The cancer research paradigm is slowly changing
Over the rest of this week I’m going to take some topics related to oncology and discuss them in more detail as part of a mini series about how cancer research is changing.
We all know that cancer isn’t one disease, but actually a myriad of different subsets, often even within each tumour type. You can see the gradual shift aware from treating a type of cancer eg breast, lung, lymphoma, leukemia, melanoma etc to finding the driving the mutations and matching the patient to the therapy.
Having just returned from the European Hematology Association (EHA) meeting in London, I can say I was absolutely fascinated by the phase II data on brentuximab vedotin or Adcetris as it is now known (Seattle Genetics and Millennium), the antibody drug conjugate (ADC) in anaplastic large cell lymphoma (ALCL). Previously, we discussed the amazing data in Hodgkin Lymphoma but the photos of the patient responses in ALCL before and after treatment were amazing.
The connection?
Targeting the CD30 antibody on the surface of the cancer cells.
We can clearly see that as we learn more from basic research about the underlying mechanisms of growth, proliferation, survival and metastases, so our knowledge and ability to slow down disease progression and perhaps even stop the disease in it’s tracks also improves dramatically in some areas.
In the future, I can see triple negative breast cancer being segmented in various subtypes, for example, each with a different driving mutation and treating accordingly with carefully selected therapies, rather than treating them all as one homogenous subset of breast cancer, when they are in fact, heterogeneous.
There are several areas where we have made huge strides over the last five years:
- Earlier diagnosis
- Chemoprevention and slowing the inflammatory response
- Identifying biomarkers, both prognostic and predictive of responses
- Preventing metastases
- Translational scientist-clinicians
Over the next few days, I’m going to take a deeper look at these areas and discuss some of the new technology and research that is emerging in oncology as part of an updated landscape overview in cancer research.
If you have any other areas you would like covered, please do make suggestions in the Comments below.
3 Responses to “The cancer research paradigm is slowly changing”
Thank you, Sally, for your clear take and infusion of optimism.
I’m interested in two really intractable breast cancers: triple negative and inflammatory. The session on ASCO on triple negative cancers brought disappointing results in Phase III trial that had been promising in Phase II. There was almost a palpable sense of dismay as the results were announced. I only saw one poster — just one — on inflammatory breast cancer in the entire convention. I’m continuing to dig in on these two topics and will be interested in finding out anything that you might see as well.
It was great to meet you at ASCO! Thanks for everything,
Jody
Hi Jody,
Firstly, finally meeting you in real life at last was one of the highlights of the meeting for me – sorry it was so frantically busy that we didn’t have more time to stop and chat. Next time.
Re: TNBC I’m assuming you mean the iniparib PARP trial. In some ways, it wasn’t a total surprise as the study treated all TNBC’s as a homogenous (same) group, when in fact they are heterogeneous (different). There was no testing for BRCA1 or 2 that I know of, so we have little idea of which subsets of women responded. In some ways, the phase II trial was lucky, whereas phase III trials on a broader scale and larger patient numbers are unforgiving.
There is usually more on IBC at the specialist meetings such as San Antonio Breast Cancer Symposium and the ASCO Breast meeting. @teamoncology specialises in this area as you know, so it is always worth setting up an alert in PubMed for his latest publications if you are interested. Until we understand the biology of IBC as a disease better, it will be a while before we see improvements in treatment or hopefully even a breakthrough.
PS Jody you might like this video on the need for targeted therapies in TNBC:
http://www.onclive.com/onclive-tv/Dr-Carey-Discusses-the-Need-for-Targeted-Therapy-in-TNBC
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