Prognostic biomarkers discovered for patients with malignant pleural effusion

In a collaboration spanning multiple departments within Oxford and beyond, Centre members led by Dr Ioannis Psallidas have developed a new risk score (PROMISE score) that can provide important information on patient prognosis, and guide the selection of appropriate management strategies for patients with malignant pleural effusion.

Malignant pleural effusion is defined as the accumulation of a significant amount of fluid in the pleural space, accompanied by the presence of malignant cells or tumour tissue. It is commonly associated with breast and lung metastases, but the majority of late stage cancer could develop this type of metastasis. Currently, patients suffering from malignant pleural effusion have poor prognosis, with median survival ranging from 3 to 12 months. Additionally, the incidence of this condition is on the rise due to the increase in cancer prevalence and therapy improvements that allow patients to live for longer.

The most common treatment of malignant pleural effusion is pleudodesis, which involves the induction of pleural inflammation and fibrosis to prevent fluid accumulation. To improve the stratification of treatment for patients and to aid the understanding of the mechanisms underlying disease progression, prognostic biomarkers need to be identified. The PROMISE study was designed with the objectives to discover, validate, and prospectively assess biomarkers of survival and pleurodesis response in malignant pleural effusion.

Researchers discovered four proteins associated with patient survival that were independent of the cancer type. The data from one protein named tissue inhibitor of metalloproteinases 1 was combined with seven clinical biomarkers to build a score that predicts risk of death within 3 months. These four proteins that were associated with predicting survival also have potential as targets for novel treatments.

Ioannis remarked ‘The PROMISE score provides a valuable tool for clinicians to help stratify patients with malignant pleural effusion. Those of which have good prognosis can be identified for clinical trials of novel treatments. The patients with poorer prognosis can be treated symptomatically, reducing the number of hospital visits and procedures, such as pleudodesis, which may result in mortality. In the future we will be to aiming to secure funding to set up trials to investigate the effects of targeting the proteins identified in this study’.

The PROMISE study results have been published in Lancet Oncology.

Aspirin and acid reflux medication reduce the likelihood of patients with Barrett’s oesophagus developing oesophageal cancer.

Results of the AspECT clinical trial, coordinated by the CRUK Oxford Centre supported Oncology Clinical Trials Office, have shown the important role aspirin and acid reflux treatment can have in preventing those at high risk of oesophageal cancer from going on to develop the disease.

The trial led by Professor Janusz Jankowski had results presented last week at the American Society of Clinical Oncology conference. The trial investigated the chemo preventative effects of different doses of the antacid medication esomeprazole, with and without low dose aspirin in patients with Barrett’s oesophagus. Since acid reflux is involved in causing Barrett’s oesophagus it had been suggested that reduction of acid to very low levels might prevent progression to cancer.

The randomised phase III trial involved over 2500 patients who were followed for 7.9 years. Patients who followed a seven year course of high dose of esomeprazole with low dose aspirin, followed by high dose esomeprazole, were 20% less likely to develop oesophageal cancer than if they had been untreated.

Professor Janusz Jankowski, who completed an MSc in clinical trial research at Oxford University in 2009 and is currently Professor of Medicine at the University of Central Lancashire said: “Our results are very exciting. Oesophageal cancer is hard to diagnose and hard to treat. So, we’re pleased that such a cheap and well-established medicine can prevent and/or delay development of cancer for these patients. Our hope is that this may also offer an opportunity to prevent oesophageal cancer in wider populations.”

AstraZeneca – Oxford collaborative Symposium September 2018 – Registration now closed

We are delighted to announce a partnership symposium between AstraZeneca and the Cancer Research UK Oxford Centre, which will take place on September 13th 2018 at Keble College.

The primary aim of the event is to provide an opportunity for researchers from both organisations to get a better understanding of the research activities of the other, in order to establish a series of collaborative cancer research projects. Through the Centre Development Fund, financial support for projects emerging from the event will be available.

The event will include presentations on 4 core topics, DNA damage repair, radiation oncology, epigenetics and immunoncology and posters covering target identification and validation, CRISPR capabilities, early phase clinical trials, biophysics, structural biology, biochemistry/cellular assays and chemical probes.

There will be a range of speakers from both Oxford and AstraZeneca (see draft schedule below), and numerous opportunities for individual networking during breaks and at the drinks reception. We will be opening our next round of development funding at the event in order to support collaborations emerging from the event.

If you are interested in attending this free event, (open to group leaders, and post-doc’s across the University and Trust) and presenting a poster to showcase your research to AZ (and making yourself eligible for the poster prize) please register your interest here by Tuesday June 19th. Places are limited to 150 attendees and will be prioritised to those researchers presenting posters and those who register sooner.

Please note, all information included in the above application and presented at the conference will be considered pre-competitive, so bear this in mind when choosing which details to disclose.