From the many health news stories that we have followed over the last 12 months (and several that we didn't), here are some of the positive health studies that have helped to advance medical knowledge this year.
Blood tests are being developed to detect breast cancer
A team of scientists have found that a blood test could help detect breast cancer up to five years before clinical signs appear. The scientists from the University of Nottingham, presented their findings at the 2019 NCRI Cancer Conference. A pilot study found that tumour-associated antibodies could be detected in the body and are good indicators of whether a patient might be developing breast cancer. The scientists compared blood samples from patients at the time of diagnosis and compared them to blood samples from patients who did not have the disease. They used technology to rapidly screen the samples for the presence of auto-antibodies, 40 of which were linked to breast cancer, and 27 of which were not known to be linked with the disease.
The tests were able to find the presence of cancer, or not, in a statistically significant number of the samples tested, both in those patients with diagnosed cancer and those who had not. The scientists are continuing to use the tests with more samples and expect the accuracy of the test to improve with the higher numbers of samples tested.
A similar test is being studied in Scotland, which detects lung cancer. Around 12,000 people in Scotland have been put into two randomised groups: one will receive an auto-antibody blood test looking for antibodies associated with lung cancer, while others will not. Patients who receive a positive auto-antibody test will then be followed up with a CT scan every two years to help detect lung cancer earlier and improve their chances of successful treatment.
Further studies are also taking place to find blood tests to detect pancreatic, colorectal and liver cancer.
Alfattani, D., NCRI Cancer Conference abstracts: Clinical Utility of Autoantibodies in Early Detection of Breast Cancer, Silent Theatre session, CEAC group
Cancer Treatment enables over 50% of people to live five years or more after diagnosis of deadliest Skin Cancer
This is an older news story - but the results continue to prove the study. Scientists have found that by combining two immunotherapy drugs, they can extend the lives of patients with melanistic melanoma. The scientists presented the findings at the European Society for Medical Oncology and published them in the New England Journal of Medicine. Melanoma is an aggressive form of the disease, which becomes more aggressive, the later it is caught and survival rates fall - only 1 in 20 patients would survive 5 years after diagnosis.
By using immunotherapy, which uses the body’s own defence system to target the cancer, scientists have found that they can extend the life of patients who would have previously died from the disease. One group of patients were put on one of the drugs, another group was on the other. A third group received both and 52% survived five years or more. Not all patients have been ‘cured’, for some, the tumour has shrunk and not grown any more, for others, their disease is in complete remission with no signs of tumours.
The decision to approve the drugs for use with melanoma, was one of the fastest for the NHS and the drugs are now available for patients to use. Some of patients were unable to finish the treatment due to side effects, but they still benefitted from using the treatment. The scientists hope that their findings can be used to help develop further treatments for cancer.
Ribas, A., et al., Association of Pembrolizumab with Tumor Response and Survival Among Patients with Advanced Melanoma, JAMA, 2016; 315(15): 1600-1609
A 15 year old girl who had lifelong cystic fibrosis, was able to benefit from the use of a three-phage cocktail after undergoing a double lung transplant in 2019. Her doctors applied to a specialist facility in the United States that stored the phages, and steps were taken to identify the most effective treatment for her case. The girl underwent the treatment via intravenous infusion and was able to tolerate the treatment.
Bacteriophages have long been suggested as a treatment for bacterial infection. They are a type of natural virus which infects bacteria, ignoring human body cells. The discovery of antibiotics meant that phage research was put on hold, as antibiotics could be used to treat a number of bacterial infections, while in order for phage-therapy to work, the right combination must be found, which takes time. However with the danger of antibiotic resistance rising, attention is returning once again to the use of phages.
The disadvantage of this study is that it involves just one person, and while it was able to improve her condition - healing long-standing wounds and skin lesions - she is not yet cured of the disease - it is just dormant. Research is underway to find the right mix of drugs to halt the infection permanently. Further trials would be needed in order to introduce the use of bacteriophages to more widestream medicine.
Spencer, H., Hatfull, G.F., et al., Engineered bacteriophages for treatment of a patient with a disseminated drug-resistant Mycobacterium abscessus, Nature Medicine 25, 730-733 (2019)