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Periodontal Disease May Be Linked to Esophageal Cancers

New cancer research is emerging each day – research that can benefit cancer patients like you, right now. At CTOAM, we ensure that YOU and your treatment team have access to the latest knowledge, tests, and targeted treatments available.

Call or email today for a FREE consultation!

+1 (778) 999-5463 | info@ctoam.com

NEW RESEARCH ON ESOPHAGEAL CANCERS

Bacteria may play a role in esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC).

A recent study examined the relationship of oral microbiota with EAC and ESCC risk, including associations between centered log-ratio transformed taxon or functional pathway abundances and risk using conditional logistic regression adjusting for BMI, smoking, and alcohol.

Results from the study found the periodontal pathogen Tannerella forsythia to be associated with higher risk of EAC. Additionally, the abundance of the periodontal pathogen Porphyromonas gingivalis trended with higher risk of ESCC. It found that bacterial biosynthesis of carotenoids, as well as depletion of the commensal genus Neisseria and the species Streptococcus pneumoniae, to be associated with lower EAC risk. Read more about the study: http://cancerres.aacrjournals.org/content/77/23/6777

Ultimately, these findings shows that several types of oral bacteria were associated with lower risk of esophageal cancer. Study author Jiyoung Ahn explains that the results also suggest that further research is warranted to determine the role these bacteria might play in preventing esophageal cancer:

“Our study indicates that learning more about the role of oral microbiota may potentially lead to strategies to prevent esophageal cancer, or at least to identify it at earlier stages. The next step is to verify whether these bacteria could be used as predictive biomarkers.” http://www.ascopost.com/News/58317

To learn how the latest cancer research can benefit your treatment plan, call CTOAM at +1 (778) 999-5463 or email info@ctoam.com.

Time is of the essence with cancer – get a FREE consultation today and get the information you NEED, immediately.

Peters et al., (2017) Oral Microbiome Composition Reflects Prospective Risk for Esophageal Cancers. AACR; (DOI: 10.1158/0008-5472).

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BGJ398 in Patients With FGFR-Altered Advanced Cholangiocarcinoma

If you’d like to learn how this new development can benefit your cancer treatment, contact CTOAM as soon as possible. Our precision oncology specialists will connect you and your treatment team with the most advanced genetic testing, analysis, and targeted treatment recommendations – for as close to home, and as close to free, as possible. Call +1 (778) 999-5463 or email info@ctoam.com.

Hear what patients like you say about working with CTOAM:

"I am amazed at the amount of detail that CTOAM assembled and I can assure you that I’m now aware of how in depth they go with their personalized approach. I want you to know what a difference you are making in my life." – Ron Edgar, carcinoma patient

NEW RESEARCH ON CHOLANGIOCARCINOMA

There is no standard treatment for patients with cholangiocarcinoma where first-line gemcitabine-based therapy fails.

Happily, a new study has found that BGJ398 – an orally bioavailable, selective pan-FGFR kinase inhibitor – is effective against tumours with FGFR alterations. It’s worth noting that Fibroblast growth factor receptor 2 (FGFR2) fusions/translocations are present in 13% to 17% of intrahepatic cholangiocarcinomas.

The study involved patients 18 years old and under, with advanced or metastatic cholangiocarcinoma containing FGFR2 fusions or other FGFR alterations, whose disease had progressed while receiving prior therapy.

All responsive tumours contained FGFR2 fusions. The overall response (OR) rate was 14.8% (18.8% FGFR2 fusions only). Disease control rate was 75.4% (83.3% FGFR2 fusions only), and estimated median progression-free survival (PFS) was 5.8 months. You can ready more about the study here: http://ascopubs.org/doi/abs/10.1200/JCO.2017.75.5009?journalCode=jco

The investigators explain, “These results show that BGJ398 is a first-in-class FGFR kinase inhibitor with manageable toxicities that shows meaningful clinical activity against chemotherapy-refractory cholangiocarcinoma containing FGFR2 fusions. This promising antitumor activity supports continued development of BGJ398 in this highly selected patient population.”

Don’t hesitant on your health – call or email us today to learn how you can feel better, faster, with precision oncology.

Phone: +1 (778) 999-5463

Email: info@ctoam.com

Javle et al., (2017). Phase II Study of BGJ398 in Patients With FGFR-Altered Advanced Cholangiocarcinoma. Journal of Clinical Oncology; (DOI: 10.1200/JCO.2017.75.5009).

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Optimizing Chemotherapy To Lower the Risk of Breast Cancer Recurrence and Death.

With cancer, time is of the essence. Contact CTOAM today to learn how this new research might benefit your breast cancer treatment plan: +1 (778) 999-5463 / info@ctoam.com

See how we’ve helped breast cancer patients just like you...

NEW RESEARCH ON BREAST CANCER

With new breast cancer diagnosis, it is typical to use a 3-week adjuvant chemotherapy scheduling. However, new research suggests that an alternate strategy – dose-dense chemotherapy – may be more effective for breast cancer patients. A meta-analysis conducted by Breast Cancer Trialists' Collaborative Group (EBCTCG) has weighed the risks and benefits of shortening the amount of time between courses, or using sequential treatment schedules versus concurrent ones.  

In an initial analysis, seven trials (involving 10,004 women, 2240 breast cancer recurrences, 1481 breast cancer deaths) compared 2-weekly dose-dense chemotherapy to the same chemotherapy given 3-weekly.

The results were very promising: there were highly significant reductions in disease recurrence with 2-weekly compared with 3-weekly chemotherapy and 10 year breast cancer mortality was 3.0% lower. Overall survival (OS) was also improved.

In a secondary analysis, nine trials (involving 11,533 women, 2773 breast cancer recurrences, 1711 breast cancer deaths) compared sequential with concurrent anthracycline and taxane-based chemotherapy.

Likewise, for sequential versus concurrent taxane plus anthracycline chemotherapy, the rate ratio for disease recurrence was 0.86, 10-year breast-cancer mortality was 2.3% lower, and overall survival (OS) was improved.

The proportional reductions in recurrence with dose-dense chemotherapy were similar and highly significant in ER-positive and in ER-negative disease, and did not differ significantly by any other patient or tumour characteristics, including age, HER2 status, nodal status, tumour size, or grade.

Increasing dose density did not have any material adverse effect on non-breast-cancer mortality, which was similar with 2-weekly and with 3-weekly chemotherapy and was, if anything, lower with sequential than with concurrent chemotherapy. Trial publications also indicate that, with haematopoietic growth factor support, dose-dense chemotherapy does not substantially increase toxicity.

The meta-analysis, therefore, concluded that increasing the dose density of adjuvant chemotherapy is safe and results in fewer disease recurrences and fewer deaths from breast cancer. You can read more about the study here: http://www.abstracts2view.com/sabcs/view.php?nu=SABCS17L_1396&terms=

If you’d like to know whether your treatment plan might benefit from dose-dense chemotherapy, contact CTOAM’s cancer experts now! Our specialists will connect you with the genetic testing, analysis, and optimized chemotherapy recommendations so you can feel better, faster – for as close to free, and as close to home,  as possible.

Don't hesitate on your health.

Phone: +1 (778) 999-5463

Email: info@ctoam.com

CTOAM: Changing the face of cancer care, one person at a time.

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New Treatment Option for Multiple Myeloma

Patients with relapsed and treatment resistant multiple myeloma (MM) typically have poor survival rates. The standard treatment for this has been a combination of lenalidomide and dexamathasone (RD). And, while this has been effective, not all patients respond to it.

Recent data, however, shows that the addition of the proteasome inhibitor carfilzomib to the RD combination offers patients superior results!

In this study of relapsed and refractory MM patients, the overall response rate (OR) was 87.1% for the triplet combination, compared with 66.7% for RD.

The progression free survival (PFS) for the triplet combo was 26.3 months compared with 17.6 months for RD, and the overall survival (OS) was 48.3 months compared with 40.4 months for RD alone. Read more about the study here: https://ash.confex.com/ash/2017/webprogram/Paper102318.html

This is excellent news for patients with relapsed and treatment resistant MM, since it offers them a superior treatment options.

If you’d like to learn whether this new combination can benefit your treatment plan, please contact us today! Our precision oncology specialists will connect you with the most advanced genetic testing, analysis, and targeted therapies available – so can feel better, faster, and get back to your normal life as quickly as possible.

Get a FREE consultation today. You have nothing to lose and everything to gain by talking with our cancer experts.

Phone: +1 (778) 999-5463

Email: info@ctoam.com

Time is of the essence; don’t hesitate on your health. See how we’ve helped patients just like you.

Precision Oncology: The Future of Cancer Treatment, Now

#oncogenomics #CancerTreatment #PrecisionMedicine #PrecisionOncology #cancer #CancerResearch

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New Targeted Treatment for EGFR Mutation-Positive NSCLC

Traditionally, the first-line targeted treatment for EGFR mutation-positive advanced NSCLC has been EGFR TKIs. (EGFR = epidermal growth factor receptor; TKI = tyrosine kinase inhibitor; NSCLC = non-small-cell lung cancer.) While this protocol has offered many NSCLC patients significant benefits in the past, a new third generation drug – Osimertinib – has now been shown to provide even greater benefits to patients when used as a first-line therapy.

Osimertinib works by selectively inhibiting both EGFR-TKI-sensitizing and EGFR T790M resistance mutations. When used as a first-line treatment, Osimertinib is able to prevent the emerging mutation, T790M, from growing further. Although not all patients with EGFR mutation-positive advanced NSCLC have this emerging mutation, many do. And it’s possible to find out for sure by doing a simply ctDNA test (liquid biopsy). This is because, unlike any other form of diagnostics, liquid biopsies look at ALL the mutations of ALL the tumours in a person’s body at once! Learn more about liquid biopsies.

A recent phase III trial tested the efficacy of Osimertinib compared to standard EGFR-TKI. The trial involved 556 patients from 132 sites in 29 countries with advanced EGFRexon 19 deletion or L858R mutation. Median progression-free survival (PFS) was 18.9 months in the Osimertinib group versus 10.2 months in the standard TKI group. A consistent benefit of osimertinib was observed across all predefined subgroups, including Asian and non-Asian patients, patients with exon 19 deletion and those with L858R mutation, and according to history of smoking or never smoking. Median PFS was 15.2 versus 9.6 months among patients with CNS metastases and 19.1 vs 10.9 months among those without CNS metastases. In other words, patients are living significantly longer on Osimertinib than they are on the standard EGFR-TKI.

Objective response was observed in 80% vs 76% of patients. The median duration of response was 17.2 vs 8.5 months. Data on overall survival were immature at interim analysis (25% maturity). The survival rate at 18 months was 83% vs 71%.

Adverse events of grade ≥ 3 occurred in 34% of the osimertinib group vs 45% of the standard TKI group, with the most common in the osimertinib group being decreased appetite (3%). This is significant, because it shows that not only does Osimertinib increased one's chance of survival, it also offers fewer adverse events than standard treatment. Read more about the study: http://www.nejm.org/doi/full/10.1056/NEJMoa1713137

These exciting results show that Obsimertinib significantly improved PFS for patients with previously untreated  EGFR-mutant NSCLC compared to standard EFGR-TKI treatment. Further, this benefit was observed across all examined subgroups, including both Asian and non-Asian patients and according to EGFR mutation type.

If you’re wondering whether this new drug might benefit your personal treatment plan, contact CTOAM immediately! Time is of the essence with cancer – the sooner we can get you tested to determine the mutations driving your cancer, the sooner we can get you on a targeted therapy that will give you the best chance at improving the quality of your life, as well as extending it.

Get a FREE consultation to discover how precision oncology can help you, or your loved one, feel better, faster – for as close to free and as close to home as possible.

Take advantage of the latest advancements in cancer research and treatment, now – read how it helped NSCLC patient, Katherine.

Phone: +1 (778) 999-5463

Email: info@ctoam.com

Precision Oncology: The Future of Cancer Treatment, Now.

Soria et al., (2017). Osimertinib in Untreated EGFR-Mutated Advanced Non–Small-Cell Lung Cancer. N Engl J Med; (DOI: 10.1056/NEJMoa1713137).

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The Future of Cancer Treatment is Available, NOW!

Spread the word! Personalized cancer medicine is the natural next step in the evolution of cancer treatment – and it's happening now! It won't be long before the traditional one-size-fits all approach to diagnosing and treating cancer is purely in our collective rear view mirror.

https://www.thestar.com/life/2017/11/06/personalized-cancer-plans-the-future-of-fighting-disease.html

Call CTOAM today to learn how precision oncology can benefit your own cancer treatment, diagnosis, and prevention.

#PersonalizedMedicine #PrecisionMedicine #PrecisionOncology #oncogenomics

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New Treatment Option for Esophageal Carcinoma

Patients with advanced esophageal carcinoma that have progressed after treatment have limited treatment options.

Fortunately, a recent study has brought promising news to these patients. In the study, patients with squamous cell carcinoma or adenocarcinoma of the esophagus or gastroesophageal junction with failure of standard therapy and programmed cell death ligand 1 (PD-L1)–positive tumours responded very well to the PD-1 inhibitor, Pembrolizumab.

The median age of patients in this study was 65 years, with 78% having squamous histology, and 87% having received at least two prior therapies for advanced or metastatic disease.

The results: partial responses were observed in 30% of patients; response was observed in 28% of patients with squamous histology, and in 40% of patients with adenocarcinoma. A decrease in target lesion burden was observed in 52%.

The median time to response was 4 months. The median duration of response was 15 months (range = 6 to ≥ 26 months). The median progression-free survival (PFS) was 1.8 months, with 6- and 12-month rates of 30% and 22%, respectively. The median overall survival was 7.0 months, with 6- and 12-month rates of 60% and 40%, respectively.

Interestingly, a higher score on a 6-gene interferon-γ gene-expression signature (CXCL9, CXCL10, HLA-DRA, IDO1, IFNG, and STAT1) was associated with a trend toward improved PFS (P = .053) and response rate (P = .107). You can read more about the study here: http://ascopubs.org/doi/abs/10.1200/JCO.2017.74.9846…

What these results clearly show is that Pembrolizumab has been demonstrated to be effective (by having manageable toxicity and durable antitumor activity) in patients with heavily pretreated, PD-L1–positive advanced esophageal carcinoma.

If you’d like to know whether you might benefit from Pembrolizumab, contact CTOAM for your free consultation. Our precision oncology specialists will help you understand all of your options and, if you like, facilitate your access to the most advanced genetic testing, personalized research, and targeted therapies currently available.

Time is of the essence with cancer – email info@ctoam.com or phone +1 (778) 999-5463 today.

You can also take a look at some of the patients we’ve helped with esophageal squamous-cell carcinoma:

Anastasia’s story: https://www.ctoam.com/success-st…/patient-success-stories/…/

Mark’s story: https://www.ctoam.com/success-st…/patient-success-stories/…/

CTOAM: Changing the face of cancer care, one person at a time.

Doi et al., (2017). Safety and Antitumor Activity of the Anti–Programmed Death-1 Antibody Pembrolizumab in Patients With Advanced Esophageal Carcinoma. Journal of Clinical Oncology; (DOI: 10.1200/JCO.2017.74.9846).

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New Cancer Research Brings Oncogenomics, Once Again, to the Fore

Congratulations to PhD candidate, Caitlin Miron, who recently discovered a new DNA binder that can not only ‘switch off’ cancer cells but prevent them from spreading.

Miron says, “we are seeing therapeutic benefits in that cancer growth is reduced in some of the cell lines. The next step is to determine the best way to adapt this compound for use in humans.”

https://globalnews.ca/news/3874569/canadian-student-cancer-discovery/

New research in precision medicine is bringing cancer patients hope each day. If you want to learn how precision oncology can help you with your cancer treatment, prevention, or diagnosis, contact us anytime.

Get a FREE consultation, today!

Email: info@ctoam.com Phone: +1 (778) 999-5463 Website: www.ctoam.com

Precision Oncology: The future of cancer treatment, now.

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Link Between Diabetes, High BMI, and Cancer

In most countries, diabetes and high body-mass index (BMI) are increasing in prevalence. Unfortunately, they’re also known to be linked to an increased risk of cancer.

A recent study estimated the number of cancer incidences that can be attributed to diabetes and high BMI as individual risk factors and in combination. The study defined high BMI as a BMI greater than or equal to 25 kg/m2.

The study estimated that 5.6% of all incident cancers in 2012 were attributable to the combined effects of diabetes and high BMI as independent risk factors, corresponding to 792,600 new cases. 187 600 (24.5%) of 766,000 cases of liver cancer and 121,700 (38.4%) of 317,000 cases of endometrial cancer were attributable to these risk factors.

In the conservative scenario, about 4.5% (626 900 new cases) of all incident cancers assessed were attributable to diabetes and high BMI combined. Individually, high BMI (544,300 cases) was responsible for twice as many cancer cases as diabetes (280,100 cases). 26.1% of diabetes-related cancers (equating to 77,000 new cases) and 31.9% of high BMI-related cancers (174,040 new cases) were attributable to increases in the prevalence of these risk factors from 1980 to 2002. You can read more about the study here: http://www.thelancet.com/journals/landia/article/PIIS2213-8587(17)30366-2/fulltext

While the data on BMI and cancer is not new, the complex interplay between fat cells and cancer cells is starting to unravel. New studies show that not only do fat cells store carcinogens, but they also release growth factors and pro-inflammatory cytokines that feed the growth and metastasis of cancer cells.  

Furthermore, muscle actually acts as a competitive inhibitor of cancer growth and metastasis by competing for the same resources the cancer causing stem cells would normally use.

These results provide further evidence that a significant number of cancer cases are attributable to diabetes and high BMI. As these cancer risk factors increase among populations, we need to make a better effort to identify preventative and screening measures.

Do you want to ensure your weight, diet, and lifestyle are not increasing your risk of getting cancer? Contact CTOAM today for a FREE consultation with cancer expert & precision oncology specialist, Alex Rolland. You’ll learn if there are any risks you need to be aware of, and how to optimize your exercise and nutrition for cancer prevention.

Call: +1 (778) 999-5463

Email: info@ctoam.com

CTOAM also offers personalized nutraceutical diets, which enhance cancer treatment plans and help to prevent cancer from occurring in the first place.

Read more about nutrition and cancer: https://www.ctoam.com/services/nutrition/

Learn about evidence-based nutraceutical diets: https://www.ctoam.com/services/nutrition/nutraceuticals/

CTOAM: Changing the face of cancer care, one person at a time.

Pearson-Stuttard et al., (2017). Worldwide burden of cancer attributable to diabetes and high body-mass index: a comparative risk assessment. The Lancet Diabetes & Endocrinology; (Volume 0, Issue 0).

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How Diet Can Benefit Colorectal Cancer (CRC)

Colorectal cancer (CRC) can be challenging to treat. Happily, a new study has expanded on the data we have regarding the impact of nutrition on its treatment.

The study involved 1575 patients with stage I to III CRC. It measured the consumption of total fiber and different sources of fiber and whole grains assessed by a validated food frequency questionnaire between 6 months and 4 years after CRC diagnosis. You can read more about the study here: https://jamanetwork.com/…/jamaonco…/article-abstract/2661061

Patients who increased their fiber intake after diagnosis from levels before diagnosis had a lower mortality, and each 5 grams per day (g/d) increase in intake was associated with 18% lower CRC-specific mortality and 14% lower all-cause mortality.

When looking at the below data, it’s important to understand the term Hazard Ratio (HR). This refers to amount of risk, benefit, or harm associated with the variable – in this case, fibre. A hazard ratio of 1 means there’s no difference between the treated and placebo groups; a hazard ratio of less than 1 means there’s a benefit with the treatment (fibre); and a hazard ratio of more than 1 means there’s a worsening effect.

According to the source of fibre, cereal fiber was associated with lower CRC-specific mortality and all-cause mortality (HR, 0.78; 22% reduction in disease risk); vegetable fiber was associated with lower all-cause mortality (HR, 0.83; 17%) but not CRC-specific mortality (HR, 0.82; 18%); no association was found for fruit fiber.

Whole grain intake was associated with lower CRC-specific mortality (HR per 20-g/d increment, 0.28; ), and this beneficial association was attenuated after adjusting for fiber intake (HR, 0.77; 23%).

These results showed that patients who increased their high fiber intake after the diagnosis of non-metastatic CRC benefitted from lower CRC-specific and overall mortality.

This is great news, since it means that patients with non-metastatic CRC, stages I to III, can improve their chance of survival by increasing their high fibre intake immediately after diagnosis. Importantly, while this study focused on patients with non-metastatic disease, based on the data, this benefit also appears to reduce the progression to metastatic disease

If you’d like to know whether your cancer treatment plan would benefit from more fibre or another dietary change, contact CTOAM today! You can get a FREE consultation to understand your best treatment options and nutrition plans. We also offer personalized nutraceutical diets to enhance your current treatment.

Call: +1 (778) 999-5463

Email: info@ctoam.com

See how CTOAM helped colorectal cancer patient Tom: https://www.ctoam.com/success-st…/patient-success-stories/…/

Learn more about the role nutrition plays in the treatment and prevention of cancer: https://www.ctoam.com/services/nutrition/

Precision Oncology: The future of cancer treatment, now.

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New Treatment Option for Non-Small-Cell Lung Cancer (NSCLC)

Most patients with locally advanced, unresectable non–small-cell lung cancer (NSCLC) have disease progression even after having definitive chemoradiotherapy.

A recent study that involved patients with stage III NSCLC (who did not have any disease progression after two or more cycles of platinum-based chemoradiotherapy) compared the PD-1L inhibitor Durvalumab as consolidation therapy with placebo (wait and see approach). Read more about the study: http://www.nejm.org/doi/full/10.1056/NEJMoa1709937

The results of the study clearly showed the benefits of Durvalumab. The median progression-free survival (PFS) was 16.8 months with Durvalumab versus 5.6 months with placebo. The 12-month PFS rate was 55.9% versus 35.3%, and the 18-month PFS rate was 44.2% versus 27.0%. The response rate was higher with Durvalumab than with placebo (28.4% versus 16.0%). The median time to death or distant metastasis was also longer with Durvalumab than with placebo (23.2 months versus 14.6 months).

Grade 3 or 4 adverse events occurred in 29.9% of the patients who received Durvalumab and 26.1% of those who received placebo, indicating that the majority of these adverse events were related to the disease itself and not the treatment.

This is great news for patients with NSCLC who don’t have disease progression after chemoradiotherapy, since it offers them a promising option for longer PFS, as well as overall survival (OS).

If you’d like to know whether Durvalumab can benefit your treatment plan, contact our oncogenomics experts today! Get a FREE consultation to discover how you can access the most advanced tests and treatments for as close to free, and as close to home, as possible!

Call +1 (778) 999-5463 or email info@ctoam.com

How do we help patients like you? Read our success story on NSCLC patient, Katherine: https://www.ctoam.com/success-stories/patient-success-stories/katherine/

CTOAM: Changing the face of cancer care, one person at a time.

Antonia et al.,(2017). Durvalumab after Chemoradiotherapy in Stage III Non–Small-Cell Lung Cancer. N Engl J Med; (377):1919-1929.

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Risk of Recurrence for ER Positive Breast Cancer

Recently, a woman with ER positive breast cancer called us for advice. She had recently been diagnosed with T1 stage cancer and had no lymph nodes involved.

She had sought multiple opinions regarding radiation therapy and had received conflicting advice, with some doctors saying yes and others saying no.

Furthermore, she wanted to know what her risk of recurrence was. Since this is an important question that many women will need to consider, the following is an overview of our conversation.

We shared the risks of recurrence with her. Based on a recent meta-analysis of 88 clinical trials involving 62,923 women with ER positive breast cancer who were disease-free after five years of adjuvant endocrine therapy.

http://www.nejm.org/doi/full/10.1056/NEJMoa1701830

The risks of recurrence are as follows.

20-year risks of distant recurrence was:

- 22% in women with no positive nodes

- 31% in those with one to three positive nodes

- 52% in those with four to nine positive nodes

Among women with T1 disease, the 20-year of distant recurrence was:

- 13% with no nodal involvement

- 20% with one to three nodes involved

- 34% with four to nine nodes involved

Among women with T2 disease, the 20-year of distant recurrence was:

- 19% with no nodal involvement

- 26% with one to three involved nodes

- 41% with four to nine involved nodes

The woman happily thanked us and stated that since she was in excellent health and took care of herself, her chances of recurrence were very low and that she would skip the dangerous radiation therapy.

HOWEVER, our conversation was not over.

Firstly, we explained to her that the recurrence data above was specific for women that were CANCER FREE after five years of endocrine therapy. She had yet to achieve that.

Secondly, we explained that sentinel lymph node biopsies are used because they are the lymph nodes that directly drain the region of the tumour, and the most likely spot for tumours to metastasize to.

However, tumours can also metastasize via blood, and directly through tissue.

Since she had not yet had a PET/CT, we could not assure her that she did not have undetected tumours elsewhere in the body.

Read more about PET/CT here: https://www.ctoam.com/services/testing/imaging/pet-ct-scan/

Thirdly, we explained to her that while the above study addressed the pathology of the tumours, it did NOT consider the molecular features and biology of the tumour.In fact, the molecular features (genetic mutations that drive the growth of the tumours) are the MOST important consideration.

A recent study looked at a small panel of molecular features. A subset analysis of the MINDACT trial shows that oncologists may be undertreating women with small (< 1 cm) node-negative breast tumours. These tumour types are clinically considered to be low risk, but can be genomically high risk.

In this study, about one in four women with small node-negative breast tumours smaller than 1cm turned out to have tumours with high genomic risk that are biologically aggressive.

This may partially explain the new data that women with T1 breast cancers and no involved lymph nodes have better long term survival with adjuvant (post-surgery) radiation therapy.

Importantly, the molecular test in the above study was the Mamaprint, which only looks at 70 genes.

Traditionally, node-negative small breast cancers have been considered low-risk, for which adjuvant treatment is unnecessary.

However, recent advances in cancer biology and tumour DNA sequencing have shown that while tumour burden is still independently prognostic, tumour biology is key for outcome.

We finished our conversation with the advice that she:

1. Get a PET-CT to ensure she did not have distant metastasis that could be dealt with at an early and more treatable stage.

2. Get a Foundation One tumour DNA sequencing assay to ensure that:

a) her cancer was indeed ER positive and not a variant of triple negative breast cancer that happened to have ER positivity;

b) her cancer was not an aggressive subtype of ER positive breast cancer;

c) she knew of any mutations that could reduce or increase the efficacy of any chemotherapy drugs;

(d) she knew of any mutations that could provide options for targeted drugs or immunotherapy.

If you’d like a FREE consultation to discuss your best testing and treatment options, call or email CTOAM today. Talk to an oncogenomics specialist about your unique case to get expert insight on your best choices moving forward.

Call: +1 (778) 999-5463

Email: info@ctoam.com

Learn more about how personalized cancer care can increase your chances of survival, extend life, and improve the quality of your life. Visit our comprehensive website at www.ctoam.com

Precision Oncology: The future of cancer treatment, now.

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Understanding the Genetic Variations Behind Triple Negative Breast Cancer (TNBC)

Triple negative breast cancer (TNBC) is named based on a pathological definition of lacking the ER, PR, and HER2 cell surface receptor.

TNBCs are aggressive cancers. They’re also a difficult subtype to treat because they are a heterogeneous (varied) disease composed of distinct molecular subtypes: each has a unique biology that responds differently to treatment.

While the majority of standard therapies treat TNBCs as a single subtype, molecular and genetic analysis has grouped them into six main subtypes. Additionally, each subtype can have its own set of unique molecular variations.

Based on recent data, the TNBC subtypes are referred to as:

1. Basal-like one (BL1) – with cell cycle and DNA damage response gene signatures

2. Basal-like two (BL2) – enriched in growth factor signaling and myoepithelial markers

3. Immunomodulary (IM) – immune response genes

4. Mesenchymal (M)  - have high expression of genes involved in differentiation and growth factor pathways

5. Mesenchymal stem-like (MSL) – have high expression of genes involved in differentiation and growth factor pathway

6. Luminal androgen receptor (LAR) – driven by androgen signaling  

Importantly, not all of these subtypes respond to standard chemotherapy with the same efficacy.

For example, with neoadjuvant adriamycin/cytoxan/taxol containing chemotherapy, the BL1 subtype achieved the highest pathological complete response (pCR) rate (52%), followed by 23% for the MSL, 10% for the LAR, and 0% for the BL2 subtypes.

As you can see, determining what subtype a patient has is key to identifying the right treatment(s).

Pre-clinical and clinical data, along with numerous clinical trials, has shown that each subtype is sensitive to specific classes of chemotherapy, targeted drugs, and immunotherapy drugs.

For example, that the BL1 subtype responds to Cisplatin chemotherapy and PARP inhibitors; the BL2 responds to mTOR inhibitors, such as Everolimus and inhibitors of growth factors; the IM subtype responds to cisplatin, PARP inhibitors and PD-1R/L inhibitors, such as Pembrolizumab/Nivolumab and Atezolizumab, Avelumab, and Durvalumab.

The M subtype responds to mTOR inhibitors, growth factor inhibitors, and SRC inhibitors; the MSL subtype responds to mTOR, PI3K, MEK and growth factor inhibitors; and the AR subtype responds to AR antagonists and PI3K inhibitors.

While this above list is simplified and based on the predicted subtypes, increased efficacy can be achieved by determining the actual drivers of YOUR OWN case through tumour DNA sequencing.

We have seen many examples of this and have been treating patients based on their driving mutations rather than the subtype. For example, we’ve just started treating one patient with ER-Positive breast cancer using immune-based drugs because the patient had molecular features of the IM subtype. Learn more about Margaret’s story here: https://www.ctoam.com/success-stories/patient-success-stories/margaret/

In another case, a young lady with ER-Positive breast cancer was found to also have a BRCA2 mutation and an inherited ATM mutation. This woman will now be a great candidate for PARP inhibitors, since her subtype is similar to the BL1 TNBC subtype.

https://www.ctoam.com/success-stories/patient-success-stories/lisa/

If you’d like to know what the driving mutations are behind your subtype of TNBC, contact us today! Our precision oncology specialists will get you access to the most advanced genetic tests and provide expert analysis of the results. They’ll also ensure you get access to the right treatment through your local treatment team – for as close to free as possible.

Call: +1 (778) 999-5463

Email: info@ctoam.com

Cancer Treatment Options & Management

Changing the face of cancer care, one person at a time.

[ctoam-blog]

Why Liquid Biopsies (ctDNA) are So Important for Cancer Treatment and Testing

Liquid biopsy, also known as circulating tumour DNA (ctDNA) analysis, is one of the most important developments in cancer diagnosis and treatment monitoring.

Not only is ctDNA testing useful in diagnosing cancer but it’s also incredibly effective for monitoring how well targeted treatment is working. Because tumours leach their DNA into the bloodstream, a liquid biopsy is able to offer a wealth of pertinent data! This test provides detailed information on the percentage of each cancer-causing mutation found in your blood. This means it’s no longer necessary to have ongoing CT scans, MRIs, and the like, in order to see how well your treatment is working.

You can see how this works in practice with this study, which looked at the efficacy of ctDNA testing in prostate cancer patients. The results showed that “in the majority of patients, a ctDNA assay is sufficient to identify all driver DNA alterations present in matched metastatic tissue and supports development of DNA biomarkers to guide [metastatic castration-resistant prostate cancer] patient management based on ctDNA alone.”

Importantly, several patients had driver mutations found via ctDNA that were NOT found in matched solid biopsy. Since tumours make up a group of cells that have varied genetic changes, it is important to identify the drivers of the group of cells overall. When you do a biopsy, you may miss certain groups of cells, which can lead to an incorrect diagnosis and missed opportunities for effective targeted treatment.

By assessing the total body-wide tumour burden, ctDNA is a much more complete diagnostic tool than a biopsy, which only looks at a small sample of a single tumour.

Additionally, this tool allows us to determine which one of those body-wide mutations happens to be actually driving the tumour at a given time. As you may know, different mutations can drive tumour growth at a different time, based on different medications.

With liquid biopsy technology, a simple blood test allows us to see how effective your treatment is, which also allows us to make quick adjustments to your treatment regime, if necessary.

http://www.ascopost.com/News/57888

Contact us today to learn how liquid biopsy can benefit your treatment monitoring – call +1 (778) 999-5463 or email info@ctoam.com. If you like, we can also get you access to the most advanced liquid biopsy test available in the world, the FoundationACT Test. Read more about that here: http://info.foundationmedicine.com/act

More information on genetic testing for cancer: https://www.ctoam.com/services/testing/genetic-testing/

You can also explore the value of a PET/CT scan – another critical tool for accurate diagnosis, as well as ongoing treatment monitoring.

https://www.ctoam.com/services/testing/imaging/

Get a free consultation with an oncogenomics expert today! Our precision oncology specialists will give you all the information you need to move forward with clarity.

CTOAM: Cancer Treatment Options & Management, Inc.

Changing the face of cancer care, one person at a time.

[ctoam-blog]

New Treatment Option for Follicular lymphoma (FL)

Follicular lymphoma (FL) is one of the most common forms of non-Hodgkin lymphoma (NHL). Importantly, cases of Follicular lymphoma that do not respond to treatment can progress to diffuse large B-cell lymphoma (DLBCL), which is typically untreatable. 

The standard treatment for FL patients is a CD20 targeted agent called Rituximab, combined with chemotherapy. However, many patients relapse resulting in a treatment refractory disease.

Recently, the FDA approved a new CD20 targeted agent called Obinutuzumab for people with previously untreated advanced follicular lymphoma (stage II bulky, III, or IV). In a recent trial, superior PFS was achieved for patients who received this obinutuzumab-based regimen, compared with those who received a rituximab - based regimen as first-line therapy.

In this study, the Obinutuzumab-based regimen significantly reduced the risk of disease worsening or death compared to a Rituximab-based regimen by 28% (HR = 0.72; 95% CI = 0.56–0.93; P = .0118). You can read more about the study here:

http://www.ascopost.com/News/58275

This is very promising news for follicular lymphoma patients, because a sustained PFS is associated with long term survival.

If you’d like more information on whether you might benefit from this new Obinutuzumab-based regimen, contact CTOAM today. You can also get a free consultation to discover how you can access the latest diagnostic tools, genetic tests, and targeted therapies for your unique form of cancer. Call +1 (778) 999-5463 or email: info@ctoam.com to learn more!

You can also read about how we’ve helped previous patients with lymphoma: https://www.ctoam.com/success-stories/patient-success-stories/kerryanne/

CTOAM: Changing the face of cancer care, one person at at time.

[ctoam-blog]

How We Help Our Patients: ER Positive Breast Cancer Success Story

Discover how we helped Margaret, a 64-year-old woman with ER Positive Breast Cancer: read her story!

[ctoam-blog]

Precision Oncology Definitions and Key Concepts

A new glossary has been created by the European Society of Medical Oncology (ESMO). Author Lucy Yates, MD, says the glossary "deals with all the new concepts in precision medicine have emerged in the last 5 to 10 years." Http://www.ascopost.com/News/58270

The goal is to nurture consistent communication on precision oncology so did everyone - from oncologists and patients to researchers and scientists - is on the same page when speaking about personalized cancer medicine.

Fabrice André, MD, PhD, corresponding author, says the glossary "should be essential reading for every oncologist.": Https://academic.oup.com /.../doi/10.1093/annonc/mdx707/4616649

If you have any questions about precision oncology, or want to know the most advanced tests and treatments for your form of cancer, contact CTOAM today! Get a free 20 minute consultation with one of our precision oncology experts to understand what your options are moving forward. Hope is here!

Call +1 (778) 999-5463 or email: info@ctoam.com

Precision Oncology: The future of cancer treatment, now.