A new National Cancer Director has addressed delegates at a critical London conference focused on the deadly condition.
Cally Palmer CBE was recently named the new Director of the critical cancer organisation, and the NHS chief executive outlined her plans for the future of the NHS in this area at the Britain Against Cancer conference.
The conference was hosted by the All Party Parliamentary Group on Cancer, with attendees including Palmer striking an optimistic note on the future of treating cancer.
Indeed, Palmer suggested that a realistic prospect for national cancer policy was for Britain to achieve the best cancer care of any nation on the planet.
The All Party Parliamentary Group on Cancer is an annual event, notable for a keynote speech made by the Secretary of State.
Indeed, Jerry Hunt was in attendance for this event, and spoke to assembled delegates on the subject of cancer care.
Also in attendance at one of the world’s most significant cancer conferences was NHS England’s National Clinical Director for Cancer Professor Sean Duffy.
Palmer is currently employed as Chief Executive of the Royal Marsden Hospital NHS Foundation Trust.
She joined NHS England as National Cancer Director in November.
Speaking at the conference, Palmer was effusive in her praise for the vision that has been outlined by the Independent Cancer Taskforce.
She also took the time to explain how she will play a critical role in assisting the implementation of the recommendations made by the report of the task force.
“Back in September NHS England announced a new ‘Cancer Vanguard’: three sites which will come together to trial new ideas and approaches to the commissioning and provision of cancer services, including testing capitated budgets from April 2017. We expect this to begin to teach us about what works and what doesn’t almost immediately,” Palmer stated.
Palmer also made it clear that as part of her new position she had made a significant decision related to Cancer Alliances.
The report had suggested that these organisations could make a serious contribution to the fight against cancer in the UK.
“In response to the recommendation by the Taskforce report, we’re also establishing Cancer Alliances across the country from April next year, which will be the cornerstone of delivering changes at a local level.”
Miss Palmer announced a new Cancer Transformation Board to lead the rollout of the other recommendations of the Taskforce report, and a Cancer Advisory Group, chaired by Harpal Kumar, Chief Executive of Cancer Research UK, to oversee and scrutinise their work.
Finally, Palmer also presented information related to the new cancer dashboard; a prototype technology that will enable the measurement of progress related to cancer patients.
“From April 2016 every CCG will be able to see their own data in this format and will be able to benchmark themselves against other CCGs. This was the first of the 96 recommendations that the Taskforce gave us, and we have made it a priority. We all need to be clear what we’re working towards, and a unified set of measures is fundamental to this,” Palmer explained.
The cancer dashboard will play a major role in UK cancer treatment going forward, with a particular focus on incidents, survival rates, patient experience and quality of life for cancer sufferers.
There are over 160,000 UK deaths from cancer every year.
AstraZeneca, the UK pharmaceuticals group, has won a significant legal victory related to one of its ovarian cancer drugs.
However, in the process of the legal proceedings, AstraZeneca promised to cut the price of the drugs and fund some treatment costs going forward.
The concessions made by AstraZeneca are indicative of the financial pressures that drug manufacturers in the UK are facing.
This agreement can be placed in the context of the mounting fiscal pressure on the health system as a whole.
The National Institute for Health and Care Excellence (NICE) indicated that it was prepared to recommend olaparib — also known by its trade name Lynparza — for use by NHS England.
This was a reversal of a decision made in June to reject the drug for distribution in the United Kingdom.
However, with the authorities cautious about the consequences of the verdict, the recommendation was made with restrictions put in place as well.
These will provide guidelines with regard to which patients shall be eligible to take the ovarian cancer drug.
The verdict coincided with a separate decision to reject a push by Johnson & Johnson, the US drugmaker, to win wider access for NHS patients to a heavily promoted prostate cancer drug called abiraterone.
Both of the drugs were developed in the United Kingdom, and AstraZeneca has suggested that the legal battle the company has face is indicative of the barriers preventing homegrown innovation in the pharmaceutical field.
However, critics of the pharmaceutical industry suggest that big pharma manufacturers only have themselves to blame for the high prices that have lead to legal restrictions.
In final draft guidance, NICE recommended use of olaparib only after three or more courses of chemotherapy.
There was also an additional condition that AstraZeneca would be responsible for footing the bill for patients who remained on the drug for a period in excess of 15 months.
Lisa Anson, head of AstrAstraZenecaeneca in the UK, agreed with the ruling, but also suggested that patients in the NHS are losing out on vital treatment owing to overly restrictive conditions.
“Despite being a world leader in the discovery and development of groundbreaking medicines, the UK has the worst overall cancer outcomes in western Europe.”
It was he pointed out that Anson obviously has a vested interest in this issue.
Johnson & Johnson indicated that it was extremely disappointed by NICE’s decision not to recommend use of abiraterone.
There were 4,271 deaths from ovarian cancer in 2012 in the UK.
A new study in the Lancet suggests that Britain is getting a good deal with regard to cancer drugs.
Research conducted by the authoritative journal indicates that the UK is paying significantly less for cancer drugs than many other wealthy nations.
While the UK, Greece, Spain and Portugal pay the least, on average, for the drugs that they utilise, Germany, Sweden and Switzerland pay the most.
The authors of the report stated that the process of purchasing cancer drugs en masse should be more transparent, owing to the fact that numerous nations apparently risk overpaying for critical drugs.
Considering the importance of the cancer treatments, this is clearly an urgent issue.
Nonetheless, it is at least good news for the British health industry that the UK is currently getting a good deal on medicines.
According to the report, drugs had accounted for nearly a third of the EU’s 51 billion euro (£37bn) cancer healthcare spending in 2009.
In order to get an accurate representation of the Western market, researchers assessed the pricing of 31 cancer drugs across 18 high-income countries in the Western world.
These included in the UK, Australia, New Zealand, France, Greece, Switzerland, Sweden and Portugal.
While cancer remains one of the biggest killers in the United Kingdom, the incidence of the disease also indicates its importance.
338,623 people in the UK were diagnosed with cancer in 2012.
Cancers of the breast, lung, prostate and bowel account for over half (53%) of all new cancer cases in the UK in 2012.
The Lancet found that prices of drugs in Switzerland, Germany and Sweden were frequently the highest – and for some drugs, such as interferon alfa 2b to treat leukaemia and skin cancer, the prices were twice as high.
It appears that at least patients and consumers in the UK are getting a reasonable deal on this key aspect of medicine.
Sabine Vogler, report author and researcher at the Austrian Public Health Institute, indicated that the system of discounts which operates at present led to the risk of some countries ovepaying for medicine.
“The discounts should be open to everyone, but industry doesn’t want to do it. However, it would allow some countries to see that they are overpaying.”
David Watson, director of pricing and reimbursement at the Association of the British Pharmaceutical Industry, largely supported this view, but also indicated that the situation for the UK was favourable present.
Watson suggested that cancer medicines are currently “affordable in the UK”, and that the UK was “getting a fair deal with regards to medicines pricing,” while the NHS was “getting good value for money”.
AstraZeneca has just had a new lung cancer drug approved by US regulators, in what will be seen as a major coup for the British pharmaceutical manufacturer.
The drug in question is AZD9291, which will be ultimately go on sale under the brand name Tagrisso.
Notable for targeting the genetic mutation known as T790M, Tagrisso effectively usurps existing cancer medication which is unable to deal with this problem.
The drug is intended to specifically target advanced non-small-cell lung cancer; the most common form of lung cancer.
Having passed US regulatory measures, the drug will now be made available to patients in the United States as soon as possible.
Although pricing has yet to be publicised, AstraZeneca have stated that they will reveal the price early this week.
It was stated by a spokeswoman that the pricing will ultimately be comparable to existing cancer treatments.
Lung cancer is the leading cause of cancer death among men and women, accounting for one-third of cancer deaths, more than breast, prostate and colorectal cancers combined.
So this drug breakthrough could be excellent news for cancer sufferers all over the world.
This latest treatment has been developed in Cheshire, and is one of several drugs that AstraZeneca is currently developing.
The company has recently been targeted by American rival Pfizer, the maker of Viagra, but AstraZeneca chief executive Pascal Soriot has cited this drug and other products in a defence against this prospect.
AstraZeneca estimates that Tagrisso could bring in sales of $3bn (£2bn) annually, which is greatly needed by the corporation considering that sales of older drugs are diminishing, and therefore losing patient protection.
The move by AstraZeneca is indicative of a scramble of drug companies to enter the immunotherapy market.
Experts believe that immunotherapy could eventually be worth in the region of £26 billion annually in sales.
Thus, Tagrisso could be an extremely valuable commodity for AstraZeneca, particularly as the drug performed so admirably in trials.
According to Richard Pazdur of the FDA’s centre for drug evaluation and research, the Tagrisso tablet had a “significant effect on reducing tumour size in over half of patients who were treated.”
The approval of the drug is a step in the right direction for AstraZeneca, with the company continuing its odyssey of creating and marketing six new cancer treatments to patients by the end of the decade.
This latest decision follows the previous launch of Lynparza for ovarian cancer in the US.
Tagrisso was first tested on humans just 30 months ago.
It had received breakthrough status in the US and has also received accelerated assessment in the EU following its filing in the summer, as well as priority review in Japan.
A study carried out at the Institute of Cancer Research in London may have led to a major drug breakthrough.
It is hoped that the research has produced a drug that targets precise genetic mutations in prostate cancer.
This is the first such pharmaceutical product of its type.
The product of the study, Olaparib, had low overall success, but slowed tumour growth in 88 per cent of patients with specific DNA mutations.
Cancer Research UK has already commented on the trial, stating that the results are exciting.
Prostate cancer is the fifth highest killer among cancers in men.
As cancer medicine continues to develop, treating the condition via mutated DNA is becoming a state-of-the-art technology.
One such drug, Herceptin, has already been produced to address breast cancer.
Results from the trial have been published in the New England Journal of Medicine, which indicated that the new product was effective on 14 of 16 men with such mutations.
Levels of the prostate-specific antigen which is produced by tumours was more than halved.
The study also indicated that there was a significant reduction in the number of prostate cancer cells detected in the blood and in the size of secondary tumours.
Overall, the research indicates that this new drug could be successful in treating prostate cancer.
Dr Joaquin Mateo, one of the researchers involved in the study, was optimistic about the prospects of the drug.
“It is very promising. Those entering the trial had an expected survival of 10 to 12 months and we have many patients on the drug for longer than a year.”
Yet despite the positive news, analysts remain cautious about the prospects of this new research.
In particular, a much more extensive clinical trial will be required before doctors can determine confidently whether or not be trouble truly extend life expectancy.
Nonetheless, Dr Mateo believes that the drug produced in the trial could be the first of many available on the market. “This is the first drug that targets specific genetically defined populations and we are going to see more and more of these coming in the next few years.”
Commenting on the outcome of this particular trial, Cancer Research UK’s Dr Aine McCarthy added:“This trial is exciting because it could offer a new way to treat prostate cancer by targeting genetic mistakes in cancers that have spread. The hope is that this approach could help save many more lives in the future.”
There are over 10,000 deaths from prostate cancer every year in the UK.
In a major cancer breakthrough, scientists have discovered a molecular mechanism that allows tumours to develop resistance to chemotherapy.
This research has been reported in the journal Cancer Cell, with scientists from the Massachusetts Institute of Technology (MIT) in Cambridge having documented the process.
The new discovery will act as a backup when a specific gene called p53 is missing. This gene usually helps healthy cells prevent mutations.
Backing up the system usually is a pathway called MK2, which allows cells with damaged DNA to repair themselves.
The study ultimately found that a measure of the MK2 pathway performed excellently in terms of predicting which patients responded to chemotherapy.
In the absence of p53, cell division continues during chemotherapy, ensuring that cancer cells continue to proliferate after the process has be completed.
Michael Yaffe, a professor of biology and biological engineering, elaborated on the process:
“I would argue that this particular RNA-binding protein is really what makes tumor cells resistant to being killed by chemotherapy when p53 is not around.”
Prof. Yaffe and colleagues discovered that when p53 is missing – as it is in about half of all tumours – the MK2 pathway takes over.
They thus suggest that targeting the backup system could make p53-deficient tumour considerably more susceptible to chemotherapy.
Yaffe states that researchers discovered that the MK2 pathway does not take over all of p53’s function, only part of it:
“It only rescues the bad parts of p53’s function, but it doesn’t rescue the part of p53’s function that you would want, which is killing the tumour cells.”
The researchers found that measuring levels of the mRNA for Gadd45 and p27 could also help predict which patients are likely to respond to chemotherapy.
In a trial of patients with stage 2 lung cancers, it was demonstrated that those with high levels of mRNA for Gadd45 and p27 did not respond as well to chemotherapy as patients who had low levels of both.
Prof. Yaffee indicates that this measure could be utilised as a surrogate for the presence or absence of the pathway and concludes:
“In this trial, it was very good at predicting which patients responded to chemotherapy and which patients didn’t.”
The study shows that cancer cells have molecular mechanisms that help them maintain their integrity and survive.
It is hoped that this research will lead to a greater understanding of cancer in the continuing battle against the debilitating condition.
There are over 160,000 deaths from cancer every year in the UK alone.
A controversial ruling by the World Health Organisation states that pork products such as bacon, ham and sausages could pose as big a cancer threat as cigarettes.
In accordance with the verdict, the World Health Organisation will publish a report on Monday outlining the dangers of consuming processed meats.
Central to this contentious report will be the suggestion that meat products such as bacon, ham and sausages should be considered carcinogenic.
As part of this ruling, the World Health Organisation’s International Agency for Research on Cancer will classify processed meat as “carcinogenic to humans”.
This is the highest of five possible rankings that the products could be classified as, and effectively puts them on par with alcohol, asbestos, arsenic and cigarettes.
The new classification of these products follows on from previous reportage from the World Cancer Research Fund (WCRF).
For several years, WCRF has stated that there is significant evidence linking red meat with bowel cancer in particular.
It also believes that processed meats in even small quantities increase the risk of contracting cancer.
Although the reasons behind this are not fully understood, one possible explanation for this phenomenon is related to haem.
This compound provides red meat with its colouring, and it is thought by many researchers that it may play a role in damaging the lining of the bowel.
It is also believed that meats preserved by smoking, curing or salting, or by adding preservatives, can result in cancer-causing substances being formed.
The dangers of red meat can also be activated to other diet-related elements.
It has been particularly noted that large consumers of red meat tend to eat fewer plants-based foods that protect against cancer.
The WCRF advises that people can reduce their bowel cancer risk by eating no more than 500g per week of red meat, such as beef, pork and lamb.
It also believes that people should consume processed meats such as ham, bacon and salami as little as possible.
Red meat consumption has multiplied by several fold in many nations in the 20th century and early years of the 21st century, due to several factors.
Among these, the production of meat has become more affordable, and the level of disposable income has generally increased worldwide.
Additionally, farming subsidies have typically been provided for meat-producing agriculture, thus exacerbating the problem.
The average person in the UK consumes approximately 60g of meat every day, but 33 per cent have more than 100g per day.
This suggests that one-in-three UK individuals could be at risk of a heightened incidence of cancer risk based on diet and meat consumption alone.
However, the verdict of the World Health Organisation has not been welcomed in all quarters.
Aside from the fact that people with a vested interest in selling meat have naturally been critical of the verdict, other health campaigners do not necessarily agree with bracketing red meat with cigarettes in particular.
The Care Quality Commission has released a statement regarding issues related to Royal Wolverhampton Hospital.
This institution has recently been the subject of media headlines, following a historical case that plagued the Midlands hospital.
Between 2005 and 2010, numerous patients were given inappropriate chemotherapy treatments, not recommended by the national guidelines of the time.
This was not investigated for several years, until the Care Quality Commission was first alerted to concerns related to the Wolverhampton hospital back in September 2013.
At this time, a comprehensive inspection of the trust was carried out, and it became clear that chemotherapy treatment had not been administered appropriately.
After a lengthy investigation, the Care Quality Commission referenced the chemotherapy treatment at Royal Wolverhampton Hospital in its most recent report.
This was published back in September 2015, at which time the Care Quality Commission rated the trust as requiring improvement.
Following on from this assessment, Professor Sir Mike Richards, Chief Inspector of Hospitals at the Care Quality Commission, has been commenting on the ongoing issue, and the existing situation at the Wolverhampton hospital.
Richards firstly noted the history of this particular complaint.
“We were informed that an internal investigation had been conducted in 2009. This showed that a number of patients had received treatment for their cancer which was not recommended in national guidelines. We were also informed that this non-standard practice had ceased by 2009.
“In 2014, the trust commissioned a further external investigation by two leading oncologists. This concluded that there had been unsatisfactory practice but that with one exception this had resulted in no long-term harm. This review also looked at a more recent group of patients and confirmed that the unsatisfactory practice had ceased.”
Richards followed up by updating healthcare professionals on the action that has taken place during 2015.
“We inspected the trust again in June 2015. Our inspection team included a senior cancer specialist to enable us to look specifically at the trust’s current chemotherapy service. The conclusion of this inspection matched that of the previous reviews. We found that changes had been made and that the trust was providing a safe chemotherapy service. We have had several conversations with a whistleblower about these issues.
“Our report was published in September 2015 with a reference to the whistleblower. It concludes that the trust has acted properly to concerns raised and taken steps to learn from the incident.”
Richards concludes by correcting errors in the published Care Quality Commission report.
“However, although our report went through a factual accuracy check, unfortunately there was a typographical error in it, which should have stated that the care the patients received was ‘not in line with practice at the time’. This has since been corrected.
“Making sure that patients get safe, high-quality and compassionate care continues to be our priority. If we receive information to suggest that patients are not being cared for appropriately then we will not hesitate to take action.”
As a result of the inappropriate conduct at the hospital, fifty-five cancer patients at New Cross Hospital were given extra chemotherapy treatment they did not need in a scandal revealed by an NHS whistleblower.
Two recent academic studies give valuable insight into diet that could have a significant impact on the obesity epidemic.
The first of the two studies was conducted at Cambridge University, and indicated that portion size and human perception could be having a significant impact on our collective weight.
Researchers from the esteemed university found that offering super-sized portions or serving food on a larger plate led to participants in the study eating significantly more.
Even those who were conscientious about the amount that they ate were susceptible to consume large amounts when bigger portions were offered, according to the Cambridge-authored research.
The conclusions from the Cambridge researchers would seem to be logical, considering the amount of time that it takes for the hypothalamus to register the fact that we no longer require food.
Research from Cambridge suggested that if the general public was exposed to smaller portions across all aspects of diet, it would be possible to cut food consumption by 16 per cent.
This would amount to approximately 1,900 calories per week, which would mean a potential loss in weight of a pound every fortnight.
Dr Gareth Hollands, of Cambridge’s Behaviour and Health Research Unit, who co-led the study, suggested that the results indicate that overeating may not merely be due to a lack of self-control.
“Helping people to avoid ‘overserving’ themselves or others with larger portions of food or drink by reducing their size, availability and appeal in shops, restaurants and in the home, is likely to be a good way of helping lots of people to reduce their risk of overeating,” Hollands stated.
Dr Alison Tedstone, chief nutritionist at Public Health England, commented that it is important for people to keep a keen eye on portion size considering the rather worrying statistics related to obesity.
“Given that almost two-thirds of adults are overweight or obese, it’s important to keep an eye on portion sizes when cooking, shopping and eating out to avoid overeating and help maintain a healthy weight,” Dr. Tedstone asserted.
The findings from the Cambridge study were published in the Cochrane Database of Systematic Reviews.
Additionally, a study assessing the so-called Mediterranean diet concluded that it has the potential to reduce the risk of breast cancer by two-thirds.
The Mediterranean diet is particularly characterised by olive oil, and is consumed by countries including Italy and Greece.
It also involves swapping butter for oils, and producing meat intake in favour of more fish. Increased proportions of fruit and vegetables are also central to this diet.
Researchers found that those who follow the Mediterranean diet had a 68% lower risk of malignant breast cancer than those who consumed a low-fat diet.
Commenting on the results, lead author, Miguel A Martínez-González, said: “The results of the trial suggest a beneficial effect of a Mediterranean diet supplemented with extra virgin olive oil in the primary prevention of breast cancer. Nevertheless, these results need confirmation by long-term studies with a higher number of incident cases.”
There were nearly 12,000 deaths from breast cancer in the UK in 2012.
The Association of the British Pharmaceutical Association (ABPI) has responded to the recent report of the National Audit Office (NAO) with regard to this investigation into the Cancer Drugs Fund.
In its final report on the subject, the NAO concluded that there are major problems with regard to the fund in the immediate future.
It was asserted by the NAO that unless significant measures were taken to improve the funding of the Cancer Drugs Fund, numerous medicines would need to be removed from the list permanently.
Speaking about the assertions of the National Audit Office, Dr Richard Torbett, Executive Director, Commercial at the Association of the British Pharmaceutical Association, acknowledged that the audit office report should be considered an important document.
“We welcome this report which sheds an important light on the impact and the sustainability of the Cancer Drugs Fund and we are pleased to have had the opportunity to contribute our views,” Torbett stated.
Torbett also acknowledged that the situation in the United Kingdom with regard to cancer drugs is less than ideal.
“Whilst the Cancer Drugs Fund improved patient access to cancer medicines that are not routinely available on the NHS, the report makes clear that the use of new cancer drugs in the UK still remains below the average in other comparable countries. We remain adamant that this needs to change,” Torbett asserted.
Far from being in disagreement with the National Audit Office report, Torbett in fact acknowledge that legitimacy of conclusions made by the organisation.
“We want to see many more patients benefitting from new and innovative medicines, including cancer medicines, and we have long voiced the view that the Cancer Drugs Fund is not sustainable in its current form, as the NAO report highlights,” Torbett conceded.
Although there are clearly significant organisational, structural and financial problems faced by the fund in the medium-to-long-term, Torbett also suggested a potential resolution to the existing situation that could assist cancer patients across the United Kingdom.
“What is needed is a wholesale reform of NICE, which, along with NHS England, needs to develop a longer-term sustainable solution to the evaluation and commissioning of cancer medicines. We therefore look forward to the upcoming consultation on the Cancer Drugs Fund and remain committed to working with all parties to achieve a more joined-up system which allows many more NHS patients to benefit from life-enhancing medicines,” Torbett espoused.
It was reported in May 2015 that the total global spending on cancer drugs exceeded $100 billion in 2014.
The National Audit Office (NAO) has documented the failure of the NHS to collect appropriate data on the cancer treatment outcome of a large raft of NHS patients related to the Cancer Drugs Fund.
In total, the National Health Service provided drugs to 74,000 cancer patients of whom the medicines regulator has no idea whether or not their lives were extended, according to the NAO.
This naturally indicates significant negligence on the behalf of the NHS, but also renders the statistical data related to cancer considerably less accurate.
According to Meg Hillier, chair of the public accounts committee, the failure to collect this wide variety of data simply makes no sense.
Furthermore, Hillier, who is a Labour MP, indicated that the oversight ensured that it is impossible to judge if the fund has indeed succeeded in extending the survival of patients, due to the gap in data.
In total, the NHS has funded in the region of £1 billion, providing cancer drugs for these 74,000 patients.
And in a report on the matter, the NAO was strongly critical of the NHS and Department of Health’s failure to collate adequate data.
The NAO describes the failure to collect information on the outcomes experienced by patients helped by the Cancer Drugs Fund as a major weakness of NHS operations.
In addition, an investigation by the public spending watchdog found that budgets for other NHS services have suffered as a result of spending on the fund.
The Cancer Drugs Fund attracts an annual budget of £416 million, since being set up by the coalition government back in 2010.
A plus point is that the fund has significantly improved access to 40 cancer drugs that are not usually readily available on the NHS.
This could enhance cancer survival rates regardless of the poor collection of data, with most recipients involved with Cancer Drug Fund requisition suffering from a terminal form of the disease.
Another notable success of the fund is that it underspent on its budget by 20 per cent overall.
However, this trend is unlikely to continue, as it is noted that spending has significantly increased in the last fiscal year.
Thus, the fund is anticipated to spend in the region of £70 million in 2015-16, according to NAO data.
“Taking 2013-14 and 2014-15 together, NHS England overspent the allocated budget for the fund by 35%. The overspend meant that less money was available for other services,” the NAO’s report on the fund states,
Commenting on the fund, the aforementioned Hillier indicated that a rethink was necessary owing to funding difficulties.
“At a time of increased pressures on NHS funding, the cancer drugs fund is not sustainable in its current form. There needs to be much better control of costs and proper assessment of whether these drugs are making a difference to the health of patients,” Hillier observed.
NHS England has already been forced to remove 28 drugs from the list of approved medicines that the fund is willing to pay for.
Cancer charities have warned that the withdrawals would mean the death of some patients awaiting medication, but NHS England has argued that inflated cost makes this decision inevitable.