TRAITEMENT DU CANCER COLORECTAL ET MISES À JOUR SUR LA RECHERCHE CLINIQUE
Month Ending October 13th, 2022
The following colorectal cancer treatment and research updates extend from October 13,, 2022, to November 17,, 2022, inclusive and are intended for informational purposes only.
Ce contenu n'est pas destiné à se substituer à un avis médical professionnel. Consultez toujours votre médecin traitant ou les conseils d'un professionnel de la santé qualifié pour toute question concernant votre santé ou un problème médical. Ne négligez jamais l'avis d'un professionnel de la santé et ne tardez jamais à le solliciter en raison d'un élément que vous avez lu sur ce site web.
CONTENU
1. Essai clinique LEAP de phase II pour le traitement du CCRm
2. TRK Fusion Cancer and How to Test for It
3. A Phase II, Open-Label, Multicentre, Study of an Immunotherapeutic Treatment for the MSI High CRC Metastatic Population
4. Phase III Study at the Odette Cancer Centre Comparing Arfolitixorin vs. Leucovorin: Both in Combination with 5FU, Oxaliplatin, and Bevacizumab in Patients with Advanced CRC
5. New Cancer CRISPR Treatment Sees Patients’ Immune System Attack Tumors
6. First-in-class, orally bioavailable KRASG12V(ON) tri-complex inhibitors, as single agents and in combinations, drive profound anti-tumor activity in preclinical models of KRASG12V mutant cancers
7. Hepatic Artery Infusion Pump (HAIP) Chemotherapy Program – Sunnybrook Hospital
8. Living Donor Liver Transplantation for Unresectable CRC Liver Metastases
9. Study Offered at the Odette Cancer Centre to Treat Recurrent Rectal Cancer
10. Trends in the Incidence of Young-Onset CRC with a Focus on Years Approaching Screening Age
11. Colonoscopies Save Lives: Doctors Push Back Against European Study that Casts Doubt
12. Exact Sciences Expands Leadership in CRC Screening with New Data Presented at the American College of Gastroenterology 2022 Annual Meeting
13. Young Adult CRC Clinic Available at Sunnybrook Hospital
14. CCRAN’s Partnership with “Count Me In”
15. Patients and Caregivers Needed to Help Shape Early Research for a CRC Therapy
16. Under 50 National Colorectal Cancer Information/Support Group Leader
17. Can Gut Microbes Impact Chemotherapy? So Far, the Answer is ‘Yes’
18. Certain CRC Survivors Should Be Closely Monitored for Lung Metastases
19. Researchers Identify Cells Responsible for Colon Cancer Relapsers Should Be Closely Monitored for Lung Metastases
20. EXercise for Cancer to Enhance Living Well (EXCEL) Study
21. Mediterranean Diet May Lower Cancer Risk
22. Metabolite From Pomegranates May Help Fight CRC
23. Lower Risk of CRC Associated with Dietary Flavanone and Anthocyanidin Intake
24.Foire Aux Questions Pour Covid-19
MÉDICAMENTS / THÉRAPIES SYSTÉMIQUES
1. Phase II LEAP Clinical Trial For mCRC (Nov.10/22)
Le but de cette étude est de déterminer la sécurité et l'efficacité de la thérapie combinée avec le pembrolizumab (MK-3475) et Levantine la levantine (E7080/MK-7902) chez les patients atteints de cancer du sein triple négatif (TNBC), de cancer des ovaires, de cancer gastrique, cancer colorectal (CCR), glioblastoma (GBM), or biliary tract cancers (BTC). Participants will be enrolled in initial tumor-specific cohorts, which will be expanded if adequate efficacy is determined. The trial is available at the Odette Cancer Centre and at the Princess Margaret Cancer Centre in Toronto as well as the following Centres throughout Canada: Abbotsford, BC; Winnipeg, MB; CHU de Quebec. For information, visit the link below.
2. TRK Fusion Cancer and How to Test for It (Nov.13/22)
https://www.bayer.ca/en/media/news/?dt=TmpBPQ==&st=1
3. A Phase II, Open-label, Multicenter, Study of an Immunotherapeutic Treatment for the MSI High CRC Metastatic Population (Nov.13/22)
L'objectif de cette étude est d'examiner l'efficacité du vaccin DPX-Survivac en combinaison avec les médicaments cyclophosphamide et l'immunothérapie Pembrolizumab in patients with solid cancers who are identified to be MSI-High. All patients will receive combination therapy of DPX-Survivac, cyclophosphamide, and pembrolizumab. Patients participating will know which treatment they are receiving. The trial is currently hosted at the Odette Cancer Centre, and a new site is opening at Mt. Sinai Hospital.
4. Phase III Study at the centre de cancérologie Odette Comparing Arfolitixorin vs. Leucovorin in Combination with 5FU, Oxaliplatin and Bevacizumab in Patients with Advanced CRC (Nov.12/22)
The purpose of this study is to look at the effectiveness of the drug Arfolitixorin in combination with 5-fluorouracil (5FU), oxaliplatin, and bevacizumab in patients with colorectal cancer (CRC). Patients with advanced/metastatic CRC who meet certain criteria may be able to participate. There will be two groups of patients participating in this study;
- un groupe recevra de L'arfolitixorine en combinaison avec du 5FU), de l'oxaliplatine et du bevacizumab,
- tandis que l'autre groupe recevra le médicament Leucovorin en combinaison avec le 5FU, l'oxaliplatine et le bevacizumab (norme de soins).
Le médecin et le personnel de l'étude ne sauront pas dans quel groupe se trouve un patient. Les patients seront répartis au hasard pour recevoir l'un ou l'autre traitement.
A propos d'Arfolitixorine:
L'arfolitixorine is Isofol’s proprietary drug candidate being developed to increase the efficacy of standard of care chemotherapy for advanced CRC. The drug candidate is currently being studied in a global Phase 3 clinical trial. As the key active metabolite of the widely used folate-based drugs, arfolitixorin can potentially benefit all patients with advanced CRC, as it does not require complicated metabolic activation to become effective.
Traiter les patients atteints de cancer avec de l'arfolitixorine - Les objectifs :
- When treating CRC, for example, arfolitixorin is administered in combination with 5-FU to increase cell mortality in circulating cancer cells and in cancerous tumours.
- Arfolitixorin is administered in conjunction with rescue therapy after high-dose treatment with the cytotoxic agent, methotrexate, in order to suppress the cytotoxic effect in surrounding healthy tissue. The treatment is used for certain types of cancer, such as osteosarcoma, a type of bone cancer. This involves administering arfolitixorin separately, 24 hours after the chemotherapy.
https://sunnybrook.ca/trials/item/?i=293&page=49335 et https://clinicaltrials.gov/ct2/show/NCT03750786
https://isofolmedical.com/arfolitixorin/
5. New Cancer CRISPR Treatment Sees Patients’ Immune System Attack Tumors (Nov.11/22
According to a report published by the BBC, patients have had their immune system hacked and redesigned to attack their own tumors. The work is centered around T-cells, parts of the immune system that patrol the body and inspect other cells for issues. They do so using proteins, referred to as receptors, to spot cells that have deviated from their natural roles and become cancerous. Cancers are notoriously complicated for T-cells to identify because they consist of a corrupted version of people’s own cells.
The new therapy aims to increase the level of T-cells in patients’ bodies to better allow them to spot the disease. The researchers achieved this by examining patient’s blood for the rare T-cells that already had receptors which could sniff out their cancer. They then turned their attention to other T-cells that could not find the cancer and redesigned them to make them adept at this task. They did this by replacing their original receptors with those from the cancer-seeking T-cells and putting them back into the patients to search for and attack tumors. They essentially created receptors that can hunt cancer. This was made possible through the gene-editing technology CRISPR. CRISPR stands for “Clustered Regularly Interspaced Short Palindromic Repeats” and is a technology that enables scientists to edit the DNA of any genome. By editing DNA, scientists can alter certain characteristics of an organism. However, the treatment still has a long way to go before it can be used on larger populations.
6. First-in-class, orally bioavailable KRASG12V(ON) tri-complex inhibitors, as single agents and in combinations, drive profound anti-tumor activity in preclinical models of KRASG12V mutant cancers (Jul.1/22)
According to phase 3 results presented at ESMO Congress 2022, fruquintinib can improve survival outcomes when
Researchers built a pipeline of small molecule inhibitors targeting multiple oncogenic RAS(ON) mutants. RAS proteins are small GTPases that drive cell proliferation (growth and division) and survival when bound to GTP. Mutant RAS proteins exist predominantly in the GTP-bound (RAS(ON)) state, leading to excessive downstream signaling via interaction with effectors such as RAF. Targeting the KRASG12V(ON) state will be critical for maximal suppression of this oncogenic driver (has the potential to cause tumors/cancer). In cancer cell lines bearing KRASG12V mutations, KRASG12V(ON) inhibitors trigger an immediate disruption of RAS-effector interactions, leading to attenuation of RAS pathway signaling, potent (sub-nM EC50) growth suppression, and apoptosis (cell death). KRASG12V(ON) inhibitors produce deep, durable, and dose-dependent suppression of tumor RAS pathway activation following oral administration. In KRASG12V mutant NSCLC, CRC and pancreatic cancers, oral administration of KRASG12V(ON) inhibitors is well-tolerated and drives profound and durable tumor regressions, with complete responses in some animals. Moving forward, these inhibitors may lead to an attractive, targeted therapeutic option for the treatment of RAS-addicted cancers with a very high unmet medical need.
LES THÉRAPIES CHIRURGICALES
7. Hepatic Artery Infusion Pump (HAIP) Chemotherapy Program – Sunnybrook Odette Cancer Centre (Nov.1/22)
Le programme PPAH est une première au Canada pour les personnes dont le cancer du côlon ou du rectum (cancer colorectal) s'est propagé au foie et ne peut être retiré par une intervention chirurgicale. Le programme implique une approche coordonnée et multidisciplinaire des soins, avec une étroite collaboration entre l'oncologie chirurgicale, l'oncologie médicale (chimiothérapie), la radiologie interventionnelle, la médecine nucléaire et les soins infirmiers en oncologie. La pompe à perfusion de l'artère hépatique (PPAH) est un petit dispositif en forme de disque qui est chirurgicalement implanté juste sous la peau du patient et est relié par un cathéter à l'artère hépatique (principale) du foie. Environ 95 % de la chimiothérapie administrée par cette pompe reste dans le foie, épargnant ainsi le reste du corps des effets secondaires. Les patients reçoivent une chimiothérapie dirigée par PPAH en plus de la chimiothérapie intraveineuse (IV) régulière (chimiothérapie systémique), afin de réduire le nombre et la taille des tumeurs. Drs. Paul Karanicolas and Michael Raphael are the program leads and happy to see patients who may be eligible for the therapy.
Maintenant au centre de cancérologie Odette, le PPAH est utilisé chez les patients atteints d'un cancer colorectal qui s'est propagé au foie et qui ne peut être enlevé chirurgicalement et ne s'est pas propagé à d'autres parties du corps. Les patients qui ont peu (1-5) et de très petites tumeurs dans les poumons peuvent être pris en considération si la maladie pulmonaire est jugée traitable avant le PPAH. Si vous pensez pouvoir bénéficier de cette thérapie et/ou si vous souhaitez en savoir plus sur l'essai clinique, votre oncologue médical ou votre chirurgien peut vous adresser par télécopie au 416-480-6179. Pour plus d'informations sur l'essai clinique PPAH, veuillez cliquer sur le lien fourni ci-dessous
http://sunnybrook.ca/content/?page=colorectal-colon-bowel-haip-chemotherapy
8. Living Donor Liver Transplantation for Unresectable CRC Liver Metastases (Nov.2/22)
Environ la moitié des patients atteints de cancer colorectal (CCR) développent des métastases, généralement au niveau du foie et des poumons. L'ablation chirurgicale des métastases hépatiques (MH) est la seule option de traitement, bien que seulement 20 à 40 % des patients soient candidats à un traitement chirurgical. La thérapie chirurgicale apporte un avantage significatif en termes de survie, avec une survie à 5 ans après résection du foie de 40 à 50 % pour les MH, contre 10 à 20 % pour la chimiothérapie seule. La transplantation du foie (TF) permettrait d'éliminer toute maladie évidente dans les cas où les métastases colorectales sont isolées au foie mais considérées comme non résécables.
Source de l'image : https://www.slideshare.net/AhmedAdel65/preoperative
While CRC LM is considered a contraindication for LT at most cancer centers, a single center in Oslo, Norway demonstrated a 5-year survival of 56%. A clinical trial sponsored by the University Health Network in Toronto will offer live donor liver transplantation (LDLT) to select patients with unresectable metastases limited to the liver and are non-progressing on standard chemotherapy. Patients will be screened for liver transplant suitability and must also have a healthy living donor come forward for evaluation. Patients who undergo LDLT will be followed for survival, disease-free survival, and quality of life for 5 years and compared to a control group who discontinue the study before transplantation due to reasons other than cancer progression.
https://clinicaltrials.gov/ct2/show/NCT02864485
LES RADIOTHÉRAPIES/RADIOLOGIE INTERVENTIONNELLE
9. Study Offered at the Odette Cancer Centre to Treat Recurrent Rectal Cancer (Nov.9/22)
Magnetic resonance-guided focused ultrasound (MRg-FU) is a less invasive; outpatient modality being investigated for the thermal treatment of cancer. In MRg-FU, a specially designed transducer is used to focus a beam of low-intensity ultrasound energy into a small volume at a specific target site in the body. MR is used to identify and delineate the tumour, focus the ultrasound beam on the target, and provide a real-time thermal mapping to ensure accurate heating of the designated target with minimal effect to the adjacent healthy tissue. The focused ultrasound beam produces therapeutic hyperthermia (40-42°C) in the target field, causing protein denaturation and cell damage. Currently, there is no prospective clinical data reported on the use of MRg-FU in the setting of recurrent rectal cancer. Recurrent rectal cancer is a vexing clinical problem. Current retreatment protocols have limited efficacy. The addition of hyperthermia to radiation and chemotherapy may enhance the therapeutic response. With recent advances in technology, the investigators hypothesize that MRg-FU is technically feasible and can be safely used in combination with concurrent reirradiation and chemotherapy for the treatment of recurrent rectal cancer without increased side-effects. The study is being offered at the Odette Cancer Centre. Here is the link to the study protocol:
DÉPISTAGE
10. Trends in the Incidence of Young-Onset CRC with a Focus on Years Approaching Screening Age (Nov.10/22)
With recent evidence for the increasing risk of young-onset colorectal cancer (yCRC), the objective of this population-based longitudinal study was to evaluate the incidence of yCRC in one-year age increments, particularly focusing on the screening age of 50 years. The study was conducted using linked administrative health databases in British Columbia, Canada including a provincial cancer registry, inpatient/outpatient visits, and vital statistics from January 1, 1986 to December 31, 2016. Researchers calculated the incidence rates per 100,000 at every age from 20 to 60 years and estimated annual percent change in incidence (APCi) of yCRC using joinpoint regression analysis. 3,614 individuals were identified with yCRC (49.9% women). The incidence of CRC steadily rose from 20 to 60 years, with a marked increase from 49 to 50 years. Furthermore, there was a trend of increased incidence of yCRC among women. Analyses stratified by age yielded APCi’s of 2.49% and 0.12% for women aged 30-39 years and 40-49 years, respectively and 2.97% and 1.86% for men. These findings indicate a steady increase over one-year age increments in the risk of yCRC during the years approaching and beyond screening age. These findings highlight the need to raise awareness as well as continue discussions regarding considerations of lowering the screening age.
11. Colonoscopies Save Lives: Doctors Push Back Against European Study that Casts Doubt (Oct.13/22)
The findings of a big European study published in the New England Journal of Medicine this week seemed to cast doubt on just how beneficial a colonoscopy is in preventing colorectal cancer (CRC). Research going back more than a decade has shown that colonoscopies can save lives. A 2018 study from Kaiser Permanente, for example, found a 67% reduction in cancer deaths among people who got a screening colonoscopy. In contrast, the findings of the NEJM study point to a mere 18% reduction in CRC among thousands of men and women in Europe who were ‘invited’ to get a colonoscopy. However, it is important to note that a colonoscopy will only work if a patient gets one. It turns out that more than half of the research participants who were ‘invited’ to get a colonoscopy never showed up for the procedure, only 42% accepted the invitation.
The American Cancer Society (ACS) has weighed in on the study, highlighting a 31% reduction in risk among participants who were screened. They also say it’s important to consider that participants in the study were screened sometime between 2009 to 2014, so some got their colonoscopy as recently as 8 years ago. “The time from polyps to cancer to mortality is almost always greater than this — so a much longer follow-up is needed,” an ACS statement concludes. Over time, the reduction in cancer or deaths could be greater. The ACS continues to recommend CRC screening for adults aged 45 and older, as there’s no reason to change that direction.
Source de l'image : https://www.istockphoto.com/illustrations/colonoscopy
12. Exact Sciences Expands Leadership in CRC Screening with New Data Presented at the American College of Gastroenterology 2022 Annual Meeting (Oct.24/22)
Exact Sciences Corp., a leading provider of cancer screening and diagnostic tests, announced the company will present new data supporting the positive impact of Cologuard as a colorectal cancer (CRC) screening too. Data from Exact Sciences will detail the positive impacts on patients when costs associated with follow-up colonoscopy are eliminated after a positive stool-based test. New data will also provide details on the value of Cologuard in detecting serrated polyps, and the importance of reconsidering the definition of false positive outcomes from stool tests in CRC screening. Data from Exact Sciences at ACG demonstrate the positive impact removing obstacles to CRC screening can have on clinical and economic outcomes associated with this highly preventable form of cancer. These results provide key information to help screen more people for CRC and support the use of Cologuard as an FDA-approved, non-invasive screening option that is included in U.S. Preventive Services Task Force guidelines.
https://www.yahoo.com/now/exact-sciences-expands-leadership-colorectal-113300366.html
AUTRE
13. Young Adult CRC Clinic Available at Sunnybrook (Nov.5/22)
A recent study led by the University of Toronto doctors has observed a rise in colorectal cancer (CRC) rates in patients under the age of 50. The study mirrors findings from the U.S., Australia and Europe. The growing CRC rates in young people come after decades of declining rates in people over 50, which have occurred most likely due to increased use of CRC screening (through population-based screening programs) which can identify and remove precancerous polyps. Patients diagnosed under the age of 50 have a unique set of needs, challenges and worries. They are unlike those diagnosed over the age of 50. Le Dr Shady Ashamalla (oncologue chirurgien spécialisé dans le cancer colorectal) et son équipe du Centre des sciences de la santé Sunnybrook comprennent les besoins de cette population de patients.
Le Dr Ashamalla fait partie d'une équipe multidisciplinaire d'experts de La Clinique Du Cancer Colorectal Des Jeunes Adultes who will work with young CRC patients, regardless of disease stage, to create an individualized treatment plan to support each patient through their cancer journey. Their needs and concerns will be addressed as they relate to:
- Préoccupations et questions relatives à la fécondité
- Les jeunes enfants à la maison
- Questions relatives aux données et à l'intimité
- Les défis au travail
- Inquiétudes concernant le cancer héréditaire
- Relations avec la famille et les amis
- Stress psychologique dû à l'un ou à l'ensemble des éléments ci-dessus
L'équipe d'experts est composée de :
- Oncologues (médicaux, chirurgicaux, radiologiques)
- Travailleurs sociaux
- Psychologues
- Généticiens
- Infirmière navigatrice
Si un patient souhaite être orienté vers Sunnybrook, il peut demander à son médecin traitant ou à son spécialiste de l'orienter vers Sunnybrook via le formulaire d'orientation électronique, accessible via le lien figurant ci-dessous. Une fois l'orientation reçue La Clinique Du Cancer Colorectal Des Jeunes Adultes sera informée si le patient a moins de 50 ans. Un rendez-vous sera alors fixé, au cours duquel le patient rencontrera différents membres de l'équipe afin de répondre à leurs préoccupations spécifiques.
http://sunnybrook.ca/content/?page=young-adult-colorectal-cancer-clinic
14. CCRAN’s Partnership with “Count Me In” (Nov.1/22)
CCRAN is proud to partner with Count Me In, a nonprofit research initiative, on The Colorectal Cancer Project. This new project is open to anyone in the United States or Canada who has ever been diagnosed with colorectal cancer (CRC). Patients can find out more and join at JoinCountMeIn.org/Colorectal.
Through the project, patients are asked to complete surveys to share information about their experience with CRC, to share biological sample(s), and to allow for the research team to request copies of their medical records. The project team then de-identifies and shares data from these with the entire research community. 10
Every patient’s story holds a piece of the puzzle that can help us better understand CRC. By discovering more about what drives cancer and sharing this data, CCRAN and the Colorectal Cancer Project believe insights can be gained to develop more effective therapies. One of the aims of the project is to reach populations that have been understudied, including individuals who are diagnosed with CRC at a young age, individuals from marginalized communities who have historically been excluded from research, and patients with metastatic CRC. Together, we can accelerate our understanding of CRC. To learn more or sign up to participate, visit JoinCountMeIn.org/Colorectal.
“Count Me In”, a nonprofit cancer research initiative, is inviting all patients across the United States and Canada who have ever been diagnosed with colorectal cancer (CRC) to participate in research and help drive new discoveries related to this disease. The Colorectal Cancer Project will enable patients to easily share their samples, health information and personal lived experiences directly with researchers in order to accelerate the pace of research.
Patients who have been diagnosed with CRC at any point in their lives can join the project by visiting JoinCountMeIn.org/colorectal. From there, patients will be invited to share information about their experience through surveys and to provide access to medical records as well as saliva samples and optional blood, stool, and/or stored tissue samples for study and analysis. Researchers from the Broad Institute of MIT and Harvard and Dana-Farber Cancer Institute use this information to generate databases of clinical, genomic, molecular, and patient-reported data that is then de-identified and shared with researchers everywhere. To date, more than 9,000 patients with different cancers have joined Count Me In and shared their data. “We still do not know why there is an alarming rise in CRC in young adults”, said Andrea Cercek, MD Co-Director, Center for Young Onset Colorectal and Gastrointestinal Cancers Memorial Sloan Kettering Cancer Center and co-scientific leader of the Colorectal Cancer Project. “What we do know is that this is a global phenomenon that affects otherwise healthy individuals with no known risk factors. The Colorectal Cancer Project will provide researchers important information that will lead to a better understanding of this disease.”
Over 250 patients have joined the Colorectal Cancer Project since the launch in fall 2021. Every patient that joins the Colorectal Cancer Project enables us to learn more about colorectal cancer. Pts diagnosed at any age, whether newly diagnosed or years from their diagnosis, can enroll. If you have ever been diagnosed with colorectal cancer, you can visit JoinCountMeIn.org/Colorectal to enroll and have a direct impact on research and future treatment strategies.
15. Patients and Caregivers Needed to Help Shape Early Research for a CRC Therapy (Nov.10/22)
16. Under 50 National Colorectal Cancer Information/Support Group Now Available at CCRAN! (Sept.2/22)
ARE YOU AN EARLY AGE ONSET (<50 YEARS) COLORECTAL CANCER PATIENT OR CAREGIVER LOOKING FOR INFORMATION OR SUPPORT?
Meet Hayley Painter R.N. and proud survivor of metastatic colorectal cancer!
Hayley will be assuming the lead on CCRAN’s Monthly National Under 50 Colorectal Cancer Information/Support Group Meetings!
When: Every third Sunday of the month
Time: 7:00 – 9:00 p.m.
Where: Via Zoom
To Register: Hayley.p@ccran.org
Please join Hayley as she will deliver important treatment updates and provide optimal support to each patient in their colorectal cancer journey at these support group meetings. To register for the meeting, please contact Hayley using the email provided above.
17. Can Gut Microbes Impact Chemotherapy? So Far, the Answer is ‘Yes’ (Nov.2/22)
Bacteria in our guts play a significant role in how we digest what we eat, and what we eat includes oral medications we take. But the gut microbiome’s impact on drugs may be different from its impact on food because drugs are often intended to target a specific tissue or organ or process in the body. Researchers wanted to know if the microbiome matters in the metabolism of anti-cancer drugs that are critical for treating colon cancer and other types of cancers. So far the answer is yes. A recently published study looked at how the microbiome effects metabolism of chemotherapy drugs called fluoropyrimidines (FPDs), which are frequently used to treat colon cancer. The researchers suspected that bacteria living in the gut can intercept and inactivate some of the drug before it’s able to get to the tumor. They discovered that multiple types of bacteria in the gut, including E. coli and other common gut bacterial species, produce very similar enzymes, and those bacterial enzymes were breaking down the drug, turning a substance that would be actively killing cancer cells into an inactive metabolite.
Each of us has a very different microbiome. We may all have E. coli in our gut, but we might have different strains of it. And those differences between strains for some bacteria can result in big differences in the genes that are found in their genome. The idea of sequencing the genome of the cancer cells themselves has been incredibly successful. Now, doctors can look at the DNA of the primary tumor, figure out what the mutations are, and tailor their treatment plan to genetic insights about the tumor. Right now, we’re still in the phase of figuring out how and why the microbiome matters for drugs across multiple disease areas, including cancer.
https://www.ucsf.edu/news/2022/11/424136/can-gut-microbes-impact-chemotherapy-so-far-answer-yes
Source de l'image : https://commons.wikimedia.org/wiki/File:202004_Gut_microbiota.svg
18. Certain CRC Survivors Should Be Closely Monitored for Lung Metastases (Nov.1/22)
Colorectal cancer (CRC) commonly spreads to lungs, but no evidence-based standard exists for post-treatment chest imaging to monitor for lung metastases. Undergoing CT scans too frequently can be costly and come with its own side effects, while too sparse scans — or worse, no scans at all — can potentially allow lung metastases to grow, thereby potentially worsening prognosis.
A recent study sought to remedy this by identifying groups of patients with surgically removed CRC that are at high risk of developing lung metastases. It combined two large databases and found a group of patients who developed spots on their CT scans of their lungs within three months of having had their CRC resected. Study findings showed that patients who were more likely to have pulmonary (lung) metastases were those who needed chemotherapy or radiotherapy before or after surgery, meaning that the cancer was more advanced, as well as those with a KRAS mutation or those who have a higher percentage of cancerous lymph nodes removed during colorectal surgery. Patients who develop these spots really early are the patients who should receive imaging early, since they also have those risk factors and characteristics that might (indicate) that they are at a higher risk of having pulmonary metastases. Knowing who should undergo chest scans more frequently is important because catching lung metastases early can be key in improving survival outcome. Looking forward, the research team plans to build a machine learning algorithm that could be helpful in determining which patients should undergo more frequent screening based on their individual risk factors.
19. Researchers Identify Cells Responsible for Colon Cancer Relapse (Nov.10/22)
Scientists at the Institute for Research in Biomedicine (IRB), in Barcelona have identified residual tumor cells responsible for colon cancer relapse and reveal the underlying mechanism behind their ability to metastasize. Researchers at IRB have now developed a new experimental animal model aiming to recreate the process of colon cancer relapse in patients. Using their model, and a parallel technique, the scientists were able to isolate tiny amounts of residual colon cancer cells that had traveled and hidden in other organs such as the lung and liver making themselves invisible to current clinical diagnostic tools.
The scientists were also able to characterize a population of cells driving colon cancer as High Relapse Cells (HRCs). These cells reportedly do not contribute to the growth of the primary tumor due to little proliferative activity. However, clusters of these cells are able to detach from the tumor and migrate via the bloodstream to other organs such as the liver, where they remain hidden after surgery. Using samples from patients with colon cancer, the researchers verified the presence of HRCs in patients with the greatest risk of relapse. In an attempt to eliminate HRCs, the researchers removed the cells in mice models using genetic techniques, achieving the prevention of the formation of metastases. Mice with colon cancer remained disease-free after primary tumor removal and the cancer did not recur. The team also demonstrated that treatment with immunotherapy before surgery can remove HRCs that have traveled to other organs, eradicating residual cancer.
This discovery reveals how the group of tumor cells responsible for relapse behaves and also the genes that define them. In addition, it represents a proof of concept that paves the way for the development of new therapies, specifically aimed at eliminating residual disease, as well as new diagnostic tools to identify those patients at the greatest risk of relapse.
NUTRITION/MODE DE VIE SAIN
20. Exercise for Cancer to Enhance Living Well (EXCEL) Study (Nov.11/22)
Exercise for Cancer to Enhance Living Well (EXCEL) is a 5-year Canada-wide project, which offers free, 12-week exercise classes designed specifically for individuals undergoing or recovering from cancer treatment. Classes are online through a secure video-conferencing platform, and where possible, in-person (post-COVID). Physical activity can help overcome treatment-related side effects such as fatigue and pain, improve mental health by reducing anxiety and depression, and improve overall quality of life for individuals living with and beyond cancer. Studies show that physical activity may even reduce the risk of recurrence for some cancers. Many urban centres in Canada offer cancer-specific exercise programs, however, rural and remote areas tend to lack exercise resources to support cancer survivors, resulting in lower activity levels, poorer health, and diminished quality of life. Thus, EXCEL targets cancer survivors living in rural and remote regions across Canada, empowering them to move more and providing opportunities to benefit from physical activity.
To learn more about the EXCEL study:
To hear about participant experiences: https://www.youtube.com/watch?v=c01oo4Yd3oA
21. Mediterranean Diet May Lower Cancer Risk (Oct.12/22)
The Mediterranean diet consistently has been linked to a lower risk of cancer, cardiovascular disease and mortality. A traditional Mediterranean diet is rich in fish, olive oil, vegetables, whole grains, nuts, and legumes and lower in red meat and dairy with modest alcohol consumption. Studies suggest that adherence to this diet can both reduce an individual’s risk of developing cancer and delay the progression of cancer in those with a cancer diagnosis.
The Mediterranean diet may also improve response to immunotherapy. Immune Checkpoint Inhibitors (ICIs) drugs are a standard treatment for melanoma and other cancers. They work by blocking immune system checkpoints, which then force the body’s own T-cells to attack their cancer. Participants in a multi-centre study had their dietary intake recorded and were treated with ICI drugs. The researchers found and improved overall response to treatment and
delayed cancer progression at 12 months in individuals on the Mediterranean diet. The study also found that eating whole grains and legumes reduced the likelihood of developing drug induced immune-related side effects, such as colitis. In contrast, red and processed meat was associated with a higher probability of immune-related side effects. The study underlines the importance of dietary assessment in cancer patients starting ICI treatment and supports a role for dietary strategies to improve patient outcomes and survival.
Source de l'image : https://nutrition.org/living-mediterranean-lifestyle/
22. Metabolite From Pomegranates May Help Fight CRC (Nov.2/22)
Recent studies show that concentrated forms of urolithin A (UA), a natural product of pomegranate digestion, induce mitophagy — the breakdown of old or redundant “cellular powerhouses” known as mitochondria. In turn, this encourages the creation of new mitochondria and slows the progression of age-related diseases. Other studies have found that UA has immunomodulatory effects in cells that reduce inflammation alongside cells that enhance immune function. Recently, researchers explored the effects of UA on colorectal cancer (CRC) in mice. They found that UA induced “strongly protective” anti-tumor T cell immunity in mice both when consumed in food and when used alongside CAR-T cell therapy, a treatment in which T cells — a type of immune cell — are altered to attack cancer cells. These findings are particularly exciting because the focus is not on the tumor cell but on the immune system, the natural defense against cancer. This is where reliable therapeutic approaches are still lacking in the reality of CRC patients. By possibly improving the combination therapy with existing immunotherapies, the study opens up meaningful possibilities for further application in the clinic.
23. Lower Risk of CRC Associated with Dietary Flavanone and Anthocyanidin Intake (Oct.31/22)
Flavonoids, found in plant-based foods, are a group of polyphenols divided into six sub-classes – isoflavones, flavanols, flavones, anthocyanidins, flavanones, and flavonols. Flavonoids act in pathways involving cellular transformation, proliferation, and apoptosis. Several epidemiologic studies have reported an inverse relationship between the risk of colorectal cancer (CRC) and dietary flavonoids. In the present study, researchers analyzed the association of flavonoid intake with CRC risk and circulating bacterial DNA. Results suggested that total flavonoid intake was not related to the risk of CRC. Nevertheless, there was a significant inverse relationship with the risk of CRC for the intake of flavanones and anthocyanidins. This means increased dietary flavanones and anthocyanidins decrease the risk of CRC.
MISES À JOUR COVID-19
24.Foire Aux Questions Pour Covid-19
Q: What is COVID-19 (or novel Coronavirus Disease – 19)?
A: Coronaviruses are a large family of viruses that can cause illnesses in humans and animals. Coronaviruses can cause illnesses that range in severity from the common cold to more severe diseases such as Severe Acute Respiratory Syndrome (SARS) and most recently, COVID-19. COVID-19 or novel coronavirus originated from an outbreak in Wuhan, China in December 2019. The most common symptoms associated with COVID-19 can include fever, fatigue, and a dry cough. Though additional symptoms have now been linked with the disease, which may include aches and pains, nasal congestion, runny nose, sore throat, diarrhea, skin rash and vomiting. It is also possible to become infected with COVID-19 and not experience any symptoms or feeling ill. The spread of COVID-19 is mainly through the transmission of droplets from the nose or mouth when a person coughs, exhales or sneezes. These droplets land on surfaces around a nearby person. COVID-19 can be transmitted to that nearby person who may end up touching the surface contaminated with COVID-19 and then end up touching their nose, mouth, or eyes. A person can also contract COVID-19 through inhaling these droplets from someone with COVID-19. Although research is still ongoing, it is important to note that older populations (over the age of 65), those with a compromised immune system and those with pre-existing conditions including heart disease, high blood pressure, lung disease, diabetes or cancer may be at a higher risk of severe illness due to COVID-19.
https://www.who.int/news-room/q-a-detail/q-acoronaviruses
Q: What can I do to avoid getting Coronavirus?
A: There are various ways in which we can reduce our risk of contracting COVID-19. Below are some measures suggested by the World Health Organization
1. Keep at least 2 metres (or 6 feet) between yourself and other people. This will reduce the risk of inhaling droplets from those infected with COVID-19.
2. Regularly clean your hands for at least 20 seconds with warm water and soap, or an alcohol-based hand rub. This will kill any viruses on your hands.
3. Avoid touching your eyes, nose and mouth. If the virus is on your hands, it can enter the body through these areas.
4. Follow good respiratory hygiene by covering your mouth and nose with a tissue or elbow when you cough and sneeze. This prevents the droplets from settling on surfaces or being released into the air around you.
5. Stay home as much as possible, especially if you are feeling unwell. If you think you may have the Coronavirus, please see “What should I do if I think I have Coronavirus?” section.
6. Please wear a face covering or mask in public when physical distancing is not possible.
https://www.who.int/news-room/q-adetail/q-a-coronaviruses
Y a-t-il des précautions particulières que les personnes atteintes d'un cancer peuvent prendre ?
R : Les personnes atteintes de cancer (et d'autres maladies chroniques telles que les maladies cardiaques, le diabète, l'hypertension et les maladies pulmonaires) sont plus exposées à une maladie grave en raison de la COVID-19, le cancer étant considéré comme un problème de santé préexistant. Certains traitements contre le cancer, notamment la chimiothérapie, les radiations et la chirurgie, peuvent affaiblir le système immunitaire, ce qui rend l'organisme plus difficile à combattre les infections et les virus, comme le Coronavirus. Il est important de suivre avec diligence les recommandations de l'Organisation mondiale de la santé ci-dessus pour réduire le risque de contracter le COVID-19. Si vous avez des inquiétudes quant à votre risque, il est préférable de contacter votre médecin ou votre équipe de soins.
Y a-t-il des changements en ce qui concerne mes visites médicales liées au cancer ? Chaque patient et chaque plan de traitement étant uniques, il est toujours préférable de contacter votre prestataire de soins de santé pour obtenir des informations actualisées sur votre plan de traitement. Dans certains cas, il est possible de retarder le traitement du cancer jusqu'à ce que le risque de pandémie ait diminué. Dans d'autres cas, il peut être sûr de se rendre dans une clinique distincte de celle où sont traités les patients COVID-19. Les options de traitement oral pourraient être prescrites par votre prestataire de soins de manière virtuelle, sans qu'il soit nécessaire de se rendre à la clinique. Enfin, certains rendez-vous ou discussions de suivi pourraient être organisés virtuellement (via skype ou zoom par exemple) ou par téléphone pour minimiser votre risque. Comme nous le savons, les conditions et les protocoles changent quotidiennement en raison de la nature de l'épidémie de COVID-19 et varient en fonction du lieu, par conséquent, la meilleure première étape consiste à demander conseil à votre prestataire de soins.
https://www.cancer.gov/contact/emergencypreparedness/coronavirus
Si vous souhaitez contacter votre agence locale de santé publique, veuillez voir ci-dessous.
Alberta
Informations COVID-19 pour Alberta
Les médias sociaux : Instagram @albertahealthservices, Facebook @albertahealthservices, Twitter @GoAHealth
Numéro de téléphone : 811
Colombie-Britannique
Informations COVID-19 pour Colombie-Britannique
Les médias sociaux : Facebook @ImmunizeBC, Twitter @CDCofBC
Numéro de téléphone : 811
Manitoba
Informations COVID-19 pour Manitoba
Les médias sociaux : Facebook @manitobagovernment, Twitter @mbgov
Numéro de téléphone : 1-888-315-9257
Nouveau Brunswick
Informations COVID-19 pour Nouveau-Brunswick
Les médias sociaux : Facebook @GovNB, Twitter @Gov_NB, Instagram @gnbca
Numéro de téléphone : 811
Terre-Neuve et Labrador
Informations COVID-19 pour Terre-Neuve-et-Labrador
Les médias sociaux : Facebook @GovNL, Twitter @GovNL, Instagram @govnlsocial
Numéro de téléphone : 811 ou 1-888-709-2929
Territoires du Nord-Ouest
Informations COVID-19 pour Territoires du Nord-Ouest
Les médias sociaux : Facebook @NTHSSA
Numéro de téléphone : 811
Nouvelle-Écosse
Informations COVID-19 pour Nouvelle-Écosse
Les médias sociaux : Facebook @NovaScotiaHealthAuthority , Twitter @healthns, Instagram @novascotiahealthauthority
Numéro de téléphone : 811
Nunavut
Informations COVID-19 pour Nunavut
Les médias sociaux : Facebook @GovofNunavut , Twitter @GovofNunavut, Instagram @gouvernement du Nunavut
Numéro de téléphone : 1-888-975-8601
Ontario
Informations COVID-19 pour Ontario
Les médias sociaux : Facebook @ONThealth, Twitter @ONThealth , Instagram @ongov
Numéro de téléphone : 1-866-797-0000
Île-du-Prince-Édouard
Informations COVID-19 pour Île-du-Prince-Édouard
Social media: Facebook @GovPe, Twitter @InfoPEI, 16
Québec
Informations COVID-19 pour Québec
Les médias sociaux : Facebook @GouvQc, Twitter @sante_qc
Numéro de téléphone : 1-877-644-4545
Saskatchewan
Informations COVID-19 pour Saskatchewan
Les médias sociaux : Facebook @SKGov, Twitter @SKGov
Numéro de téléphone : 811
Yukon
Informations COVID-19 pour Yukon
Les médias sociaux : Facebook @yukonhss, Twitter @hssyukon
Numéro de téléphone : 811
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