March 15, 2019
Expert researchers find shorter treatment cycles may reduce risk of breast cancer returning
Researchers have found that the dosage and interval of chemotherapy treatments have a significant impact on some breast cancer patients’ survival. For a very small minority of patients the difference of a week between chemotherapy treatments could mean the difference between life and death – and researchers are working to identify exactly who those patients are.
Over the last few decades, breast cancer clinical trials have investigated the way in which patients receive and respond to different chemotherapy dosing regimens. Some have tested if a shorter – but more intense – two-week treatment cycle is more effective than the standard three-week cycle. These trials, however, are often limited in size and do not have the statistical power to detect a difference in response to treatment.
Researchers from the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) have recently performed a meta-analysis across 26 breast cancer trials to help clarify this dosing dilemma. As reported in The Lancet, they found that more intense dosing regimens were associated with a decreased risk of death from breast cancer and a decreased risk that the disease will return in some patients.
“As chemotherapy kills tumour cells, the residual – or remaining – cancer cells have more room to grow and tend to grow faster,” says Dr. John Bartlett, Program Director of Diagnostic Development at OICR and member of the EBCTCG Steering Committee. “These trials hypothesized that a more intense dosing regimen would give tumour cells essentially less room to grow. With the results of the EBCTCG overview study, we can say with confidence that a two-week treatment schedule will help to prevent death in a small portion of patients.”
The analysis found that approximately one in 50 women benefited from more intense dosing.
“The challenge now is to determine exactly which patients can benefit from intense dosing and which patients would not,” says Bartlett.
“If we can do so, we can prevent deaths due to breast cancer for some, while minimizing the negative side effects of intense chemotherapy for others.”
The ECBTCG is continuing to investigate dosing intensity in common breast cancer subtypes in parallel with researchers who are looking to find the biological basis of these differing responses to treatment.
“We’re in an era of de-escalation where we’re heavily invested in reducing overtreatment,” Bartlett says. “But this work helps us move towards an era of biologically rational treatment recommendations, one where breast cancer patients get the treatment they need at the right time and in the right way.”
February 12, 2019
Sometimes the simpler, the better: bringing personalized treatment selection for bladder cancer closer to the clinic
Pathology experts review challenges and opportunities in treatment selection for muscle-invasive bladder cancer (MIBC), propose traditional pathology method to achieve same results as molecular profiling at lower cost
Research has shown that some types of bladder cancer respond well to treatment and other types are resistant, yet molecular subtyping, which can help better define a patient’s cancer and direct them to a more targeted treatment, is not performed in the clinic. This means that patients are often treated with a one-size-fits-all approach. Despite recent research progress, the movement of MIBC subtyping to the clinic has stagnated.Continue reading – Sometimes the simpler, the better: bringing personalized treatment selection for bladder cancer closer to the clinic
October 24, 2018
Research team finds aggressive breast cancers are less frequent than previously thought, and less aggressive breast cancers need more of our attention.
Different subtypes of breast cancer respond to treatment differently and require different treatment approaches. Understanding the distribution of these subtypes and their respective clinical outcomes allows researchers to better understand the disease and identify key research priorities that may have been previously overlooked.
September 24, 2018
OICR takes part in international multicentre study to standardize promising breast cancer digital pathology test
The Ki67 immunohistochemistry assay is a test that can help evaluate the aggressiveness of breast tumours, predict disease outcomes, monitor cancer progression and identify patients who are more likely to respond to a given therapy. Despite its potential to help patients with breast cancer, the analysis of Ki67 has not been widely adopted in the clinic, mostly due to the lack of standardization across laboratories.
June 4, 2018
Current HER2 tests help predict which breast cancer patients will respond to HER2-targeted therapies, but sometimes these tests provide unclear results. An Expert Panel of pathologists and cancer researchers, including Dr. John Bartlett from OICR, recently published revised clinical practice guidelines for HER2 testing in breast cancer to help improve clarity of HER2 test results.
January 25, 2018
The Canadian Data Integration Centre receives new funding to help cancer researchers translate findings to patients
Toronto (January 25, 2018) – The Canadian Data Integration Centre (CDIC) has received $6.4 million in funding from Genome Canada to help the research community translate the biological insights gained from genomics research into tangible improvements for cancer patients.
CDIC is a “one-stop shop” service delivery platform for cancer researchers, helping streamline research by providing coordinated expertise on a broad range of services, including data integration, genomics, pathology, biospecimen handling and advanced sequencing technologies. It is an international leader in genomics, bioinformatics and translational research, supporting some of the world’s largest programs in genomic data analysis, genomic and clinical data hosting, cancer data analyses and access, and the development of algorithms for advanced sequencing technology.
January 12, 2018
Endocrine therapy uses hormone antagonists to greatly reduce the risk of disease recurrence in women with early-stage, estrogen-receptor (ER) positive breast cancer. However, the treatment can come with severe side effects. Around 30 per cent of women stop taking the therapy after three years largely due to these negative impacts. Usually patients receive the hormone therapy for five years following initial treatment (e.g., chemotherapy, surgery), but it can also be taken longer-term. A central question facing patients and clinicians is how to balance, in their decision making, the side effects of long-term treatment with the potential reduction in recurrence risk. In short, they want to know: ‘is it worth it?’
May 3, 2017
The advent of genomic sequencing and targeted therapies has opened the door to new ways of diagnosing and treating cancer. The Ontario-wide Cancer Targeted Nucleic Acid Evaluation (OCTANE) program is a new, province-wide initiative supported by OICR that will allow more patients to benefit from these innovations while also helping to advance cancer research in Ontario.
April 13, 2017
Breast cancer is the most common form of cancer amongst women in Canada and worldwide, but despite its prevalence, a group of researchers believes that it should often be treated as a rare disease. Doing so would change clinical approaches and improve treatment for patients.
November 23, 2016
On November 16 OICR and the Ontario Molecular Pathology Research Network (OMPRN) joined other organizations around the world celebrating International Pathology Day.
November 9, 2016
Men newly diagnosed with prostate cancer face a difficult dilemma: either wait and see how the growth develops and whether it is aggressive, or treat it fully right away and risk the many long-term side effects of treatment. Dr. Tamara Jamaspishvili is a young researcher at Queen’s University in Kingston who is working to change that.
November 4, 2016
Dr. John Bartlett, from the Ontario Institute for Cancer Research, and Dr. Michelle Downes, from Sunnybrook Health Science Centre, will take you into a world of pathology beyond crime scene investigation and into puzzles more complex than an escape room. They will talk about the future of pathology and how this is changing the face of medicine and why a pathologist is considered ‘the doctor’s doctor’.
The Duke of York Pub – November 16, 6-8 p.m.
39 Prince Arthur Avenue, Toronto
near St. George subway station