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Blood test offers hope for better lung cancer treatment

BOSTON -- Researchers have taken an important step toward better lung cancer treatment by using blood tests to track genetic changes in tumors as they progress from their very earliest stages.

With experimental tests that detect bits of DNA that tumors shed into the blood, they were able to detect some recurrences of cancer up to a year before imaging scans could, giving a chance to try new therapy sooner.

It's the latest development for tests called liquid biopsies, which analyze cancer using blood rather than tissue samples. Some doctors use these tests now to guide care for patients with advanced cancers, mostly in research settings. The new work is the first time tests like this have been used to monitor the evolution of lung tumors at an early stage, when there's a much better chance of cure.

Only about one third of lung cancer cases in the United States are found at an early stage, and even fewer in other parts of the world. But more may be in the future as a result of screening of longtime smokers at high risk of the disease that started a few years ago in the U.S.

Early-stage cases are usually treated with surgery. Many patients get chemotherapy after that, but it helps relatively few of them.

"We have to treat 20 patients to cure one. That's a lot of side effects to cure one patient," said Dr. Charles Swanton of the Francis Crick Institute in London.

The new studies he led suggest that liquid biopsies might help show who would or would not benefit from chemotherapy , and give an early warning if it's not working so something else can be tried.

Cancer Research UK, a charity based in England, paid for the work, and results were published online Wednesday by  Nature  and the  New England Journal of Medicine .

To be clear: This kind of care is not available yet - the tests used in these studies are experimental and were customized in a lab to analyze the genes in each patient's cancer. But the technology is advancing rapidly.

The company that generated the tests for the study in Nature - California-based Natera Inc. - plans to offer the tests for research by universities and drug companies later this year and hopes to have a version for routine use in cancer care next year.

"This is coming, and it's coming fast," said Dr. David Gandara, a lung specialist at the University of California, Davis, who had no role in the studies but consults for two companies developing liquid biopsies. A test that could spare many people unnecessary treatment "would be huge," he said.

In the studies, researchers analyzed tumors from about 100 people with non-small cell lung cancer, the most common form of the disease. Even in these early-stage cases, they found big variations in the number of gene flaws, and were able to trace how the tumors' genes changed over time.

People with many gene or chromosome problems were


What Oktoberfest study reveals about heavy drinking

Drinking heavily over a short period of time can significantly boost the risk of an abnormal heart rhythm , even in healthy people, new German research suggests.

The finding stems from a study done at Munich's Oktoberfest, a long-standing Bavarian beer festival held every autumn. Over a 16-day period in 2015, researchers tracked the heart health and drinking patterns of a group of more than 3,000 men and women.

The investigators found that nearly a third of the group experienced an abnormal heart rhythm -- or "cardiac arrhythmia" -- at some point during the festival, a much higher percentage than usually seen among the general population.

What's more, investigators calculated that, for every additional gram of alcohol consumed per kilogram of blood (above zero), arrhythmia risk rose by 75 percent.

Study co-author Dr. Moritz Sinner, an assistant professor of medicine at University Hospital Munich, said that even though the phenomenon is well-known, the findings are "remarkable."

"For the first time we were able to demonstrate that alcohol has an immediate effect on the heart rhythm," he said.

He noted that this is the first study to track drinking and its impact on heart rhythms  while  participants were actually drinking , compared to other studies in which people try and recall their drinking behavior.

Sinner and his colleagues published their findings April 26 in the  European Heart Journal .

Dr. Gregg Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center in Los Angeles, expressed little surprise at the findings.

"It is well-documented that alcohol consumption can increase the likelihood of having arrhythmias," he noted, adding that the phenomenon has actually given rise to a label --  "holiday heart syndrome."

According to the U.S. National Heart, Lung, and Blood Institute , a cardiac arrhythmia is essentially an electrical disruption to the normal workings of the heart, in which the heart muscle beats excessively fast, too slow or irregularly. In most cases it is harmless, but it can interrupt the usual flow of blood, raising the risk for serious organ, brain and heart damage.

In the Oktoberfest study, the participants were on average 35 years old, and 30 percent were women.

Their drinking patterns varied, from total abstention to 3 grams of alcohol per kilogram of blood, which was the maximum permitted by the researchers and far exceeds the German legal driving limit of 0.5 grams of alcohol per kilogram of blood.

The researchers estimated that a person would have to consume roughly 6 to 10 quarts -- or liters -- of beer to reach the 3-gram maximum.

Smartphone-enabled electrocardiogram readings were repeatedly taken, alongside breathalyzer readings . The results were tracked in comparison to a community-based chronic alcohol cohort study done in Augsburg, Germany.

In the end, the team found evidence of arrhythmias in almost 31 percent of the Oktoberfest participants, much higher than the 1 to 4 percent prevalence typically seen in the population at large. Just over a quarter of the arrhythmias involved excessive heart-beating ("sinus tachycardia").

The researchers concluded that alcohol


Report: House GOP leaders to kill lawmaker exemption in health care bill

House GOP leaders are moving to kill a provision in their revised healthcare bill to repeal and replace Obamacare that allows members of Congress and their staffs to continue their Obamacare coverage while allowing states to opt out, according to a Politico report.

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