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For bad cancer survivors, the risk of tumor recurrence is a drop shadow that can be reproduced up to two decades after diagnosis. But new research could help identify and treat those most at risk.
Doctors have traditionally relied on factors such as the size and grade of a tumor when diagnosed, the lymph node involvement and the age of the patient to determine the risk of relapse.
But the rate of recurrence of bad cancer and the reason why it persists remain "misunderstood", according to a study published Thursday in the journal Nature.
To address this situation, researchers used data from more than 3,000 bad cancer patients diagnosed in the UK and Canada between 1977 and 2005.
Nearly 2,000 of the cases included molecular cancer data that provided researchers with detailed information about tumors.
The data was used to develop a computer model that identified four subgroups with "an extremely high risk of late and distant relapse," said lead author Christina Curtis, badistant professor of medicine and genetics at the University of Toronto. Stanford University.
"These are the patients who are likely to experience a relapse after the initial diagnosis," she told AFP.
The study found that about 25% of women with the most commonly diagnosed form of bad cancer were between 42% and 55% at risk of seeing their cancer reappear within two decades.
"These are the women who seem cured but then present with systemic disease many years later," Curtis said in a press release issued by Stanford University.
"Until now, there was no effective way to identify this subgroup of women likely to benefit from ongoing screening or treatment."
The study also opens up potential new pathways for further treatment of bad cancer patients by identifying gene alterations in each of the four subgroups at risk.
These alterations or mutations lead to signaling problems that can cause unwanted cell growth. And this can in turn fuel the formation of tumors or their progression.
"Many of these genomic modifications may be potentially therapeutically-targeted, suggesting the possibility of new treatment options, although this will need to be evaluated in the context of clinical trials," Curtis said at the same time. AFP.
The study also reveals when and where in the body bad cancers could metastasize and highlighted a group of patients with so-called triple negative tumors, whose cancers are unlikely to reappear after five years.
"This information can be used to refine risk estimates and improve the follow-up and stratification of bad cancer patients – for example, by determining which patients might benefit from a longer or different type of treatment", said Curtis.
Read also: No need for chemotherapy in many bad and lung cancers, according to large studies
Best treatments
The researchers cautioned that their dataset included cases from several decades ago, which means that patients were not then able to access newer and more recent treatments. approved.
Some of these treatments have significantly improved the survival rates of patients with particular types of bad cancer.
But the results should still significantly help physicians predict more precisely which patients are most at risk of seeing their cancer return.
The team even developed an online tool "predictor of bad cancer recurrence" for physicians using their model.
Curtis said the researchers are currently pursuing a clinical trial for treatment options that would target genomic defects in patients most at risk for cancer recurrence.
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