‘Second Cancers’ Are On The Rise, But It’s Kind Of A Good Thing

The number of ?second cancer? patients, or individuals who develop two unrelated forms of cancer at different times in their lives, is on the rise. Although the news may sound grim, doctors say the increase is not due to patients??poor health, but rather?a sign that we?re getting better at detecting and beating cancer.

In the United States, nearly one in five new cases of cancer occur in individuals who have already had the disease. That’s?a 300 percent increase since the 1970s, The Associated Press?reported. While this?figure?may be startling, the fact remains that no matter what type of cancer a person has had, it?s possible to develop a new, unrelated cancer. According to the American Calab-test-tubes_227ncer Society, increasing numbers of second cancer cases are a sign that advances in early detection and treatment?are saving an unprecedented amount of lives. In other words, people getting second cases of cancer?means that more people than ever are actually surviving their first case.

Cancer is caused by mutations within the DNA that cause cells to no longer function correctly. These cells may eventually become cancerous. For some, the same mutations that led to the?first?cancer inevitably spur a second or even third case. This can occur?even after the patient has made a full recovery. For example, doctors know women who have?the BRCA1 mutation and have already experienced breast cancer?are at a higher risk of developing an unrelated type of cancer, such as colon cancer. Because of this genetic risk, these patients will need to be monitored and screened for signs of other cancers for the remainder of their lives.

For others, the treatment that saved their life ends up being the reason their life is once again at risk. For example, although cancer treatments have become effective at destroying cancer without compromising the patient?s health,?some treatments, such as radiation treatment, can actually give rise to new mutations and therefore new cancers.

Translational Science ResearchBattling cancer the second time can be trickier than the first because many treatments are ineffective or even deadly when given over a longer period of time. ?Along with the medical?limitations, experts agree that a second bout of cancer can be mentally difficult for patients to deal with. “I think it’s a lot tougher” for most people, Julia Rowland, director of the federal Office of Cancer Survivorship, told AP. “The first time you’re diagnosed, its fear of the unknown. When you have your next diagnosis, it’s fear of the known.?

Those who have survived past bouts of cancer need to be hypervigilant about cancer screening throughout their lives in order to ensure that if they do develop the disease again, they are able to detect it at the earliest possible stage. Although it may be daunting, patients should remember that cancer treatments are advancing on nearly a daily basis.

By Dana Dovey, Displayed with permission from Medical Daily
RePubHub Banner

Got Questions? We have Answers! Contact us at CriteriumBlog@criteriuminc.com

HIV Uses Immune System’s Own Tools to Suppress Itself

Canadian scientists make a significant discovery on HIV persistence

A Canadian research team at the IRCM in Montr?al, led by molecular virologist ?ric A. Cohen, PhD, made a significant discovery on how HIV escapes the body’s antiviral responses. The team uncovered how an HIV viral protein known as Vpu tricks the immune system by using its own regulatory process to evade the host’s first line of defense.?The findings pave the way for future HIV prevention or cure strategies.

The study’s goal was to determine how HIV manages to compromise antiviral responses in the initial period of infection, also called the acute infection stage, during which the virus establishes itself in the body. The acute infection is considered a critical period in determining the complexity, extent and progression of the disease. It is also during this stage that HIV establishes latent infection in long-lasting cellular reservoirs. These viral reservoirs, which harbor the virus out of sight from the immune system and antiviral drugs, represent the primary barrier to a cure.

“An important component in this process is a group of proteins collectively called type 1 Interferons, which are the immune system’s first line of defense against viral infections and are known to have a beneficial role in the early stages of HIV infection,” says Dr. Cohen, Director of the Human Retrovirology research unit at the IRCM. “The problem is that HIV has developed mechanisms to suppress the Interferon response and, until now, little was known about how this was achieved.”

PHIL-18143 PubDomLic SEM HIV Particles courtesy NIAID
SEM HIV Particles courtesy NIAID PHIL-18143

Most of the Interferon is produced by a very small population of immune cells called pDCs (plasmacytoid dendritic cells), responsible for providing immediate defense against infections. PDCs patrol the body to detect invaders and, when they recognize the presence of a pathogen, they secrete Interferon. The Interferon then triggers a large array of defense mechanisms in nearby cells, creating an antiviral state that prevents the dissemination and, ultimately, the expansion of the virus.

“When pDCs encounter HIV-infected cells, the production of Interferon is regulated by a protein located on the infected cell’s surface called BST2,” explains Mariana Bego, PhD, first author of the study and research associate in Dr. Cohen’s laboratory. “BST2 has the ability to bind to and activate a receptor called ILT7, found on the surface of pDCs, which, in turns, sends a signal that suppresses the production of Interferon and halts its defensive functions. Interestingly, BST2 is also responsible for restricting HIV production by trapping the virus at the cell surface before it can exit infected cells and disseminate. However, HIV uses the viral protein Vpu to counteract BST2 antiviral activity.”

“With this study, we uncovered a unique mechanism whereby HIV exploits the regulatory process between BST2 and ILT7 to limit the body’s antiviral response, which allows the virus to spread and leads to persistent infection,” adds Dr. Bego. “We found that HIV, through Vpu, takes advantage of the role played by BST2 by maintaining its ability to activate ILT7 and limit the production of Interferon, all the while counteracting its direct antiviral activity on HIV production.”

“The hope for a definitive cure and an effective vaccine has been frustrated by HIV’s endless propensity to subvert the host’s defenses and persist in small populations of long-lasting reservoirs despite antiretroviral therapy,” describes Dr. Cohen, who also leads CanCURE, a team of leading Canadian researchers working towards an HIV cure. “Our findings can provide tools to enhance antiviral responses during the early stages of infection. By blocking Vpu’s action, we could prevent early viral expansion and dissemination, while also allowing pDCs to trigger effective antiviral responses. We believe that such interventions during primary infection have the potential to limit the establishment and complexity of viral reservoirs, a condition that seems required to achieve a sustained HIV remission.”

“The discovery by Drs. Bego and Cohen, which explains how the virus can’t be held down or wiped out during early periods of infection, will bring us closer to ending HIV/AIDS,” says Robert Reinhard, CanCURE Community Liaison. “By filling an important gap in knowledge, this new study will advance research for an HIV cure.”

About the study
The research project was funded by the Canadian Institutes of Health Research (CIHR), the Canadian HIV Cure Enterprise (CanCURE) through a partnership between CIHR, the Canadian Foundation for AIDS Research (CANFAR) and the International AIDS Society (IAS), as well as by a pilot project from the FRQS AIDS and Infectious Disease Network. The study’s authors also include ?douard C?t? and Johanne Mercier from the IRCM, as well as Nick Aschman and Winfried Weissenhorn from the Universit? Grenoble Alpes in France. For more information on the study, please refer to the article published online by PLoS Pathogens

Findings from this study presented by Dr. Cohen on July 21 at the Vancouver Convention Centre as part of the 8th IAS Conference on HIV Pathogenesis, Treatment and Prevention.

Displayed with permission from PR Newswire via RePubHub Free LicenseRePubHub Banner

 

 

Got Questions? We have Answers! Contact us at CriteriumBlog@criteriuminc.com

2015: Lung Cancer Research Outside the USA

Female Lung Cancer Deaths to Surpass Breast Cancer in Europe

In January 2015, a study by researchers from Switzerland and Italy revealed that lung cancer deaths among women in Europe would overtake those from breast cancer in 2015.[1] Lung cancer is the most common type of cancer, accounting for 13% of all cancer deaths worldwide. That represents a death toll of 1.6 million people, over 80% of who are tobacco users.[2]? While European men have been more afflicted by the disease due to higher smoking rates, the rates among men have been on the decline in the recent past. Meanwhile, the rates among women have been on an upward trend. This year, the prevalence of lung cancer among women in Europe is expected to rise by 9% over 2009 levels to reach 14.24 per 100,000 of population. Meanwhile, the death rate from breast cancer over the same period will fall by 10.2% to 14.22 deaths per 100,000 of population.[3]

The rise is attributed to the delayed effect of the surge in smoking among European women during the period after the 2nd World War and extending to the late 1960s.[4] The UK is one of the main drivers of this trend. Of all the countries surveyed independently, the UK had the highest level of lung cancer deaths, 21 per 100,000 of population.[5] Professor Carlo La Vecchia of the University of Milan, who is also the lead researcher attributed this to the fact that, ??British women started smoking during the second world war, while in most other EU countries women started after 1968.?

Research Shows Personalized Treatments are Underutilized

An international survey conducted between December and January 2015 revealed that the rates of patients receiving personalized treatment for advanced non-small cell lung cancer (NSCLC) remains low despite a large proportion of them (81%) having been tested for EGFR mutations. The results of the study were released in April in Ingelheim Germany, the seat of the Boehringer Ingelheim Pharmaceutical group which is the main sponsor of the study. The results were collected from 562 oncologists from 10 developed countries across Asia, Europe and North America. In Europe, 30% of advanced NSCLC patients were put on first-line treatment before their test results were ready, displaying a huge disparity with Asia (12%). The average global rates were 25%. The main reasons cited by oncologists for non-testing were insufficient tissue, poor patient fitness and protracted process of acquiring results once samples had been taken. Additionally 51% of all oncologists involved in the study stated that their treatment decisions were not dependent on EGFR mutation subtype of their patients. EGFR mutations are present in 40% of East Asian and 10-15% of white NSCLC patients.[6] ESMO clinical practice guidelines[7] recommend the use of EFGR mutation testing results to guide treatment decisions according to each patient?s specific cancer type as this has been shown to improve survival rates at least with the Del 19 mutation[8], the most common type of mutation.[9]

Sources:
[1] http://annonc.oxfordjournals.org/content/early/2015/01/24/annonc.mdv001.full
[2] http://www.cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-cancer/smoking-facts-and-evidence#smoking_facts0
[3] http://annonc.oxfordjournals.org/content/early/2015/01/24/annonc.mdv001.full
[4] http://www.theguardian.com/society/2014/oct/07/smoking-falls-lowest-level-uk-recording-started-1940s
[5] http://annonc.oxfordjournals.org/content/early/2015/01/24/annonc.mdv001.full
[6] https://www.boehringer-ingelheim.com/news/news_releases/press_releases/2015/17_april_2015_oncology.html
[7] http://annonc.oxfordjournals.org/content/early/2014/08/11/annonc.mdu199.full.pdf+html
[8] Afatinib versus cisplatin-based chemotherapy for EGFR mutation-positive lung adenocarcinoma (LUX-Lung 3 and LUX-Lung 6): analysis of overall survival data from two randomised, phase 3 trials
??? Yang, James Chih-Hsin et al., The Lancet Oncology , Volume 16 , Issue 2 , 141 – 151
[9] http://link.springer.com/article/10.1007/s00330-015-3697-0/fulltext.html

Got Questions? We have Answers! Contact us at CriteriumBlog@criteriuminc.com

 

IUDs safe in population at high risk for STIs

  1. ?In a study population at high-risk for sexually transmitted infections, the rate of pelvic inflammatory disease following intrauterine device placement was low.
  2. The IUD continuation rate at one year was greater than 85 percent.

Evidence Rating Level: 3 (Average)???????

IUD Diagram Jun15 Blog

 

 

 

 

 

 

Image: CC/Wikimedia Commons/Blausen.com?used with license/permission

Study Rundown: Intrauterine devices (IUDs) are some of the most effective forms of birth control, with a failure rate of less than one percent, and have been demonstrated to be safe for a wide range of women, including teenagers and young adults. Despite their high efficacy and safety record, many practitioners and patients still have misconceptions regarding the risk of pelvic inflammatory disease (PID) after IUD placement. PID is an infection of the upper genital tract (endometrium, tubes and ovaries) that commonly occurs when a sexually transmitted infection (STI), such as Chlamydia, gonorrhea, or trhichomonas ascends from the lower genital tract. Complications from PID include infertility and PID as well as an increased risk of ectopic pregnancy. If a woman has an STI at the time of IUD placement, she is at higher risk of contracting PID, but after about 20 days, the risk of PID decreases to the baseline risk among women who use a non-barrier form of contraception. Because of the concern for risk of PID with IUD insertion among women at high risk for STIs, most large studies exclude this population and limited data exists to guide their use in this population. In the present work, researchers retrospectively assessed rates of PID after IUD placement in an urban teaching hospital that did not restrict IUD eligibility based on STI risk factors.

Rates of PID following IUD placement were low and comparable to previous studies. The study population was at high-risk for STIs with a high incidence (nearly 50%) of personal history of STIs, 50% of participants were under the age of 26, and participants identified as being single. Lack of control group limited this study. Replication of findings using an age-matched control cohort would lend credence to the results presented herein.

Click to read the study in Contraception

Relevant Reading: Does insertion and use of an intrauterine device increase the risk of pelvic inflammatory disease among women with sexually transmitted infection? A systematic review

In-Depth [retrospective cohort]: Researchers reviewed charts of all patients undergoing hormonal IUD placement in the resident clinic of a large, urban, academic medical center from July 2007-June 2008 (n = 283). IUD candidates were not restricted by age, parity or STI risk. The primary outcome was diagnosis of PID within twelve months of IUD placement. Secondary outcomes included continuation and adverse outcomes: expulsion, perforation, pregnancy, pain and heavy bleeding.

Prior to IUD placement, 140 patients (49.5%) reported a history of STI and eight (3.02%) tested positive for gonorrhea or chlamydia at the time of placement in this high-risk population. In the 12 months following placement, only two patients (0.7%) were diagnosed with PID, one of which had a positive gonorrheal test at the time of placement. The continuation rate at one year was 85.2%, expulsion rate was low (5.3%) and a minority of women (17.7%) reported adverse effects.

(by Maren Shapiro; Reprinted with license and permission from 2 Minute Medicine)RePubHub Banner

 

 

Got Questions? We have Answers! Contact us at CriteriumBlog@criteriuminc.com

 

Other Gene Tests for Cancer

Other than the BRCA1 and BRCA2 gene mutation test for breast and ovarian cancer, there are other gene-related tests available for cancer.

As an example, one such test that is available is for Lynch syndrome, a hereditary condition which comes with a family history of colon cancer and other types of cancer at a younger age. Those with the syndrome have a higher risk of colorectal and uterine (womb) cancers.

Like BRCA screening, the genetic screening test for Lynch is expensive and is recommended only for high-risk individuals with a strong family history of such cancers.

Trying to find the Lynch syndrome in the general population would be rather costly and not necessarily helpful, said Dr Lim Sheow Lei, a senior consultant at the department of gynaecological oncology at KK Women’s and Children’s Hospital.

BLOG CTA ButtonRead more about how targeted treatments and translational science research methods are creating better outcomes for patients with cancer

The field of cancer genetics is a rapidly evolving area.?? But things are changing quickly.? As genomic technology advances, the cost of sequencing the human genome is plunging, said Dr Lim. Just two weeks ago, a US company announced it was offering a much cheaper and easier way for women to get tested for the BRCA1 and BRCA2 genetic mutations.

Color Genomics* has begun selling a test (USD $249) that it said could accurately analyze a saliva sample for the mutations, as well as check for 17 other genetic variants that have been associated with a somewhat increased risk for cancer of the breast or ovaries.

Cancer can sometimes appear to “run in families” even if it is not caused by an inherited mutation.? Acquired mutations are the most common cause of cancer. These mutations occur from genes damaged during a person’s life. Smoking, viruses, and aging can damage genes and cause these mutations.

One such cancer caused by an acquired mutation is cervical cancFREE MS Art - Cancer Biology Ribboner, which stem from the human papilloma virus (HPV). Last year, the US Food and Drug Administration approved the HPV DNA test, manufactured by Roche, as a first-line primary screening test in women 25 and older. The geno-typing test detects DNA from 14 high-risk HPV types and specifically identifies HPV 16 and HPV 18, which carry the highest risk of cervical cancer. It can be used to help a healthcare professional assess the need for the woman to undergo additional diagnostic testing for cervical cancer. The test can also provide information about the patient’s risk for developing cervical cancer in the future.

Women who test positive for HPV 16 or HPV 18 should have a colposcopy, an examination using a device that illuminates and magnifies the cervix so a doctor can directly observe the cervical cells. Those who test positive for one or more of the 12 other high-risk HPV types should have a PAP smear to determine the need for a colposcopy. In a United States study of more than 47,000 women that compared HPV DNA tests with PAP smear tests, up to one in three women with cervical cancer had a normal PAP smear result.

Scientists and researchers are uncovering more genetic markers for other cancers.? The challenge is to know what to do with these pieces of information, how to interpret the multitude of newly uncovered mutations, work out the associated cancer risks and to manage the risks, said Dr Lim.

(Reprinted with license and permission from The Straits Times by Ng Wan Ching)
RePubHub Banner

 

Got Questions? We have Answers! Contact us at CriteriumBlog@criteriuminc.com

*Information and link for Color Genomics does not constitute our endorsement of or any liability associated with the product, company or service.? Please consult a physician in case you believe you or someone you know may have cancer.

Halozyme: Update Following Type B FDA Meeting

Recent FDA meeting allows for potential marketing application based on progression free survival in pivotal Phase 3 pancreatic cancer study

Halozyme Therapeutics, Inc.,a biotechnology company developing novel oncology and drug-delivery therapies, today announced it plans to proceed with a Phase 3 clinical study (Study 301) of its investigational new drug PEGPH20 in patients with metastatic pancreatic cancer, using a design allowing for potential marketing application based on either progression free survival (PFS) or overall survival. The use of PFS as the basis for marketing approval will be subject to the overall benefit and risk associated with PEGPH20 combined with nab-paclitaxel (ABRAXANE ?) and gemcitabine therapy, including the:

  • Magnitude of the PFS treatment effect observed;
  • Toxicity profile;?and
  • Interim overall survival data.

The study will enroll patients whose tumors accumulate high levels of?hyaluronan?(HA)?? a?sugar?that?is sometimes more prevalent in the areas surrounding cancer cells. Halozyme recently discussed the study as part of a planned Type B meeting with the U.S. Food and Drug Administration (FDA).

bullseyeData discussed at the meeting focused on interim results from the company’s randomized Phase 2 study in pancreatic cancer, Study 202, which showed a doubling in median PFS in metastatic pancreatic cancer patients with high levels of HA who were treated with Halozyme’s investigational new drug PEGPH20 combined with nab-paclitaxel (ABRAXANE ?) and gemcitabine (9.2 months vs. 4.3 months in patients treated with nab-paclitaxel ABRAXANE ? and gemcitabine alone). The potential risk profile, including rate of thromboembolic events, was also discussed.? Additional?takeaways from the meeting include:

  • Halozyme?affirmed?plans?to enroll and evaluate high-HA patients using a companion diagnostic test; and
  • FDA provided feedback on the current?companion diagnostic approach and confirmed that an approved companion diagnostic strategy is required prior to Phase 3 study initiation.

“We are encouraged by the FDA’s feedback and their willingness to consider a novel primary endpoint such as PFS given the high unmet medical need in high-HA metastatic pancreatic cancer,” said Dr. Helen Torley, President and Chief Executive Officer. “We are committed to rapidly finalizing the Phase 3 protocol and developing the companion diagnostic regulatory filings required to initiate Study 301.” Based on this FDA feedback, the company is targeting the end of first quarter 2016 to initiate the Phase 3 study.

About Study 202 & PEGPH20microscope in laboratory
Study 202 (Halo 109-202) is a Phase 2 multi-center, randomized clinical trial evaluating investigational new drug PEGPH20 as a first-line therapy for treatment of patients with stage 4 metastatic pancreatic cancer. The primary outcome of the trial is to measure improvement in progression-free survival in patients receiving investigational new drug PEGPH20 in combination with gemcitabine and nab-paclitaxel compared to gemcitabine and nab-paclitaxel alone. A second primary endpoint will assess the thromboembolic event rate in the PEGPH20 treatment arm. Secondary endpoints also include objective response rate and overall survival. More information may be found at: http://oncologytrials.halozyme.com/pancreatic/.

PEGPH20 is an investigational PEGylated form of Halozyme’s proprietary recombinant human hyaluronidase under clinical development for the systemic treatment of tumors that accumulate hyaluronan. FDA granted orphan drug designation to PEGPH20 for treatment of pancreatic cancer and fast track for PEGPH20 in combination with gemcitabine and nab-paclitaxel for the treatment of metastatic pancreatic cancer. Additionally, the European Commission, acting on the recommendation from the Committee for Orphan Medicinal Products of the European Medicines Agency, designated investigational drug PEGPH20 an orphan medicinal product for the treatment of pancreatic cancer.

About Halozyme
Halozyme Therapeutics is a biotechnology company focused on developing and commercializing novel oncology therapies that target the tumor microenvironment. Halozyme’s lead proprietary program, investigational drug PEGPH20, applies a unique approach to targeting solid tumors, allowing increased access of co-administered cancer drug therapies to the tumor.? PEGPH20 is currently in development for metastatic pancreatic cancer and non-small cell lung cancer and has potential across additional cancers in combination with different types of cancer therapies. For more information, visit www.halozyme.com.

(Displayed with permission from PR Newswire)RePubHub Banner

 

 

Got Questions? We have Answers! Contact us at CriteriumBlog@criteriuminc.com

FDA Approves Pulmozyme with eRapid Nebulizer

CF Patients See 2 – 3 Minute Treatment Times

The eRapid Nebulizer System (eRapid) from PARI has been approved as the first electronic nebulizer by the Food and Drug Administration to deliver Genentech’s Pulmozyme for cystic fibrosis treatment.? A huge improvement for cystic fibrosis patients, eRapid is able to reduce average treatment times with Pulmozyme from 6-8 minutes down to 2-3 minutes.? Both adult and pediatric patients showed a strong preference for eRapid over conventional nebulizers in a clinical study. FDA-Logo

“We have been pleased with eRapid’s fast treatment times in the lab and are excited that patients now have access to a much faster Pulmozyme therapy.? As the first electronic nebulizer to deliver Pulmozyme, eRapid is a true breakthrough for cystic fibrosis patients who take the therapy daily, often for years,”?said Lisa Cambridge, director of Medical Science and Pharmaceutical Alliances at PARI Respiratory Equipment, Inc.

“PARI was motivated to introduce eRapid to the US market based on encouragement from the Cystic Fibrosis Foundation and their input to have a general-use, electronic nebulizer that could improve therapy adherence. For many years, eRapid has been successfully distributed in Europe (as eFlow Rapid) with favorable feedback from patients with CF. In the Pulmozyme clinical trial, there was a 10:1 preference for eRapid in the pediatric group and a 20:1 preference in the adult group.? That confirmed our decision to bring eRapid to the US,” added Geoff A. Hunziker, president of PARI USA.

“After the successful results of a Phase IV study, we are confident that physicians will see that both pediatric and adult patients favor eRapid based on reduced treatment times, quiet operation, and its small, portable size.? We were also happy to see that patients were more satisfied with treatment and eRapid had a positive influence on adherence ? good for their overall cystic fibrosis management,” added Lisa Cambridge.? eRapid is available today by prescription through a select group of specialty pharmacies.? Visit www.pari.com or call 1-800-FAST-NEB to learn more.

Pulmozyme is indicated for daily administration along with standard therapies for the management of cystic fibrosis to improve pulmonary function.? For more information, visit http://www.pulmozyme.com/.

About eRapid Nebulizer System eRapid is an electronic nebulizer that enables quick and efficient inhalation that can greatly reduce a patient’s treatment burden. ?For more information on eRapid, please visit http://www.pari.com/.

About Cystic Fibrosis Cystic fibrosis, a life-threatening disease affecting 30,000 American patients, involves a genetic mutation that results in poorly hydrated, thickened mucus secretions in the lungs, as well as severely impaired mucociliary clearance.? Get more information about Cystic Fibrosis, visit http://www.cff.org

About PARI Respiratory Equipment, Inc. PARI is a leading, worldwide developer and manufacturer of fast and efficient aerosol delivery systems for patients with asthma, chronic lung disease, cystic fibrosis, RSV, VAP, and HAP.? PARI’s worldwide vision is to improve the lives of those affected by respiratory diseases and those who care for them.?PARI is considered the gold standard for aerosol delivery for nebulizer therapies.? Featured products include the PARI LC PLUS Reusable Nebulizer, Vortex Holding Chamber, and the drug-specific eFlow Technology platform.

SOURCE: PARI Respiratory Equipment, Inc., Displayed with permission from PR Newswire via RePubHub

New Treatment Helps 80% Of Kids Overcome Peanut Allergies

In the past several decades, the number of children with peanut allergies has tripled from 0.4 percent in 1997 to 1.4 percent in 2010, according to a Mount Sinai Hospital study. While doctors aren?t certain what caused the increase, it has led schools and airlines to ban peanut products out of fear of causing severe reactions.

By Lecia Bushak? Release Date January 31, 2015

Now, a new study from Murdoch Children?s Research Institute outlines a new treatment that could possibly cure children of their peanut allergies. The researchers gave 60 peanut-allergic children a dose of a probiotic known as Lactobacillus rhamnosus (around 20 kilograms of yogurt) mixed with a peanut protein, and gradually increased the daily amount over the course of 18 months in order to test whether their tolerance would gradually increase. Over 80 percent of the children who received the treatment were no longer severely allergic to peanuts by the end of the 18 months, when compared to four percent of the placebo group.

Image Courtesy of Shutterstock via RePubHub

For the study, “the combined delivery of probiotic and oral immunotherapy was a safe and effective treatment for peanut allergy; however, it is important to point out that this treatment must be given only under close medical supervision as we are giving peanut to children who are allergic to peanut, and children did have allergic reactions,? said Professor Mimi Tang, an author of the study, in the press release. ?Nevertheless, the likelihood of success was high ? if nine children were given probiotic and peanut therapy, seven would benefit.?

Immunotherapy, more simply known as allergy shots, is a long-term treatment that helps people develop a higher tolerance to allergens, and decreases symptoms of allergic rhinitis, allergic asthma, or conjunctivitis, according to the American Academy of Allergy, Asthma, and Immunology (AAAAI). Allergy shots are similar to vaccines: The body responds to each injection by building up its immunity to the allergen, similar to how vaccines help the body create defenses against viruses.

Previous research has found that oral immunotherapy ? meaning doses of the allergen taken by mouth, not a jab ? proved useful in decreasing symptoms of peanut allergy in children. Also known as desensitization, the treatment is still being studied. Until it’s used more widely, most people with peanut allergies should still avoid peanuts at all costs, and carry an ?Epi-pen,? or a shot of epinephrine, wherever they go to prevent anaphylaxis. Less severe allergy cases involve Benadryl as the only treatment option.

The new study?s results, however, are promising. Eighty-two percent of the children treated with the probiotic mixture were able to include peanuts in their diet after the trial, compared to 3.6 percent of the placebo group. ?It appears that we have been able to modify the allergic response to peanut such that the immune system produces protective responses rather than a harmful response to the peanut protein,? Tang said.

The authors believe that finding a cure for peanut allergies is crucial, since it?s one of the most common and severe allergies ? it can also last a lifetime. Out of the 15 million Americans who have some form of food allergy, peanut, milk, and shellfish allergies are the most prevalent.

?Many of the children and families believe it has changed their lives, they?re very happy, they feel relieved,? Tang told The Guardian. ?These findings provide the first vital step toward developing a cure for peanut allergy and possibly other food allergies.?

Source: Tang M, Ponsonby A, Orsini F, Tey D, Robinson M, Su E. Administration of a probiotic with peanut oral immunotherapy: A randomized trial.?The Journal of Allergy and Clinical Immunology. 2015.

(Reprinted with license and permission from Medical Daily)RePubHub Banner

 

 

Got Questions? We have Answers! Contact us at CriteriumBlog@criteriuminc.com

The Top 5 Recent Breakthroughs in Advanced Lung Cancer Treatment

Ross Camidge MD PHD ATOMICWe might need to look at our back catalogues for treatments we could retrospectively explore for effective predictive biomarkers with our more modern approaches. ?D. Ross Camidge, MD, PhD

A countdown of the top 5 breakthrough therapies in the treatment of advanced lung cancer was presented by D. Ross Camidge, MD, PhD, at the 2014 Chicago Multidisciplinary Symposium in Thoracic Oncology. Dr. Camidge is Director, Thoracic Oncology Clinical and Clinical Research Programs, and Associate Director for Clinical Research, University of Colorado Comprehensive Cancer Center, Aurora. He is also the Director for the newly minted ATOMIC Lung Cancer Consortium. He chose the following molecular therapies as his top choices for illustrating what the future of Lung cancer treatment will involve:

#5. Crizotinib

Dr. Camidge chose crizotinib(Xalkori) as a breakthrough therapy ?because of how it has exemplified the philosophy of one size does not fit all,? he said.

#4. Second-Generation ALK Inhibitors

The second-generation ALK inhibitors werechosen ?not because of their impressive activity post-crizotinib, but because of their progress in accurately defining how we capture data on benefit in central nervous system (CNS) disease,? Dr. Camidge explained.

#3. Third-Generation EGFR Inhibitors

Dr. Camidge identified the third-generation EGFR inhibitors ?because of what they are teaching us about understanding acquired resistance in order to effectively treat it,? he said.

#2. PD-1/PD-L1 Antagonists

Dr. Camidge singled out the inhibitors of programmed death receptor 1 (PD-1) and its ligand (PD-L1) as opening the door to immunotherapy but with the open question of whether they will really be a panacea or whether they have the potential to become a truly personalized medicine.

#1. Three Possible Future Breakthroughs

The?number 1 spot was shared by three ?mini-fantasies? about what future breakthroughs might be, based on the concepts of mining the past, intraoncogene heterogeneity, and affordable incremental benefit.

Explaining his interest in mining the past, Dr. Camidge said, ?We have walked away from a large number of targeted agents because they didn?t work when given to otherwise unselected lung cancer populations. However, in almost all of these cases, no attempt at robustly exploring predictive biomarkers was conducted,? he noted.

?Consequently, the classes of drugs may not truly be ineffective, and there may have been evidence of hypersensitive subpopulations ripe for re-exploration,? he continued. ?We might need to look at our back catalogues for treatments we could retrospectively explore for effective predictive biomarkers with our more modern approaches.?

As an example, he cited the class of drugs known as death receptor agonists. These drugs ?which directly stimulate apoptosis and worked exceptionally well in various preclinical models, were all dropped when a series of randomized phase II studies adding these agents to first-line chemotherapy failed to show an advantage.? But the nonprogressors in the experimental arms approached 15% of the population in several of the studies, he said. ?Unfortunately little or no tissue was collected in these studies so no predictive biomarkers could really be explored at the time.?

Dr. Camidge used KRAS as an example of intraoncogene heterogeneity. The most common mutation among adenocarcinomas of the lung, KRAS has been shown in preclinical and clinical studies to have tremendous heterogeneity. The trial design for the FAK inhibitor VS-6063 in KRAS-mutant lung cancer is ?at least starting to address this heterogeneity by exploring its benefit in four KRAS-mutant cohorts that have also been characterized with regard to their INK4a and p53 status to see if these contexts alter the response to the drug, based on relevant preclinical data,? Dr. Camidge said.

To explain affordable incremental benefit, he cited the REVEL study, which looked at the addition of ramucirumab (Cyramza), an antibody against VEGFR2, to standard second-line docetaxel. ?The addition of ramucirumab increased the response rate from 14% to 30% and the disease control rate from 53% to 64%, increased the progression free survival from 3.0 to 4.5 months, and increased the overall survival from 9.1 to 10.5 months,? Dr. Camidge reported.

?So with an unequivocally positive phase III study, adding a little to all major endpoints, we might want to be using this drug. But only if it, and drugs like it, are affordable, as one recurring problem has been in pricing a breakthrough as if it?s a game-changer and not just a way of offering a little incremental benefit to everyone.? If not affordable, ?these minor breakthroughs will never be practical to use in the real world,? he said.

Disclosures: Dr. Camidge has received honoraria from Pfizer, Genentech/Roche, Clovis, Aria, and Eli Lilly.

Reference
Camidge DR: The top five most promising molecular therapies on the horizon. Chicago Multidisciplinary Symposium in Thoracic Oncology. Presented October 31, 2014.

Source/Complete article by Charlotte Bath (The ASCO Post) is available at: http://www.ascopost.com/issues/december-1,-2014/top-5-breakthroughs-in-the-treatment-of-advanced-lung-cancer.aspx

Got Questions? We have Answers! Contact us at CriteriumBlog@criteriuminc.com

 

There May Soon Be A Vaccine For Breast Cancer

A study?on a new breast cancer vaccine developed at Washington University School of Medicine in St. Louis has found the treatment to be safe in patients with metastatic breast cancer. According to the press release,?the vaccine helped patients? immune systems attack breast tumor cells and also slowed the cancer?s progression.

By Dana Dovey? Release date: December 1, 2014

Breast cancer is the second most common cancer among American women, surpassed by only skin cancer. It?s estimated that around one in eight American women will develop some form of breast cancer during their lifetime, and sadly, the American Cancer Society estimates that around 40,000 women will succumb to the disease every year. Breast cancer detection and treatment is constantly improving, but with the possibility of a new vaccine, the day we beat breast cancer may be sooner than imagined.

Showing Support: Pink Wristbands Courtesy of Shutterstock via RePubHub

The vaccine works by helping a patient?s own body fight off breast cancer cells by pushing the immune system to target proteins called mammaglobin-A. These proteins are only found in breast tissue, and express themselves at abnormally high levels when there’s a tumor.? The vaccine prompts the immune system to target and destroy these proteins, which significantly slows breast cancer?s progression.

?Most physician scientists believe that breast cancer vaccines will be most successful for the treatment of patients with early-stage breast cancer, or for prevention of breast cancer in patients who are at high risk for developing breast cancer,? breast cancer surgeon and senior author of the study Dr. William E. Gillanders told?Medical Daily in an email. Mammaglobin-A is found in as many as 80 percent of breast cancer cases, he said. “In theory, this means we could treat a large number of breast cancer patients with potentially fewer side effects.?

The phase 1 trial was conducted to test the vaccine?s safety, and researchers were pleased to find that it passed with flying colors. Rash, tenderness at the vaccination site, and mild-flu like symptoms were the worst reactions recorded. “Despite the weakened immune systems in these patients, we did observe a biologic response to the vaccine while analyzing immune cells in their blood samples,” said Gillanders.

It?s important to note that this vaccine did not ?cure? the patient?s cancer or cause them to go into remission. ?Cancer vaccines are not currently used as a substitute for other therapies ? they are typically given in addition to other effective treatments,? Gillanders told Medical Daily.

Now that the vaccine has been shown to be safe for human use, the team will move on to a larger clinical trial. This time, they will use volunteers who were only recently diagnosed with breast cancer, and therefore would have much stronger immune systems. It?s believed that the stronger immune systems may provide even more impressive results.

?If we give the vaccine to patients at the beginning of treatment, the immune systems should not be compromised like in patients with metastatic disease,” Gillanders said. “We also will be able to do more informative immune monitoring than we did in this preliminary trial.?

Still, of the 14 volunteers in this most recent trial, about half showed no cancer progression one year after receiving the vaccine, which Gillanders says suggests ?that the cancer growth was slowed ? i.e. the progression-free survival was prolonged.?

The team now has the funding needed for the second phase of their study and will soon begin their new trial.

For more?information on translational research in breast cancer please visit the ABRCC website.
(Reprinted with license and permission from Medical Daily)RePubHub Banner

 

 

Got Questions? We have Answers! Contact us at CriteriumBlog@criteriuminc.com