Cancer Vaccines - Where are we ?

 Sharing a nice piece from the New York Times :

After Giving Up on Cancer Vaccines, Doctors Start to Find Hope (ampproject.org)

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Cancer Care Advice

Role of High Fibre and Omega 3 rich diet in melanoma patients on immunotherapy

Here , the authors study the associations between the gut microbiota and immunotherapy response and irAE development using a clinically homogenous trial cohort of patients in Australia and the Netherlands who presented with melanoma treated with neoadjuvant combination ICIs.

A highly homogeneous prospective clinical trial cohort was utilized to show that a gut microbiome associated with higher fiber and #omega3 consumption is beneficial to facilitating optimal anti-tumor immune responses and minimizing the risk of irAEs during #immunotherapy

https://melanoma.org.au/wp-content/uploads/2022/09/Diet-driven-microbial-ecology-Nature-Medicine-paper.pdf

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Shedding light on ctDNA shedding and detection in various cancers

Analyzing over 40,000 #patients , this #realworldevidence (#RWE) study sheds light on the #ctdna shed and detected in various solid #tumours. Is it time to expand the role of #liquidbiopsy assays beyond the 9 #cancer types recommended by the NCCN guidelines ?

https://meetings.asco.org/abstracts-presentations/214579 

Biomarker driven cancer management can potentially change the whole picture , when it comes to prognosis of cancer.

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Results from the Niche -2 study in non-metastatic dMMR #Colorectalcancer patients presented at #ESMO22 becomes the face of #precisiononcology #biomarker driven #CancerCare

 ESMO22 Expert report on immune checkpoint inhibitors for dMMR Colorectal Cancer | OncologyPRO

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THERAPEUTIC TARGETING OF CIP2A IN CASTRATION RESISTANT PROSTATE CANCER (CRPC)

http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=view&path%5B%5D=3875

SECOND OPINION FOR CANCERS: AN IMPORTANT AVENUE FOR CANCER PATIENTS AND THEIR FAMIILIES

Cancer can be complicated to detect, diagnose and treat. Getting a second opinion helps you feel more confident on the entire process of detection, diagnosis and treatment. 

Why to seek a second opinion for cancers ?

There are many reasons why you want to seek second opinion during the course of your cancer journey — 

1) You have a rare tumour type and need more information on its management.

2) Lack of confidence in the diagnosis and management by your primary physician.

3) In search of alternative options due to lack of response to current treatment.

A second opinion provides new information on the various available treatment options and gives you confidence on the entire process / journey ahead. It plays the vital role of reducing stress, both for the patient and his/her caretakers. When you purchase an insurance , you do a lot of research to ensure you are taking the best option, then why not do the same for a life threatening disease like cancer.

How to begin and ask for second opinion for cancer care ?

You could  initiate the process during the management process by your primary  or current clinician. Simply indicate to them that you would be interested in getting a second opinion on the whole thing. Majority of the clinicians are pretty used to such requests and usually recommend it themselves in cases where they are not feeling confident themselves. 

Importantly , you can also seek out a second opinion on your own. This is absolutely your choice. Getting the right drug for the right tumour,  in the right patient at the earliest, is the holy grail to beating this deadly disease or achieving best possible outcomes. So do not hesitate in looking for additional support that will make you feel more confident and informed about yours or your loved one's care.

Who is best positioned to provide the most effective second opinion ?

The field of cancer therapeutics is advancing very rapidly. The explosion of data due to the genomic analysis of various different types of tumours has not only provided us valuable insights but has also opened up more questions than it has answers. The new era of cancer therapy is moving towards molecular approach rather than the orthodox chemo-radio approach of management of these patients . Having said that, the cancer management is today is dependent on several factors such as the geography, access to trials for the newer drugs, the cost factor and the lack of social security, to name a few. 

In my opinion,  a clinician who is actively involved or has experience with both clinical and pre-clinical cancer research  (has good publications and scientific reputation) is best equipped and trained to provide the most effective information and guidance in this field. This is simply because they have the apt training to understand the new emerging data  (both pros and cons) along with its implications.

Dr Anchit Khanna   

MBBS,MMedSci (Med. Genetics) , MD PhD

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Disclosure: The opinion expressed above is that of the author alone. The author is also involved in providing second opinion himself to cancer patients. 

PD-L1/PD-1 Pathway: A Security Checkpoint

DNA DAMAGE RESPONSE PROTEIN, DNA-PKc PROMOTES PROSTATIC METASTASIS

AN ELEGANT STUDY  HIGHLIGHTING THE ROLE OF DNA DAMAGE RESPONSE PROTEINS IN METASTASIS.


http://www.cell.com/cancer-cell/abstract/S1535-6108(15)00214-7

THE IMPACT OF RESEARCH ON PROSTATE CANCER THERAPEUTICS IN THE LAST DECADE

PROSTATE CANCER THERAPIES -  CHANGES IN THE LAST DECADE

DNA DAMAGE IN CANCER THERAPEUTICS : DOUBLE EDGED SWORD

 DNA-damaging modalities as treatment for cancers have been now been there for several decades. Despite it being able to kill cancer cells,  issues with relation to second cancers,  resistance and recurrence of cancers and non-specificity related adverse effects have limited their application and the advance in the field that was anticipated with their usage.  My recent comprehensive review discusses these aspects and proposes the concept of existence of distinct thresholds of DNA-damage that maybe used to design better and more effective clinical strategies and trials in the future.

The LINKS to the paper :

http://cancerres.aacrjournals.org/content/early/2015/04/30/0008-5472.CAN-14-3247.abstract

https://www.researchgate.net/publication/275659825_DNA_Damage_in_Cancer_Therapeutics_A_Boon_or_a_Curse