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Take a look at a selection of our recent media coverage:

Global cancer burden ’rapidly growing’ says WHO as England launches national gene testing

5th February 2024

Both the global cancer burden and inequity in cancer and palliative care services are growing across the world, according to new figures released by the World Health Organization (WHO).

Published to coincide with World Cancer Day (4 February 2024), the survey undertaken by the WHO’s cancer agency, the International Agency for Research on Cancer (IARC), shows a growing need for more cancer-related health services worldwide.

Over 35 million new cancer cases are predicted in 2050, a 77% increase from the estimated 20 million cases in 2022, the IARC said.

This ’rapidly growing global cancer burden’ reflects population ageing and growth, as well as changes to people’s exposure to risk factors such as tobacco, alcohol, obesity and air pollution, it added.

Cancer prevalence

The figures show that 10 types of cancer collectively comprise around two-thirds of new cases and deaths globally. Lung cancer is the most commonly occurring cancer worldwide, followed by female breast cancer and colorectal cancer.

In 2022, there were an estimated 20 million new cancer cases and 9.7 million deaths, with lung cancer accounting for 2.5 million or 12.4% of the total new cases.

Female breast cancer ranked second with 11.6% of new cases, followed by colorectal cancer, which accounted for 9.6% of new cases. Prostate cancer and stomach cancers were the next two most common, respectively.

Lung cancer was also the leading cause of cancer death, accounting for nearly a fifth of the total cancer deaths, followed by colorectal cancer 9.3% of deaths and liver cancer 7.8% of deaths.

Differences were seen between sexes, with breast cancer being the most commonly diagnosed cancer and leading cause of cancer death amongst women, whereas it was lung cancer for men.

Prostate and colorectal cancers were found to be the second and third most commonly occurring cancers for men, with liver and colorectal cancers second and third most common causes of cancer death.

For women, lung and colorectal cancer were second and third for both the number of new cases and of deaths.

Lung cancer’s re-emergence as the most common cancer is likely related to persistent tobacco use in Asia, the IARC said.

Cancer and palliative care services

The figures also show that a majority of countries do not adequately finance priority cancer and palliative care services.

Only 39% of participating countries covered the basics of cancer management as part of their funded core health services for all citizens, and only 28% of participating countries additionally covered care for people who require palliative care.

In areas where patients are underserved in relation to cancer treatments, rates of cancer are higher, highlighting a growing inequity in cancer services worldwide.

Dr Panagiota Mitrou, director of research, policy and innovation at the World Cancer Research Fund, stated that the UK Government needs to prioritise cancer care in light of the increasing number of global cases.

She said: ‘These new estimates show the increased burden that cancer will have in the years to come. UK Governments’ failure to prioritise prevention and address key cancer risk factors like smoking, unhealthy diets, obesity, alcohol and physical inactivity has, in part, widened health inequalities. We know around 40% of cancer cases could be prevented.’

She added: ‘Now is the time to turn the tide by implementing policies that enable people to live healthier lives by reducing their exposure to risk factors and prioritising a national cancer plan which includes better screening and early detection.’

Gene testing programme for England

The WHO figures come as NHS England announces the launch of a national gene testing programme to identify cancer risk for people with the BRCA gene.

The BRCA refers to two genes, BRCA1 and BRCA2, which repair DNA damage and help to protect against cancer. If one of the genes is faulty, this can increase a person’s chance of getting cancer significantly.

People with Jewish ancestry are around six times more likely to carry such genetic faults than the rest of the population and are therefore at increased risk of developing some cancers.

Through genetic testing, the NHS plans to identify people carrying faults in the BRCA gene to ensure those affected have access to early surveillance and prevention services.

People with at least one Jewish grandparent can register for a saliva test kit, and following the success of the pilot programme, it is expected that the national roll-out will see around 30,000 people tested over the next two years.

Commenting on the programme, Peter Johnson, national clinical director for cancer at NHS England, said: ‘BRCA testing for the people most at risk has the potential to save lives by allowing them to take steps to reduce the chance of cancers developing or making sure that any cancer can be detected as early as possible, with those at increased risk able to take advantage of surveillance and prevention programmes with their health teams.’

A version of this article was originally published by our sister publication Nursing in Practice.

New drug class could treat range of cancers with faulty BRCA genes

18th June 2021

Scientists have identified a class of targeted cancer drugs that offer the potential to treat patients whose tumours have faulty copies of the BRCA genes.

The drugs, known as POLQ inhibitors, specifically kill cancer cells with mutations in the BRCA genes while leaving healthy cells unharmed.
 
And crucially, they can kill cancer cells that have become resistant to PARP inhibitors – an existing treatment for patients with BRCA mutations. 
 
Researchers are already planning to test the new drug class in upcoming clinical trials. If the trials are successful, POLQ inhibitors could enter the clinic as a new approach to treating a range of cancers with BRCA mutations, such as breast, ovarian, pancreatic and prostate cancer.
 
Scientists at The Institute of Cancer Research, London, and the pharmaceutical company Artios, explored the potential of using POLQ inhibitors in treating cancer cells with defects in the BRCA genes. 
 
Their study, published in Nature Communications, was funded by Artios, Cancer Research UK and Breast Cancer Now.
 
For some time now, scientists have known that genetically removing a protein known as POLQ killed cells with BRCA gene defects, although drugs that prevent POLQ from working had not been identified. In this new work, the researchers identified prototype drugs that not only stop POLQ from working, but which also kill cancer cells with BRCA gene mutations. 
 
Both BRCA genes and POLQ are involved in repairing DNA. Cancer cells can survive without one or other of them, but if both are blocked or their genes switched off, cancer cells can no longer repair their DNA and they die. 
 
Researchers found that when cells were treated with POLQ inhibitors, cancer cells with BRCA gene mutations were stripped of their ability to repair their DNA and died, but normal cells did not. By killing cancer cells with BRCA gene mutations, while leaving normal cells unharmed, POLQ inhibitors could offer a treatment for cancer with relatively few side effects.
 
Researchers also found that POLQ inhibitors work very well when used together in combination with PARP inhibitors. 
 
The addition of POLQ inhibitors meant that PARP inhibitors were effective when used at a lower dose. And in laboratory tests in rats and in organoids – three-dimensional mini-tumours grown in the lab – POLQ inhibitors were able to shrink BRCA-mutant cancers that had stopped responding to PARP inhibitors because of a defect in a set of genes known as the ‘Shieldins’. 
 
This suggests that POLQ inhibitors could offer an alternative treatment where PARP inhibitors are no longer working. Researchers believe that using a POLQ inhibitor in combination with a PARP inhibitor in patients with cancers that have faulty BRCA genes could prevent resistance from emerging in the first place. 
 
Scientists at The Institute of Cancer Research (ICR), funded by Breast Cancer Now and Cancer Research UK, discovered how to genetically target PARP inhibitors against BRCA-mutant cancers and, with colleagues at The Royal Marsden NHS Foundation Trust, helped run clinical trials leading to the first PARP inhibitor being approved for use.
 
The next step will now be to test POLQ inhibitors in clinical trials led by Artios.
 
Study co-leader, Professor Chris Lord, Professor of Cancer Genomics at The Institute of Cancer Research, London, and Deputy Director of the Breast Cancer Now Toby Robins Research Centre at the ICR, said: “All cells have to be able to repair damage to their DNA to stay healthy – otherwise mutations build up and eventually kill them. We have identified a new class of precision medicine that strips cancers of their ability to repair their DNA. This new type of treatment has the potential to be effective against cancers which already have weaknesses in their ability to repair their DNA, through defects in their BRCA genes. And excitingly, the new drugs also seem to work against cancer cells that have stopped responding to an existing treatment called PARP inhibitors – potentially opening up a new way of overcoming drug resistance. I’m very keen to see how they perform in clinical trials.”
 
Professor Paul Workman, Chief Executive of The Institute of Cancer Research, London, said: “It’s exciting that the new POLQ inhibitors should provide a different approach to treating cancers with BRCA gene defects – and particularly that this class of drugs should retain their activity in cancers that have developed resistance to PARP inhibitors. Most exciting of all is the potential of combining POLQ and PARP inhibitor drugs to prevent the evolution of BRCA-mutant cancers into more aggressive, drug-resistant forms – a major challenge that we see in the clinic.”
 
Study Co-Leader, Dr Graeme Smith, Chief Scientific Officer at Artios Pharma, Cambridge, said: “These exciting preclinical results provide a clear rationale for future clinical studies with a POLQ inhibitor. At Artios, we are on track to initiate our POLQ clinical programme before the year end to explore POLQ inhibition in the sensitive cancer types that this study has uncovered. Our planned POLQ inhibitor clinical studies will leverage these results, exploring combination treatment with PARP inhibitors and different types of DNA damaging agents.” 

Citation
Zatreanu D et al. Polθ inhibitors elicit BRCA-gene synthetic lethality and target PARP inhibitor resistance. Nat Commun 2021;12:3636
 

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