Category: Prevention

MyLynch: A Patient-Facing Clinical Decision Support Tool for Genetically-Guided Personalised Medicine in Lynch Syndrome

Lynch syndrome (LS) is associated with varying cancer risks depending on which of the five causative genes harbors a pathogenic variant; however, lifestyle and medical interventions provide options to lower those risks.

“We developed MyLynch, a patient-facing clinical decision support (CDS) web application that applies genetically-guided personalized medicine (GPM) for individuals with LS. MyLynch informs LS patients of their personal cancer risks, educates patients on relevant interventions, and provides patients with adjusted risk estimates depending on the interventions they choose to pursue. MyLynch can improve risk communication between patients and providers while also encouraging communication among relatives with the goal of increasing cascade testing. As genetic panel testing becomes more widely available, GPM will play an increasingly important role in patient care, and CDS tools offer patients and providers tailored information to inform decision-making. MyLynch provides personalised cancer risk estimates and interventions to lower these risks for patients with LS.”

https://www.mdpi.com/2072-6694/15/2/391

“The MyLynch risk estimates and their clinical utility should be validated on larger samples of patients in future studies. We also plan to produce a mobile compatible version of the app as well as incorporate risk uncertainty into the estimates.”

Trials Test Vaccines for Prevention or Delay of Cancers Associated with Lynch Syndrome

Researchers have recruited the first vaccine candidates to one of two new prevention trials that seek to immunize high-risk individuals against Lynch syndrome, the most common cause of hereditary colorectal cancer. Individuals who inherit the condition have an estimated lifetime risk as high as 80% for developing one of these malignancies, as well as an above-average risk for cancers arising in other organs, often at an early age, and regardless of race or gender.

The Nous-209 vaccine—named partially for the number of neoantigens or “new” antigens it contains, and in part for the Switzerland-based company (Nouscom) that developed it—employs what investigators call “a brute force” approach. The vaccine contains 209 bits and pieces of cancer-specific neoantigens expressed only in premalignant or malignant tissues of individuals with Lynch syndrome that researchers hope will stimulate a robust immune-system attack that stops cancer progression at its origin.

In comparison, the Tri-Ad5 vaccines, developed through the National Cancer Institute’s (NCI’s) intramural program, rely on three tumor-associated antigens that are overexpressed in cancer cells, but are also found to a lesser degree in healthy tissues. Because early studies suggested that the approach with only the MUC-1 antigen showed promise, investigators added two other antigens (CEA and brachyury) in the Tri-Ad5 vaccines, which will be combined with an Interleukin-15 (IL-15) “superagonist,” a vaccine stimulant, to increase the vaccine’s potential for destroying premalignant lesions or early tumors.

 “Right now, we are focused on helping high-risk populations, and they, in turn, are teaching us how to develop better cancer preventive vaccines for the future.”

https://prevention.cancer.gov/news-and-events/blog/trials-test-vaccines?fbclid=IwAR2tAZ9dnoQG5wV9sqQG7IkCS-xn0c7er5BbdKrEdlhX3OcCnKDYCyU3Gko#.Y-UkYVtB9fY.facebook

Gimme Shelter from Lynch Syndrome

“There is much to be optimistic about right now for those with Lynch. Many medical discoveries and advances have been made within the past decade. Aspirin is used as a chemoprevention, immunotherapy may put various Lynch syndrome-related cancer in remission, and AI is improving screening measures, specifically for colonoscopies. What excites me the most is the Lynch vaccine in clinical trials now. The Lynch landscape has changed since my diagnosis 12 years ago.”

https://www.curetoday.com/view/gimme-shelter-from-lynch-syndrome

Online personalised resource for you and yours who have been impacted by a gynaecological cancer.

Gynaecological cancers refer to any cancer of the female reproductive system which includes the uterus (womb), the ovaries, the cervix (the neck of the womb), the vulva (the outer part of the female genitals) or the vagina.

Ovarian cancer and was launched in February 2022 and the genetic conditions, BRCA and Lynch Syndrome, were added in May 2022.  Uterine cancer went live in September 2022.  Vulva cancer and vaginal cancer will be live before the end of 2022.

Just log on to https://thisisgo.ie and select “My Profile”

Many Early Onset Colon Cancers are Caused by Genetic Mutations Through Families

“The prevalence of hereditary cancer syndromes among early-onset colorectal cancer patients – including Lynch syndrome – was quite high, which presents a tremendous opportunity for us to save lives through early detection based on genomic risk factors,” 

Based on this new data, the OSUCCC – James research team recommends genetic counseling and a broad, multi-gene panel test of cancer susceptibility genes for all early-onset colorectal cancer patients, regardless of family history or the results of tumor screening for Lynch syndrome. This differs from current professional guidelines, which recommend all colorectal cancer patients be screened for Lynch syndrome, with referral for genetic counseling and Lynch syndrome-specific genetic testing if the tumor-screening test is abnormal.

“We expected to find a high rate of Lynch syndrome among these early-onset colon cancer patients. What was surprising were some of the other gene mutations found in the young colorectal cancer patients, including mutations in genes traditionally linked to breast cancer risk, even in patients whose family history was not suggestive of those mutations,” 

https://news.cancerconnect.com/colon-cancer/many-early-onset-colon-cancers-are-caused-by-genetic-mutations-through-families

The NordICC Trial: The Devil Is in the Details

The NordICC trial was a randomized, pragmatic study that enrolled 84,585 adults aged 55 to 64 years old from Poland, Norway, and Sweden.

[T]he NordICC trial … fills an important knowledge gap and provides new insight into the real-world population-wide benefit of colonoscopy for colorectal cancer screening.

Preventing Colorectal Cancer

It is important to highlight an advantage of colorectal cancer screening that distinguishes it from all other cancer screening modalities. Colorectal cancer screening with endoscopy is unique in that it aims to, in part, prevent disease by identifying and removing premalignant lesions.

https://ascopost.com/news/november-2022/the-nordicc-trial-the-devil-is-in-the-details/

Person-based co-design of a decision aid template for people with a genetic predisposition to cancer

https://www.frontiersin.org/articles/10.3389/fdgth.2022.1039701/full

Conclusion: Adopting a co-design process helped ensure that the decision aid components were relevant and accessible to the target population. The template could have widespread application through being adapted for different genetic predispositions. The exact content should be co-designed with people from diverse backgrounds with lived experience of the specific predisposition to ensure it is as useful, engaging and relevant as possible

Lifestyle, genetic risk and incidence of cancer: a prospective cohort study of 13 cancer types

Conclusions:

The recommended lifestyle has beneficial associations with most cancers. In terms of absolute risk, the protective association is greater for higher genetic risk groups for some cancers. These findings have important implications for persons most genetically predisposed to those cancers and for targeted strategies for cancer prevention.

https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyac238/6990971?login=false&fbclid=IwAR292N2A3C-zRXHNdg969dY_gR27FgaT7BpZz1Jtx6lr0pRDQVg5h5hzwI0

She With Lynch Syndrome

“The future is bright for those of us with Lynch syndrome and, most likely, for most of us with a hereditary cancer syndrome.“

She and all of the new medical advances for those with Lynch syndrome give me hope for if and when I ever develop cancer. 

https://www.curetoday.com/view/she-with-lynch-syndrome

A Focused Clinical Review of Lynch Syndrome

In summary, LS care has come a long way over the last twenty years. We now understand the individual cancer risk to inform consent, tests to accurately diagnoses LS and ways by which we can reduce cancer risk.

However, more needs to be done to find those who are undiagnosed, develop less invasive cancer surveillance methods and develop new vaccinations and treatments.

https://www.dovepress.com/a-focused-clinical-review-of-lynch-syndrome-peer-reviewed-fulltext-article-CMAR?fbclid=IwAR33GEIsS9fAA63cUmvwRtWTrGALZ2a74tovR7JMBPYNVjDdsx_dDun9oMQ