Predicting Immunotherapy Response

A paper published Jan. 14 in Nature Genetics​ finds that a measure called tumor mutational burden (TMB) predicts immunotherapy response across a variety of cancer types. TMB is defined as the rate of mutations in the DNA of a tumor. Researchers analyzed the tumor DNA of 1,662 cancer patients who received treatment with an immune checkpoint inhibitor. After following the patients for a median 19 months, the researchers found that across most tumor types, relatively high TMB is associated with improved overall survival. One obstacle to using TMB as a biomarker in clinical practice is that different cutoffs defining high TMB may need to be established for different cancer types.

Chemotherapy Goes Digital

The company Proteus Digital Health has reported testing for the first time of a digital oncology drug. Proteus makes sensors that can track when patients take pills and transmit that data to a web portal, STAT​ explains. A health system in Minnesota is trying out giving the chemotherapy drug Xeloda (capecitabine) to patients with stage III or IV colorectal cancer along with the sensor. Xeloda is particularly hard to take correctly, says STAT, because patients must take “six to eight pills each day, with two weeks on and one week off, to complete one of eight cycles of chemotherapy.” The incorporation of the sensor allows both patients and their doctors to monitor whether they are taking all their pills at the right time. Brenda Jans Darling is one of the patients involved in the pilot program, according to The Washington Post, and she says she appreciates that she gets a notification when she misses taking her medication. “I’ll be having breakfast and one kid needs a permission slip signed and the other one needs something else and—while all that’s going on—I’m trying to make sure I took the right number of pills at the right time of day,” Darling told The Washington Post. “Life happens, right, and it can be tough to keep track of everything.”

Metastatic Breast Cancer Risk After Childbirth

Women diagnosed with stage I or II breast cancer within 10 years of giving birth are at increased risk of developing metastatic cancer compared to young women diagnosed with breast cancer who have not given birth, according to a study published Jan. 11 in JAMA Network Open. This holds true regardless of hormone receptor status, the researchers found. However, for women diagnosed within 15 years after childbirth, risk of metastasis was only elevated if the cancer was hormone receptor-positive. “These findings highlight the need to understand that postpartum breast cancer may represent a unique subtype of cancer that requires distinct care,” said study co-au​thor Virginia Borges of the University of Colorado Cancer Center in a press release​.

A New Treatment for Liver Cancer

The U.S. Food and Drug Administration on Jan. 14 approved Cabometyx (cabozantinib) for patients with liver cancer who have previously been treated with Nexavar (sorafenib). The drug was previously also approved for kidney cancer, and a version of the drug sold as Cometriq was approved for thyroid cancer. The drug inhibits the growth of blood vessels that feed tumors.​