In this slide show we take a look back at the past year in cancer news and research, with some of our most read stories of 2015 including new immunotherapy approvals, a look at the overtreatment of DCIS, a study on fish oil and chemoresistance, and more.
Too Many DCIS Patients Get Axillary Lymph Node Dissection:
While recommended for women with certain types of invasive breast cancer, axillary lymph node evaluation is not recommended for women with ductal carcinoma in situ (DCIS), as no benefit has been found in these patients. However, this lymph node analysis is often unnecessarily performed in DCIS patients, according to a study published in
. The researchers analyzed medical records of 35,591 women diagnosed with DCIS who had breast-conserving surgery or mastectomy. Rates of axillary evaluation in patients who had a mastectomy increased from 56.6% in 2006 to 67.4% in 2012. The rate remained roughly stable among patients who received breast-conserving surgery, from 18.5% in 2006 to 16.2% in 2012. Image Â© Blamb / Shutterstock.com.
Increased Coffee Intake Linked With Lower Melanoma Risk:
Consumption of four or more cups of caffeinated coffee per day was associated with a 20% decreased risk for malignant melanoma, according to the results of a recent study. In a fully adjusted multivariable model, which included body mass index, age, sex, physical activity, alcohol intake, smoking history, and ambient ultraviolet radiation exposure, the highest category of coffee consumption, defined as four or more cups a day, had a significant inverse association with malignant melanoma (hazard ratio, 0.80 [95% CI, 0.68â0.93]). Image Â© gresei / Shutterstock.com.
TCGA Classifies Four Melanoma Subtypes:
New data out of the Cancer Genome Atlas (TCGA) suggests that cutaneous melanomas can be classified into four categories based on the pattern of the most prevalent significantly mutated genes:
, and Triple-WT. Data from 331 adult patients with primary and/or metastatic melanomas showed that the largest genomic subtype was defined by the presence of
hot-spot mutations, which 52% of cases harbored. The next most common subtypes were defined by the presence of
hot-spot mutations (28% of cases) and
mutations (14% of cases). Finally, the researchers defined Triple-WT as the absence of hot-spot
mutations. Image Â© Crystal Eye Studio / Shutterstock.com.
Pathologists Often Disagree on Breast Biopsy Findings:
While pathologists are usually able to agree whether breast tissue is healthy or malignant from biopsy slides, there is far less agreement on tissue samples that fall somewhere in the middle, according to a study published in
. The study found that among 115 pathologists in the United States who reviewed the same 6,900 breast biopsy slides, the rate of overall agreement-or the concordance rate-was 75.3%. The highest level of agreement was for invasive breast cancer and the lowest was for ductal carcinoma in situ and atypical hyperplasia.
Chemo During Pregnancy Did Not Affect Early Child Development:
Children exposed to their mother’s cancer and cancer treatment did not appear to have cardiac, cognitive, or general developmental issues up to 36 months of age, according to a study published in the
New England Journal of Medicine
. The researchers enrolled 129 children who were matched with 129 children born to mothers with no complications during pregnancy. A total of 96 children (74.4%) were exposed to between 1 and 10 cycles of chemotherapy during pregnancy. Children of mothers diagnosed with cancer were born slightly premature whether or not the mother was treated for her cancer, but according to the authors, this was mostly due to induction of labor rather than spontaneous labor. Image Â© nattanan726 / Shutterstock.com.
Blood Draw Predicts Breast Cancer Relapse:
Tracking tumor DNA in the blood of early breast cancer patients after surgery can detect relapse 7.9 months earlier than conventional imaging, according to the results of a study published in
Science Translational Medicine
. Using a non-invasive circulating tumor DNA (ctDNA) analysis, researchers tracked breast tumorâspecific mutations in 55 patients who had undergone surgery and chemotherapy as a potentially curative treatment. Of the 15 patients who relapsed on study, the presence of ctDNA predicted the relapse of 12 patients. Among the patients who did not relapse, 96% had no detectable ctDNA in either the post-surgery sample or during temporal tracking of tumor mutations. Image Â© Eugene Sim / Shutterstock.com.
USPSTF Supports Aspirin for Colorectal Cancer Prevention:
The United States Preventive Services Task Force (USPSTF) recently issued a draft recommendation advising the use of aspirin to prevent cardiovascular disease and colorectal cancer in certain patients aged 50 to 69 years. The USPSTF found that taking aspirin can help 50- to 69-year-olds who are at increased risk of cardiovascular disease prevent heart attacks and stroke, as well as help prevent colorectal cancer, if taken for at least 10 years. In adults younger than 50 and older than 70, the USPSTF said there is not enough evidence to assess whether the benefits of aspirin to prevent cardiovascular disease and colorectal cancer outweigh the harms. Image Â© Shane Maritch / Shutterstock.com.
FTC Brings Charges Against Four ‘Sham’ Cancer Charities:
The Federal Trade Commission (FTC) and regulators from 50 states and the District of Columbia this week charged four US cancer charities with fraud, accusing them of diverting nearly all of more than $187 million in charitable donations to pay for solicitors, staff salaries, bonuses, and personal expenses. In a complaint filed in federal court, the FTC charges Cancer Fund of America, Cancer Support Services, Children’s Cancer Fund of America, and the Breast Cancer Society with running sham charities and lying to consumers. Donors were told their money would help cancer patients by providing them with medicines or taking them to chemotherapy appointments, for example, but in reality less than 3% of donations were spent on direct cancer care. Photo by Carol M. Highsmith.
T-DM1 Trial Disappoints in HER2-Positive Breast Cancer:
Results of the anticipated phase III MARIANNE trial found that HER2-positive metastatic breast cancer patients treated with ado-trastuzumab emtansine (T-DM1) plus pertuzumab had similar progression-free survival (PFS) compared with those treated with trastuzumab plus a taxane-based chemotherapy. Though the trial met its noninferiority endpoint, showing a similar PFS in the first-line setting between the two combination therapies along with T-DM1 alone, it failed to demonstrate that T-DM1 performs better than trastuzumab plus chemotherapy. Image Â© molekuul.be / Shutterstock.com.
Immunotherapy Nivolumab Receives FDA Approval for Several Indications:
The US Food and Drug Administration (FDA) approved nivolumab (Opdivo) for the treatment of patients with metastatic NSCLC with progression on or after platinum-based chemotherapy. Patients with
genomic tumor aberrations should have disease progression on approved therapy for these aberrations prior to receiving nivolumab. In renal cell carcinoma the drug received approval for the treatment of patients with advanced disease who have received prior anti-angiogenic therapy. In melanoma the FDA granted approval to nivolumab in combination with ipilimumab for the treatment of patients with
V600 wild-type, unresectable, or metastatic melanoma. Image Â© Bristol-Myers Squibb.
Form of Vitamin B3 Reduced Non-Melanoma Skin Cancer Occurrence:
The use of nicotinamide, a form of vitamin B3, reduced the incidence of non-melanoma skin cancers by 23% among a group of high-risk patients, according to the results of the Australian ONTRAC study presented at the 2015 American Society of Clinical Oncology Annual Meeting. The study included 386 high-risk patients, defined as people who had at least two skin cancers in the last 5 years. After 12 months, use of nicotinamide resulted in a relative rate reduction of 0.23 for non-melanoma skin cancer (95% CI, 0.04â0.38;
= .02) after adjustment for non-melanoma skin cancer history and study center. Image by Kelly Nelson.
Fish Oil Consumption Linked to Chemoresistance:
A new study has shown that consumption of fish oils can raise the levels of fatty acids in the blood. Fatty acid has previously been shown to have negative effects on chemotherapy efficacy in laboratory studies. Healthy volunteers who consumed fish oil supplements as well as herring and mackerel had a rapid increase of the platinum-induced fatty acid 16:4(n-3) in their plasma. In studies of mice, consumption of fish oil also resulted in an increase of 16:4(n-3) in plasma levels. Chemotherapy resistance occurred in mice with subcutaneous tumors when oral 16:4(n-3) was added to cisplatin. Image Â© tab62 / Shutterstock.com.
Palbociclib, Fulvestrant Delays HR-Positive Breast Cancer Progression:
The addition of palbociclib to the hormonal therapy fulvestrant resulted in an increase of 5.4 months in the delay of disease progression compared with fulvestrant alone in women with hormone receptor (HR)-positive, HER2-negative metastatic breast cancer. The results of the phase III PALOMA3 trial were presented at the 2015 American Society of Clinical Oncology Annual Meeting. The primary endpoint of this trial was progression-free survival (PFS). The median PFS was 9.2 months in the combination therapy arm compared with 3.8 months in the hormonal therapy alone arm (hazard ratio, 0.422;
FDA Approves First Oncolytic Virus With New Melanoma Therapy:
The US Food and Drug Administration (FDA) has approved its first oncolytic virus therapy, talimogene laherparepvec (Imlygic), a drug for the treatment of patients with melanoma lesions in the skin and lymph nodes. Talimogene laherparepvec is a genetically modified live oncolytic herpes virus therapy that is injected directly into melanoma lesions where it replicates inside the cancer cells producing granulocyte-macrophage colony-stimulating factor (GM-CSF). The FDA made the approval based on the efficacy results of the phase III OPTiM study, which included 436 patients. More patients assigned to talimogene laherparepvec achieved a durable response compared with patients assigned GM-CSF (16.3% vs 2.1%;
Adding Olaratumab Dramatically Improves Survival in Soft-Tissue Sarcoma:
The addition of olaratumab to doxorubicin dramatically improves survival in patients with advanced soft-tissue sarcoma, according to the results of a randomized trial presented at the 2015 American Society of Clinical Oncology Annual Meeting. This phase II trial randomized 133 unresectable/metastatic soft-tissue sarcoma patients to receive up to 8 cycles of doxorubicin 75 mg/m² with or without olaratumab 15 mg/kg. In the combination arm, olaratumab monotherapy continued after doxorubicin until disease progression. The median progression-free survival was 6.6 months in the combination arm and 4.1 months in the doxorubicin-alone arm (hazard ratio [HR], 0.67). Interim overall survival also favored the combination arm (25 months vs 14.7 months; HR, 0.44).