population.

Dr Lesley Walker, Cancer Research UK’s director of cancer information, said: “We’re dedicated to unravelling cancer risk so we can provide doctors with better tools to identify who is at risk and help select the best treatment.

“This research provides evidence that by carrying out genome wide association studies in certain subgroups - such as people with BRCA1 mutations - we can identify other breast and ovarian cancer risk factors which have previously been missed.”

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Experimental drug shrinks tumours in women with hereditary breast and ovarian cancers

Monday 16 August 2010

An experimental drug called olaparib has been shown to shrink tumours in women whose advanced cancers were caused by faults in their BRCA genes.

The international phase-II studies, both published in the Lancet, looked at women with advanced ovarian or breast tumours.

Their results add further weight to the idea that the key to treating certain types of cancer may be to target their underlying genetic weaknesses, rather than the organ in which the cancer originated.

First author on the ovarian trial Dr William Audeh, a cancer expert specialising in cancer genetics at Cedars-Sinai Medical Centre in the US, described the findings as "significant".

He revealed: "Olaparib is the first single-agent, non-chemotherapy treatment to show benefit to patients with cancers that result from BRCA1 or BRCA2 gene mutations.

"Until now, treatments for cancer have been selected based upon where in the body the cancer originated. [This study suggests] that it is the underlying genetic weakness of a cancer, not the organ of origin, that is the key to selecting effective therapy."

The investigational drug olaparib is a poly-ADP-ribose phosphorylase (PARP) inhibitor.

It is designed to interfere with an enzyme called poly-ADP ribose-phosphorylase, or PARP, which helps to repair DNA damage caused to cancer cells.

Tumours which are caused by faults in BRCA genes already have difficulty repairing their DNA, for example when given chemotherapy.

By blocking the activity of PARP, olaparib in theory makes the chemotherapy much more effective.

The ovarian cancer study, which was coordinated by researchers at the Breakthrough Breast Cancer Research Unit at King's College London, as well as researchers in the US and Australia, involved 57 patients, 33 of whom were given a high dose of olaparib.

Eleven of these women saw a significant reduction in the size of their tumours. Three out of 24 women given a lower dose also benefited.

In the breast cancer trial, 27 women received the higher dose, of whom 11 responded, while six out of a further 27 women given a lower dose also responded.

Side-effects tended to be relatively mild and included nausea, fatigue and anaemia.

Dr Audeh noted that many women with advanced BRCA-mutated cancer have limited treatment options, as they will have already tried several different chemotherapy drugs.

He revealed: "PARP inhibitors may be a promising new option for this heavily 'pre-treated' population."

Dr Claire Knight, health information officer at Cancer Research UK, said: "PARP inhibitors have been showing excellent promise in early clinical trials and these results are also encouraging.

"Cancer Research UK scientists have been key players in developing this new generation of cancer drugs. We look forward to the results of larger clinical trials to determine if these drugs could be an effective way to treat cancers caused by faults in the BRCA genes."

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Long-term survival from once-deadly cancers doubles

Monday 12 July 2010

Cancer Research UK Press Release

People diagnosed with breast, bowel and ovarian cancers and non-Hodgkin’s lymphoma are today twice as likely to survive for at least 10 years as those diagnosed in the early 1970s according to new figures1 released by Cancer Research UK.

The percentage of women likely to survive breast cancer for at least 10 years has jumped from less than 40 per cent to 77 per cent while the proportion of people likely to survive bowel cancer has risen from 23 per cent to 50 per cent.

Twice as many patients with ovarian cancer and non-Hodgkin’s lymphoma are likely to survive for at least 10 years with survival increasing from 18 to 35 per cent and from 22 to 51 per cent respectively. And for Hodgkin’s lymphoma, 10-year survival is predicted to increase from less than 50 per cent to around 80 per cent.

There is also encouraging news for leukaemia with patients four times as likely to survive for 10 years compared with those diagnosed in the early 1970s.
And while 10-year survival is still low for oesophageal cancer and myeloma (both below 20 per cent) it is predicted to have trebled over the same period.

As Cancer Research UK launches its new national TV advertising campaign today the message is clear: much has been achieved in the fight against cancer but there is still more to do. The advertisement aims to improve awareness of cancer and to raise money for continuing research.

Claire Daniels is one of the cancer survivors who appear in the television ad. She was a student at Warwick University when she complained of excessive fatigue and weight loss before being diagnosed with Hodgkin’s lymphoma.

She returned to her parents’ home in Manchester where she was initially treated with chemotherapy at the Christie Hospital. But the cancer returned and Claire had further intensive chemotherapy, radiotherapy and a stem cell transplant after which she had to spend a month in an isolation ward.

Now 24, Claire, from Leamington Spa, works as an events’ organiser at Cancer Research UK in London. “In between treatments I organised some student balls to raise money for cancer and it really helped me to focus and detract from the illness,” she said. “I wanted to stand up in front of my peers and say: ‘Don’t think cancer is just a disease that happens to old people. A year ago I was a student partying just like you. I’m 19 but I’ve got cancer.’ That’s when I realised I’d like to organise events for a living.

“I feel very lucky that I was able to have such effective treatment - some of which was shaped by the charity’s researchers - and that’s why I was so pleased to be part of this campaign. Everyone who appears in the TV ad is either a cancer survivor or a cancer doctor; there aren’t any actors so we are all genuinely involved in fighting this disease.”

Professor Peter Johnson, Cancer Research UK’s chief clinician, said: "There are many reasons for our continuing success in the fight against cancer, including faster diagnosis, better surgery, more effective radiotherapy and many new drugs, all developed using the knowledge that our laboratory research has given us.

“We expect this trend to continue, hastened by Cancer Research UK's investment in research in all these areas.”

In breast cancer, more personalised treatment is helping to increase survival and in bowel cancer improvements in surgery have had a very positive effect. Targeted treatments like imatinib and rituximab have clearly increased survival for some leukaemias and lymphomas. Better supportive care of patients being treated with strong drugs has also contributed to these encouraging results.

Professor Michel Coleman, head of Cancer Research UK’s Cancer Survival Group, who calculated the figures, said: “These big increases in long-term survival since the 1970s reflect real progress in cancer diagnosis and treatment, and they confirm the immense value of having a National Cancer Registry that holds simple information about all cancer patients diagnosed during the last 30-40 years.

“Ten-year survival figures for patients diagnosed in 2007 are of course predictions, but they are derived from the latest national data on cancer patient survival – and for most cancers, the true 10-year survival for these patients will turn out to be higher than we report.”

Harpal Kumar, Cancer Research UK’s chief executive, said: “It is thanks to our supporters and the dedicated work of our doctors and scientists that we are seeing such encouraging improvements in long-term survival of many cancers.

“But we have to do better. We need to develop even more effective treatments that can prolong life further and we need to ensure that each individual patient has optimal treatment.

“Research is expensive and – because we rely completely on donations from the public – we can only continue our vital work with people’s generous support.”

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New drug for inherited breast and ovarian cancers shows promise in early trials

Wednesday 7 July 2010

Olaparib, a new type of experimental drug called a PARP inhibitor, has shown promising results against inherited forms of breast and ovarian cancer in two small clinical trials led by scientists at the Breakthrough Breast Cancer Research Unit at King's College London.

The drug specifically targets cancers caused by faulty BRCA1 or BRCA2 genes. Women carrying these inherited genetic faults have a greatly increased risk of breast and ovarian cancers, and the mutations are thought to cause about two to five per cent of all breast cancers and about five to 15 per cent of ovarian cancers.

The new drug blocks a protein called 'poly(ADP-ribose) polymerase' (PARP), causing cancer cells with a BRCA fault to lose the ability to repair damage to their DNA. Because the cancer cells are already faulty, this extra problem kills them.

Olaparib is a targeted form of treatment, meaning it has been designed to kill cancer cells while leaving healthy cells unharmed.

This week the results of two early clinical trials of olaparib were published in the Lancet medical journal. The international trials focused on breast and ovarian cancers in women with BRCA faults.

In the first trial, scientists looked at 54 women with advanced breast cancer, all of whom had previously been treated with chemotherapy.

Half of the women were given 100mg doses of olaparib, while the other half received 400mg doses.

In the group taking the higher dose, over 40 per cent of tumours shrank significantly and tumours typically did not grow any larger for nearly six months.

In the second trial, 57 women with ovarian cancer were recruited, all of whom had previously received chemotherapy.

Of these, 24 took 100mg doses of olaparib while the other 33 were given 400mg doses.

Researchers found that more than one-third of tumours in the higher-dose group shrank significantly.

The trials were led by Dr Andrew Tutt, consultant clinical oncologist and director of the Breakthrough Breast Cancer Research Unit at King's College London.

He said: "This new type of treatment is showing great promise for patients whose cancer is caused by this specific genetic fault. It was remarkable to see that olaparib benefited women with advanced breast and ovarian cancer who had already been treated with several different chemotherapy drugs.

"However, it is important to remember this drug is at an early stage of development, and further clinical trials will be required to fully evaluate its potential before it would be considered as a licensed treatment."

Dr Susan Domchek, an associate professor of medicine at the University of Pennsylvania who was involved in the breast cancer trial, commented: "This is a different way of looking at cancer therapeutics.

"In oncology, this is really one of the first times that we've seen drugs being developed on the basis of inherited susceptibility - and that may open up a whole new avenue of drug development."

Nell Barrie, science information officer at Cancer Research UK, said: "The work of Cancer Research UK scientists has been instrumental in the development of PARP inhibitors. 

"This small study is part of the important process of testing the safety and effectiveness of these exciting new drugs, but we'll have to wait for the results of much larger trials to know if PARP inhibitors can help to save lives."

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New 'protector gene' switched off in two-thirds of ovarian cancers

Thursday 1 July 2010

Cancer Research UK Press Release

A new gene that normally protects against ovarian cancer is switched-off in two-thirds of cases of the disease, reveals a study published in the journal Neoplasia today.

This ‘protector gene’, known as EPB41L3, is inactivated in 65 per cent of ovarian cancers.

And reactivating the gene halted tumour growth and triggered large numbers of the cancer cells to commit suicide.

The research, co-funded by Cancer Research UK and gynaecological cancer research charity The Eve Appeal, raises the prospect for developing therapies that mimic or restore the function of the gene to kill ovarian cancer cells in a targeted way.

Cancer Research UK’s Dr Simon Gayther, who led the study, said: “Previous studies have found similar ‘protector genes’ but ours is the first to uncover EPB41L3 as a gene specific to ovarian cancer.

“We also discovered that the gene is completely lost in about two-thirds of the ovarian tumours we looked at.

“When we switched it back on in these tumours, it had a positive effect in killing cancer cells. This is a very exciting result because it means therapies that mimic or reactivate this gene could be a way to beat many ovarian cancers.”

The scientists, based at UCL, used a cutting-edge approach which involves transferring whole chromosomes into ovarian cancer cells.

They found that introducing an additional copy of chromosome 18 boosted the activity of 14 key genes, triggering large numbers of the cells to die.

The scientists examined more than 800 ovarian tumours and found that one of the 14 genes – EPB41L3 – was inactivated in around two-thirds of malignant ovarian tumours, compared to less than a quarter of benign tumours and no normal ovarian cells.

Reactivating the gene had the same deadly effect on the cancer cells, suggesting that it was the trigger causing the cells to self-destruct.

Jane Lyons, CEO of The Eve Appeal, said “This research is an exciting step forward - a gene has been identified that can help halt the growth and spread of ovarian cancers. The challenge now is for the researchers and clinicians to find a way to use this new information to increase survival from the disease.”

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: “We know that there is a class of genes that protect us from developing cancer. This is an exciting new one specific to ovarian cancer.

“Advanced ovarian cancer is very difficult to cure, which makes this type of research even more important.”

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"Shielded" ovarian cancer cells may survive chemotherapy

Monday 28 June 2010

Cancer Research UK Press Release

Cancer Research UK scientists have discovered certain ovarian tumour cells that are resistant to chemotherapy can survive a first round of treatment and go on to “re-grow” the cancer. This could help explain why the disease can be difficult to treat, according to new research published in Oncogene today.

The study, funded by Cancer Research UK, aimed to find out whether it is the chemotherapy itself that causes anti-cancer drug resistance to build in the body – similar to resistance to antibiotics – or if cells that are shielded against cancer treatment grow as part of the initial tumour and are already lying dormant before chemotherapy begins.

Often ovarian cancer can be hard to treat with treatment failing after women initially responded well. The number of women surviving beyond five years is less than 35 per cent.

The researchers compared the characteristics of cell lines from the tumour at the time of diagnosis to cell lines from the same patients once the disease had been treated and become resistant.

Dr James Brenton, study author from the Cancer Research UK’s Cambridge Research Institute, said: “Ovarian cancer is notoriously hard to treat. Women usually respond well to their first round of chemotherapy with the disease apparently completely removed. But unfortunately many go on to relapse within six to 24 months. Until now we haven’t known whether they are becoming resistant to the treatment or whether the cells that don’t respond to treatment re-grow the tumour.

“By examining the characteristics of ovarian tumours we now think that cells resistant to chemotherapy grow as part of the tumour. This means that when patients have treatment, cells that respond to chemotherapy are destroyed but this leaves behind resistant cells which then form another tumour of completely resistant cells. This seems to explain why successful treatment for relapsed patients is difficult. What needs to be developed now is a therapy designed to target the resistant cells.”

Dr Lesley Walker, director of science information at Cancer Research UK, said: “Discoveries like this help to tell us why chemotherapy stops working for some ovarian cancer patients. We hope it will lead to new ways to tackle the disease and increase the number of women that survive this cancer that can be so hard to cure. The next step will be to develop treatment tailored to fight the resistant cells.”

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Edinburgh launches new cancer research centre

Wednesday 16 June 2010

Cancer Research UK Press Release

Edinburgh today (Wednesday) becomes the next link in a unique chain of Cancer Research UK Centres that are being launched across the UK.

These new cancer centres will draw together world class laboratory research with medical expertise to provide the best possible results for cancer patients nationwide.

The Edinburgh Cancer Research UK Centre will help set the pace for national and international progress in bowel, breast and ovarian cancers. The Centre will build on Edinburgh’s world class research into the genetics and biology of cancer, as well as researching and developing new ways to treat the diseases. Edinburgh becomes the second Centre in Scotland after Dundee launched the first Centre earlier this year.

Scientists at the Centre will also work on tackling the problem of cancer cells spreading (metastases), and developing resistance to drugs, in order to find ways to prevent these common and life-threatening problems.

Collaboration is the key to the success of the Centre which will enable researchers to exchange ideas and information more easily. It brings together researchers and clinicians with support from Cancer Research UK, the University of Edinburgh and the NHS Lothian.

The Centre aims to be a world leader in developing treatments tailored to individual cancer patients based on understanding the biology of the disease and how treatments work, and how these may vary between patients.

Professor David Cameron, professor of oncology and head of NHS Lothian Cancer Services, and the clinical director of the new Centre, said: “This is a very exciting development for cancer patients and for research in Scotland. The new Centre will help researchers and clinicians to collaborate and work together to improve the lives of cancer patients across Lothian and Scotland. By building closer links between scientists and doctors we want to increase our knowledge about cancer and speed up the pace of research, leading to improved treatments for patients."

Susan Oliver, 58 from Dalkeith, was diagnosed with ovarian cancer in 2005 and went into remission after six months of chemotherapy. But when her cancer returned a year later she was given the chance to take part in a new clinical trial at the Edinburgh Western General called PARP 1 inhibitor. Susan took four capsules twice a day while her health was closely monitored with regular trips to hospital for tests.

She said: "I knew it wouldn’t cure my cancer, but the trial has given me two wonderful and healthy years to enjoy and I am so grateful for the opportunity to add to our understanding of cancer and improve the way future patients are treated. The trial might have had serious side effects, or it might have done me no good at all. But it was an opportunity worth taking and I knew that I was in very safe hands here in Edinburgh."

Cancer Research UK already supports research in Edinburgh but is set to increase its contribution to over £5.6million a year to help develop the Centre.

Professor Sir John Savill, Head of the College of Medicine at the University of Edinburgh, said: "I am delighted that the University of Edinburgh is being joined by our closest partners, NHS Lothian, in this exciting new collaboration with Cancer Research UK. This will ensure that research will feed through into improved cancer care as quickly as possible."

Harpal Kumar, chief executive of Cancer Research UK, said: "Huge progress has been made in beating cancer since the charity was formed and we’re determined to carry on. Funding these centres of excellence is one of the charity's priorities and will enable us to work towards the goals we have set to improve the treatment and survival of cancer patients. But we continue to welcome the generous donations we receive from the public to ensure we can continue to build on what we have started today."

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Promising early results from drug trial for inherited ovarian cancer

Tuesday 20 April 2010

A team of UK scientists, part-funded by Cancer Research UK, have found that a new type of drug could help women with an inherited form of ovarian cancer.

Treatment options are limited for the disease, and only four out of ten women currently survive for five years or more.

While patients commonly respond well to surgery and chemotherapy to begin with, the cancer can become resistant to treatment and come back.

Now, early trial results published in the Journal of Clinical Oncology suggest that an experimental drug called olaparib may help to shrink tumours or prevent further tumour growth in around half of ovarian cancer patients who have inherited faults, or mutations, in their BRCA1 or BRCA2 genes.

Inherited BRCA mutations are found in up to 15 out of every 100 breast and ovarian cancers.

Olaparib is a new type of drug called a PARP inhibitor, which works by preventing DNA repair in cancer cells with BRCA gene faults. The cancer cells are unable to repair themselves, so they die.

The drug is being investigated by scientists at The Institute of Cancer Research (ICR) and the Royal Marsden Hospital, who are working with the company KuDOS Pharmaceuticals.

Researchers recruited about 50 ovarian cancer patients with confirmed or suspected BRCA1 or BRCA2 mutations, all of whom had previously been treated with platinum-based chemotherapy drugs.

Patients were grouped according to how well their tumours responded to the platinum drugs. Patients whose cancer came back more than six months after they had been treated with a platinum-based drug were described as having 'platinum-sensitive disease', while those whose cancers came back sooner, or didn't respond at all to platinum treatment, were classed as 'platinum resistant' or 'platinum refractory'.

Patients on the trial began taking olaparib between 2005 and 2008. Twenty of the patients saw their tumours shrink or recorded a significant fall in their levels of CA125, a molecule produced by ovarian cancers. And a further three patients showed no change - either growth or shrinking - in the size of their tumours.

Nine of the 13 patients (70 per cent) with platinum-sensitive cancers showed a response to olaparib. And ten out of 24 patients (41 per cent) with platinum-resistant tumours also responded to the drug.

Women typically responded to olaparib for an average of seven months and a number of patients kept getting benefit from the drug for nearly two years.

The researchers also found that the side-effects tended to be mild in comparison to existing chemotherapy treatments.

Professor Stan Kaye, a Cancer Research UK-funded scientist who is head of the ICR's Section of Medicine and head of the Drug Development Unit at the Royal Marsden Hospital, explained: "There is an urgent need to find new drugs for women diagnosed with ovarian cancer.

"Olaparib is still in early-stage testing but the results so far are very encouraging. These findings raise the possibility that carefully selected patients in future may well be offered olaparib as an alternative to chemotherapy during the course of their treatment."

Professor Kaye added: "We have good reason for thinking that the benefit seen with olaparib in BRCA mutation-linked ovarian cancer may well extend to a broader population of patients with this disease."

Scientists are now carrying out larger trials of olaparib, and the results are expected later this year.

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Scientists find gene fault behind aggressive ovarian cancer

Wednesday 14 April 2010

Cancer Research UK Press Release

CANCER RESEARCH UK scientists have discovered how mistakes in a key gene drive the early stages of aggressive ovarian cancers. This could improve diagnosis of aggressive forms of the disease and lead to new treatments, according to a study published in the Journal of Pathology this month.

A team of researchers, from Cancer Research UK’s Cambridge Research Institute, originally set out to discover how the presence or absence of the TP53 gene affect survival and treatment response for high grade serous1 ovarian cancer - the most common type of ovarian cancer in UK women. Instead, they made the exciting and surprising discovery that defects in this gene were present in nearly all the women studied with this type of ovarian cancer.

The discovery that such a high proportion of women have a mutation in this gene led the scientists to conclude that TP53 mutations are an important early step in the development of this disease.

The researchers found the mutations by scanning the gene in the tumours of 145 women with aggressive ovarian cancer. Most of the samples were from the Australian Ovarian Cancer Study, one of the largest population-based studies of ovarian cancer in the world2.

These results also show for the first time that these aggressive ovarian cancers have the highest known rate of TP53 mutations of any solid tumour.

Lead author Dr James Brenton, from Cancer Research UK's Cambridge Research Institute and an ovarian cancer clinician at Addenbrooke's Hospital, said: “Our findings help to explain the link between TP53 and aggressive ovarian cancer, showing how faults in this gene are a key step in the development of this disease. We now want to look at how we can target this fault with new treatments for aggressive ovarian cancers.”

The TP53 gene codes for a protein called p53, which in normal cells is activated in response to cell damage and one of its functions is to order cells to die when DNA damage is beyond repair. It’s critical that p53 functions normally to prevent genetic mistakes from accumulating in cells, which can lead to cancer. The p53 protein is missing or faulty in the majority of cancers.

Ovarian cancer is the fifth most common cancer in women in the UK, each year around 6,600 women are diagnosed with the disease. Around 40 per cent of women will survive the disease for at least five years after diagnosis, but if the disease is diagnosed earlier this increases to over 70 per cent.

Dr Helen George, head of science information at Cancer Research UK, said: “These really important laboratory findings could have a significant impact for ovarian cancer patients in the future. Cancer Research UK scientists co-discovered the p53 protein around 30 years ago. Understanding how faults in the TP53 gene this gene drive the aggressive forms of ovarian cancer could lead to new more targeted treatments for women with this disease. ”

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Older women with suspected ovarian cancer 'face referral delays'

Wednesday 3 March 2010

Older women with suspected ovarian cancer are often not referred for investigation as quickly as younger women, new research suggests.

Researchers at the Brighton and Sussex Medical School, funded by the Wellcome Trust, carried out a study of electronic patient records contained in the General Practice Research Database (GPRD).

They identified recorded diagnoses of ovarian cancer and compared them against rates in the UK cancer registries to see whether older and younger patients were managed differently by their GPs.

The results, which are published in the British Journal of Cancer, show that between 2002 and 2006, GPs were less likely to refer older women for investigation by a gynaecologist.

While 82 per cent of under-55s had undergone further investigation in the 12 months before their diagnosis, the figure fell to 75 per cent for 55 to 69-year-olds and just 66 per cent for the over-70s.

The researchers also observed that GPs were slower to refer elderly women than middle-aged patients.

Women aged 45 to 69 were typically referred within ten weeks of visiting their GP, whereas those aged between 75 and 79 years usually waited for 20 weeks before seeing a specialist.

Lead author Dr Rosemary Tate commented: "Ovarian cancer is a relatively rare disease but, as with all cancers, early diagnosis is important for improving the chances of successful treatment.

"Our research suggests that age plays a role in how quickly diagnosis and referral occurs - the older the patient, the later this appears to happen."

Dr Tate noted that the team had not looked at other types of cancer, but that if the results hold true for other forms of the disease, "such delays could be an important cause of avoidable illness and mortality".

She added that the trend "could contribute to the lower survival rates and higher mortality rates experienced in the UK", whose survival rates for cancer - particularly among older people - are among the lowest in Europe and have barely improved over the past ten years.

The researchers also noticed differences between the rates of recorded diagnoses of ovarian cancer in the GPRD database and those recorded in UK cancer registries.

Professor Jackie Cassell emphasised the importance of understanding why these discrepancies occur, adding: "This will help ensure that the information available to our health services is accurate and fit for purpose."

Sara Hiom, director of health information at Cancer Research UK, commented: "Ovarian cancer symptoms can be vague and suggestive of other, less serious conditions. But it's important that the disease is diagnosed at the earliest possible stage, whether the patient is young or old, as it is then easier to treat and there is a better chance of survival.

"Ovarian cancer is more common in older women, with four out of five cases in women over 50, so it's concerning if these older women are indeed less likely to be investigated.

"All too often cancer is found at a late stage, which is why we're working with the Department of Health, NHS and others on the National Awareness and Early Diagnosis Initiative (NAEDI) to address this problem.

"These results reinforce the importance of NAEDI's work, which includes raising public awareness of cancer, promoting earlier presentation and supporting doctors with the most up-to-date evidence and decision support."

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Ovarian cancer rates fall 20 per cent

Wednesday 26 August 2009

Cancer Research UK Press Release

Ovarian cancer rates have fallen by almost 20 per cent in a decade, according to Cancer Research UK today (Wednesday).

Rates for women in their 50s and early 60s are nearly 20 per cent lower than they were in 1998.

And for women under 50* rates are 14 per cent lower than they were at their peak in 1997.

This dramatic drop is likely to be due to women taking the contraceptive Pill, which can protect against the disease.

Decreasing use of hormone replacement therapy (HRT) could also have contributed to the fall in rates.

Dr Lesley Walker, Cancer Research UK's director of cancer information, said: "The trend in the number of women getting ovarian cancer reversed suddenly around ten years ago, and these latest statistics make it clear that rates are continuing to fall steadily. This is good news for women. We know from Cancer Research UK studies that taking the Pill for more than 15 years halves the risk of ovarian cancer.

"We can't be sure that the drop in ovarian cancer rates is solely due to the Pill, but it has played an important part."

Rates of women getting ovarian cancer had been rising steadily since records began in the 1970s.

For women under 50, rates peaked in 1997, with almost 11 women in every 100,000 being diagnosed with the disease.

For women between 50 and 64, rates peaked at nearly 47 women in every 100,000 in 1998.

The latest figures revealed today show this figure has dropped to around 9 in every 100,000 women under 50 and around 38 in women between 50 and 64.

The number of women taking the Pill has been increasing since it became widely available in the 1970s, and the drop in ovarian cancer rates could be a delayed effect of this. The reduction in the number of women taking hormone replacement therapy (HRT) since 2000 when its cancer risks became clear may also have contributed to this drop**.

When hormone levels are increased, as they are with HRT, they can make cells grow and divide uncontrollably. Damaged cells usually die, but when they don't cancer can develop. But with the contraceptive Pill, high levels of hormones prevent ovulation and slow cell division. This can reduce the risk of cancer.

Dr Walker added: "These new figures add to the evidence that the protective effect of the Pill is strong and it will be interesting to see if this trend continues as women make choices about taking the Pill and HRT over the next few years.

"Any woman with concerns or questions about taking the contraceptive Pill should discuss them with her GP or local Family Planning Clinic. And if you are worried about HRT and ovarian cancer, you should speak to your GP, who can discuss the risks and benefits in your individual situation."

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Genetic link to ovarian cancer found

Sunday 2 August 2009

Cancer Research UK Press Release

Scientists have located a region of DNA which - when altered - can increase the risk of ovarian cancer according to research published in Nature Genetics today.

An international research group led by scientists based at the Cancer Research UK Genetic Epidemiology Unit, at the University of Cambridge and UCL (University College London) searched through the genomes of 1,810 women with ovarian cancer and 2,535 women without the disease from across the UK. They analysed 2.5 million variations in DNA base pairs - the letters which spell out the genetic code - to identify common spelling ‘errors’ linked to ovarian cancer risk.

The scientists identified the genetic 'letters'- called single nucleotide polymorphisms (SNPs) - which when spelt slightly differently increase ovarian cancer risk in some women. This is the first time scientists have found a SNP linked uniquely to risk of ovarian cancer and is the result of eight years of investigations. With the help of the international Ovarian Cancer Association Consortium (OCAC), they then looked at more than 7,000 additional women with ovarian cancer and 10,000 women without disease from around the world to confirm this finding.

The region of risk DNA is located on chromosome nine - there are 23 pairs of each chromosome in humans, one of each pair inherited from each parent. The scientists estimate that there is a 40 per cent increase in lifetime risk for women carrying the DNA variation on both copies of chromosome nine compared with someone who doesn’t carry it on either chromosome. The risk for women carrying the variation on both chromosomes is 14 in 1000 - compared with ten in 1000.

Approximately 15 per cent of women in the UK population carry two copies of the variant DNA.

The lifetime risk for a woman carrying the DNA variant on one copy of the chromosome is increased by 20 per cent from ten in 1000 to 12 in 1000. Approximately 40 per cent of women in the UK carry one copy.

Senior author Dr Simon Gayther, whose work is supported by Cancer Research UK and The Eve Appeal charity which fundraises for the gynaecological cancer research team based at UCL, said: "The human DNA blueprint contains more than 10 million genetic variants. These are part and parcel of our characteristics and make-up - but a handful will also increase the chances of some women getting ovarian cancer and we have found the first one of these.

"There is now a genuine hope that as we find more, we can start to identify the women at greatest risk and this could help doctors to diagnose the disease earlier when treatment has a better chance of being successful."

Dr Andrew Berchuck, head of the international Ovarian Cancer Association Consortium steering committee, said: "This study confirms that ovarian cancer risk is partly determined by genetic variants present in a large number of women. This initial discovery and others that will likely follow in the future lay the groundwork for individualised early detection and prevention approaches to reduce deaths from ovarian cancer."

Ovarian cancer is the fifth most common cancer in women in the UK with around 6,800 new cases diagnosed each year in the UK - 130 women every week. It is the fourth most common cause of cancer death in women in the UK with around 4,300 deaths from the disease in the UK each year.

BRCA1 and BRCA2 are high risk genes which cause breast cancer and are already known to significantly increase the risk of ovarian cancer- but faults in these genes are rare and probably cause less than five per cent of all cases of ovarian cancer.

Lead author, Professor Dr Paul Pharoah, a Cancer Research UK senior research fellow at the University of Cambridge, said: "We already know that people with mistakes in the BRCA1 and BRAC2 genes have a greater risk of ovarian cancer - but on their own they don’t account for all of the inherited risk of the disease. “It is likely that the remaining risk is due to a combination of several unidentified genes - which individually carry a low to moderate risk. Now we have ticked one off, the hunt is on to find the rest."

Rose Lammy*, the mother of David Lammy MP for Tottenham and Minister for Higher Education and Intellectual Property, died of ovarian cancer in 2008. Rose Lammy’s DNA sample was included in the study, and she carried both risk alleles of the new genetic marker that researchers have identified.

David Lammy said: "I am pleased that Mum's sample was included in this study as it is one step towards earlier diagnosis of ovarian cancer when treatment is more successful. We now know the fact that she had this altered DNA meant that her lifetime risk had risen from 10 in 1,000 to 14 in 1,000, an increase of 40 per cent compared to those women who don’t carry this DNA variation. Dr Lesley Walker, director of cancer information at Cancer Research UK, added: "This is an important discovery. Our researchers have worked as part of a huge collaboration to establish the regions of DNA that can increase someone’s risk of developing ovarian cancer. "This research paves the way for scientists to discover even more genes linked to ovarian cancer and could lead to new approaches to treat or prevent the disease - crucially it will help doctors manage women who are at increased risk."

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