News Article | November 28, 2016
Scientists have developed an easy-to-use software tool that can detect important genetic mutations that previously needed to be identified by a separate test. The software, called DECoN, accurately and quickly detects changes in copy number of blocks of DNA called exons, by analysing sequencing data already generated to identify smaller gene changes. It was developed by researchers at The Institute of Cancer Research, London, and the Wellcome Trust Centre for Human Genetics, Oxford. Most gene mutations are small DNA changes within an exon. These small changes are readily detected by DNA sequencing tests. But sometimes whole exons are deleted or duplicated. These are called exon copy number variants (exon CNVs), and they are not easily picked up by standard DNA sequencing tests. It is vital to be able to find these variants because they are an important cause of disease. For example, about 10 percent of the BRCA1 mutations that predispose women to breast and ovarian cancer are exon CNVs. In clinical testing laboratories a separate test has traditionally been used to detect exon CNVs, but this adds considerable time and cost, and is not available for all genes. Using DECoN (which stands for Detection of Exon Copy Number variants), the researchers took advantage of the high density of sequencing data available in new gene panels to accurately detect deletions or duplications of exons. DECoN does this automatically, adding only 30 minutes to the data analysis of up to 96 samples, and without costing any more. The team performed extensive evaluations of DECoN including in more than 1,900 clinical BRCA tests where it successfully detected all the exon CNVs. Study leader Professor Nazneen Rahman, Head of Cancer Genetics at The Institute of Cancer Research, London, and The Royal Marsden Hospital Foundation Trust, said "DECoN has transformed our gene testing pipeline, making it more efficient and more effective, whilst also making it much faster and cheaper. Previously we had to do an additional slow and expensive test to detect these tricky mutations. Now they are automatically detected by DECoN during the data analysis process." Professor Gerton Lunter at the Wellcome Trust Centre for Human Genetics in Oxford, who led the software development, said "This was an outstanding collaboration for us. It is hugely rewarding to see our work having a real impact for patients." DECoN was developed through the Wellcome-funded Mainstreaming Cancer Genetics programme and Transforming Genetic Medicine Initiative. A key element of these programmes is to develop tools that can be easily and freely used around the world. A paper detailing the development, evaluation and implementation of DECoN was published today in Wellcome Open Research, a newly launched publishing platform that promotes fast, open publication of any useful work by Wellcome researchers. Professor Rahman added: "It's very important to us that our work can be as impactful as possible. We have made an easy-to-use version of DECoN freely available from http://www. and the source code is also available." "We took advantage of the new Wellcome Open Research publication platform to publish our DECoN paper. The paper was freely available for anyone to read and download within two weeks of submitting it. If we had chosen the traditional publishing route it would have taken months. We plan to use Wellcome Open Research for much of our work. We are excited about the faster, broader impact we will have through using the platform." For more information please contact Sophia McCully on 020 7153 5136 or email@example.com. For enquiries out of hours, please call 07595 963 613. DECoN was developed, validated and implemented by the Mainstreaming Cancer Genetics Programme and the Transforming Genetic Medicine Initiative. Both are funded by Wellcome. DECoN detects deletions and duplications of exons, which are termed exon CNVs, through analysis of next-generation sequencing (NGS) data. DECoN was first evaluated through testing 96 samples with known exon CNV status and achieved 100% sensitivity and 99% specificity. Extensive simulations were also performed which showed that DECoN performance is excellent, giving >98% sensitivity and specificity for all typical NGS run parameters. DECoN performance was also validated in a real-world setting in a clinical testing laboratory, and is now used routinely to detect exon CNVs in cancer predisposition gene testing in theTGLclinical laboratory. About The Institute of Cancer Research, London The Institute of Cancer Research, London, is one of the world's most influential cancer research institutes. Scientists and clinicians at The Institute of Cancer Research (ICR) are working every day to make a real impact on cancer patients' lives. Through its unique partnership with The Royal Marsden NHS Foundation Trust and 'bench-to-bedside' approach, the ICR is able to create and deliver results in a way that other institutions cannot. Together the two organisations are rated in the top four cancer centres globally. The ICR has an outstanding record of achievement dating back more than 100 years. It provided the first convincing evidence that DNA damage is the basic cause of cancer, laying the foundation for the now universally accepted idea that cancer is a genetic disease. Today it leads the world at isolating cancer-related genes and discovering new targeted drugs for personalised cancer treatment. As a college of the University of London, the ICR provides postgraduate higher education of international distinction. It has charitable status and relies on support from partner organisations, charities and the general public. The ICR's mission is to make the discoveries that defeat cancer http://www. About The Wellcome Trust Centre for Human Genetics The Wellcome Trust Centre for Human Genetics is one of the leading international centres for the study of the genetic basis of common human diseases. As well as hosting high-profile groups pursuing the genetic basis of diabetes, cardiovascular, and infectious disease, and neuropsychiatric phenotypes (amongst others), the WTCHG has led the efforts of the Wellcome Trust Case Control Consortium and been responsible for advancing the application of large-scale genetic analysis to the dissection of common human phenotypes. The Centre also houses leading research groups in statistical genetics and structural biology in a lively interdisciplinary environment. The Centre provides core facilities in genomics, bioinformatics and statistical genetics, imaging, and chromosome dynamics. Presently the WTCHG has around 470 scientists and support staff and had a £20.3M grant turnover in 2010/11. For more information please visit: http://www. Wellcome exists to improve health for everyone by helping great ideas to thrive. We're a global charitable foundation, both politically and financially independent. We support scientists and researchers, take on big problems, fuel imaginations and spark debate. Wellcome Open Research provides all Wellcome researchers with a place to rapidly publish any results they think are worth sharing. All articles benefit from immediate publication, transparent refereeing and the inclusion of all source data.
News Article | November 7, 2016
Characteristics like seizures, location of the tumour, and pressure in the brain, give insight into length of survival and treatment options for brain tumour patients over the age of 70, according to new research* presented at the National Cancer Research Institute's (NCRI) Cancer Conference in Liverpool. In order to understand which treatments would be most appropriate for different patients, we need to understand what features predict how long patients with the disease survive. This new study looked at the records of 339 brain tumour patients over the age of 70. Overall, the study found that patients survived for an average of around four months and just four per cent were alive two years after their diagnosis**. Researchers based at the Brighton and Sussex Medical School, Beatson West of Scotland Cancer Centre, and The Royal Marsden Hospital, showed that patients with brain tumours who went to the doctor because of seizures were a third more likely to survive longer than those who presented with other symptoms such as speech impairment, confusion or weakness. The study also found that patients with higher pressure on the brain tended not to live as long. And people with tumours deeper in the brain or on the cerebellum also fared worse. Among brain tumour patients, those over the age of 70 are less likely than younger patients to survive a year after diagnosis, partly because they tend to have more aggressive forms of brain tumours or are frailer. Around 34 per cent of all brain tumour cases are diagnosed in people over 70 in the UK every year - around 3700 cases. And about 2400 over 70s die from the disease each year***. This research was supported by The Brain Tumour Charity. Dr Cressida Lorimer, study author and researcher at the Brighton and Sussex Medical School, said: "Our study in brain tumour patients aged over 70 showed that scans at diagnosis played a crucial role in determining how long a patient was likely to survive - distinguishing the position of the tumour, if there are multiple tumours, and assessing the amount of pressure on the brain. "There's an urgent need to improve survival and quality of life for brain tumour patients over the age of 70. And, because of a lack of research, it's difficult to make the best treatment decisions for individuals when they are sitting in front of you in the clinic. "Next we need to develop a guide for clinicians to improve how we treat elderly patients and to make decisions that could enhance quality of life." Dr Karen Kennedy, Director of the NCRI, said: "The outlook for brain tumour patients, especially for the elderly, is worryingly low. Research like this provides better evidence on which to base treatment decisions. "The NCRI recognises the need to increase research activity in brain tumour research and, together with some of our Partners, we are working with the Department of Health and other key stakeholders, to find ways to address this." For media enquiries contact the NCRI press office on 0151 707 4642/3/4/5 or, out of hours, on 07050-264-059. * NCRI abstract: First impressions count: Initial clinical and radiological features independently predict for overall survival in older patients with Glioblastoma **Of the patients in the study, 13 per cent survived one year and 4 per cent survived two years after diagnosis. *** Calculated by the Statistical Team at Cancer Research UK. Based on the annual average number of new cases and deaths from Brain, Other CNS and Intracranial Tumours, Malignant, Benign and Uncertain or Unknown (ICD10 C70-C72, C75.1-C75.3, D32-D33, D35.2-D35.4, D42-D43, D44.3-D44.5) in the UK between 2012-2014. The National Cancer Research Institute (NCRI) is a UK-wide partnership of cancer research funders, established in 2001. Its 19 member organisations work together to accelerate progress in cancer-related research through collaboration, to improve health and quality of life. NCRI works to coordinate research related to cancer, to improve the quality and relevance of the research and to accelerate translation of the research into clinical practice for the benefit of patients. NCRI Partners are: Biotechnology and Biological Sciences Research Council; Bloodwise; Breast Cancer Now; Cancer Research UK; Children with Cancer UK, Department of Health; Economic and Social Research Council (ESRC); Macmillan Cancer Support; Marie Curie; Medical Research Council (MRC); Northern Ireland Health and Social Care Public Health Agency (Research & Development Department); Pancreatic Cancer Research Fund; Prostate Cancer UK; Roy Castle Lung Cancer Foundation; Scottish Government Health Directorates (Chief Scientist Office); Tenovus Cancer Care; The Wellcome Trust; Welsh Assembly Government (Health and Care Research Wales); and Worldwide Cancer Research. The NCRI Cancer Conference is the UK's largest cancer research forum for showcasing the latest advances in British and international oncological research spanning basic and translational studies to clinical trials and patient involvement.
News Article | November 29, 2016
November 29, 2016 - Twitter has become an important resource for people seeking information about plastic surgery. But only a small percentage of plastic surgery "tweets" consist of evidence-based information posted by credentialed plastic surgeons, according to a report in the December issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS). "Twitter provides a great opportunity to engage with and educate patients and the public about plastic surgery," comments Dr. Olivier Alexandre Branford of The Royal Marsden Hospital, London, lead author of the new article. "But all too often, the conversation is dominated by celebrity gossip and marketing by practitioners who aren't Board-certified plastic surgeons." The researchers analyzed the sources and types of information about plastic surgery available on Twitter--one of the world's most popular social media platforms. Of nearly 2,900 tweets including the words "plastic surgery," about 70 percent were posted by members of the public. Just six percent of plastic surgery tweets were actually made by plastic surgeons. A large majority of the Twitter posts were about either celebrity plastic surgery (50 percent) or aesthetic surgery (44 percent). Few provided information about the basic science of plastic surgery, patient safety issues, or topics related to reconstructive surgery. More than 60 percent of tweets by plastic surgeons also mentioned aesthetic surgery, while 7.5 percent mentioned celebrity plastic surgery. Posts by plastic surgeons were more likely to mention basic science: 14 percent. Several tweets by plastic surgeons mentioned scientific articles, although only a few included a link to the journal where the article was published. About five percent of tweets included the #PlasticSurgery hashtag. A hashtag is a label using the pound or hash sign (#) that lets social media users search for messages on a specific topic. Nearly half of tweets tagged #Plastic Surgery were posted by plastic surgeons. A disappointingly high percentage of these posts (37 percent) were self-promotional, however. "Social media sites are a potentially powerful vehicle of integrating and enhancing education, leading to a useful role in e-learning within plastic surgery," Dr. Branford and coauthors write. They believe that Twitter "may be the best-suited platform to fulfill the role of public education and engagement." In a series of Twitter surveys, Dr. Branford found that the public wanted plastic surgeons to post about education, patient safety, and new research -- not celebrities and self-promotion. The ASPS and its publications play a leading role in building an authoritative plastic surgery presence on Twitter, with accounts including @DrRodRohrich, @PRSjournal, @ASPS_News, and @ASPSMembers. The article includes links to several recent ASPS videos designed to help plastic surgeons build their social media presence. "Board-certified plastic surgeons have a great opportunity to promote evidence-based plastic surgery practice via the hashtag #PlasticSurgery in the interests of supporting patients and the profession," the authors conclude. "As the only real plastic surgeons, we need to reclaim plastic surgery from the tabloid press, celebrity gossip and cosmetic quackery, in the interests of public safety and quality outcomes." Dr. Branford encourages all qualified plastic surgeons to join the effort to claim the #Plastic Surgery hashtag on behalf of patients. He comments: "As a result of our work, the hashtag now has 2.4 billion views per year and is now consistently the most trending healthcare hashtag in the world, just after one year of promoting it." Plastic and Reconstructive Surgery® is published by Wolters Kluwer. For more than 70 years, Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, and cosmetic surgery, as well as news on medico-legal issues The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 7,000 physician members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world. Wolters Kluwer reported 2015 annual revenues of €4.2 billion. The group serves customers in over 180 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY). Wolters Kluwer Health is a leading global provider of information and point of care solutions for the healthcare industry. For more information about our products and organization, visit http://www. , follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.
Constantinidou A.,The Royal Marsden Hospital |
Martin A.,The Royal Marsden Hospital |
Sharma B.,The Royal Marsden Hospital |
Johnston S.R.D.,The Royal Marsden Hospital
Annals of Oncology | Year: 2011
Background: Despite the increasing use of positron emission tomography/computed tomography (PET/CT) in the management of patients with breast cancer, its role is yet to be defined. Patients and methods: We reviewed PET/CT scans carried out in breast cancer patients, the indication, concordance/discordance with other imaging and whether their use had altered patient management. Results: PET/CT scans (233) were carried out in 122 patients between July 2004 and October 2008. Indications were as follows: staging (S) (91), response assessment (RA) (87), clarification (C) of findings on other imaging (32) and reassurance (ASS) (23). In the S group, positive scans were helpful in accurately defining the extent of disease and guided localised or systemic treatment. PET/CT was particularly useful for detecting lytic bone metastases. One-third of the scans was carried out for RA. PET/CT allowed early RA and in some cases appropriate discontinuation of ineffective treatment. PET/CT was used effectively for the clarification of indeterminate lesions on CT (18), magnetic resonance imaging (15) and bone scan (13). In the ASS group, all scans were negative. Conclusions: PET/CT is useful in accurately staging metastatic disease, assessing response to systemic treatment and clarifying equivocation on other imaging. Incorporation of PET/CT in these areas contributes to breast cancer management optimisation. © The Author 2010. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
Okines A.F.C.,The Royal Marsden Hospital |
Cunningham D.,The Royal Marsden Hospital
Annals of Oncology | Year: 2010
Surgery alone remains an international standard of care for early stage (Ia) oesophagogastric cancers. There is also international consensus that multimodality therapy is appropriate for more advanced stage operable disease, however there is marked geographical variation in standard practice. For gastric adenocarcinomas, adjuvant oral fluoropyrimidines became the standard of care in Japan after improved survival was demonstrated following resection with D2 nodal dissection, compared to surgery alone. Adjuvant chemoradiation improves survival following surgery with any level of nodal dissection compared to observation and is the accepted standard of care in the US. Similarly, perioperative triplet chemotherapy improves survival compared to surgery alone in gastroesophageal adenocarcinomas and is widely used across Europe and Australasia. For oesophageal adenocarcinoma, neo-adjuvant chemotherapy and neo-adjuvant chemoradiation are further accepted standards, widely utilized in the UK and US respectively, with similar survival benefits reported for each strategy. Patients with localized squamous cell carcinomas of the oesophagus benefit from chemoradiation, which may be delivered as a neo-adjuvant or definitive strategy, the latter avoiding surgical morbidity and mortality. Targeted agents are currently under evaluation in localized oesophagogastric cancer, with translational sub-studies attempting to define which patients may benefit from the addition of these high cost drugs. © The Author 2010. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
Morgan G.,The Royal Marsden Hospital
Blood Reviews | Year: 2010
The introduction of thalidomide, lenalidomide, and bortezomib has changed the way that multiple myeloma (MM) is treated and has greatly improved survival outcomes. These novel agents are often used in combination with conventional drugs, such as dexamethasone, to optimize clinical responses; however, they are also being evaluated as part of novel treatment combinations to build upon the success of available treatment regimens. Lenalidomide-based combinations are a focus of clinical research due to the high efficacy, good tolerability, and lack of cumulative toxicity associated with lenalidomide. Lenalidomide is an IMiDs® immunomodulatory compound with a dual mechanism of action - tumoricidal effects rapidly reduce MM burden while long-term immunomodulatory actions maintain tumor suppression. Several new agents with antimyeloma effects have been identified including: epigenetic agents (e.g. histone deacetylase inhibitors); novel proteasome inhibitors; novel immunomodulatory compounds; cyclin-dependent kinase inhibitors; interleukin-6 inhibitors; and other experimental agents such as heat-shock protein 90 inhibitors and monoclonal antibodies targeting MM cell surface receptors (e.g. anti-CS1 and anti-CD40). Many of these new agents, in combination with lenalidomide, are in early phases of clinical evaluation. Early clinical results are promising, indicating that the novel lenalidomide-based drug combinations are effective and generally well tolerated in patients with MM; future research will continue to evaluate these novel combinations and help to identify the optimal setting (e.g. induction, salvage, or maintenance) in which they may provide the greatest impact on the disease course. © 2010 Elsevier Ltd.
Messiou C.,The Royal Marsden Hospital |
Kaiser M.,The Institute of Cancer Research
British Journal of Haematology | Year: 2015
The recent consensus statement from the International Myeloma Working Group has introduced the role of whole body (WB) magnetic resonance imaging (MRI) into the management pathway for patients with multiple myeloma. The speed, coverage and high sensitivity of WB diffusion weighted (DW)-MRI and the unique capability to quantify both burden of disease and response to treatment has led to increasing implementation at leading centres worldwide for imaging malignant marrow disease, both primary and metastatic. WB DW-MRI is likely to have a significant impact on management decisions and pathways for patients with multiple myeloma. This review will introduce the basic principles of DW-MRI, present current evidence for patients with myeloma and will discuss practicalities and exciting future applications. © 2015 John Wiley & Sons Ltd.
Good J.S.,The Royal Marsden Hospital |
Harrington K.J.,The Royal Marsden Hospital |
Harrington K.J.,The Institute of Cancer Research
Clinical Oncology | Year: 2013
A comprehensive, mechanistic understanding of radiobiological phenomena that can be integrated within the broader context of cancer biology offers the prospect of transforming clinical practice in radiation oncology. In this review, we revisit the six established biological hallmarks of cancer and examine how they have provided insights into novel therapeutic strategies. In addition, we discuss the potential of two emerging hallmarks to continue to expand our understanding beyond the narrow confines of the traditional 5Rs of radiobiology. © 2013 The Royal College of Radiologists.
Kerawala C.J.,The Royal Marsden Hospital
Oral Oncology | Year: 2010
Surgery continues to retain a pivotal role in head and neck cancer in terms of the management of both the index tumour and potential or proven cervical disease. This review considers the specific complications of surgery in this anatomical region and, on the basis of the available evidence, describes both their management and prevention. © 2010 Elsevier Ltd. All rights reserved.
Morgan G.,The Royal Marsden Hospital
Seminars in oncology | Year: 2010
Bisphosphonates are firmly entrenched in the treatment of metastatic bone disease secondary to several tumor types, including breast cancer, prostate cancer, and myeloma. More recently, an emerging body of preclinical and clinical evidence indicates that bisphosphonates might also exhibit antitumor activity. This expanded role for bisphosphonates in the adjuvant setting might have profound clinical implications in many cancer types, particularly in the context of prevention of bone metastasis. Increased understanding of the mechanistic basis of the antitumor effects indicates that these might occur via direct mechanisms such as induction of apoptosis and inhibition of tumor cell adhesion and invasion, as well as indirect mechanisms such as inhibition of angiogenesis. There is also considerable evidence to suggest that nitrogen-containing bisphosphonates might exert additive or synergistic interactions with standard cytotoxic agents. However, mature clinical data with bisphosphonates are limited and, thus far, provide conflicting evidence regarding the antitumor role of bisphosphonates, but have mostly been conducted with first-generation bisphosphonates such as clodronate that are not as effective as next-generation bisphosphonates. Several large randomized clinical trials are ongoing with the next-generation bisphosphonate zoledronic acid to prospectively confirm an antitumor role for bisphosphonates in various tumor types. This review assesses the current body of preclinical and clinical evidence in favor of an antitumor effect of bisphosphonates in different cancer types. Copyright © 2010. Published by Elsevier Inc.