Pic Of The Day

Posted by rob on under Uncategorized | Be the First to Comment

Two Russian policemen guard the desolate Red Square with St. Basil Cathedral in the background, as heavy snowfall hit the Russian capital.

Pic Of The Day

Posted by rob on January 27, 2005 under Uncategorized | Be the First to Comment

A Thai visitor looks at the descending sun on the devastated Khao Lak beach.

Proteomic analysis of nuclear matrix proteins during arsenic trioxide induced apoptosis in leukemia K562 cells.

Posted by rob on under Uncategorized | Be the First to Comment

http://www.hubmed.org/display.cgi?issn=03666999;uids=15667793

Selective effect of imatinib on serum IgM in a patient with CML.

Posted by rob on under Uncategorized | Be the First to Comment

No abstract yet

http://www.hubmed.org/display.cgi?issn=09255710;uids=15615266

Pic Of The Day

Posted by rob on January 26, 2005 under Uncategorized | Be the First to Comment

Alexandra Kauc and Michal Zych of Poland perform in the Ice Dancing compulsory dance competition at the European Figure Skating Championships in Turin.

Synergistic interactions between imatinib and the novel phosphoinositide-dependent kinase-1 inhibitor OSU-03012 in overcoming imatinib resistance.

Posted by rob on under Uncategorized | Be the First to Comment

http://www.hubmed.org/display.cgi?issn=00064971;uids=15665113

AMN107 and BMS-354825 Trials

Posted by rob on under Uncategorized | Be the First to Comment

Drugs for leukaemia on trial

LOH FOON FONG attended a haematology meeting in San Diego, the United States, recently and gives an update on treatment for chronic myeloid leukaemia.  

TWO drugs â?? codenamed AMN107 and BMS-354825 â?? will be moving into Phase II trials on patients who do not respond to higher doses of, or are intolerant to, imatinib mesylate (IM), the drug in current use to treat myeloid leukaemia, a type of blood cancer.  

Encouraging results of both drugs from Phase I trials were reported during the 46th Annual Meeting of the American Society of Hematology in San Diego, the United States, recently. 

Dr Francis Giles

Patients in the chronic phase of chronic myeloid leukaemia (CML) who did not react to IM were said to have responded well to the new drugs. â??We hope that the AMN107 drug has less resistance problem than the IM,â? said Dr Francis Giles, chief of developmental therapeutics from the MD Anderson Cancer Centre in Houston, Texas.  

â??We have a molecule that is more potent, binds more tightly and should be less vulnerable to mutations, and hopefully a better toxicity profile. So far what we have from the Phase 1 study is some marrow toxicity but interestingly the only marrow toxicity we have was transient to people who went on to respond to the treatment,â? he said. 

There were also some skin rashes that did not go away with any drug and some changes in the liver which went away even when patients continued the drug at the same dosage, he said. The researchers are working on defining the dosage toxic limit, he said. 

When IM was discovered five years ago, it was a major breakthrough in leukaemia treatment because it targeted specific proteins in cancer cells and stopped them from growing without killing the normal cells like traditional treatment did. 

The results from IM, or also commonly called Imatinib, were so significant that the drug was quickly introduced to the world. IM is now recognised as the main standard treatment for CML patients and offers more than 90% survival in newly-diagnosed patients. Interferon alpha was previously considered the standard treatment for this group of patients. 

CML is a cancer that starts in the bone marrow and invades the blood. The incidence of CML is 1.6 per 100,000 per year. The American Cancer Society estimates that 4,600 cases will be diagnosed in the United States this year. It usually occurs among middle-aged adults, mostly among 50-year-olds. 

Dr Jorges Cortes

About 95% of CML patients have a genetic abnormality called the Philadelphia (Ph+) chromosome. The chromosome produces an abnormal enzyme Bcr-Abl tyrosine kinase that blocks the normal signal that tells the body to stop producing white blood cells. As such, there is a proliferation of white blood cells. IM is a relatively selective inhibitor of the abnormal enzyme. 

Despite the breakthrough, the disease in a small number of chronic phase CML patients continues to deteriorate and patients in worse stages, accelerated and blast phases of CML, have a poorer prognosis and higher IM resistance rates. 

Close to 80% of patients who are treated with IM as the first line therapy on the standard 400gm dose achieve a complete cytogenic response (the disease is no longer detected in the genes), said Dr Jorge Cortes, the scientist from the MD Anderson Cancer Centre in a press briefing on Five years of Imatinib: Lessons Learned in CML Treatment Strategy organised by Novartis Corporation (Malaysia).  

After three years, over 90% of them are still sustaining the cytogenic response and the molecular response rate continues to improve, he said. 

â??It clearly changed the way we manage patients. We have gone from an era of trying to control the manifestation of the disease to trying to achieve cytogenic responses, which we had learned from the use of interferon. Now we are trying to achieve molecular responses,â? he said. 

In CML, improvement in molecular response means the reduction in quantities of Bcr-Abl while a complete molecular response means the Bcr-Abl levels are undetectable. 

Australian data has indicated that more patients are getting into complete molecular response after four years. If they achieve a good response, especially if it is cytogenic within 12 months and molecular by 12 months, their survival rate is good, said Dr Cortes. 

â??But what happens after 10 years, we donâ??t know. Four or five years is remarkable considering anything we had in the past,â? he said. 

Dr Oliver Ottmann.

â??There is a new method our (American) group and the Australian team are looking at â?? higher doses of IM and trying to improve on the early responses to get more durable responses. We are seeing more early responses,â? he said. 

Dr Oliver Ottmann, study coordinator and head of the Experimental Haematology at the Johann Wolfgang Goethe University, Frankfurt, Germany, said combination therapy would be the future direction of leukaemia treatment: IM can be combined with non-targeted conventional therapy or two intelligent agents can be combined together.  

Since IM was introduced, transplantation has taken a back seat. What is the role of transplantation today? 

Although it can cure patients, the number of transplants carried out on CML patients has decreased, said Dr Cortes. 

â??Patients are reluctant to go for a transplant because of the mortality risk. But for young patients, transplant will still be an option,â? he said. 

The problem with transplantation is that patients can have a relapse 10-15 years after the transplant, he said. â??Since medical treatment has become more defined, hopefully, we will develop transplantation into a more defined therapy,â? he said.  

Dr Ottmann said the transplant method when combined with IM has worked in some elderly patients, who usually cannot tolerate the method. 

The greatest challenge with mutations for IM and the two new drugs being researched is with one particular mutation known as T315I. 

â??In IM-treated patients, all of the common mutations except T315I appear to be highly sensitive to IM,â? said Dr Giles. â??At this stage, we are highly suspicious based on the pre-clinical data that the T3151 may be particularly resistant. We canâ??t say it clinically yet although I suspect it would be true,â? he said adding that less than 10% of patients have the mutations. 

â??However, we do not have to worry about mutations if there is no disease. These mutations need time to develop. If we can eliminate them, it will not be a long-term issue,â? he said. 

Dr Nicholas Choong, oncologist and haematologist at the University of Chicago, said the challenge with IM, ANM107 and BMS-354825 is that they might block the signal of the receptors on normal cells, and stop the receptors from conveying messages to the chromosomes for certain genes to be expressed. The implications are that normal blood cells with the receptors can be affected and platelets level can fall and patients become anaemic or have their white blood count wiped out and patients become susceptible to infections, he said. As such, doctors will have to find the right dosage for each patient so that the normal cells are not affected, he said. 

Dr Choong added that the AMN and BMS are promising drugs for a difficult disease but further studies need to be done for the toxicity. â??In the first phase BMS study, patients had irregular heart beats. They may or may not be related to the toxicity. Itâ??s too early to say. They are better defined in larger clinical trials,â? he said. 

IM is also being tested for treating other cancers. Now more than 150 clinical trials are evaluating IM in certain forms of prostate, lung and brain cancers, and blood diseases. 

http://thestar.com.my/lifestyle/story.asp?file=/2005/1/26/features/9648305&sec=features

Program Introduces New Tool That Helps Identify Older Patients’ Capacity To Benefit From, Tolerate Cancer Treatment

Posted by rob on January 25, 2005 under Uncategorized | Be the First to Comment

Program Introduces New Tool That Helps Identify Older Patients’ Capacity
                  To Benefit From, Tolerate Cancer Treatment

    WHITE PLAINS, N.Y., Jan. 25 /PRNewswire/ — The Leukemia & Lymphoma
Society announced today the launch of a pilot program, “Breaking Through the
Age Barrier.”  The launch coincides with the Society’s release of a toolkit
for older patients and their caregivers.  The pilot program, for patients and
healthcare professionals, aims to encourage older blood cancer patients to get
the best possible care and equip their medical team with tools to make
treatment decisions.  At the core of the project is the Geriatric Assessment
which helps providers recognize who will benefit from treatment who may have
special needs that need to be addressed during treatment.  A Comprehensive
Geriatric Assessment checklist, which evaluates an individual’s physical and
emotional capacity to undergo and tolerate cancer treatment and its side
effects, includes simple forms to fill out as well as physical and laboratory
tests.
    “Older patients may need special attention when it comes to cancer
treatment,” says Robin Kornhaber, the Society’s Senior Vice President of
Patient Services.  “But the concept of being too old for cancer treatment is
outdated.”  More than half of all cancers occur in people older than 65 years
and they appear to benefit from treatment to the same extent as younger
individuals.

    Six-Chapter Pilot Program Introduces Geriatric Assessment
    The Society’s pilot program will be introduced this spring in Detroit,
Mich., Palm Beach, Fla., Northern New Jersey, Upstate New York, Baltimore,
Md., and Orange, Riverside, San Bernardino, Calif.  Next year, the Society
expects the program to be offered at each of its 63 chapter sites across the
U.S.  At the pilot sites this year, the Society will hold workshops for older
patients to familiarize them with advocacy, communication and emotional
aspects of battling blood cancer.
    The Society will also introduce the Comprehensive Geriatric Assessment
checklist (CGA) to elderly patients.  Health care professionals review CGA
criteria with patients to assess how much an older adult might benefit from
cancer treatment and how well he or she would be likely to tolerate it.  The
CGA is also useful in identifying problems that can be remedied (such as poor
nutrition), making cancer treatment safer for the individual.
    By familiarizing elderly patients with this tool, the Society hopes
patients will fully participate in this evaluation and even ask for such an
assessment if one is not offered.  This provides patients the opportunity to
proactively engage in treatment decisions and also helps patients recognize
the impact their general health, independence and emotional well-being may
have on the success of their cancer treatment.
    The CGA looks at a person’s ability to carry out day-to-day activities
independently (called functional status), the presence of other illnesses,
living conditions and support, thinking and mood, other medications taken,
nutrition and so-called geriatric syndromes.

    Age Not a Barrier to Treatment
    “Age alone is not enough to identify a patient’s chances to benefit from
cancer treatment,” said Lodovico Balducci, M.D., program leader of the Senior
Adult Oncology Program at the H. Lee Moffitt Cancer Center and Research
Institute in Tampa.  “One 75-year-old can be perfectly healthy with no other
illnesses and be very independent and capable, while another may be struggling
with other ailments and be completely dependent.  Health care professionals
who conduct a CGA with patients will get a more complete picture, and
patients, in turn, when educated about the value of the CGA will find it more
palatable and will likely be more engaged in their health care.”

    Without such an assessment, it is not unusual for an older patient to be
turned away from a clinical trial (a controlled test of a new drug or medical
device in humans) based on age or for a clinician to take a less-aggressive
treatment tact with an elderly patient.  When John Rowe of Washington, D.C.,
was diagnosed with chronic myelogenous leukemia in 2000, he was initially
rattled, but quickly optimistic.  He was 62 and in good health when the
diagnosis came.  He had heard about a new experimental drug (now marketed as
Gleevec) in clinical trials and was going to see a 35-yr-old ‘whiz kid’
oncologist.  The ‘whiz kid,’ however, consulted a statistical table, told Rowe
that, at 62, he probably had between one and four years left, should get his
affairs in order and the doctor would keep him comfortable until the end came.
Rowe quickly collected his own patient records, ceased his relationship with
the whiz kid, investigated the clinical trials on his own and was enrolled.
He’s been on Gleevec for four years and was in remission six months after
starting on the drug.

    Toolkit for Older Adults and Their Caregivers
    In addition, The Leukemia & Lymphoma Society has published “A Toolkit for
Older Adults with Cancer, and Their Caregivers.”  The brochure series includes
pamphlets on choosing a healthcare team, understanding treatment options and
clinical trials, money matters and a caregiver’s guide.  The brochure series,
which is available free, can be obtained by calling The Leukemia & Lymphoma
Society’s Information Resource Center (IRC) at 1-800-955-4572.  For
information about the Breaking Through the Age Barrier pilot program and when
it will be offered, patients are encouraged to call their local chapters.

    About The Leukemia & Lymphoma Society
    The Society, headquartered in White Plains, NY, with 63 chapters in the
United States and additional branches in Canada, is the world’s largest
voluntary health organization dedicated to funding blood cancer research and
providing education and patient services. The Society’s mission: Cure
leukemia, lymphoma, Hodgkin’s disease and myeloma, and improve the quality of
life of patients and their families. Since its founding in 1949, the Society
has invested more than $360 million in research specifically targeting
leukemia, lymphoma and myeloma. Last year alone, the Society made more than
812,000 contacts with patients, caregivers and healthcare professionals.

    For more information about blood cancer, visit http://www.LLS.org or call
the Society’s Information Resource Center (IRC), a call center staffed by
master’s level social workers, nurses and health educators who provide
information, support and resources to patients and their families and
caregivers. IRC information specialists are available at (800) 955-4572,
Monday through Friday, 9 a.m. to 6 p.m. ET.

http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=109&STORY=/www/story/01-25-2005/0002901885&EDATE=

Pic Of The Day

Posted by rob on under Uncategorized | Be the First to Comment

An Indian family of tsunami survivors are sillhouetted against the setting sun as they return to their shelter with their belongings in Nagapattinam District