A Queen’s Speech to speed up progress against cancer?

The Queen

Today, the Queen set out the Government’s priorities for the next year

This morning the Queen opened the third session of the 2010-15 Parliament with a speech in the House of Lords.

Her speech was written by the Government, and outlined its legislative agenda for the upcoming parliamentary session (which will last roughly a year).

And over the next couple of days, both Peers in the House of Lords, and MPs in the House of Commons will debate its contents.

Cancer Research UK takes a great interest in the Government’s plans, and how we think they will affect cancer patients and research into the disease.

So what are the key points for us from this speech?

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Watching cancers evolve using ‘liquid biopsies’

DNA fingerprint

Cancer’s evolving DNA can be detected using a blood test

Sometimes it feels like cancer research is progressing at a dizzying speed.

Just last year, we reported how Cancer Research UK scientists had reconstructed the evolution of a patient’s kidney tumour during treatment – one of many studies over the past few years illustrating cancer’s fearsome genetic complexity and adaptability.

This phenomenon, known as ‘intratumour heterogeneity’, led many to predict a long, hard slog to fully understand it – let alone get a handle on its implications for treatment.

One key concern was that patients would need to undergo a series of small operations (biopsies) to take repeated tissue samples to track how their cancer develops – and that this could be painful, costly and risky – especially for cancers deep in the body. And even then, because of the genetic variation within each patient’s cancer, there would be no guarantee that the biopsy results would represent an accurate picture.

Others also pointed out that such heterogeneity was a blow to the optimism around new-generation ‘targeted’ therapies, designed to treat cancer cells driven by individual mutations.

But recent discoveries have renewed this optimism. It turns out that tumours release DNA into the bloodstream, and that this seems to contain signals about what’s going on inside it. Consequently, there’s been a growing hope that analysing these DNA fingerprints could provide a quick, simple ‘liquid biopsy’ to track tumours’ progress.

And last month, researchers at our Cambridge Institute published compelling evidence that circulating DNA could indeed be used to take a snapshot of the DNA errors (mutations) in a patient’s breast cancer.

Today they’ve gone one step further proving, in a beautifully detailed paper in the journal Nature, that blood samples can be used to monitor genetic changes in a patient’s disease over time.

This has the potential to be a game-changer, and rapidly accelerate research into what makes cancers tick, in real patients, in timeframes that can impact on clinical decision making.

Let’s look at what they found.

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Clinical trials: Helping more children beat cancer every year

A child on a clinical trial

Clinical trials have helped to save thousands of children’s lives.

December is childhood cancer awareness month, so we thought we’d focus on an area that contributed more to saving children’s lives from cancer than anything else – clinical trials.

More and more children are now surviving cancer, and today there’s over 33,000 long-term survivors of childhood cancer alive in the UK. Clinical trials are at the heart of this progress, testing new treatments or different ways of giving drugs to see if they’re more effective than what’s already available.

In the 1970s, when clinical trials for childhood cancers first started, fewer than three in 10 children with cancer survived. Today nearly eight out of 10 make it.

This life-saving progress is fantastic, but we can’t rest on our laurels. With more than 200 children losing their lives to cancer every year in the UK, we’re still searching for cures. And for those we can cure, the drugs they’re given need to be made kinder and with fewer side effects. This will give them the chance to live full, long lives without a lasting legacy from their treatment.

To help bring hope for the future we’re running clinical trials for children with cancer across the whole of the UK. Here are a few we’ve recently launched.

Finding better treatments for neuroblastoma 

Each year around 100 children in the UK are diagnosed with neuroblastoma, and many have access to immunotherapy through a Cancer Research UK trial opened three years ago. This new trial is offering immunotherapy to children and young people whose cancer has come back– around half of all cases. Doctors hope that this new trial will mean almost all children in the UK have access to this cutting-edge treatment.

The treatment works by ‘flagging up’ cancer cells to the immune system, so it can hunt them down and destroy them. As well as offering more children access to immunotherapy, the trial will also look at a different way of giving it. Immunotherapy has to be given with a strong pain killer such as morphine because it causes severe pain, meaning patients need to stay in hospital. This trial will see if giving immunotherapy more slowly and over a longer time reduces the pain it causes so children could stay at home while having it.

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Expert opinion: Professor Dion Morton – combining chemo and surgery in colon cancer

Earlier this month we announced trial results showing that giving patients with colon cancer (bowel cancer that originates in the colon) a short course of chemotherapy before surgery, could significantly shrink their tumour. This makes the tumour easier and safer to remove, potentially reducing the chances of it coming back.

We caught up with trial leader Professor Dion Morton, a surgeon based at the University of Birmingham, to find out when patients might begin to benefit from this potentially exciting advance.

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A vitamin pill a day keeps cancer away? Unlikely

Vitamins

Headlines claiming that “vitamins lower cancer risk” don’t truly reflect trial results

The media’s search for a ‘magic pill’ to reduce cancer risk continues. Yesterday saw several stories about multivitamins “lowering the risk of cancer”. Some of the headlines would have you believe the magic pill has been found – but unfortunately it’s not that simple.

The headlines were based on the results of a study published in the Journal of the American Medical Association, which looked at the effects of taking multivitamins on cancer in middle-aged or older men.

Over 11 years, about 15,000 male health professionals took either a general multivitamin, or either vitamin E, vitamin C, beta carotene (a precursor of vitamin A) or a dummy pill (placebo). This was a ‘blind’ trial, so neither the researchers nor the men on the study knew which pill they were taking. The study included men with a history of cancer as well as healthy individuals.

Daily multivitamin use was shown to slightly reduce the overall risk of developing cancer – by 8 per cent. To put that in perspective, about 18 cancers per 1,000 people per year were diagnosed in the placebo group, compared with  17 cancers per 1,000 people per year in the multivitamin group.

But we don’t recommend you rush out to your local vitamin emporium based on this research. Let’s take a look at why…

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Why we’re Standing Up To Cancer

Neil and her colleagues, Standing Up to Cancer

Nell and her colleagues, Standing Up to Cancer

Sometimes the battle of science against cancer can seem like a long, hard slog. But history proves that research can make a difference.

Cancer survival rates in the UK have doubled in the last 40 years, and research has been central to this progress. But when someone you love is affected by this terrible disease, it’s hard to feel hopeful.

Fear is a powerful emotion – but hope can be stronger. And there’s certainly reason to be hopeful. The fight against cancer is at a turning point, and we know we can beat it – if we join together.

This Friday, Cancer Research UK is collaborating with Channel 4 to bring you the UK’s first ever TV fundraising show for cancer research – Stand Up To Cancer. We’re doing this because we know new cures are within our grasp, and it’s time to seize the moment.

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Research into new treatments shouldn’t be hampered by red tape

Paperwork

Researchers face considerable paperwork when setting up trials

Without clinical trials, there would be no new cancer treatments. And there are few better places to set up a clinical trial than in the UK.

As a result we have one of the highest rates of participation in trials anywhere in the world. And our clinical researchers – often working in partnership with colleagues in other countries – have been behind many of the important treatment advances in recent times.

But over the years, the way the European Union regulates clinical trials across the continent (known as the European Clinical Trials Directive) has come in for criticism - much of which we agree with.

Thankfully, in response, the European Commission has now announced (pdf) proposals aimed at addressing these issues.

These proposals will soon be debated by MEPs in the European Parliament, and the Governments of the member states, before becoming law.

Today, we’ve published our thoughts on the Commission’s proposals (pdf), with the aim of influencing the debate and hopefully strengthening the resulting regulation.

In general, we’re broadly supportive of the proposals, and pleased that a lot of the criticism has been taken on board.

But there are still a few things we think could be improved, as we’ll see below. Making clinical research as effective as possible is vital if we’re to translate laboratory breakthroughs into treatments for patients.

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