Chances Of Cancer Coming Back After Chemo

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Chances Of Cancer Coming Back After Chemo – Click to tweet @Hopkinskimmel’s research has reduced the use of chemotherapy in stage II. stage colon #cancer; did not threaten survival. ›

A new research has shown that circulating tumor DNA (ctDNA) – the genetic material from tumors that enters the bloodstream – can identify those in type II. stage colon cancer patients who benefit most from chemotherapy after surgery and can save other patients who need this type of treatment.

Chances Of Cancer Coming Back After Chemo

Chances Of Cancer Coming Back After Chemo

An international, multi-institutional trial led by researchers at the Johns Hopkins Kimmel Cancer Center in Melbourne, Australia, and WEHI found that postoperative ctDNA testing and directing chemotherapy to ctDNA-positive patients overall reduced the use of chemotherapy. reduced without jeopardizing returns. free survival.

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Several previous research studies have shown that circulating tumor DNA can be detected in the blood, and the presence of ctDNA predicts the risk of cancer recurrence after surgery. However, this is believed to be the first clinical trial to show that measuring circulating tumor DNA before treatment can benefit patients.

These findings are published in the New England Journal of Medicine and will be presented at the annual meeting of the American Society of Clinical Oncology on June 4.

“Previous studies have suggested that ctDNA measurements may be useful in patient care, and this study provides real-world clinical evidence to support these theories,” said Bert Vogelstein, M.D., Clayton Professor of Oncology and co-director of the Ludwig Center. He is a researcher at Johns Hopkins and the Howard Hughes Medical Institute. Vogelstein and his team were the first to show that colon cancer is caused by a series of genetic mutations, and showed that DNA released from tumors can be detected in blood, stool and other body fluids.

Currently, the use of chemotherapy in stage II is controversial. in stage 1 colon cancer that has grown through the wall of the colon but has not spread to lymph nodes or other organs. Cancer experts disagree about its benefits. This study aimed to help resolve the debate by determining whether ctDNA can be used to more accurately predict the risk of recurrence after surgery. Patients who were ctDNA-negative could be spared the toxicity of chemotherapy, and those with residual cancer could receive chemotherapy to attack the remaining malignant cells.

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In the investigation, 455, II. patients with stage 1 colon cancer were randomized 2:1 to surgery with standard treatment or ctDNA-guided treatment. Of these patients, 153 received standard care, which included monitoring for recurrence or chemotherapy over time. An additional 302 patients had their blood tested for ctDNA within seven weeks of surgery. If ctDNA was detected, patients received fluoropyrimidine- or oxaliplatin-based chemotherapy. If ctDNA was not detected, patients did not receive chemotherapy.

The ctDNA-guided approach reduced the use of chemotherapy compared to the standard care group (15.3% of patients in the ctDNA-guided group received chemotherapy compared to 27.9% in the standard care group). Two- and three-year recurrence-free survival rates were similar in the ctDNA-guided group and the standard control group.

“Stage II colon cancer presents a unique challenge,” explains Anne Marie Lennon, M.B.B.Ch., Ph.D., professor of medicine and director of the Division of Gastroenterology and Hepatology. “In stage I colon cancer, patients do not receive chemotherapy because their survival prognosis exceeds 90%. The risk of discomfort and toxicity from treatment outweighs the benefits of treatment. On the other hand, all patients with stage III colon cancer currently receive chemotherapy because relapse is high risk.”

Chances Of Cancer Coming Back After Chemo

The goal of chemotherapy for colon cancer is to eradicate micrometastases, cancer cells not yet visible on radiographs, which travel through the bloodstream and cause the cancer to return or spread to other parts of the body. By using ctDNA to detect these invisible cells, it is now possible to identify which patients are most likely to have micrometastases and therefore benefit from chemotherapy.

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“By using ctDNA to guide treatment, ctDNA-negative stage II colon cancer patients have a lower chance of cancer recurrence than the average stage I colon cancer patient, so we have the opportunity to change clinical practice,” said Joshua Cohen. lead author of the study and M.D./Ph.D. candidate at the Johns Hopkins University School of Medicine

The researchers hope that these findings will encourage the study of ctDNA in patients with other stages and types of colon cancer. In future studies, the researchers will investigate early-stage pancreatic cancer and stage III. will examine patients with stage 1 colon cancer to see if ctDNA can similarly identify patients who are most likely to receive more aggressive chemotherapy than currently used. They also plan to investigate whether the presence of residual ctDNA can be used to optimize treatment for individual patients after surgery or other therapy.

Using ctDNA to stratify treatments among patients is part of a shift toward precision medicine—personalized care that tailors therapies to the unique characteristics of cancer.

The researchers believe that the results provide an opportunity to test promising new drugs in patients with earlier stages of cancer.

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“Each drug works better in cancer patients who are caught relatively early, before they have developed large metastatic masses. But new drugs are usually first tested in patients whose cancer is very advanced,” says Vogelstein. “We hope that ctDNA analysis will enable testing of new drugs in patients with early tumors and micrometastases, when new drugs are most likely to save lives.”

In addition to Vogelstein, Cohen, Lennon, other researchers included: Kamel Lahouel, Ph.D., Yuxuan Wang, M.D., Ph.D., Janine Ptak, M.S., Natalie Silliman, B.S., Lisa Dobbyn, B.A., Maria Popoli, M.S., Ralph Hruban , M.D., Nicholas Papadopoulos, Ph.D., Kenneth Kinzler, Ph.D., and Cristian Tomasetti, Johns Hopkins, and Jeanne Tie, M.D., Serigne Lo, Ph.D., Suzanne Kosmider, M.B.B.S., Jeremy Shapiro M.B.B.S., Margaret Lee , M.B.B.S., Sam Harris, M.B.B.S., Adnan Khattak, M.B.B.S., Matthew Burge, M.B.B.S. Marion Harris, M.B.B.S., James Lynam, M.B.B.S., Louise Nott, M.B.B.S., Fiona Day, Ph.D., Theresa Hayes, M.B.B.S., Sue-Anne McLachlan, M.B.B.S., Belinda Lee, M.B.B.B.S. Eliza Hall Institute of Medical Research, Peter MacCallum Cancer Research Center or the University of Melbourne in Melbourne, Australia.

This research was supported by the National Health and Medical Research Council of Australia, the Marcus Foundation, Virginia and D.K. supported it. Ludwig Cancer Research Fund, Lustgarten Foundation, Conrad R. Hilton Foundation, Sol Goldman Charitable Trust, John Templeton Foundation, National Institutes of Health (CA62924, CA009071, GM136577, CA06973), and Eastern Health Research Foundation Linda Williams Memorial Grant.

Chances Of Cancer Coming Back After Chemo

Bert Vogelstein, Kenneth Kinzler and Nickolas Papadopoulos are founders and shareholders of Exact Sciences Company, Thrive Earlier Detection. Kenneth Kinzler and Nickolas Papadopoulos are consultants to Thrive Earlier Detection, an Exact Sciences Company. Bert Vogelstein, Kenneth Kinzler, Nickolas Papadopoulos, and Joshua Cohen are advisors to and have equity interests in Haystack Oncology. Nickolas Papadopoulos and Kenneth Kinzler are on the board of Haystack Oncology. The above companies have licensed previously described technologies related to the work described in this article from Johns Hopkins University. Bert Vogelstein, Kenneth Kinzler, Nickolas Papadopoulos and Joshua Cohen are some of the inventors of these technologies. Licenses to these technologies are associated with or subject to royalty payments to the inventors and Johns Hopkins University. Based on these agreements, the University may also be entitled to capital. This agreement has been reviewed and approved by Johns Hopkins University in accordance with its conflict of interest policy. Chemotherapy is a common cancer treatment. It uses drugs to kill cancer cells and prevent tumor growth. It can be combined with other cancer treatments, such as radiation therapy or surgery. Chemotherapy is usually given intravenously (through a vein). It is an effective treatment, but it can also cause side effects.

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Chemotherapy is a form of cancer treatment. Also called “chemo,” this is one of several cancer treatments that use drugs to treat different types of cancer. Other drug treatments include:

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Your oncologist will perform tests to make sure you are well enough for treatment. In the meantime, you can take steps to prepare for chemotherapy.

Chemotherapy is usually systemic, which means that the chemotherapy goes throughout the body. You may receive systemic chemotherapy:

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Some cancers do not respond well to systemic chemotherapy. In some cases, you may need chemotherapy delivered to a specific area of ​​your body. Examples:

The most common way to administer chemotherapy is by intravenous injection. Chemotherapy can be given directly into a vein:

Catheters and ports are useful if you need more chemotherapy. They avoid having a constant needling in your arm. The oncologist may also use catheters and ports to deliver other medications. These may include antibiotics or antiemetics (medicines to prevent nausea and vomiting).

Chances Of Cancer Coming Back After Chemo

The duration of chemotherapy treatment depends on the type of chemotherapy received. A treatment session can last from a few minutes to a few hours. Some people need a continuous infusion that can take several days. It can be a continuous infusion

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