Immune System Boosting Drug to Work With Hodgkin’s Lymphoma

Nivolumab PD1 inhibitor drug

Nivolumab PD1 inhibitor drug

A number of new drugs have shown the ability to boost the immune system to help it fight cancer. Some of the drugs simply help the immune system detect and kill cancer cells. They do this by disabling the mechanisms cancer cells use to remain hidden.

One such drug is Nivolumab. There is a protein called programmed cell death 1 (PD-1), that helps the immune system understand which cells should die. Another molecule can attach itself to PD-1 to form PD-L1, which tells the immune system to not attack a cell. This prevents the immune system from going overboard and killing too many cells. The problem is the fact that cancer cells are smart enough to product their own PD-L1 protein and avoid detection by the immune system. The drug stops cancer cells from creating PD-L proteins, which helps the immune system notice and attack the cancerous cells.

Trials have seen some great results with Nivolumab, particularly in the treatment of Hodgkin’s Lymphoma and other lymphatic system cancers. The drugs are especially useful for shrinking the size of tumors, as the immune system starts to recognize the cancerous cells and pull them away from the tumor mass. Researchers expect these kinds of drugs to be particularly effective at beating cancers affecting the blood and bone marrow.

A drug called pembrolizumab is another (PD-1) receptor inhibitor, showing promising results. A small study showed that the drug shrank tumors in 66% of the sample group.

These results should be looked at with some caution though, because they are phase one trial results. The research has only used small groups of test subjects so far.

According to Cancer.gov, there are 185,793 people living with Hodgkin Lymphoma in the United States. The five year survival rate is 85.3% (based on 2004-2010 figures).

There are some serious side effects with drugs that inhibit PD-1. 22% of the people involved in the nivolumab trial had a serious side effect. That can include inflammation of internal organs like the colon, lung and pancreas.

If the trials continue to go well, we will see these drugs in the market within a couple of years.

Repurposing Drugs for use in Oncology

Cimetidine to help fight cancer

Cimetidine to help fight cancer

A new research paper has looked at commonly used drugs that can be repurposed to help fight cancer. One example is the common used indigestion medicine cimetidine, which can help treat colorectal cancer.

Medical professionals already know cimetidine is safe, from various trials and many years of use. Therefore, it can be easily combined with other cancer treatments. Cimetidine reduces digestion by blocking histamine receptors in the gut, which reduces the production of gastric acid. It turns out that the drug can also block histamine receptors in cancer cells, which helps the immune system defend against them.

Cimetidine may have a beneficial effect in treating colorectal cancer, renal cancer and melanoma.

The researchers found that:

Based on the evidence presented, it is proposed that cimetidine would synergise with a range of other drugs, including existing chemotherapeutics, and that further exploration of the potential of cimetidine as an anti-cancer therapeutic is warranted. Furthermore, there is compelling evidence that cimetidine administration during the peri-operative period may provide a survival benefit in some cancers. A number of possible combinations with other drugs are discussed in the supplementary material accompanying this paper.

Reducing Cancer Risk

One of the most common drugs that can be repurposed to help avoid cancer may be aspirin. There is a growing body of research that aspirin can reduce pancreatic cancer risk and improve colorectal cancer prognosis.

Repurposing Drugs in Oncology (ReDO)

ReDO is a project that has been looking at ways common drugs may be used to help improve cancer treatments.

It’s primary pbjectives are:

– Identify the most promising drugs for further clinical investigation
– Review and bring to the attention of clinical investigators the data for these drugs
– Document on how these drugs can be combined with existing therapies, or with other repurposed drugs
– Develop clinical trials to provide positive or negative evidence of efficacy
– Where necessary, suggest areas where further pre-clinical work is necessary

By finding commonly used drugs that have a beneficial effect in the fight against cancer, the research group also helps provide low cost treatments and preventatives against cancer.

FDA Approves Ovarian Cancer Drug “Avastin”

Avastin Receives FDA Approval for Ovarian Cancer

Avastin Receives FDA Approval for Ovarian Cancer

Drugmaker Roche has notified the public that the FDA has approved Avastin as a treatment for Ovarian cancer.

The new drug is designed to work in conjunction with chemotherapy in recurrent cases where there is resistance to platinum-based chemotherapy. The drug has already been approved for Glioblastoma (GBM), Metastatic Colorectal Cancer (mCRC), Non–Small Cell Lung Cancer (NSCLC) and Metastatic Kidney Cancer (mRCC).

Avastin is a angiogenesis inhibitor, that slows the growth of new blood vessels. It blocks angiogenesis by inhibiting vascular endothelial growth factor A (VEGF-A), which is a chemical signal used by cancer to help the disease spread.

The drug was first approved in 2004 by the FDA for metastatic colon cancer. In the past Roche also tried to have the drug approved for breast cancer, but it was shown to be ineffective in trials.

The drug is a big money maker for Roche, having netted them a whopping $6.25 billion in 2013.

Side Effects
The drug carries a number of serious side effects that cancer patients must be aware of.

Some of the more serious ones are:

  • GI perforation (a hole that develops in your stomach or intestine)
  • Wounds that don’t heal
  • .

  • Serious bleeding
  • (This includes vomiting or coughing up blood; bleeding in the stomach, brain, or spinal cord; nosebleeds; and vaginal bleeding)

Other side effects can include severely high blood pressure, kidney problems, infusion reactions, stroke, heart problems, nervous system problems and vision problems.

The drug carries some serious side effects, but is an important part of the cancer treatment regime for many people.

Stanford Researchers Target Cancer Cell Proliferation

Axl and Gas6 Proteins Cancer Metastasis

Axl and Gas6 Proteins Cancer Metastasis

Researchers at Stanford University have developed a new therapy which may be able to disrupt cancer cell proliferation. The treatment prevents cancer cells breaking away from a tumor to spread cancer to other locations in the body.

The metastasis process is how cancer cells proliferate and create more problems for cancer patients. Most people die from cancer spreading to other parts of their bodies. Traditionally doctors use drug therapies and chemotherapy to halt metastasis.

The new treatment developed by Stanford researchers, prevents two proteins from interacting and helping spread cancer cells. The two proteins, Axl and Gas6, play an important role in helping cancer cells leave the tumor and migrate elsewhere.

The treatment created fake Axl proteins to distract the Gas6 protein and prevent proliferation of cancer cells. The treatment has been successfully tested on mice with breast and ovarian cancers.

The best part about the treatment is that it is non-toxic! The next step is more animal trials, followed by a human trial within the next few years.

Researchers say that all biological processes are driven by the interaction of various proteins. The way cancer grows and spreads is just a simple biological process that also relies upon proteins. Researchers must first identify the proteins responsible for cancer growing and spreading, then neutralise them with fake proteins or by limiting specific proteins.

Survival Rates Increasing with Targeted Molecular Therapy

James Lagno Cancer Genomics Treatment

James Lagno Cancer Genomics Treatment

ABC news have posted a story about a man named James Lango, who was diagnosed with a number of cancers, but has survived longer than expected thanks to an experimental cancer treatment. “Molecular targeted therapy” was used on Lagno, with new varieties of drugs tailored specifically to target the type of cancer he has.

Lagno had a combination of cancers including late stage lung cancer, thyroid cancer and brain lesions. The survival rate for late stage lung cancer alone is very low, so doctors had given him a year at the most.

A biopsy of one of the tumors in James’ lungs found a rare mutation responsible for the cancer. Using the DNA from that mutation, a drug was developed that specifically targeted it. The drugs target specific proteins that are used by this particular cancer mutation.

Lagno still has tumors, but they have not grown or spread, because the cancer lacks the proteins required to help it spread. He has survived for three year so far, when doctors expected one year at the most thanks to the treatent.

The drug in question is “Ceritinib”. It has recently been approved by the FDA. It is one of a wave of new drugs coming onto the market that are designed to target specific cancers based upon their DNA and the proteins they use to spread through the body.

The FDA are also streamlining their approvals process so many of the high specialized DNA targeted cancer drugs are getting to market quickly. Great news for cancer sufferers.

Exciting New Lung Cancer Drugs

Immunotherapy Lung Cancer Treatment

Immunotherapy Lung Cancer Treatment

Researchers have revealed some new drug treatments which are capable of completely clearing tumors for people with advanced stage lung cancer.

Lung cancer is one of the most aggressive forms of the disease and once it has metastasized to other parts of the body the prognosis for the patient is usually very grim and they usually only have months to live. These new immunotherapy drugs are capable of not only attacking tumors within the lungs but following the cancer to other sites that it has metastasized throughout the body.

One patient who had lung cancer that metastasized through to his brain, bones and adrenal glans saw complete remission, which astonished and excited many researchers.

Lung cancer is still one of the biggest killers in the world with many baby boomers who were smoking earlier in their lives finding themselves afflicted with it. Lung cancer kills more people than breast or bowel cancer, the other two prevalent forms of the disease.

The results of the most recent drug trial will be presented at the American Society of Clinical Oncology in Chicago, in a few days time.

One of the drugs that has shown incredible results is called nivolumab. In the trials, at least 129 (24% of the total patients) who had advanced lung cancer have survived for two or more years since starting nivolumab. For a disease that usually kills within months once it has advanced, that is an astonishing result.

Researchers said some of the patients had extremely advanced cancer that would normally kill them within a couple of months, but they are still alive because of the treatment.
One of the researchers, Dr Mick Peake of Glenfield Hospital says: “By the time it’s spread that far, you don’t expect patients to last more than a couple of months. But in a recent scan, his doctor could not find any evidence of residual disease.”

Survival rates with the optimum dose are even higher, with 45% still alive after two years. To get such large percentages surviving an aggressive form of cancer for so long is exciting for researchers. The sheer number of positive cases is also unusual, as it is such a massive and widespread improvement.

These new types of “immunotherapy” drugs are also called anti-PD1s or anti-PDL1s, and work by teaching the immune system to see tumors as something to be attacked. Normally cancer cells cloak themselves from the immune system, so unlike an infection the immune system will ignore them.

Another similar drug called MK3475 has also been showing incredible results and according to researchers they could conceivably be a large component of the the cure for cancer. At the very least, with refinement they could allow cancer patients to live for many more years than they currently do.

Dr Julie Brahmer of John Hopkins Sidney Kimmel Comprehensive Cancer Centre in Baltimore has helped lead the US nivolumab trials. Dr Brahmer suggests that while it is too early to call the treatments a cure for cancer, the results are astonishing with tumors shrinking to almost nothing and people with aggressive cancers living for years.

There is also some suggestion that the immune system learns how to treat cancerous tumors in the future because it continues to attack them after the drugs have stopped.

The researchers will continue to develop the immunotherapy drugs and research how they can interact with other new drugs and common treatments to make them more effective. There may be even some possibility of combining the effectiveness of these drugs with other that utilize viruses to further mark the tumors as foreign bodies that should be attacked.

Measles Vaccine to Combat Cancer?

Viruses May be a Cancer Cure?

Viruses May be a Cancer Cure?

An unusual and experimental cancer treatment is currently being tested by the Mayo Clinic and is showing good signs – injecting people with high doses of measles vaccine.

Some results have been impressive including a woman with widespread blood cancer who received the injection and went into complete remission afterwards. The injection of measles vaccine is enough to inoculate 10 million people, so a massive amount of vaccine is used.

It turns out the vaccine plays an unusual role when cancer and tumors are found within the body. The theory goes that a single massive dose of the vaccine can be used to kill the cancer by overwhelming it’s natural defenses.

Dr. Stephen Russell, a professor of molecular medicine at Mayo Institute says of the treatment: “It’s a landmark. We’ve known for a long time that we can give a virus intravenously and destroy metastatic cancer in mice. Nobody’s shown that you can do that in people before.”

The research is in extremely early stages with the initial findings just published in the journal Mayo Clinic Proceedings. However researchers in the field like Dr. John C. Bell from the Centre for Innovative Cancer Research suggests: “Without trying to hype it too much, it is a very significant discovery”

The next step is to expand the size of the trial to a few hundred patients to see if the results can be replicated. According to Mayo, that trial should begin before September 2014.

So how does it work?

Cancer researchers have understood for a long time that viruses can kill cancer cells and tumors. The virus can bind itself to tumors within the body and use them to replicate their own genetic material. So the measles virus will latch onto tumors and use them to replicate. The cancer cells eventually explode and release more of the virus, the fantastic part is that the cancer cells are devastated by the virus. There are a number of antiviral vaccines like the measles vaccine that have been rendered safe and can attack cancer cells.

An additional benefit is that thanks to recent progresses, the viruses can be modified to carry radioactive molecules that destroy cancer cells without damaging healthy tissue. The human body’s immune system will also be seeking to eradicate the virus, so any cancer cells that look like a part of the virus will be attacked, including those tumors that have been attacked by the virus.

Other viruses that may be used to attack cancer cells include herpes and poxvirus, which have shown fantastic results in rats. Researchers have been unsure what level of viral infection would be required to combat cancer effectively and this recent study indicates that a substantial amount is most likely required to overcome the defense mechanisms that cancerous tumors have.

Researchers also suggest that because different viruses tend to target certain parts of the body, they may be more effective against cancers that appear in that part of the body. For example the common influenza virus may be the most effective for attacking lung cancer. That would mean that a modified virus wouldn’t cause damage to other parts of the body!

The measles vaccine used looked at the cancerous myleoma tumors as a form of food and literally gobbled them up to reproduce. Of course most people have already been vaccinated for measles, so the treatment would be less effective as their system would attack the virus quickly. However that is somewhat mitigated because cancer patients often have compromised immune systems and the virus can spread more effectively. Drugs could be used to help the virus work throughout the body as well.

Researchers had to establish how much of the virus to give patients and there is still some work to be done to determine the right amount of the virus on a case by case basis. Some patients might only need a couple of million infectious units, others might need billions, as was used in the successful case study.

The study used only 2 patients, with the woman who had tumors in her bone marrow showing complete recovery, but the woman with tumors in her leg muscle showing any substantial improvement. Researchers suggest that more research is needed to determine a better virus for tumors in that location or an increase in dosage.

This form of viral treatment is a one off, because after it has been used the body will recognize the virus and attack it quickly. Researchers will also take a look at reducing the effectiveness of the immune system so repeated courses of a virus may be used if required. One approach there is to take the patients cells, load the virus into them and inject them back into the body. That gives the virus time to reach the tumors and attack them before the immune system kills the virus.

Another current study is looking at treating pancreatic cancer with Reolysin, which is a variation of the virus that causes the common cold. In this study, researchers are also looking at the prospect of injecting tumors directly with the virus as opposed to using the bloodstream as a viral delivery mechanism.

Doctors are very excited about the possibilities with one researcher saying viral treatment is: “an incredibly innovative way to actually attack the cancer and perhaps even offer a better chance at complete remission”.

It is still early days, and large scale randomized trials are required, but the early results are very encouraging!

What is Cancer Genomics?

Oncogenomics

Oncogenomics

Genomics

To understand what the term Cancer Genomics actually means first requires you to understand what Genomics are. To put it as simply as possible, genomics refers to a discipline in genetics that uses DNA sequencing, recombinant DNA and bioinformatics to analyze, sequence and assemble the function and structure of genomes. Genomes are a “complete set of DNA within a single cell of an organism”.

People in this field are busy with genetic mapping of the human body, looking at interactions within the genome and complex interactions between genomes. They examine concepts like heterosis (which deals with breeding), epistasis (“modifier” genes) and pleiotropy (when one gene affects several seemingly unrelated traits). To put it in simple terms they are trying to understand how genes interact, how genomes function and what specific genes control within the human body.

Cancer Genomics (Oncogenomics)

Cancer Genomics is a new sub-field of genomics that applies cutting edge technology to look into genes associated with cancer. The term “Cancer Genomics” means the same thing as “Oncogenomics”. Researchers in this field have found that cancer is a genetic disease caused by accumulations of mutations in the DNA. That mutation leads to cancer cells proliferating and spreading throughout the body.

Cancer Genomics largely seeks to find genes that can allow cancer to proliferate, called oncogenes, and to find treatments that suppress those genes. It also seeks to find the genes that are capable of suppressing tumors and harness their ability. Cancer genomics research aims to find new forms of diagnosis, treatments and cancer prediction technologies from the understand of those types of genes.

In tumor cells, the oncogenes are mutated and expressed at high levels. While normal cells undergo a scheduled death within the body, activated oncogenes cause those cells to survive and proliferate. Cancer can be established within the body by gene mutations or environmental factors and then the oncogenes play a crucial role in spreading that infection.

Since research in the area began, dozens of oncogenes have been identified as playing a role in proliferating cancer within the human body. Some cancer drugs that have already been released actually target the proteins encoded by oncogenes. Some of the drugs that have been released in recent years such as Gleevec, Herceptin and Avastin have been developed with the help of insights from the field Cancer Genomics.

There are a number of research organisations like the Wellcome Trust Sanger Institute who are exploring the human genome in depth to find new forms of diagnosis and treatments for cancer.

The main target for the institute:

The Cancer Genome Project is using the human genome sequence and high-throughput mutation detection techniques to identify somatically acquired sequence variants/mutations and hence identify genes critical to the development of human cancers. This initiative will ultimately provide the paradigm for the detection of germline mutations in non-neoplastic human genetic diseases through genome-wide mutation detection approaches.

There are now many databases available for cancer researchers who collect and share data on the role of specific genes in cancer. The Cancer Genome Project is only one of those organisations and seeks to map out all the somatic intragenic mutations in cancer. They look at genes, mutations and tumors to gain an understanding of how the interactions are playing out.

Another project is the Cancer Genome Anatomy Project which has collated a great of information on the cancer genome, transcriptome, and proteome. The Progenetix database is another oncogenomic reference database, collecting cytogenetic and molecular-cytogenetic tumor data. This data will eventually be used to identify which form of mutation a patient may have, how their genes are interacting and how to fight the cancer.

Personalized Cancer Treatment

In addition to looking at the underlying genetic causes of cancer, oncogenomics also looks into the development of personaliazed cancer treatments. Because cancer develops due to a series of mutations in the DNA, different kinds of mutations exist for different people. Two people with the same form of cancer will have different DNA mutations because their genetic makeup is different.

Researchers realized that identifying those specific gene mutations and targeting them will lead to more efficient forms of cancer treatment. Because the human genome project has been complete and sequencing technologies have advanced, it has allowed doctors in this field to dig deeper into the relationships between genes, oncogenes and cancer.

With the large amount of research currently being carried out on cancer genomes, and the completion of the genome database it has been predicted that these cancer-causing mutations, rearrangements, will be cataloged and characterized within the next decade. At that point doctors will be able to understand how your cancer is propagating at a genetic level.

That makes a for a very exciting time within the cancer community and the hope that someday soon, these advanced treatments will lead to a cure for cancer.

Trials Show Good Results For Cancer Drug Neratinib

Puma Biotechnology

Puma Biotechnology

Continuing trials for a new breast cancer drug called Neratinib have shown some encouraging results. The drug has been developed by biotechnology company Puma Biotechnology and is currently in mid stage trials. In the trials it was shown to be more effective than Herceptin, a similar drug developed by pharmaceutical company Roche. The drugs have been developed to work for patients with hormone receptor (HR)-negative, HER2-positive breast cancer.

The trial consisted of nearly 200 patients who had just been diagnosed with breast cancer and had not yet had surgery. 40% of the patients were given a combination of Neratinib and chemotherapy and achieved a pathological complete response (pCR) which means there is no longer evidence of tumors in the breast tissue. That compares to Herceptin and chemotherapy which only achieved 23% pathological complete response.

The drug also has a higher level of pCR than other conventional treatments, 45% compared to 29% in women who have a high risk of cancer returning, determined by genetic indicators.

The company is planning to launch Stage 3 trials in the near future which will look at HER2 positive patients as well as women who have issues with returning breast cancer.

Researchers are also going to look at other cancer indicators to determine the effectiveness of the drug in further studies. The stage 2 results are going to be presented at the American Association for Cancer Research conference in San Diego shortly.

About 25 percent of breast cancers are HER2 positive so this treatment could affect thousands of women.

The most recent study was conducted with adaptive randomization which means that patients were assigned to the best possible treatment for their cancer sub-type. Researchers also looked at the hormone sensitivity of patients before putting them into different groups.

The best thing about this new cancer drug is that it uses a different action than previous drugs like Herceptin and Perjeta. So theoretically a number of drugs could be used at the same time to aggressively go after the cancer.

Unfortunately Breast Cancer is still one of the most common forms of cancer in the world with over 1.4 million new cases diagnosed each year and nearly half a million women dying annually. This new drug will hopefully be another positive step forward in the battle against this insidious disease.

Promising New Breast Cancer Drug Improves Prognosis

Pfizer Breast Cancer

Pfizer Breast Cancer

A new breast cancer drug by pharmaceutical company Pfizer is having some promising results in improving the prognosis of women with advanced breast cancer, according to new research.

The clinical trial found that the drug halved the risk that the cancer would worsen. According to the research the median survival time for women taking the drug was over 20 months and in the control group the median survival rate was just 10 months.

These are remarkable results for a cancer drug, as pointed out by Dr. Richard S. Finn who said: “The magnitude of benefit we are seeing is not something commonly seen in cancer medicine studies”. The Dr Finn says the results are “quite groundbreaking”.

The drug, called palbociclib, appears to prolong survival rates by a significant amount. These results have been shared with other researchers at the American Association for Cancer Research annual meeting and are being hailed by many researchers as a fantastic step forward in improving breast cancer prognosis.

These results, while impressive, are not as good as the earlier trials which saw a massive 300% improvement in prognosis with patients living for 26 months compared to 7 months for the control group.

This drug while halting the progress of the cancer may not have a large impact on the actual survival rate, because other treatments are required to actually reduce the cancer. The interaction between this drug and other drugs is also ot fully understood yet, so it might in fact be hampered by simultaneous drug treatments the patients were taking.

Palbociclib reduces the rate that cancer cells can proliferate throughout the body by inhibiting enzymes that breast cancer cells use to multiply. The enzymes are cyclin-dependent kinases 4 and 6.

This new class of drugs that lock down enzymes is expected to create a new wave of cancer drug treatments in the coming decades. Navartis also has a CDK 4/6 inhibitor drug that it is currently testing. There is still a great deal of research to be done on the effects of these drugs on other forms of cancer, so we may be looking at the tip of the iceberg here.

Doctors are positive but cautious about the drug and hope that it will provide improved breast cancer prognosis, according to Dr Jose Baselga: “These results are strikingly positive and with a large potential impact to patients” However he was dubious about the research findings because the clinicians who assessed tumor sizes knew which patients had received the drug. The research was also funded by Pfizer, so some people questioned it’s independence and veracity.

The study itself looked at 165 post-menopausal women who had just begun receiving treatment for metastatic breast cancer. The cancers were all “estrogen receptor-positive” which meant they were fueled by that hormone and they were all negative for the Her2 growth protein.

More than 60% of the breast cancers diagnosed fall into that category, with their growth fueled by estrogen. That would mean that more than 50’000 women with this form of breast cancer would potentially see benefit from the drug.

The women in the trial were on a combination of letrozole to block the syntheses of estrogen and half were on palbociclib.

In terms of side effects, many women saw a moderate decrease in white blood cell count which would leave them prone to infections and other illness. More than 10% of patients dropped out of the palbociclib because of side effects which are yet to be fully documented.

It is unknown if this trial will be enough to gain approval by the FDA which usually requires larger studies to be undertaken before approving a drug for the market. The FDA does sometimes make exceptions for cancer drugs which is sometimes allows to be rushed to market. If the company gets early approval we could see it available in early 2015.