Archive for TREATMENT OPTIONS

Reliable, Relevant Cancer Info Delivered Straight to Your Inbox

 

Medivizor provides personalized, reliable medical information to people coping with serious or chronic medical conditions.  Medical conditions currently supported include breast cancer, colorectal cancer, lung cancer, lymphoma, melanoma and prostate cancer as well as diabetes, hypertension, cardiovascular disease and infertility.

It’s similar to a google alert but much, much better.  Medivizor‘s FREE service scans hundreds of clinical reports; selects the ones most relevant to you; interprets the content; and notifies you of the findings in simple terms that even a 10th grader can understand.

Research has shown that patients who take an active role in their health care tend to have better outcomes.  The information Medivizor provides enables users become more knowledgeable about their medical condition.  Users learn about cutting edge research relative to their condition, possible treatments, clinical trials, lifestyle tips and more that they can discuss with their doctors.

SAMPLE ARTICLE I RECEIVED ABOUT breast cancer:

Breast cancer staging: one lymph node or several?In a nutshellThis paper compares the benefits and risks of axillary lymph node dissection compared to sentinel lymph node dissection.Some backgroundBreast cancer can spread to nearby lymph nodes (organ that is involved in the immune system that is found throughout the body). Generally, for patients with no cancer in their lymph nodes, sentinel lymph node dissection is performed to stage the cancer. This involves removal of only the first lymph node to which the cancer is most likely to spread, to determine the severity of cancer. For patients with early invasive breast cancer and metastatic disease (cancer that has spread to other parts of the body), axillary lymph node dissection is undertaken. This involves removal of several lymph nodes to determine the severity of cancer.Methods & findingsThe authors studied women with breast cancer that had spread to the sentinel lymph node. Data from 10 previous articles were combined and studied.

From three studies, there were similar survival rates between patients who had sentinel lymph node dissection alone and complete axillary lymph node dissection.

In one study, 1.6% of patients who had sentinel lymph node dissection compared with 3.1% of patients who had axillary lymph node dissection experienced return of breast cancer. However, another study reported that significantly more women who underwent a sentinel lymph node dissection alone had higher rates of cancer return. Women who had sentinel lymph node dissection alone had similar disease-free-survival (period without symptoms of disease) rates compared with women who had complete axillary lymph node dissection.

The studies also evaluated the risks associated with each option. Compared to patients who had complete axillary lymph node dissection, those who had sentinel lymph node dissection alone had a 70% lower risk of lymphedema (swelling in the limbs) after 6 months, 74% lower risk of limited range of motion75% lower risk of pins and needles in arms and a 42% lower risk of wound infections.

The bottom line

The authors concluded that for some women with early invasive breast cancer, sentinel lymph node dissection can be an alternative to axillary lymph node dissection.

The fine print

There could be publication bias and some studies had low strength of evidence.

What’s next?

Discuss with your doctor the advantages and disadvantages of both treatment methods.

Published By :

European journal of cancer

Date :

Mar 01, 2013

Original Title :

Sentinel lymph node dissection only versus complete axillary lymph node dissection in early invasive breast cancer: a systematic review and meta-analysis.

 

Hope In A Mouse Kept Us Afloat

 

Science Magazine

 

 

 

 

 

 

 

 

 

 

 

I am truly honored to have been interviewed by Jennifer Couzin-Frankel of Science Magazine for the article she wrote on using animal models to guide patient care as this is where my family’s battle with cancer led us.  You can read Jennifer’s  article “Hope In A Mouse” by clicking here.  Thank you Jennifer for including my perspective in this amazing, well-balanced and informative article.  

 

A little more info on our experience….

When I look back on my family’s war with cancer, I believe that “hope” kept us afloat.  

We tried everything possible to gain control over the cancer that was ravaging my husband’s body, but nothing was working.  We were under the care of top doctors in sarcoma (that is after we fired our first oncologist); we followed the advice of a nutritionist who specialized in working with oncology patients (as a result, my husband Alan had never looked better and his body became strong enough to withstand the massive amounts of toxic therapies he received); we even worked with a spiritual healer (what can I say, we were desperate).

 

Come November 2009, we were left with no options… and no hope.  It was pure luck (and one amazing Uncle) that led us to Champions Oncology.  Champions offered us the ability to implant Alan’s cancer into immunodeficient mice (mice with no immune system); test any drug or treatment regimen in these mice; and if we were lucky enough to find something that killed off Alan’s cancer in the mice, there was a really good chance it would do the same in Alan’s body.

 

Although we knew the odds of success were not in our favor, the ability to test different therapies against Alan’s tumors in mice using the Champions TumorGraft gave us hope. Hope gave us the strength to get out of bed each day and enjoy whatever time our family had left together.

 

Although we did not find a cure for Alan’s cancer or anything to substantially slow down its growth, we know that we tried everything possible to beat this diagnosis.  I sleep at night knowing that we left no stone unturned.

 

My family’s battle with cancer led me to create CancerHawk.  My mission is to connect cancer patients and caregivers to groups and resources they never knew existed or even thought to seek out- groups like Champions Oncology for instance.  Knowledge is hope.  And hope is everything.

 

Read the article Hope In A Mouse” in this week’s Science Magazine and let us know what you think…  Would you want access to an experimental approach to guide your treatment even if it’s not yet 100% proven?  Or would you prefer that researchers keep it locked up until it is?

 

 

 

 

 

Breast Cancer Is Actually 10 Different Diseases

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2014 – 2015 Top Ranked US Cancer Hospitals

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Each year US News & World Report ranks the top 50 cancer hospitals in the US.  Every hospital ranked is experienced in treating difficult cases.  Reputation among specialists, survival rates, success in keeping patients safe and patient volume are among the criteria used to evaluate the cancer hospitals.  For a complete explanation of how these rankings are determined, click HERE.

*** Regardless of which hospital center you choose, even if it’s a top ranked one, it is still important to get a second opinion… or a 3rd or a 4th. ;-) ***

So without further ado, below are the 2014-2015 US News & World Report’s Top Ranked Hospitals for Cancer:

1.  Memorial Sloan-Kettering Cancer Center (New York, NY)

2.  University of Texas MD Anderson Cancer Center (Houston, TX)

3.  Mayo Clinic (Rochester, MN)

4.  Dana Farber/ Brigham & Women’s Cancer  (Boston, MA)

5.  Johns Hopkins (Baltimore, MD)

6.  University of Washington Medical Center (Seattle, WA)

7.  Massachusetts General Hospital (Boston, MA)

8.  UCSF Medical Center (San Francisco, CA)

9.  UCLA Medical Center (Los Angeles, CA)

10.  Stanford Hospital & Clinics (Stanford, CA)

11.  Hospitals of the University of Pennsylvania-Penn Presbyterian (Philadelphia, PA)

12.  City of Hope (Duarte, CA)

13.  Cleveland Clinic (Cleveland, OH)

14.  New York-Presbyterian University Hospital of Columbia & Cornell (NY, NY)

15.  University of Colorado Hospital (Aurora, CO)

16.  Moffitt Cancer Center (Tampa, FL)

17.  Northwestern Memorial Hospital (Chicago, IL)

18.  Seidman Cancer Center at UH Case Medical (Cleveland, OH)

19.  Fox Chase Cancer Center (Philadelphia, PA)

20.  Wake Forest Baptist Medical Center (Winston-Salem, NC)

21.  Barnes-Jewish Hospital/ Washington University (Saint Louis, MO)

22.  Duke University Hospital (Durham, NC)

23.  USC Norris Cancer Hospital-Keck Medical Center of USC (Los Angeles, CA)

24.  Emory University Hospital (Atlanta, GA)

25.  UC San Diego Medical Center (San Diego, CA)

26.  Mayo Clinic (Phoenix, AZ)

27.  Thomas Jefferson University Hospital (Philadelphia, PA) *tied

27.  University of Iowa Hospitals and Clinics (Iowa City, IA)  * tied

29.  University of Kansas Hospital (Kansas City, KS)

30.  Ohio State University James Cancer Hospital (Columbus, OH)

31.  University of Chicago Medical Center (Chicago, IL)

32.  UPMC- University of Pittsburgh Medical Center (Pittsburgh, PA)

33.  Oregon Health and Science University Hospital (Portland, OR)

34.  University of California, Davis Medical Center (Sacramento, CA)

35.  University of Michigan Hospitals and Health Centers (Ann Arbor, MI)

36.  Nebraska Medical Center (Omaha, NE)

37.  Hackensack University Medical Center (Hackensack, NJ)

38.  University of North Carolina Hospitals (Chapel Hill, NC)

39.  Vanderbilt University Medical Center (Nashville, TN) *tied

39.  Yale-New Haven Hospital (New Haven, CT) *tied

41.  Cedars-Sinai Medical Center (Los Angeles, CA)

42.  Houston Methodist Hospital (Houston, TX)

43.  University of Wisconsin Hospital and Clinics (Madison, WI)

44.  Beth Israel Deaconess Medical Center (Boston, MA)

45.  Florida Hospital Orlando (Orlando, FL)

46.  University of Maryland Medical Center (Baltimore, MD)

47.  Loyola University Medical Center (Maywood, IL)

48.  Mount Sinai Hospital (New York, NY) *tied

48.  Rush University Medical Center (Chicago, IL)

50.  NYU Langone Medical Center (New York, NY)

The 411 on Cancer Immunotherapy

 

One of the most promising areas in cancer research and precision medicine today is “Immunotherapy.  Credited as the first therapy ever proven to extend the lives of patients with metastatic melanoma, immunotherapy is changing the way some cancers are treated.

 

Here’s the dealio (as my daughter always says)…  Immunotherapy refers to a class of treatments that use the body’s own immune system to help fight cancer.  Some treatments boost the body’s immune system in a very general way, while others help train the immune system to attack cancer cells specifically.  Today, most people who receive immunotherapy have cancers that are advanced. Their cancers have either recurred and spread after primary treatment, or were diagnosed in an advanced stage.  Often times, patients receiving immunotherapy treatments are enrolled in a clinical trial.

 

Because immunotherapy is a rapidly evolving field, understanding the “basics”  can be complicated and confusing.  One of the best resources I’ve found to help explain the complexities of immunotherapy is the Cancer Support Community’s  new program… Frankly Speaking About Cancer: Your Immune System & Cancer Treatment.  

 

Additionally, the Cancer Support Community is hosting several FREE webinars on immunotherapy for patients diagnosed with melanoma, leukemia, lymphoma and lung cancers.  “Immunotherapy Advances in Melanoma” is scheduled for September 9, 2014 at 6:30pm EST.

 

Other fantastic resources on immunotherapy include:

Cancer Research Institute

The Cancer Research Institute (CRI) is dedicated to advancing the immune system’s power to conquer all cancers. Click HERE to see brief statistics on specific cancers as well as an overview of the current and potential impact of immunotherapy for each cancer type. All content on this site has been reviewed and verified by experts in cancer immunotherapy.

 

TheAnswerToCancer.org

Great informational site for patients and caregivers who are interested in learning more about cancer immunotherapy as a treatment option.  Hear firsthand from patients who have benefitted from this novel approach to cancer treatment.  

 

Immunotherapy Clinical Trial Finder  

Many patients are not aware of opportunities to participate in clinical trials and may find it difficult to identify trials that may be appropriate for them.  The Cancer Research Institute has partnered with EmergingMed to provide the Cancer Immunotherapy Clinical Trial Finder, a tool designed to help patients quickly search for clinical trials that match their specific cancer diagnosis and treatment history.  

The Cancer Research Institute also has Clinical Trial Navigators available Monday through Friday from 8:30 a.m. to 6:00 p.m. EST who can help you find personalized trial matches, connect with study sites, and answer many of your questions.  Simply call (toll-free) 1-855-216-0127.  This service is free and completely confidential.  

 

Lazarex Cancer Foundation  

If you need help navigating clinical trial options or financial assistance to attend a clinical trial, connect with Lazarex Cancer Foundation.  Lazarex can help with the costs associated with participating in a clinical trial, including:

  • Transportation (airfare, gas, rental cars, taxi fare, parking/tolls)
  • Lodging (short- and long-term housing)
  • Certain medical expenses not covered by insurance and necessary for clinical trial treatment.

 

A Brief History of Immunotherapy

In case you’re interested, Targeted Oncology (fantastic site for the latest news and insights from leading researchers and cancer centers) has a great article on the history of immunotherapy which dates back to the late 19th century.

 

Make sure to discuss any findings with your doctors and health care team.  Knowledge is power…

 

What You Need to Know About Breast Reconstruction

The Cancer Support Community surveyed 762 breast cancer survivors (who were eligible for breast reconstruction) and found that 43% of these women did not receive any info about breast reconstruction PRIOR to making surgical decisions (mastectomy or lumpectomy). Why is this a huge problem? Well, if you opt to reconstruct one or both boobs, the method you choose to reconstruct can be affected depending on how the initial surgery is done. Since you can’t go back and re-do your mastectomy, this is an extremely important conversation to have with your doctor BEFORE a mastectomy takes place.

 

Watch this fantastic video created by Understand.com to learn more about breast reconstruction options.  Then ask your doctor what options would be best for you.

When It Comes to Cancer, Unknown is Unacceptable…

Molecular profiling, biomarker testing and targeted therapies are changing the way physicians treat cancer patients.  In the not-too-distant future, experts agree that cancer will be defined and treated based on each person’s unique molecular profile and biomarkers rather than the body part where it first originated.  Until this happens, oncologists must rely on knowing the part of the body where the cancer started (known as the primary site) to guide their treatment plans.

 

So what happens when a person is diagnosed with cancer and doctors do not know it’s primary site?

 

Each year 45,000 – 75,000 US cancer patients are diagnosed with metastatic disease but the primary site (the part of the body where the cancer started) cannot be determined. This is known as “cancer of unknown primary” or CUP.  In some instances, physical examination, detailed blood tests and various imaging scans can help determine the primary tumor location.  In other cases, doctors are forced to use their best guess and treat accordingly. As a result, the prognosis of patients diagnosed with CUP is poor.

 

If you’ve been diagnosed with Cancer of Unknown Primary, check out the Rosetta Genomics Cancer Origin Test. The Cancer Origin Test uses highly sensitive technology to measure the level of microRNAs in a tumor sample to determine the primary tumor location.

 

How accurate is the Cancer Origin Test? In a nutshell, I’d say it’s pretty darn accurate.  In a study of 509 tumor samples, 82% of the samples tested using the Cancer Origin Test produced a single predicted origin with 90% accuracy.  In another study, 84 CUP patients were tested and results from 77 patients predicted a single origin with 92% accuracy.*

 

The Bottom Line… The origin of your cancer can have a big impact on your treatment plan.  If you’ve been diagnosed with Cancer of Unknown Primary (CUP), ask your doctor which test(s) he or she plans to use to diagnose your cancer.  The Cancer Origin Test can yield results in just 4-7 days enabling doctors to provide patients with their best treatment options quickly.  If your doctor is not familiar with the Cancer Origin Test, let them know about it. The right diagnosis can save your life. 

 

BTW, many insurance companies including Medicare now cover this testing. For those patients who may not be able to afford testing, Rosetta Genomics has a Patient Assistance Program (PAP).   For more information, call their Customer Service at 1-215-389-9000 or US Toll Free at 1-888-522-7971.

 

*Rosetta Genomics
*Meiri E., Mueller W.C., Rosenwald S., A second-Generation MicroRNA-Based Assay for Diagnosing Tumor Tissue Origin, The Oncologist 2012
*Pentheroudakis G, Pavlidis N, Fountzilas G, et al. Novel microRNA-basedassay demonstrates 92% agreement with diagnosis based on clinicopatholoic and management data in a cohort of patients with carcinoma of unknownprimary. Mol Cancer June 2013

 

10 Biggest Cancer Clinical Trial Myths BUSTED

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According to the National Cancer Institute, less than 5% of adult cancer patients sign up for cancer clinical trials.  But how is this possible if clinical trials are considered the backbone of medical research?  It may boil down to the fact that many people have misconceptions about what clinical trials are and how they operate.  In fact, I have been guilty of this… I remember when our Oncologist suggested a clinical trial for Alan’s sarcoma… I immediately assumed that meant we were out of treatment options and at the end of our rope.

Fast forward to today… I read a fantastic article on cancer clinical trials written for the Cleveland Clinic’s Health Hub, a free health information website and eNewsletter.  It was so good that I’m reposting the article below … after all, knowledge is power.  Let’s share the power!

“People have a lot of misconceptions about cancer clinical research trials. They might think patients mostly just take sugar pills instead of receiving actual treatment.  Or they may think clinical research studies are only for people who have no other options.

These and many other common beliefs about cancer clinical research trials are simply not true, says Joshua Beaver, Research Program Manager for Solid Tumor Oncology at Cleveland Clinic.

Mr. Beaver and his colleagues lined up a list of the Top 10 myths that they frequently hear about clinical trials and set about shooting them down one by one:

Myth 1: Participating in clinical research provides no benefit to me as the patient

In fact, trials give patients access to the latest drugs and procedures. Studies show that patients who participate in clinical trials have outcomes at least as good, if not better, than the general patient population.

Myth 2: My doctor can tell me whether or not to consent to clinical research

A physician’s job is to help a potential clinical research patients weigh the pros and cons and otherwise educate them.  Your doctor can’t give you a “yes” or “no” answer or try to predict whether a particular treatment will work or not. Instead, think of your doctor as a helpful resource in making an informed decision.

Myth 3: Researchers treat patients like guinea pigs

This is far from the truth,” Mr. Beaver says, mentioning a survey finding 97 percent of trial participants experienced respectful treatment and care exceeding their expectations.  Often, patients will not even feel like they are part of a study because clinical trials incorporate the best available medicine. Researchers will then adjust treatment to see if enhancements can improve patients’ quality of life or response rates.

Myth 4: Clinical research patients are taking sugar pills

Researchers never use sugar pills in place of the best known treatment for a given cancer, and they are very rarely used in clinical cancer trials whatsoever, Mr. Beaver says. “Patients who join clinical trials will never sacrifice quality of care.”

Myth 5: Health insurance won’t cover the cost

Check with your carrier but the chances are good that coverage will extend to the full cost of your treatment.

Myth 6: Cancer clinical research studies are for people who have no other options

Sometimes clinical trials are a last resort. But many times they simply involve a simple addition or adjustment to a standard treatment plan that can provide patients with a better quality of life.

Myth 7: You need to live near a major hospital to participate

Many clinical trials take place at regional hospitals. “Some trials even extend to local cancer clinics and doctor’s offices,” says Mr. Beaver.

Myth 8: Informed consent exists primarily to protect researchers’ legal interests

Informed consent provides patients with information about their rights as a participant to help them decide whether to participate. Mr. Beaver adds, “The consent process is actually designed to avoid ‘legalese’ and to make absolutely sure that it is understandable to everybody.”

Myth 9: Once you sign the informed consent form, you’re legally bound to participate

Patients have the right to decline participation at any time. Their doctors will then switch to the standard treatment for their condition.

Myth 10: Patients can’t expect medical personnel to keep them informed

Physicians, medical professionals and research staff are all available at any time to help patients. “We know and appreciate that patients’ willingness to participate is what makes cancer trials possible,” Mr. Beaver says.”

(Source: Health Hub from Cleveland Clinic)

Check Out Cleveland Clinic’s FREE Clinical Trials App

Cleveland Clinic has created a free Clinical Trials app for cancer patients to keep abreast of their 130+ active cancer clinical trials. This Cancer Clinical Trials app is available for both Apple and Android devices.

With this app, you can:

The app also includes contacts for patient resources, financial services information, support groups and treatment guides.

The 4 Stages of Mesothelioma & Their Treatment Options

doctors Meet GUEST BLOGGER Michelle Whitmer.  Michelle has been a medical writer and editor for The Mesothelioma Center since 2008. Focused on the benefits of natural and holistic medicine for cancer patients, Michelle is a certified yoga instructor and earned her B.A. in Environmental Studies from Rollins College in Florida.

Accurately diagnosing a mesothelioma patient’s stage of cancer development is essential to getting appropriate treatment. The stages of mesothelioma are determined by the degree of tumor growth and spread. Stage I represents minimal tumor growth and stage IV indicates extensive tumor growth and spread.

Diagnosing the correct mesothelioma stage is challenging, but crucial to providing effective treatment recommendations. Unless your first opinion came from a mesothelioma expert, most people diagnosed with mesothelioma should seek a second opinion from one of the nation’s specialists. Because the cancer is relatively rare, few oncologists have experience diagnosing and treating mesothelioma. Seeking the opinion of a mesothelioma specialist could lead to better treatment.

For example, pleural mesothelioma specialist Dr. David Sugarbaker pioneered one of the most effective surgeries for the cancer, the extrapleural pneumonectomy. Patients with early-stage mesothelioma often qualify for his aggressive treatment approach that may significantly extend survival.

The same goes for people with peritoneal mesothelioma, which develops in the lining of the abdominal cavity. Specialist Dr. Paul Sugarbaker pioneered the most effective treatment for peritoneal mesothelioma, which is cytoreductive surgery with heated chemotherapy that is circulated throughout the abdominal cavity rather than systemically throughout the whole body. The treatment approach significantly improved survival rates for the cancer.

Diagnosing Mesothelioma

Mesothelioma is a challenging cancer to diagnose. There’s no officially adopted standard protocol for diagnosing mesothelioma, so patients will have different experiences. However, certain diagnostic tools are universally used to reach a mesothelioma diagnosis, such as imaging scans and biopsies.

In many cases, the first imaging scan patients receive is an X-ray, which is followed with more scans if anything unusual is seen in the X-ray. More detailed imaging scans like CT, PET and MRI come next. These scans help provide a clearer indication of how far the cancer may have spread.

To confirm a mesothelioma diagnosis, a biopsy is necessary. A thoracoscopy is a common biopsy for pleural mesothelioma that involves the use of a camera-tipped tube to collect a tumor sample. A mediastinoscopy might also be used to determine if the cancer has spread to the mediastinal lymph nodes, which are located between the lungs in the center of the chest. Spread to the lymph nodes is an indication of stage III cancer.

Treatment for Mesothelioma by Stage

Treatment recommendations are made based upon a patient’s stage. Early-stage tumors respond best to surgery, while stage IV mesothelioma has spread too far for surgery to be effective. Chemotherapy and radiation therapy may be used at any stage, except when a person’s general health is too poor to withstand the side effects.

Most people with mesothelioma receive multimodal therapy, which is the combination of two or more cancer treatments. The most effective combination for mesothelioma to date is surgery, chemotherapy and radiation therapy. This approach is most effective for stage I patients, but stage II and III patients often qualify for the aggressive approach with life-extending results. Stage IV patients may receive a combination of chemotherapy and radiation therapy to relieve symptoms and extend survival.

Stage I Treatment

Because tumor growth is minimal at stage I, surgery is highly recommended to remove as much cancerous tissue as possible. There are two surgeries patients may qualify for, a pleurectomy/decortication (P/D) and an extrapleural pneumonectomy (EPP). An EPP removes one lung while a P/D keeps the lung intact and only removes the lining of the lung.

Chemotherapy with the drugs cisplatin and Alimta is commonly administered after surgery in stage I patients. Radiation therapy is used after surgery to prevent local recurrence, though some centers are having improved success administering radiation prior to surgery to shrink tumors.

Stage II Treatment

Stage II surgery for pleural mesothelioma is usually an EPP. A P/D surgery wouldn’t be as effective since the cancer has spread to the lung in stage II. Following recovery from surgery, chemotherapy is recommended to kill remaining cancer cells the surgery couldn’t remove. Radiation therapy is then used to prevent recurrence, especially along surgery incisions (which is a common place for the cancer to recur).

Stage III Treatment

Certain patients in good health with stage III mesothelioma can qualify for an EPP. The surgery is extensive, so the person must be in adequate physical health to undergo the surgery. Chemotherapy and radiation therapy are given to destroy lingering cancer cells. If the cancer returns, second-line chemotherapy with other drugs, such as gemcitabine and vinorelbine, are recommended.

Stage IV Treatment

Stage IV tumors have grown too much and have spread too far for an EPP surgery to remove all the cancer. However, less aggressive surgeries might be recommended to otherwise healthy patients to reduce tumor size, which can help to relieve pain and improve breathing.

Chemotherapy and radiation therapy can be used to shrink tumors, which can help to relieve pain and improve breathing as well. They might also help to prolong life expectancy by several months.

Other therapies are given to alleviate symptoms, such as medication for pain, pulmonary rehabilitation to improve breathing and occupational therapy to reduce discomfort.

Because the cancer rarely causes symptoms in the early stages, the majority of mesothelioma patients are diagnosed in stage III or IV. Aggressive treatment is most effective at early stages, which stresses the importance of annual physical checkups for anyone who may have been exposed to asbestos in the past.

Sources:

Guidelines for the diagnosis and treatment of malignant pleural mesothelioma. 

Malignant mesothelioma: Review.

Malignant pleural mesothelioma: Update on treatment options with a focus on novel therapies. 

 

Personalizing YOUR Cancer Treatment (part 4): Do you know your cancer biomarkers?

Personalized-Medicine

In the near future, instead of saying, “I have breast cancer,” a patient will say something like , “I have a HER2-positive carcinoma with a KRAS mutation.”  Cancer will be defined by it’s own unique molecular profile and biomarkers rather than the body part where it originated.

To learn more about the dozens of biomarkers already being used to guide cancer treatment, check out the table below. Please note: there are thousands of known biomarkers without currently known effectiveness or relevance to cancer care. This table only represents the biomarkers that are currently known to be significant in informing cancer care today.*

Biomarker About Cancers that may benefit from testing Treatments associated with response or lack of response/resistance*
ALK anaplastic lymphoma kinase, an enzyme that can form a oncogenic fusion gene with EML4 lung (non-small cell), lymphoma (anaplastic large-cell), nervous system (familial neuroblastoma) crizotinib (Xalkori®), pemetrexed (Alimta®)
AR androgen receptor, part of the nuclear hormone receptor superfamily, active in cell signaling and therefore cell multiplication and growth prostate, breast, ovarian, bladder, lung (non-small cell) bicalutamide (Casodex®), flutamide (Eulexin®), goserelin (Zoladex®), leuprolide (Lupron®), abarelix (Plenaxis®), gonadorelin (Factrel®)
BRAF also know as v-raf murine sarcoma viral oncogene homolog B1, a proto-oncogene in the RAF/MIL family of molecules active in MAP/ERK cell signaling, promotes cell multiplication and growth colon, skin (melanoma), lung (adenocarcinoma), thyroid (papillary thyroid carcinoma), nervous system (pleomorphic xanthoastrocytomas with and without anaplasia) cetuximab (Erbitux®), panitumumab (Vectibix®), vemurafenib (Zelboraf®)
BRCA1 a so-called “breast cancer gene”, its expression in many cancers can indicate potential response to certain types of therapies lung, ovarian cisplatin (Platinol®)
c-Kit cytokine receptor also know as CD117, a proto-oncogene that interacts with cell growth factors, plays a roll in cell survival, multiplication and differentiation GIST (gastrointestinal stromal tumor), skin (melanoma), blood (acute myelogenous leukemia) imatinib (Gleevec®), sorafenib (Nexavar®), sunitinib (Sutent®)
c-MET also known as MET (mesenchymal epithelial transition factor) or HGFR (hepatocyte growth factor receptor), a proto-oncogene active in cell signaling, promotes cancer cell growth and multiplication lung (non-small cell), ovarian erlotinib (Tarceva®), gefitinib (Iressa®)
COX-2 cyclooxygenase-2, also known as protaglandin-endoperoxide synthase-2 (PTGS2), an enzyme important to creation of prostaglandins, which are messenger molecules that play a role in many cancers lung (non-small cell) celecoxib (Celebrex®)
EGFR epidermal growth factor receptor, also known as ErbB-1 or HER1, a receptor tyrosine kinase active in cell signaling, promotes cell growth and multiplication lung (non-small cell) cetuximab (Erbitux®), erlotinib (Tarceva®), gefitinib (Iressa®), panitumumab (Vectibix®)
EGFR secondary mutation (T790 M) a mutation of the EGFR gene associated with acquired resistance to certain treatments lung (non-small cell), colorectal, head and neck resistance to erlotinib (Tarceva®), gefitinib (Iressa®)
ER estrogen receptor, part of the nuclear hormone family of intracellular receptors, active in cell multiplication breast, ovarian, female genital tract cancer anastrazole (Arimidex®), exemestane (Aromasin®), letrozole (Femara®), tamoxifen (Nolvadex®), megestrol acetate (Megace®, Megace® ES), fulvestrant (Faslodex®), toremifene (Fareston®), medroxyprogesterone, (Provera®, Amen®, Curretab®, Cycrin®), goserelin (Zoladex®), leuprolide (Eligard®, Lupron®, Viadur®)
ERCC1 excision repair cross-complementation group 1, an enzyme active in DNA repair and therefore a sign of resistance to treatments that work by disrupting tumor DNA lung (non-small cell and small cell), gastric, ovarian, colorectal, bladder resistance to cisplatin (Platinol®), carboplatin (Paraplatin®), oxaliplatin (Eloxatin®)
HER2 human epidermal growth factor receptor 2, also known as HER2/neu or ErbB-2, a receptor tyrosine kinase active in cell signaling, promotes cell growth and multiplication breast, gastroesophageal, gastric, ovarian, colorectal lapatinib (Tykerb®), trastuzumab (Herceptin®), doxorubicin (Adriamycin®, Rubex®), liposomal doxorubicin (Caelyx®, Myocet®), epirubicin (Ellence®)
KRAS proto-oncogene of the Kirsten murine sarcoma virus, active in cell signaling in the EGFR pathway, promotes cell growth and multiplication lung (non-small cell), colon, pancreatic cetuximab (Erbitux®), erlotinib (Tarceva®), gefitinib (Iressa®), panitumumab (Vectibix®)
MGMT O-6-methylguanine-DNA methyltransferase is a gene that encodes a DNA repair enzyme, loss of MGMT may play a role in cancer formation, MGMT can also interfere with treatments that work by disrupting tumor DNA breast, lung (non-small cell), esophageal, brain (glioblastoma multiforme, oligodendrogliomas), skin (melanoma), pituitary gland (carcinoma) lack of response to temozolomide (Temodar®)
MRP1 multidrug resistance-associated protein 1, an ATP-dependent transmembrane drug efflux pump associated with resistance to many drugs breast, lymphoma, head and neck lack of response to anthracyclines such as doxorubicin (Adrimycin®), vinca alkaloids, and methotrexate (Trexall®)
PGP p-glycoprotein, also known as P-gp, an ATP-dependent transmembrane drug efflux pump associated with acquired resistance to many drugs breast, ovarian, lymphoma, head and neck lack of response to anthracylines such as doxorubicin (Adriamycin®), epirubicin (Ellence®) and liposomal-doxorubicin (Doxil®), and other drugs such as paclitaxel (Taxol®), docetaxel (Taxotere®), vinblastine (Velban®), vincristine (Oncovin®), vinorelbine (Navelbine®)
PIK3CA a specific mutation within the PI3 (phosphoinositide 3) kinase pathway or a gene copy number variation, aberrations along the PI3K pathway are associated with many cancers colorectal, brain (glioblastoma), gastric, breast, lung, ovarian lapatinib (Tykerb®); resistance to cetuximab (Erbitux®), panitumumab (Vectibix); decreased response to trastuzumab (Herceptin®)
PR progesterone receptor, also called PGR, part of the nuclear hormone family of intracellular receptors, active in cell multiplication breast, ovarian, female genital tract cancer letrozole (Femara®), tamoxifen (Nolvadex®), fulvestrant (Faslodex®), toremifene (Fareston®), exemestane (Aromasin®), anastrozole (Arimidex®), goserelin (Zoladex®), gonadorelin (Factrel®), leuprolide (Eligard®, Lupron®, Viadur®), medroxyprogesterone (Provera®, Amen®, Curretab®, Cycrin®), megestrol acetate (Megace®, Megace® ES)
PTEN phosphatase and tensin homolog, a tumor suppressor active in EGFR, HER2 and AKT cell signaling pathways breast, colon, lung (non-small cell), brain (glioblastoma), head and neck low expression associated with lack of response to cetuximab (Erbitux®), gefitinib (Iressa®), trastuzumab (Herceptin®), panitumumab (Vectibix®), erlotinib (Tarceva®)
RRM1 ribonucleotide reductase subunit M1, an enzyme required for DNA synthesis from RNA and therefore can interfere with treatments that work by disrupting RNA activity lung (non-small cell), pancreatic high expression associated with lack of response to gemcitabine (Gemzar®), hydroxyurea (Hydrea®, Droxia®)
SPARC secreted protein acidic rich in cysteine, a protein active in tumor growth and spreading skin (melanoma), breast, gastric, pancreatic, head and neck albumin-bound paclitaxel/nab-paclitaxel (Abraxane®)
TLE3 a member of the transducin-like enhancer of split family of proteins, implicated in creation of tumors breast, ovarian taxane therapy such as paclitaxel (Taxol®), docetaxel (Taxotere ®)
TOPO2A topoisomerase IIA, an enzyme active in DNA synthesis and repair breast, colon, ovarian, lung (small cell) doxorubicin (Adriamycin®), epirubicin (Ellence®, Pharmorubucin®), liposomal doxorubicin (Caelyx®, Myocet®)
TS thymidylate synthetase, an enzyme active in DNA synthesis and repair, can be inhibited by certain compounds breast, colon, gastric, head and neck, liver, pancreatic, lung (non-small cell) lack of response to 5-fluorouracil (Adrucil®), cytarabine (Cytosar-U®), pemetrexed (Alimta®)
TUBB3 Class III -tubulin, protein found in microtubules which are important cell structures ovarian, lung (non-small cell) taxanes such as paclitaxel (Taxol®), docetaxel (Taxotere ®), vinca alkaloids such as vinorelbine (Navelbine®)

* Biomarker status (overexpressed, underexpressed, positive or negative for specific mutations, etc.) determines whether that biomarker is associated with response, lack of response or resistance to each treatment. Treatment associations are from published, peer-reviewed medical literature. Citations available upon request. Only your doctor can decide which treatments are appropriate for you.

**Got questions about YOUR biomarkers, e-mail PatientNavigator@carisls.com.  A Patient Navigator who is well versed in molecular profiling and biomarkers will answer your questions.  (this is a FREE service provided by Caris Life Sciences.) 

*** Source:  MyCancer.com (an educational resource sponsored by Caris Life Sciences®) is a fantastic website for cancer patients and their caregivers that provides information about personalizing your cancer treatment using molecular profiling and cancer biomarkers.