News Highlights

Recent news, curated and summarized by ACKC, that may be of interest — directly or tangentially — to our kidney cancer community. Let us know if you see or hear of an article or post that should be included here.

President signs Omnibus Bill including $50M for kidney cancer research

December 30, 2022 — President Biden signed the FY2023 Omnibus Bill today, which includes $50 million for the Kidney Cancer Research Program for this fiscal year ending on September 30, 2023. That brings the total funding for kidney cancer research, since 2006 when ACKC started lobbying Congress for kidney cancer research, to 248 million!

 A prenatal test for aberrant fetal DNA can diagnose maternal cancer cells

December 23, 2022 — Genetic testing, used to pick up abnormalities in the fetus of pregnant women, has coincidentally picked up abnormalities in the DNA of the mother, which has led to diagnosing cancer in the mother.

Amniocentesis has been offered, for several years, to pregnant women who are at greater risk for having a child born with birth defects, such as Down Syndrome. However, amniocentesis, can itself be risky and can even cause a miscarriage in rare instances. A new, non-invasive genetic test (noninvasive prenatal testing or NIPT) has been developed to test for abnormalities in the fetus via a simple blood test that id designed to pick up aberrant DNA that is shed from the placenta.

It turns out that this test has also picked up abnormal DNA from the mothers’ cells. When further testing is done, it was found that close to half of the abnormal DNA has turned into a cancer diagnosis for the mother. For example, a Dutch study of 232,000 pregnant women found 48 who had suspicious results with 23 of them having multiple chromosomal aberrations and 16 having malignancies — see https://ascopubs.org/doi/abs/10.1200/jco.21.02260.

The NIH has set up a clinical trial called the Identify Study to further test pregnant women who were diagnosed with having aberrant maternal DNA — see https://clinicaltrials.gov/ct2/show/NCT04049604.

For a summary of this issue, listen to a 6-minute NPR radio report at https://tinyurl.com/mvshxeww.

Cause of death in CT prisons

October 25, 2022 — A study conducted by Yale University found that cancer was the most frequent cause of death among men and women in prison in Connecticut, accounting for 30% of all deaths. In the general population, the most frequent cause of death is cardiovascular disease. Cancer is second with 21% of the deaths.

The study was conducted for the years 2005 through 2016 for those people who had invasive cancer, evaluating the five-year survival rate from time of diagnosis among three groups: those incarcerated, those who were diagnosed within one year of being released from prison, and those who were never incarcerated. The most frequent cause of death were gastrointestinal cancers, specifically colorectal and liver cancers. People diagnosed while in prison had a 39% higher probability of dying from cancer than the never-incarcerated group while those diagnosed within 12 months of release from prison had an 82% higher rate! People in both the latter two groups, who were diagnosed with invasive cancer, tended to be younger, male, and non-Hispanic Black or Hispanic compared with the never-incarcerated group.

The authors of the study highlighted the fact that close to two-thirds of those diagnosed with cancer during incarceration and one-half of those diagnosed shortly after release were found to have metastasized cancer, similar to other findings in the incarcerated population. The authors postulated that the causative factor is lack of cancer screening, especially for screenable cancers such as colon and prostate cancer. For the original source article in PLoS, see https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0274703.

Tumors eventually develop resistance to immunotherapies by one tumor cell hiding inside another tumor cell

October 4, 2022 — Amit Gutwillig, a researcher in Yaron Carmi’s lab in Tel Aviv University made a remarkable discovery. Immunotherapies help many cancer patients, but eventually, they become ineffective in most patients, who then progress. Studying mouse cultures, Gutwillig showed that when attacked by killer T-cells, tumor cells form a cell within a cell. When the T-cells, kill the outer cell, the inner cancer cell not only survives but senses that they are about to be attacked and killed so they hide from the T-cells and proliferate once the attackers leave the scene. This experiment has to be repeated to validate Gutwillig’s finding, but if it does so, it means that new processes can be developed to fool the cancer cells that survived the initial attack, then seek them out and destroy them too. For Guttwillig’s technical article, go to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9489212. For a more readable explanation of the phenomenon https://www.nytimes.com/2022/09/29/health/cancer-hiding-cells.html.

Walking is fine, but “brisk” walking is finer in the search for longevity

September 30, 2022 — We all know that exercise is good for your health, even walking is recommended, at 30 minutes a day. But there’s walking and “brisk walking,” and the latter makes all the difference. Brisk walking is 80 to 100 steps a minute. In a British study of 78,500 people, it was shown that brisk walkers had a 35% lower risk of dying, a 25% lower risk of developing heart disease or cancer, and a 30% lower risk of developing dementia compared to slow walkers. See New York Times article at https://tinyurl.com/3bec6by4.

5-organization meetup about healthcare disparities

August 10, 2022 — The 2022 Summit on Cancer Health Disparities met in the spring to discuss healthcare disparities and initiatives taken by the participating five organizations. The proceedings are not published but some factoids that illustrated the disparity issues were noted by the organizations’ presidents.

The ASCO President pointed out that “Black and Latinx patients currently represent about 6% and 2% of patients in cancer clinical trials in the U.S., respectively, despite making up a significantly higher proportion of the population – and similar percentages apply to the oncology workforce.” The President of EONS (European Oncology Nursing Society) said that “Europe accounts for only 10% of the world’s population, but it accounts for one-quarter of the world’s cancer cases … and, depending on the country, considerable disparities in cancer survival rates exist.”

The President of ASTRO (American Society for Radiation Oncology) noted that “About 20% of U.S. citizens live in rural communities more than 25 miles from a radiation center. Although the number of radiation oncology centers has increased, (but) the increase has been in urban areas. The evidence states that if a patient must travel more than 25 miles for radiation oncology, or medical oncology, their treatment outcomes will be worse.” And further, “…about 30% of the population identify as Black or Hispanic, but only 7% of radiation oncologists fall into that category.” Finally, the President of NCCN (National Comprehensive Cancer Network) pointed out that “People of color are less likely to receive optimal and guideline-adherent care, even when accounting for insurance status, according to some studies.” And further, “Huge disparities also exist on the care provided to the LGBTQ+ community…including implicit bias…of the health-care system, misgendering, and health-care policies that don’t support chosen caregiver support.” For a fuller report, see the ASCO Post article at https://tinyurl.com/y2whfemc.

Dr. Christopher Ryan, Oregon Health and Science University, reports on results of an adjuvant trial testing everolimus (Afinitor) versus placebo

July 25, 2022 — Dr. Christopher Ryan from the Oregon Health and Science University reported, at the 2022 ASCO Meeting on an adjuvant trial testing everolimus (Afinitor), versus placebo in non-metastatic, intermediate high-risk and very high-risk in a total of 1,499 patients. 83% of the patients had clear cell RCC. For the total population, the 6-year recurrence-free survival was 64% for the everolimus group versus 61% for the placebo group, thus not significant. There was an advantage for the very high-risk group of 21% over the placebo. The Grade 3 or greater Adverse Events was significant with 46% in the everolimus cohort versus 11% in the placebo patients. There was a “robust” response in African Americans, but it was a small group. Finally, Dr. Ryan noted that no adjuvant therapy (designed to prevent recurrence in non-metastatic cancer patients) has reported a significant survival thus far. To read the entire story, view the ASCO Post article at https://tinyurl.com/yr3547r4.

Biden Administration announces Enhancing Oncology Model (EOM) initiative

June 27, 2022 — The Biden Administration announced, for a handful of cancers, a 5-year test program called the Enhancing Oncology Model (EOM), a feature of the Cancer Moonshot Initiative, for Medicare and Medicaid patients. The object is to provide superior care to cancer patients such as access to social services, help to overcome obstacles to obtaining the proper medical care, 24/7 access to clinicians, a detailed care plan, and addressing inequities in race, gender, region, and income, which prevent adequate health care. The program is voluntary but oncology practices will be incentivized to join EOM by providing them with increased payments. See the ASCO Post article at https://tinyurl.com/y93uvzcb for the full story.

­­­­­High-deductible insurance plans cause delays in metastatic cancer diagnosis

June 4, 2022 — Dr. Nicolas Trad, from Harvard Medical School, presented a study at the ASCO General Meeting this year comparing high deductible worker insurance plans versus low deductible plans as to time to cancer diagnosis finding that high deductible health plans (deductibles > $1000) manifest delays of 4.6 months in diagnoses of metastatic cancer versus plans that are low-deductible ($500 or less). Dr. Trad is planning a follow-up study to determine if there is a difference in mortality of those workers diagnosed with metastatic cancer.

In a different study by the RAND Corporation to survey the effects of having a high deductible insurance plan (HDHP), they found that those employees with HDHPs cut back spending by eliminating preventive care spending, such as childhood immunizations and cancer screening, which can have long-term consequences. Furthermore, low-income and chronically ill workers cut back their spending on health care, like other workers. But the consequences to the former group are more dire.

Finally, a 2021 study by the Kaiser Family Foundation found that only 59% of companies offer any health care benefits to their employees.

For the Harvard study, go to https://dailynews.ascopubs.org/do/10.1200/ADN.22.200994/full/  and for the RAND study, see High-Deductible Health Plan Study: Five Takeaways at https://www.chcf.org/wp-content/uploads/2017/12/PDF-HDHPStudyFiveTakeaways.pdf