Most Read Articles
Natalia Reoutova, 20 May 2020

Cancer patients infected with coronavirus disease 2019 (COVID-19) appear to be at higher risk of severe outcomes, including death, but cancer type and treatment serve as better predictors, according to recent research presented at the American Association for Cancer Research (AACR) 2020 Virtual Annual Meeting I.

At the time of writing, COVID-19 has spread to more than 200 countries and territories, affecting an estimated 4.5 million people and killing over 300,000. Cancer, on the other hand, is newly diagnosed in 18 million people and takes the lives of 10 million every year.

“We have invited physician scientists who are at the epicentre of the COVID-19 pandemic, taking care of patients with cancer. They gathered prospective information to understand the effects of COVID-19 on patients with cancer, are testing new treatments, and are making this knowledge available to the global research community, so we can all benefit from their experience,” said Professor Antoni Ribas from UCLA Medical Center, Los Angeles, California, US, chairperson of the COVID-19 and cancer plenary session of the meeting.

14 Feb 2020
The phase III CASTOR and POLLUX studies previously demonstrated benefit of daratumumab plus bortezomib and dexamethasone (DVd) or lenalidomide and dexamethasone (DRd) vs standard-of-care (SoC) Vd or Rd regimen in relapsed or refractory multiple myeloma (R/R MM). The latest efficacy and safety results after 4 years of follow-up from CASTOR and POLLUX were presented at the American Society of Hematology (ASH) 61st Meeting & Exposition 2019 held in Orlando, Florida, US.  
Natalia Reoutova, 28 May 2020

Fasting-mimicking diet (FMD) cycles in combination with endocrine therapy (ET) cause metabolic changes in hormone receptor (HR)-positive breast cancer patients analogous to those observed in animal models, where they are associated with anticancer activity.

Dr. Jason Butler, 01 Apr 2020
Proteasome inhibitors have become a cornerstone of therapy for multiple myeloma (MM). At the Hong Kong Society of Myeloma Annual Scientific Meeting 2019, Dr Jason Butler of the Icon Cancer Care & Royal Brisbane and Women’s Hospital, Brisbane, Australia, reviewed current evidence for the use of proteasome inhibitors in the management of relapsed/refractory MM (R/R MM), with a focus on the efficacy and safety profile of carfilzomib.

Eradicating pathogens may lead to improved outcomes in gastric cancer

Natalia Reoutova
21 Mar 2020

A review article written by scientists from the Chinese University of Hong Kong highlights the therapeutic significance of eradicating bacterial, viral and fungal pathogens in gastric cancer (GC) treatment. [Oncogene 2020, doi: 10.1038/s41388-020-1241-4]

Helicabacter pylori and Epstein-Barr virus (EBV) are the most well-known pathogens in gastric carcinogenesis, with H. pylori infection being identified in 65–80 percent of primary GCs and 90 percent of all lower stomach (noncardia) GCs, and EBV being associated with 10 percent of GC cases. [Gene 2004;341:1-17; Lancet Glob Health 2016;4:e609-e616]

WHO describes H. pylori as a class I carcinogen due to its unequivocal role in GC. A prospective study of Japanese patients with duodenal or gastric ulcers, gastric hyperplasia, or non-ulcer dyspepsia with (n=1,246) or without (n=280) H. pylori found that 2.9 percent of the infected patients vs no uninfected patients developed GC (p<0.001). [N Engl J Med 2001;345:784-789] A randomized, placebo-controlled primary prevention study of 1,630 healthy Chinese H. pylori carriers demonstrated that none of the subjects without precancerous lesions on presentation who received H. pylori treatment developed GC during 7.5 years of follow-up vs 6 of those who received placebo (p=0.02). [JAMA 2004;291:187-194]

As a first-line strategy for H. pylori eradication, the 2016 Toronto Consensus guidelines recommend a 14-day course of either PAMC (proton pump inhibitor [PPI], amoxicillin, metronidazole, and clarithromycin) or bismuth quadruple PBMT (PPI, bismuth, metronidazole, and tetracycline) therapy. [Gastroenterology 2016;151:51-69]

A rRNA gene analysis of 81 gastric mucosal samples from China, including cases of superficial and atrophic gastritis, intestinal metaplasia and GC, demonstrated significant differences in microbial diversity and richness between GC and all other conditions (p<0.001), indicating the presence of microbial dysbiosis in gastric carcinogenesis. Peptostreptococcus stomatis, Dialister pneumosintes, Slackia exigua, Parvimonas micra, and Streptococcus anginosus were identified as potential biomarkers for differentiating GC. [Gut 2018;67:1024-1032]

Viral pathogens have also been postulated to play a role in gastric tumourigenesis, with EBV, cytomagalovirus, and human herpes virus 6 being identified as particularly relevant to gastrointestinal tumours. [Virology 2018;513:208-216] Among them, EBV is classified as a group I carcinogen by the International Agency for Research on Cancer. [Int J Cancer 2006;118:3030-3044] Interestingly, co-infection with EBV and H. pylori in paediatric patients was found to be significantly associated with severe gastritis unlike either infection alone, suggesting a cooperative effect of H. pylori and EBV in the gastric mucosa. [PLoS ONE 2013;8:e62850]

In a prospective phase II trial, patients with EBV-positive (n=6) metastatic GC achieved a remarkable 100 percent overall response rate, with a median duration of response of 8.5 months, following salvage treatment with pembrolizumab. “EBV should therefore be routinely tested to identify potential GC patients who may benefit from immunotherapy,” suggested the researchers. [Nat Med 2018;24:1449-1458]

In contrast, a study evaluating nivolumab’s efficacy in advanced GC yielded an objective response in only one of four EBV-positive patients. Unlike the pembrolizumab trial, the nivolumab study also found little concordance between EBV status and PD-L1 expression, leading the latter study’s authors to suggest that “both EBV status and PD-L1 expression should be evaluated in a larger cohort.” [J Immunother Cancer 2019;7:24]  

Gastrointestinal mucosal lesions and surgical procedures can lead to fungal infection. Although thought to affect only 20 percent of GC cases, “it is necessary to eliminate opportunistic infection of Candida to reduce significant morbidity and mortality,” advised the authors. [Gut 1982;23:137-139]

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Most Read Articles
Natalia Reoutova, 20 May 2020

Cancer patients infected with coronavirus disease 2019 (COVID-19) appear to be at higher risk of severe outcomes, including death, but cancer type and treatment serve as better predictors, according to recent research presented at the American Association for Cancer Research (AACR) 2020 Virtual Annual Meeting I.

At the time of writing, COVID-19 has spread to more than 200 countries and territories, affecting an estimated 4.5 million people and killing over 300,000. Cancer, on the other hand, is newly diagnosed in 18 million people and takes the lives of 10 million every year.

“We have invited physician scientists who are at the epicentre of the COVID-19 pandemic, taking care of patients with cancer. They gathered prospective information to understand the effects of COVID-19 on patients with cancer, are testing new treatments, and are making this knowledge available to the global research community, so we can all benefit from their experience,” said Professor Antoni Ribas from UCLA Medical Center, Los Angeles, California, US, chairperson of the COVID-19 and cancer plenary session of the meeting.

14 Feb 2020
The phase III CASTOR and POLLUX studies previously demonstrated benefit of daratumumab plus bortezomib and dexamethasone (DVd) or lenalidomide and dexamethasone (DRd) vs standard-of-care (SoC) Vd or Rd regimen in relapsed or refractory multiple myeloma (R/R MM). The latest efficacy and safety results after 4 years of follow-up from CASTOR and POLLUX were presented at the American Society of Hematology (ASH) 61st Meeting & Exposition 2019 held in Orlando, Florida, US.  
Natalia Reoutova, 28 May 2020

Fasting-mimicking diet (FMD) cycles in combination with endocrine therapy (ET) cause metabolic changes in hormone receptor (HR)-positive breast cancer patients analogous to those observed in animal models, where they are associated with anticancer activity.

Dr. Jason Butler, 01 Apr 2020
Proteasome inhibitors have become a cornerstone of therapy for multiple myeloma (MM). At the Hong Kong Society of Myeloma Annual Scientific Meeting 2019, Dr Jason Butler of the Icon Cancer Care & Royal Brisbane and Women’s Hospital, Brisbane, Australia, reviewed current evidence for the use of proteasome inhibitors in the management of relapsed/refractory MM (R/R MM), with a focus on the efficacy and safety profile of carfilzomib.