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Breast cancer: Blood test may predict relapse

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    Posted: Aug 27 2015 at 10:03pm
Breast cancer relapse could be predicted with new blood test
A test that identifies genetic information in the blood picks up sensitive amounts of DNA that can be used to shape decisions about cancer treatment.

One of the challenges of modern medicine is to know if and when a cancer patient will relapse. A new study shows that months before tumors are visible on hospital scans, a "mutation-tracking" blood test can pick up valuable signs of a cancer's return.

The study, undertaken by researchers at The Institute of Cancer Research (ICR) and The Royal Marsden NHS Foundation Trust - both in the UK - is an important step toward changing the way cancer is monitored in the clinic and informing treatment decisions.

The clue to identifying a return of cancer cells is to look at circulating tumor DNA present in the blood. These are cancer cells left behind that may seed new tumors even after treatment.

By monitoring patients with blood tests taken after surgery, the study says, and then every 6 months in follow-up, the researchers were able to predict very accurately who would experience a relapse.

The study involved 55 women who had been successfully treated for early-stage breast cancer.

It was found those who tested positive for circulating tumor DNA were at 12 times greater risk of relapse compared with those who tested negative. In addition, the blood test was able to detect cancer recurrence an average of 7.9 months before any visible signs appeared.

Explaining what the researchers are attempting to achieve with the blood test, Kat Arney, science information manager at Cancer Research UK, told BBC Radio:

"They are looking for ways to detect DNA that has been shed by tumor cells into the bloodstream and saying can we use this DNA as a way of monitoring if the cancer is coming back - how it is changing, how it is evolving in the body - and then could we use that to monitor cancer and pick up potentially when it has come back without having to give scans or biopsies."

"There are still challenges in implementing this technology [...] but the information that it provides could make a real difference to breast cancer patients, " added Dr. Nicholas Turner, team leader in molecular oncology at ICR and consultant medical oncologist at The Royal Marsden.

Findings could be applied to all breast cancer subtypes

Because the researchers were searching for mutations common to various breast cancer types, they found the test could be applied to all subtypes of the disease.

"This test could help us stay a step ahead of cancer by monitoring the way it is changing and picking treatments that exploit the weakness of the particular tumor, " says Prof. Paul Workman, chief executive at ICR.

The potential of this new test, Arney told BBC Radio, is to "separate those mutations that are driving the cancer from all the other genetic chaos that is going on in there, looking at how we can target these particular gene faults in this particular person, and those are the same faulty genes that are driving their relapse when the cancer comes back."

Medical News Today recently reported on a study published in Nature Cell Biology in which researchers detailed a way to reprogram cancer cells back to normal, opening the door to new treatments for cancer.

http://www.medicalnewstoday.com/articles/298690.php?tw


New 'mutation-tracking' blood test could predict breast cancer relapse months in advance





Edited by 123Donna - Jul 10 2019 at 9:25pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Aug 27 2015 at 10:48pm
Blood Draw Predicts Breast Cancer Relapse

"The results of the prospective study suggest that patients at risk for relapse may be identified earlier and given more aggressive treatment to prevent metastasis.

Of the 15 patients who relapsed on study, the presence of ctDNA predicted the relapse of 12 patients. Among the patients who did not relapse, 96% had no detectable ctDNA in either the post-surgery sample (24 of 25; P = .0038) or during temporal tracking of tumor mutations (27 of 28; P < .0001). One patient, with triple-negative disease, had detectable ctDNA after surgery but did not relapse on study.

All metastatic tumors were detectable by ctDNA except for three patients who had recurrence in the brain.

The study also showed that ctDNA analysis could identify the genetic events that define minimal residual disease among breast cancer patients. This genetic analysis of minimal residual disease also predicted the genetics of the relapsed tumor better than sequencing analysis of the primary breast tumor. The study authors concluded that tracking of ctDNA linked to cancer relapse could facilitate the tailoring of adjuvant therapies based on the mutations captured in patients’ blood samples."

- See more at: http://www.cancernetwork.com/breast-cancer/blood-draw-predicts-breast-cancer-relapse
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Breast cancer: Blood test may predict relapse

Using data from a person's immune response, researchers have devised a blood test that may accurately predict the risk of breast cancer recurrence.


Despite scientific advancements in breast cancer research, this type continues to be the leading cancer among women in the United States and the second deadliest after lung cancer.

Many breast cancer survivors live with a continual worry that the condition will reemerge, while researchers are hard at work, trying to discern patterns of breast cancer recurrence.

For instance, studies of breast cancer receptors show that estrogen receptor (ER)-negative breast cancers are more likely to recur in the first 5 years after diagnosis, while ER-positive breast cancers are associated with a higher risk of recurrence in the following 10 years.

However, much remains to be known about breast tumor recurrence, and scientists are still trying to understand all the factors that come into play, from the nature of the cancerous cells to the timing of treatment.

New research looks at the body's antitumor inflammatory response to devise a blood test that may soon predict a person's chances of experiencing breast cancer recurrence.

Dr. Peter P. Lee, chair of the Department of Immuno-Oncology at the City of Hope Comprehensive Cancer Center, in Duarte, CA, is the senior author of the new study, which appears in the journal Nature Immunology.

Predicting recurrence risk within 3–5 years

The balance between the immune system's pro- and anti-inflammatory signaling in response to cytokines can determine a person's antitumor immune reaction, explain Dr. Lee and colleagues in their paper.

For the study, the researchers recruited 40 breast cancer survivors and clinically followed them for a median period of 4 years. The researchers also used an additional sample of 38 breast cancer survivors to attempt to replicate their findings from the previous group.

A person with cancer tends to have peripheral blood regulatory T cells (T-reg cells, for short) with less active pro-inflammatory cytokine signaling pathways and more active immune suppressive cytokine signaling pathways, explain the researchers.

Such an environment can lead to the spread of cancer. So, Dr. Lee and colleagues examined the signaling responses to pro- and anti-inflammatory cytokines in various types of peripheral blood immune cells from breast cancer survivors.

The researchers found that the signaling response in T-reg cells was altered for two pro-inflammatory and two anti-inflammatory cytokines in some breast cancer survivors.

These signaling responses correlated with the state of the participants' immune systems and with accurate predictions of their breast cancer recurrence within the following 3–5 years.

Using this signaling data, the scientists created an index. The hope is that, eventually, healthcare professionals will be able to run data of a blood sample from a breast cancer survivor through an algorithm based on Lee and the team's cytokine signaling index.

The goal is for physicians and breast cancer patients to know the risk of the disease recurring within the next 3–5 years.

"Knowing the chance of cancer relapse will inform doctors how aggressive a particular patient's cancer treatment should be," Dr. Lee explains. "The [cytokine signaling index] is an overall reflection of a patient's immune system at diagnosis, which we now know is a major determinant of future relapse."

"This is the first success [in] linking a solid tumor with blood biomarkers — an indicator of whether a patient will remain in remission."

Dr. Peter P. Lee

The researcher goes on to explain the significance of the study and findings. "When patients are first diagnosed with cancer, it is important to identify those at higher risk for relapse for more aggressive treatments and monitoring," he says.

"Staging and new tests based on genomics analysis of the tumor are currently available for risk stratification. However, a predictive blood test would be even more attractive but is not yet available. We are trying to change the status quo."

The researcher also says that "These findings may go beyond cancer to address other diseases the immune system must battle," because the balance of cytokine signaling responses among peripheral blood T-reg cells indicates how strong a person's immune system is overall.

"This general approach may also be useful for predicting outcomes in patients with autoimmune and infectious diseases," Dr. Lee explains.

https://www.medicalnewstoday.com/articles/325702.php



DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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