Anaximperator blog

Blogging against alternative cancer treatments

ECCO (European CanCer Organisation) Conference: results

BerlijnThe ECCO is Europe’s oldest and largest scientific conference on cancer and currently the ECCO 15 – ESMO 34 in Berlin is in full swing.

Here’s a short overview of some of the main highlights. 

Breast cancer

Dr Jetske Ruiterkamp and Dr Miranda Ernst of the Jeroen Bosch Hospital, The Netherlands, found that it is useful to remove the primary tumour in women with metastasized breast cancer (stage IV).

The researchers discovered that those patients who had received surgery survived for considerably longer than those who had not – an average of 31 months as opposed to 14. The five-year survival rates of the two groups also showed significant differences, with 24.5% of the surgery group being still alive five years later, whereas only 13.1% of those did not have surgery were still living five years on.

This is particularly important because most women and oncologists opt for palliative treatment in this stage. 

There are a number of possible explanations for this,” said Dr Ruiterkamp, “but we think that the most likely is that by excising the primary tumour, we reduce the number of circulating tumour cells elsewhere in the body. It is also possible that surgery reactivates the immune system.

Surgical removal of primary tumour improves survival in metastatic breast cancer patients.

Again breast cancer: switching from Tamoxifen to Exemestane provides a considerable advantage in the prognosis of early stage breast cancer:

We found that six years after changing treatment, women who got exemestane were 18% more likely to remain disease free and were 14% less likely to die than those who stayed on tamoxifen.

Switching early breast cancer patients to exemestane improves long-term survival.

It is also important that breast cancer patients continue taking their medication: 

Patients who stopped study treatment (tamoxifen or exemestane) had significantly higher chance of a recurrence; the chance was between four and five times higher among this group than among those who continued their treatment.

Keep taking the medicine: study of adjuvant endocrine treatment for breast cancer reveals the cost of patient non-compliance.

Brain metastases

Researchers also found that whole-brain radiotherapy should not be given routinely to all patients whose cancer has spread to the brain. They found that using it after surgery or radiosurgery in patients with a limited number of brain metastases and stable cancer in the rest of the body did not extend lives or help patients remain functionally independent for longer.

Whole-brain radiotherapy after surgery or radiosurgery not recommended for all patients with brain metastases.

Melanoma

Researchers have made significant advances in the treatment of metastatic malignant melanoma – one of the most difficult cancers to treat successfully once it has started to spread. In the phase I extension study, researchers have seen rapid and dramatic shrinking of metastatic tumours in patients treated with a new compound that blocks the activity of the cancer-causing mutation of the BRAF gene, which is implicated in about 50% melanomas and 5% of colorectal cancers.

Dr Paul Chapman, an attending physician on the Melanoma/Sarcoma service at Memorial Sloan-Kettering Cancer Center (New York, USA) and one of the leaders of the trial, said:

We are very excited about these results. Of the 22 patients we have been able to evaluate so far, 20 have had some objective tumour shrinkage. This is impressive as they all had metastatic disease and most of them had failed several prior therapies. A lot of these patients were pretty sick but many of them had a significant and rapid improvement in the way they function. We’ve had patients come off oxygen and we’ve got several patients who have been able to come off narcotic pain medication soon after starting treatment.

Trial of new treatment for advanced melanoma shows rapid shrinking of tumours.

See also the article on Science Update Blog of Cancer Research UK.

Pancreatic cancer

For the first time researchers have shown that by inhibiting the action of an enzyme called TAK-1, it is possible to make pancreatic cancer cells sensitive to chemotherapy, opening the way for the development of a new drug to treat the disease. Dr Davide Melisi said that resistance to chemotherapy was the greatest challenge to treating pancreatic cancer:

Pancreatic cancer is an incurable malignancy, resistant to every anti-cancer treatment. Targeting TAK-1 could be a strategy to revert this resistance, increasing the efficacy of chemotherapy. During the past few years we have been studying the role played by a cytokine or regulatory protein called Transforming Growth Factor beta (TGFbeta) in the development of pancreatic cancer. Recently we focused our attention on a unique enzyme activated by TGFbeta, TAK-1, as a mediator for this extreme drug resistance.

Pancreatic cancer: researchers find drug that reverses resistance to chemotherapy.

Cervical cancer

Cervical cancer could be eradicated within the next 50 years if countries implement national screening programmes based on detection of the human papilloma virus (HPV), which causes the disease, together with vaccination programmes against the virus, according to professor Jack Cuzick. 

While the current HPV vaccines protect against two cancer-causing strains of the HPV virus, soon there would be vaccines available that protect against nine types. If vaccination were to be combined with HPV screening (which is much more sensitive than the currently used Pap smear test), then eventually the cancer would disappear in those countries that had successfully implemented national programmes. However, this would require political will and effort at both national and European level.

It’s important to say up front that the HPV is responsible for all cervix cancer. If you can eradicate the virus, the cancer will not appear. So the current vaccine holds the promise of eradicating about 70-75% of cervical cancers (caused by HPV types 16 and 18), and there appears to be some additional cross protection amongst types that are closely related to 16 or 18, in particular 31, 45 and a little bit of 33. There are new vaccines being planned that will vaccinate against nine types. If they are successful, there should be no need to screen women that have been vaccinated at all. That’s the long-term future: vaccination and no screening. After about 50 years, we could see cervical cancer disappearing.

As the current HPV vaccine only protects against two of the cancer-causing types, vaccinated women will still require screening for the rest of their lives.

Vaccination and testing for the human papilloma virus could eradicate cervical cancer – but the EU and national governments should be taking action now.

Here’s more on the vaccine

Abstracts

For those of you who want to know more: here’s the list of abstracts.

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