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Breast cancer: Can a wearable device help to detect it?

Breast cancer: Can a wearable device help to detect it?

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To screen for breast cancer at home, researchers created a wearable gadget.

Initial testing reveal that it is capable of detecting tiny cysts that are comparable in size to early-stage breast tumours. To confirm the effectiveness of the gadget, clinical trials are required.

One day, a cutting-edge piece of wearable technology that can be fastened to a bra might enable individuals to identify breast cancer symptoms while lounging at home.

With approximately 1 in 6 cancer-related deaths among women, breast cancer is the most common cancer in the world. Women make up the great majority of breast cancer patients. Men experience 0.5% to 1% of cases, though.

If discovered when the cancer has not yet moved outside of the breast, breast cancer has a 5-year relative survival rate of up to 99%. The 5-year survival rate drops to 30% if discovered later, such as when cancer has spread to distant bodily areas like the lungs, liver, or bones.

Currently, the most popular approach for detecting breast cancer is a mammography, an X-ray imaging procedure.

Mammograms must be performed in an imaging center even though they are typically efficient at detecting 87% of malignancies. This limits access for many people, especially those with low incomes, who could postpone screening as a result of the high associated expenses and challenges in organizing transportation.

The health outcomes for those diagnosed with the condition globally could be improved by initiatives to increase accessibility and lower the cost of breast cancer screening.

Researchers recently created a wearable ultrasound breast patch that could enable patients to scan for breast cancer at home.

Bard-certified doctor Dr. Kamila Seilhan, stated: “This wearable ultrasound device may help patients at high risk of breast cancer in the interim between routine mammograms by enabling early tumor detection.”

A breast-attached wearable breast cancer detector

The same ultrasound technology that imaging centres utilise is the foundation of the device. However, because of the piezoelectric materials used, it can be made smaller to function as a portable ultrasound scanner. Through a mechanism called piezoelectricity, crystals transform mechanical energy into electrical energy, which in this instance can be used to interpret ultrasound measurements.

“The device sends sound waves into the breast tissue, and as it moves across the breast, it produces high-quality images identifying cysts that may need to be investigated by a breast cancer specialist,” said Dr. Jennifer Tseng, F.A.C.S., medical director of breast surgery and a double board-certified surgical oncologist specializing in breast cancer at City of Hope Orange County Lennar Foundation Cancer Centre in Irvine, California, who was not involved in the research.

To make the device wearable, the researchers created a flexible, 3D-printed patch with honeycomb-like holes. The patch fastens to a bra with holes so it may touch the skin and scan breast tissue there.

The entire breast may be imaged thanks to the scanner’s six various positioning options. In order to capture photographs from various perspectives, it can also be rotated.

The scanner has already been tested on a 71-year-old woman who has a history of breast cysts. They were able to identify cysts with the gadget that were as small as early-stage tumours, or 0.3 centimetres in diameter. According to their findings, the images produced had an 80mm depth and a resolution comparable to that of conventional ultrasounds.

Senior author of the study Canan Dagdeviren, Ph.D., Associate Professor of Media Arts and Science at Massachusetts Institute of Technology (MIT), stated that the technology makes it simple to repeatedly take pictures from the same location.

Increased screening availability for breast cancer

Dr. Dagdeviren stated that the ultimate purpose of the device is to reach underrepresented women, including those living in less economically developed nations, and to make breast cancer screening more accessible and affordable.

Dr. Seilhan remarked that if successful, the device could be especially helpful in isolated locations without simple access to medical facilities.

“Healthcare facilities and organizations with limited funds can purchase the device more easily because of its low cost,” she said.

She continued by saying that while the gadget is simple to operate, it might be useful in settings where medical personnel have limited technical expertise.

Dr. Tseng pointed out, however, that in order for patients in less developed nations to benefit fully from diagnostic technologies, it is equally critical for them to have better access to those tools.

However, she added, “patients still need to have the data reviewed by an expert who can recommend what to do next.” This device may assist patients identify potential problem areas that they were unable to identify before.

When will the breast cancer wearable device be obtainable?

According to Dr. Dagdeviren, the device might be usable for 4-5 years. She is starting a business to achieve this goal and is looking for partners and investors. For mass production and FDA certification, she stated, “we will need about $40 million.”

In spite of the fact that the device now needs a “bulky computer interface” to process photographs, the author continued, her team is currently working on a more portable design and will soon release an iPhone-size image processor.

The researchers are also creating a workflow that will enable artificial intelligence to examine data and produce diagnostic evaluations that might be more precise than those made by a radiologist comparing photos that were obtained over some time.

Experts spoke with Dr. Richard Reitherman, Ph.D., a board-certified radiologist and medical director of breast imaging at MemorialCare Breast Centre at Orange Coast Medical Centre in Fountain Valley, California, who was not involved in the study to learn more about potential future uses for the device.

“This kind of product will be a welcomed supplemental addition to women’s health care,” the doctor said. “If it can be demonstrated to be on par with mammography and dedicated breast ultrasound for breast cancer screening, it will be a welcome alternative.”

However, he pointed out that one of the biggest obstacles for any new gadget is completing successful clinical trials, which will probably require collaboration with the American College of Radiology.

“This is a complex and difficult proposition,” he said. “The jump from translational science to clinical efficacy remains to be seen.”

What are the limitations of the study?

Its limits stem from the fact that the technology is still in its early stages of development.

The University of Kansas Cancer Centre breast radiologist Dr. Onalisa Winblad, who was not part of the study, stated that she does not currently support its use because it “does not have scientific data to prove utility.”

The linked article’s photographs are of low quality when compared to those from our normal breast ultrasound. In patients with dense breast tissue, ultrasonography is a tool that is beneficial in addition to mammography.

Dr. Tseng concurred that although ultrasonography is a useful tool for breast cancer screening, it cannot take the place of mammography and other types of preventive treatment provided by a breast cancer specialist.

Different technologies are more effective than others at detecting various breast alterations. For instance, while some calcifications cannot be seen with ultrasonography, others can be seen with mammography, she noted.

She stated that two of the most crucial elements in how effectively the tool performs as a breast cancer screening tool are “the device’s ability to find true positive cases and avoid fake positive cases.“

She continued by saying that even while the tool might be simple to use, how well it works may still rely on the user. Also, she added that because the human breast varies from person to person and even among individuals, large-area and deep-tissue imaging can be challenging.

When challenged about the device’s limits, Dr. Reitherman stated that in order to maintain good quality metrics, the scanner must be operated under medical supervision, such as through “virtual supervision by a radiologist.”

“Therefore, the existing medical community and physicians that would be interpreting and recommending actions based on this device’s information would need to be on board,” he said.

REFERENCES:

For Breast Cancer medications that have been suggested by doctors worldwide are avalaible here (https://mygenericpharmacy.com/index.php?therapy=10)

Cancer: physical activity a day could lower your risk.

Cancer: physical activity a day could lower your risk.

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In a recent study, the impact of vigorous intermittent lifestyle physical activity (VILPA) on the risk of developing cancer was examined.

Using information from wrist-worn accelerometers, researchers followed 22,398 non-exercisers’ health records for cancer for nearly 7 years while also tracking their daily intense activity.

When compared to not participating in VIPLA, 4.5 minutes of VILPA per day, divided into 1-minute bursts, was linked to a 32% lower chance of developing cancer.

Power walking, lugging groceries, and climbing stairs are just a few examples of the many possibilities that exist in daily life for strenuous physical activity.

The importance of physical activity to overall health and wellbeing cannot be overstated. According to research, regular exercise can reduce the risk of developing chronic diseases like cancer, diabetes, and cardiovascular disease.

In fact, the World Health Organisation (WHO) reports that those who are not adequately active have a death risk that is 20–30% higher than those who are.

Even though the benefits of physical activity are obvious, only about 1 in 3 women and 1 in 4 men globally adhere to the guidelines for 75 minutes of strenuous exercise or at least 150 minutes of moderate exercise per week.

Good news has arrived from a recent study for those who dislike or are unable to engage in structured, intense exercise.

Just 4.5 minutes per day of vigorous-intensity physical exercise undertaken in 1-minute bursts was related with an up to 32% decreased risk of cancer, according to wrist-worn accelerometer data taken from 22,398 non-exercising people collected from the UK Biobank.

VILPA: What is it?

Short bursts of physical activity that are a regular component of our lifestyle (daily living) are referred to as vigorous intermittent lifestyle physical activity (VILPA) by Dr. Stamatakis and his colleagues.

VILPA examples include, but are not restricted to:

  • climbing hills
  • ascending stairs
  • power walking, also known as maximising walking pace for a short distance (like 100–200 metres) to reach intense intensity, involves carrying children or groceries for 50–100 metres.
  • intense housework.
  • VILPA differs from conventional intense physical activity in that it is intermittent and transient, lasting up to two minutes at a time, as opposed to continuous and planned.

Effects of VILPA and cancer risk

The study was a prospective cohort study of adults, aged 40 to 69, who provided the UK Biobank with their data.

The research team led by Dr. Stamatakis only included participants from the accelerometer-wearing group who reported not exercising in their free time and taking one or fewer leisurely walks per week in their analysis of the association between VILPA and cancer incidence.

The study removed participants who provided incomplete information, had a history of cancer, or improperly wore the activity monitor.

22,398 participants made up the study population, and their average age was 62. 54.8% of these were female, and 96% of them were white.

The researchers found 2,356 new cancer occurrences throughout a mean follow-up period of 6.7 years, including cancer registration, hospitalisation for cancer, or death from any malignancy.

The researchers utilised a machine-learning method known as “random forest” to categorise accelerometer-recorded physical activity based on intensity — vigorous, moderate, and light.

VILPA reduces cancer risk by just a few minutes every day.

The majority of VILPA incidents took place in spurts of up to one or two minutes. People participated in VILPA for a maximum of 16 minutes, or about 4.5 minutes per day on average.

According to statistical assessments, the association between VILPA and cancer risk is almost linear, meaning that a person’s risk of developing cancer decreases as they engage in more VILPA.

People who engaged in VILPA for an average of 4.5 minutes per day, in short bursts of up to 1 or 2 minutes, had a 20% lower chance of developing cancer than those who did not engage in any VILPA (6.2% of study participants).

Previous studies have demonstrated a link between insufficient physical activity and several cancer forms. These consist of:

  • liver
  • lung
  • kidney
  • gastric cardia (a type of stomach cancer)
  • endometrial
  • Leukaemia myeloid
  • myeloma
  • colorectal
  • neck and head
  • bladder
  • mammary cancer
  • esophageal adenocarcinoma (esophageal cancer)

This study demonstrates that those who engaged in 4.5 minutes of VILPA daily have a 31% lower risk of developing certain physical activity-related malignancies.

The least amount of VILPA necessary to significantly lower the chance of developing cancer was also determined by the researchers. They discovered that 3.4 minutes of VILPA per day can reduce the risk of cancer overall by 17% and 3.6 minutes of VILPA per day can reduce the risk of cancer linked to physical activity by 18%.

More study is required to determine how VILPA affects cancer.

A relatively small quantity of strenuous lifestyle activity can have such a large link with decreased cancer risk, according to the “high-quality study,” according to Dr. David Raichlen, professor of biological sciences and anthropology at the University of Southern California.

According to him, “the authors used a novel machine learning-based method to identify behaviours and this study moves the field forward, allowing us to better understand the benefits of this form of physical activity on [the] risk of developing cancer.”

Because of the study’s methodology, Dr. Raichlen advised that causality could not be established; however, “this work certainly suggests that future intervention studies using VILPA are warranted.”

According to Prof. Markus Gruber, chair of Training and Movement Science and director of the University Konstanz’s Human Performance Research Centre, the study supports the long-held belief in exercise science that “intensity matters.”

Prof. Gruber made the same observation as Dr. Raichlen, namely that although the study’s data, methods, and analysis are sound, the study is cross-sectional and can only report relationships between VILPA and cancer incidence.

When challenged about the connection between VILPA and cancer incidence, Prof. Gruber responded that there are a number of plausible “explanations for the results that need to be tested.”

He claims that VILPA may either directly lower the risk of cancer, boost physical fitness, or show superior physical fitness, which is linked to a lower risk of cancer. Additionally, VILPA may reduce the effects of aging-related fitness decreases and reduce cancer risk by doing so.

Overall, according to Prof. Gruber, VILPA is a promising substitute for duration-based advice on physical activity, “especially for people who don’t like to exercise.”

REFERENCES:

For Cancer disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=10

Melanoma: Black man at 26% higher risk to die.

Melanoma: Black man at 26% higher risk to die.

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Significant melanoma discrepancies between racial and ethnic groupings have been discovered by researchers.

Using the National Cancer Database, researchers discovered that Black males had the lowest survival rates for melanoma diagnoses and a 26% higher mortality risk than white men.

Put on sun-protective clothing, use sunscreen, and examine your skin once a month to protect yourself from melanoma.

While there are many studies on both male and female melanoma instances, there is little information on how race affects this skin disease, particularly in men.

A group of experts looked over the National Cancer Database to find out more. They looked at male non-Hispanic white, non-Hispanic black, non-Hispanic Asian, non-Hispanic American Indian/Alaska Native instances of primary cutaneous invasive melanoma.

Their data showed melanoma incidence differences between racial and ethnic groupings.

The trunk was the most typical site for melanoma in both white people and American Indian/Alaskan Native people. Men of color Black, Asian, and Hispanic had their lower extremities found to have melanoma, though.

The majority of stage 3 or stage 4 melanomas (48.6%) were seen in Black people. White guys (75.1%) and Black males (51.7%) had the highest 5-year overall melanoma survival rates.

According to research, black people with melanoma had a 26% higher mortality rate than white people with the same diagnosis.

Dr. Bianka Bubic, study author and a dermatology research fellow at The Ohio State University Wexner Medical Centre, said, “We hope that this study lays the foundation for future research to explore the reasons for why there are different presentations and survival among men of diverse racial groups in melanoma.”

Survival rates for melanoma vary by race

Researchers are currently looking into why Black people have a higher chance of developing severe melanoma. Pigmented lesions that may have variations in size, form, symmetry, or pattern can be early indicators of melanoma.

A board-certified dermatologist at Psoriasis Telehealth in Palo Alto, California, Dr. Faranak Kamangar, told that early detection of skin abnormalities in the Black community may be more challenging, thus postponing diagnosis.

She pointed out that the results emphasise the value of early cancer screening in many racial and ethnic groups.

Dr. Kamanger pointed out that socioeconomic issues such a lack of cheap insurance and medical treatment may disproportionately affect the severity of melanoma in Black communities, which could result in a diagnosis at a late stage.

“The main tendency, that Black men are diagnosed with melanoma at later stages, making it less likely to be treated and probably leading to greater rates of morbidity and mortality for this population, has been known to us for some time. The research also confirms previously reported findings that Black men are more likely to develop acral lentiginous melanoma, a subtype of melanoma that is typically detected at a later stage and may occur in difficult-to-examine body regions. Bob Marley is a well-known illustration. He unfortunately had a late diagnosis of melanoma and passed away from it,” according to board-certified dermatologist Dr. Faranak Kamangar.

Acral lentiginous melanoma is the most prevalent melanoma subtype in Black people, but it is also more challenging to identify and diagnose early.

Dr. Wael Harb, a haematologist and medical oncologist at MemorialCare Cancer Institute at Orange Coast Medical Centre in Fountain Valley, California, said that acral lentiginous melanoma “typically appears on less noticeable or examined areas like the palms, soles, or under the nails.”

Are there genetic factors that influence melanoma risk?

Racial and ethnic inequalities in melanoma risk may also be influenced by genetics.

According to Dr. Kamanger, “Acral lentiginous melanoma has higher rates in this population due to genetic predispositions and, in general, is diagnosed at a later stage.”

We have now discovered genes that predispose to acral lentiginous melanoma, and this is the key factor contributing to greater risk among some groups. Diagnosis may be delayed if the nails and bottom of the feet are involved. Except for the amelanotic subtype, melanoma is often pigmented and brown in colour, according to Dr. Kamanger.

Dr. Harb emphasised that acral lentiginous melanoma frequently manifests in locations that are not as exposed to the sun. This may explain why certain body parts, such as the palms, soles, and areas under the nails, are particularly vulnerable.

Dr. Harb noted that “this type of melanoma frequently develops in areas with less melanin, which provides natural protection against UV damage.”

Dr. Harb contrasted this with the development of superficial spreading melanoma, which frequently appears as a new or changing mole or discoloured area on sun-exposed skin.

The different ways that melanoma manifests in Black and White people emphasizes the significance of thorough skin inspections that include all body parts, not just those that are regularly exposed to the sun.

Research on the prevalence of melanoma in various racial groups is still lacking.

The majority of research papers conducted so far focus on white people’s melanoma cases. Dr. Kamanger noted that as a result, the conclusions that may be drawn are limited by the tiny sample size of Black men.

The primary flaw with this study is that Black men make up less than 0.5% of the population. To obtain useful sub-data, this is a very small quantity, as Dr. Kamanger pointed out.

“The study has some limitations, even if it offers insightful information. It does not take into consideration disease-specific survival, which limits our capacity to distinguish between melanoma mortality and death from other causes,” according to Dr. Harb.

Additionally, certain data were missing, which may have impacted the precision and thoroughness of the findings.

Additionally, compared to white people, there were significantly fewer instances of melanoma among ethnic minority groups. Dr. Harb continued that this can result in bias because the sample might not accurately reflect the entire population.

Taking steps to prevent melanoma

The first step in preventing skin cancer is to shield yourself from the sun. There is no safe level of ultraviolet light exposure, according to Dr. Kamanger, who described ultraviolet light as a real carcinogen.

“UPF clothing, SPF 30 and above sun protection, and seeking shade should be practised.”

Every part of your body, including your feet and nails, should be examined once a month, according to Dr. Kamanger.

When in doubt, schedule a yearly skin cancer test with a board-certified dermatologist, said Dr. Kamanger.

According to Dr. Bubic, “any lesions that may be changing, increasing in size, bleeding, or not healing appropriately should be evaluated.”

REFERENCES:

For Alzheimer’s disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=10

Improve melanoma treatment with fecal transplant?

Improve melanoma treatment with fecal transplant?

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Using immune checkpoint inhibitors like pembrolizumab or nivolumab in conjunction with fecal transplants demonstrated the procedure’s safety in patients with advanced melanoma, according to a phase 1 clinical trial.

65% of the trial participants experienced a favorable response to immunotherapy. Following the fecal transplant, positive responders’ gut microbiomes revealed a rise in helpful bacteria and a decrease in dangerous bacteria.

Larger phase 2 trials will be carried out, and the use of faecal transplants in difficult-to-treat malignancies like pancreatic cancer will be investigated.

Numerous cancer patients have recently benefited from a type of treatment called immunotherapy, which uses the immune systems of the patients to identify and eliminate cancer cells.

Some immunotherapy medications, such as pembrolizumab (Keytruda) and nivolumab (Opdivo), function by preventing the mechanism by which cancer cells can conceal themselves from the immune system.

These immune checkpoint inhibitors, also known as anti-programmed death (PD-1) medications, are successful in treating roughly 50% of patients with melanoma, a kind of skin cancer.

Recently, researchers investigated whether patients with metastatic melanoma might respond better if immunotherapy and fecal microbiota transplants were combined.

This combination was not only risk-free but most patients responded well to the therapy, with some obtaining complete remission.

Phase 1 of the trial

Faecal transplants were coupled with the licenced medications pembrolizumab or nivolumab, which are already the standard of care for advanced melanoma, in the phase 1 MIMic trial.

The objective of the clinical experiment was to determine whether it is secure to combine these two medications in melanoma patients. As a supplementary goal, the impact of faecal transplants on the immune system and gut flora was evaluated.

Following a technique that was approved by Health Canada, healthy donors were carefully chosen. Then, capsules were created using the faeces of healthy donors.

Twenty metastatic melanoma patients were enrolled in the trial from Lawson Health Research Institute, the Jewish General Hospital (JGH), and the Centre Hospitalier de l’Université de Montréal (CRCHUM).

Each research subject was given capsules containing 80–100 mg of a fecal transplant from a single healthy volunteer donor. At least a week before receiving treatment with approved immunotherapy medications (either pembrolizumab or nivolumab), the fecal transplants were administered orally as capsules.

Is fecal transplantation plus immunotherapy safe?

The faecal transplantation operation was successfully completed by each of the 20 patients.

No major side effects were noticed prior to beginning immunotherapy, and no infections were spread through faecal transplantation. However, eight patients (40%) did have mild to moderate side effects from faecal transplantation, including diarrhoea, flatulence, and abdominal discomfort.

17 patients (85%) of the group encountered adverse immune-related events, the majority of which (70%) happened within the first three months of immunotherapy. Of these, five study participants (25%) experienced significant immune-related adverse effects, including nephritis (n = 1), arthritis (n = 2), exhaustion (n = 1), pneumonitis (n = 1), and arthritis (n = 2). These side effects forced the study participants to stop receiving their medication.

The researchers found no previously unreported adverse reactions to immunotherapy or faecal transplantation.

Did combined therapy lead to better results?

Four of the 20 participants in the trial (20%) experienced complete remission, making up 65% (13 out of 20) of the patients who responded favorably to the therapy.

All patients had strains of the donor’s bacteria in their gut microbiomes, according to analysis; however, this resemblance only got stronger over time in those patients who had a good response to the therapy. After receiving faecal transplants, respondents had higher levels of helpful bacteria and lower levels of dangerous bacteria.

The good impact of healthy donor faeces in boosting the efficiency of immunotherapy was further demonstrated in studies on mice by the researchers.

Fecal microbial transplantation: what is it?

Fecal transplantation, also known as fecal microbial transplantation (FMT), is a medical treatment in which the recipient’s intestines are filled with a healthy person’s donated poo (or feces).

In order to address medical disorders linked to abnormalities in gut bacteria, this method involves introducing healthy bacteria into the recipient’s intestines.

The effective treatment for recurrent Clostridium difficile infections is fecal transplantation. Fecal transplants are frequently administered via colonoscopy, however they can also be given as pills.

Gut and immune system interaction

So why do immune checkpoint inhibitors not work for everyone?

Recent research reveals that the bacteria in the gut may have an impact on how well the medications work. Immune checkpoint inhibitor-responsive individuals have a distinctive and healthy gut microbiome, often known as a “group of microorganisms in their gut.”

One of the study’s authors, Saman Maleki, Ph.D., assistant professor of oncology, pathology and laboratory medicine, and medical biophysics at Western University, as well as a researcher at the London Regional Cancer Programme and Lawson Health Research Institute, reasoned that altering a person’s gut microbiome to make it more diverse and healthy may enhance their response to immune checkpoint inhibitors.

Faecal microbial transplantation is one technique to modify the gut microbiota.

Will fecal transplants be used in the management of melanoma?

The principal study investigator, Dr. John Lenehan, a medical oncologist at the London Regional Cancer Programme, an associate scientist at the Lawson Health Research Institute, and an associate professor of family medicine and oncology at Western University, stated that the most significant finding in the study was that “none of the patients were harmed by the experimental treatment.”

Faecal transplants had been demonstrated to be beneficial by observational and pre-clinical studies, but “what happens in mice does not always translate to patients,” he noted. In fact, according to Dr. Lenehan, “more recent studies using similar therapies have shown harm, with patients having a worse response.”

He clarified that faecal transplantation was carried out differently in these other investigations than it was in the MIMic experiment.

“There are several factors, including bowel preparation, the number of FMTs required, the amount of stool required, and the identity of the donors. We had no idea if our approach would be secure or efficient. Thankfully, it appears that it was both! “, he exclaimed.

The director of the Supportive Oncology Research Group at the University of Adelaide and a research fellow at the Hospital Research Foundation Group, Hannah Wardill, Ph.D., who was not involved in this study, thinks this combination therapy strategy has the potential to be a successful treatment.

“FMT is a reasonably accessible intervention, and this study shows it is safe and likely effective at improving immunotherapy response,” she added.

The combination of faecal transplants and immunotherapy results in an improved response rate in patients who would otherwise be unresponsive to immunotherapy, which indicates that “more people will benefit from immunotherapy,” according to Dr. Wardill.

REFERENCES:

For Cancer disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=10

Boost skin cancer immunotherapy by targeting proteins.

Boost skin cancer immunotherapy by targeting proteins.

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A protein that aids tumors in evading immune response and supports the growth of melanoma has been discovered by new research.

According to researchers, immunotherapy should be more effective with tailored medicines directed particularly at this protein.

One of the most prevalent malignancies, melanoma is typically brought on by exposure to UV light, while hereditary factors also play a part in its development.

Experts advise staying away from tanning beds and direct sunshine, as well as keeping an eye out for any moles that seem out of the ordinary.

The growth of melanoma has been the subject of recent research, which has also opened up new potential treatment options.

In a study that was published in the journal Science Advances, researchers showed how a protein called NR2F6 aids tumor growth by assisting tumours to elude the immune system.

The scientists discovered that in mice, eliminating the protein made the immune treatment work more effectively.

“This tells us that NR2F6 helps melanoma evade the immune system, and without it, the immune system can more readily suppress tumour growth,” said Dr. Hyungsoo Kim, a research assistant professor at Sanford Burnham Prebys, a research centre in La Jolla, California, and the study’s first author.

Treatments that prevent the protein’s action are thought to be twice as effective since it behaves the same way whether it is in a tumor or the tissues around it.

The scientists are currently searching for fresh medications that can particularly target NR2F6.

learning about melanoma

Melanoma develops when the DNA in skin cells is harmed, according to dermatologist Dr. Ahmad Chaudhry of the United Kingdom, who spoke to us.

According to Chaudhry, exposure to ultraviolet (UV) light from the sun or tanning booths is frequently to blame for this. “Due to this damage, the melanocytes (cells that produce melanin) proliferate out of control and aggregate into a mass of malignant cells. The development of melanoma in the eyes or internal organs does occur occasionally, but it is less frequent.”

While there are some hereditary risk factors that can potentially play a role, sunshine and tanning beds are linked to skin cancer for a reason.

We were informed by Dr. Sudarsan Kollimuttathuillam, a medical oncologist and haematologist at the City of Hope cancer research organization’s Huntington Beach and Irvine Sand Canyon locations, that 7% to 15% of people with melanoma also have a family member who has the condition.

According to him, having characteristics like pale skin, freckles, or blonde or red hair raises one’s overall risk of developing skin cancer. Atypical mole syndrome is another genetic disorder that dramatically raises the lifetime risk of melanoma and is characterized by a high number of moles with odd forms or color.

Risk can be reduced, but genetics cannot be changed. Doctors advise limiting exposure to the sun during peak hours, staying away from tanning beds in general, and wearing sun protection when outdoors to reduce your risk of acquiring skin cancer.

In the words of Kollimuttathuillam, “regular skin examinations by both you and a dermatologist will help detect melanoma at an early stage, when it is more treatable.”

Experiencing melanoma

One of the most prevalent types of cancer are skin malignancies like melanoma.

More than 97,000 Americans are expected to receive melanoma diagnoses in the US in 2023, according to the American Cancer Society.

As previously mentioned, melanoma can be detected early by a number of telling indications, including genetics and moles. The following procedure usually entails removing and then examining the mole if a doctor suspects it may be malignant. Melanoma presence or absence can be assessed by a range of tests.

It’s crucial to get an early diagnosis of melanoma because it spreads quickly.

According to Kollimuttathuillam, melanoma is the type of skin cancer that is most likely to spread to distant organs or bones. Because of this, imaging technologies may be utilized to spot cancer cells that have done so.

After receiving a melanoma diagnosis, a patient has a variety of treatment choices at their disposal, including radiation therapy, surgery, and immunotherapy.

In the earliest stages of melanoma, patients typically do not require imaging tests because, as Kollimuttathuillam noted, “we know that the best way to stop cancer is to prevent it.” “I cannot emphasize enough how crucial it is for patients to be advocates for their skin health to avoid advanced stages of this disease,” the doctor said.

Types of Immunotherapy

Medication is used in immunotherapy to boost your immune system. This might aid in its attack on cancer cells.

Severe melanoma is treated with a variety of immunotherapies, including:

Checkpoint blockers. The PD-1 blockers nivolumab (Opdivo) and pembrolizumab (Keytruda) as well as the CTL4-blocker ipilimumab (Yervoy) are among these drugs. These medications could aid T cells in your immune system in identifying and eliminating melanoma cancer cells.

Oncolytic virus therapy. In this procedure, melanoma tumors are injected with talimogene laherparepvec (T-VEC, Imylgic), a modified virus. In addition to killing cancer cells, this virus may also cause your immune system to fight cancer cells.

Cytokine therapy. Immune cells can interact with one another with the aid of a class of proteins called cytokines. Interleukin-2 (aldesleukin, proleukin) therapy may enhance your immune system’s defense against cancer.

Your doctor may recommend a single immunotherapy treatment or a cocktail of immunotherapy medications. They might prescribe Yervoy and Opdivo combined, for instance.

Individuals with stage 4 melanoma now have better survival rates thanks to immunotherapy. However, there is a chance that this treatment will have negative side effects.

Contact your doctor straight away if you suspect any potential side effects.

REFERENCES:

For Skin cancer medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=10

Experimental drugs could improve several cancer therapies.

Experimental drugs could improve several cancer therapies.

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In order to combine medication with diagnostics, researchers have found a novel radioactive compound named CB-2PA-NT as a possible possibility.

The chemical exhibits strong uptake and retention in tumors while maintaining a distinct difference from surrounding tissues. It works by targeting neurotensin receptors, which are prevalent in numerous malignancies.

Shortly, researchers intend to carry out human imaging investigations utilizing CB-2PA-NT, which may have an impact on personalized cancer treatment for patients. Regulatory approval is still waiting.

The University of Wisconsin and the University of North Carolina worked together to create the anti-cancer medication candidate CB-2PA-NT, which has the potential to be used widely.

This study lays the framework for future investigations that will use CB-2PA-NT in human imaging, albeit these studies still require regulatory approval in order to start.

New research positions CB-2PA-NT as a promising candidate for an original theranostics method, according to data presented at the Society of Nuclear Medicine and Molecular Imaging Annual Meeting (SNMMI 2023).

Therapy and diagnostics are combined in theranostics.

Correct diagnosis is a prerequisite to choosing the best course of action. A precise diagnosis is even more crucial in the era of personalized medicine. This is where treatments can be tailored to a person’s unique biomarkers.

This is especially true in the field of cancer, where it is crucial to get a precise diagnosis.

Theranostics offers a potent method for battling cancer by fusing two crucial components. It entails locating cancer cells throughout the body and removing them with specialized radiation.

Positron emission tomography (PET) is used to localise the malignancy, and then medicine is given to kill it. Theranostics’ astounding accuracy greatly reduces the possibility of damaging nearby healthy tissues.

CB-2PA-NT has the potential to significantly advance the field of precision medicine by particularly targeting neurotensin receptors (NTSRs) present in diverse cancer types.

Researchers pursue the receptors on cancer cells

When it comes to many malignancies, including lung, colorectal, breast, pancreatic, and prostate cancers, NTSRs are more prevalent receptors.

A radioactive chemical that can precisely bind to NTSR1, one of these receptors, has been developed by scientists.

In terms of how well they are absorbed and retained by tumors, earlier attempts to synthesize these compounds have had mixed results.

One of the study’s authors and doctorate candidate at the University of North Carolina in Chapel Hill, Xinrui Ma, gave us an explanation of the main conclusions.

“This [study] abstract reports] a novel theranostic agent targeting neurotensin receptor 1 (NTSR1) and its application in cancer imaging and therapy,” said Ma.

The optimization of NTSR1-related compounds has already been attempted by numerous organizations, including our own. In fact, we have been working on this topic since 2012. Challenges include limited serum stability, significant liver absorption, some ligands’ agonistic character, and/or quick washout, she added.

The cross-linked propylamine moiety, Ma continued, “can significantly improve tumor uptake and retention, building on previous research and experience.”

“The tumor absorption increased 10-fold as compared to the peptide-based ligand while still maintaining the high contrast. The high uptake was also sustained at 24 and 48 hours following injection, which is more significant, the researcher said.

We have a rare chance to create theranostic drugs for patient treatment because of the much better tumor absorption and retention. Indeed, to investigate the theranostic potential of these novel compounds in a variety of cancer types, such as lung cancer, colorectal cancer, and PSMA-negative prostate cancer, we have forged a close partnership with Prof. Jonathan Engle’s team at the University of Wisconsin, said Xinrui Ma.

Which NTSR1 inhibitor is most effective?

The best NTSR1 antagonist for imaging and therapy was determined by the researchers’ investigation, which looked at a variety of NTSR1 antagonists.

They then carried out studies to radioactively designate these compounds. They verified that the NTSR1 receptor was in fact present in the lung cancer cells (H1299 cells) using a procedure known as western blot.

The compounds were also examined for stability in test tubes and on living lung cancer cells. Also, for their capacity to bind to lung cancer cells in laboratory settings and on animals.

Finally, to examine how the chemicals were dispersed throughout the body, they used PET and CT imaging on tiny animals.

Western blot analysis of the results revealed that the NTSR1 receptor was substantially expressed in the H1299 lung cancer cells. The chemical known as CB-2PA-NT has shown a potent ability to bind to the H1299 lung cancer cells among the NTSR1 antagonists.

Small animal imaging provided proof that CB-2PA-NT was taken up by the tumor in large numbers. Clearly contrasted with the surrounding tissues, and stayed in the tumor for a considerable amount of time.

CB-2PA-NT was chosen for additional research because it stood out as the most promising compound when compared to the other NTSR1 antagonists.

There is a “need to confirm application in humans”

If this theranostic strategy is successful, it may provide a reliable method for imaging to detect the presence of NTSR1 in many cancer types.

This would be helpful for making diagnoses, selecting patients, and keeping track of how well treatments were working. It might also function as a radioactive material used in therapy.

We were informed by Yale resident doctor Dr. Tejasav Sehrawat. He was unrelated to the experiment, that “theranostics is a young discipline for diagnosing and treating malignancies. The growth of the field overall is quite intriguing and has a lot of potential. The competent execution of this investigation and the good preclinical findings are encouraging.

“While the authors have already demonstrated their findings in animal models, application in people still has to be verified. We should all be eagerly awaiting the findings of the authors’ next human investigations. Because there is significant inter-species heterogeneity in these studies, according to Dr. Tejasav Sehrawat.

Possibly negative future effects for cancer patients

This finding, according to Ma, “is important because it could offer personalised medicine for cancer patients,”

She informed us that, in terms of the disease, NTSR was discovered to be overexpressed in prostate cancer tissues. Specifically in PSMA-negative prostate cancer tissues.

This shows that NTSR1-targeted theranostics may be a prostate cancer treatment option in populations that are ineligible for PSMA-based methods. Lung, colorectal, breast, and pancreatic cancers are only a few of the tumors that could potentially benefit from NTSR-targeted theranostics, says Ma, Xinrui

“A broad spectrum of patients may benefit from the newly developed agents,” Ma noted. The researchers are still awaiting regulatory authorization to carry out the first-ever human imaging tests with CB-2PA-NT, and more study is required.

REFERENCES:

For Cancer disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=10

Important signs to consider to avoid Colorectal cancer.

Important signs to consider to avoid Colorectal cancer.

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The incidence of colorectal cancer, which ranks third among all cancers in the globe, is on the decline in older people and is largely avoidable. However, the prevalence of colorectal cancer among younger people is rising.

Seven risk factors that raise the likelihood of colorectal cancer in younger males have been found in a recent study. Men under 45 who are at increased risk should get screened for colorectal cancer, according to the authors.

Colorectal cancer is the third most prevalent cancer in the world, behind breast and lung cancer. Only lung cancer accounts for more fatalities. It is estimated that each year, more than 150,000 people in the United States alone receive a colorectal cancer diagnosis.

The median age of diagnosis for colorectal cancer is 66, and persons over the age of 45 are most likely to develop it. According to the American Cancer Society, widespread screening of adults over 50 and the removal of pre-cancerous growths known as polyps are contributing to a decline in colorectal cancer occurrences and deaths in older people.

Those under 45 have a low chance of developing colorectal cancer, the number of cases and fatalities in this age group has been rising since the 1990s.

Currently, a research of American veterans has identified certain elements that are linked to a higher risk of early-onset colorectal cancer in males. The authors contend that in some situations, targeted screening may aid in case prevention.

What exactly is colorectal cancer?

Cancer that starts in the colon or rectum is called colorectal cancer. These cancers may also be known as colon cancer or rectal cancer depending on where they first appear.

The majority of colorectal malignancies begin as polyps, which are growths on the colon’s inner lining. Even though not all polyps develop into cancer, some of them can over time.

In the United States, colorectal cancer ranks third among all cancers, excluding skin cancer, according to the American Cancer Society.

Causes of colorectal cancer risk

The researchers located 956 men between the ages of 35 and 49 who had received a non-hereditary colorectal cancer diagnosis between 2008 and 2015 from the National Veterans Affairs database in the United States. 600 of them satisfied the requirements for study inclusion.

These were then matched with 1,200 controls who underwent colonoscopies but did not develop colorectal cancer and 1,200 controls who had not.

For both cases and controls, the researchers examined sociodemographic and lifestyle characteristics, family and personal medical histories, physical measurements, vital signs, medications, and laboratory results. For people with colorectal cancer, data from the six to eighteen months before diagnosis were utilized to identify characteristics that might vary with the development of the disease.

Age, cohabitation, employment, BMI, malignancies in first- or second-degree relatives, comorbidities, alcohol use, hyperlipidemia, and usage of statins, non-steroidal anti-inflammatory medications (NSAIDs), or multivitamins were all examined to find risk variables.

From this, scientists discovered 15 variables that were each independently linked to a higher chance of developing colorectal cancer at an early stage. They singled out seven of these that offered equivalent precision and whose data are easily obtainable:

  • elder age (between the ages of 35 and 49)
  • NSAIDs (such as aspirin or ibuprofen) should not be regularly used.
  • no consistent statin use
  • usage of alcohol today
  • relatives in the first or second degree who have colorectal cancer
  • a greater burden of sickness

According to corresponding author Dr. Thomas F. Imperiale, a research scientist at the Regenstrief Institute, several characteristics raised risk more than others:

It was more significant to have a first- or second-degree family who had colorectal cancer. Non-steroidal anti-inflammatory drug use and statin use were two additional factors with a stronger impact.

Risk of colorectal cancer and lifestyle

The risk of colorectal cancer may be increased by a number of lifestyle variables, according to the Centres for Disease Control and Prevention (CDC). These consist of:

The study’s author, Dr. Bilchik, who was not involved in it, emphasized the importance of lifestyle factors:

According to this study, lifestyle choices have a significant impact on the development of colorectal cancer. For instance, taking statins is connected to elevated cholesterol, and food and alcohol have also been linked to a number of different cancers.

Screening for high-risk individuals

The researchers pointed out that although their study only included men, men are still twice as likely to develop colorectal cancer as women of any age. However, they are currently conducting research along these lines on female risk factors.

They emphasised that not all younger men should have colorectal cancer screenings, but those who are at higher risk may benefit.

“Only high-risk men between the ages of 35 and 44 should be screened. Guidelines now recommend colorectal cancer screening for men between the ages of 45 and 49 but do not specify how (i.e., which test),” Thomas F. Imperiale, M.D.

“The risk factors may be helpful in deciding whether noninvasive testing (with the faecal immunochemical test or with the multi-target stool DNA test) or a colonoscopy is more appropriate,” Dr. Imperiale said to us.

Additionally, he hoped that highlighting these risk factors will prompt males between the ages of 45 and 49 who are already eligible for screening to request testing.

The findings indicating that colorectal cancer screening is advised starting at age 45 are particularly pertinent to male veterans under the age of 35. Dr. Imperiale continued, “However, the results may also be valuable for persuading 45-49 year old male veterans that they should be examined.

How is colon cancer identified?

Your doctor would advise exams and testing to determine the cause if you have colorectal cancer symptoms or if a screening test result was abnormal.

The American College of Physicians advises colorectal cancer screening using one of the following methods for those with a typical risk of developing the disease:

  • a colonoscopy every ten years
  • every two years, a high sensitivity guaiac-based faecal occult blood test (gFOBT) or faecal immunochemical test (FIT)
  • FIT every two years in addition to flexible sigmoidoscopy every ten years.

People who have a higher risk of developing colorectal cancer should discuss the type and frequency of screening that is most appropriate for them with their doctor.

To determine your personal risk level, use this risk calculator. Additional testing is necessary to stage colorectal cancer and determine the best course of therapy if it is discovered.

Physical examination and medical history

To ascertain whether you have any risk factors, such as a family history of colorectal cancer, your doctor will inquire about your medical history. Additionally, the duration of your symptoms will be questioned of you.

During a physical examination, your abdomen will be felt for lumps or enlarged organs, and a digital rectal exam (DRE) may be performed.

A gloved finger is inserted into your rectum by the doctor during a DRE to look for any anomalies.

Stool tests

Tests to look for blood in your stool may be advised by your doctor. To the naked eye, blood in the faeces is not always obvious. These examinations aid in finding blood that cannot be seen.

These tests, such as a FOBT or FIT, are carried out at home with the aid of a kit that is provided. You can use the kit to gather one to three stool samples for testing.

A blood test

Blood tests may be required to look for colorectal cancer symptoms include anaemia, which is a condition when there are not enough red blood cells in the body.

Additionally, your doctor can request tests for liver function and tumour markers such carcinoembryonic antigen (CEA) and CA 19-9. Colorectal cancer cannot be identified by blood testing alone.

Signoidoscopy

Your doctor can view the interior of your sigmoid colon via a sigmoidoscopy, also known as a flexible sigmoidoscopy. If a colonoscopy is not possible for any reason, this less intrusive technique could be suggested instead.

Colonoscopy

A diagnostic colonoscopy is carried out as a result of symptoms you are experiencing or an anomaly discovered during a screening test. The test is performed to observe your colon and rectum in their entirety.

A colonoscope, which is put into the body through the anus, is used to perform it because it is a small, flexible tube with a camera on the end.

The colonoscope can be used to insert specialised tools that can be used to remove polyps and collect tissue samples for biopsies.

Proctoscopy

During a proctoscopy, the anus is used to introduce a proctoscope. To observe the interior of the rectum, a proctoscope is a short, rigid tube with a camera at one end. It is used to examine the rectum for cancer.

Biopsy

A biopsy is a lab test that looks at a tissue sample. Polyps or questionable spots are typically removed during a colonoscopy, but if necessary, they can also be removed surgically.

The tissue is delivered to a lab where a microscope is used to examine it. The samples might also be examined for gene alterations if cancer is discovered. To help categorise the malignancy, more lab tests could be carried out.

Imaging exams

Imaging examinations can:

  • view potential cancerous regions that are suspicious
  • determine the extent of the cancer’s spread
  • test the efficacy of the treatment

REFERENCES:

For Cancer disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=10

Ultrasonic sound helps chemo drugs might treat brain cancer

Ultrasonic sound helps chemo drugs might treat brain cancer

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Because chemotherapy medications cannot cross the blood-brain barrier, brain cancer can be challenging to treat. According to researchers, an ultrasound device has the potential to momentarily remove that barrier and allow chemotherapy medications to get through.

According to experts, this technique could revolutionize the way brain cancer is treated. The most lethal type of brain cancer, glioblastoma, may now be treatable according to recent studies.

Treatment for brain tumors is very challenging. The blood-brain barrier, which regulates what can travel from the bloodstream to the brain, is a contributing factor in that the majority of chemotherapy medications are inhibited by this barrier.

The issue was overcome by Northwestern Medicine doctors who implanted an ultrasonic device in the brain to momentarily break down the blood-brain barrier, enabling chemotherapy medications to be injected intravenously into the brain.

“Finding that a new technology can safely and effectively open the blood-brain barrier to deliver chemotherapy is potentially a game-changing step forward in brain cancer research and treatment,” Dr. Jason Salsamendi, the lead interventional radiologist at the City of Hope Orange County Lennar Foundation Cancer Centre in California, told us.

Throughout a 4-month period, the 4-minute procedure which is performed on awake patients was repeated once every few weeks for a total of six sessions.

According to the study, which was written up in the journal Lancet Oncology, the surgery caused the concentration of chemotherapy medications in the brain to virtually multiply by four to six.

New brain cancer treatments importance

Dr. Adam Sonabend, a neurosurgeon at the Feinberg School of Medicine at Northwestern University in Illinois, is the study’s primary investigator and neurosurgeon. He also serves as an associate professor of neurological surgery. “While we have concentrated on brain cancer, this provides an opportunity to explore novel drug-based therapies for the millions of patients who are affected by a variety of brain diseases,” the authors write.

Dr Albert Kim, director of the brain tumour centre at Washington University in St. Louis’ Siteman Cancer Centre, who was not involved in this trial, told us that systemic distribution via IV is typical and simple to carry out.

Although the blood-brain barrier had previously been opened with ultrasound, Kim stated that “the implantable device allows for repeated openings, which could enable the delivery of multiple cycles of systemic drugs.”

The trial included paclitaxel and carboplatin, two powerful chemotherapy medications that are typically ineffective in the treatment of glioblastoma.

Temozolomide, the major chemotherapeutic agent now being used to treat glioblastoma, can cross the blood-brain barrier, however it is somewhat ineffective.

Injecting paclitaxel directly into the brain has been shown in prior studies to be beneficial, but it also carries the risk of meningitis and irritated brain tissue.

The five-year survival rate for glioblastoma is now at around 10%, and patients have not benefited from recent developments in cancer treatment, such as targeted medicines and immunotherapy, according to Salsamendi. An option to administeradminister medication directly into the brain each time a dose is needed is the ability to distribute chemotherapy across the blood-brain barrier.

Blood-brain barrier being opened

The blood-brain barrier quickly closed after being forced open, often within 30 to 60 minutes, according to the study’s researchers.

Salsamendi noticed that there is a greater possibility of dangerous substances entering the brain if the blood-brain barrier is breached for a longer period. In terms of treatment planning and risk minimization, it would be important to know how long the barrier may be open with as much accuracy as feasible.

The French biotech company Carthera created the ultrasound device, which breaks down the blood-brain barrier via a stream of tiny bubbles.

One hour later, the blood-brain barrier recloses.

The researchers found that the blood-brain barrier may be temporarily opened in people using ultrasound and microbubble technology and that most of its integrity returns an hour later.

The brain is permeable to medications circulating in the bloodstream for a critical period of time following sonification, according to Sonabend, who is also a member of Northwestern University’s Robert H. Lurie Comprehensive Cancer Centre.

The blood-brain barrier is fully restored 24 hours after brain sonication, according to prior human investigations. However, the field previously made the assumption that the blood-brain barrier is open during the first six to eight hours. According to the Northwestern study, this window may be smaller.

Another first is that the blood-brain barrier is opened in a brain volume that is nine times greater than the initial device (a modest single-ultrasound emitter implant) when a revolutionary skull-implantable grid of nine ultrasound emitters created by the French biotech company Carthera is used. This is crucial because for this method to be effective, a sizable area of the brain close to the cavity that remains after the excision of glioblastoma tumours must be covered.

REFERENCES:

For Cancer disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=10

New drug combination reduces Lung cancer tumors.

New drug combination reduces Lung cancer tumors.

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The second most frequent type of cancer in the world is lung cancer. Around 2 million people are given a lung cancer diagnosis each year, and 1.8 million people pass away from the condition.

Small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) are the two forms of lung cancer, with NSCLC accounting for the majority of instances. Surgery, radiation, and chemotherapy are all effective treatments for NSCLC, although it is rarely curable.

Today, studies have discovered that a combination of two medications reduces the size and quantity of tumours in mice with NSCLC, a finding that could result in human clinical trials.

Lung cancer is the second most prevalent cancer diagnosed in the United States, according to the American Cancer Society. Moreover, it is the main cause of cancer mortality, accounting for one in five cancer-related deaths, more than colon, breast, and prostate cancers put together.

The typical age of diagnosis for lung cancer is 70 years old, with most cases being found in older patients. The good news is that cases are declining as fewer individuals smoke tobacco, which is responsible for more than 80% of lung cancer cases. A diagnosis of lung cancer is still given to over 2 million people annually worldwide.

Lung tumours other than small cell comprise 85% of cases (NSCLCs). There is an urgent need for novel therapies because immunotherapy and chemotherapy are not very successful against this kind of lung cancer.

Now, researchers from the Salk Institute and Northwestern University have discovered that treating NSCLC-affected mice with a cocktail of two drugs—one of which is already approved by the Food and Drug Administration (FDA) and the other is undergoing clinical trials—reduced the size and frequency of the tumours.

Need for new treatments

According to Dr. Lillian Eichner, a principal author of the study and an assistant professor of biochemistry and molecular genetics at Northwestern University, “This medication might be helpful for patients with KRAS/LKB1 mutant lung adenocarcinoma.”

About 20,000 new cases of this disease’s molecular subtype are reported each year in the United States, she said. “Patients with this terrible disease currently have an average survival duration of 10 months after diagnosis, and improved therapeutic techniques are desperately needed.”

Histone deacetylase (HDAC) inhibitors have been suggested as a possible therapy for this particular form of lung cancer by the researchers. Animal tumour growth has been demonstrated to be slowed by HDAC inhibitors, which are epigenetic regulators.

After proving that HDAC3 was essential for the development of difficult-to-treat LKB1-mutant cancers, the study’s authors investigated if pharmacologically inhibiting HDAC3 may have an impact on tumour growth.

In this study, they treated KRAS/LKB1 mutant NSCLC in mice with two different medications: the FDA-approved MEK inhibitor trametinib and the HDAC1/HDAC3 inhibitor entinostat, which is currently in clinical development.

Lung tumor study

The LKB1 genetic mutation is present in NSCLCs, and Salk researchers were interested in investigating a novel targeted therapeutic option.

According to Dr. Andrew McKenzie, vice president of personalised medicine at Tennessee’s Sarah Cannon Research Institute and scientific director at Genospace, targeted therapies are medicines created for certain molecular subtypes of NSCLCs.

Since that these treatments are “tailored,” he explained, “it is preferable to administer a targeted therapy rather than immunotherapy or immunotherapy and chemotherapy if you test a patient and discover a mutation.

Initially, the Salk team demonstrated that the body’s histone deacetylase 3 (HDAC3) protein is essential for the development of NSCLCs with the LKB1 mutation.

This was unexpected, according to co-lead of the study Lillian Eichner, PhD, a professor at Northwestern University in Illinois who was a postdoctoral researcher at Salk during the research.

She said, “We believed the entire HDAC enzyme class was intimately related to the origin of LKB1 mutant lung cancer.

“We didn’t know the exact involvement of HDAC3 in lung tumour formation,” Eichner stated. She then moved to two drugs with the assistance of the team.

The potent drug combination

Entinostat was the first medication. Although the Food and Drug Administration (FDA) has not yet approved this medication, clinical tests have demonstrated that it targets HDACs.

Trametinib was the second medication and it works by preventing the growth of cancer cells. Trametinib is FDA-approved for the treatment of NSCLCs, but it must be used in conjunction with the medication dabrafenib, McKenzie added.

These two medications are only permitted for use in NSCLCs with the BRAF V600E mutation, the author continued.

According to McKenzie, “Trametinib on its own has not been very effective and requires to be paired with dabrafenib to see the clinical outcomes associated with FDA approval.” Because trametinib might cause tumours to become resistant, dabrafenib is often used in conjunction with it.

The goal of the study was to determine whether trametinib and the HDAC3-targeting drug entinostat would reduce resistance in the same way. Mice with LKB1-mutated NSCLC were treated with the medication cocktail for 42 days, and then the tumours were examined again.

Tumors in recipient mice have shrunk by 79% in size compared to mice not receiving the medication treatment. The researchers also noted a 63% decrease in lung cancers in the treated animals.

Human trials needed

Cancers are already being treated with these medications. For the first time, the FDA approved trametinib in 2013 to treat metastatic malignant melanoma. In 2017, it received approval for the treatment of NSCLC.

Entinostat has undergone phase 1 and phase 2 clinical trials but has not yet received FDA approval for clinical usage. Phase 3 trials in people with breast cancer are also still being conducted. People have typically tolerated the medication well during the studies.

The medications have not yet been combined in human subjects. The following stages in evaluating the combined therapy were described by Dr. Eichner.

She said that in order to determine the safety of this combined therapeutic method, a phase 1 clinical research would be conducted first.

“Based on the known safety profiles of both medications, we are hoping that this would also be the case in people,” said Dr. Eichner. “Our preclinical investigations were extremely encouraging with regard to the safety of this pharmacological combination.”

A phase 2 research would then determine whether this combination inhibits tumour growth and lengthens the patients’ lives, she continued.

New hope for cancer patients

On average $1.3 billion is spent to bring a new treatment to market, according to a recent study, making drug development a time-consuming and expensive process.

Also, it often takes 6 to 12 years for new cancer medications to be approved. So, it is quicker and more cost-effective to identify new ways to use existing medications.

According to our research, cancer treatments that were previously unsuccessful might be successful if they are modified. In some cases, understanding basic tumour biology can result in novel cancer therapy strategies without the need to first create new medications, which can be a lengthy process, according to Dr. Lillian Eichner.

Although it is still early, their discoveries might result in new lung cancer medicines for this difficult-to-treat disease. Dr. Eichner is upbeat, but more study is required to validate the results.

According to “our findings,” treating patients concurrently with both of these already-approved medications “may significantly limit the growth of lung tumours for this set of patients.”

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New combination could reduce the risk of Prostate cancer.

New combination could reduce the risk of Prostate cancer.

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The effectiveness of talazoparib plus enzalutamide in treating metastatic castration-resistant prostate cancer in adult males was investigated in the TALAPRO-2 international phase 3 clinical trial.

Comparing talazoparib and enzalutamide therapy to placebo and enzalutamide therapy, a 37% lower risk of cancer progression or death was observed.

In 2023, the Food and Drug Administration (FDA) is anticipated to make a decision on the use of this combination therapy to treat men with metastatic castration-resistant prostate cancer.

Prostate cancer affects one in eight men in the United States and is the second most frequent cancer in males after skin cancer, according to the American Cancer Society.

Male hormones called androgens, such testosterone, promote the growth of prostate cancer cells. Even when blood testosterone levels are controlled, prostate cancer occasionally still progresses. Castration-resistant prostate cancer is the term for this.

Metastatic castration-resistant prostate cancer is the term used to describe a type of cancer that has migrated from the prostate gland to other bodily tissues like the lymph nodes and bones.

Treatment for metastatic castration-resistant prostate cancer has greatly advanced in recent years. Despite these advancements, cancer might recur after therapy because existing medicines only have a temporary impact.

Pfizer researchers have combined the drugs talazoparib (Talzenna) and enzalutamide to create a breakthrough treatment for metastatic castration-resistant prostate cancer (Xtandi). In the phase 3 trial of TALAPRO-2, they evaluated the effectiveness and safety of this combination medication.

Dr. Neeraj Agarwal, professor of oncology and Presidential Endowed Chair of Cancer Research at Huntsman Cancer Institute, University of Utah, and principal investigator for TALAPRO-2, delivered the trial’s findings at the 2023 ASCO Genitourinary Cancers Conference.

Why this combination therapy?

Enzalutamide is a type of hormone therapy that has been approved for the treatment of prostate cancer in males. It functions by preventing testosterone from growing prostate cancer cells. Even after they have migrated to other parts of the body, without which they cannot proliferate.

The group of cancer medications known as poly-ADP ribose polymerase (PARP) inhibitors includes talazoparib. An enzyme (protein) called PARP is present in all cells and aids in the self-healing of injured cells. The repair activity of PARP in cancer cells is blocked by PARP inhibitors, which leads to the death of the cancer cells.

The FDA has authorised the PARP inhibitor talazoparib to treat germline (inherited) HER2-negative advanced breast cancer. However, has not yet licenced it to treat prostate cancer.

When combined with medications that restrict testosterone, PARP inhibitors may be beneficial for the treatment of advanced prostate cancer, according to earlier research.

This inspired Pfizer researchers to create a combination therapy that combines the testosterone-blocking drug enzalutamide with the PARP inhibitor talazoparib.

Study

Adult men from 26 different countries who had metastatic castration-resistant prostate cancer were included in the trial in December 2017.

At random, the participants were given one of the following:

  • Enzalutamide 160 mg once daily and talazoparib 0.5 mg were given to 402 individuals.
  • Or, for 403 individuals, a placebo and enzalutamide 160 mg once daily.

The TALAPRO-2 trial’s main goal was to determine whether adding talazoparib to enzalutamide extends radiographic progression-free survival (rPFS)—the period of time patients remain cancer-free—in comparison to placebo plus enzalutamide.

To see if any study participants had defective DNA repair genes, the researchers also analysed the DNA from the cancer cells of all study participants.

Drug combo lowers cancer progression risk

The median follow-up period for the combination therapy group was 24.9 months. However, the group receiving placebo + enzalutamide experienced a median follow-up period of 24.6 months.

According to the findings, talazoparib plus enzalutamide significantly decreased the risk of disease progression or mortality compared to placebo and enzalutamide by 37%. This was true whether “homologous recombination repair,” or DNA repair gene mutations, were present or not (HRR).

Dr. Andrew J. noted that TALAPRO-2, which joins the PROPEL research, is the second randomised phase 3 trial to show a benefit with combination [androgen receptor] plus PARP inhibition in delaying rPFS in the first line [metastatic castration-resistant prostate cancer] context.

According to Dr. Armstronf, “the delays in rPFS range from > 50% relative improvements in HRR+ patients to 30-40% improvements in HRR-undetected individuals.

The results of TALAPRO-2 “differ from what was seen in the MAGNITUDE study with niraparib and abiraterone. Those without HRR deficiency (biomarker negative) group were stopped early due to lack of efficacy,” added Dr. Cora N. Sternberg, a genitourinary cancer specialist at Weill Cornell Medicine who was not involved in the study.

Data on overall survival were “immature” when the trial findings were announced. This indicates that more research is required to evaluate whether combination therapy with talazoparib and enzalutamide extends patient survival when compared to placebo and enzalutamide.

Is the combination therapy safe?

The study assessed any negative effects that men may have had from combination therapy.

The most frequent negative consequences were:

  • (65.8%) Anemia
  • reduction in neutrophil count (35.7%)
  • exhaustion (33.7%)
  • reduction in platelet count (24.6%)
  • Leukocyte count dropped (22.1%).
  • a backache (22.1%)
  • loss of appetite (21.6%
  • sickness (20.6%).

According to Dr. Zorko, the severe anaemia and neutropenia in the combination therapy group are not surprising given what is known about the side effects of PARP inhibitors.

Also, he advised that “before beginning combination therapy, consideration should be given to the necessity for transfusions and dose cessation. Particularly since 49% of patients had anaemia previous to therapy.”

The time toxicity required to obtain transfusions and supportive care in the clinic may further lessen patients’ enthusiasm for this oral combo therapy, the doctor added.

According to Dr. Armstrong, “there is higher toxicity and cost to patients getting combination [treatment], but these are tolerable for most patients and do not seem to impede quality of life in the long run in most patients with [dose] changes and side effect control.”

Study limitations and next steps

The primary limitations of this trial, according to Dr. Scott T. Tagawa, professor of medicine and urology at Weill Cornell Medicine who was not involved in it, include “early data for overall survival as well as [unknown] long-term adverse events.”

Dr. Zorko added: “In the trial, only 5.2% of patients had received abiraterone treatment in the past. We will see more patients in this area as they become castration-resistant as [triple therapy with] androgen-deprivation therapy, docetaxel, abiraterone/prednisone is used more frequently in the metastatic hormone-sensitive prostate cancer setting, but whether this specific subgroup benefits will be interesting to see.

The final stage of medication development was the phase 3 clinical trial. The FDA must now analyse the results of the clinical trials and make a determination regarding the applicability of this therapy to patients with metastatic castration-resistant prostate cancer. In 2023, the FDA is anticipated to make a decision regarding the clinical application.

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