image: An MSK researcher at work in the lab.
Credit: Memorial Sloan Kettering Cancer Center
New research from Memorial Sloan Kettering Cancer Center (MSK) uncovers unique genetic signatures in cancer patients of non-European ancestry; identifies social adversity as a potential risk factor for higher rates of triple-negative breast cancer among Black women; shows a web-based system could help head-and-neck cancer survivors report their concerns; and finds adding immunotherapy can boost the effectiveness for hard-to-treat follicular lymphomas.
Study uncovers unique genetic signatures in cancer patients of non-European ancestry
In the era of personalized oncology, it’s becoming increasingly important to understand the genetic differences found in common cancers across people with different ancestries. These variations can help to explain why certain cancers are more common among people with certain backgrounds, and why targeted therapies may not work the same across members of different ancestral groups.
A new study from researchers at MSK used two large datasets to study tumor genetic sequences from more than 275,000 patients with 14 cancer types. The data came from patients whose tumors were sequenced using MSK-IMPACT® or the commercial test FoundationOne. The patients were categorized by genetic ancestry: African, admixed American, East Asian, European, or South Asian.
The team identified 447 gene signatures across people of different ancestries involving 116 unique, cancer-specific genes. The team also detected significantly fewer driver alterations in renal cell carcinoma among patients of African ancestry. Among those of East Asian ancestry, there were fewer driver alterations in lung squamous cell carcinoma and glioblastoma. These findings highlight the need to expand sequencing diversity, researchers say.
“Genomic testing is important for the development of new cancer drugs, as well as finding the best care for each cancer patient,” says computational geneticist Jian Carrot-Zhang, PhD, the study’s senior author. “The lack of population diversity in existing tumor sequencing datasets may result in biases against people of non-European ancestry.” Read more in Nature Genetics.
Social adversity is a potential risk factor for higher incidence rates of triple-negative breast cancer among Black women
Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer that often has a poor prognosis. It affects Black women, especially non-Hispanic Black women, more than other groups. Now a new multicenter study led by MSK has found that living in difficult social and economic conditions is linked to a higher incidence of developing TNBC.
The researchers used a federal database to study more than 13,000 Black women around the United States who were diagnosed with TNBC between 2010 to 2020. The researchers analyzed the data from the breast cancer patients’ neighborhoods using the Yost Index — which looks at median household income, median house value, median gross rent, education index, percent unemployed, percent working class, and percent below 150% of the federal poverty line. The study found the higher the Yost Index score and the more “unhealthy” the neighborhood, the higher the incidence of TNBC among Black women.
“My lab studies — from ‘ZIP code to genomic code’ — how social adversity–associated stress from one’s social and living environment impacts aggressive gene expression profiles or epigenomic alterations within the context of genetic ancestry,” says MSK breast surgeon Neha Goel, MD, MPH, the paper’s senior author. “If we can find ways to improve people’s living conditions or develop interventions to help them manage stressors from their living conditions, we might be able to reduce one potential modifiable risk factor for aggressive diseases like TNBC.” Read more in JAMA Network Open.
Web-based system helps head-and-neck cancer survivors report their concerns
More than two-thirds of people with head and neck cancer survive at least five years after diagnosis, but the long-term effects of treatments for these cancers — including difficulty speaking and swallowing, hearing loss, and dental problems — can persist after treatment and severely impact survivors’ quality of life, leading to high levels of distress.
Researchers are looking for better ways to help doctors identify these effects so that they can intervene and provide help. A multicenter study led by researchers at MSK has found a web-based interface called HN-STAR (for Head and Neck Survivorship Tool: Assessments and Recommendations), which asks survivors to report their concerns prior to routine follow-up visits, could improve how these concerns are addressed in the clinic.
The national trial to test the effectiveness of HN-STAR included more than 340 survivors treated at 28 oncology practices. Survivors whose oncology providers used HN-STAR reported that 33% more of their concerns were discussed in the clinic visit compared with those receiving usual care. Additionally, the proportion of survivors’ concerns discussed at the clinic visit was 14% higher in the HN-STAR group.
“Using electronic patient-reported outcomes has promise after cancer treatment is over, when chronic concerns are particularly relevant,” says outcomes research scientist Talya Salz, PhD, who presented the findings at the recent American Society of Clinical Oncology (ASCO) Quality Care Symposium in Chicago. “These tools also have promise for delivering survivorship care at the point of care, rather than adding to the burden of symptom monitoring between clinic visits.” Read more in JCO Oncology Practice.
Adding immunotherapy boosts effectiveness for hard-to-treat follicular lymphomas
Adding an immunotherapy regimen to standard treatments for follicular lymphomas is safe, effective, and led to durable responses, a phase 1b/2 study found. Almost all participants responded to the therapy, and almost 90% had their cancer disappear entirely. Two years after treatment, 75% remained in remission.
Most people with follicular lymphoma respond well to initial treatment, but the disease often returns, requiring additional therapies and often leading to drug resistance. MSK researchers have been pioneering new strategies to combat drug resistance and prevent cancer from coming back.
Lymphoma specialist Lorenzo Falchi, MD, led the study to see if adding the immunotherapy epcoritamab to a combination of rituximab and lenalidomide would boost the effectiveness and prolong the time that trial participants lived cancer-free. Epcoritamab is a bispecific antibody that simultaneously binds to immune cells and cancer cells, allowing the immune system to better recognize and destroy cancer cells. It was granted accelerated approval by the U.S. Food and Drug Administration (FDA) in 2024 as a standalone therapy for follicular lymphoma, prompting investigators to consider combining it with other effective therapies.
The trial enrolled 108 adults with follicular lymphoma whose cancer returned after at least one prior treatment. Participants received epcoritamab for up to two years, and rituximab plus lenalidomide for up to five months and one year, respectively. Side effects included low white blood cells and cytokine release syndrome, but none led participants to discontinue treatment. Read more in Blood.