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India can bring down cost for Breast Cancer Detection, says US Scientist

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Breast Cancer (representational Image), Pixabay
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Kolkata, Feb 28, 2017: American genome expert Mary-Claire King, whose work resulted in the identification of the breast cancer gene BRCA1 and transformed the diagnosis and treatment of the disease, on Tuesday expressed faith in Indian scientists to make technology cheaper for breast cancer detection.

“We need to tackle this problem with modern 21st-century tools. The actual cost of sequencing patients dropped from about $4,000 to $250 (around Rs 16,000) in the US in the last few years. Indians are incredibly good at making technology better, faster and cheaper,” she said.

King was addressing a packed audience of researchers, students and faculty at a lecture here on ‘Understanding Inherited Breast and Ovarian Cancer: From Gene Discovery to Precision Medicine and Public Health’ for The Cell Press-TNQ India distinguished Lectureship Series, 2017. It was supported by National Institute of Biomedical Genomics, Kalyani.

For India, the US National Medal of Science awardee proposed that every breast and ovarian cancer patient be tested genetically for mutations BRCA1 and BRCA2 as well as other known breast and ovarian cancer genes.

Specific inherited mutations in BRCA1 and BRCA2 increase the risk of female breast and ovarian cancers, and they have been associated with increased risks of several additional types of cancer.

“My proposition for India is every breast and ovarian cancer patient should be sequenced for mutations to BRCA1 and BRCA2 and all other known breast and ovarian cancer genes. I am not suggesting that in the resource-limited context here that all women above the age of 30 be screened, just begin with patients,” said the University of Washington professor.

Testing could help women predisposed to mutations to make an informed choice on whether to opt for risk-reducing surgery, chemoprevention and also encourage follow-ups of sisters and daughters of patients (there’s a 50 percent chance of passing it along).

The 71-year-old active researcher dubbed cervical cancer a “disease of poor women” while breast cancer is one of those “rare conditions that is a disease of prosperity”.

“The reason that breast cancer incidences are going up is because we are the most successful mammals that have ever lived, by this we mean we are fabulous. We are fertile longer, we are able and we are fit, we retain cognitive functions longer,” she added.

In addition to her work on identifying breast cancer genes, King is recognised worldwide for demonstrating that humans and chimpanzees are 99 per cent genetically identical and applying genomic sequencing to identify victims of human rights abuses (Grandmothers of Plaza de Mayo in Argentina wanted King to find their kidnapped grandchildren). (IANS)

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Immunotherapy Drugs Show Significant Improvement Against Breast Cancer: Study

Side effects need a close look, both doctors said. Nearly all study participants had typical chemo side effects such as nausea or low blood cell counts.

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Breast Cancer
This undated fluorescence-colored microscope image made available by the National Institutes of Health in September 2016 shows a culture of human breast cancer cells. For the first time, one of the new immunotherapy drugs has shown promise against breast cancer in a large study that combined it with chemotherapy to treat an aggressive form of the disease. VOA

For the first time, one of the new immunotherapy drugs has shown promise against breast cancer in a large study that combined it with chemotherapy to treat an aggressive form of the disease. But the benefit for most women was small, raising questions about whether the treatment is worth its high cost and side effects.

Results were discussed Saturday at a cancer conference in Munich and published by the New England Journal of Medicine.

Drugs called checkpoint inhibitors have transformed treatment of many types of cancer by removing a chemical brake that keeps the immune system from killing tumor cells. Their discovery recently earned scientists a Nobel Prize. Until now, though, they haven’t proved valuable against breast cancer.

Breast Cancer
Weight loss may lower breast cancer risk for post-menopausal women. Pixabay

In the study

The new study tested one from Roche called Tecentriq plus chemo versus chemo alone in 902 women with advanced triple-negative breast cancer. About 15 percent of cases are this type, their growth is not fueled by the hormones estrogen or progesterone, or the gene that Herceptin targets, making them hard to treat.

Women in the study who received Tecentriq plus chemo went two months longer on average without their cancer worsening compared with those on chemo alone, a modest benefit. The combo did not significantly improve survival in an early look before long-term follow-up is complete.

Failed protein test

Previous studies found that immunotherapies work best in patients with high levels of a protein that the drugs target, and the plan for the breast cancer study called for analyzing how women fared according to that factor if Tecentriq improved survival overall.

breast cancer
FILE – A patient receives chemotherapy treatment for breast cancer at the Antoine-Lacassagne Cancer Center in Nice, July 26, 2012. VOA

The drug failed that test, but researchers still looked at protein-level results and saw encouraging signs. Women with high levels who received the combo treatment lived roughly 25 months on average versus about 15 months for women given chemo alone.

That’s a big difference, but it will take more time to see if there’s a reliable way to predict benefit, said Dr. Jennifer Litton of the MD Anderson Cancer Center in Houston. She had no role in running the study but enrolled some patients in it and oversees 14 others testing immunotherapies.

“We’re really hopeful that we can identify a group of women who can get a much bigger and longer response,” she said.

Another breast cancer specialist with no role in the study, Dr. Michael Hassett at Dana-Farber Cancer Institute in Boston, said he felt “cautious excitement” that immunotherapy may prove helpful for certain breast cancer patients.

Breast Cancer
Breast cancer cell, Wikimedia Commons

Side effects and cost

Side effects need a close look, both doctors said. Nearly all study participants had typical chemo side effects such as nausea or low blood cell counts, but serious ones were more common with the combo treatment and twice as many women on it stopped treatment for that reason.

Three of the six deaths from side effects in the combo group were blamed on the treatment itself; only one of three such deaths in the chemo group was.

Also Read: New DNA Tool To Predict People’s Height And Risk For Cancer

Cost is another concern. Tecentriq is $12,500 a month. The chemo in this study was Celgene’s Abraxane, which costs about $3,000 per dose plus doctor fees for the IV treatments. Older chemo drugs cost less but require patients to use a steroid to prevent allergic reactions that might interfere with the immunotherapy. Abraxane was chosen because it avoids the need for a steroid, said one study leader, Dr. Sylvia Adams of NYU Langone Health.

The study was sponsored by Roche and many study leaders consult or work for the company or own stock in it. (VOA)