Health Life

New algorithm helps select patients for urgent surgery or chemotherapy during pandemic

Credit: CC0 Public Domain

A new approach to better select breast cancer patients in need of urgent surgery or chemotherapy during the COVID-19 pandemic has been developed by researchers at The Royal Marsden and the Breast Cancer Now Research Centre at The Institute of Cancer Research, London, in collaboration with colleagues in the UK, Germany and US.

The innovative algorithm, using data from multiple international trials, can identify postmenopausal patients with primary ER+HER2- (c.70% of cases) who have less endocrine-sensitive tumors and who should be prioritized for early or .

The COVID-19 pandemic has led to an international need to prioritize the number of cancer surgeries and chemotherapy treatments to the most urgent patients to protect staff and vulnerable patients. While patients diagnosed with triple negative and Her2 positive breast cancer have still been going forward for urgent surgery or chemotherapy, for a large group of patients deferring these treatments and prescribing neoadjuvant endocrine therapy (NeoET), i.e. treatment to reduce the stimulation of the disease by estrogen without the surgical removal of the breast tumor, has been identified as the best course of treatment.

Development of the new treatment algorithm was led in the UK by researchers working in the Ralph Lauren Centre for Breast Cancer Research at The Royal Marsden and the Breast Cancer Now Toby Robins Research Centre at The Institute of Cancer Research (ICR).

Professor Mitch Dowsett, Head of the Ralph Lauren Centre for Breast Cancer Research at The Royal Marsden and Professor of Biochemical Endocrinology at the ICR, led the collaboration published in NPJ Breast Cancer this week. The work highlighted that while 85% of patients in whom treatment by surgery is deferred would be safe to remain on NeoET treatment for up to six months, 15% can be identified who

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Could one woman help researchers find a cure for Alzheimer’s?

Alzheimer’s disease is the most common cause of dementia, which contributes to a decline in memory, thinking, and social skills. More than 5 million people in the U.S. live with Alzheimer’s, which currently has no cure. 

But results from a study funded by the National Institutes of Health offer a new direction for developing a treatment.

Researchers looked at a large, extended family in Colombia, South America. Many members of that family have a gene difference that causes Alzheimer’s symptoms early, usually in their 40s, rather than after age 65.

Of the more than 6,000 people in the family, about 20% had this gene difference. Everyone who had it developed problems with thinking early—except one woman.

Unlike her family members, this woman didn’t have symptoms until she was in her 70s. This interested the researchers, and she volunteered for brain imaging and genetic testing to help them understand why her Alzheimer’s developed later.

Images of her brain showed less damage than is normally seen in people with the disease. The results of the genetic testing were also intriguing. It turned out that the woman had two copies of a rare variation in the APOE gene, called APOE3ch.

This discovery could go a long way in helping to advance Alzheimer’s research, for example, by mimicking how this gene variation affects the brain.

“Sometimes close analysis of a single case can lead to discovery that could have broad implications for the field,” says National Institute on Aging Director Richard J. Hodes, M.D.

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