Friday, July 11, 2014

Study: Increase In Thyroid Cancer Likely Linked To Environment, Behavior - capradio.org

Study: Increase In Thyroid Cancer Likely Linked To Environment, Behavior - capradio.org:



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Stress of cancer diagnosis eased with yoga, meditation

More patients, doctors are embracing complementary cancer therapies, including yoga and mediation to ease stress and promote healing.

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For our series on complementary cancer care, we spoke to five local women who tried different therapies.
DEBRA RICHARDSON
Yoga and meditation
Her cancer story: Debra Richardson always tried her best to stay healthy — eating plenty of fruit and vegetables, cutting out dairy products, getting regular exercise — so that made her 2005 cancer diagnosis all the more shocking. In fact, she was about to leave for a two-week detoxification and cleansing program in Thailand when her doctor noticed a lump on her neck during a checkup. Soon afterward, the Upper Grandview resident had surgery to remove a plum-sized tumor from the left lobe of her thyroid, a butterfly-shaped gland that secretes hormones that influence the body's metabolism. Richardson had wanted to leave at least part of the thyroid intact, in case the mass wasn't malignant. Unfortunately, it was — so she underwent another procedure two months later to take out the rest of the gland. The cancer was advanced enough that she needed radioactive iodine therapy to kill any remaining cells. Though thyroid cancer is uncommon, most people who get it do very well. "It's pretty treatable," says Richardson. Even with those reassurances, she remembers feeling very scared. "This was one of the most difficult and terrifying times of my life."
The complementary therapy: Richardson, who's 58, had taken up yoga about six years before her cancer diagnosis, but after that, she became much more devoted. Now, she goes to classes at Nyack's Birchwood Center at least four times a week, although she's had to change her practice. Before, she preferred a brisk, flowing vinyasa yoga; as her throat healed from surgery, she switched to hatha yoga, which has easier movements and a slower pace, and which she continues to practice. "It's still powerful when you have to hold those positions for a long time," she says. "I feel strong and balanced."
The real change, however, has been adding meditation to her daily routine. A model and actress who travels frequently, Richardson felt a lot of work-related stress; at the time she found out about the cancer, she also had a second job at a salon and beauty boutique in Piermont. "I said, 'I have to calm down. I know about taking care of myself, but I have to do something more,'" she recalls. The Birchwood Center's owners suggested that she try one of the free meditation classes offered there throughout the week. A key component of ancient Eastern religious practices, meditation is a process that uses concentration to bring the body and mind to a peaceful state. "It's very difficult to quiet the chatter in the mind," says Richardson. Even after years of practice, she says it's sometimes harder to meditate than to achieve the toughest yoga pose. "Some days are better than others," she adds. "It's all about how you are on that day." Good day or bad, Richardson says, "I can't imagine my life without it."

Debra Richardson, 58, was diagnosed with thyroid cancer in 2005 and had surgery to remove her thyroid. She deepened her yoga practice and took up mediation in order to reduce stress and anxiety. ( Video by Tania Savayan / The Journal News ) Video by Tania Savayan / The Journal News
How it helped: Many cancer centers and support groups offer yoga and meditation; it's not fully known exactly how these age-old practices help those who are ill, but research is starting to provide stronger evidence of the physical and mental health benefits. A study published in the Journal of Clinical Oncology in March found that yoga lessened pain, fatigue and depression among breast cancer patients; new research from the University of Montreal shows that meditation improved mood and sleep problems in teens with cancer. Richardson tries to meditate for an hour every day, whether it's on the road or in the yoga-meditation room she's set up at home, a tranquil space with candles, crystals and statues of Buddha. For her daily practice, she lies down or sits comfortably, closes her eyes and focuses on breathing. When asked how to describe how she feels afterward, she says: "I feel like I'm almost out of my body. Your blood pressure lowers. You feel so clear and awake, like you had a great nap. It's amazing how it calms you down, and fast. I feel really revived and refreshed."
Her health now: Richardson is currently on Synthroid, a medication that replaces the hormones produced by the thyroid, though her doctor recently reduced her dosage because it could affect her bone density. "It's still a nice amount," she says. "I'm never tired." The American Thyroid Association notes that for patients over 45, or those with larger, more aggressive tumors, the prognosis for those with thyroid cancer remains very good, but the risk of a recurrence is high. Despite her earlier fears, Richardson has adopted a bright outlook. "With cancer, people just have to live like every single day is a gift. You have to live in the moment, and you can't think too far ahead."
About this project
Learn more about complimentary cancer care on our special page at www.lohud.com/mindbodycancer. Find stories like:
Retired Spanish teacher Gloria Esteves turned to therapeutic massage to manage the weakness, numbness, pain and extreme sensitivity.
New Rochelle's Louise Kuklis found peace in watercolor classes organized by Gilda's Club after her colon cancer diagnosis.
A relapse isn't the only health problem that plagues cancer survivors like Leslie Boxer. A holistic approach to treating and preventing chronic diseases can be key to maintaining a health life.
Life with cancer is stressful. Upper Grandview's Debra Richardson turned to a combination of yoga and meditation to bring the body and mind to a peaceful state, and provide a focus in the battle against the disease.
Breast cancer didn't stop New City's Kirsten Rota from pursuing her dreams: marriage, a family, a happy life. She found mental and physical relief through customized acupuncture treatments.
Equine therapy has brought joy to many people with disabilities. Why not cancer patients? The Therapeutic Equestrian Center in Cold Spring aids women with breast cancer by engaging them in horse-related activities.
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ASCO 2014 kicks off with news on lenvatinib,....

http://www.thepharmaletter.com/article/asco-2014-kicks-off-with-news-on-lenvatinib-cyramza-olaparib-and-recentin


The 2014 Annual Meeting of the American Society of Clinical Oncology (ASCO) began on Friday in Chicago, providing a platform for the release of thousands of scientific abstracts and highly anticipated cancer research news. The meeting continues through Monday June 2, but here are some highlights from the earlier sessions.
Eisai’s lenvatinib shows promise in differentiated radioiodine-resistant thyroid cancer
Results from a recent study show that the drug lenvatinib could become a new, effective treatment option for patients with differentiated thyroid cancer that is resistant to standard radioiodine (RAI) therapy. Lenvatinib (E7080), produced by Japanese drug major Eisai (TYO: 4523) is a multi-kinase inhibitor being investigated for the treatment of various types of cancer.
In this study, 392 patients with differentiated thyroid cancer that was RAI resistant and had worsened within a year received either lenvatinib or an inactive treatment called a placebo. Patients receiving the placebo were offered treatment with lenvatinib if the cancer worsened.
About 65% of the patients receiving lenvatinib had the tumors shrink, usually within the first two months of treatment. Only 3% of patients receiving the placebo had the tumors shrink. In addition, researchers found that it took about 18 months for the disease to worsen for patients who received lenvatinib, compared with about four months for those who received the placebo.
The side effects of lenvatinib include high blood pressure, diarrhea, decreased appetite, decreased weight, and nausea. About 79% of patients needed to have their doses of lenvatinib reduced due to the side effects, although the lead author noted that these patients still benefitted from the lower doses.
“We are confident that, based on our findings, lenvatinib will eventually become a standard treatment for radioiodine-resistant thyroid cancer,” said lead study author Martin Schlumberger, a professor of oncology at the University Paris Sud in Paris, France. “As little as a year ago, this group of patients had no effective treatment options. It’s remarkable that today we now have two targeted therapies that could be potential options.” The targeted therapy sorafenib (Nexavar, from Bayer) is currently the only option outside of clinical trials available for patients with this type of thyroid cancer. It was approved by the US Food and Drug Administration in 2013 and by the European Commission last week. Lenvatinib is not currently approved by the FDA.

SECOND-LINE RAMUCIRUMAB AND CHEMOTHERAPY LENGTHENS LIVES OF NSCLC PATIENTS

Results from a new study show that combining the targeted therapy ramucirumab (Cyramza) with standard chemotherapy lengthens the lives of patients with non-small cell lung cancer (NSCLC).
Cyramza is under development by US pharma major Eli Lilly (NYSE: LLY) and was approved in the USA for gastric cancer. Investment bank Cowen and Co forecast annual sales for the drug will reach $1.2 billion by 2020.
In this study, ramucirumab was combined with a current standard chemotherapy, docetaxel (Docefrez, Taxotere), as a second-line therapy, ie, after the first treatments, called first-line therapy, stop working. There are few treatments approved as second-line therapy for NSCLC, and those that are currently available do not often work very well, with patients living about seven to nine months.
The 1,253 patients who participated in this study had stage IV NSCLC that had worsened while receiving chemotherapy. They received either ramucirumab plus chemotherapy with docetaxel or an inactive treatment called a placebo plus docetaxel. Researchers found that almost 23% of patients who received ramucirumab plus docetaxel had the tumors shrink, compared with about 14% of those who received the placebo plus docetaxel. In addition, patients who received ramucirumab plus docetaxel lived about one and a half months longer than those who received the placebo plus docetaxel, ten and a half months compared with nine months.
“This is the first treatment in approximately a decade to improve the outcomes for patients in the second-line setting,” said lead study author Maurice Perol, head of Thoracic Oncology at Cancer Research Center of Lyon in France. “The survival improvement is significant because patients with advanced NSCLC typically have a very short survival time following second-line therapy,” he added,

COMBINATION OF ASTRAZENECA TARGETED THERAPIES INCREASES THE TIME TAKE FOR RECURRENT OVARIAN CANCER TO WORSEN

In a recent study, researchers found that the combination of olaparib and cediranib (Recentin) - both from Anglo-Swedish drug major AstraZeneca (LSE: AZN) - kept recurrent ovarian cancer from worsening for almost nine months longer than treatment with olaparib alone. Recurrent ovarian cancer is cancer that has come back after the initial treatment.
The current standard treatment for recurrent ovarian cancer is chemotherapy, which can cause severe side effects and may not work very well because the cancer often develops a resistance to chemotherapy, meaning that the chemotherapy that was used initially can no longer control the cancer’s growth. This is why researchers have been studying other ways to treat recurrent ovarian cancer, such as the use of olaparib and cediranib.
“The significant activity that we saw with the combination suggests that this could potentially be an effective alternative to standard chemotherapy,” said lead study author Joyce Liu, an instructor in medical oncology at Dana-Farber Cancer Institute in Boston, USA, adding: “At the same time, this approach is not yet ready for clinical practice as neither of these drugs is currently FDA approved for ovarian or any other cancer. We also need additional clinical trials to confirm the findings of this study to see how this combination compares to standard treatment.”
In a Phase III ICON 6 trial, also presented at ASCO, cediranib demonstrated significant improvements in progression free survival and overall survival in platinum sensitive relapsed ovarian cancer, when given during and after chemotherapy, compared to chemotherapy alone.
AstraZeneca has consulted with regulatory agencies in the USA and European Union to understand how the results of the ICON 6 study conducted by the UK Medical Research Council (MRC) can best support a potential regulatory submission for approval of cediranib in ovarian cancer. As a result of these interactions, AstraZeneca is working with the MRC to conduct relevant analyses of cediranib data with a view to potential regulatory submissions later this year.
Eisai, Lenvatinib, Eli Lillly, Cyramza, Ramucirumab, AstraZeneca, Olaparib, Recentin, ASCO 2014

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Thursday, May 15, 2014

Cancer Immunotherapy Method Could Be Effective Against a Wide Range of Cancers | DG News

May 14, 2014
BALTIMORE, Md -- May 14, 2014 -- A new method for using immunotherapy to specifically attack tumour cells that have mutations unique to a patient’s cancer has been developed by scientists at the National Cancer Institute (NCI), part of the National Institutes of Health (NIH).
The researchers demonstrated that the human immune system can mount a response against mutant proteins expressed by cancers that arise in epithelial cells which can line the internal and external surfaces (such as the skin) of the body. These cells give rise to many types of common cancers, such as those that develop in the digestive tract, lung, pancreas, bladder, and other areas of the body.
The research, published in the journal Science, provides evidence that this immune response can be harnessed for therapeutic benefit in patients.
“Our study deals with the central problem in human cancer immunotherapy, which is how to effectively attack common epithelial cancers,” said Steven A. Rosenberg, MD, NCI’s Center for Cancer Research, Rockville, Maryland. “The method we have developed provides a blueprint for using immunotherapy to specifically attack sporadic or driver mutations, unique to a patient’s individual cancer.”
All malignant tumours harbour genetic alterations, some of which may lead to the production of mutant proteins that are capable of triggering an antitumor immune response. Research led by Dr. Rosenberg had shown that human melanoma tumours often contain mutation-reactive immune cells called tumour-infiltrating lymphocytes (TILs). The presence of these cells may help explain the effectiveness of adoptive cell therapy (ACT) and other forms of immunotherapy in the treatment of melanoma.
In ACT, a patient’s own TILs are collected, and those with the best antitumor activity are grown in the laboratory to produce large populations that are infused into the patient. However, prior to this work it had not been clear whether the human immune system could mount an effective response against mutant proteins produced by epithelial cell cancers. These cells comprise more than 80% of all cancers. It was also not known whether such a response could be used to develop personalised immunotherapies for these cancers.
In the current study, Dr. Rosenberg and his team set out to determine whether TILs from patients with metastatic gastrointestinal cancers could recognise patient-specific mutations. They analysed TILs from a patient with bile duct cancer that had metastasised to the lung and liver and had not been responsive to standard chemotherapy. The patient, a 43-year-old woman, was enrolled in an NIH trial of ACT for patients with gastrointestinal cancers (Clinical trial number NCT01174121).
The researchers first did whole-exome sequencing, in which the protein-coding regions of DNA are analysed to identify mutations that the patient’s immune cells might recognise. Further testing showed that some of the patient’s TILs recognised a mutation in a protein called ERBB2-interacting protein (ERBB2IP). The patient then underwent adoptive cell transfer of 42.4 billion TILs, approximately 25% of which were ERBB2IP mutation-reactive T lymphocytes, which are primarily responsible for activating other cells to aid cellular immunity, followed by treatment with 4 doses of interleukin-2 to enhance T-cell proliferation and function.
Following transfer of the TILs, the patient’s metastatic lung and liver tumours stabilised. When the patient’s disease eventually progressed, after about 13 months, she was re-treated with ACT in which 95% of the transferred cells were mutation-reactive T cells, and she experienced tumour regression that was ongoing as of the last follow up (6 months after the second T-cell infusion). These results provide evidence that a T-cell response against a mutant protein can be harnessed to mediate regression of a metastatic epithelial cell cancer.
“Given that a major hurdle for the success of immunotherapies for gastrointestinal and other cancers is the apparent low frequency of tumour-reactive T cells, the strategies reported here could be used to generate a T-cell adoptive cell therapy for patients with common cancers,” said Dr. Rosenberg.
SOURCE: National Institutes of Health

Thursday, May 8, 2014

Vemurafenib Combination Effective in Advanced BRAF-Mutant Melanoma

ilas Inman
Published Online: Wednesday, May 7, 2014
     
Dr. Sandra Horning
Sandra Horning, MD
The combination of the BRAF inhibitor vemurafenib (Zelboraf) with the investigational MEK inhibitor cobimetinib (GDC-0973) demonstrated a 13.7-month median progression-free survival (PFS) and an overall response rate (ORR) of 87% in treatment-naïve patients with BRAFV600 mutation-positive metastatic melanoma, according to phase Ib results presented at the 10th European Association of Dermato Oncology Congress in Vilnius, Lithuania.

The large open-label phase Ib trial, known as BRIM7, enrolled 66 vemurafenib-refractory patients and 63 BRAF inhibitor-naïve patients with BRAFV600 mutation-positive metastatic melanoma. In the patients who progressed on vemurafenib, the median PFS was 2.8 months and the ORR was 15%. The median overall survival (OS) for the BRAF inhibitor-naïve patients had not been reached after a median 12.7-month follow-up. The 1-year survival estimate was 83%. Among vemurafenib-refractory patients, median OS was 8.3 months with an estimated 1-year survival of 32%.

The FDA approved single-agent vemurafenib in August 2011 for patients with unresectable or metastatic melanoma with the BRAFV600E mutation. This decision was based on an improvement in PFS and OS for vemurafenib compared with the chemotherapy dacarbazine. Median PFS with vemurafenib was 5.3 months compared with 1.6 months with dacarbazine. At the time of the approval, median OS was not reached for vemurafenib compared to a median of 7.9 months with dacarbazine. At 6 months, OS rate was 84% with vemurafenib compared with 64% with dacarbazine.

In 2012, Roche launched a phase III trial to compare cobimetinib in combination with vemurafenib to single-agent vemurafenib in previously untreated BRAFV600 mutation-positive patients with unresectable locally advanced or metastatic melanoma. Results from this study, labeled coBRIM, are expected later this year.

“These encouraging final data from the phase Ib BRIM7 study are an important step in understanding the potential role of combining the MEK inhibitor cobimetinib and the BRAF inhibitor Zelboraf to treat metastatic melanoma,” Sandra Horning, MD, the head of Global Product Development and chief medical officer at Roche, said in a press release. “In combining these molecules we aim to overcome resistance to BRAF inhibition and maximize potential patient benefit, and we look forward to the results of the ongoing phase III coBRIM trial.”

The primary endpoint of the BRIM7 study focused on safety, tolerability, and the identification of an optimal dose. The secondary outcome measures focused on efficacy. The study identified cobimetinib at 60 mg daily for 21 days followed by 7 days of rest with continuous vemurafenib twice daily at 960 mg as the optimal dose. This dose was used in the coBRIM study.

In the BRAF inhibitor-naïve arm of the BRIM7 study, 78% of patients experienced a partial response (PR), 10% achieved a complete response (CR), and 10% reached stable disease (disease control rate [DCR] = 97%). In patients refractory to vemurafenib, ORR was 15% and 42% of patients achieved stable disease (DCR = 57%).

Across all 129 treated patients, the most common all-grade adverse events were diarrhea (64%), non-acneiform rash (60%), fatigue (48%), nausea (45%), liver laboratory test abnormality (40%), and photosensitivity/sunburn (40%). The most frequently reported grade ≥3 adverse events were liver laboratory test abnormality (11%), cutaneous squamous cell carcinoma (9%), non-acneiform rash (8%), anemia (7%), joint pain (6%), fatigue (5%), and diarrhea (5%).

“Building on the previous data from the BRIM7 trial, these final results provide encouraging signs of clinical activity in BRAF inhibitor-naïve patients with the combination of cobimetinib and vemurafenib,” Michael M. Morrissey, PhD, president and chief executive officer of Exelixis, said in a release. “People with this disease still urgently need improved treatment options, and we look forward to the top-line data from coBRIM, the ongoing phase III pivotal trial, anticipated later this year.”

The dual inhibition of both MEK and BRAF is thought to circumvent treatment resistance that commonly occurs with single-agent therapy. Moreover, this combination is thought to reduce the incidence of secondary skin cancers associated with BRAF-targeted monotherapy.

In January 2014, the FDA approved the combination of the BRAF inhibitor dabrafenib (Tafinlar) and the MEK inhibitor trametinib (Mekinist) for patients with unresectable or metastatic melanoma who harbor a BRAF V600E or V600K mutation. This approval was based on an open-label phase I/II trial that demonstrated a 9.4-month PFS with the combination compared with 5.8 months for dabrafenib alone. This combination is being explored in phase III studies.
- See more at: http://www.onclive.com/web-exclusives/Vemurafenib-Combination-Effective-in-Advanced-BRAF-Mutant-Melanoma#sthash.UrzFbZRz.dpuf