ESMO calls for oncology-specific safeguards in EU joint clinical assessments of medical and in vitro diagnostic devices in the new EU public consultation

The European Society for Medical Oncology (ESMO) has compiled a detailed response to the European Commission's public consultation draft regarding Implementing Regulation for Joint Clinical Assessments of medical and in vitro diagnostic devices.  The 4 key strategic priorities noted in the framework include systematic inclusion of oncology expertise, structured stakeholder involvement, proportional and feasible evidence requirements, and clear and consistent guidance on comparators and outcomes. 

To learn more and read the full submission, click here. 

Incidence rates for most local and regional stage cancers declined during first year of COVID-19

 A new report, recently published in the International Journal of Cancer, indicates that during the first year of COVID-19, "cancer incidence rates declined for almost all cancer types."  While these findings, which also explored impact of COVID-19 pandemic on cancer incidence rates by stage at diagnosis, as well as race and ethnicity, can be attributed to suspension of healthcare during this time, study authors emphasize the importance of "strengthening the return to preventive care campaigns and outreach for detecting cancers at early and more treatable stages." 

To read more about this study, click here. 

Source mentioned: Schafer EJ, Islami F, Han X, Nogueira LM, Wagle NS, Yabroff KR, Sung H, Jemal A. Changes in cancer incidence rates by stage during the COVID-19 pandemic in the US. Int J Cancer. 2023 Nov 16. doi: 10.1002/ijc.34758. Epub ahead of print. PMID: 37971377.

Prognostic role of ctDNA in patients with surgically resectable colorectal cancer

 Results from GALAXY, part of the CIRCULATE study from Japan, analyzing circulating tumour DNA (ctDNA) was recently published in Nature Medicine.  Investigators from GALAXY demonstrated that "postsurgical ctDNA status is a most significant prognostic biomarker than the currently used high-risk clinicopathological features in resectable colorectal cancer and can potentially be predictive of adjuvant chemotherapy benefit."  The study authors thus believe that incorporating postsurgical ctDNA into TNM staging criteria can be further developed as a result of findings from GALAXY. 

To read more about this study, click here. 

Source mentioned: Kotani D, Oki E, Nakamura Y, Yukami H, Mishima S, Bando H, Shirasu H, Yamazaki K, Watanabe J, Kotaka M, Hirata K, Akazawa N, Kataoka K, Sharma S, Aushev VN, Aleshin A, Misumi T, Taniguchi H, Takemasa I, Kato T, Mori M, Yoshino T. Molecular residual disease and efficacy of adjuvant chemotherapy in patients with colorectal cancer. Nat Med. 2023 Jan;29(1):127-134. doi: 10.1038/s41591-022-02115-4. Epub 2023 Jan 16. PMID: 36646802; PMCID: PMC9873552.

New study shows cancer mortality higher among American Indian and Alaska Native individuals

 A new study recently released by the American Cancer Society indicates that "cancer mortality among American Indian and Alaska Native individuals is 18% higher than among White individuals despite similar cancer incidence."  The study is the first U.S. nationwide mortality data that has been published for this demographic and explains that the "disparity is driven by common cancers that are receptive to early detection."  Thus, breast and prostate cancer incidence rates are 15% and 12% lower, but 7% and 31% higher mortality rates.  Further, mortality rates for infection-related cancers, including liver, stomach, cervix, and kidney, were twice the rate among American Indian and Alaska Native groups compared to White individuals. 

To read more about this study, click here. 

Source mentioned:  Kratzer TB, Jemal A, Miller KD, et al. Cancer statistics for American Indian and Alaska Native individuals, 2022: Including increasing disparities in early-onset colorectal cancer. CA Cancer J Clin. 2022;1‐27. https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21757

New study shows recently diagnosed adult cancer survivors at higher risk for bone fractures

 A new study conducted by the American Cancer Society indicates that adult cancer survivors, especially those diagnosed within 5 years and/or treated with chemotherapy, "have an increased risk for bone fractures, specifically pelvic and vertebral fractures, compared to older adults without cancer." These findings were further correlated with levels of physical activity and smoking status; active adults had a lower risk of bone fractures, whereas smoking among survivors lead to an increased risk of bone issues. The study, conducted on 92,431 participants over 20 years (1997-2017) unveiled 12,943 with bone fractures.  

To read more about this study, click here. 

Early cancer detection with blood test may change cancer screening paradigms

New data from a study conducted in France suggests that multi-cancer early detection (MCED) tests (currently in development) have the ability to determine common cancer signals from over 50 different types of cancer.  Known as PATHFINDER, the MCED test "detected a cancer signal in 1.4% of 6621 people aged 50 years and over who were not known to have cancer, and cancer was confirmed in 38% of those with a positive test. Of 6290 people who were cancer free, 99.1% received a negative test result." 

To read more about this study, click here. 

Sources mentioned:  

Abstract 903O ‘A prospective study of a multi-cancer early detection blood test’ will be presented by Deb Schrag during the proffered paper session “Basic science and translational research” on Sunday, 11 September, 16:30 to 18:00 CEST in Orléans Auditorium. Annals of Oncology, Volume 33 Supplement 7, September 2022

Swanton C, Neal RD, Johnson PWM et al. NHS-Galleri Trial Design: Equitable study recruitment tactics for targeted population-level screening with a multi-cancer early detection (MCED) test. J Clin Oncol 2022; 40(16) suppl. 

First study examining mental illness and self-harm events across 26 cancer types

 Recently published findings in Nature Medicine studied risk of unnatural death following self-harm amongst 459,542 cancer patients diagnosed with 26 different types of cancer.  Due to psychological distress and depression experienced by cancer patients, the study authors concluded that the self-harm "prevalence ratio is higher among younger individuals, as they are more likely to be referred for specialized psychosocial cancer care."  In particular, the study further revealed the patients with co-occurring were mostly likely to cause self-harm to themselves during the first 12 months of a cancer diagnosis. 

To read more about this study, click here.  

Source mentioned: Chang WH, Lai AG. Cumulative burden of psychiatric disorders and self-harm across 26 adult cancers. Nature Medicine; Published online 28 March 2022. DOI: https://doi.org/10.1038/s41591-022-01740-3

Cure probability models for evaluation of patients with a previous cancer diagnosis for solid organ transplantation

 A recently published study conducted in the Division of Cancer Epidemiology and Genetics at the National Cancer Institute in Bethesda, Maryland, United States reported on the use of statistical models to calculate cure probabilities for 17 different types of cancer.  These models were applied to patients "with a previous cancer who underwent solid organ transplantation to estimate the probability that those patients had been cured of their cancer at the time of transplantation." Study results shows that of the 5,425 patients studies who went through solid organ translation, the median cure probability at transplantation was 94%. 

To read more about this study, click here. 

Study mentioned: Engels EA, Haber G, Hart A, et al. Predicted Cure and Survival Among Transplant Recipients With a Previous Cancer Diagnosis. JCO; Published online 22 October 2021. DOI:10.1200/JCO.21.01195

PICOS score can help in identifying patients with brain metastases at high risk for VTEs

A recent study conducted within the Department of Neurology at University Hospital in Zurich, Switzerland, determined that applying the PICOS (primary, immobilization, chemotherapy, obesity, steroid) score is more effective than current venous thromboembolism (VTE) risk estimation models for cancer patients.  Of the 811 patients with brain metastases analyzed in this study, 97 (12%) experienced VTE.  As a result of these findings, the authors concluded that PICOS "may be useful for stratification in controlled studies...to identify patients with brain metastasis at high risk for VTEs."

To read more about this study, click here.

Study mentioned:

Wolpert F, Berghoff AS, Grossenbacher B, et al. Venous thromboembolic events in patients with brain metastases: the PICOS score. European Journal of Cancer2020; 134:P75-85. DOI: https://doi.org/10.1016/j.ejca.2020.04.018. 

AI detects breast cancer as accurately as expert radiologists, study finds

Researchers in the United States and Britain recently reported that Google DeepMind, an artificial intelligence (AI) system, "proved as good as expert radiologists at detecting which women had breast cancer based on screening mammograms and showed promise at reducing errors."  According to the American Cancer Society, radiologists miss about 20% of breast cancers in mammograms; Google Deep Mind can reduce false positive results by 5.7%.

To read more about this study, click here.

Study mentioned: McKinney SM, Sieniek M, Godble V, Godwin J, Antropova H, Back T, et al. International evaluation of an AI system for breast cancer screening.  Nature, 2020 Jan; 577 (7788): 89-94.

Myelodysplastic syndrome: Is it just that? The importance of obtaining an accurate family history

Up to 72 percent of adolescents with myelodysplastic syndrome (MDS), and monosomy 7 have the GATA2 mutation. Approximately one-half of the cases of GATA2 deficiency result from a germline mutation and is heritable.

Oncology nurses and providers are in a unique position to impact these outcomes by obtaining detailed and accurate family histories to optimize treatment decisions, especially for patients with MDS and/or AML. Research has shown that GATA2 patients that undergo stem cell transplantation prior to development of life-threatening infections or cytogenetic abnormalities have better outcomes.Interventions: An accurate family history is a valuable, inexpensive, and often underused tool. Please read the latest conference abstract on the Importance of obtaining an accurate family history.

CA-125 testing, CT scans still used for ovarian cancer surveillance despite lack of proven benefit

Despite evidence of no benefit from a 2009 randomized clinical trial, a new study shows that doctors appear to still routinely use the CA-125 blood test to monitor women for recurrent ovarian cancer. The findings, published July 21 in JAMA Oncology, also suggest that computed tomography (CT) scans continue to be routinely used to check for recurrences even though clinical practice guidelines discourage this practice.

Read the full update here.

Study mentioned:
Esselen KM, Cronin AM, Bixel K, et al. Use of CA-125 Tests and Computed Tomographic Scans for Surveillance in Ovarian Cancer. JAMA Oncol. Published online July 21, 2016. doi:10.1001/jamaoncol.2016.1842.

Overdiagnosis is a major driver of the thyroid cancer epidemic

18 August 2016 – A new report by the International Agency for Research on Cancer (IARC) in collaboration with the Aviano National Cancer Institute in Italy shows that the growing epidemic of thyroid cancer reported in recent decades in several high-income countries is largely due to overdiagnosis (i.e. the diagnosis of tumours that are very unlikely to cause symptoms or death during a person’s lifetime).

The article, published today in The New England Journal of Medicine, used high-quality cancer registry data from IARC’s reference publication Cancer Incidence in Five Continents to estimate the number of overdiagnosed cases of thyroid cancer in 12 countries (Australia, Denmark, England, Finland, France, Italy, Japan, Norway, Republic of Korea, Scotland, Sweden, and the USA).

Full report is here.

Study mentioned:
Worldwide Thyroid-Cancer Epidemic? The Increasing Impact of Overdiagnosis

A benign breast biopsy that is not so benign

A breast biopsy that results in a diagnosis of atypical hyperplasia is considered a benign finding, but that description obscures the riskiness of the condition, according to a special report published in the January 1, 2015, issue of the New England Journal of Medicine.

Dr Hartmann and coauthors, all of whom are from the Mayo Clinic in Rochester, Minnesota, report there is a cumulative incidence of breast cancer of 30% at 25 years of follow-up in their 698-patient cohort of women with atypical hyperplasia.

Study mentioned:
N Engl J Med. 2015 Jan;372(1):78-89. doi: 10.1056/NEJMsr1407164.
Atypical hyperplasia of the breast--risk assessment and management options.
Hartmann LC1, Degnim AC, Santen RJ, Dupont WD, Ghosh K.

Fighting disparity in lung cancer diagnosis and treatment

This report from Lung Cancer Canada was prepared and designed to highlight the national voices and faces of patients and families living with lung cancer. More than Canadians with other cancers or illnesses, those with lung cancer face the challenges of disparity even more deeply on five important levels that are examined in this report: stigma, toll, diagnosis, treatment, and research. Read the full report here.

Blood test may help to diagnose pancreatic cancer

Indiana University cancer researchers have found that a simple blood test might help diagnose pancreatic cancer, one of the most deadly forms of the disease. In research published in the American Journal of Gastroenterology, Murray Korc, M.D., the Myles Brand Professor of Cancer Research at the Indiana University School of Medicine and a researcher at the Indiana University Melvin and Bren Simon Cancer Center, and colleagues found that several microRNAs – small RNA molecules -- circulate at high levels in the blood of pancreatic cancer patients. Read more here.

RNA molecules found in urine, tissue that detect prostate cancer

Researchers at Sanford-Burnham Medical Research Institute have identified a set of RNA molecules that are detectable in tissue samples and urine of prostate cancer patients, but not in normal healthy individuals. The study sets the stage for the development of more-sensitive and specific non-invasive tests for prostate cancer than those currently available, which could result in fewer unnecessary prostate biopsies with less treatment-related morbidity, according to a new study in The Journal of Molecular Diagnostics. Read more here.

Researchers reveal genomic diversity of individual lung tumors

Known cancer-driving genomic aberrations in localized lung cancer appear to be so consistently present across tumors that a single biopsy of one region of the tumor is likely to identify most of them, according to a recent paper. The study, led by scientists at The University of Texas MD Anderson Cancer Center, addresses the challenge of what scientists call genomic heterogeneity, the presence of many different variations that drive tumor formation, growth and progression, and likely complicate the choice and potential efficacy of therapy. Read more here.

Circulating tumor cells provide genomic snapshot of breast cancer

The genetic fingerprint of a metastatic cancer is constantly changing, which means that the therapy that may have stopped a patient's cancer growth today, won't necessarily work tomorrow. Although doctors can continue to biopsy the cancer during the course of the treatment and send samples for genomic analysis, not all patients can receive repeat biopsies. Taking biopsies from metastatic cancer patients is an invasive procedure that it is frequently impossible due to the lack of accessible lesions. Research published in the journal Breast Cancer Research suggest that tumor cells circulating in the blood of metastatic patients could give as accurate a genomic read-out as tumor biopsies. Read more here.

Researchers identify early sign of pancreatic cancer

Scientists at Dana-Farber Cancer Institute, the Massachusetts Institute of Technology, and other institutions have discovered a sign of the early development of pancreatic cancer – an upsurge in certain amino acids that occurs before the disease is diagnosed and symptoms appear. Although the increase isn’t large enough to be the basis of a new test for early detection of the disease, the findings will help researchers better understand how pancreatic cancer affects the rest of the body, particularly how it can trigger the sometimes deadly muscle-wasting disease known as cachexia. Read more here.