Make Chiangmai Mail | your Homepage | Bookmark

Chiangmai 's First English Language Newspaper

Pattaya Blatt | Pattaya Mail |

 

Copyright 2017 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Update May 2017


Home
Thailand News
World News
World Sports
Arts - Entertainment - Lifestyles
Book Review
Health & Wellbeing
Odds & Ends
Science & Nature
Technology
Update by Natrakorn Paewsoongnern
 
 
 
Health & Wellbeing
 

Update May 27, 2017

FDA OKs immune-boosting drug for advanced bladder cancer

This image provided by AstraZeneca shows the company’s drug Imfinzi, known chemically as durvalumab. (AstraZeneca via AP)

Linda A. Johnson

Trenton, N.J. (AP) - U.S. regulators have approved a new drug that harnesses the immune system to treat bladder cancer that has spread after chemotherapy or surgery.

The Food and Drug Administration on Monday approved Imfinzi for advanced bladder cancer, along with a companion diagnostic test for identifying which patients are most likely to benefit from it.

Imfinzi, also known as durvalumab, is part of a new generation of drugs that stimulate the immune system to help fight cancer. British drugmaker AstraZeneca PLC, which developed the drug, is testing it for several other cancers.

The average monthly list price for Imfinzi is roughly $15,000, but varies with the patient’s weight, according to AstraZeneca. It’s given by IV, usually every two weeks.

Imfinizi works by binding to a protein, found in varying levels on tumor cells, that blocks immune system cells from attacking the tumor.

In a company-funded study, 26 percent of patients with high levels of the protein responded to Imfinzi; their tumors shrank or stopped growing, some for 20 months or more, according to the FDA. Only 4 percent of patients with low levels of the protein responded to the drug. The diagnostic test, made by Ventana Medical Systems, distinguishes between those groups.

The FDA gave the drug accelerated approval and is requiring AstraZeneca to complete ongoing testing in more patients to confirm the drug’s benefits and safety.

Common side effects include fatigue, bone and muscle pain, nausea, swelling in hands and feet, and urinary tract infections. Infections elsewhere in the body were infrequent. However, two patients died, one from a lung infection and the other from a liver infection.

Bladder cancer is the sixth most common type of cancer in the U.S., with about 79,000 new cases and nearly 17,000 deaths expected this year, according to the National Cancer Institute. When bladder cancer has spread, only about 5 percent of patients survive beyond five years, government figures show.

Until recently, treatment options were limited to chemotherapy, radiation or surgery.


Update May 20, 2017

Hope for preemies as artificial womb helps tiny lambs grow

Fetal physiologist Marcus G. Davey of the Children’s Hospital of Philadelphia, who helped design the artificial womb system, is shown near giant tanks holding a liquid designed to simulate amniotic fluid. (Ed Cunicelli/Children’s Hospital of Philadelphia via AP)

Lauran Neergaard

Washington (AP) - Researchers are creating an artificial womb to improve care for extremely premature babies - and remarkable animal testing suggests the first-of-its-kind watery incubation so closely mimics mom that it just might work.

Today, premature infants weighing as little as a pound are hooked to ventilators and other machines inside incubators. Children’s Hospital of Philadelphia is aiming for a gentler solution, to give the tiniest preemies a few more weeks cocooned in a womb-like environment - treating them more like fetuses than newborns in hopes of giving them a better chance of healthy survival.

The researchers created a fluid-filled transparent container to simulate how fetuses float in amniotic fluid inside mom’s uterus, and attached it to a mechanical placenta that keeps blood oxygenated.

In early-stage animal testing, extremely premature lambs grew, apparently normally, inside the system for three to four weeks, the team reported Tuesday.

“We start with a tiny fetus that is pretty inert and spends most of its time sleeping. Over four weeks we see that fetus open its eyes, grow wool, breathe, swim,” said Dr. Emily Partridge, a CHOP research fellow and first author of the study published in Nature Communications.

“It’s hard to describe actually how uniquely awe-inspiring it is to see,” she added in an interview.

Human testing still is three to five years away, although the team already is in discussions with the Food and Drug Administration.

“We’re trying to extend normal gestation,” said Dr. Alan Flake, a fetal surgeon at CHOP who is leading the project and considers it a temporary bridge between the mother’s womb and the outside world.

Increasingly hospitals attempt to save the most critically premature infants, those born before 26 weeks gestation and even those right at the limits of viability - 22 to 23 weeks. Extreme prematurity is a leading cause of infant mortality, and those who do survive frequently have serious disabilities such as cerebral palsy.

The idea of treating preemies in fluid-filled incubators may sound strange, but physiologically it makes sense, said Dr. Catherine Spong, a fetal medicine specialist at the National Institutes of Health.

“This is really an innovative, promising first step,” said Spong, who wasn’t involved with the research.

One of the biggest risks for very young preemies is that their lungs aren’t ready to breathe air, she explained. Before birth, amniotic fluid flows into their lungs, bringing growth factors crucial for proper lung development. When they’re born too soon, doctors hook preemies to ventilators to keep them alive but risking lifelong lung damage.

Flake’s goal is for the womb-like system to support the very youngest preemies just for a few weeks, until their organs are mature enough to better handle regular hospital care like older preemies who have less risk of death or disability.

The device is simpler than previous attempts at creating an artificial womb, which haven’t yet panned out.

How the “Biobag” system works:

- The premature lambs were delivered by C-section and immediately placed into a temperature-controlled bag filled with a substitute for amniotic fluid that they swallow and take into their lungs.

“We make gallons of this stuff a day,” said fetal physiologist Marcus Davey. It’s currently an electrolyte solution; he’s working to add other factors to make it more like real amniotic fluid.

- Then the researchers attached the umbilical cord to a machine that exchanges carbon dioxide in blood with oxygen, like a placenta normally does.

- The lamb’s heart circulates the blood, without the need for any other pump.

The researchers tested five lambs whose biological age was equivalent to 23-week human preemies, and three more a bit older. All appeared to grow normally, with blood pressure and other key health measures stable and few complications during the weeks they were inside the womb-like device.

The study didn’t address long-term development. Most of the lambs were euthanized for further study that found normal organ development for their gestational age. One was bottle-weaned and is now more than a year old, apparently healthy and living on a farm in Pennsylvania.

Flake stressed that the womb-like system isn’t intended to support preemies any younger than today’s limits of viability - not what he calls the more “sensationalistic” idea of artificially growing embryos.

He acknowledged that parents might question the approach, but notes that the preemies always could be whisked into standard care if they fared poorly in the new system. And while he said further adaptation of the device is needed before it can begin human testing, he envisioned parents being able to see the baby and even piping in the sound of mom’s heartbeat.


Update May 13, 2017

Blood test offers hope for better lung cancer treatment

In results published Wednesday, April 26, 2017 by Nature and the New England Journal of Medicine, researchers have taken an important step toward better lung cancer treatment. Using experimental tests that detect bits of DNA that tumors shed into the blood, they were able to track genetic changes in early-stage cases over time, and to find some recurrences up to a year before imaging scans could, giving a chance to try new therapy sooner. (AP Photo/Richard Drew)

Marilynn Marchione

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

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

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

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

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

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

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

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

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

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

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

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

People with many gene or chromosome problems were four to five times more likely to have their cancer return, or to die from their disease within roughly two years.

They also looked at 14 patients whose cancers recurred after surgery, and compared them to 10 others whose did not. Blood tests after surgery accurately identified more than 90 percent of them that were destined to relapse, up to a year before imaging tests showed that had occurred.

The results suggest that using liquid biopsy tests to help select and adjust treatments is “now feasible,” at least from a scientific standpoint, the authors write.

A big issue is cost, though. Liquid biopsies sold now in the U.S. cost nearly $6,000. Tests that more narrowly track a patient’s particular tumor gene changes, like the one in these studies, may cost less. They may save money in the long run, by preventing futile treatment, but this has yet to be shown.

Online:

Liquid biopsy video: https: //www.youtube.com/watch? v=fPKqtPcPvd4

Lung cancer treatment info: https://www.cancer.org/cancer/non-small-cell-lung-cancer/treating/by-stage.html


Maine poet wins international prize for work about dementia

Portland, Maine (AP) - A Maine poet’s endearing piece about her husband’s dementia has won an international poetry award.

The Press Herald reports that Lee Sharkey was presented with the Ballymaloe International Poetry Prize for her poem, “Letter to Al”, at an award ceremony in Dublin, Ireland, on Thursday. The Moth magazine sponsors the contest.

Sharkey and three other finalists were selected from thousands of entries. The Maine native was awarded 10,000 euros, or about $10,725.

Sharkey’s piece details the effects of dementia on her husband, Al Bersbach, and their marriage.

The contest’s lone judge describes the poem as “spellbinding”.

Sharkey says that she was hesitant about writing the poem because she knew it would be painful. However, she says that it is an important narrative to share.
 


DAILY UPDATE

|

Back to Main Page

HEADLINES [click on headline to view story]

FDA OKs immune-boosting drug for advanced bladder cancer


Hope for preemies as artificial womb helps tiny lambs grow


Blood test offers hope for better lung cancer treatment

Maine poet wins international prize for work about dementia


 



Chiangmai Mail Publishing Co. Ltd.
189/22 Moo 5, T. Sansai Noi, A. Sansai, Chiang Mai 50210
THAILAND
Tel. 053 852 557, Fax. 053 014 195
Editor: 087 184 8508
E-mail: [email protected]
www.chiangmai-mail.com
Administration: [email protected]
Website & Newsletter Advertising: [email protected]

Copyright © 2004 Chiangmai Mail. All rights reserved.
This material may not be published, broadcast, rewritten, or redistributed.