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03-Aug-2007 - Britain 'treats child cancer as low priority'
By Rebecca Smith, Medical Editor Last Updated: 2:02am BST 01/08/2007
Children with cancer are treated as a "low priority" by the NHS meaning their chances of surviving the disease are amongst the worst in Europe, experts warn today.
Until recently child cancer victims received poorer care than adults with the disease, according to a leading comment article in the medical journal Lancet Oncology.
The authors attacked the standards of children's health care in general in the UK, saying diabetes care and infant mortality rates were also below European standards. advertisement Telegraph - TravelShop
Prof Alan Craft, of the Institute of Child Health and Newcastle University, and Prof Kathy Pritchard-Jones, of the Royal Marsden Hospital in Surrey, said children should be monitored more carefully from a young age and GPs and health visitors needed to be aware of the symptoms of cancer.
The latest data, from 2003, shows only 71 per cent of children with cancer survive for five years after diagnosis, this falls below those in Iceland at 91 per cent, Finland and Switzerland at 81 per cent, Sweden at 79 per cent, Germany at 76 per cent and France at 72 per cent. Figures for adult cancers also show survival rates below other comparable European countries such as France, Spain and Germany.
The authors said that in Germany and France children are registered with a specialist paediatrician in primary care alongside family doctors and have regular proactive checks of all aspects of health care. In the UK GPs only refer children on to specialists if they suspect a serious condition.
It means more cancers are detected at an earlier stage in Europe giving patients the best chance of survival. In Germany 27.4 per cent children who had Wilms' tumour, a type of kidney cancer that affects 70 children a year in the UK, were picked up during routine checks compared to four per cent in some parts of Britain.
Prof Craft told The Daily Telegraph that some things have improved, such as Europe-wide co-ordinated trials, meaning children are getting access to the best care and latest innovations, as it is generally accepted that survival rates improve if child patients are included in clinical trials.
Prof Craft said: "It is not about drug access. Treatment regimes are difficult and very arduous but children's cancers usually respond very well to treatment. It is about early diagnosis, more consistently applied and proper funding of the centres that are treating children." Cancers are 200 times less common in children than in adults. One in 600 will develop cancer before the age of 15 whereas one in three adults will have it at some point. This means there is little awareness of the cancers, which are very different to adults' diseases.
But Prof Craft stopped short of calling for universal proactive screening of all children.
The article was disputed by other cancer experts who said the situation has improved since this data was first collected and the differences may be explained by variations in information held by individual countries.
Professor Alex Markham, Cancer Research UK's senior medical advisor, said: "Today, five-year survival from childhood cancer in the UK has reached 77 per cent, and for some types is over 90 per cent.
"We recognise the concerns raised by the authors that differences in timing of diagnosis could account for some the survival difference and encourage further research to confirm this."
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2007.05.31 - The Telegraph - Wilms Tumour Child
Dream come true for Angelina ballerina Last Updated: 3:13am BST 31/05/2007
A four-year-old girl's dream of being a ballerina for the day came true yesterday.
Angelina Vidler, who has a rare form of cancer, rehearses with the Royal Ballet’s Francesca Filpi
Angelina Vidler, of Shoeburyness, Essex, who suffers from a rare form of cancer, rehearsed at the Royal Opera House.
With her own silver outfit and ballet slippers, she joined ballerinas from the Royal Ballet rehearsing on stage. Her wish was made possible by the Rays of Sunshine Children's Charity, which helps seriously ill youngsters.
Her mother, Hilary, said: "Angelina enjoyed every minute of it and couldn't take her eyes off the beautiful ballerinas. This wish has given us all, as a family, so many happy memories."
Angelina, who was also given a signed pair of ballet shoes, is receiving treatment for Wilms Tumour, a form of Kidney Cancer.
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2007.05.12 - The Telegraph - Sutent denied
The drugs the NHS won't give you Last Updated: 2:25am BST 12/05/2007
Suninitib (Sutent) For Kidney Cancer.
Licensed, but the Department of Health has yet to refer it to N.I.C.E. for a recommendation.
John Quance, 57
The former fireman was told he could not have the drug Sutent because the NHS would not pay for it.
Mr Quance, who has been diagnosed with Kidney Cancer, cashed in his pension and remortgaged his house to pay for it privately, but fears that he may have to sell his home unless the NHS steps in. Cornwall Primary Care Trust said it was not prepared to pay the £22,000-a-year cost of the drug until it was approved by N.I.C.E..
Mr Quance said: "I have worked all my life, I have been in the forces, the prison service and the fire service for 30-odd years and I feel a little bit abandoned.
"The staff and the hospital have been excellent but it is a little disappointing not to get funding when it has been proved [the drug] is working."
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2006.11.15 - The Telegraph - Kidney Cancer Vaccine Trovax
British Kidney Cancer vaccine 'wipes out tumours'
By Roger Highfield, Science Editor Last Updated: 1:56am GMT 15/11/2006
Two Americans with Kidney Cancer have had their tumours eradicated after being injected with a vaccine based on a genetically altered virus.
Two more patients had a partial response to the vaccine. The tumours shrank in the two phase II trials on 24 patients with two common forms of kidney cancer.
TroVax, developed by Oxford BioMedica, a British gene therapy company, was tested by Dr Robert Amato, of the Methodist Hospital in Houston, who presented the results at a recent symposium in Prague, Czech Republic.
"Both patients that appear to be complete responders have previously been treated and have been given targeted treatments," said Dr Amato. "But now with this vaccine we are seeing striking responses.
"We need to find out why some patients are responding and others aren't."
A worldwide study on 700 patients is now under way.
The trials are designed to evaluate the safety and effectiveness of Trovax as a single agent, injected seven times over 41 weeks, and in combination with standard therapy.
To date, the two trials have enrolled patients with progressive Kidney Cancer .
All patients had been given Surgery and Chemotherapy.
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2005.10.08 - The Telegraph - The Search for Vaccine for Kidney Cancer
Search for the jab that can combat cancer
By Roger Highfield, Science Editor
Last Updated: 1:14am BST 08/10/2005
A simple injection to treat cancer sounds like pure science fiction, yet a range of prototype vaccines are being developed for breast, colon, skin and other tumours that could offer a new weapon in the war against cancer.
Unlike the new cervical cancer vaccines, which only give immunity against the viruses which trigger cancer, this second family of cancer vaccines make the body attack tumours in an approach that doctors call Immunotherapy, or Biological Therapy.
Noel Drury studies cells which have been treated with a vaccine Designing a vaccine against a virus linked with cancer, as has been done to help prevent Liver Cancer - with the Hepatitis B vaccine - and now cervical cancer, is relatively simple compared with educating the body's immune system to mount an effective attack on a tumour and actually treat cancer.
One of the pioneers of Immunotherapy is American Dr Steven Rosenberg. In 1969, while working at the Veterans' Hospital near Harvard, he was stunned by the medical history of a patient who consulted him to have a gall bladder removed.
The patient had been diagnosed with stomach cancer more than a decade earlier, and sent home to die. "Spontaneous remission is a very, very rare event in medicine," Dr Rosenberg said. "It got me thinking that this patient's body had in some way reacted against the cancer."
This reaction is rare because cancer is caused by a series of genetic changes within one of the body's own cells, so that, rather than working in harmony with the body, the cell runs amok.
While the body's immune system offers elaborate protection against invaders such as viruses and bacteria, it usually reacts only weakly to cancer because tumour cells are so similar to normal cells.
A hunt has been under way to find the subtle differences between cancer and normal cells. If a protein could be identified that was made only on the surface of a cancer cell, it could be used as the basis of a vaccine to train the body to attack the diseased cells.
One such protein was identified a few years ago by Prof Peter Stern, of the Paterson Institute for Cancer Research in Manchester. He became interested in 5T4, a protein thought to be used by the foetus to plumb into the mother's womb, and was surprised to find that cancer cells reactivate this embryonic genetic programming to help spread around the body.
Studies reveal that 5T4 features in many solid cancers, such as colon cancer, and the protein is linked with patients who have a gloomy prognosis. This remarkable finding has now been turned against cancer. In one approach, the company Active Biotech, Lund, has made an antibody for 5T4, a protein that recognises this molecule, and hitched it to a second molecule, one made by bacteria, which is able to trigger a huge immune response.
Survival data for Kidney Cancer patients given the resulting drug were presented last month to the National Cancer Research Institute conference in Birmingham. Patients with the highest drug exposure lived almost twice as long as expected, 26.6 months, compared with 15.1 months.
The 5T4 protein has also been turned into a vaccine called Trovax by the company Oxford BioMedica. Yesterday its chief executive, Prof Alan Kingsman, said that it is based on a pox virus which has been genetically altered to deliver the gene for 5T4.
The altered virus, injected into muscle, does not multiply and reprogrammes a patient's muscle cells to make 5T4, while at the same time stimulating the immune system.
The vaccine is being used against colorectal cancer in a Phase II trial backed by Cancer Research UK presented to the American Society of Clinical Oncology in Orlando, Florida, earlier this year.
The vaccine triggered the manufacture of antibodies against 5T4 and of white blood cells, called killer T cells, thought to be important in shrinking tumours.
When combined with Chemotherapy, 18 of 19 patients responded.
"We got fantastic results when it came to Tumour shrinkage," said Prof. Kingsman, "And the immune responses in some patients are comparable to what one would expect with an infectious disease."
Earlier this week, the team reported similarly encouraging results in the treatment of kidney cancer, for which chemotherapy is not effective, at the World Vaccine Congress in Lyon, France. The Phase II trial in the New York-Presbyterian Hospital, New York led by Dr. Howard Kaufmann once again showed an immune attack on 5T4.
The US National Cancer Institute is backing a trial of the vaccine against breast cancer and a major Phase III trial is expected to be launched next year against either kidney or colon cancer.
Impressive results have been reported in the use of a vaccine to fight non- small cell lung cancer by the company Transgene in Strasbourg.
Transgene has genetically altered pox virus with two genes: one, Interleukin, helps stimulate the production of killer T cells and the second is MUC1, a protein specific to cancer cells.
Of the first 35 patients who received the vaccine along with Chemotherapy, 13 have responded to the treatment. The results were encouraging, Prof Thierry Velu, of the Erasme Hospital, Brussels, told the American Society for Clinical Oncology.
Another "cell-based" cancer vaccine is being developed by the British company Onyvax. The company points out that the genes that wink on and off in tumour cells change as the disease progresses.
To overcome this, Onyvax's vaccines are made from three different prostate cell lines, each representing a different stage of the disease.
In one trial presented in June last year involving 26 men with advanced disease that had not spread to the bones, the median survival was 58 weeks, around double that expected.
A special class of immune cells is being harnessed to help prevent lung cancer recurrences in patients by Prof Edward Hirschowitz and Dr John Yannelli at the University of Kentucky.
The vaccine uses dendritic cells, the most potent immune-inducing cells found in the human body, and reprogrammes them to recognise and kill tumour cells.
Although striking progress is being made on a range of fronts, Prof. Stern, sounded a note of caution.
This approach faces several hurdles. The body does react a little to an evolving Tumour and can become exhausted by the time doctors want to harness the immune system to attack a Tumour; cancers are a genetic hotch-potch, so they are hard to stamp out completely and can evolve to outwit a specific vaccine; and scientists suspect some tumours evolve ways to damp down the immune system.
However, Prof. Stern is confident that cancer treatment vaccines will be in use within a few years. But they will probably be deployed alongside Chemotherapy, drugs and Radiotherapy, rather than offer the long-sought "magic bullet" to defeat cancer.
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