Cancer Research: Oral contraceptives have prevented about 200,000 cases of endometrial cancer ♦ England still struggling to close the gap in cancer survival

Cancer markers may be present early during human development Researchers have uncovered a link between the genomes of cells originating in the neural crest and development of tumors -- a discovery that could lead to new ways to diagnose and treat cancer

Oral contraceptives have prevented about 200,000 cases of endometrial cancer in the last decade Use of oral contraceptives (usually referred to as "the pill"), even for just a few years, gives substantial long-term protection against endometrial (womb) cancer, and the longer the pill is used the greater the reduction in risk, according to a detailed re-analysis of all the available evidence.

England still struggling to close the gap in cancer survival Cancer survival in England remains lower than countries with similar healthcare systems, according to a new study. The research compared survival for colon, breast, lung, ovarian, rectal and stomach cancers in England, Australia, Canada, Denmark, Norway and Sweden between 1995 and 2009, and survival trends in England up to 2012.

Topical gel proves safe, effective treatment for patients with skin t cell lymphoma Results of a phase one trial show that an investigational topical drug, resiquimod gel, causes regression of both treated and untreated tumor lesions and may completely remove cancerous cells from both sites in patients with early stage cutaneous T cell lymphoma (CTCL) – a rare type of non-Hodgkin lymphoma that affects the skin. Currently, there is no cure for CTCL aside from a bone marrow transplant. However, the new study shows that the topical gel can eliminate malignant T cells, leading to diminished lesions.

Neutrophil and cancer cell 'crosstalk' underlies oral cancer metastasis An abnormal immune response or 'feedback loop' could very well be the underlying cause of metastases in oral cancers, according to research that has unearthed a significant connection between the inflammatory response of a very specific form of immune cells, neutrophils, and the spread of this deadly disease.

Cancer Research:'Pill on a string' could help spot early signs of cancer ♦ Immune system linked with cancer survival rates ♦ Precision medicine for most common type of lymphoma

Life-saving breast cancer drugs going untaken in Appalachia Nearly one-third of breast cancer survivors in Appalachia are not taking the critical, potentially life-saving follow-up treatment -- despite having insurance that would pay for

'Pill on a string' could help spot early signs of cancer of the gullet A 'pill on a string' could help doctors detect esophageal cancer -- cancer of the gullet -- at an early stage, helping them overcome the problem of wide variation between biopsies.

Gene expression, immune system linked with cancer survival rates Physicians have long sought a way to accurately predict cancer patients' survival outcomes by looking at biological details of the specific cancers they have. But despite concerted efforts, no such clinical crystal ball exists for the majority of cancers. Now researchers have compiled a database that integrates gene expression patterns of 39 types of cancer from nearly 18,000 patients with data about how long those patients lived.

T-cell receptor therapy achieves encouraging clinical responses in multiple myeloma Results from a clinical trial investigating a new T cell receptor therapy that uses a person's own immune system to recognize and destroy cancer cells demonstrated a clinical response in 80 percent of multiple myeloma patients with advanced disease after undergoing autologous stem cell transplants.

Study shows promise of precision medicine for most common type of lymphoma Patients with a specific molecular sub type of diffuse large B-cell lymphoma are more likely to respond to the drug ibrutinib (Imbruvica) than patients with another molecular subtype of the disease.

Cancer Research: Blood test for lung cancer a step closer ♦ Researchers define unique group of high-risk lymphoma patient ♦ Breast cancer treatment with fewer potential side effects

Breast cancer treatment with fewer potential side effects has equally good patient outcomes Women diagnosed with breast cancer and treated with a one-week regimen of partial breast radiation after the surgical removal of the tumor, or lumpectomy, saw no increase in cancer recurrence or difference in cosmetic outcomes compared to women who received radiation of the entire breast for a period of up to six weeks after surgery.

Researchers define unique group of high-risk lymphoma patients About 20 percent of follicular lymphoma patients consistently experience their disease coming back within two years of being treated with the latest therapies. New research confirms that patients in this group have very poor survival outcomes; 50 percent die in five years. People who relapse early may have a disease with distinctly different biology and should not be approached the same at diagnosis nor at the time of relapse in terms of therapies

Blood test for lung cancer a step closer Two oncologists and a research scientist are helping pave the way to an easier, more accurate, less invasive way to screen for the most common form of lung cancer. Lung cancer the number one cancer killer in the United States

Treatment with PI3K inhibitors may cause cancers to become more aggressive and metastatic The enzyme PI3K appears to be exploited in almost every type of human cancer, making it the focus of considerable interest as a therapeutic target. However, PI3K inhibitors have only shown modest clinical activity. Now, new research shows that treatment with PI3K inhibitors alone may actually make a patient’s cancer even worse by promoting more aggressive tumor cell behavior and increasing the cancer’s potential of spreading to other organs.

Cancer Research:Nanoparticles inhibit breast cancer metastasis ♦ Assessing cancer risk of pollutants ♦ Potential new targets for cancer treatments identified

siRNA-toting nanoparticles inhibit breast cancer metastasis Researchers combined finely crafted nanoparticles with one of nature's potent disrupters to prevent the spread of triple-negative breast cancer in mouse models. The researchers are working toward clinical trials.

New method developed to assess cancer risk of pollutants A faster, more accurate method to assess cancer risk from certain common environmental pollutants has been developed by scientists. The study focused on pollutants known as polycyclic aromatic hydrocarbons that commonly occur in the environment as diesel exhaust and cigarette smoke.

Potential new targets for cancer treatments identified Key steps in cell division have now been revealed by new research, possibly leading to treatments aimed at inhibiting cancer cell division.

First-in-class antibody mixture shows clinical activity against Tx-resistant, advanced CRC Sym004, a mixture of two anti-epidermal growth factor receptor antibodies, was found in patients with advanced colorectal cancer that had become resistant to prior therapies.

New treatment option for subtype of aggressive lymphoma A specific combination of mutations and new gene fusions have been discovered, that appear to be heavily implicated in tumor growth in patients with a particularly aggressive subtype of lymphoma. The findings could lead to new targeted treatments for this disease and even to successful treatment of other types of cancer

New low-intensity Cancer Therapy Highly Effective

Adult patients with a type of cancer known as Burkitt lymphoma had excellent long-term survival rates — upwards of 90 percent — following treatment with low-intensity chemotherapy regimens, according to a new clinical trial finding. Standard treatment for Burkitt lymphoma involves high-dose chemotherapy, which has a high rate of toxicity, including death, and cures only 60 percent of adult patients. This trial was conducted by researchers at the National Cancer Institute (NCI), part of the National Institutes of Health, and appeared Nov. 14, 2013, in the New England Journal of Medicine.

Burkitt lymphoma is the most aggressive type of lymphoma, which is a cancer that begins in cells of the immune system. It is more common in equatorial Africa than in Western countries. In Uganda, for example, the estimated prevalence of Burkitt lymphoma is between 5 and 20 cases per 100,000 inhabitants, whereas in the United States, according to NCI’s statistical database for 2001-2009, prevalence was 0.4 cases per 100,000 inhabitants. Cure rates for Burkitt lymphoma in Western countries approach 90 percent in children, which is higher than adult cure rates seen prior to this new approach to treatment, whereas only 30 percent to 50 percent of children in Africa are cured due to an inability to safely administer high-dose treatment. Thus, there is an important need for less toxic and more effective therapies.

Wyndham H. Wilson M.D. Ph.D., head of NCI’s Lymphoma Therapeutics Section, and colleagues conducted the trial at NIH’s Clinical Center. The trial involved two variants of EPOCH-R, a chemotherapy regimen that includes the drugs etoposide (E), prednisone (P), vincristine (Oncovin), cyclophosphamide (C), doxorubicin (Hydrodoxorubicin), and rituximab (R). EPOCH-R involves longer exposures to lower concentrations of drugs instead of briefer exposures to higher concentrations of drugs. Previously, Wilson’s team found that EPOCH-R was very effective for treating mediastinal B-cell lymphoma, a disease that is distinct from Burkitt lymphoma.

Thirty patients with previously untreated Burkitt lymphoma were included in the trial. The patients received one of the two EPOCH-R variants, depending on their HIV status. Burkitt is a disease that occurs frequently in immune-suppressed AIDS patients. Nineteen HIV-negative patients received dose-adjusted (DA)-EPOCH-R, whereas 11 HIV-positive patients received SC-EPOCH-RR, which is a short-course (SC) variant of EPOCH-R that includes two doses of rituximab per treatment cycle and has a lower treatment intensity than DA-EPOCH-R. Adjustment of dose levels is done to try to provide the optimum amount of drug based on a person’s tolerance of chemotherapy. The median age of the patients was 33 years old and most had intermediate- or high-risk disease. The principal toxicities seen in the trial were fever and neutropenia (low white blood cell counts); no treatment-related deaths occurred. With median follow-up times of 86 and 73 months, the overall survival rates were 100 percent and 90 percent, respectively, with DA-EPOCH-R and SC-EPOCH-RR.

“The toxicity of EPOCH-R-based treatment in Burkitt lymphoma is considerably less than that reported with standard Burkitt regimens,” said Wilson. “Furthermore, these two regimens were highly effective in adult patients, who have significantly worse outcomes than children.”

“These promising results with low-toxicity treatment suggest that this approach may be effective and worth investigating in certain geographic and economically challenged regions where Burkitt lymphoma is highly prevalent as well as in adult populations,” said Kieron Dunleavy M.D., NCI, and first author of the study.

Based on these results, two trials to confirm the efficacy of EPOCH-R therapy in adult and pediatric Burkitt lymphoma patients are under way.

This trial is registered at http://www.clinicaltrials.gov as NCT00001337 and NCT00006436 and was funded by the intramural program at NCI.