Among the topics discussed at this years annual meeting of the American Association for Cancer Research (AACR) was disparities in cancer care. Several MSK researchers presented research that directly addresses these problems.
In a prerecorded presentation, MSK physician-scientist Sana Raoof explained how clinical trials of liquid biopsies a type of blood test for cancer can include concrete measures to reduce disparities related to access and inclusion.
Dr. Raoof said such trials should aim to include at least 25% of participants who are non-white a figure that more accurately represents the percentage of non-white individuals in the U.S. population. Previous liquid biopsy trials have included 4% to 13% non-white participants.
The lack of representation of minorities is a huge problem in cancer clinical trials, Dr. Raoof says. Its not just a problem because its unfair and inequitable; its also a problem because it affects scientific conclusions.
To improve access to liquid biopsy trials, academic medical centers should seek to partner with community hospitals that see a more diverse patient population, she says.
Liquid biopsies may aid in early detection because they could potentially be administered in a primary care physicians office, rather than at a cancer center, where most imaging scans and other tests are performed.
In the context of the COVID, were seeing later and later stages at diagnosis across multiple types of cancer, Dr. Raoof says. People are missing their cancer screening tests and are therefore being diagnosed when they have symptoms at later stages, when its harder to cure the disease. That is particularly affecting minorities who, at baseline, have worse access to healthcare.
The lack of representation of minorities is a huge problem in cancer clinical trials.
Sana Raoof, MD, PhD physician-scientist
It would be very useful, Dr. Raoof continues, if we had a point-of-care test that was convenient, quick, and cheap that could be used by everyone but might be of particular benefit to minorities to supplement cancer screening.
Dr. Raoof wrote an editorial about the potential of liquid biopsies to address disparities in access in the Boston Globe last year.
MSK computational oncologist Francisco Sanchez-Vega is part of a team that has for a number of years been studying the genomics of colorectal cancer, trying to identify genomic features that correlate with worse outcomes. They are mining the wealth of genomic data obtained from MSK-IMPACT, a gene-sequencing panel that looks for cancer-associated mutations in 500+ genes.
While doing this work, Dr. Sanchez-Vega noticed that, on average, African American patients in the MSK-IMPACT cohort had worse outcomes compared with other patients. The question that he and others want to understand is why.
The general belief is that this disparity is probably driven by socioeconomic factors, differences in risk factors, differences in access to healthcare, maybe differences in environmental exposure, lifestyle, diet, etc., Dr. Sanchez-Vega says. But we had a very good opportunity to try to understand if there were any genomic features that could at least partially explain these differences or give some insight into these differences.
In his presentation at AACR, Dr. Sanchez-Vega discussed the various genomic factors that they measured, including tumor mutation burden, location of the tumor, and frequency of various oncogenes. The study population included 3,963 patients with colorectal cancer treated at Memorial Sloan Kettering Cancer Center (MSK), including 336 (8%) self-reported Black patients and 3,627 (92%) self-reported white patients.
They found some differences. For example, right-sided colon tumors were more common among Black patients (37% versus 25% in white patients). Hypermutated tumors, including tumors with a condition called microsatellite instability, were more frequent among white patients (12% versus 8% in Black patients).
Tumors in Black patients were enriched in KRAS mutations (60% versus 45% in white patients), but high-risk KRAS-G12C mutations accounted only for 3% of all driver KRAS mutations in Black patients versus 8% of all driver mutations in white patients.
When the investigators factored in all these genomic and clinical differences, however, they still did not explain the difference in outcomes between the two groups namely, that Black patients had shorter overall survival from the time of sequencing (median 28months versus 50months for white patients). This was true even though all patients were treated at the same single institution (MSK) during the study.
Dr. Sanchez-Vega cautions that these results may not apply behind the specific cohort of people who came to MSK, since this population may not be fully representative of the wider community. Nevertheless, the results would seem to point to other factors beyond genomic ones to explain these disparities in outcomes.
For certain types of cancer, knowing ones precise genetic ancestry can be important for properly assessing genetic risk factors for the disease and weighing possible treatments. Perhaps the best example of this phenomenon is people with Ashkenazi Jewish European ancestry, who have a much higher risk of carrying a high-risk BRCA1 or BRCA2 mutation than the general population. These mutations put one at risk for hereditary breast, ovarian, prostate, and pancreatic cancers.
Traditionally, establishing someones genetic ancestry required looking at genetic markers from across the entire genome. At AACR, computational biologists Kanika Arora, Michael Berger, and their colleagues in the Marie-Jose and Henry R. Kravis Center for Molecular Oncology presented their work showing that data from MSK-IMPACT which sequences only a subset of genes in the human genome can be used to reliably establish someones genetic ancestry.
The finding raises the possibility that genetic ancestry testing could be incorporated into routine clinical care whenever a test such as MSK-IMPACT is administered. The potential benefits include a more accurate genetic risk assessment than self-reported race.
A lot of times in medicine, self-reported race is used as a substitute for genetic ancestry, but its not always a good indication of someones actual genetics, explains Arora. For example, someone who identifies as Black could have close to 100% African ancestry, or they could have 50% or less African ancestry. So, while both are Black, self-reported race does not always capture the genetic component well, which is why for certain questions about risk factors, its important to look in detail at measures of ancestry.
A lot of times in medicine, self-reported race is used as a substitute for genetic ancestry, but it's not always a good indication of someone's actual genetics.
Kanika Arora computational biologist
According to the investigators, one particularly noteworthy finding to emerge from their analysis is a discrepancy in the rates of clinically actionable alterations in patients of African ancestry versus patients of European ancestry as determined by MSKs OncoKB database. While the overall proportion of biologically relevant driver mutations was similar between the two groups, patients of African ancestry had, on average, fewer options for drugs matching those mutations.
There are likely several reasons for that, Dr. Berger says, including the fact that genomic-sequencing panels themselves are skewed toward the genomic data collected from largely European populations.
Regardless of the reason, the data would seem to call for more equitable drug development programs, he notes. Patients with African ancestry are not as well served as people with European ancestry by our current precision oncology therapies, Dr. Berger says.
Go here to read the rest:
At AACR, MSK Researchers Spotlight Health Disparities and Propose Solutions - On Cancer - Memorial Sloan Kettering
- Multiple neurodevelopmental disorders have a common molecular cause [Last Updated On: October 9th, 2014] [Originally Added On: October 9th, 2014]
- Human Longevity, Inc. Hires Industry Experts Barry Merriman, Ph.D., and Paul Mola, M.S. to Lead New Global Solutions ... [Last Updated On: October 31st, 2014] [Originally Added On: October 31st, 2014]
- Scientists create artificial human eggs and sperm [Last Updated On: December 27th, 2014] [Originally Added On: December 27th, 2014]
- What if the severity of our seasonal influenza were related to our genetic background? [Last Updated On: March 27th, 2015] [Originally Added On: March 27th, 2015]
- UCLA Human Genetics [Last Updated On: October 1st, 2015] [Originally Added On: October 1st, 2015]
- Human Genetics - Estrella Mountain Community College [Last Updated On: October 1st, 2015] [Originally Added On: October 1st, 2015]
- Human genetics - Wikipedia, the free encyclopedia [Last Updated On: October 29th, 2015] [Originally Added On: October 29th, 2015]
- Human genetics - An Introduction to Genetic Analysis ... [Last Updated On: November 2nd, 2015] [Originally Added On: November 2nd, 2015]
- Home Institute for Human Genetics at UCSF [Last Updated On: November 3rd, 2015] [Originally Added On: November 3rd, 2015]
- National Human Genome Research Institute [Last Updated On: August 8th, 2016] [Originally Added On: August 8th, 2016]
- Genetics - Smithsonian's Human Origins Program [Last Updated On: November 23rd, 2016] [Originally Added On: November 23rd, 2016]
- Toddler's Hair Stands Up Like Troll Doll Thanks To Rare Genetic Condition - HuffPost [Last Updated On: July 4th, 2017] [Originally Added On: July 4th, 2017]
- Can genetics play a role in education and well-being? - USC News [Last Updated On: July 4th, 2017] [Originally Added On: July 4th, 2017]
- Genetic variant linked to osteoarthritis favored in cold climates - Scope (blog) [Last Updated On: July 4th, 2017] [Originally Added On: July 4th, 2017]
- Human Evolution: Africa Exodus Made Homo Sapiens Shorter and Gave Them Arthritis - Newsweek [Last Updated On: July 4th, 2017] [Originally Added On: July 4th, 2017]
- Dispute Over British Baby's Fate Draws In Pope and US President - New York Times [Last Updated On: July 4th, 2017] [Originally Added On: July 4th, 2017]
- Human mitochondrial genetics - Wikipedia [Last Updated On: July 4th, 2017] [Originally Added On: July 4th, 2017]
- Using Big Data to Hack Autism - Scientific American [Last Updated On: July 7th, 2017] [Originally Added On: July 7th, 2017]
- This Study Could Help Extend the Human Lifespan - Futurism [Last Updated On: July 7th, 2017] [Originally Added On: July 7th, 2017]
- Evolution and war: The 'deep roots' theory of human violence - Genetic Literacy Project [Last Updated On: July 7th, 2017] [Originally Added On: July 7th, 2017]
- Human Genetics | Pitt Public Health | University of Pittsburgh [Last Updated On: July 7th, 2017] [Originally Added On: July 7th, 2017]
- human genetics | biology | Britannica.com [Last Updated On: July 7th, 2017] [Originally Added On: July 7th, 2017]
- The Era of Human Gene Editing Is HereWhat Happens Next Is Critical - Singularity Hub [Last Updated On: August 2nd, 2017] [Originally Added On: August 2nd, 2017]
- In US first, scientists edit genes of human embryos - Indiana Gazette [Last Updated On: August 2nd, 2017] [Originally Added On: August 2nd, 2017]
- A protein involved in Alzheimer's disease may also be implicated in cognitive abilities in children - Medical Xpress [Last Updated On: August 2nd, 2017] [Originally Added On: August 2nd, 2017]
- Genome Sequencing Shows Spiders, Scorpions Share Ancestor - R & D Magazine [Last Updated On: August 2nd, 2017] [Originally Added On: August 2nd, 2017]
- Mindful of eugenics' dark history, researchers are reexamining the genetics of social mobility - Quartz [Last Updated On: August 2nd, 2017] [Originally Added On: August 2nd, 2017]
- Shrinking Bat DNA and Elastic Genomes - Quanta Magazine [Last Updated On: August 2nd, 2017] [Originally Added On: August 2nd, 2017]
- Bacteria May Rig Their DNA to Speed Up Evolution - WIRED [Last Updated On: August 19th, 2017] [Originally Added On: August 19th, 2017]
- Will Gene Editing Allow Us to Rid the World of Diseases? - Healthline [Last Updated On: August 19th, 2017] [Originally Added On: August 19th, 2017]
- Genes causing intellectual disabilities identified - The Indian Express [Last Updated On: September 3rd, 2017] [Originally Added On: September 3rd, 2017]
- Split-brain fruit fly research gives insight into autism - Nevada Today [Last Updated On: September 3rd, 2017] [Originally Added On: September 3rd, 2017]
- Human Genetics - McGill University [Last Updated On: August 18th, 2018] [Originally Added On: August 18th, 2018]
- Human Genetics - medschool.ucla.edu [Last Updated On: October 6th, 2018] [Originally Added On: October 6th, 2018]
- Department of Human Genetics | The University of Chicago [Last Updated On: October 6th, 2018] [Originally Added On: October 6th, 2018]
- Human genetic clustering - Wikipedia [Last Updated On: November 3rd, 2018] [Originally Added On: November 3rd, 2018]
- Mitochondrial Eve - Wikipedia [Last Updated On: November 18th, 2018] [Originally Added On: November 18th, 2018]
- Human Genetics - McGraw-Hill Education [Last Updated On: November 18th, 2018] [Originally Added On: November 18th, 2018]
- Human Genetics | Biomedical Sciences Graduate Program [Last Updated On: December 1st, 2018] [Originally Added On: December 1st, 2018]
- Human Genetics | Michigan Medicine | University of Michigan [Last Updated On: December 24th, 2018] [Originally Added On: December 24th, 2018]
- Human behaviour genetics - Wikipedia [Last Updated On: February 11th, 2019] [Originally Added On: February 11th, 2019]
- Human Genetics and Embryology - Open Access Journals [Last Updated On: February 11th, 2019] [Originally Added On: February 11th, 2019]
- Marshfield Clinic Research Institute - Welcome to The ... [Last Updated On: March 9th, 2019] [Originally Added On: March 9th, 2019]
- Human Genetic Modification | Center for Genetics and Society [Last Updated On: April 25th, 2019] [Originally Added On: April 25th, 2019]
- Humanized Liver Mice Model Market Emerging Niche Segments and Regional Markets - Commerce Gazette [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Short Sleeper Syndrome: When You Can Get By on Just a Few Hours of Sleep - The Crux - Discover Magazine [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Ceremony honors 2019 GASD hall inductees - The Recorder [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Genes, the social environment and adolescent smoking - Princeton University [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- LSU researcher looking at 'miracle drug' metformin as potential weapon against breast cancer - NOLA.com [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- The next omics? Tracking a lifetime of exposures to better understand disease - Knowable Magazine [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- 'Rejuvenation treatment can delay onset of heart diseases, cancer' - Down To Earth Magazine [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Global Human Genetics Market Report, History and Forecast 2014-2025, Breakdown Data by Companies, Key Regions, Types and Application - Market Industry... [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- DNA Found in 70000-Year-Old Pinky Bone Gives 1st Glimpse of Ancient Human Relative - Inside Edition [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Scientists release genetically altered mosquitoes to fight malaria - Global News [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Scientists Release Sterile Mosquitoes in Burkina to Fight Malaria - News18 [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Genes implicated in bipolar disorder identified - The Hindu [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Genetics and Justice: DNA Identification Technologies in Post-Dictatorial Argentina - KCPW [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- When Did Humans Reach North America? The Question Keeps Growing More Complex - The Crux - Discover Magazine [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Early postnatal overnutrition sets the body on a fast-track to aging - Baylor College of Medicine News [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Oxford Nanopore signs CRISPR licence - Life Sciences Intellectual Property Review [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Medical student with rare disease finds possible cure from studying his own blood samples - Fox News [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Study Gives the Green Light to the Fruit Fly's Color Preference - Nature World News [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Genetics CRISPR enters its first human trials - Science News for Students [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Lakin Named Finalist In Global Science Video Contest - My veronanj [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- The Genetic Origins of Sex Differences in Disease - Yale News [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- Human Genetics Market 2019 Growing with Major Key Player QIAGEN, Agilent Technologies, Thermo Fisher Scientific, Illumina, Promega, LabCorp, GE, etc -... [Last Updated On: September 22nd, 2019] [Originally Added On: September 22nd, 2019]
- The Complicated Truth About That Controversial 'Gay Gene' Study - Out Magazine [Last Updated On: September 27th, 2019] [Originally Added On: September 27th, 2019]
- Government launches 'UMMID' initiative to tackle inherited genetic diseases of new born ba - 5 Dariya News [Last Updated On: September 27th, 2019] [Originally Added On: September 27th, 2019]
- 1400-year-old Pictish Remains Finally Unearthed in Scotland - Ancient Origins [Last Updated On: September 27th, 2019] [Originally Added On: September 27th, 2019]
- GSK and AstraZeneca's PARP Inhibitors Will Flex Their Muscles at ESMO - BioSpace [Last Updated On: September 27th, 2019] [Originally Added On: September 27th, 2019]
- What Do Dairy Cows' Y Chromosomes Have to Do with Young Earth Creationism? Plenty. - Patheos [Last Updated On: October 22nd, 2019] [Originally Added On: October 22nd, 2019]
- New books explore why dogs and humans have such a special bond - Science News [Last Updated On: October 22nd, 2019] [Originally Added On: October 22nd, 2019]
- We need to understand the culture of whales so we can save them - Dal News [Last Updated On: October 22nd, 2019] [Originally Added On: October 22nd, 2019]
- New Research on Climate Change and the Brain, the Relationship Between Stroke and Dementia, Advances in Epilepsy and MS Among the Brain Health... [Last Updated On: October 22nd, 2019] [Originally Added On: October 22nd, 2019]
- This is Why Gene Editing of Plants and Animals Needs to be Regulated - In These Times [Last Updated On: October 22nd, 2019] [Originally Added On: October 22nd, 2019]
- What's Behind Rise Of STDS Among Young People?: Epidemic Alarms Health Officials As Prevention Funding Drops - Kaiser Health News [Last Updated On: October 22nd, 2019] [Originally Added On: October 22nd, 2019]
- Opinion: The Nature of Social Inequalities in Great Britain - The Scientist [Last Updated On: October 22nd, 2019] [Originally Added On: October 22nd, 2019]
- Hacking Darwin: How the coming genetics revolution will play out - New Atlas [Last Updated On: October 22nd, 2019] [Originally Added On: October 22nd, 2019]
- New research on climate change and the brain among the brain health initiatives unveiled at 24th World Congress of Neurology - WFN News [Last Updated On: October 22nd, 2019] [Originally Added On: October 22nd, 2019]
- Overthinking Can Shorten Your Life, Says New Study - International Business Times [Last Updated On: October 22nd, 2019] [Originally Added On: October 22nd, 2019]