NCRI2016: Tuesday highlights from the NCRI bloggers
Multimodal genomics to improve precision oncology for prostate cancer: Embrace complexity!
Ontario Cancer Institute/Princess Margaret Hospital, University of Toronto, Canada
Prostate cancer treatment fails in almost 40% of cases, and in his talk, Rob Bristow explained the subgroup complexities of castration-resistant prostate cancer. Heterogeneity mutations, copy number alterations and methylation influence the aggressiveness of the cancer, and can potentially provide independent prognostic variables to predict metastatic disease. Increasing the precision of genomics, information on tumour microenvironment, sub-clonality and novel pathological indices will be valuable.
There are many challenges with localised, non-indolent prostate cancer, but Rob encouraged everyone at the Conference to embrace the complexities, saying that biomarkers will provide information to allow subgrouping of patients so that tests can identify patients with poor prognosis and look for ways to treat them for better outcomes.
Targeting tumour evolvability
from Howard Hughes Medical Institute, University of Minnesota, gave a plenary lecture entitled targeting tumour evolvability.
Reuben explained that cancers often display huge genetic heterogeneity and that tumour evolution is an ongoing process. He outlined some of the common sources of mutations, including in the anti-viral APOBEC enzymes, the focus of his talk.
His presentation highlighted recent progress in understanding in this area and he explained how the APOBEC enzymes are dominant drivers of tumour evolution and their inhibition is predicted to decrease tumour evolvability, therefore improving efficacy of existing targeted therapeutics.
In the final part of his talk, Reuben shared some insights into the structure of the APOBEC enzymes.
Improving the evidence base for symptom control in advanced cancer: Phase III studies of common interventions
David Currow, Flinders University, Adelaide, Australia
David Currow's plenary talk painted a stark picture of failures to control symptoms in advanced bowel cancer patients. He explained there is a lack of evidence underpinning commonly used symptom control measures and more needs to be done to encourage researchers to find innovative new ways to treat pain and delirium.
He presented data from 3 Phase III trials, demonstrating that common pain control measures can do more harm than good. He called for systematic and practical improvements in symptom control measures, and more willingness to involve patients with advanced cancers in clinical trials. To do this we need to bring clinical trials involvement in line with the normal care pathway, he said.
This year's NCRI Cancer Conference includes 3 sessions of 'proffered papers' - abstracts highlighted by the Scientific Committee as important, and timely research carried out by prominent researchers.
Today we heard a series of fascinating talks from researchers reflecting the breadth of cancer research, from palliative care provision to metabolic pathways within tumours.
NCRI's Lorna Fern gave an animated insight into data collected over 10 years that indicates access to clinical trials for young people is in decline. She described a 5 point multi-stakeholder approach to improving access to research for young people with cancer to support improvements to access. Lorna is pursuing these through a programme of work supported by the Teenage Cancer Trust and facilitated by NCRI.