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New Drug May Help Immune System Fight Cancer
THURSDAY May 16, 2013 — An experimental drug that taps the power of the body’s immune system to fight cancer is shrinking tumors in patients for whom other treatments have failed, an early study shows.
The drug binds to a protein called PD-L1 that sits on the surface of cancer cells and makes them invisible to the immune system, almost like a cloaking device.
“That [the protein] allows the tumor cell to grow unchecked and cause harm to the patient,” said study author Dr. Roy Herbst, chief of medical oncology at Yale University.
But with the protein blocked, the immune system can see and destroy cancer cells.
Of 140 patients in the pilot safety study, 29 (or 21 percent) initially saw significant tumor shrinkage after at least three months on the medication. Researchers say 26 patients have continued to respond over time, including some who have been on the drug for more than a year. One patient saw tumors disappear completely.
The drug also seems to work on a wide range of cancers, including some of the toughest to treat, including non-small cell lung cancer, melanoma skin cancer, colorectal cancer, kidney cancer and stomach cancer.
“This has all the characteristics of a really amazing drug,” said Herbst, who has been testing new cancer medications for two decades. “I can count on one hand the number of times I’ve seen response rates like this.”
The study was funded by Genentech/Roche, the company that is developing the drug. The results were presented at a Wednesday news conference organized by the American Society of Clinical Oncology in advance of its annual meeting, which starts May 31 in Chicago.
Study results presented at medical meetings are considered preliminary because they have not been subjected to the rigorous scrutiny required for publication in a medical journal.
At least four other companies — Merck, Bristol-Meyers Squibb, MedImmune and Amplimmune — also are racing to develop drugs that target PD-L1 or the molecule that binds to it (PD-1).
“I don’t think in the history of cancer therapy have you had five or more companies virtually simultaneously developing antibodies targeted at the same pathway,” said Dr. Drew Pardoll, co-director of cancer immunology at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, in Baltimore.
Pardoll is testing a drug that targets PD-1 for Bristol-Myers Squibb. He was not involved in the current study.
The drugs are part of a wave of new treatments that work by spurring the immune system to take on tumors. These drugs are building on the successes of medications like Provenge, the first cancer immunotherapy, which was approved in 2010 to treat prostate tumors, and Yervoy, which was approved in 2011 to treat metastatic melanoma.
Yervoy works early in the immune reaction to wake up T-cells that are essentially napping on the job, Pardoll said. The PD-1 and PD-L1 drugs work later, at the cellular level.
“This is a whole new kind of treatment, and the early data has looked so impressive,” Pardoll said. “I think this just reflects the excitement among biotechnology companies and big pharma in this field.”
To understand why researchers are excited, it helps to understand how poorly most cancer drugs perform in early trials. A study published in the journal Clinical Cancer Research in August 2005 found that middle-of-the-road response rates for cancer drugs in early trials was just 3 percent, with the best response rate topping out at 18 percent.
Response rates are so dismal in part because doctors usually don’t try unproven drugs in cancer patients until they have run out of other options. All the patients in this study had seen their cancer progress despite several prior treatments. Most had seen their cancer spread beyond its original site.
Pardoll said he also has been impressed with the length of time that patients continue to see benefits from the medications in the new study.
“Among the patients that did respond to anti-PD-1, who had been followed for more than a year, roughly two-thirds were still in a response a year out,” he said. “That’s something you don’t see with chemotherapy; you don’t see it with current targeted therapies.
“We think this is because the immune system is being re-educated,” Pardoll said. “If that’s the case, will we be able to discontinue the antibody and have the patient’s immune system take over and keep the cancer at bay?”
Although the drugs have great promise, the researchers said they also were keeping an eye on the adverse events they can cause, some of which have been very serious.
PD stands for programmed death, and together the two molecules work to switch off the body’s immune response. Blocking one or the other keeps the immune system active, which is good for fighting cancer, but there are also early signs that manipulating this response may have a downside.
Some patients had side effects that researchers believe are caused by autoimmunity — the body mistakenly attacking its own organs and tissues. Those side effects include lung and liver inflammation, rashes and hypoglycemia (low blood sugar), perhaps because of a problem with the thyroid gland.
In a study published in a June 2012 issue of the New England Journal of Medicine, three patients who were taking an anti-PD-1 drug died from pneumonitis, or inflammation of the lungs.
The researchers said they’re working to understand why the drugs seem to be particularly toxic to the lungs and to mitigate their adverse effects.
“We need to be cautious about the toxicities,” Herbst said. “It’s great that we’re making progress, and now we need to go to randomized trials.”
More information
To find clinical trials that are testing immunotherapy drugs, head to the Cancer Immunotherapy Trials Network.
Posted: May 2013
A Little Formula Might Help Breast-Feeding for Some Babies
Early study looked at newborns who were losing weight
WebMD News from HealthDay
By Robert Preidt
HealthDay Reporter
MONDAY, May 13 (HealthDay News) — Giving small amounts of infant formula to newborns who experience significant weight loss can increase the length of time that they are breast-fed, according to a new study.
New mothers do not immediately produce high volumes of milk and their babies can lose weight during this period, said the researchers from the University of California, San Francisco.
“Many mothers develop concerns about their milk supply, which is the most common reason they stop breast-feeding in the first three months,” study author Dr. Valerie Flaherman, an assistant professor of pediatrics and epidemiology and biostatistics, said in a university news release.
“But this study suggests that giving those babies a little early formula may ease those concerns and enable them to feel confident continuing to breast-feed,” added Flaherman, who also is a pediatrician at UCSF Benioff Children’s Hospital.
Flaherman and her colleagues looked at 40 full-term newborns between 24 and 48 hours old who had lost more than 5 percent of their birth weight. Some babies received early limited formula consisting of one-third of an ounce of infant formula by syringe after each breast-feeding session. The babies stopped receiving the formula when their mothers began producing adequate volumes of milk, about two to five days after birth.
The babies in the early-limited-formula group were compared to a control group of infants whose mothers tried to breast-feed only.
After one week, all the babies in both groups were still breast-feeding, but only 10 percent of those in the early-limited-formula group had received formula in the past 24 hours, compared with 47 percent of those in the control group.
After three months, 79 percent of the babies in the early-limited-formula group were still breast-feeding, compared with 42 percent of those in the control group, according to the study, published online May 13 and in an upcoming print issue of the journal Pediatrics.
The researchers said their findings need to be confirmed in larger studies, a point also made by an expert who wasn’t involved in the study.
“The results of this study are provocative and challenge conventional wisdom,” Dr. James Taylor, medical director for the University of Washington Medical Center’s Newborn Nursery, said in the news release.
A Little Formula Might Help Breast-Feeding for Some Babies
MONDAY May 13, 2013 — Giving small amounts of infant formula to newborns who experience significant weight loss can increase the length of time that they are breast-fed, according to a new study.
New mothers do not immediately produce high volumes of milk and their babies can lose weight during this period, said the researchers from the University of California, San Francisco.
“Many mothers develop concerns about their milk supply, which is the most common reason they stop breast-feeding in the first three months,” study author Dr. Valerie Flaherman, an assistant professor of pediatrics and epidemiology and biostatistics, said in a university news release.
“But this study suggests that giving those babies a little early formula may ease those concerns and enable them to feel confident continuing to breast-feed,” added Flaherman, who also is a pediatrician at UCSF Benioff Children’s Hospital.
Flaherman and her colleagues looked at 40 full-term newborns between 24 and 48 hours old who had lost more than 5 percent of their birth weight. Some babies received early limited formula consisting of one-third of an ounce of infant formula by syringe after each breast-feeding session. The babies stopped receiving the formula when their mothers began producing adequate volumes of milk, about two to five days after birth.
The babies in the early-limited-formula group were compared to a control group of infants whose mothers tried to breast-feed only.
After one week, all the babies in both groups were still breast-feeding, but only 10 percent of those in the early-limited-formula group had received formula in the past 24 hours, compared with 47 percent of those in the control group.
After three months, 79 percent of the babies in the early-limited-formula group were still breast-feeding, compared with 42 percent of those in the control group, according to the study, published online May 13 and in an upcoming print issue of the journal Pediatrics.
The researchers said their findings need to be confirmed in larger studies, a point also made by an expert who wasn’t involved in the study.
“The results of this study are provocative and challenge conventional wisdom,” Dr. James Taylor, medical director for the University of Washington Medical Center’s Newborn Nursery, said in the news release.
More information
The U.S. National Institute of Child Health and Human Development explains how to breast-feed.
Posted: May 2013
Eating insects could help fight obesity, U.N. says
Various stages of beetles crawl around on the palm of a hand at an insect farm in Ermelo January 12, 2011.
Credit: Reuters/Jerry Lampen
ROME |
ROME (Reuters) – The thought of eating beetles, caterpillars and ants may give you the creeps, but the authors of a U.N. report published on Monday said the health benefits of consuming nutritious insects could help fight obesity.
More than 1,900 species of insects are eaten around the world, mainly in Africa and Asia, but people in the West generally turn their noses up at the likes of grasshoppers, termites and other crunchy fare.
The authors of the study by the Forestry Department, part of the U.N. Food and Agriculture Organization (FAO), said many insects contained the same amount of protein and minerals as meat and more healthy fats doctors recommend in balanced diets.
“In the West we have a cultural bias, and think that because insects come from developing countries, they cannot be good,” said scientist Arnold van Huis from Wageningen University in the Netherlands, one of the authors of the report.
Eva Muller of the FAO said restaurants in Europe were starting to offer insect-based dishes, presenting them to diners as exotic delicacies.
Danish restaurant Noma, for example, crowned the world’s best for three years running in one poll, is renowned for ingredients including ants and fermented grasshoppers.
As well as helping in the costly battle against obesity, which the World Health Organization estimates has nearly doubled since 1980 and affects around 500 million people, the report said insect farming was likely to be less land-dependent than traditional livestock and produce fewer greenhouse gases.
It would also provide business and export opportunities for poor people in developing countries, especially women, who are often responsible for collecting insects in rural communities.
Van Huis said barriers to enjoying dishes such as bee larvae yoghurt were psychological – in a blind test carried out by his team, nine out of 10 people preferred meatballs made from roughly half meat and half mealworms to those made from meat.
(Reporting by Catherine Hornby; Editing by Philip Pullella and Mike Collett-White)
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Mediterranean Diet Might Help Stave Off Dementia
Large study showed better retention of mental skills in seniors who had followed it
WebMD News from HealthDay
By Steven Reinberg
HealthDay Reporter
MONDAY, April 29 (HealthDay News) — Eating fish, chicken, olive oil and other foods rich in omega-3 fatty acids while staying away from meats and dairy — the so-called Mediterranean diet — may help older adults keep their memory and thinking skills sharp, a large new U.S. study suggests.
Using data from participants enrolled in a nationwide study on stroke, the researchers gleaned diet information from more than 17,000 white and black men and women whose average age was 64.
The participants also took tests that measured their memory and thinking (cognitive) skills. During the four years of the study, 7 percent of the individuals developed problems with these skills, the researchers reported.
“Greater adherence to Mediterranean diet was associated with lower risk of incident cognitive impairment in this large population-based study,” said lead researcher Dr. Georgios Tsivgoulis, from the University of Alabama at Birmingham as well as the University of Athens, in Greece.
There was no evidence of racial or regional differences in response to the diet. However, the diet did not help diabetics ward off mental decline, Tsivgoulis said.
“It may also be that the benefit of a Mediterranean diet differs in people with different diseases,” Tsivgoulis said.
Because there are no definitive treatments for dementia, anything people can do to possibly delay the onset of symptoms, such as modifying their diet, is very important, Tsivgoulis noted.
The report was published in the April 30 issue of Neurology.
An earlier study published in the journal last year suggested that foods rich in omega-3s might help guard against Alzheimer’s disease by affecting levels of a specific substance in the brain.
Dr. Sam Gandy, associate director of the Mount Sinai Alzheimer’s Disease Research Center in New York City, said this latest study “is further support for the benefit of Mediterranean diet.”
This important paper should be used to guide clinical practice, he suggested.
“The best way to minimize Alzheimer’s disease is with 30-minute sessions three times a week of brisk walking or weight lifting, maximizing mental activity and a Mediterranean diet,” Gandy said.
“This is the best prescription for maintaining of mental function that we have in hand right now,” he said.
In the study, the investigators found that those who followed the Mediterranean diet were 19 percent less likely to develop thinking and memory problems. This finding was the same for both black and white participants.
The single exception was the 17 percent of the participants who had diabetes. Among these people, the Mediterranean diet didn’t appear to prevent thinking and memory difficulties from developing, the researchers found.
Although the study found a lower rate of these symptoms of early dementia in people who followed a Mediterranean diet, it did not establish a cause-and-effect relationship.
Further research is needed to generalize these results to other groups, and to establish how the Mediterranean diet exerts its neuroprotective effects on mental status, Tsivgoulis said.
