A common asthma drug reduced pancreatic cancer cell growth in laboratory experiments and animal tests, a new study reports.
A protein called S100P is found in excess amounts in some cancers and is important for pancreatic cancer cell growth and survival. This protein also activates a cell surface protein receptor called RAGE that plays a role in Alzheimer disease, diabetes, and cancer.
A drug called cromolyn, an allergy and asthma treatment, has been shown to bind to proteins similar to S100P. To test cromolyn^aEURTMs effects on S100P in pancreatic cancer cells, Thiruvengadam Arumugam, Ph.D., Vijaya Ramachandran, Ph.D., and Craig D. Logsdon, Ph.D., of the University of Texas M. D. Anderson Cancer Center in Houston, conducted experiments with the drug in tissue cultures and in mice with implanted pancreatic cancer.
They found that cromolyn bound to S100P, halted the activation of RAGE, and slowed cancer cell growth and survival in cell lines. In mice, the drug slowed pancreatic tumor growth and improved the effectiveness of gemcitabine, a chemotherapy drug used to treat pancreatic cancer.
"Together, these data support the further investigation of cromolyn as a possible treatment for pancreatic cancer," the authors write.
Contact: Scott Merville, M. D. Anderson Cancer Center External Communications
###
Other highlights in the December 20 JNCI
Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at http://jncicancerspectrum.oxfordjournals.org/.
Contact: Andrea Widener
Journal of the National Cancer Institute
Showing posts with label Cancer. Show all posts
Showing posts with label Cancer. Show all posts
Wednesday, May 7, 2008
Wednesday, April 16, 2008
Survival In Asbestos-Related Cancer Improved By Chemo Combination
People with mesothelioma - a form of cancer associated with asbestos exposure - have a higher survival rate when treated with a combination of two cancer drugs, a large multicenter study finds.
Mesothelioma, a rare but aggressive form of cancer that occurs in the lining of the lungs, heart and abdomen, is associated with exposure to asbestos. There is no known cure.
In the study, patients receiving pemetrexed and cisplatin - along with the vitamin supplements folic acid and B12 - survived nearly three months longer than patients getting cisplatin alone.
Researchers led by John Green, M.D., at the Clatterbridge Center for Oncology in England, reviewed a study of 448 patients with advanced mesothelioma who were treated with either the single drug or the combination.
"Pemetrexed used in combination with cisplatin significantly increases the length of survival, when compared with cisplatin alone," the researchers say. "Further research is needed into the optimum treatment regimen for pleural mesothelioma."
The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
The researchers examined data from a clinical trial of 20 treatment centers in Europe, the Americas, Australia and Asia. Eighty-one percent of the patients were men, with an average age of 61. Patients who received the combination treatment survived an average 2.8 months longer.
Patients receiving both medications also reported improved quality of life in terms of fatigue, loss of appetite, pain and cough.
During the early stages of the trial, patients receiving pemetrexed had serious symptoms of toxicity, including drug-related death. Other side effects included blood cell abnormalities, nausea and diarrhea, which decreased in both incidence and severity after the vitamins were added to the treatment. People who work trades such as shipbuilding, railway engineering, construction work and asbestos manufacture have higher rates of mesothelioma than the general public. The cancer may take 10 to 60 years to develop, and the risk does not diminish after exposure to asbestos has stopped. Family members of people exposed to asbestos at work also have an increased risk of developing mesothelioma from asbestos fibers carried home on the clothes of the people they live with.
Daniel Baram, M.D., a pulmonologist at the Lung Cancer Evaluation Center at the State University of New York, said, "Most cases [of mesothelioma] are still from pre-OSHA workplace improvements. I suspect that modern asbestos abatement precautions will avoid most, if not all, future cases. The latency is over 30 years, so we are still diagnosing cases with exposure during World War II and the '40s and '50s."
Mesothelioma is difficult to diagnose, Green said, because "there is a lag of many years between exposure and asbestosis, which is a nonmalignant condition, and a greater lag before the development of overt malignancy."
"There is no way of diagnosing the premalignant phase during the latent period of 15 to 20 years," Green added. "Many of these patients smoke and are in economically disadvantaged communities. Many individuals have moved away from heavy industries and may not admit or know they were exposed to asbestos as young men, with similar issues for their partners."
According to the U.S. Environmental Protection Agency, 10 percent to 15 percent of schools and other public buildings in the United States contain asbestos insulation.
Although safety measures for working with asbestos have been in place since the 1970s, mesothelioma is projected to account for 65,000 deaths between 2001 and 2050 worldwide, peaking between 2012 and 2015, according to background information in the review.
It is a personal matter as to whether the survival increase for patients receiving the two drugs is worthwhile, Baram said. "It depends in large part on the patient. A 2.8-month mean survival increase means that some patients may get even more than that, though some people will get less. Many, if not most, patients when faced with a disease with a very bad prognosis are often willing to undergo aggressive therapy, although the toxicity is serious and potentially life-threatening."
###
By Lise Millay Stevens, Contributing Writer
Health Behavior News Service
Green J, et al. Pemetrexed disodium in combination with cisplatin versus other cytotoxic agents or supportive care for the treatment of malignant pleural mesothelioma. Cochrane Database of Systematic Reviews 2007, Issue 1.
The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org/ for more information.
Contact: Lisa Esposito
Center for the Advancement of Health
Mesothelioma, a rare but aggressive form of cancer that occurs in the lining of the lungs, heart and abdomen, is associated with exposure to asbestos. There is no known cure.
In the study, patients receiving pemetrexed and cisplatin - along with the vitamin supplements folic acid and B12 - survived nearly three months longer than patients getting cisplatin alone.
Researchers led by John Green, M.D., at the Clatterbridge Center for Oncology in England, reviewed a study of 448 patients with advanced mesothelioma who were treated with either the single drug or the combination.
"Pemetrexed used in combination with cisplatin significantly increases the length of survival, when compared with cisplatin alone," the researchers say. "Further research is needed into the optimum treatment regimen for pleural mesothelioma."
The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
The researchers examined data from a clinical trial of 20 treatment centers in Europe, the Americas, Australia and Asia. Eighty-one percent of the patients were men, with an average age of 61. Patients who received the combination treatment survived an average 2.8 months longer.
Patients receiving both medications also reported improved quality of life in terms of fatigue, loss of appetite, pain and cough.
During the early stages of the trial, patients receiving pemetrexed had serious symptoms of toxicity, including drug-related death. Other side effects included blood cell abnormalities, nausea and diarrhea, which decreased in both incidence and severity after the vitamins were added to the treatment. People who work trades such as shipbuilding, railway engineering, construction work and asbestos manufacture have higher rates of mesothelioma than the general public. The cancer may take 10 to 60 years to develop, and the risk does not diminish after exposure to asbestos has stopped. Family members of people exposed to asbestos at work also have an increased risk of developing mesothelioma from asbestos fibers carried home on the clothes of the people they live with.
Daniel Baram, M.D., a pulmonologist at the Lung Cancer Evaluation Center at the State University of New York, said, "Most cases [of mesothelioma] are still from pre-OSHA workplace improvements. I suspect that modern asbestos abatement precautions will avoid most, if not all, future cases. The latency is over 30 years, so we are still diagnosing cases with exposure during World War II and the '40s and '50s."
Mesothelioma is difficult to diagnose, Green said, because "there is a lag of many years between exposure and asbestosis, which is a nonmalignant condition, and a greater lag before the development of overt malignancy."
"There is no way of diagnosing the premalignant phase during the latent period of 15 to 20 years," Green added. "Many of these patients smoke and are in economically disadvantaged communities. Many individuals have moved away from heavy industries and may not admit or know they were exposed to asbestos as young men, with similar issues for their partners."
According to the U.S. Environmental Protection Agency, 10 percent to 15 percent of schools and other public buildings in the United States contain asbestos insulation.
Although safety measures for working with asbestos have been in place since the 1970s, mesothelioma is projected to account for 65,000 deaths between 2001 and 2050 worldwide, peaking between 2012 and 2015, according to background information in the review.
It is a personal matter as to whether the survival increase for patients receiving the two drugs is worthwhile, Baram said. "It depends in large part on the patient. A 2.8-month mean survival increase means that some patients may get even more than that, though some people will get less. Many, if not most, patients when faced with a disease with a very bad prognosis are often willing to undergo aggressive therapy, although the toxicity is serious and potentially life-threatening."
###
By Lise Millay Stevens, Contributing Writer
Health Behavior News Service
Green J, et al. Pemetrexed disodium in combination with cisplatin versus other cytotoxic agents or supportive care for the treatment of malignant pleural mesothelioma. Cochrane Database of Systematic Reviews 2007, Issue 1.
The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org/ for more information.
Contact: Lisa Esposito
Center for the Advancement of Health
Statement On The Passing Of Congressman Charlie Norwood (R-GA), By John Kirkwood, American Lung Association President & CEO
The American Lung Association's volunteers and staff wish to express our deepest condolences to family of U.S. Congressman Charlie Norwood, DDS (R-GA), who died today after a long battle with idiopathic pulmonary fibrosis and lung cancer. A long-time champion for all patients, Representative Norwood inspired lung disease patients across the country when he returned to Congress following his lung transplant in 2004. American Lung Association staff and volunteers fondly remember Representative Norwood's keynote speech to our national conference in May 2002.
Idiopathic pulmonary fibrosis is a form of interstitial lung disease. When a person has idiopathic pulmonary fibrosis, the lung is affected in three ways. First, the lung tissue is damaged in some known or unknown way. Second, the walls of the air sacs in the lung become inflamed. Finally, scarring (or fibrosis) begins in the interstitium (or tissue between the air sacs), and the lung becomes stiff. The American Lung Association supports an array of research into the basic cellular and molecular processes that underlie the inflammatory response in the lungs that precedes pulmonary fibrosis. Our researchers are also examining new ways to prevent the lung scarring that follows this type of inflammation and are looking for new treatments for lungs damaged excess scar tissue formation.
Lung cancer is the number one cancer killer in the U.S., and the American Lung Association is committed to funding vital research to help fight this devastating disease including our Lung Cancer Discovery Award which is specifically directed at developing improved treatments. Lung cancer may also be the most tragic cancer because in most cases, it might have been prevented. Nearly 90 percent of lung cancer cases are caused by smoking. The more time and amount you smoke, the greater your risk of lung cancer. But if you stop smoking, the risk of lung cancer decreases each year as normal cells replace abnormal cells.
About the American Lung Association
Beginning our second century, the American Lung Association is the leading organization working to prevent lung disease and promote lung health. Lung disease death rates continue to increase while other leading causes of death have declined. The American Lung Association funds vital research on the causes of and treatments for lung disease. With the generous support of the public, the American Lung Association is "Improving life, one breath at a time." For more information about the American Lung Association or to support the work it does, call 1-800-LUNG-USA ( 1-800-586-4872) or log on to http://www.lungusa.org.
Idiopathic pulmonary fibrosis is a form of interstitial lung disease. When a person has idiopathic pulmonary fibrosis, the lung is affected in three ways. First, the lung tissue is damaged in some known or unknown way. Second, the walls of the air sacs in the lung become inflamed. Finally, scarring (or fibrosis) begins in the interstitium (or tissue between the air sacs), and the lung becomes stiff. The American Lung Association supports an array of research into the basic cellular and molecular processes that underlie the inflammatory response in the lungs that precedes pulmonary fibrosis. Our researchers are also examining new ways to prevent the lung scarring that follows this type of inflammation and are looking for new treatments for lungs damaged excess scar tissue formation.
Lung cancer is the number one cancer killer in the U.S., and the American Lung Association is committed to funding vital research to help fight this devastating disease including our Lung Cancer Discovery Award which is specifically directed at developing improved treatments. Lung cancer may also be the most tragic cancer because in most cases, it might have been prevented. Nearly 90 percent of lung cancer cases are caused by smoking. The more time and amount you smoke, the greater your risk of lung cancer. But if you stop smoking, the risk of lung cancer decreases each year as normal cells replace abnormal cells.
About the American Lung Association
Beginning our second century, the American Lung Association is the leading organization working to prevent lung disease and promote lung health. Lung disease death rates continue to increase while other leading causes of death have declined. The American Lung Association funds vital research on the causes of and treatments for lung disease. With the generous support of the public, the American Lung Association is "Improving life, one breath at a time." For more information about the American Lung Association or to support the work it does, call 1-800-LUNG-USA ( 1-800-586-4872) or log on to http://www.lungusa.org.
Tuesday, April 15, 2008
Asthma Medicine Halts Pancreatic Cancer Cell Growth
A common asthma drug reduced pancreatic cancer cell growth in laboratory experiments and animal tests, a new study reports.
A protein called S100P is found in excess amounts in some cancers and is important for pancreatic cancer cell growth and survival. This protein also activates a cell surface protein receptor called RAGE that plays a role in Alzheimer disease, diabetes, and cancer.
A drug called cromolyn, an allergy and asthma treatment, has been shown to bind to proteins similar to S100P. To test cromolynвTMs effects on S100P in pancreatic cancer cells, Thiruvengadam Arumugam, Ph.D., Vijaya Ramachandran, Ph.D., and Craig D. Logsdon, Ph.D., of the University of Texas M. D. Anderson Cancer Center in Houston, conducted experiments with the drug in tissue cultures and in mice with implanted pancreatic cancer.
They found that cromolyn bound to S100P, halted the activation of RAGE, and slowed cancer cell growth and survival in cell lines. In mice, the drug slowed pancreatic tumor growth and improved the effectiveness of gemcitabine, a chemotherapy drug used to treat pancreatic cancer.
"Together, these data support the further investigation of cromolyn as a possible treatment for pancreatic cancer," the authors write.
Contact: Scott Merville, M. D. Anderson Cancer Center External Communications
###
Other highlights in the December 20 JNCI
Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at http://jncicancerspectrum.oxfordjournals.org/.
Contact: Andrea Widener
Journal of the National Cancer Institute
A protein called S100P is found in excess amounts in some cancers and is important for pancreatic cancer cell growth and survival. This protein also activates a cell surface protein receptor called RAGE that plays a role in Alzheimer disease, diabetes, and cancer.
A drug called cromolyn, an allergy and asthma treatment, has been shown to bind to proteins similar to S100P. To test cromolynвTMs effects on S100P in pancreatic cancer cells, Thiruvengadam Arumugam, Ph.D., Vijaya Ramachandran, Ph.D., and Craig D. Logsdon, Ph.D., of the University of Texas M. D. Anderson Cancer Center in Houston, conducted experiments with the drug in tissue cultures and in mice with implanted pancreatic cancer.
They found that cromolyn bound to S100P, halted the activation of RAGE, and slowed cancer cell growth and survival in cell lines. In mice, the drug slowed pancreatic tumor growth and improved the effectiveness of gemcitabine, a chemotherapy drug used to treat pancreatic cancer.
"Together, these data support the further investigation of cromolyn as a possible treatment for pancreatic cancer," the authors write.
Contact: Scott Merville, M. D. Anderson Cancer Center External Communications
###
Other highlights in the December 20 JNCI
Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at http://jncicancerspectrum.oxfordjournals.org/.
Contact: Andrea Widener
Journal of the National Cancer Institute
Costs Of Long-Course Palliative Radiotherapy Acceptable In Late-Stage Lung Cancer
A longer, less intense course of radiotherapy provides better value for the money than a shorter, more intense regimen when given to ease pain and other complaints in patients with late-stage non-small-cell lung cancer (NSCLC), according to a study in the Journal of the National Cancer Institute.
Patients with late-stage NSCLC are often too ill to receive intensive treatment for their cancer. Palliative radiotherapy is given to ease symptoms such as chest pain and difficulty breathing and swallowing. In 1999, Wilbert B. van den Hout, Ph.D., of Leiden University Medical Center in the Netherlands, and colleagues conducted a randomized clinical trial in 297 patients with inoperable stage IIIA/B or stage IV NSCLC to compare two palliative radiotherapy regimens - a short course, two treatments of 8 gray (Gy) of radiation each, with a long course, 10 treatments of 3 Gy each. They found that the long course better eased symptoms over time and improved 1-year survival compared with the short course.
However, that study did not take into account the higher costs of the longer treatment and the continued medical costs of the patients who survive longer with their cancer. For this new study, van den Hout and colleagues conducted a cost-utility analysis of the two treatments to see which offers the best value for the money. Using data from a patient questionnaire on factors such as their mobility, ability to perform usual activities, and pain and anxiety levels, the authors calculated that quality of life was roughly equal in both treatment groups. However, because life expectancy was longer in the long-course treatment group, that groupвTMs overall quality-of-life benefit was greater than that in the short-course group.
The researchers also estimated the costs associated with the treatment and other nontreatment costs, such as medical care for people who survived their cancer. They estimated that the lifetime societal costs of the long-course radiotherapy were $16,490 and the short-course radiotherapy costs were $11,164, a $5,326 difference. In their final calculations, the authors found that, although the dollar costs of the long-course radiotherapy were higher than those of the short course, the benefit in improved survival meant that the long-course treatment yielded benefit at an acceptable cost by current economic standards.
"In our group of poor-prognosis non-small-cell lung cancer patients, the additional costs of the protracted radiotherapy schedule were justified by longer survival rather than by improved quality of life," the authors conclude.
The authors point out that their study does not show that long-course radiotherapy reduces costs. In addition, areas with limited radiotherapy facilities may find it more efficient to treat patients with the shorter course. Finally, different countries and regions may have different economic factors that influence the decision of which radiotherapy regimen to use.
###
Contact:
в Leiden University Medical Center Communications Department
Citation:
в van den Hout WB, Kramer GWPM, Noordijk EM, Leer JWH. Cost-utility analysis of short- versus long-course palliative radiotherapy in patients with non-small-cell lung cancer. J Natl Cancer Inst 2006; 98:1786-94.
Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at http://jncicancerspectrum.oxfordjournals.org/.
Contact: Andrea Widener
Journal of the National Cancer Institute
Patients with late-stage NSCLC are often too ill to receive intensive treatment for their cancer. Palliative radiotherapy is given to ease symptoms such as chest pain and difficulty breathing and swallowing. In 1999, Wilbert B. van den Hout, Ph.D., of Leiden University Medical Center in the Netherlands, and colleagues conducted a randomized clinical trial in 297 patients with inoperable stage IIIA/B or stage IV NSCLC to compare two palliative radiotherapy regimens - a short course, two treatments of 8 gray (Gy) of radiation each, with a long course, 10 treatments of 3 Gy each. They found that the long course better eased symptoms over time and improved 1-year survival compared with the short course.
However, that study did not take into account the higher costs of the longer treatment and the continued medical costs of the patients who survive longer with their cancer. For this new study, van den Hout and colleagues conducted a cost-utility analysis of the two treatments to see which offers the best value for the money. Using data from a patient questionnaire on factors such as their mobility, ability to perform usual activities, and pain and anxiety levels, the authors calculated that quality of life was roughly equal in both treatment groups. However, because life expectancy was longer in the long-course treatment group, that groupвTMs overall quality-of-life benefit was greater than that in the short-course group.
The researchers also estimated the costs associated with the treatment and other nontreatment costs, such as medical care for people who survived their cancer. They estimated that the lifetime societal costs of the long-course radiotherapy were $16,490 and the short-course radiotherapy costs were $11,164, a $5,326 difference. In their final calculations, the authors found that, although the dollar costs of the long-course radiotherapy were higher than those of the short course, the benefit in improved survival meant that the long-course treatment yielded benefit at an acceptable cost by current economic standards.
"In our group of poor-prognosis non-small-cell lung cancer patients, the additional costs of the protracted radiotherapy schedule were justified by longer survival rather than by improved quality of life," the authors conclude.
The authors point out that their study does not show that long-course radiotherapy reduces costs. In addition, areas with limited radiotherapy facilities may find it more efficient to treat patients with the shorter course. Finally, different countries and regions may have different economic factors that influence the decision of which radiotherapy regimen to use.
###
Contact:
в Leiden University Medical Center Communications Department
Citation:
в van den Hout WB, Kramer GWPM, Noordijk EM, Leer JWH. Cost-utility analysis of short- versus long-course palliative radiotherapy in patients with non-small-cell lung cancer. J Natl Cancer Inst 2006; 98:1786-94.
Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at http://jncicancerspectrum.oxfordjournals.org/.
Contact: Andrea Widener
Journal of the National Cancer Institute
Friday, March 7, 2008
Costs Of Long-Course Palliative Radiotherapy Acceptable In Late-Stage Lung Cancer
A longer, less intense course of radiotherapy provides better value for the money than a shorter, more intense regimen when given to ease pain and other complaints in patients with late-stage non-small-cell lung cancer (NSCLC), according to a study in the Journal of the National Cancer Institute.
Patients with late-stage NSCLC are often too ill to receive intensive treatment for their cancer. Palliative radiotherapy is given to ease symptoms such as chest pain and difficulty breathing and swallowing. In 1999, Wilbert B. van den Hout, Ph.D., of Leiden University Medical Center in the Netherlands, and colleagues conducted a randomized clinical trial in 297 patients with inoperable stage IIIA/B or stage IV NSCLC to compare two palliative radiotherapy regimens - a short course, two treatments of 8 gray (Gy) of radiation each, with a long course, 10 treatments of 3 Gy each. They found that the long course better eased symptoms over time and improved 1-year survival compared with the short course.
However, that study did not take into account the higher costs of the longer treatment and the continued medical costs of the patients who survive longer with their cancer. For this new study, van den Hout and colleagues conducted a cost-utility analysis of the two treatments to see which offers the best value for the money. Using data from a patient questionnaire on factors such as their mobility, ability to perform usual activities, and pain and anxiety levels, the authors calculated that quality of life was roughly equal in both treatment groups. However, because life expectancy was longer in the long-course treatment group, that groupвTMs overall quality-of-life benefit was greater than that in the short-course group.
The researchers also estimated the costs associated with the treatment and other nontreatment costs, such as medical care for people who survived their cancer. They estimated that the lifetime societal costs of the long-course radiotherapy were $16,490 and the short-course radiotherapy costs were $11,164, a $5,326 difference. In their final calculations, the authors found that, although the dollar costs of the long-course radiotherapy were higher than those of the short course, the benefit in improved survival meant that the long-course treatment yielded benefit at an acceptable cost by current economic standards.
"In our group of poor-prognosis non-small-cell lung cancer patients, the additional costs of the protracted radiotherapy schedule were justified by longer survival rather than by improved quality of life," the authors conclude.
The authors point out that their study does not show that long-course radiotherapy reduces costs. In addition, areas with limited radiotherapy facilities may find it more efficient to treat patients with the shorter course. Finally, different countries and regions may have different economic factors that influence the decision of which radiotherapy regimen to use.
###
Contact:
в Leiden University Medical Center Communications Department
Citation:
в van den Hout WB, Kramer GWPM, Noordijk EM, Leer JWH. Cost-utility analysis of short- versus long-course palliative radiotherapy in patients with non-small-cell lung cancer. J Natl Cancer Inst 2006; 98:1786-94.
Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at http://jncicancerspectrum.oxfordjournals.org/.
Contact: Andrea Widener
Journal of the National Cancer Institute
Patients with late-stage NSCLC are often too ill to receive intensive treatment for their cancer. Palliative radiotherapy is given to ease symptoms such as chest pain and difficulty breathing and swallowing. In 1999, Wilbert B. van den Hout, Ph.D., of Leiden University Medical Center in the Netherlands, and colleagues conducted a randomized clinical trial in 297 patients with inoperable stage IIIA/B or stage IV NSCLC to compare two palliative radiotherapy regimens - a short course, two treatments of 8 gray (Gy) of radiation each, with a long course, 10 treatments of 3 Gy each. They found that the long course better eased symptoms over time and improved 1-year survival compared with the short course.
However, that study did not take into account the higher costs of the longer treatment and the continued medical costs of the patients who survive longer with their cancer. For this new study, van den Hout and colleagues conducted a cost-utility analysis of the two treatments to see which offers the best value for the money. Using data from a patient questionnaire on factors such as their mobility, ability to perform usual activities, and pain and anxiety levels, the authors calculated that quality of life was roughly equal in both treatment groups. However, because life expectancy was longer in the long-course treatment group, that groupвTMs overall quality-of-life benefit was greater than that in the short-course group.
The researchers also estimated the costs associated with the treatment and other nontreatment costs, such as medical care for people who survived their cancer. They estimated that the lifetime societal costs of the long-course radiotherapy were $16,490 and the short-course radiotherapy costs were $11,164, a $5,326 difference. In their final calculations, the authors found that, although the dollar costs of the long-course radiotherapy were higher than those of the short course, the benefit in improved survival meant that the long-course treatment yielded benefit at an acceptable cost by current economic standards.
"In our group of poor-prognosis non-small-cell lung cancer patients, the additional costs of the protracted radiotherapy schedule were justified by longer survival rather than by improved quality of life," the authors conclude.
The authors point out that their study does not show that long-course radiotherapy reduces costs. In addition, areas with limited radiotherapy facilities may find it more efficient to treat patients with the shorter course. Finally, different countries and regions may have different economic factors that influence the decision of which radiotherapy regimen to use.
###
Contact:
в Leiden University Medical Center Communications Department
Citation:
в van den Hout WB, Kramer GWPM, Noordijk EM, Leer JWH. Cost-utility analysis of short- versus long-course palliative radiotherapy in patients with non-small-cell lung cancer. J Natl Cancer Inst 2006; 98:1786-94.
Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage. Visit the Journal online at http://jncicancerspectrum.oxfordjournals.org/.
Contact: Andrea Widener
Journal of the National Cancer Institute
Wednesday, March 5, 2008
Novel Approach To Cancer Drug Given Major Boost
Scientists at the ProXara Biotechnology Limited have identified a way of switching off one of the key mechanisms that leads to the development and growth of a tumour. Under the Wellcome Trust's Seeding Drug Discovery initiative, the researchers hope to use their findings to develop a drug which could be used to fight cancer. The funding will be used to develop the drug to a point at which it is close to entering a clinical trial.
All cells in the body contain protein kinase B (PKB), a naturally-occurring enzyme that if active prevents cells from committing suicide. Programmed cell death, or apoptosis, is an important process in the body's development, but when this process goes wrong, unregulated cell growth occurs, leading to the development of tumour cells.
Recent research has shown that certain types of genetic damage, common to many cancer cells, lead to the movement of PKB from the interior of the cell to its surface membrane. When PKB attaches to the surface membrane, it becomes active, triggering a signal that tells the cell not to commit suicide. Professor Jeremy TavarГ(c) at ProXara Biotechnology Ltd, a spin-out company at the University of Bristol, believes that by preventing PKB binding to the cell's surface membrane, he can ensure that apoptosis occurs, thus killing the cancer cells.
"There has been a lot of interest in targeting PKB as a way of preventing tumour growth," says Professor TavarГ(c). "Most of the interest so far has been in developing drugs that block the enzyme's signal. However, such drugs are very non-specific and can have many adverse side effects. We are working on a novel approach to prevent PKB actually binding to the cell membrane."
Professor TavarГ(c) and his team have discovered a drug-like compound, which prevents PKB binding to the cell membrane and makes the tumour cells commit suicide. They now wish to develop this compound to a point at which it could be used in clinical trials.
"Professor TavarГ(c)'s research offers a novel approach to cancer drug research," says Dr Ted Bianco, Director of Technology Transfer at the Wellcome Trust, which is funding the research under its Seeding Drug Discover initiative. "Cancer affects very large numbers of people which is why it receives so much attention from those engaged in medical research. But it is a complex disease to tackle and as a result many of the current anti-cancer drugs have unpleasant side -effects. This work has the potential to provide a more targeted approach to drug therapy with fewer adverse effects."
Professor TavarГ(c) says that the drug would be used initially to target lung cancer, the most common cancer in the UK. Almost 38,000 people are diagnosed with this particular cancer each year. If the approach works it could be adapted to treat other types of cancer or even inflammatory diseases such as arthritis or asthma.
"We anticipate that a drug based on this approach may benefit a significant proportion of people with lung cancer," explains Professor TavarГ(c). "As well as developing the drug itself, we are also working on a way of identifying which individuals are most likely to respond to the drug."
This targeted therapy is based on five years of research by Professor TavarГ(c) and Dr Paul England. The research has now been given a major boost by way of a В2.8 million award to the University of Bristol under the Wellcome Trust's Seeding Drug Discovery initiative. The initiative aims to bridge the funding gap in early-stage drug discovery, assisting researchers to take forward projects in small molecule therapeutics that will be the springboard for further R&D by the biotech and pharmaceutical industry.
###
Contact: Craig Brierley
Wellcome Trust
All cells in the body contain protein kinase B (PKB), a naturally-occurring enzyme that if active prevents cells from committing suicide. Programmed cell death, or apoptosis, is an important process in the body's development, but when this process goes wrong, unregulated cell growth occurs, leading to the development of tumour cells.
Recent research has shown that certain types of genetic damage, common to many cancer cells, lead to the movement of PKB from the interior of the cell to its surface membrane. When PKB attaches to the surface membrane, it becomes active, triggering a signal that tells the cell not to commit suicide. Professor Jeremy TavarГ(c) at ProXara Biotechnology Ltd, a spin-out company at the University of Bristol, believes that by preventing PKB binding to the cell's surface membrane, he can ensure that apoptosis occurs, thus killing the cancer cells.
"There has been a lot of interest in targeting PKB as a way of preventing tumour growth," says Professor TavarГ(c). "Most of the interest so far has been in developing drugs that block the enzyme's signal. However, such drugs are very non-specific and can have many adverse side effects. We are working on a novel approach to prevent PKB actually binding to the cell membrane."
Professor TavarГ(c) and his team have discovered a drug-like compound, which prevents PKB binding to the cell membrane and makes the tumour cells commit suicide. They now wish to develop this compound to a point at which it could be used in clinical trials.
"Professor TavarГ(c)'s research offers a novel approach to cancer drug research," says Dr Ted Bianco, Director of Technology Transfer at the Wellcome Trust, which is funding the research under its Seeding Drug Discover initiative. "Cancer affects very large numbers of people which is why it receives so much attention from those engaged in medical research. But it is a complex disease to tackle and as a result many of the current anti-cancer drugs have unpleasant side -effects. This work has the potential to provide a more targeted approach to drug therapy with fewer adverse effects."
Professor TavarГ(c) says that the drug would be used initially to target lung cancer, the most common cancer in the UK. Almost 38,000 people are diagnosed with this particular cancer each year. If the approach works it could be adapted to treat other types of cancer or even inflammatory diseases such as arthritis or asthma.
"We anticipate that a drug based on this approach may benefit a significant proportion of people with lung cancer," explains Professor TavarГ(c). "As well as developing the drug itself, we are also working on a way of identifying which individuals are most likely to respond to the drug."
This targeted therapy is based on five years of research by Professor TavarГ(c) and Dr Paul England. The research has now been given a major boost by way of a В2.8 million award to the University of Bristol under the Wellcome Trust's Seeding Drug Discovery initiative. The initiative aims to bridge the funding gap in early-stage drug discovery, assisting researchers to take forward projects in small molecule therapeutics that will be the springboard for further R&D by the biotech and pharmaceutical industry.
###
Contact: Craig Brierley
Wellcome Trust
Tuesday, March 4, 2008
Sequella Receives FDA Fast Track Status For TB Drug
Sequella, Inc., a clinical-stage biopharmaceutical company focused on commercializing improved treatment paradigms for diseases of epidemic potential, today announced it has received Fast Track designation from the U.S. Food and Drug Administration (FDA) for SQ109, the company's proprietary lead drug candidate for treatment of pulmonary tuberculosis (TB). With a mechanism of action distinct from other antibiotics used in TB therapy, SQ109 shows excellent in vitro activity against drug susceptible and drug resistant TB bacteria, including XDR-TB, as well as potent in vivo activity against pulmonary TB alone and with other TB drugs.
"This FDA Fast Track designation validates SQ109 as a potentially unique addition to the TB therapeutic armamentarium," said Dr. Carol Nacy, CEO of Sequella. "This is an important regulatory milestone and recognition that SQ109 may address unmet needs in TB therapy to improve and shorten the current treatment regimen."
According to a letter from the FDA, SQ109 received fast track designation based on the following: "SQ 109 has the potential to fulfill an unmet medical need, and the preclinical information available thus far demonstrates that SQ 109 has the potential to enhance the treatment of tuberculosis during the first two months of intensive therapy and to treat multi-drug resistant TB." The FDA letter also stated that: "In 2002 the estimated number of active cases of tuberculosis was 9 million, with approximately 2 million deaths, worldwide."
Mandated by the FDA Modernization Act of 1997, Fast Track designation expedites the development and review of a New Drug Application (NDA) for approval.
About Tuberculosis (TB)
TB is a contagious infectious disease caused by the bacterium Mycobacterium tuberculosis. TB bacteria can be inhaled into lungs and are able to avoid destruction by certain white blood cells. Without containment by immune cells, the bacteria can spread throughout the body, multiply, survive and remain dormant for years. TB is the leading cause of global deaths that result from a single-agent infectious disease. Nine million new cases of active TB disease are reported every year. The World Health Organization (WHO) estimates that one-third of the world's population is infected with TB.
About SQ109
SQ109 is an orally active small molecule antibiotic that inhibits cell wall synthesis and acts on multiple cellular pathways in a select group of microorganisms, including Mycobacterium tuberculosis, the bacteria that cause TB. SQ109 enhances, both in vitro and in vivo, the activity of the anti- tubercular drugs isoniazid and rifampin, thereby shortening by 25% the time required to cure mice of experimental TB. SQ109 is currently in Phase I clinical trials under a US IND, and could replace one or more of the current first-line anti-TB drugs, simplify therapy, and shorten the treatment regimen. Since 2000, Sequella has applied its scientific expertise in TB research and product development to identify, characterize, and complete preclinical evaluation of SQ109. SQ109 was developed in partnership with the NIH, with several grants from the National Institute of Allergy and Infectious Diseases (NIAID) and the assistance of the NIAID and the National Cancer Institute Inter-Institute Program (NCI IIP) for IND-enabling studies.
About Sequella, Inc.
Sequella is a clinical-stage biopharmaceutical company focused on commercializing improved treatment paradigms for diseases of epidemic potential. The company leverages its global influence, infectious disease expertise, and diverse product portfolio to proactively address emerging health threats with significant market opportunity. The Company's lead drug candidate SQ109, a new orally-active diamine antibiotic for the treatment of tuberculosis (TB) and other infectious diseases, is presently in Phase I clinical studies. The company's lead diagnostic product candidate, the TB Patch, is completing several international clinical trials in anticipation of world-wide product registration. For more information, please visit http://www.sequella.com.
Forward-Looking Statement
This press release contains forward-looking statements that are subject to risks and uncertainties, and includes statements that are not historical facts. Actual results could differ significantly from results discussed. Sequella disclaims any intent or obligation to update forward-looking statements, except as required by law.
Sequella, Inc.
http://www.sequella.com
"This FDA Fast Track designation validates SQ109 as a potentially unique addition to the TB therapeutic armamentarium," said Dr. Carol Nacy, CEO of Sequella. "This is an important regulatory milestone and recognition that SQ109 may address unmet needs in TB therapy to improve and shorten the current treatment regimen."
According to a letter from the FDA, SQ109 received fast track designation based on the following: "SQ 109 has the potential to fulfill an unmet medical need, and the preclinical information available thus far demonstrates that SQ 109 has the potential to enhance the treatment of tuberculosis during the first two months of intensive therapy and to treat multi-drug resistant TB." The FDA letter also stated that: "In 2002 the estimated number of active cases of tuberculosis was 9 million, with approximately 2 million deaths, worldwide."
Mandated by the FDA Modernization Act of 1997, Fast Track designation expedites the development and review of a New Drug Application (NDA) for approval.
About Tuberculosis (TB)
TB is a contagious infectious disease caused by the bacterium Mycobacterium tuberculosis. TB bacteria can be inhaled into lungs and are able to avoid destruction by certain white blood cells. Without containment by immune cells, the bacteria can spread throughout the body, multiply, survive and remain dormant for years. TB is the leading cause of global deaths that result from a single-agent infectious disease. Nine million new cases of active TB disease are reported every year. The World Health Organization (WHO) estimates that one-third of the world's population is infected with TB.
About SQ109
SQ109 is an orally active small molecule antibiotic that inhibits cell wall synthesis and acts on multiple cellular pathways in a select group of microorganisms, including Mycobacterium tuberculosis, the bacteria that cause TB. SQ109 enhances, both in vitro and in vivo, the activity of the anti- tubercular drugs isoniazid and rifampin, thereby shortening by 25% the time required to cure mice of experimental TB. SQ109 is currently in Phase I clinical trials under a US IND, and could replace one or more of the current first-line anti-TB drugs, simplify therapy, and shorten the treatment regimen. Since 2000, Sequella has applied its scientific expertise in TB research and product development to identify, characterize, and complete preclinical evaluation of SQ109. SQ109 was developed in partnership with the NIH, with several grants from the National Institute of Allergy and Infectious Diseases (NIAID) and the assistance of the NIAID and the National Cancer Institute Inter-Institute Program (NCI IIP) for IND-enabling studies.
About Sequella, Inc.
Sequella is a clinical-stage biopharmaceutical company focused on commercializing improved treatment paradigms for diseases of epidemic potential. The company leverages its global influence, infectious disease expertise, and diverse product portfolio to proactively address emerging health threats with significant market opportunity. The Company's lead drug candidate SQ109, a new orally-active diamine antibiotic for the treatment of tuberculosis (TB) and other infectious diseases, is presently in Phase I clinical studies. The company's lead diagnostic product candidate, the TB Patch, is completing several international clinical trials in anticipation of world-wide product registration. For more information, please visit http://www.sequella.com.
Forward-Looking Statement
This press release contains forward-looking statements that are subject to risks and uncertainties, and includes statements that are not historical facts. Actual results could differ significantly from results discussed. Sequella disclaims any intent or obligation to update forward-looking statements, except as required by law.
Sequella, Inc.
http://www.sequella.com
Heart Disease In Women Linked To Air Pollution
A US study has found significant links between the exposure to small particle air pollution and risk of fatal and non fatal heart disease and strokes in older women.
The study is published in the New England Journal of Medicine.
The researchers were based at the University of Washington and used data from the Women's Health Initiative (WHI) observational study.
Previous studies have assessed deaths due to fine particulate air pollution and compared impact of exposure between cities. But this is the first study to examine links between long term exposure to particles smaller than 2.5 micrometers and cardiovascular events.
Previous research has shown that fine particles in air pollution is linked to pulmonary and coronary heart disease, and also that women are different to men, for instance they have smaller blood vessels, and therefore may be more susceptible to fine particles which get deep into the lungs and cause inflammation that leads to heart disease and strokes.
The scientists examined data from 1994 to 1998 on 65,893 postmenopausal women aged between 50 and 79 who had no record of cardiovascular disease. The women came from 36 different metropolitan areas of the US.
The air pollution was measured by taking readings from meters situated near each woman's home. These recorded the air pollution level of particles smaller than 2.5 micrometers in aerodynamic diameter (denoted as PM2.5).
After a median period of 6 years, the researchers looked at the women's medical records again to see what kind and number of first incidence cardiovascular events had taken place during that time.
The scientists then estimated the risk for cardiovascular events against step increases in air pollution measures in the group. They adjusted the figures to take into account demographic, lifestyle, health, education, socio-economic factors. The health factors included smoking status, presence of diabetes, high blood pressure, high cholesterol, and body mass index (BMI).
The results showed that 1,816 of the women (nearly 3 per cent) had either died from or survived cardiovascular events during the follow up period. The events included coronary heart disease, cerebrovascular disease (damage to blood vessels in the brain), heart attack, coronary revascularization (procedures to restore heart function), and stroke.
The exposure concentrations of particles below 2.5 micrometer diameter (PM2.5) ranged from 3.4 to 28.3 micrograms per cubic meter, with a mean level of 13.5. This was measured in the year 2000, toward the beginning of the follow up period.
The limit set last autumn by the Environmental Protection Agency was 15 micrograms per cubic meter. Nearly two thirds of the women in this study were exposed to concentration levels above that limit.
Using these results the researchers showed that each 10 microgram per cubic meter step up in air pollution was linked to a 24 per cent increase in the risk of a cardiovascular event, and a 76 per cent increase in the risk of death from cardiovascular disease.
This is a significantly higher risk than found in previous studies. For instance research by the American Cancer Society puts the increased risk of death from cardiovascular disease for the same step up in PM2.5 at 12 per cent, with 18 per cent increased death risk from ischemic heart disease and 13 per cent from arrhythmia, heart failure, or cardiac arrest, according to an editorial in the same issue of the journal.
The researchers also found that the between city effect was smaller than the within city effect for cardiovascular events.
For cerebrovascular events the risks also increased with steps up in small particle pollution levels (35 per cent increase for each 10 microgram increase in PM2.5).
The first Clean Air Act in the US came into force in the 1960s, and about every ten years since, the standards for air pollution have strengthened. In 1999, the Environmental Protection Agency changed the measuring system from Pollution Standards Index (PSI) to the Air Quality Index (AQI) to take into account the small particle PM2.5 measure, and another one for ozone.
In an accompanying editorial, calls are made to tighten up the regulations even further, for instance to reduce the ceiling on the long term air pollution limits for the PM2.5 particles even further, since this study clearly shows that there is a damaging long term effect to public health.
"Long-Term Exposure to Air Pollution and Incidence of Cardiovascular Events in Women."
Kristin A. Miller, M.S., David S. Siscovick, M.D., M.P.H., Lianne Sheppard, Ph.D., Kristen Shepherd, M.S., Jeffrey H. Sullivan, M.D., M.H.S., Garnet L. Anderson, Ph.D., and Joel D. Kaufman, M.D., M.P.H.
NEJM Volume 356:447-458, Number 5, February 1, 2007
Click here for Abstract.
Click here for more information on the Environmental Protection Agency's Fine Particle Rule (US).
Written by: Catharine Paddock
Writer: Medical News Today
The study is published in the New England Journal of Medicine.
The researchers were based at the University of Washington and used data from the Women's Health Initiative (WHI) observational study.
Previous studies have assessed deaths due to fine particulate air pollution and compared impact of exposure between cities. But this is the first study to examine links between long term exposure to particles smaller than 2.5 micrometers and cardiovascular events.
Previous research has shown that fine particles in air pollution is linked to pulmonary and coronary heart disease, and also that women are different to men, for instance they have smaller blood vessels, and therefore may be more susceptible to fine particles which get deep into the lungs and cause inflammation that leads to heart disease and strokes.
The scientists examined data from 1994 to 1998 on 65,893 postmenopausal women aged between 50 and 79 who had no record of cardiovascular disease. The women came from 36 different metropolitan areas of the US.
The air pollution was measured by taking readings from meters situated near each woman's home. These recorded the air pollution level of particles smaller than 2.5 micrometers in aerodynamic diameter (denoted as PM2.5).
After a median period of 6 years, the researchers looked at the women's medical records again to see what kind and number of first incidence cardiovascular events had taken place during that time.
The scientists then estimated the risk for cardiovascular events against step increases in air pollution measures in the group. They adjusted the figures to take into account demographic, lifestyle, health, education, socio-economic factors. The health factors included smoking status, presence of diabetes, high blood pressure, high cholesterol, and body mass index (BMI).
The results showed that 1,816 of the women (nearly 3 per cent) had either died from or survived cardiovascular events during the follow up period. The events included coronary heart disease, cerebrovascular disease (damage to blood vessels in the brain), heart attack, coronary revascularization (procedures to restore heart function), and stroke.
The exposure concentrations of particles below 2.5 micrometer diameter (PM2.5) ranged from 3.4 to 28.3 micrograms per cubic meter, with a mean level of 13.5. This was measured in the year 2000, toward the beginning of the follow up period.
The limit set last autumn by the Environmental Protection Agency was 15 micrograms per cubic meter. Nearly two thirds of the women in this study were exposed to concentration levels above that limit.
Using these results the researchers showed that each 10 microgram per cubic meter step up in air pollution was linked to a 24 per cent increase in the risk of a cardiovascular event, and a 76 per cent increase in the risk of death from cardiovascular disease.
This is a significantly higher risk than found in previous studies. For instance research by the American Cancer Society puts the increased risk of death from cardiovascular disease for the same step up in PM2.5 at 12 per cent, with 18 per cent increased death risk from ischemic heart disease and 13 per cent from arrhythmia, heart failure, or cardiac arrest, according to an editorial in the same issue of the journal.
The researchers also found that the between city effect was smaller than the within city effect for cardiovascular events.
For cerebrovascular events the risks also increased with steps up in small particle pollution levels (35 per cent increase for each 10 microgram increase in PM2.5).
The first Clean Air Act in the US came into force in the 1960s, and about every ten years since, the standards for air pollution have strengthened. In 1999, the Environmental Protection Agency changed the measuring system from Pollution Standards Index (PSI) to the Air Quality Index (AQI) to take into account the small particle PM2.5 measure, and another one for ozone.
In an accompanying editorial, calls are made to tighten up the regulations even further, for instance to reduce the ceiling on the long term air pollution limits for the PM2.5 particles even further, since this study clearly shows that there is a damaging long term effect to public health.
"Long-Term Exposure to Air Pollution and Incidence of Cardiovascular Events in Women."
Kristin A. Miller, M.S., David S. Siscovick, M.D., M.P.H., Lianne Sheppard, Ph.D., Kristen Shepherd, M.S., Jeffrey H. Sullivan, M.D., M.H.S., Garnet L. Anderson, Ph.D., and Joel D. Kaufman, M.D., M.P.H.
NEJM Volume 356:447-458, Number 5, February 1, 2007
Click here for Abstract.
Click here for more information on the Environmental Protection Agency's Fine Particle Rule (US).
Written by: Catharine Paddock
Writer: Medical News Today
Monday, March 3, 2008
Lung Cancer Alliance Hails Courage Of Congressman Norwood And Extends Well Wishes As He Battles Lung Cancer
Today, the Lung Cancer Alliance (LCA) hailed Congressman Charles Norwood (R-GA) for his courage and willingness to publicly disclose his valiant battle with lung cancer.
"Sharing this kind of news with family, friends and constituents is never easy, but in doing so, Congressman Norwood is showing courage and selflessness," said Laurie Fenton, President of the Lung Cancer Alliance. "Even during this very difficult time, Congressman Norwood continues his lifelong commitment to advocacy for patients' rights by informing people about the enormous toll lung cancer takes on all sectors of our community. The congressman helps shine the light on the urgent need for more research, earlier detection and better treatments for the number one cancer killer."
Edward J. Levitt, Executive Director of LCA's Georgia chapter said, "He is a true hero and we are all praying for him."
During the twelve years Congressman Norwood has represented eastern Georgia in the U.S. House of Representatives, he has distinguished himself as a nationally recognized leader and the author of major legislation on patients' rights and health care benefits for veterans and military retirees.
Lung cancer is killing more people each year than breast, prostate, colon, melanoma, liver and kidney cancers combined. Only 16 percent of lung cancer cases are diagnosed at Stage 1, when the cancer can be treated and cured.
The stigma of smoking has led to the under funding of lung cancer research and early detection programs, even though more than 60 percent of new lung cancer cases are diagnosed in people who never smoked, were exposed to significant second-hand smoke (10-15 percent), or in former smokers (50 percent) who had already quit, many of them decades ago.
Both Fenton and Levitt assured Congressman Norwood, his wife, Gloria, and his family of their admiration, support and gratitude.
"We are committed to dedicating our continued efforts in Congressman Norwood's name to raise awareness of the need for early detection and the devastating statistics on lung cancer that have been ignored for too long," Fenton said.
The Lung Cancer Alliance (http://www.LungCancerAlliance.org), headquartered in Washington D.C., is the only national non-profit organization solely dedicated to patient support and advocacy for people living with, or at risk for, lung cancer. The Georgia chapter is headed by Executive Director Edward J. Levitt of Acworth, GA.
Lung Cancer Alliance
http://www.LungCancerAlliance.org
"Sharing this kind of news with family, friends and constituents is never easy, but in doing so, Congressman Norwood is showing courage and selflessness," said Laurie Fenton, President of the Lung Cancer Alliance. "Even during this very difficult time, Congressman Norwood continues his lifelong commitment to advocacy for patients' rights by informing people about the enormous toll lung cancer takes on all sectors of our community. The congressman helps shine the light on the urgent need for more research, earlier detection and better treatments for the number one cancer killer."
Edward J. Levitt, Executive Director of LCA's Georgia chapter said, "He is a true hero and we are all praying for him."
During the twelve years Congressman Norwood has represented eastern Georgia in the U.S. House of Representatives, he has distinguished himself as a nationally recognized leader and the author of major legislation on patients' rights and health care benefits for veterans and military retirees.
Lung cancer is killing more people each year than breast, prostate, colon, melanoma, liver and kidney cancers combined. Only 16 percent of lung cancer cases are diagnosed at Stage 1, when the cancer can be treated and cured.
The stigma of smoking has led to the under funding of lung cancer research and early detection programs, even though more than 60 percent of new lung cancer cases are diagnosed in people who never smoked, were exposed to significant second-hand smoke (10-15 percent), or in former smokers (50 percent) who had already quit, many of them decades ago.
Both Fenton and Levitt assured Congressman Norwood, his wife, Gloria, and his family of their admiration, support and gratitude.
"We are committed to dedicating our continued efforts in Congressman Norwood's name to raise awareness of the need for early detection and the devastating statistics on lung cancer that have been ignored for too long," Fenton said.
The Lung Cancer Alliance (http://www.LungCancerAlliance.org), headquartered in Washington D.C., is the only national non-profit organization solely dedicated to patient support and advocacy for people living with, or at risk for, lung cancer. The Georgia chapter is headed by Executive Director Edward J. Levitt of Acworth, GA.
Lung Cancer Alliance
http://www.LungCancerAlliance.org
Survival In Asbestos-Related Cancer Improved By Chemo Combination
People with mesothelioma - a form of cancer associated with asbestos exposure - have a higher survival rate when treated with a combination of two cancer drugs, a large multicenter study finds.
Mesothelioma, a rare but aggressive form of cancer that occurs in the lining of the lungs, heart and abdomen, is associated with exposure to asbestos. There is no known cure.
In the study, patients receiving pemetrexed and cisplatin - along with the vitamin supplements folic acid and B12 - survived nearly three months longer than patients getting cisplatin alone.
Researchers led by John Green, M.D., at the Clatterbridge Center for Oncology in England, reviewed a study of 448 patients with advanced mesothelioma who were treated with either the single drug or the combination.
"Pemetrexed used in combination with cisplatin significantly increases the length of survival, when compared with cisplatin alone," the researchers say. "Further research is needed into the optimum treatment regimen for pleural mesothelioma."
The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
The researchers examined data from a clinical trial of 20 treatment centers in Europe, the Americas, Australia and Asia. Eighty-one percent of the patients were men, with an average age of 61. Patients who received the combination treatment survived an average 2.8 months longer.
Patients receiving both medications also reported improved quality of life in terms of fatigue, loss of appetite, pain and cough.
During the early stages of the trial, patients receiving pemetrexed had serious symptoms of toxicity, including drug-related death. Other side effects included blood cell abnormalities, nausea and diarrhea, which decreased in both incidence and severity after the vitamins were added to the treatment. People who work trades such as shipbuilding, railway engineering, construction work and asbestos manufacture have higher rates of mesothelioma than the general public. The cancer may take 10 to 60 years to develop, and the risk does not diminish after exposure to asbestos has stopped. Family members of people exposed to asbestos at work also have an increased risk of developing mesothelioma from asbestos fibers carried home on the clothes of the people they live with.
Daniel Baram, M.D., a pulmonologist at the Lung Cancer Evaluation Center at the State University of New York, said, "Most cases [of mesothelioma] are still from pre-OSHA workplace improvements. I suspect that modern asbestos abatement precautions will avoid most, if not all, future cases. The latency is over 30 years, so we are still diagnosing cases with exposure during World War II and the '40s and '50s."
Mesothelioma is difficult to diagnose, Green said, because "there is a lag of many years between exposure and asbestosis, which is a nonmalignant condition, and a greater lag before the development of overt malignancy."
"There is no way of diagnosing the premalignant phase during the latent period of 15 to 20 years," Green added. "Many of these patients smoke and are in economically disadvantaged communities. Many individuals have moved away from heavy industries and may not admit or know they were exposed to asbestos as young men, with similar issues for their partners."
According to the U.S. Environmental Protection Agency, 10 percent to 15 percent of schools and other public buildings in the United States contain asbestos insulation.
Although safety measures for working with asbestos have been in place since the 1970s, mesothelioma is projected to account for 65,000 deaths between 2001 and 2050 worldwide, peaking between 2012 and 2015, according to background information in the review.
It is a personal matter as to whether the survival increase for patients receiving the two drugs is worthwhile, Baram said. "It depends in large part on the patient. A 2.8-month mean survival increase means that some patients may get even more than that, though some people will get less. Many, if not most, patients when faced with a disease with a very bad prognosis are often willing to undergo aggressive therapy, although the toxicity is serious and potentially life-threatening."
###
By Lise Millay Stevens, Contributing Writer
Health Behavior News Service
Green J, et al. Pemetrexed disodium in combination with cisplatin versus other cytotoxic agents or supportive care for the treatment of malignant pleural mesothelioma. Cochrane Database of Systematic Reviews 2007, Issue 1.
The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org/ for more information.
Contact: Lisa Esposito
Center for the Advancement of Health
Mesothelioma, a rare but aggressive form of cancer that occurs in the lining of the lungs, heart and abdomen, is associated with exposure to asbestos. There is no known cure.
In the study, patients receiving pemetrexed and cisplatin - along with the vitamin supplements folic acid and B12 - survived nearly three months longer than patients getting cisplatin alone.
Researchers led by John Green, M.D., at the Clatterbridge Center for Oncology in England, reviewed a study of 448 patients with advanced mesothelioma who were treated with either the single drug or the combination.
"Pemetrexed used in combination with cisplatin significantly increases the length of survival, when compared with cisplatin alone," the researchers say. "Further research is needed into the optimum treatment regimen for pleural mesothelioma."
The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
The researchers examined data from a clinical trial of 20 treatment centers in Europe, the Americas, Australia and Asia. Eighty-one percent of the patients were men, with an average age of 61. Patients who received the combination treatment survived an average 2.8 months longer.
Patients receiving both medications also reported improved quality of life in terms of fatigue, loss of appetite, pain and cough.
During the early stages of the trial, patients receiving pemetrexed had serious symptoms of toxicity, including drug-related death. Other side effects included blood cell abnormalities, nausea and diarrhea, which decreased in both incidence and severity after the vitamins were added to the treatment. People who work trades such as shipbuilding, railway engineering, construction work and asbestos manufacture have higher rates of mesothelioma than the general public. The cancer may take 10 to 60 years to develop, and the risk does not diminish after exposure to asbestos has stopped. Family members of people exposed to asbestos at work also have an increased risk of developing mesothelioma from asbestos fibers carried home on the clothes of the people they live with.
Daniel Baram, M.D., a pulmonologist at the Lung Cancer Evaluation Center at the State University of New York, said, "Most cases [of mesothelioma] are still from pre-OSHA workplace improvements. I suspect that modern asbestos abatement precautions will avoid most, if not all, future cases. The latency is over 30 years, so we are still diagnosing cases with exposure during World War II and the '40s and '50s."
Mesothelioma is difficult to diagnose, Green said, because "there is a lag of many years between exposure and asbestosis, which is a nonmalignant condition, and a greater lag before the development of overt malignancy."
"There is no way of diagnosing the premalignant phase during the latent period of 15 to 20 years," Green added. "Many of these patients smoke and are in economically disadvantaged communities. Many individuals have moved away from heavy industries and may not admit or know they were exposed to asbestos as young men, with similar issues for their partners."
According to the U.S. Environmental Protection Agency, 10 percent to 15 percent of schools and other public buildings in the United States contain asbestos insulation.
Although safety measures for working with asbestos have been in place since the 1970s, mesothelioma is projected to account for 65,000 deaths between 2001 and 2050 worldwide, peaking between 2012 and 2015, according to background information in the review.
It is a personal matter as to whether the survival increase for patients receiving the two drugs is worthwhile, Baram said. "It depends in large part on the patient. A 2.8-month mean survival increase means that some patients may get even more than that, though some people will get less. Many, if not most, patients when faced with a disease with a very bad prognosis are often willing to undergo aggressive therapy, although the toxicity is serious and potentially life-threatening."
###
By Lise Millay Stevens, Contributing Writer
Health Behavior News Service
Green J, et al. Pemetrexed disodium in combination with cisplatin versus other cytotoxic agents or supportive care for the treatment of malignant pleural mesothelioma. Cochrane Database of Systematic Reviews 2007, Issue 1.
The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org/ for more information.
Contact: Lisa Esposito
Center for the Advancement of Health
Statement On The Passing Of Congressman Charlie Norwood (R-GA), By John Kirkwood, American Lung Association President & CEO
The American Lung Association's volunteers and staff wish to express our deepest condolences to family of U.S. Congressman Charlie Norwood, DDS (R-GA), who died today after a long battle with idiopathic pulmonary fibrosis and lung cancer. A long-time champion for all patients, Representative Norwood inspired lung disease patients across the country when he returned to Congress following his lung transplant in 2004. American Lung Association staff and volunteers fondly remember Representative Norwood's keynote speech to our national conference in May 2002.
Idiopathic pulmonary fibrosis is a form of interstitial lung disease. When a person has idiopathic pulmonary fibrosis, the lung is affected in three ways. First, the lung tissue is damaged in some known or unknown way. Second, the walls of the air sacs in the lung become inflamed. Finally, scarring (or fibrosis) begins in the interstitium (or tissue between the air sacs), and the lung becomes stiff. The American Lung Association supports an array of research into the basic cellular and molecular processes that underlie the inflammatory response in the lungs that precedes pulmonary fibrosis. Our researchers are also examining new ways to prevent the lung scarring that follows this type of inflammation and are looking for new treatments for lungs damaged excess scar tissue formation.
Lung cancer is the number one cancer killer in the U.S., and the American Lung Association is committed to funding vital research to help fight this devastating disease including our Lung Cancer Discovery Award which is specifically directed at developing improved treatments. Lung cancer may also be the most tragic cancer because in most cases, it might have been prevented. Nearly 90 percent of lung cancer cases are caused by smoking. The more time and amount you smoke, the greater your risk of lung cancer. But if you stop smoking, the risk of lung cancer decreases each year as normal cells replace abnormal cells.
About the American Lung Association
Beginning our second century, the American Lung Association is the leading organization working to prevent lung disease and promote lung health. Lung disease death rates continue to increase while other leading causes of death have declined. The American Lung Association funds vital research on the causes of and treatments for lung disease. With the generous support of the public, the American Lung Association is "Improving life, one breath at a time." For more information about the American Lung Association or to support the work it does, call 1-800-LUNG-USA ( 1-800-586-4872) or log on to http://www.lungusa.org.
Idiopathic pulmonary fibrosis is a form of interstitial lung disease. When a person has idiopathic pulmonary fibrosis, the lung is affected in three ways. First, the lung tissue is damaged in some known or unknown way. Second, the walls of the air sacs in the lung become inflamed. Finally, scarring (or fibrosis) begins in the interstitium (or tissue between the air sacs), and the lung becomes stiff. The American Lung Association supports an array of research into the basic cellular and molecular processes that underlie the inflammatory response in the lungs that precedes pulmonary fibrosis. Our researchers are also examining new ways to prevent the lung scarring that follows this type of inflammation and are looking for new treatments for lungs damaged excess scar tissue formation.
Lung cancer is the number one cancer killer in the U.S., and the American Lung Association is committed to funding vital research to help fight this devastating disease including our Lung Cancer Discovery Award which is specifically directed at developing improved treatments. Lung cancer may also be the most tragic cancer because in most cases, it might have been prevented. Nearly 90 percent of lung cancer cases are caused by smoking. The more time and amount you smoke, the greater your risk of lung cancer. But if you stop smoking, the risk of lung cancer decreases each year as normal cells replace abnormal cells.
About the American Lung Association
Beginning our second century, the American Lung Association is the leading organization working to prevent lung disease and promote lung health. Lung disease death rates continue to increase while other leading causes of death have declined. The American Lung Association funds vital research on the causes of and treatments for lung disease. With the generous support of the public, the American Lung Association is "Improving life, one breath at a time." For more information about the American Lung Association or to support the work it does, call 1-800-LUNG-USA ( 1-800-586-4872) or log on to http://www.lungusa.org.
New Blood Thinner For Patients With Leg And Lung Clots
A new oral blood thinner is being compared to an old standby to see if it works as well and is easier to manage long term, researchers say.
Other medications and even diet can dramatically impact blood levels of warfarin, or Coumadin™, increasing the risk of bleeding or clotting, says Dr. James R. Gossage Jr., pulmonologist at the Medical College of Georgia.
"You eat too much broccoli or spinach and it sends your levels out of whack; almost every other medicine affects Coumadin," says Dr. Gossage, who calls warfarin a "high-maintenance" medication.
Unfortunately, many people, including those with a clot in their legs - called deep vein thrombosis - or their lungs - called pulmonary embolism - may need it for months or years, Dr. Gossage says.
An international study of 2,000 adult patients with these problems will determine if dabigatran, manufactured by Boehringer Ingelheim, a Germany based pharmaceutical company, makes long-term clot control easier.
Deep vein thrombosis or a pulmonary embolism generally are treated with intravenous blood thinners; really big clots also may need a clot-buster like tPA, says Dr. Gossage, a principal investigator on the study. Blood thinners keep the clot from growing while the body's endogenous clot-busters eliminate it. That can take a while, especially when clots measure several inches or more, so patients also need a blood thinner they can take at home for months or longer, depending on their diagnosis. When patients start taking warfarin, they need daily, then weekly monitoring until levels stabilize, then at least monthly checks as long as they take the drug, he says.
At the right level, the drug works well, inhibiting vitamin K, which is involved in the synthesis of several coagulation factors and found in abundance in green leafy vegetables, vegetable oils, cranberries and even licorice. "It's very uncommon for a person taking warfarin to have a blood clot if his or her level is in the proper range," Dr. Gossage says.
The trouble is that a big helping of collard greens, for example, can dramatically reduce the drug's effectiveness and increase clotting risk. Patients are encouraged to eat stable diets, but even so, Dr. Gossage has patients whose blood levels, charted on a graph, look like a roller coaster.
Many common over-the-counter and prescription drugs contribute to the problem by affecting the liver mechanism that determines how much and how fast warfarin is eliminated, Dr. Gossage says. "We are looking for medicines that are more like most others we take; they are not affected by our diet and by every other pill we take," he says.
Previous work with dabigatran indicates it could fit the bill. It works early in the clotting process, inhibiting thrombin, one of the main clotting factors. "When you cut yourself, platelets start sticking, thrombin comes in and activates the whole cascade of coagulation factors that form a clot. Warfarin works later in the cascade, so getting something that works earlier may be even better," says Dr. Gossage.
"Hopefully we won't have these big swings in the level and people won't have these periods where they are at great risk," says Dr. Gossage. "I can give you a dose and it's going to work the same way whether you are eating broccoli or spinach or taking penicillin or some other antibiotic"
This phase III study randomizes patients to warfarin or dabigatran and closely follows them for 18 months. If dabigatran appears ineffective, patients are moved to more standard therapy. All blood thinners can have the side effect of bleeding, he notes.
Immobility, blood vessel injury and anything that increases blood's tendency to clot, called hypercoagulability, are risk factors for clots. "Most people think you have to have at least two of those, says Dr. Gossage.
Long plane rides or hospital stays can put patients at risk ; trauma, even an intravenous line needed for medicine, can injure vessels. A host of things contribute to hypercoagulability, including birth control pills, hormone replacement therapy, age, and perhaps smoking and obesity. Cancer, particularly solid tumors, is a big risk factor for clotting. Ironically its primary treatments, chemotherapy and radiation therapy, can narrow blood vessels and add to the risk.
An estimated 600,000 pulmonary embolisms occur each year in the United States and deep vein thrombosis is about twice as common. Many patients have both because a clot in the leg has nearly a straight shot to the lungs through the venous system.
###
Contact: Toni Baker
Medical College of Georgia
Other medications and even diet can dramatically impact blood levels of warfarin, or Coumadin™, increasing the risk of bleeding or clotting, says Dr. James R. Gossage Jr., pulmonologist at the Medical College of Georgia.
"You eat too much broccoli or spinach and it sends your levels out of whack; almost every other medicine affects Coumadin," says Dr. Gossage, who calls warfarin a "high-maintenance" medication.
Unfortunately, many people, including those with a clot in their legs - called deep vein thrombosis - or their lungs - called pulmonary embolism - may need it for months or years, Dr. Gossage says.
An international study of 2,000 adult patients with these problems will determine if dabigatran, manufactured by Boehringer Ingelheim, a Germany based pharmaceutical company, makes long-term clot control easier.
Deep vein thrombosis or a pulmonary embolism generally are treated with intravenous blood thinners; really big clots also may need a clot-buster like tPA, says Dr. Gossage, a principal investigator on the study. Blood thinners keep the clot from growing while the body's endogenous clot-busters eliminate it. That can take a while, especially when clots measure several inches or more, so patients also need a blood thinner they can take at home for months or longer, depending on their diagnosis. When patients start taking warfarin, they need daily, then weekly monitoring until levels stabilize, then at least monthly checks as long as they take the drug, he says.
At the right level, the drug works well, inhibiting vitamin K, which is involved in the synthesis of several coagulation factors and found in abundance in green leafy vegetables, vegetable oils, cranberries and even licorice. "It's very uncommon for a person taking warfarin to have a blood clot if his or her level is in the proper range," Dr. Gossage says.
The trouble is that a big helping of collard greens, for example, can dramatically reduce the drug's effectiveness and increase clotting risk. Patients are encouraged to eat stable diets, but even so, Dr. Gossage has patients whose blood levels, charted on a graph, look like a roller coaster.
Many common over-the-counter and prescription drugs contribute to the problem by affecting the liver mechanism that determines how much and how fast warfarin is eliminated, Dr. Gossage says. "We are looking for medicines that are more like most others we take; they are not affected by our diet and by every other pill we take," he says.
Previous work with dabigatran indicates it could fit the bill. It works early in the clotting process, inhibiting thrombin, one of the main clotting factors. "When you cut yourself, platelets start sticking, thrombin comes in and activates the whole cascade of coagulation factors that form a clot. Warfarin works later in the cascade, so getting something that works earlier may be even better," says Dr. Gossage.
"Hopefully we won't have these big swings in the level and people won't have these periods where they are at great risk," says Dr. Gossage. "I can give you a dose and it's going to work the same way whether you are eating broccoli or spinach or taking penicillin or some other antibiotic"
This phase III study randomizes patients to warfarin or dabigatran and closely follows them for 18 months. If dabigatran appears ineffective, patients are moved to more standard therapy. All blood thinners can have the side effect of bleeding, he notes.
Immobility, blood vessel injury and anything that increases blood's tendency to clot, called hypercoagulability, are risk factors for clots. "Most people think you have to have at least two of those, says Dr. Gossage.
Long plane rides or hospital stays can put patients at risk ; trauma, even an intravenous line needed for medicine, can injure vessels. A host of things contribute to hypercoagulability, including birth control pills, hormone replacement therapy, age, and perhaps smoking and obesity. Cancer, particularly solid tumors, is a big risk factor for clotting. Ironically its primary treatments, chemotherapy and radiation therapy, can narrow blood vessels and add to the risk.
An estimated 600,000 pulmonary embolisms occur each year in the United States and deep vein thrombosis is about twice as common. Many patients have both because a clot in the leg has nearly a straight shot to the lungs through the venous system.
###
Contact: Toni Baker
Medical College of Georgia
Breath Test Detects Lung Cancer In Early Stages
A new breath test has been reported to detect lung cancer in its early stage. Lung cancer is the leading cause of cancer death in the United States, and doctors believe that early detection could offer sufferers their best chance for early survival.
Dr. Michael Phillips, CEO of Menssana Research, the company that developed the breath test, said, "We developed a breathalyzer that is one billion times more sensitive than those the police use to measure alcohol in the breath. It detects around 200 different chemicals in a person's breath, and some of these chemicals are markers of cancer. A breath test has great advantages over most other medical tests - it is completely safe, painless and non-invasive. All you have to do is breathe gently into a tube for two minutes. There are no potentially dangerous x-rays to worry about, and it will certainly be a lot less expensive than chest imaging."
In a study funded by the National Institutes of Health that will be published in Cancer Biomarkers, researchers studied 404 smokers and ex-smokers aged over 60. The breath test predicted lung cancer with almost the same accuracy as computerized tomography, or chest CT, the best screening test for lung cancer currently available.
Early detection is essential to save lives. Lung cancer affects over 170,000 Americans annually and more than 95% of them are dead within 5 years if the tumor has metastasized to other organs, versus only 20% if the tumor is found while it is still confined to the lung.
The breath test will not be available in the USA until approved by the Food and Drug Administration, but may be available sooner in the European Union.
Menssana Research is currently developing breath tests to detect several other diseases in their early stages, including pulmonary tuberculosis, breast cancer, and ischemic heart disease. The FDA has already approved the Heartsbreath test for heart transplant rejection. Dr. Phillips said he hopes that physicians and patients will eventually consider a breath test the way we think of a chest x-ray or blood test: as an inexpensive and convenient screening test which can detect several diseases in their earliest and most treatable stages.
Menssana Research, Inc.
http://www.menssanaresearch.com/
Dr. Michael Phillips, CEO of Menssana Research, the company that developed the breath test, said, "We developed a breathalyzer that is one billion times more sensitive than those the police use to measure alcohol in the breath. It detects around 200 different chemicals in a person's breath, and some of these chemicals are markers of cancer. A breath test has great advantages over most other medical tests - it is completely safe, painless and non-invasive. All you have to do is breathe gently into a tube for two minutes. There are no potentially dangerous x-rays to worry about, and it will certainly be a lot less expensive than chest imaging."
In a study funded by the National Institutes of Health that will be published in Cancer Biomarkers, researchers studied 404 smokers and ex-smokers aged over 60. The breath test predicted lung cancer with almost the same accuracy as computerized tomography, or chest CT, the best screening test for lung cancer currently available.
Early detection is essential to save lives. Lung cancer affects over 170,000 Americans annually and more than 95% of them are dead within 5 years if the tumor has metastasized to other organs, versus only 20% if the tumor is found while it is still confined to the lung.
The breath test will not be available in the USA until approved by the Food and Drug Administration, but may be available sooner in the European Union.
Menssana Research is currently developing breath tests to detect several other diseases in their early stages, including pulmonary tuberculosis, breast cancer, and ischemic heart disease. The FDA has already approved the Heartsbreath test for heart transplant rejection. Dr. Phillips said he hopes that physicians and patients will eventually consider a breath test the way we think of a chest x-ray or blood test: as an inexpensive and convenient screening test which can detect several diseases in their earliest and most treatable stages.
Menssana Research, Inc.
http://www.menssanaresearch.com/
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