Promising new treatment for rare pregnancy cancer leads to remission in patients

credit:imperial college London

"An immunotherapy drug can be used to cure women of a rare type of cancer arising from pregnancy when existing treatments have failed.

Three out of four patients with the cancerous forms of gestational trophoblastic disease (GTD) went into remission after receiving the immunotherapy drug pembrolizumab in a clinical trial carried out by researchers at Imperial College London.

The trial, which took place at Charing Cross Hospital, part of Imperial College Healthcare NHS Trust, is the first to show that pembrolizumab can be used to successfully treat women with GTD.

The team hopes that this small early stage study, published in The Lancet, could provide another treatment option for women who have drug-resistant GTD and lead to a 100 per cent cure rate.

Professor Michael Seckl, lead author of the study, said:

"We have been able to show for the first time that immunotherapy may be used to cure patients of cancerous GTD. The current treatments to tackle GTD cure most cases of the disease. However, there are a small number of women whose cancers are resistant to conventional therapies and as a result have a fatal outcome. Immunotherapy may be a life-saving treatment and can be used as an alternative to the much more toxic high dose chemotherapy that is currently used. These are landmark findings that have implications on how we treat the disease in the UK and around the world."

GTD is the term used to describe abnormal cells or tumors that start in the womb from cells that normally give rise to the placenta. They are extremely rare but can happen during or after pregnancy.

The most common type of GTD is so-called molar pregnancy where a foetus doesn't form properly in the womb and a baby doesn't develop, instead a lot of abnormal placental-like tissue forms. A molar pregnancy can usually be treated with a simple procedure to remove the growth of abnormal placental cells from the womb but some of this material is usually left behind. This can become cancerous and spread to other parts of the body, requiring lifesaving chemotherapy. In around one in 50,000 pregnancies cancerous GTD known as choriocarcinoma develops after other types of pregnancy including normal pregnancies and this also requires life-saving chemotherapy..."

Learn more:

https://medicalxpress.com/news/2017-11-treatment-rare-pregnancy-cancer-remission.html

Infertility linked to higher risk of death among women

via hormonesmatter.com

"Women with a history of infertility have a 10 percent increased risk of death compared to those without reported infertility struggles, according to results of a new study from researchers at the Perelman School of Medicine at the University of Pennsylvania.

The study, which examined the association between infertility and mortality as well as specific causes of death, also showed that women with a history of infertility have a 20 percent increased risk of cancer-related mortality. The results of the study were presented this week at the annual American Society of Reproductive Medicine Scientific Congress & Expo in San Antonio, Texas.

"While associations between infertility and overall health have been noted in the male population, until now, the relationship between a woman's fertility and her overall health has not been as robustly examined," said lead author Natalie Stentz, MD, a fellow in Reproductive Endocrinology and Infertility at the Perelman School of Medicine at the University of Pennsylvania. "Though we can't yet explain the association between infertility and mortality, it is possible that the condition may be an early indicator of either endocrine or inflammatory disruption that over time, leads to long term health issues such as malignancy or diabetes."

In the new study, researchers examined data from the 78,214 women enrolled in the National Cancer Institute's Prostate Lung, Colorectal, and Ovarian (PLCO) Cancer screening trial. Study participants were enrolled between 1992 and 2001, and were followed 13 years, or until study withdrawal or death. Using data collected in that study, the Penn team examined the effect of self-reported infertility (inability to conceive for one year or greater) on all causes of mortality and primary cause of death..."

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https://www.sciencedaily.com/releases/2017/11/171101141635.htm

Existing drugs may shield women from infertility after cancer

"An existing drug may one day protect pre-menopausal women from the infertility that commonly follows cancer treatments.

Women who are treated for cancer with radiation or certain chemotherapy drugs are often unable to have a baby later. A 2006 study showed that nearly 40 percent of all female breast cancer survivors experience premature ovarian failure, in which they lose normal function of their ovaries and often become infertile.

Women are born with a lifetime reserve of oocytes, or immature eggs, but those oocytes are among the most sensitive cells in the body and may be wiped out by cancer treatments.

The new study, published in Genetics, builds on earlier research that identified a so-called checkpoint protein (CHK2) that becomes activated when oocytes are damaged by radiation.

CHK2 functions in a pathway that eliminates oocytes with DNA damage, a natural function to protect against giving birth to offspring bearing new mutations. When the researchers irradiated mice lacking the CHK2 gene, the oocytes survived, eventually repaired the DNA damage, and the mice gave birth to healthy pups.

The new study explored whether the checkpoint 2 pathway could be chemically inhibited.

“It turns out there were pre-existing CHK2 inhibitor drugs that were developed, ironically enough, for cancer treatment, but they turned out not to be very useful for treating cancer,” says senior author John Schimenti, professor of biomedical sciences and molecular biology and genetics at Cornell University..."

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http://www.futurity.org/infertility-after-cancer-1535282-2/

Many young cancer patients do not receive adequate fertility information and support

image credit: irishexaminer.com

"All cancer patients of reproductive age should be provided with fertility information and referrals for fertility preservation. A new Psycho-Oncology analysis of the published literature indicates that many cancer patients are not receiving such support, however.

In the analysis of 23 relevant studies, investigators found that many clinicians are broadly informed about the risk to their patients' fertility brought about by cancer treatment, but many factors hinder the appropriate discussions and referrals needed to provide adequate fertility support to patients of reproductive age. For example, some oncology clinicians may lack appropriate fertility knowledge and be unsure whose role it is to provide fertility support.

"Impaired fertility brought about by cancer treatment leads to long-term psychological distress and lowered quality of life for cancer patients of a reproductive age. As such, it is paramount that clinicians are able to deliver oncofertility services to the standard of best practice guidelines, to assist in lowering long term distress," said Dr. Shanna Logan, lead author of the article. "However, as the results of this review indicate, oftentimes oncofertilty related services are not delivered to the standard required or in line with patient's needs. Moving forward, the results of this review will be utilised to aid in the development of an international competency framework, to better assist clinicians in providing necessary oncofertility care in the future."

Source: https://www.sciencedaily.com/releases/2017/08/170821102728.htm

 

Infertility in cancer patients: drug to prevent infections may also help regenerate sperm from stem cells

via human-fertility.com

"A new study led by Brian Hermann, assistant professor of biology at The University of Texas at San Antonio (UTSA), shows promising evidence that a medication previously used to prevent infections in cancer patients can also keep them from becoming infertile. Losing fertility is a frequent problem among cancer patients, as treatments for the disease often halt sperm production.

Hermann and his research team have been pursuing a number of cutting-edge research initiatives to restore fertility in men who have lost their ability to have children as a result of cancer treatments they received as children. While working on methods to restart sperm production, the researchers discovered a link between a drug for recovering cancer patients and the absence of normal damage to reproductive ability.

The drug is called G-CSF or granulocyte colony-stimulating factor. It stimulates the bone marrow to produce neutrophils, which are white blood cells that are needed to fight infections. They're commonly lost after chemotherapy and radiation treatments.

"We were using G-CSF to prevent infections in our research experiments," Hermann said. "It turned out that the drug also had the unexpected impact of guarding against male infertility..."

Learn more:

https://www.sciencedaily.com/releases/2017/02/170213083801.htm

Protein network linked to cancer is critical to male fertility

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"Researchers studying reproductive science identified a network of proteins often linked to cancer as also important to male fertility and the birth of healthy offspring, according to a study in the Oct. 18 online issue of Cell Reports.

The study by Satoshi Namewaka, PhD, and colleagues at Cincinnati Children's Hospital Medical Center focuses on the precise epigenetic regulation of the sex chromosomes, which is important to germline cells that make male sperm.

Epigenetics involves changes in organisms caused by modifications to gene expression, rather than alterations in the genetic code. Scientists increasingly study the epigenetics of reproduction to learn how environmental exposures or lifestyle may affect fertility or inherited traits in offspring.

The current study looks at the Fanconi anemia (FA) pathway, a network of 21 proteins that normally work to repair DNA damage in the body's cells. Mutations in the FA pathway can lead to severe anemia, genetic instability and different cancers. But the current study also uncovers roles in ensuring healthy human reproduction..."

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https://www.sciencedaily.com/releases/2016/10/161018132611.htm

How cancer spreads in the body?

via the journal.ie

"Cancer cells appear to depend on an unusual survival mechanism to spread around the body, according to an early study led by Queen Mary University of London (QMUL). The discovery could help with future development of novel treatments to prevent metastasis and secondary tumours.

The spread of cancer around the body - metastasis - is one of the biggest challenges in cancer treatment. It is often not the original tumour that kills, but secondary growths. These happen when cancer cells are able to break away from the primary site, travel around the body and 'seed' new tumours.

A key question in cancer research has been how cancer cells are able to survive once they break away from a tumour to spread around the body. Cells are relatively protected when they are attached to other cancer cells and their surroundings, but become more vulnerable when they detach and 'float', and normally undergo cell death.

Lead researcher Dr Stéphanie Kermorgant from QMUL's Barts Cancer Institute said: "Metastasis is currently incurable and remains one of the key targets of cancer research. Our research advances the knowledge of how two key molecules communicate and work together to help cancer cells survive during metastasis. We're hoping that this might lead to the discovery of new drugs to block the spread of cancer within the body."

The study, published in Nature Communications, examined the changes that occur in cancer cells as they break away from tumours in cell cultures, zebrafish and mice. The researchers revealed a previously unknown survival mechanism in cancer cells and found that molecules known as 'integrins' could be key..."

Learn more:

http://medicalxpress.com/news/2016-06-unexpected-reveal-insight-cancer-body.html

Prevention of genetic breast cancer within reach

Source: Institute of Molecular Biotechnology | Summary: About one in eight women will develop invasive breast cancer over the course of her lifetime. Causes can be the use of synthetic sex hormones and other environmental factors, but also gene mutations like in the BRCA1 gene (BReast CAncer). US actress Angelina Jolie who underwent a preventive double mastectomy is the most famous carrier of a "faulty“ BRCA1 gene.On average, women with this mutation have an up to 87% lifetime risk of developing breast cancer. Tumors usually develop early in life. Until now, prophylactic surgery is the only procedure which significantly reduces the breast cancer risk, but which is also often associated with postoperative complications.

"In 2010, Josef Penninger, the scientific director of IMBA in Vienna and his team have shown that sex hormones can trigger breast cancer (Schramek et al., Nature) through proteins called RANKL and its receptor RANK, which are key factors in bone metabolism. RANKL and RANK also link sex hormones to breast cells by providing signals telling the breast cells to grow. This occurs normally in every woman during pregnancy and the menstruation cycle. However, if deregulated, mammary cells start to divide and multiply and fail to die when they should, ultimately resulting in breast cancer.

A multinational research effort now made the discovery that RANKL is also the main driver of BRCA1 mutation-driven breast cancer. In the current study, Verena Sigl, graduate student from Penninger's research group, showed that blocking the RANKL/RANK system in BRCA1 mutant mice led to largely normal mammary glands whereas invasive carcinomas could be found in the control group. 

To determine the relevance of their results for humans, scientists in Vienna and Toronto isolated breast tissue cells from women who had undergone preventive mastectomy because of their BRCA1 mutation. In the human cell culture, too, RANKL inhibition led to a significant reduction of growth and spreading of breast tissue cells..."

Learn more:

https://www.sciencedaily.com/releases/2016/05/160531082159.htm

Test For Cancer, HIV is 10,000 Times More Sensitive

via zbrushcentral.com

Source: Stanford University

"A common theme in medicine is that detecting a disease early on can lead to more effective treatments. The idea relies partly on luck that the patient gets screened at the right time, but more important is that the testing techniques are sensitive enough to register minuscule hints that diseases leave in the blood stream.

A new technique shows promise to be thousands of times more sensitive than current techniques in lab experiments, and it is now being put to test in real-world clinical trials.

When a disease—whether it’s a cancer or a virus like HIV—begins growing in the body, the immune system responds by producing antibodies. Fishing these antibodies or related biomarkers out of the blood is one way that scientists infer the presence of a disease.

The process involves designing a molecule that the biomarker will bind to, and which is adorned with an identifying “flag.” Through a series of specialized chemical reactions, known as an immunoassay, researchers can isolate that flag, and the biomarker bound to it, to provide a proxy measurement of the disease..."

Read more here:
http://www.futurity.org/sensitive-diagnostic-test-1118972-2/

Preserving fertility in women facing cancer

via survivingglobalresessioncom

"In 2012, 790,000 new cases of cancer were diagnosed in women in the United States alone, with more than 10% of cases diagnosed in women of reproductive age (younger than 45).With advances in cancer treatment and improved survival rates, issues such as loss of fertility are coming to the forefront. 

Retrospective studies indicate that 30% to 40% of reproductive-age survivors experience a feeling of loss of control over their reproductive future, are discontent with their current number of children, and are unable to talk openly about their fertility.

In a survey of more than 600 young women with early-stage breast cancer, 29% reported that concern about infertility influenced their treatment decisions.3 Hence, the American Society of Reproductive Medicine (ASRM) and the American Society of Clinical Oncology have put forth official guidelines recommending that patients be educated about the effect of cancer treatment on fertility and fertility preservation options.

Even so, loss of fertility remains an under-represented topic. A retrospective survey of 1041 California women diagnosed with cancer and aged 18 to 40 found that only 60% were counseled by their oncologists about the risk of infertility, and only 5% were referred to reproductive endocrinologists.6 Educated women are more likely to be counseled, and female oncologists with a favorable opinion of fertility preservation are most likely to refer patients..."

Learn More here:
http://contemporaryobgyn.modernmedicine.com/contemporary-obgyn/content/tags/cancer/preserving-fertility-women-facing-cancer

Using big data to chart cancer's hidden genetic weaknesses

"Nevan Krogan, PhD, thinks genomics has brought us closer to a revolution in cancer treatment than most geneticists even realize.

"There's been a tsunami of genetic data about different cancers," says Krogan, a UC San Francisco professor of Cellular and Molecular Pharmacology and member of the UCSF Helen Diller Family Comprehensive Cancer Center. But despite this rising tide of knowledge, Krogan says, breakthroughs in cancer treatment have been slow to materialize.

In part, this is because all of the new data have only gone to show cancer's staggering diversity: Even a single tumor can contain a unique profile of thousands of genetic mutations, leaving researchers to puzzle out which are disease drivers and which are just along for the ride.

"The sequencers say we just need to pour more money into sequencing and the answer will become clear," Krogan says. "We say no. We're actually done. We've reached a point of saturation in terms of the information we can extract."

Instead of collecting yet more data, he argues, researchers need to look harder at the connections hidden in the data they already have..."

Read the whole article here:
http://medicalxpress.com/news/2016-02-big-cancer-hidden-genetic-weaknesses.html

More than 8 percent of children with cancer have genetic predisposition, new study suggests

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"The most detailed analysis yet of the role germline mutations in genes associated with cancer predisposition play in the development of childhood cancer suggests that comprehensive genomic screening may be warranted on all pediatric cancer patients, not just those with a family history of cancer.

The most detailed analysis yet of the role germline mutations in genes associated with cancer predisposition play in the development of childhood cancer suggests that comprehensive genomic screening may be warranted on all pediatric cancer patients, not just those with a family history of cancer. The study from the St. Jude Children’s Research Hospital — Washington University Pediatric Cancer Genome Project appears in the November 19 edition of the New England Journal of Medicine.

Ultimately, researchers anticipate that systematic monitoring of patients and family members who have germline mutations in cancer predisposition genes will allow the detection of cancers at their earliest and most curable stage, thereby improving the outcomes for these children and family members..."

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The Revelation of Telomerase's Secrets in Anti-Aging and Cancer

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"Nowadays, there is a lot of talking about cancer, but also for new biological markers that contribute in the laboratorial proof of improving the quality of life and longevity of the modern human. Telomerase, an enzyme which is the main regulator of the length of the human chromosome telomere, is one of these important factors in anti-aging.

  

J.Muller and Barbara Mc Clintoc described telomeres in the beginning of 1930 (complex name from the Greek word “telos” and “meros”) as a protective shield of the genetic code, which are the edges of our chromosomes. 

The lack of telomere leads in cellular death.  The meaning of those biological markets is huge, if someone thinks that recently in 2009 the Nobel price in medicine was given in three scientists (Elizabeth H. Blackburn, Carol W. Greider and Jack W. Szostak) for their important studies in terms of structure, function, and the effects of telomerase and telomeres in the cells. 

Today, many researchers try to clarify telomerase’s secrets and they believe that its role is important in cancer and in anti-aging. Telomerase works maintaining and repairing the lengths of telomeres adding recurrent small fragments of DNA so it can prevent the damage and loss of genetic material during cellular division..."

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