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Exercise Can Now Be Prescribed Like Medicine for Cancer Patients

It is well known that regular exercise can help prevent and treat many forms of heart disease, but less commonly known are the benefits of physical activity for cancer patients.

A new initiative called Moving Through Cancer — led by Dr. Kathryn Schmitz, professor of public health sciences at Penn State College of Medicine, and an international team of health practitioners and researchers — is hoping to change that.

According to the researchers, exercise is important for cancer prevention, as it can lower the risk of developing colon, breast, endometrial, kidney, bladder, esophagus and stomach cancers.

Exercise during and after cancer treatment can also help improve fatigue, anxiety, depression, physical function, and quality of life and can also help increase survival rates after a breast, colon or prostate cancer diagnosis.

In their new paper published in CA: A Cancer Journal for Clinicians, Schmitz and her team outline new exercise recommendations for people living with and beyond cancer.

“With more than 43 million cancer survivors worldwide, we have a growing need to address the unique health issues facing people living with and beyond cancer and better understand how exercise may help prevent and control cancer,” said Schmitz, who is also a member of the Penn State Cancer Institute.

“This esteemed, multidisciplinary group of leaders on the forefront of exercise oncology aimed to translate the latest scientific evidence into practical recommendations for clinicians and the public and to create global impact through a unified voice.”

Depending on each patient’s activity levels and abilities, the researchers generally recommend 30 minutes of moderately intense aerobic exercise three times a week and 20 to 30 minutes of resistance exercise twice a week.

But, Schmitz said health care professionals can also customize exercise prescriptions to individual patients.

“Through our research, we’ve reached a point where we can give specific FITT exercise prescriptions — which means frequency, intensity, time and type — for specific outcomes like quality of life, fatigue, pain and others,” Schmitz said.

“For example, if we’re seeing a head and neck cancer patient with a specific set of symptoms, we could give them an exercise prescription personalized to them.”

Schmitz said the recommendations will help with one of the premier goals of Moving Through Cancer: raising public awareness about the benefits of exercise for people living with and beyond cancer by 2029.

“Currently, an average person on the street will know that exercise is good for preventing and treating heart disease, but not for melanoma,” Schmitz said. “We want to change that. When researchers in the 1950s built an evidence base for exercise and heart disease, there was a shift in public knowledge about that connection. It’s now time for the same thing to happen with exercise and cancer.”

Schmitz said the second piece of the initiative is resources and programs to help get cancer patients moving. The Moving Through Cancer website has an exercise program registry that can help patients, families, health care providers and others find programs near them.

The final piece is policy, Schmitz said, which could be used to increase the chances that health care professionals will talk to their patients about exercise and that patients will be adequately referred as they move through cancer.

“This is the center of my professional heart,” Schmitz said. “My mission for a decade now has been that I want exercise to be as ubiquitous in cancer care as it is in cardiac disease care, only better. The new recommendations and guidance are a tool that can help make that a reality.”

Source: Penn State

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Pancreatic cancer drug reaches Phase III status

A pancreatic cancer drug discovered in professors Paul Bingham and Zuzana Zachar’s lab in the Department of Biochemistry and Cell Biology at Stony Brook University has now entered Phase III, or multi-center testing stage.

During the multi-center testing stage, the drug will be tested among qualifying patients in clinical research centers nationwide, including Stony Brook Cancer Center. The trial will use a combination of FOLFIRINOX and CPI-613 — a partial inhibitor of the tricarboxylic acid (TCA) cycle, a pathway used in the mitochondria for glucose metabolism — in metastatic pancreatic cancer patients. Dr. Minsig Choi, an attending physician who specializes in gastrointestinal medical oncology, is the principal investigator of the trial.

FOLFIRINOX is a chemotherapy regimen that uses multiple drugs to kill cancer cells. The use of CPI-613, a lipoate analog — a chemically equivalent compound similar to one of the intermediates in the TCA cycle — may increase the vulnerability of cancer cells to traditional chemotherapy regimens by inhibiting cancer cells’ almost “addictive” use of the TCA cycle, Choi explained. Thus, combinational therapy may improve life expectancy for patients.

“While normal cells can use other pathways when the TCA cycle is inhibited, cancer cells are more sensitive to changes in the TCA cycle,” Choi said.

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European Society of Medical Oncology Congress Presentations Show B-Cell Vaccine Combinations

(ASX:IMU), a clinical stage immuno-oncology company, today announced two presentations by medical investigators at the European Society of Medical Oncology in Barcelona Spain showed combining its HER2 vaccines with PD1 vaccines reduced cancer growth in a number of standard preclinical models.

The findings were detailed in posters presented by Dr Tanios Bekaii-Saab from the Mayo Clinic Phoenix USA and Dr Joshua Tobias from the Medical University Vienna, Austria.

Dr Bekaii-Saab’s poster presentation was entitled ‘Antitumor activity and safety of a novel PD-1 vaccine (PD1-Vaxx) alone and in combination with two chimeric HER-2 peptide vaccine (B-Vaxx) in syngeneic Balb/c mice and canines.’

The presentation detailed how Imugene’s PD1-Vaxx combined with B-Vaxx was more effective in reducing tumour growth in a model of HER2 positive colon cancer compared to either the PD1-Vaxx vaccine alone, or the positive control standard anti-mouse PD-1 monoclonal antibody.

The vaccine combination was found to be safe and did not appear to exhibit toxicity or autoimmunity. Imugene is working to evaluate PD1-Vaxx and its potential efficacy in a range of human cancers.

Dr Joshua Tobias’ poster presentation was entitled ‘Active immunization with immune checkpoint inhibitors-mimotope elicits strong in vivo anti-tumor effect against Her-2/neu-expressing tumors.’

The presentation showed active immunization with a PD1-derived mimotope vaccine combined with Imugene’s HER-Vaxx increased the anti-tumour effect of the combination vaccine compared to each vaccine alone in a model of HER2 positive breast cancer.

Active immunisation with the PD1-derived mimotope vaccine increased cancer cell death and anti-proliferative effect of the HER2 positive cancer cells in breast cancer tumours.

Imugene will initiate a Phase 1 trial of PD1-Vaxx as a monotherapy in 2020. In addition to safety and efficacy, a focus will be to assess the vaccine when combined with Imugene’s immunotherapy pipeline and other immunotherapies on the market.

Imugene Managing Director and Chief Executive Officer Leslie Chong said, “The global medical community is actively seeking inmuno-oncology combination treatments which do not increase toxicity and demonstrate improved response rates and efficacy at minimal cost.”

“The promising new B-cell vaccine data presented at this year’s ESMO congress and other major cancer research conferences has helped raise the profile of our promising anti-cancer pipeline and its potential clinical value when used in combination with other immune-oncology therapies.”

“These latest presentations of comprehensive vaccine combination results help further demonstrate the significant value of Imugene’s B-cell vaccine strategy and the strength of our pipeline,” she said.

All the Imugene related research posters presented at ESMO are available on the company website.

Dr Bekaii-Saab’s poster presentation was entitled ‘Antitumor activity and safety of a novel PD-1 vaccine (PD1-Vaxx) alone and in combination with two chimeric HER-2 peptide vaccine (B-Vaxx) in syngeneic Balb/c mice and canines.’

Dr Joshua Tobias’ poster presentation was entitled ‘Active immunization with immune checkpoint inhibitors-mimotope elicits strong in vivo anti-tumor effect against Her-2/neu-expressing tumors.’

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COLOSSUS project which we are supporting has published a new video

Colorectal cancer is the third most common cancer in Europe. COLOSSUS is an EU-funded Horizon 2020 project that aims to provide new and more effective ways to classify patients with a specific type of colorectal cancer (microsatellite stable RAS mutant metastatic colorectal cancer or MSS RAS mt mCRC) and to develop better treatments for them. Our ultimate goal is to deliver a personalised medicine approach for patients with MSS RAS mt mCRC that is currently not available.

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 754923. The material presented and views expressed here are the responsibility of the author(s) only. The EU Commission takes no responsibility for any use made of the information set out.

Click here to view the COLLOSSUS video.

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Digestive Cancers Europe has developed a position paper on the use of biosimilars medicine in colorectal cancer

With the help of the Patient Advisory Committee (PAC) comprising of 7 colorectal cancer patients and carers, Digestive Cancers Europe has developed a position paper on the use of biosimilar medicines in colorectal cancer.

We believe equality of access to medicines is a fundamental right for all patients. Partly due to the disparities in availability of biological medicines, there are wide ranging standards of care for colorectal cancer across Europe, which means that where someone lives is a crucial factor in their prognosis. We passionately believe that all patients with colorectal cancer should have access to the same high standard of care, regardless of where they live.
With this in mind, we believe there is an important role for biosimilar medicines to play in the treatment of colorectal cancer.

Because they are generally less expensive than the reference medicine, the introduction of biosimilar medicines could increase patient access to biologic therapies, without compromising quality. This in turn could generate cost savings that could be redistributed to expand patient access to other biologic therapies, or improve healthcare by providing services and care that are currently not provided.

Patient safety is the main priority and it is vital that biosimilars continue to be evaluated with the same exacting standards as the reference medicines. It is also important that patients are fully informed about the medicines available to be able to make an informed decision themselves. We also acknowledge that the companies that create the reference medicines invest millions into the research and development program of each medicine in extremely thorough clinical trial programs. They have well-established manufacturing processes for these complex medicines and well-established pharmacovigilance in place. The EMA has imposed similar pharmacovigilance programs for all biosimilars.

To see Digestive Cancers Europe position on the use of biosimilar medicines in colorectal cancer, click here.

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Overcoming resistance in pancreatic cancer

In pancreatic cancer cells' struggle to survive, the cells choose alternative routes when their main pathways are blocked by drugs. Researchers recently developed a new cocktail of drugs that shrink pancreatic tumors in mice by blocking both the main and alternative pathways that cancer cells use.

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More Antibiotics, Higher Odds for Colon Cancer?

Taking certain antibiotics -- especially multiple times or for long courses -- may put you at risk for colon cancer, a large new study suggests.

The researchers found that as people's antibiotic use increased, their odds of being diagnosed with colon cancer inched up. Specifically, the risk was tied to antibiotics that kill anaerobic bacteria -- which include common drugs like penicillins and cephalosporins such as Keflex.

The findings add to recent research hinting at a link between antibiotics and colon cancer.

The reasons for the connection, however, remain unclear -- and it might not reflect a direct effect of antibiotics at all, according to one colon cancer expert.

"We don't know why people in this study received antibiotic prescriptions," said Dr. Emmanouil Pappou, a colon cancer surgeon at Memorial Sloan Kettering Cancer Center, in New York City.

In particular, he noted, the risk was greatest among people who'd used antibiotics for longer periods -- 30 to 60 days, or longer. And those patients might have been quite sick, said Pappou, who was not involved in the study.

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Simple test produces a color change in urine to signal tumor growth in mice

A simple and sensitive urine test developed by Imperial and MIT engineers has produced a color change in urine to signal growing tumors in mice.

Tools that detect cancer in its early stages can increase patient survival and quality of life. However, cancer screening approaches often call for expensive equipment and trips to the clinic, which may not be feasible in rural or developing areas with little medical infrastructure. The emerging field of point-of-care diagnostics is therefore working on cheaper, faster, and easier-to-use tests.

An international pair of engineering labs have now developed a tool that changes the color of mouse urine when colon cancer is present. The findings from testing the fast, non-invasive cancer test are published today in Nature Nanotechnology.

The early-stage technology, developed by teams led by Imperial's Professor Molly Stevens and MIT professor and Howard Hughes Medical Institute investigator Sangeeta Bhatia, works by injecting nanosensors into mice, which are cut up by enzymes released by the tumor, known as proteases.
When the nanosensors are broken up by proteases, they pass through the kidney, and can be seen with the naked eye after a urine test that produces a blue color change.

The researchers applied this technology to mice with colon cancer, and found that urine from tumor-bearing mice becomes bright blue, relative to test samples taken from healthy mice.

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Exercise ‘delays progression’ of advanced colorectal cancer

Metastatic colorectal cancer patients who engage in moderate exercise while having chemotherapy tend to have delayed disease progression and fewer severe side effects, according to a US study...

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How alcohol can affect the development of colorectal cancer

While heavy alcohol consumption is recognised as a contributor to the development of colorectal cancer (CRC), an increasing number of studies suggest that moderate alcohol consumption may not have an adverse effect on the risk of CRC, or even decrease the risk.

A recent study, comprising a meta-analysis of 16 studies into the relation of alcohol consumption to invasive CRC, was conducted by leading investigators in the field. ISFAR members consider this to be a well-done study, with a large number of subjects, the ability to use individual level data in their meta-analysis, and the use of appropriate and complete analytic techniques.

The key finding of their study was that there was a J-shaped curve evident in all of their analytic approaches; their results strongly support a J-shaped association for the relation of alcohol intake to CRC; a slightly lower risk of cancer for light- to moderate-drinkers and an increased risk for subjects reporting an average of three or more drinks per day. Further, they found that their results did not vary by age, obesity, smoking or family history of CRC.

Overall, the effects of benefits/harms were somewhat more striking for cancers in the distal colon than in the proximal colon.

Potential mechanisms for heavy alcohol consumption being related to an increase in risk were discussed by the authors. As for moderate drinking decreasing the risk, potential mechanisms have been considered by an ISFAR member. He describes active, beverage-specific metabolites other than ethanol that reach the intestine. In particular, our attention goes to the several microbial catabolites that can be formed via our host microbiota in the colon.

The finding of a J-shaped curve between alcohol and CRC is similar to the relation seen for a number of other diseases, including coronary artery disease, ischemic stroke, dementia and total mortality. While a linear relation between heavy drinking and certain upper aero-digestive tract cancers has been shown, for certain cancers there may be a J-shaped curve of effect, with reductions in risk for light-to-moderate drinkers.

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