Cancer discovery
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The composition of patients' gut microbiomes influences whether they will respond to anti-PD-1 therapy, according to a trio of recently published studies. One of the studies also found that using antibiotics can reduce treatment efficacy, presumably by killing important species of gut bacteria. Now researchers are investigating how these findings can be used to increase the proportion of patients who respond to checkpoint inhibitor therapy.
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A phase II trial of the pan-class I PI3K inhibitor copanlisib demonstrated that it induces objective responses in 59% of patients with relapsed or refractory indolent lymphoma. The responses lasted a median of 22.6 months. Although the drugs weren't compared head to head, researchers suspect that the side effects of copanlisib may be less severe than those of idelalisib, another PI3K inhibitor.
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The investigational ALK inhibitor lorlatinib, whose early clinical activity was first reported last year, continues to look promising in advanced ALK-positive or ROS1-positive non-small cell lung cancer. In a phase II study, robust responses were seen in previously untreated patients, as well as those who had received as many as three prior ALK inhibitors.
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Researchers have developed a new liquid biopsy technique that may allow screening for certain types of cancer. The technique can detect tumor mutations from the small amount of blood DNA present early in the disease. In four types of cancer, the technique's overall sensitivity was between 56% and 83%, and it could pinpoint 62% of patients with early-stage cancer.
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Biliary tract cancers (BTC), including cholangiocarcinoma and gallbladder cancer, are poor-prognosis and low-incidence cancers, although the incidence of intrahepatic cholangiocarcinoma is rising. A minority of patients present with resectable disease but relapse rates are high; benefit from adjuvant capecitabine chemotherapy has been demonstrated. Cisplatin/gemcitabine combination chemotherapy has emerged as the reference first-line treatment regimen; there is no standard second-line therapy. ⋯ Significance: The authors address genetic drivers and molecular biology from a translational perspective, in an intent to offer a clear view of the recent past, present, and future of BTC. The review describes a state-of-the-art update of the current status and future directions of research and therapy in advanced BTC. Cancer Discov; 7(9); 943-62. ©2017 AACR.