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New breast cancer test to predict spread of the disease

The test works by identifying the presence of two proteins in cells of the original cancer

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A new breast cancer test, which may be able to accurately predict those at risk of their cancer spreading, is to be trialled in the UK.

The test, which will be trialled at the University of Bradford’s Institute of Cancer Therapeutics, could mean those at low risk could avoid undergoing follow-on treatment as well as potentially save the NHS millions of pounds a year.

In pilot studies, the test has proved 98 per cent accurate in predicting which patients are at low risk of their cancer spreading or returning, referred to as metastasis, after their initial treatment.

Now, a trial funded by Innovate UK is being conducted to test whether Ran Diagnostics works in practice.

Professor Chris Twelves, clinical director of the Institute of Cancer Therapeutics, University of Bradford, who is leading the study, said: “When people are first diagnosed with breast cancer, their oncologist will want to discuss whether they may benefit from extra drug treatment to reduce the risk of the cancer returning and spreading.

“One of the ways we do that now is through a genetic test on the cancer, but that test is expensive and can be slow.

“If, as we hope, Ran Diagnostics is as good at identifying who may benefit from such extra treatment, it will be quicker and less expensive, helping us to better personalise cancer treatment for our patients.”

Dr Mohammad Isreb, associate professor in medicine development at the University of Bradford, said: “The Ran Diagnostics test has the potential to accurately predict the likelihood of someone newly diagnosed with breast cancer developing metastasis in the future more quickly and economically than current tests.

“It may help indicate who may benefit from extra treatment, and those at low risk, who may be able to be spared extra treatment and avoid its painful and unpleasant side effects.”

The test is designed for people with the most common type of breast cancer – hormone receptor positive, HER2, receptor negative. It works by identifying the presence of two proteins in cells of the original cancer, Ran GTPAse (Ran) and MMP-2.

In laboratory tests of 181 tumour samples from patients diagnosed with breast cancer in the 1990s and whose medical histories are known, the Ran Diagnostics test showed 98 per cent accuracy.

Dr Mohammad Isreb, associate professor in medicine development at the University of Bradford and Professor Sherif El-Khamisy, director of the Institute for Cancer Therapeutics at the University of Bradford

Dr Jason Jones, commercial manager, faculty of life sciences, University of Bradford,  said: “We measured levels of the two biomarkers in those samples then we looked at their medical histories to see which ones later developed metastatic disease.

“There is a clear correlation between high levels of Ran and MMP-2 and patient outcomes. Tests showed 98 per cent of patients with low levels did not go on to develop secondary cancer and therefore may have been spared chemotherapy. We have not seen anything with such a strong relationship as this before.”

The trial will be conducted in collaboration with Leeds Teaching Hospitals NHS Trust and the University of Leeds.

Breast cancer is the most commonly diagnosed cancer globally. Metastatic breast cancer – also known as secondary or stage four breast cancer – can be treated but not cured.

The NHS has committed to improving cancer care in its Long Term Plan and NICE recommends tumour profiling for some people with breast cancer to guide clinicians and patients decisions on the best treatment for patients.

Ran Diagnostics could be carried out within a hospital’s own pathology lab, with results potentially available within hours.

The team has been awarded an £897,000 Innovate Biomedical Catalyst grant to test a further 600 samples with known tumour profiling results to see if Ran Diagnostics gives equivalent results.

Ran Diagnostics will comprise of two elements: the physical testing kit used to stain the biomarkers along with AI-enabled software to analyse the data.

The grant also includes funding for Carmen Diagnostic Technologies Ltd, a spin-out company of the University of Bradford that owns the Intellectual Property (IP), to develop Ran Diagnostics into a commercial product.  If the new test is successful, Carmen Diagnostic Technologies could have the product available to use in clinic within two to three years.

Professor Krzysztof Poterlowicz, director of research for computational and data-driven science at the University of Bradford and co-investigator in the project, commented: “This groundbreaking project provides a unique opportunity to leverage the latest advancements in AI and data science to develop software that optimises the results of the Ran Diagnostics test.”

Everard Mascarenhas, director of Carmen Diagnostics Technology, based in Southport, Merseyside, said: “Ran Diagnostics utilises equipment and pathology expertise that already exists in the hospital and can be adopted very quickly in hospitals around the world.

“Furthermore, as the cancer tumours can be tested by the hospital, unlike genetic tests where samples have to be transported internationally, Ran Diagnostics is closely aligned to helping the NHS achieve its net zero climate change objectives.”

He added: “A further limitation of existing genetic tests is that they only work for around 70 per cent of breast cancers.

“The science behind Ran Diagnostics means it can work for all breast cancer. In the future, there is the potential for a similar test to be used on other forms of breast cancer as well as other cancers.”

Professor Sherif El-Khamisy, director of the Institute for Cancer Therapeutics at the University of Bradford, said: “Our mission at the Institute of Cancer Therapeutics is developing smarter and personalised ways to diagnose, predict and treat cancer.

“Ran Diagnostics is an important step towards achieving our aspirations by providing a cost-effective, rapid and potentially point-of care test that informs more personalised cancer treatments that help reducing the risk of the cancer coming back or spreading to other parts of the body.”

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‘Groundbreaking’ endometriosis study identifies patient priorities

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A “groundbreaking” study into endometriosis has identified three areas for future research that can help improve the outcomes for women with the condition.

The study, commissioned by Endometriosis New Zealand, attracted 1,262 participants, including 1,024 people with confirmed endometriosis, making it the largest ever study involving endometriosis patients and supporters in New Zealand.

Study participants identified the management and treatment of endometriosis, the need for a better understanding of its cause and improvements to diagnostic capability as the three main priorities for further research.

While these findings provide a clear pathway for future work, Endometriosis New Zealand chief executive, Tanya Cooke, said endometriosis research had historically been underfunded.

“With an estimated 120,000 New Zealanders living with endometriosis, much more needs to be invested into finding solutions,” Cooke explained.

“The reality is the outcomes for many endometriosis patients are pretty poor, with diagnosis often taking many years and treatment patchy across the country.”

Estimates based on Australian data suggest that endometriosis is likely to be costing New Zealand somewhere in the range of $1.3-1.5bn annually through increased healthcare costs and lost workforce productivity.

Cooke said: “The good news is that our findings align closely with those in Australia and provide three clear priorities for future research – improved treatment options, causation and better diagnostic capability.

“What New Zealand now requires is proper funding for a future research programme that can investigate these priorities more closely and improve the outcomes for individuals living with endometriosis.”

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Virtual care platform secures US$46m to address US maternal health crisis

Pomelo Care will use the funding to scale its care model and improve maternal and infant outcomes

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Marta Bralic Kerns, founder and CEO of Pomelo Care

The US virtual maternity care platform Pomelo Care has secured US$46m in funding to address the US maternal health crisis.

One in 10 babies born in the US today start their life in a neonatal intensive care unit.

Healthcare access continues to worsen, with one in eight births occurring in US counties with limited-to-no access to maternal care. Due to significant gaps in postpartum care, about half of pregnancy-related deaths in the US occur after hospital discharge.

The evidence exists for how to identify people at highest risk for complications and which interventions are most effective, but existing data gaps and provider capacity challenges make it difficult to apply these interventions at scale.

Pomelo has developed a care model that aims to address these challenges by analysing claims and health record data to identify individual risk factors and providing virtual pregnancy, postpartum, and infant care to patients to reduce those risks.

“We’ve long known what works to reduce maternal and infant complications,” said Marta Bralic Kerns, founder and CEO of Pomelo Care.

“The questions have always been: can you identify the patients who are at highest risk, can you deeply engage them in care to drive uptake of the prevention strategies we know work, and can you do it in the highest risk populations with the most limited access to care?”

“This data demonstrates that we absolutely can. And with this additional funding, we’ll have the opportunity to scale our care model to more pregnant people across the country.”

The funding, led by existing investors First Round Capital and Andreessen Horowitz (a16z) Bio + Health, is hoped to help Pomelo accelerate its partnerships with payors across the US and increase access to “evidence-based” care.

Josh Kopelman, partner at First Round Capital and Pomelo board member, said: “It’s rare to come across an opportunity where the incentives between patient, provider and payor are all aligned.

“Marta and the Pomelo team have found an incredible opportunity to dramatically improve outcomes for the highest risk populations, while helping payors reduce their avoidable costs.”

Vineeta Agarwala, general partner at a16z Bio + Health and Pomelo board member, added: “Pomelo is one among a small set of health tech companies that have earned true scale.

“This scale is evident in our partnerships with major Medicaid and commercial plans covering over three million lives, which create the opportunity to collaborate with OB providers, labour and delivery wards, and NICUs nationwide, while serving hundreds of thousands of expecting mothers and newborns with high quality, technology-enabled care.”

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One in three UK fertility patients seek treatment abroad due to high costs

Expensive fertility treatments prompt UK patients to seek help abroad

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One in three fertility patients in the UK seek treatment abroad due to high costs, a new survey has shown.

Fertility Family has gathered insights from 429 UK participants who have experienced difficulties with infertility.

The Infertility Awareness Report found that the high cost of fertility treatment in the UK has driven over one in four people to spend over £10,000 on both treatments and investigative procedures.

The research showed around 35 per cent of people struggling with infertility have considered seeking fertility treatment abroad due to the prospect of lower costs.

Of those seeking fertility treatment in a foreign country, however, only 14 per cent believed that clinics abroad have a higher success rate.

Of those actively trying to conceive almost one in five have used their life savings in the pursuit of having a child, whilst 25 per cent have paid for their fertility treatments using a credit card.

Dr Gill Lockwood, consultant at Fertility Family, said: “While we tend to cast our gaze on women when it comes to infertility, case studies have shown that infertility can impact both women and men in similar ways. However, women have been observed to seek help more than men.

“Although the psychological struggles of infertility can be overwhelming, many patients ultimately reach some type of resolution. Some of the alternatives include becoming parents to a relative’s children, adopting children, or deciding to adopt a child-free lifestyle.

“Needless to say, this resolution is usually psychologically demanding, and patients may feel forever impacted by the experience of infertility.”

A combination of fertility struggles and accessible healthcare have impacted people across the UK significantly, with one in two admitting to feeling “ashamed” due to their difficulties trying to conceive.

A further 31 per cent reported feeling that other people think “less” of them due to their fertility struggles, showcasing the need for better mental health support.

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