News in brief: AAMDC oncogene in aggressive breast cancer; Is it really MD care without PROs?; BMI may be good or bad for cancer survival

Tuesday, 30 Mar 2021

New breast cancer gene unravelled 

A deep dive into the adipogenesis associated Mth938 domain containing (AAMDC) oncogene has revealed metabolic vulnerabilities that could be therapeutically exploited in aggressive ER-positive breast cancers.

Research from the Harry Perkins Institute of Medical Research and the University of WA found AAMDC is overexpressed in high risk ER+ breast cancer but also in ovarian, lung and prostate cancers.

They found that signal transduction oncoprotein activates the PI3K-AKT-mTOR pathway, thereby inducing survival of ER+ breast cancer during metabolic stress conditions such as oestrogen deprivation.

AAMDC also regulates the expression of metabolic enzymes involved in the one-carbon (1C) folate and methionine cycles, and lipid metabolism.

“Excitingly, the metabolite most downregulated by AAMDC knock down was cystathionine, which is a product of the CBS enzyme involved in the methionine cycle and implicated in tumour survival in breast cancer and lipid metabolism in ovarian cancer,” the researchers said.

Nature Communications

PROs: the final frontier in cancer care?

Adoption of patient-reported outcomes (PROs) into clinical practice has been slow, according to a COSA working group.

While the technology exists for efficient real‐time collection, reporting and response to PROs through portals and dashboards, as well as integration with the EMR, progress has been patchy.

The authors, led by Professor Bogda Koczwara, have delivered a set of principles and list of resources on the clinical use of PROs in cancer care.

“While the barriers to adoption of PROs in clinical practice are significant, they are not insurmountable,” they said.

“System redesign may be required to integrate PROs collection and feedback into the routine workflow, with clear pathways to inform a standardised approach.”


Obesity could mean poor cancer prognosis – or be protective 

Obesity is associated with increased overall and cancer specific mortality – especially in patients with breast, colon and uterine cancer.

The relapse rate was also increased in patients with obesity and breast, colorectal, prostate and gastroesophageal cancers.

However  the association between high BMI and outcomes was not universal for all cancers, a systematic review and meta-analysis of the evidence, comprising data from more than 6.3 million participants, showed.

Patients who were obese and had renal cell carcinoma, lung cancer, or melanoma had better survival than patients without obesity.

The researchers said hormonal factors, reduced physical activity, more lethal or aggressive disease behaviour, metabolic syndromes, and potential undertreatment in patients with obesity were possible reasons for the increased mortality in many cancers.

They said weight-reducing strategies may be effective measures for reducing mortality in these patients.

JAMA Network Open

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