The lancet oncology
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The lancet oncology · Aug 2017
Insertion-and-deletion-derived tumour-specific neoantigens and the immunogenic phenotype: a pan-cancer analysis.
The focus of tumour-specific antigen analyses has been on single nucleotide variants (SNVs), with the contribution of small insertions and deletions (indels) less well characterised. We investigated whether the frameshift nature of indel mutations, which create novel open reading frames and a large quantity of mutagenic peptides highly distinct from self, might contribute to the immunogenic phenotype. ⋯ Cancer Research UK, UK National Institute for Health Research (NIHR) at the Royal Marsden Hospital National Health Service Foundation Trust, Institute of Cancer Research and University College London Hospitals Biomedical Research Centres, the UK Medical Research Council, the Rosetrees Trust, Novo Nordisk Foundation, the Prostate Cancer Foundation, the Breast Cancer Research Foundation, the European Research Council.
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Therapeutic cancer prevention is a developing area that can gain a lot from the successes in the prevention of cardiovascular diseases. Although weight control and physical activity are important in the prevention of both diseases, several other preventive measures exist. Low-dose aspirin for cancer prevention is often cited as the most important approach in terms of population benefit, and should be offered to those older than 50 years of age without hypertension or risk factors for gastrointestinal bleeding. ⋯ Other therapies, such as anti-oestrogen drugs for breast cancer prevention, should be targeted to high-risk groups to maintain a favourable benefit-risk ratio. Better algorithms for identification and improved platforms to reach these groups, such as during a screening visit, remain a key priority to allow existing knowledge to inform public health. Many other promising compounds have been identified, often as components of food, but results suggesting increased disease incidence with β carotene and vitamin E administration indicate that such treatments need rigorous evaluation before acceptance.