'Life-changing': Revolutionary new HIV drug approved for use in the UK

 A revolutionary HIV drug that reduces the need for a daily cocktail of drugs to half a dozen injections a year has just been approved in the UK.

By Euronews  with AP  •  Updated: 19/11/2021

For those suffering from the disease, the news of a long-acting treatment is "extraordinary" and "life-changing".

The injectable treatment is a combination of cabotegravir (also called vocabria) with rilpivirine (also called r_ekambys_) and is as effective as oral antiretrovirals at maintaining a low viral load in clinical trials, according to the National Institute for Health and Care Excellence (NICE).

Cabotegravir is the result of the FLAIR trial run by Professor Chloe Orkin at Queen Mary University of London. The results were first published in March 2019.

Now more than two years later, its supply has been scaled up and the drug is being made available freely to HIV patients throughout the UK.

• Argentine woman may be second person to naturally recover from HIV

Charities have welcomed the move as it offers an alternative to taking daily antiretroviral drugs to suppress the virus.

An estimated 13,000 people will be eligible for the new treatment via the NHS.

The treatment is already being used in parts of Europe, the US, and Canada, with scientists saying it is highly effective.

Original Source

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‘Great step forward’ for HIV treatment as long-acting jabs to replace daily pills

Charities hail ‘incredible’ news as injectable treatment to be offered to 13,000 people on NHS

Ella Pickover   19 Nov 2021

A new injectable HIV treatment could replace daily pills

(Getty Images)

The NHS has been given the green light to offer people living with HIV the first "long-acting injectable" to keep the virus at bay.

Charities have hailed the "incredible news" which offers an alternative to adults living with HIV who have to take daily antiretroviral drugs.

Many people living with HIV can keep the virus at very low levels by taking antiretroviral tablets each day.

These drugs keep the number of virus particles in the blood - also known as the viral load - so low that it cannot be detected or transmitted between people.

But now an estimated 13,000 people will be eligible for the injectable treatment in England which means they no longer need daily treatment but will have two injections every two months.

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This means they can reduce the days they receive treatment from 365 to six per year.

The National Institute for Health and Care Excellence said that cabotegravir (also called vocabria and made by Viiv Healthcare) with rilpivirine (also called Rekambys and made by Janssen) can be offered to adults who have managed to keep HIV viral load to a low level through daily antiretroviral medicines.

Clinical trial results show that cabotegravir with rilpivirine is as effective as oral antiretrovirals at maintaining a low viral load, Nice said.

Meindert Boysen, deputy chief executive Nice, said: "Despite scientific advances HIV is still incurable, but the virus can be controlled by modern treatment.

"However, for some people, having to take daily multi-tablet regimens can be difficult because of drug-related side effects, toxicity, and other psychosocial issues such as stigma or changes in lifestyle.

"We're pleased therefore to be able to recommend cabotegravir with rilpivirine as a valuable treatment option for people who already have good levels of adherence to daily tablets, but who might prefer an injectable regimen with less frequent dosing."

Commenting on the news, Debbie Laycock, head of policy at Terrence Higgins Trust, said: "It's incredible news for people living with HIV in England and Wales that they will be able to access the first long-acting injectable treatment on the NHS as an additional treatment option.

"We have incredibly effective treatment which means HIV is now a manageable virus, however, it is lifelong so it is important that taking treatment is as easy as possible.

"HIV unfortunately remains a stigmatised condition. Although we're working hard to tackle the stigma surrounding HIV, this new injectable treatment option could help people in house-shares for example who do not wish to share their HIV status and will no longer have to worry about hiding their medication.

"Pill fatigue is also an issue for some people living with HIV who struggle with the idea of taking antiretroviral drugs every day.

"Long-acting injectable treatment is also a better option for those who have difficulty swallowing medication. Therefore, the institute's approval provides a welcome additional treatment option for people living with HIV across England and Wales.

'This is a great step forward as we work towards ending new cases of HIV by 2030. The institute's decision brings great potential for HIV prevention including long-lasting PrEP in the future."

Deborah Gold, chief executive of National Aids Trust, said the charity was "delighted" with the news, adding: "The voice of people living with HIV is clear: they want this technology available as part of a range of treatment options. It won't be right for everyone but, for some, monthly injections are highly preferable to daily pills.

"Innovations that can make it easier for people to stick to their treatment plans both improve the wellbeing of people living with HIV and bring us one step closer to the goal of ending transmissions by 2030."

Dr Jonathan Stoye, from the Francis Crick Institute, said: "Drug treatment of HIV-1 has been one of the great successes of modern medicine.

"While HIV-1 was once a virtual death sentence from Aids, combination therapy now allows an essentially normal life span.

"However, almost all treatments require taking medicines at least once a day. This is inconvenient and brings with it the risk of missing doses essential for virus control.

Original Source

Coronavirus vaccine protection waning ...

 Coronavirus vaccine protection waning in those first jabbed, study suggests

The protection provided by two doses of the Pfizer or AstraZeneca coronavirus vaccines begins to wane within six months, new research suggests.

Daniel Keane   22 hrs ago  Independent

© PA

The protection provided by two doses of the Pfizer or AstraZeneca coronavirus vaccines begins to wane within six months, new research suggests (Stock image)

In a reasonable “worst-case scenario”, protection could fall to below 50 per cent for the elderly and healthcare workers by winter, analysis from the Zoe COVID study found.

The Pfizer jab was 88 per cent effective at preventing Covid-19 infection a month after the second dose, but this fell to 74 per cent after five to six months - a drop of 14 percentage points in four months.

With the AstraZeneca vaccine, there was a protection against infection of 77 per cent one month after the second dose. This decreased to 67 per cent after four to five months, suggesting a fall of 10 percentage points over three months.

Pfizer’s mid-term efficacy trial observed an initial 96.2 per cent risk reduction in infection up to two months after the second dose. There was an 83.7 per cent reduction more than four months after the second dose, a 12.5 percentage point risk reduction.

The results of the study, which drew on more than 1.2 million test results and participants, will intensify calls for an Autumn booster vaccination campaign to help prevent a spike in cases and hospitalisations.

Other countries have already set out plans for booster campaigns. Earlier this month, the Biden administration announced that third inoculations will be available to most US adults from September.

Israel has already been administering booster shots for those aged over 50 following a surge in cases. Research conducted by the country’s health ministry also suggested the protection conferred by the Pfizer vaccine had begun to wane in the vulnerable population.

The vaccine rollout in the UK prioritised the elderly and vulnerable, beginning with care home residents and those aged over 80. As many will have received their jab over six months ago, the Zoe study suggests they are likely to be vulnerable to infection this Winter compared with those vaccinated more recently.

Real world analysis would be expected to show less protection than clinical trials, and the vaccines in the Zoe study were not trialled against the now dominant Delta variant of the virus.

Professor Tim Spector, lead scientist on the Zoe Covid Study app, said: “In my opinion, a reasonable worst-case scenario could see protection below 50% for the elderly and healthcare workers by winter.

“If high levels of infection in the UK, driven by loosened social restrictions and a highly transmissible variant, this scenario could mean increased hospitalisations and deaths.

“We urgently need to make plans for vaccine boosters, and based on vaccine resources, decide if a strategy to vaccinate children is sensible if our aim is to reduce deaths and hospital admissions. Waning protection is to be expected and is not a reason to not get vaccinated.

“Vaccines still provide high levels of protection for the majority of the population, especially against the Delta variant, so we still need as many people as possible to get fully vaccinated.”

Yesterday, the UK government signed a deal to get 35 million more doses of the Pfizer vaccine for the second half of next year, in a clear indication that ministers are preparing for regular ongoing booster programmes. The Joint Committee on Vaccination and Immunisation is expected to rule soon on a booster plan for the UK.

The Zoe Covid Study launched an app feature on December 11, 2020 to enable logging of Covid-19 vaccines and monitor real-world side-effects and effectiveness in its cohort of over a million active users.

It used data from vaccines which were logged from December 8 last year to July 3, 2021 and from infections which occurred between May 26 this year when the Delta variant became dominant, and July 31.

The results of the study have been adjusted to give an average risk of infection reduction across the population.

https://www.msn.com/en-gb/health/medical/coronavirus-vaccine-protection-waning-in-those-first-jabbed-study-suggests/ar-AANIxrN

Coronavirus fatigue is near – the public may eventually rebel against government restrictions

 President Trump’s illness may mean fewer infections for a while, but Britain has been here before and the popular mood is growing tired

3rd Oct 2020

One consequence of Donald Trump contracting coronavirus might be positive: a reduction in the coronavirus infection rate. I feel no great sense of schadenfreude about the president’s condition, by the way, because it is an appalling disease and, as the saying goes, you’d not wish it on your worst enemy. That includes Trump.

Yet there is a huge and beneficent irony that attaches to the blanket coverage since the news broke: more people will wear masks, practise social distancing, work from home, wash their hands and generally be more vigilant and realistic about this virus than they might otherwise be. The conspiracy theorists may even relax some of their unhelpful claims that Covid-19 is a just a hoax or something invented by Bill Gates/the Chinese/the Russians/lizard people. Having said that, though, the number of people suggesting – double irony – that Trump is now hoaxing his own diagnosis of a disease he once called a political hoax suggests that sanity is not about to break out across social media.

In any case, I bet quite a few of us have been reminding ourselves about going shopping or taking a train ride. We are reminded of the truly dangerous and insidious nature of this hidden enemy, and how it will attack anyone.

Yet the effect of this dramatic development may not be permanent. The shock will wear off, as it eventually did when Boris Johnson fell ill in the spring. It’s been six months now since the first national lockdown and we may well be heading for a second national exercise in time for Christmas. Even if there is no national lockdown, the various combined local lockdowns already constitute a considerable partial national lockdown, so that distinction is growing rather academic. 

London is on the watch list, millions of businesses are deprived of their trade, millions will lose their jobs and the liberties of millions are being withdrawn without so much as a parliamentary vote. We may well be saving millions of lives too, but the balance of argument and sentiment is inevitably shifting. The likes of Dominic Cummings and Margaret Ferrier haven’t done anything to strengthen public confidence in our national leaders.

Even in the summer, there were signs of patience wearing thin. Then came the Tory MPs, narrowly prevented from launching a rebellion over the emergency powers. This week we have the first evidence of local resistance edging towards defiant rejection.

Andy Burnham, mayor of Manchester and enjoying his political revival, went about as far as he could when he advised ministers to return-think the 10pm pub curfew. The mayor of Middlesbrough, Andy Preston, went further in opposing the new restrictions in his town: “I don’t accept the statement at all, I don’t accept the measures, we need to talk to government, they need to understand our expertise to get things done and preserve jobs and wellbeing”. In Leicester, which hardly came out of the first lockdown, the mayor, Peter Soulsby has cavilled at the extension of rules in his city and made similar complaints about lack of local consultation – a common refrain among municipal leaders.

In an age of populism, such shifts in opinion matter.

They will become even more important if people start to wilfully ignore fresh regulations because they’re bored with them, or they’re simply impractical, such as telling students not to go out. Like all laws, they can only be upheld and policed by consent, and, as we saw during civil disturbances earlier this year and in the (very different) riots in 2011, if a population decides to break the law there’s not much the authorities can do to restrain them. (In that context talk about military involvement, even just “backfilling”, and a heavier police presence on the streets is even more worrying).

What happens in the weeks ahead if the population of a great conurbation decides to follow the lead of a mayor and collectively defy the rules? What if the publicans and their customers all stay open until 11 or 12? Imagine, if you can, 10pm closing on Christmas Eve or New Year’s Eve. What if the council refuses to enforce rules, or advises the police to turn a blind eye? Does Priti Patel round them all up and send them to Ascension Island?

Maybe that’s a bit fanciful, though, I suspect there are elements of such light disobedience already establishing themselves among what Boris Johnson calls “freedom living people”.

More realistic is a gradual decline in observance of social distancing, mask-wearing and meeting indoors, coupled with an ever more determined parliamentary assault on the rules as the weeks grind on, with the locally locked down areas the first to rebel. 

President Trump’s illness gives us all pause for thought, but the popular mood is growing tired, and it is being felt and reflected in the Commons. The Tory rebels and opposition parties could easily throw the existing emergency powers out; but what would they put in their place? Ministers and their scientific advisers must be terrified about what the MPs might do under pressure of increasingly hostile and angry public opinion. As with Brexit, and as a result of the 2016 referendum, sovereignty and power has moved from parliament to people, to the street. We have a culture of populism, whether we like it or not, and it does not mix well with science. 

https://www.independent.co.uk/voices/coronavirus-fatigue-boris-johnson-lockdown-restrictions-b757300.html

Newly identified third type of diabetes is being wrongly diagnosed as type 2

Type 3c diabetes is quite common, but most doctors are missing it
Most people are familiar with type 1 and type 2 diabetes. Recently, though, a new type of diabetes has been identified: type 3c diabetes.

• ANDREW MCGOVERN
• Tuesday 31 October 2017 00:00 GMT

Type 1 diabetes is where the body’s immune system destroys the insulin-producing cells of the pancreas. It usually starts in childhood or early adulthood and almost always needs insulin treatment. Type 2 diabetes occurs when the pancreas can’t keep up with the insulin demand of the body. It is often associated with being overweight or obese and usually starts in middle or old age, although the age of onset is decreasing.

Type 3c diabetes is caused by damage to the pancreas from inflammation of the pancreas (pancreatitis), tumours of the pancreas, or pancreatic surgery. This type of damage to the pancreas not only impairs the organ’s ability to produce insulin but also to produce the proteins needed to digest food (digestive enzymes) and other hormones.

However, our latest study has revealed that most cases of type 3c diabetes are being wrongly diagnosed as type 2 diabetes. Only 3 per cent of the people in our sample (of more than two million) were correctly identified as having type 3c diabetes.

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Small studies in specialist centres have found that most people with type 3c diabetes need insulin and, unlike with other diabetes types, can also benefit from taking digestive enzymes with food. These are taken as a tablet with meals and snacks.

Researchers and specialist doctors have recently become concerned that type 3c diabetes might be much more common than previously thought and that many cases are not being correctly identified. For this reason, we performed the first large-scale population study to try and find out how common type 3c diabetes is.

We also looked into how well people with this type of diabetes have their blood sugar controlled. To do this we analysed health records from more than two million people in England. The records used were taken from the Royal College of General Practitioners Research and Surveillance Database (RCGP RSC). This database, mainly used for flu surveillance, contains the anonymised healthcare records of people of all ages for a sample of GP practices spread out across England.

We looked for cases of diabetes occurring after conditions which had caused damage to the pancreas including pancreatitis, pancreatic cancer and tumours, and pancreatic surgery. These cases of diabetes are likely to be cases of type 3c diabetes. The proportion of people with diseases of the pancreas who go on to develop diabetes is not clear but it does not happen in all cases, and there may be a long delay before the onset of diabetes.

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To our surprise, we found that in adults, type 3c diabetes was more common than type 1 diabetes. We found that 1 per cent of new cases of diabetes in adults were type 1 diabetes compared with 1.6 per cent for type 3c diabetes.

People with type 3c diabetes were twice as likely to have poor blood sugar control than those with type 2 diabetes. They were also five to 10 times more likely to need insulin, depending on their type of pancreas disease.

We found that the onset of type 3c diabetes could occur long after the onset of pancreas injury – in many cases more than a decade later. This long lag may be one of the reasons the two events are not often thought of as being linked, and the diagnosis of type 3c diabetes is being overlooked.

Correctly identifying the type of diabetes is important as it helps the selection of the correct treatment. Several drugs used for type 2 diabetes, such as gliclazide, may not be as effective in type 3c diabetes. Misdiagnosis, therefore, can waste time and money attempting ineffective treatments while exposing the patient to high blood sugar levels.

Our findings highlight the urgent need for improved recognition and diagnosis of this surprisingly common type of diabetes.

Andrew McGovern is clinical researcher at the University of Surrey. This article was originally published on The Conversation (www.conversation.com)

http://www.independent.co.uk/life-style/health-and-families/newly-identified-third-type-of-diabetes-is-being-wrongly-diagnosed-as-type-2-a8020881.html

Ketamine has 'truly remarkable' effect on depression and is effective in elderly patients, scientists say

After six months, 43% of the subjects said they had no significant symptoms of depression

Ketamine can have a “truly remarkable” effect on people with depression, researchers have said after a new study showed promising results among elderly patients.

Tuesday 25 July 2017

Ketamine is used as a horse tranquiliser (file photo) Rex Features

Colleen Loo, a professor at the University of New South Wales in Australia, led the world’s first randomised control trial into the drug’s effect on people over 60 with treatment-resistant depression.

“This trial has shown ketamine can be used safely in the elderly and it tends to be effective,” she told The Independent, adding that a similar effect was observed in this age group as in younger patients.

It is important to test how people of different ages respond to a new treatment before it can be offered by doctors, she said: “Sometimes depression in the elderly can be harder to treat, especially with medication. 

“Also, they tend to have more medical problems, which can interfere with medication.”

Ketamine was discovered in 1962 and is licenced for medical use in the UK as an anaesthetic, but is also used illegally as a recreational drug.

Of the study’s 16 participants, 11 reported an improvement in their condition while being treated with the drug, according to the research published in the American Journal of Geriatric Psychiatry.

After six months, 43 per cent of the subjects said they had no significant symptoms of depression – a high rate given that the participants had not responded to previous treatment, said Professor Loo.

“It is truly remarkable the way ketamine can work,” she said. “Other people have also found you get a rapid and powerful effect after a single dose of ketamine.”

“Some people mistakenly think we are inducing a temporary, drug-induced euphoria and people are ‘out of it’, which is why they’re not depressed. 

“But the effects take place in the first hour, and they’re not euphoric at all. In fact, all of our research participants disliked them. They considered them adverse effects. 

“The antidepressant effect kicks in a few hours later and are maximised about 20 hours later, when you’re fully alert and in your usual state of mind.”

While research into the use of ketamine to treat mental health problems is still in its early stages, scientists at Oxford University have said their studies show the drug can provide relief to patients with severe depression “where nothing has helped before”.

Rupert McShane, the consultant psychiatrist who is leading Oxford’s ketamine treatment programme, told The Independent it was “good to see that, contrary to some reports, some older people do respond to ketamine.”

“This study highlights that ketamine can be given in a variety of ways (not just intravenous), that it’s a good idea to adjust the dose, and that the more resistant someone’s depression is, the higher the dose that they are likely to need,” he said.

Professor Loo and her colleagues delivered ketamine to the patients using a small injection under the skin – similar to the insulin jabs given to diabetes patients.

This makes the drug easier and quicker to administer than the intravenous infusions used in other trials, which require a machine pump to regulate the dose and takes up to an hour to complete.

Participants received increasing doses of ketamine over a period of five weeks, with the dose personalised for each patient.

However, she warned that while the research is one step closer to providing a model for how doctors could prescribe ketamine as a treatment for depression in future, it would still be “premature to jump into clinical practice”.

“There are ‘super-responders’, who after a single treatment can be well for several months,” said Professor Loo, giving the example of a subject who, in 2014, remained free of depressive symptoms for five months after just one dose of ketamine. 

But “most people are well but then they relapse over around three to seven days,” she said. “That’s where repeated dosing comes in.”

It is estimated around three per cent of the UK population, or nearly two million people, suffer from depression.

A small proportion of this group – around 158,000 people in total – have very severe depression that is resistant to existing treatments, studies have shown.

Professor Loo and her colleagues at the Black Dog Institute in Sydney are also conducting a large-scale trial into the effects of ketamine on treatment-resistant depression.

“These results are a promising early piece of the puzzle, but the risks of ketamine use are still not wholly understood. Future studies with greater sample sizes are needed to formally assess ketamine's side effects, such as its impact on liver function."

http://www.independent.co.uk/news/health/ketamine-elderly-patients-severe-depression-effect-benefit-horse-tranquiliser-study-colleen-loo-new-a7859511.html

Completing antibiotic courses is a medical advice myth that may make bacterial resistance worse, say scientists

Researchers say it may be best for patients to stop taking their medicine when they feel better

Patients are often reminded they should complete each course of antibiotics to prevent bacteria becoming drug-resistant – but this advice is a “myth” that should be dropped, experts have argued.

Wednesday 26 July 2017


Patients are usually advised to complete the prescribed course of antibiotics Getty

Official guidance from the NHS says “it’s essential to finish taking a prescribed course of antibiotics, even if you feel better, unless a healthcare professional tells you otherwise”.

Now scientists have challenged this piece of received wisdom, which they say is not backed by evidence, warning unnecessary exposure to antibiotics could in fact make resistance worse.

It may in fact be best for people to stop taking the drugs when they feel better, wrote a team of researchers in the British Medical Journal(BMJ).

However, GPs have indicated they do not intend to remove advice to patients to finish their antibiotics, as “changing this will simply confuse people” and could cause patients to fall ill again, because an improvement of symptoms does not always mean an infection has been eradicated.

Oxford professor Tim Peto said he was taught about the importance of finishing a course of antibiotics as a medical student, but when he began discussing the origin of the idea with his colleagues, “no one could work out where it came from”.

“This is slow-motion fake news. It went through word of mouth, before the internet,” he told The Independent. “Yes, it’s an urban myth.”

Professor Peto and the group of experts led by Professor Martin Llewelyn, from Brighton and Sussex Medical School, traced our concern over giving too little treatment to the period of very early antibiotic innovation.

It may be attributable to unproven speculation by Alexander Fleming, the biologist who discovered penicillin, they said.

When he accepted the Nobel Prize for his work in 1945, Fleming, who had noted that bacteria could mutate when exposed to the new drugs, delivered a vivid speech describing an imaginary patient with a throat infection who had failed to complete his course of antibiotics.

Sir Alexander Fleming (1881-1955) in his laboratory at St Mary’s Hospital in Paddington, London, in October 1943 (Getty)

This was an “emotive story” in which “the man got better, resistance emerged, then his wife got the bug and died,” said Professor Peto. “We think it became embedded in people’s minds and became part of the ‘known facts’.”

It has now been shown that the bacteria Fleming named in his tale, Streptococcus pyogenes, never actually developed resistance to penicillin, casting his hypothesis further into doubt.

Antimicrobial resistance is caused when bacteria, viruses, fungi and parasites change through continued exposure to drugs, which then become ineffective against them.

Over time, excessive use of antibiotics could lead to minor infections causing serious health complications, making surgery and treatment for diseases such as cancer much riskier.

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England’s chief medical officer Dame Sally Davies has warned that 50,000 people die each year in Europe and the US from infections that have developed resistance against antibiotics.

“The relation between antibiotic exposure and antibiotic resistance is unambiguous both at the population level and in individual patients. Reducing unnecessary antibiotic use is therefore essential to mitigate antibiotic resistance,” wrote the researchers.

They also recommended that doctors should be able to change the duration of antibiotic treatment based on the patient’s responses to the medication.

But Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said recommended courses of antibiotics “are not random” and are tailored to individual conditions.

“In many cases courses are quite short, for example for urinary tract infections, three days is often enough to cure the infection,” she said.

“We are concerned about the concept of patients stopping taking their medication mid-way through a course once they ‘feel better’, because improvement in symptoms does not necessarily mean the infection has been completely eradicated.

“It’s important that patients have clear messages and the mantra to always take the full course of antibiotics is well known – changing this will simply confuse people.

“We agree with the researchers that more high quality, clinical trials are needed – and when guidelines are updated, they should take all new evidence into account. But we’re not at that stage yet.”

Professor Stokes-Lampard added that while antibiotic resistance was one of the biggest global challenges, “we cannot advocate widespread behaviour change on the results of just one study”.

Alison Holmes, director of Infection Prevention and Control at Imperial College Healthcare NHS Trust, said the “dogma” of telling patients to complete the course of antibiotics “has been pervasive and persistent.”

“Whilst there has been an enormous focus on developing new agents to combat AMR, there is just not enough existing data and current research to optimise the prescribing of existing antibiotics in terms of dosage and duration,” she said.

“The ‘complete the course’ message also directly conflicts with the societal messages regarding the changes needed in behaviour and attitudes to minimise unnecessary exposure to antibiotics.”

http://www.independent.co.uk/news/health/antibiotic-courses-complete-bacterial-resistance-worse-medical-myth-scientists-doctors-pills-a7861351.html

New breast cancer blood test could improve treatment options in more serious cases

'Liquid biopsy' detects tumour DNA and can track alterations in 13 different genes

Women with advanced stages of breast cancer could receive potentially life-extending personalised treatment after taking a new blood test that detects tumour DNA.

The test, known as a “liquid biopsy”, can detect and track alterations in 13 different genes, including some of the most important drivers of the disease.


A doctor examines a mammograph of a breast cancer patient Rex Features

• Thursday 27 July 2017

Breast cancer is the most common type of cancer in the UK, with around 150 new cases diagnosed every day. 

For patients whose cancer has spread beyond the breast and nearby glands – the most deadly stage of the disease – the new test could be used to improve and individualise their treatment as the disease progresses, researchers have said.

Around 10 per cent of women have metastatic, or stage four, breast cancer at the time of their diagnosis, according to cancer support charity Macmillan. The average survival rate is around two years.

This is the first time scientists have been able to analyse two kinds of acquired DNA mutation in a single blood test.

The study, published in the journal Clinical Chemistry, described how the researchers first looked at cells grown in a laboratory before analysing DNA in blood donated by 42 women with advanced breast cancer.

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Cancer-specific genetic changes were detected in half the women. In the case of one in five patients, information from the tumour DNA could have been used to alter treatment.

None of the mutations were found in the blood of nine healthy women that was also tested.

One gene that can be examined for changes using the new blood test is called HER2. It usually makes proteins that control the growth of healthy breast cells, but also plays a role in the development of around 15 to 25 per cent of breast cancer cases.

• READ MORE

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These “HER2 positive” breast cancers can be targeted with the drug Herceptin.

In addition, the test can spot mutations in the oestrogen receptor gene ESR1, linked to resistance to anti-hormone therapies such as aromatase inhibitors.

Once a patient is known to have these mutations, she can be offered other forms of treatment such as chemotherapy.

“By analysing blood plasma to measure for cancer-specific changes to key breast cancer genes – including the HER2 and oestrogen receptor genes – we hope this test could help doctors and patients choose the best treatment at the best time,” said Dr David Guttery, from the University of Leicester.

Somatic “point” mutations occur when DNA molecules are shuffled in the wrong order. Copy number alterations (CNA) are another type of mutation involving extra copies of genes that produce too much protein.

“We have developed a novel blood test that can simultaneously detect somatic mutations and copy number alterations that are integral in driving the growth of breast cancer,” said Dr Guttery.

“This study represents proof of concept, and further validation is now needed to confirm the clinical usefulness of this test before any test could be rolled out.”

The study was funded by two charities, Breast Cancer Now and Cancer Research UK.

Baroness Delyth Morgan, chief executive of Breast Cancer Now, said: “If validated by further research, this blood test could help tell us how a patient's secondary breast cancer is evolving. 

“Analysing the genetic make-up of tumours could enable us to identify women who might benefit from changing their treatment, ensuring that breast cancer patients receive the most personalised therapy possible.“

Dr Justine Alford, senior science information officer at Cancer Research UK, said: “While survival for women with early breast cancer has greatly improved, the outlook for patients with advanced disease is still poor, something we urgently need to change. This early research could help achieve this.

“The researchers may have developed a way to track breast cancer as it grows, allowing doctors to act swiftly and give patients the treatments that are right for them as early as possible. On top of that, such a tailored approach could spare patients receiving drugs, and the side effects that go with them, that aren't likely to work.”

http://www.independent.co.uk/news/health/breast-cancer-blood-test-new-treatment-improve-detect-tumour-dna-liverpool-uk-advanced-metastatic-a7862241.html