Docetaxel significantly increases survival for incurable gastric cancers

Wednesday 23 January 2013

Cancer Research UK Press Release

Survival for advanced stomach and oesophagael cancer patients increases by 40 per cent when treated with the chemotherapy drug, Docetaxel* – providing evidence to prescribe it as a second-line treatment, according to the results of a Cancer Research UK trial presented at the American Society of Clinical Oncology (ASCO) Gastrointestinal cancers symposium today (Wednesday)**.

Patients with the advanced disease who do not respond to the initial standard treatment of platinum and fluoropyrimidine chemotherapy have very low survival – around four months. And in all patients with advanced disease and most of those with early disease (70 per cent) their cancer will eventually progress further after chemotherapy.

But these new results show that patients taking Docetaxel lived, on average, more than 40 per cent longer – 5.2 months compared with 3.6 months. The drug improved symptoms, without affecting quality of life.

Docetaxel is a chemotherapy drug usually given to treat breast, prostate and non-small cell lung cancer.

The trial, called COUGAR-02 was coordinated by the Cambridge Cancer Trials Centre at Addenbrooke’s hospital.

It recruited 168 patients from 31 UK hospitals with incurable oesophageal or stomach cancer after initial therapy.

They were then randomly assigned either chemotherapy for up to 18 weeks with Docetaxel, or symptom-control treatment with no chemotherapy.

Chief investigator Dr Hugo Ford, Cancer Research UK-funded clinician at Cambridge University Hospitals, said: “This is important progress for stomach and oesophageal cancer patients. At the moment there aren’t any options for gastric cancer patients whose first round of treatments haven’t worked and there’s an urgent need for new drugs.

“But for the first time we’ve shown that giving further chemotherapy can not only improve survival but also maintain quality of life and reduce pain.

“It’s incredibly hard as a clinician telling a patient with advanced disease that there are no treatments that will work for them. So it’s fantastic that these results will provide new hope and valuable extra time for people and their families who otherwise would have no option other than pain management drugs.”

Each year more than 12,000 people die from oesophagus or stomach cancer in the UK. Stomach cancer is one of the most common cancers worldwide.

Kate Law, Cancer Research UK’s director of clinical research, said: “These exciting results from our trial provide the evidence that Docetaxel is effective when patient’s initial treatment for advanced stomach cancer wasn’t effective.  

“Our scientists were among the first to show that the major cause of stomach cancer is a common infection of the stomach lining by the bacterium Helicobacter pylori (H. pylori). This work has underpinned current research aimed at preventing stomach cancer. And we’re delighted that this latest study will provide new, long overdue treatment options for these patients.

“We hope that Docetaxel can be made available on the NHS as soon as possible to treat the disease.”

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Trial launch of urgently-needed combination treatment for oesophago-gastric cancer

Friday 17 August 2012

Cancer Research UK Press Release

Cancer Research UK’s Drug Development Office (DDO), in collaboration with academia and industry, has announced a new trial to open in Oxford. 

The trial will test an experimental drug from AstraZeneca in patients with advanced oesophago-gastric cancer – a disease for which no well-established standard treatments exist.

The Phase I national trial is the second study to open through the Experimental Cancer Medicine Centre (ECMC) Combinations Alliance initiative, which launched last year to run trials of the newest and most exciting combinations of cancer medicine for UK patients.

Cancer Research UK’s DDO is working in partnership with AstraZeneca and the ECMC network to provide strategic oversight and funding to the trial. AstraZeneca is providing the investigational drug AZD8931 and additional funding. Oxford University is sponsoring and managing the trial with support from the Oxford NIHR Biomedical Research Centre.

The trial will investigate whether combining the experimental drug AZD8931 with existing chemotherapy drugs, called oxalipatin and capecitabine, is more effective than treatment with chemotherapy alone.

Survival rates for patients with these cancers remain low, with less than 20 per cent of patients in England surviving for five years. Around 12,600 people in the UK die from these cancers each year.

Chief Investigator, Dr Anne Thomas, a clinical reader in the Department of Cancer Studies and Molecular Medicine at the University of Leicester and consultant oncologist at Leicester Royal Infirmary, said: “It’s wonderful news that this trial is opening, testing a promising new way to treat oesophago-gastric cancer.

“There still isn’t a standard treatment plan for these diseases and patients are often diagnosed at a late stage when there are fewer options available. So there’s an urgent need to innovate, and develop new and effective treatments.

“The opening of this trial brings fresh hope for the future and we’ll follow the results with great interest.”

Dr Ian Walker, head of alliance management at Cancer Research UK’s DDO, said: “We’re delighted to see the Combinations Alliance with AstraZeneca is now opening a second trial - demonstrating the value and importance of such collaborative partnerships. This trial is particularly important as oesophago-gastric cancers remain difficult to treat. It’s clear that without the Combinations Alliance this trial may never have taken place and this is an excellent example of what can be achieved through such collaborations.

“By combining molecularly-targeted experimental drugs developed and owned by the company with other treatments, we’re able to increase the options for patients and, we hope, save more lives in the future.”

AstraZeneca is the first pharmaceutical industry partner to join the initiative. The Combinations Alliance will be expanded to include more partners and establish cross-company agreements, providing patients with access to a larger number of potential combinations.

AZD8931 works by blocking a family of proteins called erbB which are found on the surface of cancer cells in the oesophagus and stomach. The erbB proteins tell cancer cells to carry on dividing. Turning off this signal will help kill the cancer cells.

Graham Richmond, project leader for AZD8931 at AstraZeneca, said: “It is increasingly evident that strategic partnerships such as this are highly valuable in determining the broader utility of new experimental compounds such as AZD8931 for patients with oesophago-gastric cancer. Through collaborations, we are able to explore the potential of combination therapies for cancer, building on our strong oncology heritage and at the same time tapping into external expertise.”

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Cancer Research UK launches trial of experimental drug combination for advanced stomach and oesophageal cancer

Friday 8 June 2012

Cancer Research UK Press Release

Cancer Research UK’s Drug Development Office (DDO) has joined forces with academia and industry to open a clinical trial that will test an experimental drug from AstraZeneca called AZD4547 in combination with standard chemotherapy to treat a group of patients with advanced stomach or oesophageal cancer.

This is the first study to open through the ECMC Combinations Alliance which launched last year. AstraZeneca is the first pharmaceutical industry partner to join the alliance, which aims to increase patient access to trials of potential new cancer treatments, combining molecularly-targeted experimental drugs developed and owned by the company with standard chemotherapy, radiotherapy and other new experimental drugs.

The Phase Ib/IIa clinical trial will be led from the Glasgow Cancer Research UK and Scottish Health Department’s Experimental Cancer Medicine Centre (ECMC) and the Cancer Research UK Glasgow Clinical Trials Unit at The Beatson West of Scotland Cancer Centre.

The trial is open for patients that have higher than usual amounts of a protein called fibroblast growth factor receptor-2 (FGFR2).

FGFR2 signaling controls cell growth and survival – and is often faulty in cancer cells, causing them to grow and divide beyond control. Studies have shown that patients with higher than normal levels of the FGFR2 gene tend to respond poorly to standard treatment approaches. It is hoped that adding AZD4547 will improve response to treatment by blocking FGFR2.

Chief investigator, Professor Jeff Evans at the University of Glasgow, said: “I’m delighted to see the launch of this trial, which will find out if a new combination of drugs could be used to treat patients with advanced stomach or oesophageal cancer.

“There are very few treatment options for advanced forms of these diseases and there’s an urgent need to develop new therapies.

“We hope this trial will be an important step forward in finding a more effective treatment approach – ultimately improving survival from these diseases – and we’ll be watching the trial results with great interest.”

Patients will receive the experimental treatment AZD4547 alongside the conventional chemotherapy treatment of a drug combination of cisplatin and capecitabine – also called ‘CX’.

In the initial part of the study, to find the correct dose of AZD4547 to give with the chemotherapy drugs, patients with other types of tumour will also be eligible to take part. This may lead on to potential studies in other tumour types in the future.

AstraZeneca is providing the investigational drug AZD4547 
and additional funding. Cancer Research UK’s Drug Development Office is also providing support.

Andrew Foxley, clinical programme director for AZD4547 at AstraZeneca, said: “AstraZeneca is committed to pushing new boundaries in oncology therapy and delivering medicines to broaden the options available to cancer patients and make a meaningful difference to their lives. We are pleased to collaborate with others through efforts such as the ECMC Combinations Alliance to help speed up the delivery of high-quality, targeted medicines to patients.”

Dr Ian Walker, head of alliance management at Cancer Research UK’s DDO, said: “The alliance enables UK patients to take part in important clinical trials of potential new treatment approaches – such as this trial for advanced stomach and oesophageal cancer – and will provide a huge boost to UK research in developing exciting new combination therapies.

“Our aim is to develop cross-company agreements to provide access to a larger number of potential combinations to help us beat cancer.

“We will take the model we’ve established with AstraZeneca forward by actively looking for additional partners who are interested in collaborating with us.”
 

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One in six worldwide cancers down to 'largely preventable or treatable' infection

Wednesday 9 May 2012

Around one in six worldwide cancers - two million new cases every year - are caused by infections, according to a French study.

Four particular infections - human papillomaviruses (HPV), Helicobater pylori and hepatitis B and C - were behind 1.9 million cancers, most of which were cancers of the cervix, stomach and liver.

The estimates, published in The Lancet Oncology, show that eighty per cent of these cases occur in less developed parts of the world, where measures to prevent and treat infections are not always widely available.

Lead authors Catherine de Martel and Martyn Plummer, from the International Agency for Research on Cancer, said: "Infections with certain viruses, bacteria, and parasites are one of the biggest and preventable causes of cancer worldwide. Application of existing public-health methods for infection prevention, such as vaccination, safer injection practice, or antimicrobial treatments, could have a substantial effect on future burden of cancer worldwide."

The researchers carried out a systemic analysis to estimate the proportion of cancers across the world that could be attributed to infection. For eight regions, they also calculated the proportion of new cancer cases that could have been prevented.

The group found that, overall, 16 in every hundred cancers worldwide in 2008 were infection-related, but this figure was three times higher in developing countries. The figures also varied widely from region to region, from 3.3 per cent in Australia and New Zealand, to 32.7 per cent in sub-Saharan Africa.

Cervical cancer accounted for half the infection-related cancer figures in women, with liver and stomach cancers accounting for 80 per cent of male cases.

Jessica Harris, health information manager at Cancer Research UK, said: "It's important that authorities worldwide make every effort to reduce the number of infection-related cancers, especially when many of these infections can be prevented."

In the UK, she said, infections are thought to be responsible for 3 per cent of cancers, or around 9,700 cases each year.

"Vaccination against HPV, which causes cervical cancer, should go a long way towards reducing rates of this disease in the UK. But it's important that uptake of the vaccination remains high. At a global level, if the vaccine were available in more countries, many thousands more cases could be prevented," she added.

Copyright Press Association 2012

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Genetic clues can separate stomach cancer into two distinct types

Monday 1 August 2011

Research from Singapore identifying genetic differences that distinguish two distinct types of stomach cancer could give clues for better ways to treat the disease.

Currently experts use a microscopic test to assess how tumour cells are arranged, describing them as either "intestinal" or "diffuse". But the Lauren classification, named after the doctor who first recognised the differences, is not precise enough to help doctors predict how patients will respond to different treatments.

The latest research from Duke-National University of Singapore Graduate Medical School looked at the genomes of stomach cancer cells grown in the lab to see if there were significant differences between samples.

Where the Lauren classification was clear, the analysis backed up the findings. But importantly, in cases where the cell grouping could not be distinguished with the traditional test, the genetic analysis was able to separate the cancers into two distinct groups.

The researchers also found that the two tumour types responded differently to chemotherapy treatment. The chemotherapy drugs 5-fluorouracil and oxaliplatin were more effective in treating intestinal tumours, while diffuse tumours responded better to the drug cisplatin.

The findings, published in the journal Gastroenterology, could in the future help doctors to select the most effective treatment for each patient.

Senior author of the study, Professor Patrick Tan, said: "Our study is the first to show that a proposed molecular classification of gastric cancer can identify genomic subtypes that respond differently to therapies, which is crucial in efforts to customize treatments for patients."

Nell Barrie, senior science information officer at Cancer Research UK, said "Doctors are moving away from a 'one size fits all' approach to treating each type of cancer, and this study suggests that it could be possible to tailor treatment for people with stomach cancer. It's only by understanding the biology of the disease that we can make sure each patient will get the treatment that works best for them in the future."

Copyright Press Association 2011

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Cancer Research UK launches groundbreaking research centre in Oxford

Tuesday 15 March 2011

Cancer Research UK Press Release

A new centre launched today (Tuesday) will cement Oxford’s place at the forefront of cancer research, and form one of the final links in a unique chain of Cancer Research UK Centres across the country.

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

The Oxford Cancer Research Centre is a partnership between Cancer Research UK, the University of Oxford and the Oxford Radcliffe Hospitals NHS Trust.

It will help set the pace for national and international progress in the understanding and treatment of a variety of cancers, including breast, skin, urological and gastrointestinal.

Collaboration will be the key to the success of the centre, as it will bring together and build on Oxford’s existing world-class research in many areas of cancer medicine, from identifying the causes of cancer to improving diagnosis and treatment of the disease.

The centre will carry out research on the molecular basis of cancer, as well as work on understanding the genetic and lifestyle factors that can increase the risk of cancer.

Other research strengths will include new methods for improving cancer diagnosis, and finding new ‘biomarkers’ to predict the effect drugs have on patients.

The latest developments in radiotherapy and surgery will be brought together with clinical trials of new drugs, providing the best evidence to guide the treatment of cancer.

Professor Gillies McKenna, director of the Gray Institute for Radiation Oncology and Biology, and head of the Department of Oncology said: “With 2011 designated as the Year of Radiotherapy, there is increased recognition that greater access to this treatment is vital to improving cancer survival.

“Cancer Research UK has long been committed to improving radiotherapy through research, by supporting the Gray Institute in Oxford. The Institute has the world’s largest group of clinicians and scientists working in radiation oncology, and the Oxford Cancer Research Centre will help provide the vital infrastructure to help translate these discoveries into benefits for patients.”

Michael Kinane, 70, from Bicester, was diagnosed in September 2010 with bowel cancer which had spread to the liver.

He began his treatment with radiotherapy for the bowel tumour to relieve symptoms. He then received another form of radiotherapy in combination with chemotherapy to treat the spread of cancer to his liver.

He is being treated at the Oxford Cancer Research Centre, in one of the clinical trials developed by the Gray Institute for Radiation Oncology and Biology at the University of Oxford and supported by the Bobby Moore Fund for Cancer Research UK.

The trial – known as FOXFIRE - is testing a new treatment called radio-embolisation, a form of internal radiotherapy that uses the tumour’s blood supply to target multiple sites of disease within the liver.

Radiotherapy is already a well-established treatment in bowel cancer. This new way of administering high-dose radiation therapy directly into the blood supply of the cancer could be even more effective at treating bowel cancer which has spread to the liver, when combined with chemotherapy.

“Being part of the trial has been amazingly simple and I feel very fortunate to have had the opportunity of being given another treatment,” said Michael. “I hope that taking part in this trial will help more people like me in the future. I’ve been lucky to benefit from the excellent research which already takes place in Oxford and it’s good to know that this will become even better with the new Centre.”

Sir Jonathan Michael, chief executive of the Oxford Radcliffe Hospitals NHS Trust, said: “This is an exciting development for our cancer patients. Patients will benefit from the close working relationship between the Trust and the University. We want to ensure that research is translated into treatment for patients in order to prolong and improve their quality of life.”

The Oxford Cancer Research Centre is the 16th Cancer Research UK-funded centre and will be funded by Cancer Research UK to the tune of £2.8 million in the first year.

Professor Alastair Buchan, head of the medical science division at the University of Oxford, said: “The University of Oxford is delighted to join the Cancer Research UK Centre’s Initiative. The Centre will help bring together the extensive community of outstanding cancer researchers in Oxford, acting as a nucleus for researchers, doctors and patients to engage with each other. It will ensure optimal translation of fundamental research into patient benefit, and will train the next generation of world-leaders in cancer detection, treatment and prevention.”

Harpal Kumar, chief executive of Cancer Research UK, said: "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 across all types of cancer.

“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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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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Stomach cancer deaths lowest for forty years

Thursday 24 June 2010

Cancer Research UK Press Release

Deaths from stomach cancer are the lowest since UK records began nearly 40 years ago, according to new Cancer Research UK figures released today (Thursday).

Figures from 1971 show there were more than 14,100 deaths from stomach cancer. This has dropped to fewer than 5,200 in 2008.

In 1971 there were 22.3 deaths for every 100,000 people in the UK and this has dropped to 5.5 per 100,000 in 2008. 

The drop in stomach cancer deaths reflect the dramatic fall in the number of people being diagnosed with the disease over the last 40 years.

The number of cases has dropped as living conditions have improved. Infection with the common bacteria Helicobacter pylori (H. pylori), smoking and diet are three key risk factors for stomach cancer.

Better living conditions with less overcrowding has led to a decrease in H. pylori infection. Cancer Research UK researchers first revealed the link between H. pylori and stomach cancer in studies in rural China in 1990 and in middle-aged men in England and Wales in 1991.

Dr Lesley Walker, Cancer Research UK’s director of cancer information, said: "These figures are fantastic news showing fewer people are now dying from stomach cancer. But with more than 5,000 deaths from the disease every year, more work needs to be done to raise awareness of how to reduce the risk of stomach cancer and improving the outcome for patients.

"Smoking doubles the risk of developing the disease with around one in five stomach cancers in Europe caused by smoking. A poor diet also increases the risk as does a family history of the disease. Persistent indigestion should be reported to the doctor as it can be a sign of stomach cancer."

A healthy diet high in fruit, veg and fibre and low in red and processed meat and salt helps reduce the risk of many different cancers.

Stomach cancer is the seventh most common cause of cancer death and accounts for around three per cent of all cancer deaths in the UK. More men die from stomach cancer with around 3,200 deaths every year and nearly 2,000 stomach cancer deaths for women.

Professor Peter Johnson, Cancer Research UK’s chief clinician, said: "The falling number of people developing stomach cancer is further evidence of the important positive effects that improved living conditions and stopping smoking can have. A key to further reducing the number of people who die from the disease is improvements to treatment. Early diagnosis is critical with surgery being the main treatment for stomach cancer when it is diagnosed early enough. Research is taking place across the UK looking at better chemotherapy combinations and biological drugs to help patients."
 

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Scientists take the first step to targeted treatment for stomach cancer

Wednesday 12 August 2009

Cancer Research UK Press Release

Researchers have identified a protein that plays an important role in the development of stomach cancers and that could one day be a target for new treatments for the disease, according to research published today* (Wednesday) in the British Journal of Cancer.

Scientists based at the  Chinese University of Hong Kong explored the role of a protein called RAMP in stomach cancer cell lines and tissues, finding that it is more common in these cells compared to surrounding normal tissues.

The increased presence of RAMP suggests that this protein may play a pivotal role in the multi-step development of stomach cancer. Higher levels of the protein were seen in the very early stages of stomach cancer and were also present throughout the development of the disease. To add further evidence to RAMP's role in this cancer they found that the protein also encouraged cells to grow, fuelling the disease further.

This is the first study to establish a possible link between RAMP and stomach cancer and could help doctors to gain a better understanding of the disease, leading to more effective treatments.

Next the scientists proceeded to 'knock out' RAMP's function in two human gastric cancer cell lines. This slowed down the growth of the cancer in these cell lines and even led to cell death.

It is hoped that these findings could be the first step to developing a new approach to treating stomach cancer by developing treatments that 'switch off' RAMP. This could halt the growth of these tumours and even reduce tumour size.

Study author Dr WK Leung said: "We have established for the first time the role that RAMP plays in stomach cancer. Working out a role for RAMP in stomach cancer gives us more information about the common, but poorly understood steps that lead to the development of this cancer.

"We're very excited about with these results. The next stage of our research will aim to discover more about RAMP's specific role in stomach cancer and begin exploring the possibility of developing new drugs that can stop RAMP in its tracks."

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: "This interesting study helps us understand more about the mechanisms behind the development of stomach cancer. One of the reasons that survival rates for stomach cancers remain low is because they are often at an advanced stage when diagnosed, so making it harder to treat successfully. We welcome new research that could one day help those with stomach cancer face a better prognosis."

In the UK more than 7,700 people are diagnosed with stomach cancer each year, with 95 per cent of cases among the over 50's. Over the last 25 years five-year survival rates have tripled in the UK, but the disease remains very difficult to treat successfully and five year survival is still low at around 15 per cent.

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Stomach cancer cases almost halve over the last 30 years

Thursday 6 August 2009

Cancer Research UK Press Release

Cancer Research UK figures out today reveal that stomach cancer cases in Great Britain have dropped by nearly half from around 14,000 in 1975 to 7,485 in 2006.

Cases in women have dropped by more than half from around 5900 in 1975 to around 2650 in 2006. And cases in men have nearly halved, dropping from their peak of nearly 8300 cases in 1980 down to around 4800 cases in 2006.

The number of cases has dropped as lifestyles have become healthier. Infection, smoking and diet are three key risk factors for stomach cancer.

A common stomach bacterium called Helicobacter pylori (H. pylori) is the major cause of stomach cancer. Better living conditions with less overcrowding has led to a decrease in H. pylori infection. It is the decrease in infection that is thought to be a major reason for the fall in cases of stomach cancer.

Cancer Research UK researchers first revealed the link between H. pylori and stomach cancer in studies in rural China in 1990 and in middle-aged men in England and Wales in 1991.

Refrigeration has also had a major impact on reducing cases of stomach cancer. Keeping food cool meant that fresh food could be kept longer and fewer additives were needed to preserve food.

A poor diet low in fruit and vegetables and high in salt also increases the risk of stomach cancer as does a family history of the disease.

Smoking doubles the risk of developing the disease with around one in five stomach cancers in Europe caused by smoking.

Smoking rates have also fallen over the last 30 years. In the early 1970s around 50 per cent of men and around 40 per cent of women smoked. Today the figure for men is around 22 per cent and 20 per cent for women.

Stomach cancer is the seventh most common cause of cancer death with more than 5200 people dying from the disease every year.

Dr Lesley Walker, Cancer Research UK director of cancer information, said: "These figures illustrate that stomach cancer is largely preventable. Healthier living conditions, fewer infections, better diets and lower smoking rates mean fewer people are developing the disease. More cases can still be prevented.

"It's important that people know how to reduce their risk of the disease. Fruit and vegetables have a protective effect against stomach cancer and people with diets high in salt have an increased risk. A healthy diet high in fruit, veg and fibre, low in red and processed meat and salt helps reduce the risk of not just stomach cancer but many different cancers."

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Aspirin cuts stomach cancer risk

Friday 6 February 2009

Cancer Research UK Press Release

Aspirin users could be 36 per cent less likely to get a type of stomach cancer, according to a study published in the British Journal of Cancer*.

In a study of over 300,000 people, the researchers found that people who had taken aspirin at least once in the previous year were significantly less likely to get non-cardia gastric cancer - cancer of the middle or lower parts of the stomach.

There was also a 32 per cent reduction for the same type of stomach cancer in people who used other types of non-steroidal anti-inflammatory drugs - or NSAIDs.

In contrast to results of previous studies, the researchers found that aspirin does not protect against oesophageal cancer and cardia gastric cancer, which is cancer of the top of the stomach**.

Taking aspirin regularly has been found to cut the risk of bowel cancer, but it is not currently recommended because side effects could include bleeding within the abdomen.

Now, scientists believe that placebo controlled trials, which would assess risks and benefits should be conducted to see if NSAIDs can be used to protect against stomach and oesophageal cancers. Five year survival rates for these cancers are 15 and 8 per cent in the UK respectively, so research in how to prevent the disease is important.

Study author Dr Christian Abnet, based at the National Cancer Institute in America, said: "We found that the risk of non-cardia stomach cancer was lower in people who had taken aspirin, and this risk lowered the more regularly they took it. Interestingly, our results didn’t show a significant cut in the risk of oesophageal or cardia stomach cancer, so it's important that we continue to review data that suggests otherwise.

"The number of people who survive at least five years following a diagnosis of stomach or oesophageal cancer is low, so it's important to increase our understanding of ways to prevent the disease and to investigate aspirin as a possible preventative drug."

The rate of non-cardia stomach cancer calculated in this study was 7 per 100,000 person-years*** for aspirin users, compared with 11 per 100,000 person-years for non-users.

The figures were calculated from a study of more than 311,000 people in America and an analysis of 17 published studies on the topic.

Each year in the UK, around 8,000 people are diagnosed with stomach cancer, and around 5,250 people die from the disease.

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: "It's far too early to recommend that people take aspirin to protect themselves from these cancers. In cancers where survival is low, understanding how to prevent the disease is crucial, but more research is needed to discover how side effects can be balanced with the benefits. Cancer Research UK would urge people to speak to their doctor before taking aspirin regularly."

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One in ten trusts has shortage of specialist oesophageal and stomach cancer surgeons

Thursday 16 October 2008

One in ten NHS hospital trusts in England and Wales does not have the minimum three surgeons required to provide care for patients with oesophageal (gullet) and stomach cancers, new figures show.

Oesophageal cancer is now the ninth most common adult cancer in the UK, with around 7,800 cases diagnosed every year. A similar number are diagnosed with stomach cancer.

Hospital trusts were meant to have met the target of at least three specialist surgeons by December 2007.

In September 2007, 39 out of 63 trusts had fewer than three specialist surgeons and this figure had improved to eight trusts within three months.

However, new figures from the three-year National Audit show that some trusts have still not met the target, meaning that lives may be placed at risk.

Report co-author Richard Hardwick, consultant surgeon and lead clinician for upper GI cancer for the Association of Upper GI Surgeons (AUGIS), told the BBC that the type of surgery required is "complicated" and patients must be constantly monitored by a specialist.

He said: "If you are going to provide a comprehensive service it is almost impossible to do with two surgeons.

"Three specialist surgeons is the absolute bare requirement. Otherwise you are getting by on a wing and a prayer."

Professor Peter Johnson, Cancer Research UK's chief clinician, said that the findings highlight the importance of specialist treatment centres and support services.

"We know that results are better in those centres which have been able to do this, and good progress has been made in many places in the UK," he revealed.

"Oesophago-gastric cancer is often diagnosed late, and until recently the results of treatment have not been good, although trials using chemotherapy are showing promise.

"We are confident that with further effort to concentrate expertise we can make progress faster in the future."

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Chance of surviving gut cancers up 40 per cent in two decades

Tuesday 7 October 2008

Cancer Research UK Press Release

Cancer patients in England are 40 per cent more likely to survive for at least a year after diagnosis of stomach and oesophageal cancer than they were in the eighties, according to latest figures revealed at the National Cancer Research Institute (NCRI) Cancer Conference in Birmingham today (Tuesday).

Experts say that one important factor in this significant increase in survival is improved early diagnosis of these cancers, which is important for treatment to be successful. Stomach and oesophageal cancers have been hard to diagnose as the symptoms of the diseases are often a sign of conditions other than cancer.

Improvements in treatment have also played a part, including the shift to surgery by experts in specialist centres and the introduction of chemotherapy for advanced disease.

The figures also show that early detection of breast cancer has led to 95 per cent of patients surviving for more than one year following diagnosis.

The report, published by the National Cancer Intelligence Network (NCIN), looked at one-year survival for all cancers* in over 3.5 million cancer patients recorded by English cancer registries between 1985 and 2004.

Despite more people being diagnosed with cancer in England since the 1980s - due to the ageing population - there has been a fall in the number of deaths. In the five years in the late 1980s, around 840,000** people were diagnosed with cancer and 56 per cent survived beyond a year after diagnosis. In the five years from 2000, over a million people were diagnosed in a five year period with the disease, but 67 per cent survived beyond a year.

Professor David Forman, information lead at the NCIN based at the University of Leeds, said: "Increases in one-year survival rates are a useful signpost - for many types of cancer, they suggest that the disease is being diagnosed at an earlier stage, which is vitally important in treating the disease successfully.

"It's really positive that survival rates for stomach and oesophageal cancer have significantly increased, because they're cancers that are usually diagnosed very late - too late to cure."

One year survival for stomach cancer went from 27 per cent in the 80s to 38 per cent in the 00s - an increase of 11 per cent. And one year survival for oesophageal cancer went from 25 to 36 per cent in the same period.

In addition, one-year survival for all of the most common cancers increased significantly in twenty years. Although survival did not decrease for any cancer***, rates for cervix, Hodgkin disease and a group including eye, brain and CNS cancers stayed relatively constant.

Marked increases in survival were also seen for breast, ovary and bowel cancer.

Professor Forman continued: "One-year survival has significantly increased for around 75 per cent of cancers. Most of the rest have shown small improvements but clearly there is more work needed to improve the detection of some cancers."

One-year breast cancer survival has increased by six per cent in the last two decades, meaning 95 per cent of women will survive at least a year after diagnosis. This is a clear indication of greater awareness of the disease in patients and GPs, leading to faster referrals of cancer patients to specialist doctors. And the breast cancer screening programme has helped pick up the disease earlier - survival rates jumped in the early 90s following the introduction of the screening programme in 1988.

Sara Hiom, director of health information at Cancer Research UK, said: "Early detection of cancer is vital in ensuring the disease is successfully treated. It's important that people are aware of the signs and symptoms of cancer and they go for screening when invited. Cancer Research UK is investing in research to improve early detection of the disease and is working with GPs to provide relevant information to help this."

ENDS

For media enquiries please contact the Cancer Research UK press office on 020 7061 8300, or the out-of-hours duty press officer on 07050 264059.

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Removal of bacteria reduces risk of stomach cancer redeveloping

Friday 1 August 2008

Treating any Helicobacter pylori infection in the stomachs of people who have been treated for gastric (stomach) cancer appears to reduce the risk of cancer redeveloping, a Japanese study has found.

The bacterium Helicobacter pylori (H. pylori) has been classified as a group I carcinogen for stomach cancer by the World Health Organisation, and studies have suggested that infection with the bacterium increases stomach cancer risk up to five-fold.

But it is not yet known for certain that treating the infection reverses this increase.

To investigate the effects of treating H. pylori, a team of researchers at Hokkaido University Graduate School of Medicine and the Japan Gast Study Group carried out a study involving 544 patients.

They found that treating H. pylori infection decreased the incidence of further 'metachronous' stomach cancers in patients who have previously been operated on for the disease.

Metachronous stomach cancers are cancers that develop at a new site in the stomach, but do not actually develop directly from the original cancer.

A total of 272 patients were treated with lansoprazole to reduce the production of stomach acid, and the antibiotics amoxicillin and clarithromycin to eradicate H. pylori, while the remaining 272 received no such treatment.

Publishing their findings in the Lancet medical journal, the researchers reveal that after three years, 24 patients in the untreated group had developed metachronous gastric cancer, compared with just nine patients who had been treated to remove the bacteria.

The researchers concluded: "The results of our study suggest that treatment to eradicate H. pylori reduces the risk of developing new gastric carcinoma in patients who have a history of such disease and are thus at risk for developing further gastric cancers.

"We believe that our data add to those from previous studies showing a causal relationship between H. pylori infection and gastric cancer, and also support the use of H. pylori eradication to prevent the development of gastric cancer."

Writing in an accompanying editorial, Dr Nicholas Talley from Florida's Mayo Clinic said that preventing gastric cancer by eradicating H. pylori "should be a priority".

Henry Scowcroft, science information manager at Cancer Research UK, said: "This result adds to our understanding of the relationship between H. pylori and stomach cancer, and to the debate on how we should treat people with this infection.

"Cancer Research UK is helping fund a long-term trial specifically looking at whether treating H. pylori can prevent stomach cancer. The trial aims to recruit 56,000 people across the UK, treat any who show signs of H. pylori infection, and follow them over 15-20 years to see if this treatment is effective."

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Study confirms link between inflammation and bowel and stomach cancer

Wednesday 4 June 2008

New research has provided evidence for the long-suspected link between chronic inflammation of the intestine or stomach, and cancer.

Two studies published in the Journal of Clinical Investigation show that chronic inflammation accelerated the rate of formation of tumours in a strain of mice that had been bred to have an impaired DNA repair system.

Inflammation is known to produce immune response chemicals called cytokines, which encourage the multiplication of cells and block the natural process of cell death - a key natural defence against cancer.

However, some people appear to be more susceptible to inflammation-induced cancers than others, and this is now thought to be due to genetic variations that govern the effectiveness of their DNA repair systems.

If DNA repair systems do not work effectively, mutations can accumulate as cells multiply naturally, leading to cancer.

Leona Samson, senior author of the study and director of MIT's Centre for Environmental Health Sciences (CEHS), said: "[Genetic] variation could influence the susceptibility of individuals and how they are going to respond to chronic inflammation."

The researchers gave mice a chemical that creates chronic inflammation similar to ulcerative colitis (a form of inflammatory bowel disease) and found that mice which had been bred to have a poor DNA repair system were more likely to develop cancer.

In a second study, these DNA repair-deficient mice infected with Helicobacter pylori - an infectious agent that causes inflammation and increases the risk of stomach cancer - were shown to be more susceptible to pre-cancerous stomach growths.

Lead author Lisiane Meira, a researcher in MIT's Centre for Environmental Health Sciences, commented on the link, saying: "It's something that was expected but it was never formally proven."

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Stomach cancer rates to fall

Wednesday 15 August 2007

Researchers in the Netherlands have predicted that cases of stomach cancer will fall by 25 per cent in western countries over the next ten years.

The research, published in Gut, looked at the number of people diagnosed with conditions that frequently precede stomach cancer - displasia, intestinal metaplasia and atrophic gastritis - over a 14-year period.

Over the course of the of the study, the researchers found that new cases of intestinal metaplasia fell by 2.4 to 2.9 per cent each year, and dysplasia and atrophic gastritis fell by eight per cent each year.

These results allowed the scientists to calculate the rate of decline for stomach cancer in the upcoming years.

The authors of the study have attributed this decreasing rate to the fall in the number of cases of gastric inflammation caused by Helicobacter pylori infection.

The Helicobacter pylori bacterium is thought to cause inflammation that makes the stomach more susceptible to cancer. As the rates of infection have fallen, so have the rates of stomach cancer.

Stomach cancer is the fourth most common cancer in the world, with around 5,700 cases diagnosed in the UK each year.

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Possible new treatment for stomach cancer

Friday 7 July 2006

A combination of pre and postoperative chemotherapy has been found to improve the survival rates of patients with stomach cancer over those who receive only surgery. The researchers, led by David Cunningham, an oncologist at the Royal Marsden Hospital, studied 503 patients and their findings were published in this week's New England Journal of Medicine. They used a regimen of epirubicin, cisplatin, and infused fluorouracil (ECF). Chemotherapy consisted of three preoperative and three postoperative cycles of intravenous epirubicin and cisplatin on day one, and a continuous intravenous infusion of fluorouracil for 21 days. Dr Cunningham hoped to show that using preoperative chemotherapy would kill hidden tumor cells to reduce the risk that the cancer would spread after surgery. It was also hoped tumours would be made smaller. The results showed that those who received chemotherapy had a 36 per cent survival rate in compared to 23 per cent for those who only received surgery. The tumours of those who received chemotherapy were also significantly smaller and less advanced. "This is the first time we've been able to demonstrate that chemotherapy alone significantly improves outcome," Dr Cunningham told Reuters.

For more information about stomach cancer, visit the CancerHelp UK website

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Stomach cancer genes identified

Tuesday 16 May 2006

Irish researchers have identified two genes that appear to be involved in the development of stomach cancer.

While the research remains in its earliest stages, if further studies confirm the results, the discovery could lead to progress against the disease.

Examining thousands of tissue samples, scientists at the University College Dublin identified two genes, NET1 and MYEOV, that were both "switched on" in tissue from stomach tumours.

"When we compared the normal lining of the stomach to stomach cancer we saw this gene was 'up'," researcher Dr Peter Doran told the Times.

The study also suggested that the NET1 gene seems to be instrumental in allowing cancer cells to enter the lining of the stomach or colon.

Once cancer cells reach the lining , it is easy for tumours to spread throughout the body, with often fatal results.

"When we have taken cancer cells and switched off the NET1 gene, we found that the cancer cells don't invade. That is a hugely significant finding," said Dr Doran. "We have tried for so long to kill these tumours and this is giving us a little opening. We are trying to push that door completely open and identify how to stop this gene working to cause disease."

The study is published in the British Journal of Cancer, which is owned by Cancer Research UK.

Read the paper online

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Salt increases risk of stomach cancer

Tuesday 6 January 2004

Cancer Research UK Press Release

People who eat a regular diet of highly salted food double their risk of stomach cancer according to a report published in the British Journal of Cancer¹.

A study based on around 40,000 middle-aged Japanese examined dietary, drinking and smoking habits over an 11 year period.

The study shows that the risk of stomach cancer for Japanese men with the lowest salt intake was one in 1000 per year. This doubled to one in 500 among those with the highest salt intake.

For women with a low salt intake the risk was one in 2000 which rose to one in 1300 for those whose diet was high in salt.

Gastric or stomach cancer is the second most frequent cause of cancer deaths world wide with an estimated 776,000 deaths in 1996. It is the fourth most common cancer in the world; in the UK stomach cancer is the sixth most common cancer with 10,000 new cases each year.

Scientists from the National Cancer Centre Research Institute in Kashiwa, near Tokyo, studied questionnaires detailing the diets of men and women in four districts of Japan (Iwate, Akita, Nagano and Okinawa).

Out of 18,684 men studied a total of 358 cases of stomach cancer were reported while 128 cases of the cancer were found in 20,381 women.

Dr Shoichiro Tsugane, who led the study, says: "Although there is a steady decline in its incidence, gastric cancer is still the most common form of cancer in Japan. In addition to salt intake our study also shows that smoking and low consumption of fruit and vegetables increases the risk of stomach cancer particularly in men."

Scientists know that high salt intake can induce atrophic gastritis which is a precursor to stomach cancer. Salting, pickling and smoking are traditionally popular ways of preparing food in Japan. Pickled vegetable and noodles are rich in sodium and low in vitamin C.

As the Japanese diet has become increasingly westernised there has been a noticeable drop in the rates of stomach cancer but an increase in the rates of brewast and bowel cancers, emphasising the role of diet in the disease.

Dr Tim Key, an epidemiologist for Cancer Research UK which owns the British Journal of Cancer, says: "This study shows strong associations of stomach cancer with the intake of highly salted Japanese foods including salted fish and pickled vegetables. What we don't know is whether it is specifically the salt in these foods that can cause cancer or a combination of salt and other chemicals.

"In Britain, stomach cancer rates are much lower than in Japan and these types of highly salted foods are not widely consumed. But limiting salt intake is also important for reducing the risk for high blood pressure and cardiovascular disease."

"The study underlines the importance of limiting salt intake in our daily diet not only to reduce the risk of stomach cancer but also to protect against heart disease."

ENDS

1. British Journal of Cancer90 (1)

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Scientists point way to screening for inherited stomach cancer

Friday 24 May 2002

Cancer Research UK Press Release

Genetic screening could soon offer hope for families affected by an inherited form of stomach cancer, following research published this week by Cancer Research UK scientists¹.

Researchers have found that a rare form of stomach cancer - affecting 200 people in the UK each year - is often caused by the inheritance of a faulty gene. They were able to detect the damaged gene in a third of families with a history of the disease.

Screening in this way could save lives, by giving affected people the chance of life-saving pre-emptive surgery. And understanding how the damaged gene causes stomach cancer will give scientists vital information about more common, non-inherited forms of the disease.

Of the 10,500 cases of stomach cancer in the UK each year, about 10 per cent run in families. The disease normally affects the over sixties, but inherited forms strike much earlier, usually before the age of 40. Since survival is very poor, it's vital that scientists identify those at highest risk and try to prevent the disease.

Dr Carlos Caldas and his team at the Cancer Research UK Department of Oncology, Cambridge University, studied a form of the disease called hereditary diffuse gastric cancer (HDGC). Researchers looked at 39 families with a history of stomach cancer from nine different countries, including the UK. Eleven of the families were affected by HDGC while the rest had various other inherited types.

Scientists took blood samples from several cancer patients in each family and used them to analyse the E-cadherin gene, which is involved in helping cells bind together in tissues. When it goes wrong, cancers like HDGC, in which tumour cells spread rapidly outwards, can develop.

In four of the 11 HDGC families, the patients had faulty versions of the E-cadherin gene. But none of the patients with other forms of stomach cancer had the fault, suggesting that it is exclusive to this particular type.

Dr Caldas says: "People with a faulty E-cadherin gene have a 60-80 per cent chance of developing stomach cancer at some stage of their life, with many getting it very young. It's not an easily treated disease and survival is very poor."

"But if we can screen for the damaged gene, those affected could have surgery to prevent the disease. This may be a difficult option to take, but it's preferable to having a very high chance of dying young from cancer."

Researchers estimate that about 200 people develop HDGC in the UK each year. The majority of these will have the disease in their family, which means that they could easily be identified as being eligible for screening.

Dr Caldas says: "We know that the gene is damaged in about a third of HDGC families, but apparently in none with other forms of inherited stomach cancer. That makes it simpler to screen because you've got a self-selecting target group and a high chance of a positive test."

Dr Caldas now intends to extend his research to look at other genes that may increase the risk of stomach cancer. He hopes that the success of his current work will encourage people with a family history of the disease to volunteer themselves for large scale clinical studies.

Many of the same genes responsible for inherited cancers also go wrong within tumours in non-hereditary forms of the disease, which means that the new results could have wide-ranging implications.

Sir Paul Nurse, Interim Chief Executive of Cancer Research UK, says: "Often genes which go wrong in hereditary cancers can play an important role in other forms of the disease as well. Learning more about the way these genes work is therefore vital for the better understanding of cancer."

He adds: "This work is extremely important, because it offers a way of testing for those at very high risk of stomach cancer. It's a very difficult disease to cure so prevention is a much more attractive option."

ENDS

1. Human Mutation19 (5) pp. 510-517

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