Innovations occur in medicine all the time. Some happen quickly, like the unprecedented speed with which the COVID-19 vaccines were developed. Others take more time to develop, as researchers leverage current knowledge and new ideas to develop novel pathways toward diagnosis, treatment, and survival for people with a wide variety of diseases.
Each column, we dive deeply into lab reports, journals, and conferences to bring you the most anticipated innovations coming down the pike for one of the most dreaded diseases: cancer. This round, our focus is on breast cancer. Among new developments to keep an eye on include:
Artificial Intelligence (AI) That May Allow for More Accurate Breast Cancer Screenings
A new AI tool may take breast cancer screenings to the next level by increasing radiologists’ accuracy when interpreting ultrasound images. Using a data set of more than five million images collected from 288,000 exams of roughly 143,000 patients, researchers have trained and validated an AI system to automatically identify malignant lesions in breast ultrasound images.
Findings from the study, which were published online in September 2021 in Nature Communications, show that the AI tool decreased the rate of false positives (samples erroneously categorized as positive) by 37.3 percent, significantly reducing the number of women referred for unnecessary biopsies.
Next Steps The tool isn’t quite ready for prime time, according to the researchers. More work is needed to further test its accuracy. They also plan to refine and personalize the tool to use patient-specific information (e.g., genetic history, family risk) to better inform evaluations and follow-ups.
RELATED: 6 Stretches to Help With Recovery After Breast Cancer Surgery
Precision-Activated Cancer Therapeutics That Could Usher in a New Era in Therapy
Researchers have discovered a way to activate cancer therapies, such as the drug Adriamycin (doxorubicin), directly in tumors, thereby reducing side effects felt throughout the rest of the body. (Adriamycin has been notoriously nicknamed “the red devil” for its color and difficult side effects.) The technology involves giving an inactivated form of chemotherapy intravenously and injecting an activating agent directly into the tumor. This approach to therapy, known as CAPAC (Click Activated Protodrugs Against Cancer), keeps the toxic effects of the chemotherapy mostly contained inside the tumor, while sparing the rest of the body the worst of the side effects. CAPAC can also be used for other tumor types that are amenable to direct injection.
In the first study in which the technology was used in humans, the results, presented at the European Society for Medical Oncology Congress in mid-September, showed that levels of SQ3370 (equivalent to conventional doxorubicin) were 50 times higher in the tumor than in the bloodstream, with no serious adverse events that would require dosage adjustments. The small experimental trial included nine patients, eight of whom had metastatic cancer, including triple-negative breast cancer. Cancer progression stabilized in more than half of the patients treated with CAPAC, including those in whom the disease had progressed when treated with prior Adriamycin or other chemotherapy agents.
Next Steps The CAPAC platform is compatible with a variety of drugs, including some often limited in use because of their toxicity. The trial is ongoing, and researchers will continue to increase doses using the system. If CAPAC is successful, researchers may someday be able to leverage drug effectiveness while limiting or even eliminating some of the most toxic side effects.
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Liquid Biopsies That May Help Identify Breast Cancers With Poor Prognoses
Liquid biopsies, which rely on identifying circulating DNA fragments from tumor tissue in the blood (also called circulating cell-free DNA, or cfDNA), might provide an alternative to traditional biopsies for certain patients.
Prior studies established that patients with advanced breast cancer have higher concentrations of cfDNA than those with benign tumors (or healthy persons). Researchers looked at data from a Finnish cancer project launched during the 1990s, a data set that included 204 breast cancer patients with nonmetastatic disease before treatment was started. Research findings, which were published in September 2021 in the journal Cancers, showed that when the ratio of larger circulating DNA fragments versus smaller fragments was higher, the patient was likely to have a poorer prognosis.
Next Steps Future studies will also focus on how liquid biopsies can be used to delineate breast cancer patients with a poor prognosis at the time of diagnosis, in order to improve treatment and outcomes.
RELATED: What Is a Liquid Biopsy for Lung Cancer — and Do You Need One?
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November 17, 2021 at 10:45AM
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