Tag Archives: cancer

Pap tests could one day tell women if they have breast or ovarian cancer

Experts have identified changes in a woman’s cervix that can help detect tumors elsewhere in the body. These tests involve scraping cells from the cervix to detect any abnormalities that could cause cervical cancer. But researchers from Innsbruck University and gynecological cancer research charity The Eve Appeal found the cells from this test can also give clues and alerts for other types of cancers. With development, they state that the method used could one day predict the risk of developing ovarian, breast, womb, and cervical cancers from a straightforward smear pap test.

They developed their system using a process known as DNA methylation — epigenetic modifications to DNA that don’t alter the genetic sequence but do determine whether a gene expresses or stifles its function: in this case, forming or preventing cancer in the body. These modifications leave ‘methylation markers or signatures’ on genomic regions that scientists can read to determine what has occurred within a person’s body throughout their lifetime. Akin to the rings of a tree, this method can provide chronological clues as to what has happened in our biological life.

Researchers created the test, dubbed WID (Women’s Risk Identification), to analyze markers left by cancerous activity in the DNA of cervical cells. By calculating a woman’s WID, they hope to identify those with a high risk of developing ovarian, breast, womb, or cervical cancers: providing an early-warning system for medical teams to increase treatment outcomes.

The team was able to spot these modifications because they matched DNA markers found in diseased cervical, breast, ovarian, and womb biopsy tissue (a highly invasive procedure) to those found in the easier to access cells of the cervix — whose similar biological structures undergo the same hormonal changes as the tissues these cancers flourish in.

Finding cancer through the cervix

The first study examined cervical cell samples collected from 242 women with ovarian cancer and 869 healthy controls. To develop the WID risk scale, the scientists measured 14,000 epigenetic changes to identify ovarian cancer’s unique DNA signature to spot the presence of the disease in epithelial tissue scraped from the cervix.

They then validated the signature in an additional cohort of 47 women who had ovarian cancer and 227 healthy subjects. Results identified 71% of women under 50 and roughly 55% of the volunteers older than 50 who had previously tested positive for the disease — giving the tests an overall specificity of 75%. A test’s specificity is its ability to correctly identify people without the disease.

Professor Martin Widschwendter of the University of Innsbruck and UCL, heading up the research, said the findings suggest their WID index is picking up cancer predisposition, adding that the results were similar to a study on women with cancer of the womb. He is adamant their test cannot predict ovarian, with more studies needed.

A possible screening method for an undetectable cancer 

In the second study, the same team analyzed epigenetic changes in cervical cell samples provided by 329 women with breast cancer against those from the same 869 healthy volunteers in the first study. Using the WID index, they were able to identify women with breast cancer based on a unique epigenetic signature. The group once again confirmed these markers in a smaller consort of 113 breast cancer patients and 225 women without this condition.

The researchers also used the patterns to predict whether patients had breast cancer-but they didn’t say exactly how accurate the tests were. Instead, they stressed that further trials are needed-with the hope that clinicians could use their WID as a regular test for women in the future-specifically for those under fifty years of age who do not have access to screening for this disease.

“This research is incredibly exciting,” said Liz O’Riordan, a breast cancer surgeon who was also diagnosed with this disease. “At the moment, there is no screening test for breast cancer in women under the age of 50. If this test can help pick up women with a high risk of developing breast, ovarian, cervical, and uterine cancer at a younger age, it could be a game-changer.”

The team adds that these findings are also crucial for ovarian cancer, whose symptoms can be as benign as a bloated abdomen. The biggest killer of women out of gynecological-based tumors, this disease is diagnosed late by clinicians in an alarming 3 out of four cases.

But for now, Widschwendter says, the findings suggest that the molecular signatures in cervical cells may detect the predisposition to other women-specific cancers rather than providing a solid prediction of the disease.

Because of the pandemic, women have stopped taking pap tests

A pap smear test detects abnormal cells on the cervix, which is the entrance to the uterus from the vagina. Removing these cells can prevent cervical cancer, which most commonly affects sexually-active women aged between 30 and 45. In most cases, the human papillomavirus causes this cancer after being acquired through unprotected sex or skin-to-skin contact. To summarise, the whole point of these tests is to detect women at risk of developing cancer and encourage them to carry further health check-ups, not to find those displaying cancer symptoms.

Around the world, the number of women taking smear tests has dropped substantially during the pandemic. In England, for instance, one of the countries with the highest testing rates, just 7 out of 10 eligible women got a cervical check-up — and conditions are expected to worsen due to a new policy brought in by the UK government at the start of 2022, which saw all eligible women in Wales have their wait times increased from three to five years in between tests. The government expects to roll out the policy in England this year after the pandemic caused the delay of its initial release. Experts insisted the move was safe, but campaigners hit back at the plans, arguing it would cause preventable deaths by delaying the detection of cancer or pre-cancerous issues.

In a statement to the Guardian, the UK’s Secretary for Patient Safety and Primary Care says it’s “great to see how this new research could help alert women who are at higher risk to help prevent breast, ovarian, womb, and cervical cancer before it starts.” Until this time, cancer screening remained vital and urged all women aged 25 and above to attend their appointments when invited. The secretary did not remark on the new government policy.

An ovarian cancer specialist urged caution in interpreting the data: They show a “moderate association” between the methylation signature and ovarian cancer, said Dr. Rebecca Stone, the Kelly Gynecologic Oncology Service director at Johns Hopkins Hospital. “They are not showing that it’s predictive or diagnostic,” Stone stressed. Clarifying that to see whether the cervical cell signature predicts cancer, a study would have to observe a large group of women over a long period.

Filling the gap in screening options for women

In contrast, Athena Lamnisos, CEO of the Eve Appeal, emphasizes the importance of a new screening tool:

“Creating a new screening tool for the four most prevalent cancers that affect women and people with gynae organs, particularly the ones which are currently most difficult to detect at an early stage, from a single test could be revolutionary.”

The Eve Appeal goes on that women could get separate risk scores for each of the four cancers in the future where medical teams could offer those with high scores more active monitoring, regular mammograms, risk-reducing surgery, or therapeutics.

Ultimately, it’s better to prevent than to treat, and this method could offer women worldwide access to proper screening services that could save lives through the application of early intervention and preventative medicine.

A novel blood test can detect the presence of cancer, and whether it’s metastasized

A candidate for a cheap and simple blood test for cancer has shown promise in early tests. The findings point the way towards such a procedure which, in the future, could become a widely available method of screening patients at risk of various types of cancer.

Image credits Fernando Zhiminaicela.

The test is non-specific — it can be used to detect the presence of a wide range of cancer types — and provides doctors with quick and reliable information on whether it has metastasized (spread) throughout the patient’s body.

Quick and easy

“Cancer cells have unique metabolomic fingerprints due to their different metabolic processes. We are only now starting to understand how metabolites produced by tumors can be used as biomarkers to accurately detect cancer” says Dr. James Larkin from the University of Oxford, first author of the study.

“We have already demonstrated that this technology can successfully identify if patients with multiple sclerosis are progressing to the later stages of disease, even before trained clinicians could tell. It is very exciting that the same technology is now showing promise in other diseases, like cancer.”

The study worked with samples harvested from 300 patients that were showing non-specific cancer symptoms, including fatigue and weight loss. All participants were recruited through the Oxfordshire Suspected CANcer (SCAN) Diagnostic Pathway. It involved the researchers assessing whether their test could tell apart patients with a range of solid tumors from those who were cancer-free.

All in all, the test correctly detected the disease in 19 out of every 20 patients with cancer. Apart from this, the test identified the metastatic phase of the disease with an overall accuracy of 94%.

This is the first method to be developed that can determine metastatic cancer from a simple blood test without previous knowledge of the type of cancer the patient is suffering from, the authors explain.

Unlike many other blood tests for cancer, which look for genetic material from tumorous cells, the current test relies on a technique called NMR metabolomics. This involves the use of magnetic fields and radio waves to measure metabolite levels in the patient’s blood.

Patients with localized cancer, those with metastatic cancer, and healthy individuals all have different metabolite profiles in their blood, the authors explain. Raw data from the test is then run through an algorithm that distinguishes between these states and offers a diagnosis.

The authors are hopeful that their test can help doctors detect and assess cancer much more quickly and cheaply than ever before. Although the test itself cannot accurately pinpoint the particular type of cancer in question, it still is a very powerful tool in determining who needs further tests, and who’s in the clear.

Early detection of cancer improves a patient’s chances of a successful outcome. Being rapid and cheap to administer, this test could help improve the overall rate of successful cancer treatments, especially in patients who only show non-specific symptoms (for whom a diagnosis generally takes longer).

“This work describes a new way of identifying cancer. The goal is to produce a test for cancer that any GP can request,” says Dr. Fay Probert, lead researcher of the study from the University of Oxford. “We envisage that metabolomic analysis of the blood will allow accurate, timely and cost-effective triaging of patients with suspected cancer, and could allow better prioritization of patients based on the additional early information this test provides on their disease.”

For now, the test is still in its early testing stages. Further research with larger cohorts of patients will be needed to give us a better and more reliable understanding of it, its capabilities, and its limitations.

The paper “Metabolomic Biomarkers in Blood Samples Identify Cancers in a Mixed Population of Patients with Nonspecific Symptoms,” has been published in the journal Clinical Cancer Research.

Galápagos giant tortoises often live over 100 years without cancer. The secret to their longevity may be in their genes

Extra copies of genes, known as duplications, protect these giant tortoises from cancer and help them live a long life.
Galápagos tortoises. Credit: Ylenia Chiari.

Galápagos giant tortoises are one of the longest-lived vertebrates, with many living past 100 years of age in the wild. In captivity, they can live even longer. One captive individual, Harriet, lived for at least 175 years. How do they do it? In a new study, researchers at the University of Buffalo compared the genomes of Galápagos giant tortoises with those of other turtles and found the animals evolved to have extra copies of certain genes. These extra copies are thought to offer protection against the biological degeneration typically associated with aging, including cancer.

The new study builds upon past research performed in 2018. Back then, Yale University and Universidad de Oviedo, Spain, sequenced the genome of the famous Lonesome George, who died in 2012 at age of 100 and was the last giant tortoise on Pinta Island. When researchers compared Lonesome George’s genome, as well as that of the Aldabra giant tortoise (Aldabrachelys gigantea), to other species, they found genes associated with metabolism regulation and immune response.

These genes may explain the generous size and long lifespans of these species. The researchers have found that tumor suppressors are expanded in the tortoises’ genomes compared to other vertebrates. The analysis also found specific alterations in two genes whose overexpression is known to contribute to cancer, and which may be part of a giant-tortoise-specific cancer mechanism.

But it’s not only the genes themselves that may offer protection against cancer. The new study found that giant tortoises have extra copies of genes, an indirect consequence of a defense mechanism they evolved in order to cope with stress related to damaged proteins.

Experiments on cells cultured from Galápagos giant tortoises showed that they self-destruct faster and easier than those of other turtle cells when exposed to stressors. That may sound like a poor defense mechanism, but this proclivity for self-destruction protects the giant tortoises from biological glitches that can form tumors, thereby helping the animals evade cancer.

“In the lab, we can stress the cells out in ways that are associated with aging and see how well they resist that distress. And it turns out that the Galápagos tortoise cells are really, really good at killing themselves before stress has a chance to cause diseases like cancer,” said Vincent Lynch, an evolutionary biologist at the University at Buffalo and co-author of the new study.

Very large animals like the Galápagos giant tortoises, which can weigh as much as 300 kg (660 lbs) and can grow to be 1.3 m (4 ft) long, ought to be more prone to cancer because, all other things being equal, they have more cells in their bodies. The more cells, the greater the statistical odds that some mutations arise that can lead to cancer. But since the 1970s, scientists have found that there is no relationship between body size and cancer incidence, a counter-intuitive phenomenon known as Peto’s Paradox after English statistician and epidemiologist Richard Peto, who first observed the connection.

In fact, one of the largest animals in the world, the bowhead whale, is virtually cancer free. On land, only a fraction of elephants get cancer compared to 1 in 5 humans. Why exactly some of the largest animals have such long lives is a major avenue of research with important implications for our cancer-prone species.

“If you can identify the way nature has done something — the way certain species have evolved protections — maybe you can find a way to translate those discoveries into something that benefits human health and disease,” Lynch says. “We’re not going to go treating humans with Galápagos tortoise genes, but maybe we can find a drug that mimics certain important functions.”

The authors of the new study add that their research also carries a message about conservation. Five subspecies of the Galápagos tortoise have been extinct since they were first studied by Charles Darwin, who used their evolutionary defenses, like a distinct shell, to define his theory of natural selection. Over 100,000 have been killed over the centuries by hunters, pirates and whalers who ate the tortoises on their travels. Although not endangered, the Galápagos tortoise is listed as a vulnerable species.

“Studies like this demonstrate why preserving biodiversity is so important,” says Scott Glaberman, the paper’s first author and an assistant professor of environmental science and policy at George Mason University. “Extreme species like Galápagos giant tortoises probably hold many secrets for dealing with major human challenges like aging and cancer, and even climate change. Our study also shows that even within turtles, different species look, act and function differently, and losing any species to extinction means that a piece of unique biology will be lost to the world forever.”

The findings appeared in the journal Genome Biology and Evolution.

Breakthrough immunotherapy can kill tumors in some terminally ill cancer patients

Some patients who were “supposed” to die years ago based on their cancer prognosis are not only alive today, they’re cancer-free and living well. That’s all thanks to a novel immunotherapy that primes the patients’ immune system to hunt down cancer cells and eradicate tumors.

Researchers at the Institute of Cancer Research (ICR), London, and the Royal Marsden NHS foundation trust may have struck medical gold by combining nivolumab and ipilimumab medications to significantly reduce the size, and in some odd cases completely eradicate, the tumors in patients diagnosed with terminal head and neck cancer.

3D medical animation still showing the cancer formation in the tissues of the oropharynx. Credit: Scientific Animations, Wikimedia Commons.

Head and neck cancer is distinct from brain cancer, affecting tissues in the lip and oral cavity (mouth), larynx (throat), salivary glands, nose, sinuses or the skin of the face. Globally, head and neck cancer accounts for around 900,000 cases and over 400,000 deaths annually

Previous studies that tried the same combination and various amounts found similar benefits in terminally ill kidney, skin, and bowel cancer patients, suggesting the immunotherapy cocktail is active for a broad range of cancers.

Nivolumab is an anti-PD-1 drug, containing an antibody that promotes the tumor-killing effects of T-cells, a type of white blood cell that helps the body ward off disease. Ipilimumab, sold under the brand name Yervoy, is a monoclonal antibody medication used for adjuvant therapy in patients who have had surgery to remove melanomas in the skin and lymph nodes.

Almost 1,000 terminally ill head and neck cancer patients were given this combination as part of a phase 3 clinical trial. Early results suggest the therapy is extremely promising and, in some cases, life-saving, despite many aspects of the trials still ongoing.

“These are promising results,” Prof Kristian Helin, the ICR chief executive, told the Guardian. “Immunotherapies are kinder, smarter treatments that can bring significant benefits to patients.”

Guardian journalists talked to a number of patients who agreed to participate in the trial with a ‘nothing to lose’ attitude. Barry Ambrose, a 77-year-old man from Bury St Edmunds, was among them.

“Although I had to make biweekly trips from Suffolk to the hospital for the treatment, I had virtually no side-effects and was able to carry on as normal doing the things I love: sailing, cycling, and spending time with my family.”

Eight weeks later, the tumor in his throat had disappeared.

“When the research nurses called to tell me that, after two months, the tumour in my throat had completely disappeared, it was an amazing moment,” said Ambrose. “While there was still disease in my lungs at that point, the effect was staggering.”

The early results from the trial suggest that the immunotherapy combination was most successful in patients whose tumors had high levels of an immune marker called PD-L1. Compared to those receiving conventional chemotherapy, those who were given the cocktail lived three months longer, on average.

In 2020, the FDA approved the combination of nivolumab and ipilimumab as first-line treatment for patients with metastatic non-small cell lung cancer whose tumors express PD-L1. In a clinical trial involving 793 cancer patients from the United States, researchers found the therapy improved overall survival from 14.9 months to 17.1 months.

Researchers want to continue this work by performing follow-up studies. It is still rather early and they would like to determine with greater confidence whether the therapy improves survival rates across all patients in the trial.

A Himalayan fungus has been used to treat cancer for centuries. Scientists now boost its potency 40-fold

Cordyceps militaris, a fungus that contains a compound with anti-inflammatory and anti-cancer properties.

There is no shortage of traditional herbal remedies that allegedly can treat cancer. The vast majority, however, don’t hold up to scrutiny. But a fungus that has been used for centuries in Chinese medicine for its anti-cancer properties is different — it really works. Now, researchers at the University of Oxford have supercharged a compound derived from the fungus and boosted its anti-cancer potency by up to 40 times.

Cordycepin, one of the bioactive ingredients found in Cordyceps, a genus of ascomycete fungi that parasitizes the larvae of arthropods in the Himalayan region, can kill cancer cells and retard their cancerous properties, studies have previously shown.

The fungus was first recorded as Ben-Cao-Bei-Yao in 1694 and is usually called ‘Dong-Chong-Xia-Cao’ in China. There are over 400 species of Cordyceps, of which Cordyceps sinensis and Cordyceps militaris are the most broadly researched. Both Cordyceps species contain similar bioactive ingredients, including cordycepin as a major component.

A 2018 study by Chinese researchers concluded that Cordycepin, a derivative of adenosine (a signaling molecule that affects various types of cells, tissues, and organ systems) regulates tumor microenvironment via suppressing tumor metastasis-related pathways.

However, despite its promising anti-cancer properties, Cordycepin is broken down too quickly once it hits the blood stream. As a result, just a minute amount reaches tumors while the rest is lost.

In order to amplify its potency, researchers at Oxford University teamed up with biopharma company NuCana to devise a new chemotherapy drug and succeeded in doing so by employing a novel technology that can bypass the resistance mechanisms that break down the anti-cancer metabolites.

Called ProTide, this technology works by attaching chemical groups to nucleoside analogs like Cordycepin that are metabolized only once they reach the patient’s cancer cells. Previously, the same technology has been used in the FDA-approved antiviral drug Remsidivir, which is used to treat COVID-19.

The new chemotherapy drug, called NUC-7738, is up to 40 times more potent in killing cancer cells than the original compound derived from the Himalayan fungi. The researchers have commenced the Phase 1 clinical trial for NUC-7738, which involves cancer patients with advanced solid tumors that are resistant to conventional chemotherapy. Early results suggest the drug is well tolerated and there are signs of anti-cancer activity.

“Our study provides proof that NUC-7738 overcomes cellular resistance mechanisms and support its further clinical evaluation as a novel cancer treatment within the growing pantheon of anti-cancer ProTides,” researchers wrote.

The findings appeared in the journal Clinical Cancer Research.

Aspirin could become a potential treatment against breast cancer

Credit: Pixabay.

Aspirin (acetylsalicylic acid), the world’s most popular drug, may one day become an important component in treatments against some of the most aggressive forms of breast cancer. Clinical trials have commenced in the United Kingdom in order to establish whether aspirin can enhance immunotherapy for patients with triple-negative breast cancer.

Could aspirin become a generic cancer drug? Some scientists want to find out

Aspirin is classed as a non-steroidal anti-inflammatory drug that is primarily recommended to reduce pain and inflammation. Until not long ago, doctors used to recommend it to prevent heart attacks and strokes, but recent research suggests healthy people with no history of cardiovascular disease shouldn’t routinely use aspirin due to internal bleeding risks.

But, more strikingly, some studies seem to indicate that this cheap and widely available generic drug could also play an important role in battling cancer. A 2014 study led by Professor Jack Cuzick, head of the center for cancer prevention at Queen Mary University of London, found that people who took aspirin daily for at least five years had a 35% reduction in bowel cancer, as well as a 30% reduction in esophageal and stomach cancers.

“Aspirin is showing promise in preventing certain types of cancer, but it’s vital that we balance this with the complications it can cause – such as bleeding, stomach ulcers, or even strokes in some people,” said Dr. Julie Sharp, head of health information at Cancer Research UK.

Emboldened by previous research that hints at aspirin’s potential role in treating cancer, a team of scientists, led by Dr. Anne Armstrong from the Christie NHS foundation trust in Manchester, UK, have embarked on a new clinical trial that will see aspirin combined with avelumab, a fully human monoclonal antibody medication for cancer.

During the trial, patients with triple-negative breast cancer will be given avelumab either with or without aspirin before receiving surgery and chemotherapy.

Triple-negative breast cancer is considered to be more aggressive and has a poorer prognosis than other types of breast cancer. It is characterized by the lack of the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), hence its name. Around 15% of breast cancers are of this type.

 “Our earlier research has suggested that aspirin can make certain types of immunotherapy more effective by preventing the cancer from making substances that weaken the immune response,” Armstrong told The Guardian.

“Anti-inflammatory drugs like aspirin could hold the key to increasing the effectiveness of immunotherapy when used at the same time. Trialing the use of a drug like aspirin is exciting because it is so widely available and inexpensive to produce. ”

“We hope our trial will show that, when combined with immunotherapy, aspirin can enhance its effects and may ultimately provide a safe new way to treat breast cancer.”

Radio-wave treatment shows some promise against liver cancer

New research from the Wake Forest School of Medicine has shown that targeted radio wave treatments are safe to use against hepatocellular carcinoma (HCC), the most common type of liver cancer, and shows benefits for the patient’s overall survival rates.

Image credits Qasim Zafar / Flickr.

The researchers used a hand-held device called TheraBionic P1, produced by TheraBionic GmbH in Ettlingen that works by delivering specific, amplitude-modulated radiofrequency electromagnetic fields (AM RF EMF), meant specifically for use against HCC.

Radio treatment

“HCC accounts for nearly 90% of all liver cancers, and current survival rates are between six and 20 months,” said Boris Pasche, M.D., Ph.D., chair of cancer biology and director of Wake Forest Baptist’s Comprehensive Cancer Center. “Currently, there are limited treatment options for patients with this advanced liver cancer.”

“Our findings show an improvement in overall survival of more than 30% in patients with well-preserved liver function and also in those with more severe disease”.

This device emits radio waves that are spread through the patient’s body in an attempt to inhibit the growth of liver cancer cells without damaging healthy ones. A spoon-shaped antenna is placed under each patient’s tongue during the treatment, which is administered in three one-hour sessions per day. According to the paper, the low-level radiofrequency electromagnetic fields emitted by the antenna spread through the patient’s body.

Previously, the device was proven to be effective at blocking the growth of liver cancer cells, and it received breakthrough designation from the FDA in 2019.

The current study worked with 18 patients with advanced HCC, all of whom were enrolled for this type of treatment. Data from another 41 patients from a previous phase II study, as well as data from control participants from earlier clinical trials, was also factored into the study. 

Although the authors also kept an eye out for side effects, no patients stopped the treatment due to adverse reactions. The team reports that participants’ overall survival showed an improvement, although how much depended on their baseline health conditions at the start of the trial. Those who still maintained high levels of liver functionality showed a roughly 30% improvement in survival odds.

While the results are quite exciting, especially in conjunction with previous research on the subject, there is still a long way to go. The current study is limited by the small sample size used and “selection bias inherent in the use of historical control data”, according to Pasche.

The paper “Safety and Efficacy of amplitude-modulated radiofrequency electromagnetic fields in advanced hepatocellular carcinoma” has been published in the journal 4open.

A blood test that can detect early-stage cancer is accurate enough to be rolled out

The blood test, soon to be piloted in the UK, is aimed at people at higher risk of the disease, including patients of 50 years or older. It can identify more than 50 types of cancer before any clinical signs or symptoms of the disease, including some that are difficult to diagnose early – such as pancreatic, head and heck, ovarian and esophageal. Although it’s not perfect, it’s still good enough to spot a lot of early cancers, and save a lot of lives.

Image credit: Flickr / Phillip Jeffrey

The quicker you detect any type of cancer, the better your chances to eliminate it without any dangerous complications. Survival rates have improved substantially in recent years for many types of cancer, in part due to earlier detection. Unfortunately, detecting cancer early is often difficult — and the tests themselves can be expensive and unpleasant. This is where the new blood test would come in.

Using a blood test to detect cancer is not a new idea. It’s extremely challenging, but in the past few years, there have been a few encouraging results from studies. In the latest effort, an international team developed a blood test that can accurately detect cancer, often before any signs or symptoms, while having a very low false positive rate. 

“Finding cancer early, when treatment is more likely to be successful, is one of the most significant opportunities we have to reduce the burden of cancer,” Eric Klein, first author of the paper, said in a statement.  “These data suggest that, if used alongside existing screening tests, the multi-cancer detection test could have a profound impact on how cancer is detected.”

The test looks for chemical changes in fragments of genetic code that leak from tumors into the bloodstream. Scientists investigated the performance of the test in 3,537 people (2,823 people with cancer and 1,254 without). It correctly identified when cancer was present in 51.5% of cases, across all stages of the disease, with a false-positive rate of 0.5%. It misses just under half of all cases, which means there’s still a lot of work to be done, but given its relative ease, identifying half of cancers (most of which would otherwise go undetected) can be very helpful.

The test’s performance varied based on the type of cancer and how far it had progressed. Esophageal, liver and pancreatic tumors were more likely to be detected (65.6% detection rate) than cancers of the breast, bowels, cervix and prostate (33.7%).

The test’s sensitivity also increased with the cancer’s malignancy, across all disease types — from 16.8% at the earliest stage I, 40.4% at stage II, 77% at stage III and up to 90.1% at stage IV, when the tumor has metastasized and spread to other locations in the body. The test was also able to identify the tumors’ organ sites 88.7% of the time, giving clinicians a head-start.

“We believe that cancers that shed more cfDNA (cell-free DNA) into the bloodstream are detected more easily. These cancers are also more likely to be lethal, and prior research shows that this multi-cancer early detection test more strongly detects these cancer types,” said Klein. “Cancers such as prostate shed less DNA than other tumours, which is why existing screening tests are still important for these cancers.”

The test, developed by US-based company Grail, is currently available by prescription in the US. Meanwhile, in the UK, the National Health Service (NHS) will trial the test this year with 165,000 people. If it works as expected for people without symptoms, the test will be rolled out to become routinely available. Results are expected by 2023. 

The study was published in the journal Annals of Oncology. 

Urine test detects brain tumors with 97% accuracy

Brain tumors are some of the most challenging types of cancers to diagnose. When they’re caught by a doctor, the patient often already has neurological symptoms such as partial limb immobility or slurred speech. Japanese researchers at Nagoya University have recognized this problem and have devised a novel microRNA test that can detect brain tumors from less than a drop of urine.

Various regions of the brain that are affected by brain cancer. Credit: Wikimedia Commons.

MicroRNAs — not to be confused with mRNA or messenger RNA, which some COVID vaccines employ — are a class of non-coding RNAs that play important roles in regulating gene expression. These tiny molecules of nucleic acid are secreted by various cells in the body, but can also survive undamaged in biological fluids like blood and urine.

The researchers at Nagoya University identified these microRNAs as a potentially reliable biomarker for detecting brain tumors.

“Urine can be collected easily without putting a burden on the human body,” says Nagoya University Associate Professor Atsushi Natsume.

Indeed, rather than employing biopsies and other invasive techniques, the prospect of tumor diagnosis from blood or urine has become increasingly appealing over the years. Previously, ZME Science reported on urine tests that detect different types of cancers, such as prostate, bladder, or lung cancer.

However, up until now, urine-based tests for diagnosing brain tumors have fallen short due to technological barriers in extracting microRNAs from urine.

Like any good engineers, the Japanese researchers led by Natsume made their own device capable of accurately extracting and reading microRNA from urine samples.

The device consists of 100 million zinc oxide nanowires, which are suitable for medical use. The wires can extract a great variety and quantity of microRNAs from a single milliliter of urine.

In order to validate the urine test, the researchers collected urine from patients who were previously diagnosed with brain tumors and non-cancer individuals that acted as a control. Their microRNAs were compared.

The results showed that the test could distinguish patients with brain tumors from non-patients at a sensitivity of 100% and a specificity of 97%, regardless of the malignancy and size of tumors.

Natsume was ecstatic by the promising results, hoping the test could soon contribute to the early diagnosis of some of the most aggressive types of brain cancers, such as glioblastomas.

“In the future, by a combination of artificial intelligence and telemedicine, people will be able to know the presence of cancer, whereas doctors will be able to know the status of cancer patients just with a small amount of their daily urine,” he said.

The findings appeared in the journal ACS Applied Materials & Interfaces.

Swiss researchers develop virus that makes cancer tumors destroy themselves

New research at the University of Zurich (UZH) points the way towards a new type of anti-tumor treatment. This, they hope, will help protect patients from the side effects of cancer therapy.

A piece of tumor that was scanned and modelled in 3D (red: blood vessels, turquoise: tumor cells, yellow: therapeutic antibody). Image credits: Plückthun Lab.

Tumors are notoriously tricky to eliminate. The new approach, therefore, involves using our own bodies to produce therapeutic compounds at the tumor’s exact location. This should dramatically limit the negative side effects of traditional interventions because, unlike chemotherapy or radiotherapy, this approach does no harm to normal healthy cells. In fact, this approach could, potentially, also be used for targeted delivery of medicine against COVID-19 directly to the lungs.

Viral aides

It all revolves around a genetically-modified respiratory virus (an adenovirus, to be exact) which delivers genes encoding anti-cancer and signaling compounds directly into tumor cells. Here, they cause the cells to produce the very substances that destroy them, as well as chemical signals such as cytokines, which tells our immune system that the tumor is a target.

“We trick the tumor into eliminating itself through the production of anti-cancer agents by its own cells,” says postdoctoral fellow Sheena Smith, who led the development of the delivery approach.

“The therapeutic agents, such as therapeutic antibodies or signaling substances, mostly stay at the place in the body where they’re needed instead of spreading throughout the bloodstream where they can damage healthy organs and tissues” adds Andreas Plückthun, who led the research effort.

The team christened their new approach SHREAD: SHielded, REtargetted ADenovirus. It draws on the previous work of the same team, including ways to guide the virus to particular areas of the body, as well as methods to hide them from our immune system.

In order to test their approach, the authors used SHREAD to induce a breast tumor in the mammaries of a lab mouse to produce trastuzumab, a clinically approved breast cancer antibody. In a few days, levels of the antibody inside the tumor itself were higher than they could have been if they were injected directly. At the same time, they were significantly lower in the bloodstream and other tissues compared to what’s seen with direct injections — this helps reduce side effects.

The team used high-resolution 3D imaging methods and tissues rendered totally transparent to see how the antibody creates pores in blood vessels of the tumor and destroys tumor cells from the inside out.

One of the best parts of this approach is that it’s not limited only to cancer. The authors explained that by insulating healthy tissues from significant levels of an active substance, it also opens the door for other therapies. For example, it makes it possible to more easily use ‘biologics’, a family of protein-based drugs. If administered using a traditional injection, such biologics would be too toxic for use, they explain.

The team is currently working on applying SHREAD to anti-COVID-19 therapies.

“By delivering the SHREAD treatment to patients via an inhaled aerosol, our approach could allow targeted production of COVID antibody therapies in lung cells, where they are needed most,” Smith explains. “This would reduce costs, increase accessibility of COVID therapies and also improve vaccine delivery with the inhalation approach.”

The paper “The SHREAD gene therapy platform for paracrine delivery improves tumor localization and intratumoral effects of a clinical antibody” has been published in the journal PNAS.

Personalized cancer vaccine shows efficacy against multiple cancers in early tests

A personalized cancer vaccine prototype has shown great promise in a phase 1 trial against different types of cancer, including some that have a high risk of reappearing.

Image credits Arek Socha.

I’m not sure if everybody here is old enough to remember this, but there used to be a time when “finding the cure to cancer” was seen as the be-all-end-all of human ingenuity. Back when my family was still toying with the idea of sending me off to medical school, my grandparents would cheer me on saying that maybe I’ll be the one to discover it — with everybody sharing the silent knowledge that such a wonder would not be possible in our lifetime. So it’s a very surreal experience to see just how far along we’ve come towards that goal.

A new paper reports that personalized vaccines against cancers — compounds created from the genetic data of individual patients and their tumors — are effective against the disease, safe to use, and show promise against commonly recurring cases.

Individually tailored

“While immunotherapy has revolutionized the treatment of cancer, the vast majority of patients do not experience a significant clinical response with such treatments,” said study author Thomas Marron, MD, Ph.D., Assistant Director for Early Phase and Immunotherapy Trials at The Tisch Cancer Institute and Assistant Professor of Medicine at the Icahn School of Medicine at Mount Sinai.

“Cancer vaccines, which typically combine tumor-specific targets that the immune system, can learn to recognize and attack to prevent recurrence of cancer. The vaccine also contains an adjuvant that primes the immune system to maximize the efficacy.”

This class of vaccines was developed with help from the Mount Sinai computational platform OpenVax, created by a group which “develops open-source software for designing personalized cancer vaccines”. In order to create these personalized vaccines, Dr Marron and his team sequenced tumor and germline DNA, alongside tumor RNA, from each patient. They also used this data to help predict whether each individual’s immune system would recognize the vaccine’s targets or not.

For the trial, the participants received 10 doses of the personalized vaccine over a six-month period after undergoing any standard cancer treatment (for example surgery). It was administered alongside an immunostimulant (or an ‘adjuvant’). This adjuvant, poly-ICLC, is a synthetic, stabilized, double-stranded RNA capable of activating multiple innate immune receptors, making it the optimal adjuvant for inducing immune responses against tumor neoantigens,” said study author Nina Bhardwaj.

Thirteen participants received the prototype vaccine. Out of them, 10 had been diagnosed with solid tumors, and 3 had multiple myeloma. All of them had, statistically speaking, a high chance of seeing a resurgence of the disease following treatment.

However, after a mean follow-up interval of 880 days, four of the participants were still cancer-free, four were receiving subsequent lines of therapy, four had died, and one chose to not continue the trial. The vaccine was tolerated well upon administration, with only one-third of the participants developing minor reactions

“Most experimental personalized cancer vaccines are administered in the metastatic setting, but prior research indicates that immunotherapies tend to be more effective in patients who have less cancer spread,” said Dr. Bhardwaj.

“We have therefore developed a neoantigen vaccine that is administered after standard-of-care adjuvant therapy, […] when patients have minimal — typically microscopic — residual disease. Our results demonstrate that the OpenVax pipeline is a viable approach to generate a safe, personalized cancer vaccine, which could potentially be used to treat a range of tumor types.”

The most exciting area of the finding relates to types of cancer that have a high risk of recurrence, such as lung and bladder cancers. Personalized vaccines could finally give us a safe and efficient means of fighting them, and preventing them from reforming.

Still, these results were from a phase 1 trial, whose main aim is to determine whether a drug candidate is safe to use. While the potential benefits of the compound were noticed, determining how best to administer it for the greatest effect is the object of the phase 2 trial — meaning, we’ll have a good idea of what this vaccine can and can’t do quite soon.

The findings have been presented during Week 1 of the virtual AACR Annual Meeting 2021, held April 10-15.

New compound shows promise against hard-to-kill pancreatic and breast cancers, in mice

A drug developed at the Georgia State University (GSU) could pave the way towards new treatment avenues for pancreatic and breast cancer, according to a pair of reports.

Image credits Miguel Á. Padriñán.

The drug, christened ProAgio, was developed by Zhi-Ren Liu, a biology professor at the GSU, and his team. Lab tests with mice showed that the compound is effective at treating pancreatic cancer. A second study shows that it is also effective against “triple-negative breast cancer”, a particularly aggressive and hard-to-treat type of breast cancer that had poor treatment prospects up to now.

Taking down the walls

The drug works by targeting not the disease’s cancerous cells themselves, but rather the ones they use for defense. Cancer cells use fibroblasts, a specialized type of cell that produces collagen and other mechanically-strong molecules, to build a shield around the tumor. This shield is called “stroma” and acts as a physical barrier preventing drugs from reaching inside and doing their job.

ProAgio targets these cells and forces them to undergo apoptosis — programmed cell death. This breaks down the stroma, leaving the tumor vulnerable.

According to the authors, it’s this stroma that makes pancreatic cancer extremely lethal and difficult to treat. The 5-year survival rate for this type of cancer is only 8%, they explain. Triple-negative breast cancer also tends to form a very dense stroma, and offers similarly poor prospects for patients. The team hopes that targeting these conditions’ most powerful asset and neutralizing it would finally give our current cancer treatments the upper hand.

“All solid tumors use cancer-associated fibroblasts, but in pancreatic cancer and triple-negative breast cancer, the stroma is so dense there’s often no way for conventional drugs to penetrate it and effectively treat the cancer,” said Liu.

Furthermore, the stroma is also involved in the tumor’s ability to confuse our immune systems. So it not only insulates from direct treatment but also makes immunotherapy — which uses our natural immune systems to fight cancer — much less effective.

Since cancer-associated fibroblasts also grow new blood vessels to supply the tumor, they speed up its spread through the body. Any cells that break off from the tumor can enter the bloodstream and start developing somewhere else, which we call metastasis. ProAgio, the team showed, has a pronounced effect on the vasculature of tumors. For pancreatic cancers, it helped reopen healthy vessels that were crushed by the stroma. For triple-negative breast cancer, it reduced the rate of new blood vessels being created by the tumor.

ProAgio is derived from a human protein and targets a specific receptor on the surface of cancer-associated fibroblasts to make sure it doesn’t attack any other, healthy tissues.

“When you have a wound, for example, normal fibroblasts will secrete fibers to limit the damage and promote healing,” said Liu. “The tumor region is basically a wound that won’t heal. Quiescent fibroblasts may play a role in preventing cancer from spreading. You don’t want to kill the good guys, only the bad guys.”

The drug is currently licensed to ProDa BioTech, a pharmaceutical research company founded by Liu. It has currently passed the toxicology and pharmacokinetic studies required before a drug can enter the first stages of clinical trials. These will start after ProAgio passes its Investigational New Drug (IND) Application, the process through which the Food and Drug Administration gives its approval for testing with human subjects.

The first trials will likely begin in early 2021 if everything goes well with the FDA, Liu says, and hopefully everything will progress to late-stage trials sometime by the end of the year.

The first paper “Simultaneously targeting cancer-associated fibroblasts and angiogenic vessel as a treatment for TNBC” has been published in the Journal of Experimental Medicine.

The second paper “Modulation of Cancer-Associated Fibrotic Stroma by An Integrin αvβ3 Targeting Protein for Pancreatic Cancer Treatment” has been published in the journal Cellular and Molecular Gastroenterology and Hepatology.

Hibernating cancer cells may explain relapse after chemotherapy

The Himalayan black bears go in hibernation during winters. To survive this winter period, the bears need to eat and store fats before they go to hibernate. Credit: Wikimedia Commons.

Cancer is extremely tricky to get rid of. Even after a successful therapy that has seemingly extinguished a tumor, cancer can return unexpectedly years later. According to a new study, this happens as a result of cancer cells entering a dormant state that allows them to evade destruction from chemotherapy. The same cellular process is employed by some hibernating animals in nature.

“We never actually knew that cancer cells were like hibernating bears,” Aaron Schimmer, a scientist at the Princess Margaret Cancer Centre in Toronto and co-author of the new study, said in a statement. “This study also tells us how to target these sleeping bears so they don’t hibernate and wake up to come back later, unexpectedly.”

The team of researchers led by Dr. Catherine O’Brien, who is an Associate Professor in the Department of Surgery at the University of Toronto, studied human colorectal cancer cells that were treated with chemotherapy. The scientists observed that the chemotherapy induced the cells into a slow-dividing state.

Gene expression in these treated cancer cells was found to closely resemble that of rodent embryos when they shift to a hibernation-like state known as embryonic diapause. This survival mechanism is used by more than 100 species of mammals in nature to keep their embryos safe during times of extreme environmental conditions, such as freezing winters or lack of food.

During embryonic diapause, cell division is minimal, thus reducing energy expenditure and greatly reducing metabolism. This slow-dividing state requires the activation of a cellular process called autophagy (“self-devouring”), a process in which the cell literally consumes its own proteins or other cellular components in order to survive the absence of other nutrients. Once environmental conditions improve, the embryo resumes normal development with no adverse effects on pregnancy.

Essentially, the cancer cells have hijacked this embryonic survival strategy, enabling them to withstand the onslaught of chemotherapy, even though humans themselves seem to have lost this ability. All cancer cells enter this state in a coordinated manner, the researchers reported in their study published in the journal Cell.

Understanding how exactly cancer cells resurface even after successful therapies may be key to preventing relapses. When the researchers employed a molecule known to inhibit autophagy, they found that cancer cells no longer survived when subjected to chemotherapy.

“This gives us a unique therapeutic opportunity,” says Dr. O’Brien. “We need to target cancer cells while they are in this slow-cycling, vulnerable state before they acquire the genetic mutations that drive drug-resistance.

“It is a new way to think about resistance to chemotherapy and how to overcome it.”

New mesothelioma treatment involves tiny tubes of gold and lasers

There’s no silver bullet against mesothelioma, a type of cancer caused by exposure to asbestos. However, there might be a golden one.

A schematic of the rods’ preparation (top) and electron microscopy scans of the finished products. Image credits Sunjie Ye et al., (2020), Small.

Tiny, hollow cylinders of gold a thousand times thinner than a human hair — gold nanotubes — could be useful in treating mesothelioma, a new paper reports. After being injected in affected tissues, these nanotubes absorb light and produce heat, killing nearby cancer cells.

Bling treatment

“Mesothelioma is one of the ‘hard-to-treat’ cancers, and the best we can offer people with existing treatments is a few months of extra survival,” said co-author Dr Arsalan Azad from the Cambridge Institute for Medical Research at the University of Cambridge. “There’s an important unmet need for new, effective treatments.”

To say that asbestos is bad for you is kind of an understatement. The UK has had a particular problem with this stuff because they imported and used a great deal of asbestos following the second world war — in fact, they have the highest rate of mesothelioma in the world, with roughly 2,600 new cases diagnosed each year.

The authors, a team of researchers at the Universities of Cambridge and Leeds, show that gold nanotubes can be used to treat the condition. The UK isn’t the only country that stands to benefit from this, as asbestos is still widely used, particularly in low- and middle-income countries.

The gold nanotubes have ‘tunable’ properties — the team can change their properties such as wall thickness, microstructure, composition, and ability to absorb particular wavelengths of light, for different applications. As a proof-of-concept, the authors added the nanotubes to mesothelioma cultures in the lab, which absorbed and stored them close to their nucleus. When the team targeted the cells with a laser, the nanotubes absorbed the light and heated up, killing the cells.

“The mesothelioma cells ‘eat’ the nanotubes, leaving them susceptible when we shine light on them. Laser light is able to penetrate deep into tissue without causing damage to surrounding tissue. It then gets absorbed by the nanotubes, which heat up and, we hope in the future, could be used to cause localised cancer-cell killing,” explains co-author Professor Stefan Marciniak, also from the Cambridge Institute for Medical Research.

The nanotubes are created in a two-step process. A base of silver nanorods of the desired diameter are created first, and then a gold solution is poured over them. As it builds-up on their surface, the silver dissolves from the inside to leave a hollow nanotube. The approach allows these nanotubes to be developed at room temperature, which should make them easier and cheaper to manufacture at scale.

“Having control over the size and shape of the nanotubes allows us to tune them to absorb light where the tissue is transparent and will allow them to be used for both the imaging and treatment of cancers,” adds co-author Professor Stephen Evans from Leeds.

“The next stage will be to load these nanotubes with medicines for enhanced therapies.”

The paper “Exploring High Aspect Ratio Gold Nanotubes as Cytosolic Agents: Structural Engineering and Uptake into Mesothelioma Cells” has been published in the journal Small.

Researchers confirm the first case of bone cancer in dinosaurs

Evidence is mounting that, despite living hundreds of millions of years ago, dinosaurs were not strangers to cancer.

An image and computerized scan of the bone.
Image credits Royal Ontario Museum / McMaster University.

Researchers have uncovered a new dinosaur fossil that seems to have suffered from a severe form of bone cancer around 77 million years ago. The findings help underscore the fact that cancer is in no ways a modern affliction — or a human-only one — and points to the role disease and other medical conditions play in the wild.

The bad bone

The research is based on the fossils of a Centrosaurus apertus, a herbivore that lived in the Canadian stretches during late Cretaceous (76 to 75 million years ago). Its life, at least during its latter parts, was probably not very enjoyable at all, as this dinosaur had to contend with a very aggressive case of bone cancer in one of its hind legs.

Not only would this make it difficult and painful for the dinosaur to move around — either to forage or to evade/fight off predators — but the team studying its fossil believes the cancer was malignant. If so, it means it could spread to its other tissues, mainly its internal organs.

The cancer in its leg bones was so advanced, that at first the team was convinced they were looking at a bone that had healed at sutured itself after a fracture. It was only after the bone was studied in depth using a host of techniques, including radiology and orthopedic surgery, that they found a massive, aggressive tumor inside the bone.

“Diagnosis of aggressive cancer like this in dinosaurs has been elusive and requires medical expertise and multiple levels of analysis to properly identify,” Dr. Mark Crowther, co-author of the study, said in a statement.

“Here, we show the unmistakable signature of advanced bone cancer in 76-million-year-old horned dinosaur—the first of its kind. It’s very exciting.”

The disease had progressed to an “advanced stage” by the time the animal died and likely made it very difficult for it to move. Still, it’s not all tragedy and woe with the dino: his remains were found in a “bone bed” along with many others from the same species. The team believes we’re looking at a pack of C. apertus that died in a flood. From the lack of bite marks on the diseased dino, and from his final resting place alongside his family and friends, it’s safe to assume that the herd lifestyle allowed it to survive despite his condition.

“The shin bone shows aggressive cancer at an advanced stage. The cancer would have had crippling effects on the individual and made it very vulnerable to the formidable tyrannosaur predators of the time,” adds Dr. David Evans, corresponding author of the study.

“The fact that this plant-eating dinosaur lived in a large, protective herd may have allowed it to survive longer than it normally would have with such a devastating disease.”

This isn’t the first time we’ve found evidence of tumors in dinosaur fossils, but it is the first confirmed case of bone cancer we’ve seen in such an animal.

The finding goes to show that even the mightiest animals sometimes have to bow in the face of disease. But it also shows how far we’ve come: dinosaurs, for all their might and long reign, were at the mercy of such conditions, and we’re starting to learn how to identify, manage, and cure them.

The paper “First case of osteosarcoma in a dinosaur: a multimodal diagnosis” has been published in the journal The Lancet.

Gum disease may put people at high risk of developing some cancers

Credit: Pixabay.

Gum disease isn’t just terrible for oral health, its impact on the human body may extend well beyond the mouth. Previously, researchers found a strong association between gum disease and Alzheimer’s. Now, a new study has found that gum disease is strongly linked to cancers that affect the gut.

Gum disease, which affects a third of all people, is caused by oral bacteria like P. gingivalis. In its mild form, known as gingivitis, only the gum line is affected. However, if left untreated, the bacteria can travel below the gum line and into the bone, causing a more serious form of gum disease known as periodontitis.

Besides swollen gums, smelly breath, and bad teeth, gum disease is also known to contribute to diabetes, heart disease, osteoporosis, and pneumonia.

Most recently, researchers at the Harvard T.H. Chan School of Public Health in Boston have also found an association between a history of periodontal disease and a heightened risk of esophageal (gullet) cancer and gastric (stomach) cancer.

The researchers examined datasets pertaining to 98,459 women from the Nurses’ Health Study (1992-2014) and 49,685 men from the Health Professionals Follow-up Study (1988-2016). The researchers gained access to dental measures, demographics, lifestyle, and diet for each participant, as well as follow-up reports of cancer diagnostics.

During the two decades of follow-up, there were 199 cases of esophageal cancer and 238 cases of gastric cancer recorded for the two cohorts.

When all other factors were accounted for, the researchers found that those with a history of periodontal disease had a 43% and 52% increased risk of esophageal cancer and gastric cancer, respectively.

The participants who lost two or more teeth had a 42% and 33% higher risk of developing oesophageal and gastric cancer, respectively, compared to those with no tooth loss.

Compared with those who had no history of periodontal disease and no tooth loss, the participants who had the gum disease and lost one or more teeth had a 59% increased risk of oesophageal cancer. The same group had a 68% greater risk of gastric cancer.

Since this is an observational study, the authors of the study could not draw any cause-effect conclusions. However, the researchers have some ideas about potential causal mechanisms that may explain the findings.

The presence of oral bacteria like Tannerella forsythia and Porphyromonas gingivalis was associated with a heightened risk of oesophageal cancer. Regarding gastric cancer, gum disease could promote the formation of endogenous nitrosamines through nitrate-reducing bacteria, which are known to cause this type of cancer.

In any event, these findings reinforce the importance of proper oral health — not just for the sake of your gums and teeth, but for your very own life, too.

“Together, these data support the importance of oral microbiome in oesophageal and gastric cancer. Further prospective studies that directly assess oral microbiome are warranted to identify specific oral bacteria responsible for this relationship. The additional findings may serve as readily accessible, non-invasive biomarkers and help identify individuals at high risk for these cancers,” the authors concluded in their study, which was published today in the journal Gut.

Simple blood test can detect 50+ types of cancer before any symptoms even start

A key ally in our fight against cancer is early detection. The sooner you discover a potential tumor, the sooner you can take action, and the likelier it is that a full recovery is made.

Unfortunately, cancer can be insidious. It can brew up for years without causing clear symptoms, and diagnostic tests can be painful, expensive, and intrusive. That might change soon.

Image credits: Teresa J. Cleveland.

In a new study, researchers from the Dana-Farber Cancer Institute and Harvard Medical School presented the results of a new blood test for cancer. The diagnosis was tested against 4,000 samples from patients, some of which had cancer, and some of which didn’t.

Remarkably, the test proved accurate at detecting over 50 types of cancer, including bladder, esophagus, lung, and breast cancer. The test had a 98.3% to 99.8% accuracy for positive results and a 0.7% false-positive rate — not perfect, but remarkably accurate. In the samples where cancer was detected, the test was also able to pinpoint its type of cancer in 93% of instances (in the others, it correctly identified the presence of cancer, but misrepresented the type).

The test looks for chemical markers in the bloodstream (methylation patterns in DNA). These bits of cell-free, free-floating DNA pieces are leaked from tumors into the bloodstream and can be a tell-tale indicator. The team used a machine learning algorithm (a type of artificial intelligence) to train the test to look for patterns that indicate the presence of cancer and classify it accordingly.

It’s still in its early days, and it’s unclear how the test will perform in a broader sample size — particularly one where no information is known about the patients. Researchers plan to further improve the test’s detection rate — particularly in the early stages, where detection rates were substantially lower. Detecting cancers at their earliest stages, when they are less aggressive and far more treatable, is a key objective for the test.

The fact that the test is painless and scalable is promising, but it remains to be seen whether its efficacy will be confirmed in larger trials. A blood-based multi-cancer detection test should demonstrate certain fundamental performance to be useful in a general screening population.

Now, researchers are already embarked on several clinical trials to test the validity of the new diagnosis. It will be a while before such a test will become readily available, but so far at least, things are looking promising.

The study has been published in the journal Annals of Oncology.

Fermented soy products may reduce mortality risk

A new study reports finding a link between higher intake of fermented soy products such as miso and nato and a lower risk of all-cause mortality. However, at this point, the findings aren’t conclusive; further research is needed to establish a cause-and-effect relationship between the two.

A bowl of gochujang miso.
Image credits Jinwoo Lee.

Fermented soy products are quite widely consumed in Asian countries, particularly Japan. These include natto (soybeans fermented with Bacillus subtilis), miso (soybeans fermented with Aspergillus oryzae), and tofu (soybean curd). A new study aimed at studying the potential health benefits associated with these products reports that they may help reduce mortality from any cause, although the link is not yet properly established.

Spilling the beans

“In this study a higher intake of fermented soy was associated with a lower risk of mortality,” the authors write. “A significant association between intake of total soy products and all cause mortality was not, however, observed.”

“The findings should be interpreted with caution because the significant association of fermented soy products might be attenuated by unadjusted residual confounding.”

The team set out to investigate the association between several types of fermented soy products and death from any cause (“all-cause mortality”), from cancer, total cardiovascular disease (heart disease and cerebrovascular disease), respiratory disease, and injury.

The findings were drawn from a pool of 42,750 men and 50,165 women aged 45-74 who were taking part in the Public Health Centre-based Prospective Study, which includes 11 public health center areas in Japan. As part of the study, participants were asked to fill in detailed questionnaires regarding their dietary habits, lifestyle, and personal health. Residential registries and death certificates were used to track the evolution of these participants over a 15-year-period after filling in the questionnaires. Roughly 13,300 deaths were identified during this time.

All in all, the team reports, a higher intake of fermented soy was associated with a 10% lower risk of all-cause mortality. Participants who ate natto also had a “significantly” lower risk of cardiovascular mortality than those who did not eat natto, the team adds. Total (unfermented) soy and soy product intake, however, had no observable link to all-cause mortality, they add, or to cancer-related mortality.

The association stood firm even after the team adjusted for vegetable intake — higher rates of which are associated with better overall health and reduced mortality. Participants who consumed higher portions of natto were, on average, also chowing down on more vegetables than their peers, the team explains. Fermented soy products are higher in fiber, potassium, and other beneficial compounds than non-fermented soy products, the team explains. They believe this might underpin the association observed in this study.

However, they also strongly stress that this is an observational study. The team simply found that people who eat more of these products are less likely to die from certain causes, but that doesn’t mean the products themselves lead to decreased mortality. The authors controlled for several factors, including overall diet, body-mass index (BMI), smoking status, alcohol intake, and engagement in sports among many others. Still, unaccounted for factors (these are the ‘confounders’ they mention) could be causing the observed link.

Further research is needed “to refine our understanding of the health effects of fermented soy,” they add, noting that there is some evidence linking fermented soy products with various health benefits — so it’s a promising line of study.

“These efforts should be collaborative, including not only researchers but also policymakers and the food industry,” they conclude.

The paper “Association of soy and fermented soy product intake with total and cause specific mortality: prospective cohort study” has been published in the journal BMJ.

US cancer survival rates have reached record highs

The cancer death rate in the US fell by the greatest percentage on record, thanks to advances in treatments and prevention approaches.

Better treatments played a key role in fighting off cancer. Image credits: US Air Force.

Slowly winning the battle with cancer

U.S. Cancer Death Rate Lowest In Recorded History! A lot of good news coming out of this Administration Trump tweeted on January 9.

But, while the first part of his statement is true, the implication of the second part (that the current administration had anything to do with it) is baseless.

Cancer rates have been on the decline for 26 years, with the overall death rates from cancer in the U.S. declining by 29% from 1991 to 2017. That translates to about 3 million fewer cancer deaths in the past three decades — and that’s not all the good news.

The most recent analyzed year (2017) also marked the sharpest decline: 2.2%, the most that death rates from cancer have decreased in any year.

However, results aren’t uniform across all types of cancer, and at a closer look, it becomes clear that much of this decrease is owed to one particular type.

“It is really lung cancer that is driving this,” Rebecca Siegel, scientific director of surveillance research at the American Cancer Society, and lead author on the new study, told Bloomberg. “We found increases in survival for lung cancer at every stage in diagnosis.”

The causes

Lung cancer, one of the most aggressive types of cancer, has decreased spectacularly — by 51% for men since their peak rate in 1990, and by 26% for women since their peak rate in 2002 (and the figure for women is expected to catch up to that of men).

There are multiple reasons for this, including improvements in treatments, video-assisted surgery, better radiation treatment, and better diagnosis. However, when it comes to 2017 in particular, the cause was something much simpler: people smoked less.

This is an important reminder that although different types of cancer can vary dramatically, when it comes to reducing cancer deaths, having a healthy lifestyle can make a major difference. Often times, this simply means avoiding things like cigarettes or alcohol. The fact that new cancer drugs are being developed also helps — notably, two important such drugs were approved by the Food and Drug Administration in 2014 and 2015.

The decrease is, therefore, part of a longer-term scientific and societal change, rather than the merit of any administration. President Trump’s statement rings particularly hollow as last year, he advocated cutting $4.5 billion from the National Institutes of Health (NIH) — including a $1 billion cut for the National Cancer Institute — only to be overruled by Congress, who decided on an increase in the (NIH) budget.

Nevertheless, despite these encouraging trends, 1.8 million new cancer cases are expected to be diagnosed in 2020. Society is winning important battles, but the war with cancer is far from over.

In addition, some types of cancer (such as cervical cancer) are actually becoming more prevalent, largely due to socioeconomic factors.

An AI walks into a hospital — and it’s really good at detecting tumors

A novel approach combines advanced imaging with artificial intelligence to offer real-time tumor detection.

During cancer surgery, surgeons sometimes extract tissue samples for lab analysis. This is an important step that allows medics to perform more accurate diagnoses and direct the course of treatment, which may include a subsequent surgery to remove the tumor.

The new study compared the ability of an AI to detect tumors in these samples with the ability of competent pathologists. The AI-based diagnosis software was 94.6% accurate, compared to 93.9% for the pathologist interpretation. It also works in near-real-time, with the diagnosis taking little over 2 minutes.

Over 1 million brain samples are analyzed in the US alone every year, a process that is time-, resource-, and labor-intensive. To add even more to this problem, vacancies in neurology departments are not uncommon.

With this in mind, neuroscientists Daniel Orringer and his colleagues set out to develop a new diagnostic tool. It combines a powerful optical imaging technique, called stimulated Raman histology (SRH), with an artificially intelligent deep neural network. During surgery, images are acquired through SRH and then fed to the AI algorithm, which makes the assessment in 150 seconds.

Pathologists are generally accurate, but this approach can greatly reduce the time and effort needed for diagnosis. As an added bonus, the AI is also capable of detecting features that can escape the human eye.

“As surgeons, we’re limited to acting on what we can see; this technology allows us to see what would otherwise be invisible, to improve speed and accuracy in the [operating room], and reduce the risk of misdiagnosis,” Orringer, the senior author of the paper, said in a press statement. “With this imaging technology, cancer operations are safer and more effective than ever before.”

The researchers trained the AI using more than 2.5 million samples, classifying them in different categories that represent the most common types of brain tumors. The algorithm was then tested for efficiency on 278 brain tumor and epilepsy patients, and its results compared to that of human doctors. Neither the AI nor the pathologists are perfect but there’s an upside to this: the errors that the AI did were different from the ones that humans made. This suggests that, should a pathologist and an AI analyze the same tissue sample, they might come very close to 100% accuracy. This means that the AI could be used both to complement the lack of neuroscientists or to complement them and improve the results.

Slowly but surely, AI is starting to enter the medical room — and it can make a real difference.

The study has been published in Nature Medicine.