cancer

CAR-T cell-based treatments have been successful against some blood tumours, but are much less effective for solid tumours. A phase 1 clinical trial has tested their use in 11 children and young adults with diffuse midline glioma, a tumour of the nervous system that is considered incurable. The results, published in the journal Nature, indicate that the treatment improved functional status in nine of the 11 patients. One of the four who showed a strong response is still healthy four years later.

The HTAN (Human Tumor Atlas Network) consortium is simultaneously publishing 11 papers in different journals of the Nature group. These include analyses of the architecture of tumors and their environment in more than 2,000 patients and twenty different locations, which will make it possible to study how they start and evolve. Among the novelties found are new clues about the development of metastasis and resistance to treatments, and the finding that colorectal cancer can arise from multiple cells with different mutations that act collectively, instead of from a single initial clone as previously thought.

A study conducted in several Spanish provinces has analysed the relationship between breast cancer and obesity in more than 2,000 postmenopausal women. Its findings are that around 40% of estrogen receptor positive (ER+) cases - the most common type - can be attributed to excess body fat (above 40%). This is much higher than the 10% considered attributable when only a high body mass index is taken into account. The results are published in the Journal of Epidemiology and Community Health.

Despite considerable advances in the discovery and development of new cancer drugs, there are significant disparities in both the availability and timeliness of these medicines around the world, with the poorest countries being left out, according to an analysis published in the journal BMJ Global Health. According to the study, few new cancer drugs were launched in low- and lower-middle-income countries, and the gap between rich and poor countries widened over the three decades between 1990 and 2022.

If lifetime tobacco consumption were banned among young people currently aged 14 to 18, 1,200,000 lung cancer deaths worldwide could be prevented in the future, according to a study with Spanish involvement published in the journal The Lancet Public Health. The greatest impact would occur in low- and middle-income countries, but in higher-income regions, more than 60% of lung cancer deaths in that age group would also be avoided.

Prostate cancer screening tests using PSA (Prostate Specific Antigen) are associated with overdiagnosis, which calls into question their use. A clinical trial in men aged 50-60 years published in the journal NEJM has studied the possibility of adding an MRI test in those with an elevated PSA level and dispensing with biopsy if imaging finds no suspicious lesions. The results indicate that the procedure avoids more than half of clinically irrelevant cancer diagnoses that would not need treatment and only slightly increases the risk of failing to identify those that may become incurable. The authors recommend, on the basis of the study, to review the recommendations for such screening.

Newborns with Down syndrome, as they grow, face a higher risk of developing leukemia compared to those without the syndrome. An international team has sequenced the genes of more than 1.1 million cells from fetuses with and without Down syndrome, and it has discovered that the extra chromosome 21 they have alters the way DNA is packaged inside cells. According to the authors, whose research is published in Nature, this difference affects the regulation of certain genes and may contribute to the development of leukemia.

The regulatory agencies for medicines in the United States and Europe have issued statements informing about a possible risk of developing certain types of tumors following CAR-T cell immunotherapy treatment. What do we know so far? What is the real risk? Does the benefit-risk balance still hold? Has anything changed after these alerts? We answer these questions with expert opinions and the data currently available. 

A study has analyzed data on prostate cancer incidence and mortality in 26 countries in Europe between 1980 and 2020. Its findings are that new diagnoses have increased due to the widespread use of PSA [prostate-specific antigen] testing, but mortality rates have not benefited in parallel. This suggests possible overdiagnosis, i.e., the detection of harmless tumors that are unlikely to cause symptoms or death in the patient's lifetime. The results are published in the journal The BMJ. 

The radiation exposure from mobile phone use does not increase the risk of brain cancer, with evidence of “moderate” certainty, according to a systematic review, funded in part by the WHO and published in Environmental International. Exposure from fixed-site transmitters (like broadcast antennas) is also not associated with childhood leukaemia.