New ovarian cancer blood test is promising – but screening still a way off
A new screening method can detect twice as many women with ovarian cancer as conventional strategies, according to the latest results from the largest trial of its kind led by UCL.
The method uses a statistical calculation to interpret changing levels in women’s blood of a protein called CA125, which is linked to ovarian cancer. This gives a more accurate prediction of a woman’s individual risk of developing cancer, compared to the conventional screening method which uses a fixed ‘cut-off’ point for CA125. The new method detected cancer in 86% of women with invasive epithelial ovarian cancer (iEOC), whereas the conventional test used in previous trials or in clinical practice would have identified fewer than half of these women (41% or 48% respectively).
The results come from analysis of one arm of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), the world’s largest ovarian cancer screening trial, led by UCL and funded by the Medical Research Council, Cancer Research UK, Department of Health and The Eve Appeal. The trial involved 202,638 post-menopausal women aged 50 or over who were randomly assigned to two different annual screening strategies (multimodal screening or transvaginal ultrasound) or no test at all.
Rebecca Banks: “Spotting cancer earlier could save 5,000 lives a year”
Content on this post is produced by Cancer Research UK
Cancer Research UK is the world’s leading cancer charity dedicated towards saving lives, and the second biggest funder of cancer research worldwide. In the last 40 years, we’ve helped double the cancer survival rate so that two in four people now survive their disease. But this is just the beginning. We have now set ourselves a target that within 20 years, three in four people will beat cancer.
We will only achieve this by working in partnership with healthcare professionals. Primary care provides the first point of contact for nine out of 10 patients in the healthcare system. It is in primary care that potential cancer symptoms are first assessed and it is therefore essential that we give GPs and the primary care community the support they need to help spot cancer earlier.
Rebecca Banks, the senior primary care engagement manager at Cancer Research UK (CRUK), tells us about how the charity is working with the primary care community to help increase the number of people who survive their cancer.
“Much of CRUK’s work involves researching new, more effective treatments that will become the therapies of the future,” she says. “We also fund research into cancer awareness, prevention and early diagnosis and use all of this information to inform the public and influence cancer policy and clinical practice for patients’ benefit. Our facilitator programme takes this research and translates it into practice to make a positive impact on people’s lives immediately, in local areas.
Even though cancer touches each and every one of us, the average GP sees fewer than eight cancer cases a year. And spotting the earliest signs of cancer is not always easy, there are more than 200 types of cancer and symptoms can be vague. Spotting cancer earlier could save 5,000 lives a year, so if we are to save lives now, then supporting doctors to improve early diagnosis is key.”
“We are committed to working with the NHS to support GPs and other primary care health professionals to do this,” says Banks. “We work hard to provide the latest information, practical tools and education to help these key frontline professionals to identify the earliest signs of cancer. The earlier a cancer is detected, the better the chance a person has of beating their disease.”
Banks’ team are embarking on ambitious plans to expand the programme across the UK.
“The aim is that by 2018, we’ll have CRUK facilitators in every region across the country,” she explains. “Each facilitator will visit GP practices in their area and work in partnership with local NHS professionals to improve cancer prevention, early diagnosis and survival. Essentially they will be catalysts for change.”
“Ideal candidates will have firsthand experience of the challenges facing primary care and relish working with others to make a difference. They thrive on knowing that no two work days are ever the same. Facilitators also need to build and maintain successful relationships. It is through mutual trust and understanding that we will be able to help GPs and their practice in their work, diagnosing cancer earlier and giving more people, more time with their families. Without this work we will not be able to succeed in our goal of beating cancer.”
This large team of dedicated CRUK facilitators will not just support GPs and practice staff, they will also provide a valuable feedback network to the charity’s research arm, allowing us to respond to emerging healthcare needs.
Banks says: “Already, feedback from our facilitators has led to CRUK working on resources that will help local areas increase their bowel screening uptake, an important element in the early diagnosis of bowel cancer. We heard what the need was and have responded on this.”
“We are unique. No other charity does anything like this”
Content on this post is produced by Cancer Research UK
Cancer Research UK is the world’s leading cancer charity dedicated to saving lives, and the second biggest funder of cancer research worldwide. In the last 40 years, we’ve helped double the cancer survival rate so that now, two in four people survive their disease. But this is only the beginning. We have now set ourselves a target that within 20 years, three in four people will beat cancer.
If we are to achieve this goal, then new, more effective treatments are required. This is why we are working to accelerate the development of novel therapies, bringing them to patients as quickly as possible.
Dr Nigel Blackburn leads Cancer Research UK’s Centre for Drug Development (CDD), a centre of excellence in early phase cancer drug development, focusing on novel technologies that wouldn’t progress without the charity’s support.
“We are unique,” says Blackburn. “No other charity does anything like this; we are the only charitably funded drug development group in the world – and that’s an exciting place to be.”
“Industry is naturally driven by the market, and is therefore risk adverse. Because we are free of this profit burden we get to be more innovative, we can try new things and take more risks, and so the rewards are potentially greater. The ideal project for CDD will be one that is first in class, first in man, novel – in short we want exciting science. If you love drug development and are interested in oncology, this is a great place to be.”
With a portfolio of 28 projects, CDD’s cancer portfolio ranks alongside those of the top five pharmaceutical companies in terms of cancer drugs in development. These drugs range from small molecules, immunologicals and cell therapies through to imaging agents and vaccines.
Blackburn adds: “At the moment we are working on the world’s first therapeutic IgE antibody, called MOV18. Originally no companies were interested in this as it was deemed too new, too risky. But now we are showing that it is viable, several companies are interested in licensing it. As another example, we are also developing a chimeric antigen receptor (CAR) immunotherapy which will be the third ever CAR trial in the UK (and CDD will have run two of them). Being a charity we can be brave and take risks that no one else will. And if it one day results in new treatments that might give more people more time with their families, then that is a fantastic result.”
As part of Cancer Research UK’s new strategy, CDD is expanding, aiming to increase its portfolio to around 35 projects. These are sourced from both industry and academia, picking up on good projects that are not being taken forward, either because of a lack of funding, being outside a company’s strategic priorities, or deemed too novel for pharma giants to adopt.
“We recently took on a cancer vaccine called IMA950 from a small German biotech,” says Blackburn. “They lacked the resources to carry out phase one trials on a glioblastoma treatment, so we ran it for them. After successfully meeting all our end points, the biotech company were in a place to buy the data back from us and continue its trials. Should the drug progress, not only will we receive milestones payments and royalties, but most importantly we will have helped a potential life-saving therapy to reach the people who need it. Without our work this vaccine may have remained on the shelf indefinitely.”
As well as carrying out early stage trials, CDD also runs Combinations Alliance, a matchmaking service for investigators seeking novel drug combinations. “Here, we don’t fund trials,” explains Blackburn. “Industry partners open up their portfolios of phase 2 and 3 drugs, and we act like a dating agency, providing the framework, resources and knowledge to help partners find potentially exciting new matches. We also offer preclinical funding to help investigators acquire the data they need to carry out a new combination trial. This service could really help advance cancer therapy, and is only possible because we are a charity.”
He adds: “We are now recruiting for new researchers for our team. As we typically focus on smaller, phase one projects, our researchers get to work on five, six, even seven projects, all with different modalities. There is an incredible breadth of research here. If you are interested in becoming an expert in oncology, in working on novel and exciting science, and in helping to beat cancer, then there is nowhere better to work.”
Scientists who are working to develop a test that can screen for multiple cancer types from a single blood sample have taken a step closer to their goal. Researchers systematically reviewed thousands of scientific papers and identified more than 800 markers in the blood of cancer patients that could help lead to a single blood test for early detection of many types of cancer in future.
LB3 Press Release
UK rates of early cancer detection are lower than in many other western countries and survival remains relatively poor. At present early (pre-symptomatic) cancer detection is limited to cases identified through specific national screening programmes or via incidental radiological findings. In 2012, fifteen UK universities established an Early Cancer Detection (ECDC) Consortium to identify, validate and implement new generic blood tests for early tumour detection. Funded by Cancer Research UK, work package one aims to identify the evidence base of blood-based biomarkers for early detection of cancer.
A systematic mapping review is being undertaken to establish “What biomarkers exist that could be used to develop a general cancer screening assay from blood sampling and what is their state of development?”
Electronic searches of several relevant databases were conducted in May 2014. Screening for relevant biomarkers is being undertaken by one reviewer using a process of “data mining” within the database of retrieved references. All blood based biomarkers, their relevant properties and characteristics, and their corresponding references are entered into a comprehensive database for further scrutiny by the Early Cancer Detection Consortium, and subsequent selection of biomarkers for rapid review.
Over 19,000 papers have been identified by the initial searches. Data mining has identified over 800 blood-based biomarkers. Each technology will be tabulated separately to summarise the available data and data sources for consideration by the consortium at its Autumn meeting in October 2014.
This abstract will outline the key findings of the systematic review, and the discussion at the Consortium’s Autumn 2014 meeting. The deliberations of the consortium will form the basis of a narrative synthesis of the results, and prepare for the next stage of the blood test development as it moves forward into clinical laboratory based test.
Sources and more information
Step towards blood test for many cancer types, Cancer Research UK, Press release, 2 November 2014.
Single blood test that screens for several cancers steps closer, MNT 284805, 3 November 2014.
The UK Early Cancer Detection Consortium – Building the evidence base of blood-based biomarkers for early detection of cancer, 2014 NCRI Cancer Conference, LB3, November 2014.
Doctors and researchers are constantly looking for ways to improve treatments
Treating cancers with immunotherapy and radiotherapy at the same time could stop them from becoming resistant to treatment, according to a study published in Cancer Research.
The researchers, based at The University of Manchester and funded by Cancer Research UK and MedImmune found that combining the two treatments helped the immune system hunt down and destroy cancer cells that were not killed by the initial radiotherapy in mice with breast, skin and bowel cancers.
Sources and more information:
Acquired Resistance to Fractionated Radiotherapy Can Be Overcome by Concurrent PD-L1 Blockade, Cancer Research, October 1, 2014 74;5458.
Immunotherapy could stop resistance to radiotherapy, Cancer Research UK Press release, 1 October 2014.
Analysis of the financial implications of achieving earlier diagnosis of colorectal, lung and ovarian cancer
” A Cancer Research UK analysis out today reveals that 46 per cent of cancers in England are diagnosed at an advanced stage, when they are harder to treat successfully.
The figures come as a new report shows that if all areas diagnosed cancers as early as the best in England, for four types of cancer alone, this could save the NHS over £44 million in treatment costs and benefit over 11,000 patients each year. Extrapolating this to all types of cancer would imply an annual saving of nearly £210m, while helping to improve the survival prospects for more than 52,000 patients. ”
Sources and More Information:
Half of cancers diagnosed at late stage as report shows early diagnosis saves lives and could save the NHS money, CancerResearchUK, Press release, 22 September 2014.
NHS cancer services in England are at a “tipping point” in the wake of years of efficiency savings and the recent NHS reforms
NHS cancer services in England are at tipping point as staff fight a brave ‘rear-guard action’ to keep the services viable for cancer patients, according to a new report commissioned by Cancer Research UK and conducted by experts at the University of Birmingham and the company ICF CHK Consulting.
The research highlights a number of concerns and key challenges facing the NHS:
A rising demand for services and a lack of capacity to respond to this demand;
Due to the removal of the National Cancer Action Team and cancer networks, there has been a loss of leadership capacity at national and local level;
A fragmentation of commissioning across the patient pathway;
Wide variation in the roles and responsibilities of new NHS organisations and the need to rebuild relationships and regain expertise.
More than 1.4 million patients in England were referred by their GPs with suspected cancer in 2013-14 – a 50% increase from 2009-10. But there is no longer the capacity to respond to this demand, according to the report…
Sources and More Information:
Measuring up? The health of NHS cancer services, Health Services Management Centre at the University of Birmingham and ICF GHK Consulting, (full 66 pages report), September 2014.
NHS cancer services need increased investment or ‘cracks will begin to show’, Cancer Research UK press release, 8 September 2014.
NHS cancer services struggling, says charity, BBC News, health-29107762, 8 September 2014.
In a world first collaboration lead by Cancer Research UK, Amazon Web Services, Facebook and Google developers joined academics, scientists, gamers and designers for a weekend GameJam. Their aim was to transform Cancer Research UK’s cancer gene data into an engaging and playable game that would generate robust scientific analysis. In just 48 sleep deprived hours, this inspirational collaboration produced 12 gaming prototypes based on Cancer Research UK’s cancer gene data – truly epic achievement.
Play to CureGenes in Space is a pioneering mobile phone game from Cancer Research UK, which lets players unravel real cancer data through a space game. What would have taken scientists hours to analyse, can now be done faster with your help and the collective force of thousands of players. Watch this to find out more about the game and see real game play.
Help Cancer Research UK Beat Cancer Sooner through a Space Game
If you have ever wanted to help cure cancer, you might now be able to do so – with a spot of space-travel from the comfort of your own home. Scientists at Cancer Research UK have developed an intergalactic smartphone game to help them analyse the overwhelming reams of genetic data generated in recent studies. They hope thousands of people will play the game, simultaneously trawling through genetic material to pinpoint more precisely which genes cause the disease.
Play to CureGenes in Space is a new pioneering mobile phone game from Cancer Research UK, which lets players unravel real cancer data through a space game. What would have taken scientists hours to analyse, can now be done faster with your help and the collective force of thousands of players. Watch this to find out more about the game and see real game play.
The number of UK women under aged 50 diagnosed with breast cancer has topped 10,000 for the first time
DES Daughters are 82% more likely to develop breast cancer after age 40 … Could the fact that Breast cancer in women under 50 is becoming more common be explained by the fact that the majority of DES Daughters are only reaching their 40’s now?