News in brief: Cancer patients hit by 70% rise in out of pockets; Mycobacteria make for simple, effective intratumoural immunotherapy; HIV patients still face excess risk of some cancers

30 Sep 2021

Cancer patients hit by 70% rise in out of pocket expenses

Australians with cancer have been burdened with a 70% rise in out-of-pocket direct medical expenses in recent years, a new study shows.

For patients with breast cancer the rise in expenses was particularly high, increasing from AU$2513 in 2011 to AU$6802 in 2015, according to an analysis by researchers at the QIMR Berghofer Medical Research Institute, Brisbane.

Out-of-pocket expenses also increased more for people with private health insurance, they found.

For people with prostate cancer, expenses increased for those without private health insurance over time, from $1586 in 2011 to $4748 in 2014, and remained stable for those with private health insurance (AU$4397 in 2011 to AU$5623 in 2015).

The higher financial costs were due to increased prices for medicines and doctor attendances, the study published in BMC Cancer showed.

Mycobacteria make for simple and effective intratumoural immunotherapy

Australian researchers have developed a low-cost, non-toxic bacterial-based intratumoral cancer immunotherapy that they say has shrunk renal cancers in a phase 1 study.

The process involves injecting a slow-release emulsion of killed mycobacteria directly into tumours, which is hypothesised to activate the innate immune system to fight cancer cells, followed by activation of the acquired immune system to attack non-tumour metastases.

Lead researcher Associate Professor Aude Fahrer, an immunologist at the Australian National University (ANU) says the immunotherapy has been shown to induce tumour regression in animal models, with evidence of increased B and T cell infiltrates in tumours.

The technique has now also shown positive results in eight patients being treated for renal cancer at The Canberra Hospital, with preliminary results published in the BMJ Journal of for Immunotherapy of Cancer.

“They were all late-stage patients, but in one case in particular we were able to significantly improve the patient’s quality of life,” she said.

“The treatment reduced the amount of liquid around their lungs and was able to shrink one of their cancers.”

“The best things about this new treatment are that it requires few dosages, is simple to administer, and has low side effects. It is also extremely low cost. We are looking at around $20 a dose, whereas the cost of other immunotherapies can run to $40,000. This makes the treatment accessible for patients in developing countries.”

A second clinical trial at The Canberra Hospital has already been approved.

HIV patients still face excess risk of some cancers

Rates of AIDS-defining cancers such as Kaposi sarcoma and non-Hodgkin lymphoma have significantly dropped over time in people living with HIV.

However an analysis of cancer rates in more than 33,000 people notified to the Australian National HIV Registry between 1982 and 2012 has shown infection-related, non-AIDS defining cancers have increased.

There was an elevated risk of most infection-related cancers compared with the general population, including increases in anal and liver cancer.

The study authors said delays in antiretroviral therapy (ART) initiation may have resulted in people developing moderate levels of immunosuppression, facilitating the early stages of anal carcinogenesis.

“Recent changes to guidelines recommending that ART should be commenced soon after HIV diagnosis may result in eventual declines in anal cancer incidence, although longer follow-up is require to observe this trend.”

“Optimising hepatitis B vaccination and screening and treatment of hepatitis B and hepatitis C infections in people living with HIV may decrease the risk of liver cancer,” they suggested.

Read more in HIV Medicine


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