UK scientists are currently analysing the complete genetic make-up – or whole genome sequence – of tumours from about 12,000 patients in the country.

The team says that the unprecedented amount of data allowed them to discover new patterns in the DNA of cancer, hinting at causes that are not yet understood. They add that the genetic clues are likely to help improve diagnosis and treatment.

The research is published in Science and led by the University of Cambridge. The research team analysed anonymised DNA data provided by the 100,000 Genomes Project – a nationwide initiative to sequence the whole genomes of patients affected by cancer and rare diseases.

Researchers were able to detect specific combinations of genetic alterations – so-called ‘mutational signatures’, which may be key to the growth of cancers. Through comparing the data to other international genetic cancer projects, the researchers confirmed patterns that are already known, while also uncovering 58 new ones.

The scientists also created a computer programme to help scientists and doctors check whether patients who have had whole genome sequencing have any of the newly discovered mutational clues.

Professor Matt Brown, chief scientific officer of Genomics England, explained: “Mutational signatures are an example of using the full potential of whole genome sequencing. We hope to use the mutational clues seen in this study and apply them back into our patient population, with the ultimate aim of improving diagnosis and management of cancer patients.”

Lead researcher, Professor Serena Nik-Zainal, a consultant at Cambridge University Hospitals, said the study was like an “archaeological dig” of people’s cancer.
She added: “We can see the patterns or imprints in the field of their cancers – like dinosaur footprints – of what is going wrong with their cancers. And everyone’s cancer is different. To know we can personalise each person’s cancer report means we are a step closer to personalising treatment for them.”

The National Institute for Health and Care Excellence (NICE) has released new guidelines outlining the prescription and management of withdrawal from opioids, benzodiazepines, gabapentinoids, Z-drugs and antidepressants in primary and secondary care.

The guidelines share that while antidepressants are not ‘dependence-forming’ drugs, they can still cause withdrawal symptoms. ‘Antidepressants, although historically not classified as dependence-forming medicines, can nevertheless cause withdrawal symptoms when they are stopped,’ the guidelines stated.

The guidelines also highlight dose reduction, managing withdrawal symptoms and interventions to support withdrawal.

In 2017 Public Health England was commissioned to identify the scale, distribution and causes of drug dependence, and found that in 2017 to 2018, 7.3 million adults in England (17% of the adult population) received, and had dispensed, antidepressants.
Between 2015 to 2016 and 2017 to 2018, the rate of prescribing antidepressants increased from 15.8% of the adult population to 16.6%.

Furthermore, the pandemic saw the prescription and use of antidepressants in the UK soaring, as access to counselling decreased. In 2021, there were 235,000 fewer referrals for talking therapies in England between March and August, compared to the same period of 2020.

The guidelines released in April also correlate to the NICE recommendation from October 2021 that GPs should regularly review patients withdrawing from addictive medication. NICE has previously warned of the ‘severe’ and lengthy antidepressant withdrawal symptoms, a revision of earlier designations of these symptoms as ‘mild’.

In conclusion, NICE emphasised that GPs should “not withhold the medicine solely on the basis of one of these factors”, but should “consider delaying prescribing if the person needs more time to think about their options or the prescriber needs to consult with other members of the healthcare team. If prescribing is delayed, ensure that a follow-up appointment is arranged”.