United Kingdom Reveals DNA Testing For Individualized Treatment Of Cancer

This testing is a wonderful development because it focuses on the DNA of cancer patients which allows treatment to be personalized instead of treating everyone the same way depending on their diagnosis.


Health Secretary Andrew Lansley unveiled plans to give more cancer patients access to tests that screen their DNA.
The aim is to make the most of recent advances that enable cancer treatments to be tailored to individuals.
Increasingly, targeted drugs are being developed that work in small sub-groups of patients with specific genetic profiles. Future genetic tests will also show if a patient is more likely to respond to one treatment or another.

Mr Lansley said: "The new developments can help patients to get the best treatments to improve their chances of survival and their quality of life. We want to make sure that all patients can benefit from these tests - as soon as the tests are recommended by Nice (National Institute for health and Clinical Excellence). We have therefore been working to establish a new system to ensure speedy introduction of high quality tests. This is the way forward for the future."

For more information:  http://www.google.com/hostednews/ukpress/article/ALeqM5i-DSigwZkCOwNI32CB6h-inucDfg?docId=N0127971327500789606A

Waldenstrom Macroglobulinemia, A Rare and Complicated Disease

WM is a rare disorder with an incidence of approximately three per million people per year with 1400 new cases diagnosed in the United States each year . The median age at diagnosis is 64 years; less than 1 percent of patients are under 40 years of age, and approximately 60 percent are males. WM is much more common in Caucasians than in other ethnic groups . Specifically, it is uncommon in Blacks and those of Mexican descent who make up approximately 5 percent of cases.
The majority of patients with the histopathologic finding of lymphoplasmacytic lymphoma (LPL) have a circulating monoclonal IgM consistent with the diagnosis of WM. In the past, LPL and WM have been arbitrarily differentiated from each other based on the level of the monoclonal IgM protein. Currently, the preferred terminology in cases of LPL with circulating monoclonal IgM is WM, rather than lymphoplasmacytic lymphoma, regardless of the size of the monoclonal IgM protein.

Waldenström macroglobulinemia, one of the malignant monoclonal gammopathies, is a chronic, indolent, lymphoproliferative disorder.It is characterized by the presence of a high level of a macroglobulin (immunoglobulin M [IgM]), elevated serum viscosity, and the presence of a lymphoplasmacytic infiltrate in the bone marrow. (See Pathophysiology, Etiology, and Workup.)
A clonal disease of B lymphocytes, Waldenström macroglobulinemia is considered to be a lymphoplasmacytic lymphoma, as defined by the Revised European American Lymphoma Classification (REAL) and World Health Organization (WHO) classification.
The clinical manifestations of Waldenström macroglobulinemia result from the presence of the IgM paraprotein and malignant lymphoplasmacytic cell infiltration of the bone marrow and other tissue sites. The clinical presentation is similar to that of multiple myeloma except that organomegaly is common in Waldenström macroglobulinemia and is uncommon in multiple myeloma and  lytic bony disease and renal disease are uncommon in Waldenström macroglobulinemia but are common in multiple myeloma. (See Pathophysiology, Presentation, and Workup.)

Complications

Complications of Waldenström macroglobulinemia include the following:

• Hyperviscosity syndrome
• Visual disturbances secondary to hyperviscosity syndrome
• Diarrhea and malabsorption secondary to gastrointestinal (GI) involvement
• Renal disease (less common)
• Amyloidosis of the heart, kidney, liver, lungs, and joints
• Bleeding manifestations secondary to platelet dysfunction and coagulation factor and fibrinogen abnormalities due to interaction with  plasma IgM
• Raynaud phenomenon secondary to cryoglobulinemia
• Increased predisposition to infection due to B-cell dysfunction (disease related) or T-cell dysfunction (therapy related, particularly after nucleoside analogues)
• Cardiac failure
• Increased incidence of lymphomas, myelodysplasia, and leukemias
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  Initially this disease may look like Multiple Myeloma, but one can see that extensive testing is required for diagnosis. Of course, a bone marrow biopsy is important so the pathologist can look for abnormalities in the bone marrow tissue.
   

  Blood counts

  The complete blood count (CBC) is a test that measures the levels of red cells, white cells, and platelets in the blood. If the lymphoma cells occupy too much of the bone marrow, these levels will be low.
  

  Quantitative immunoglobulins

  This test measures the blood levels of the different antibodies. There are several different types of antibodies in the blood: IgA, IgE, IgG, and IgM. The levels of these immunoglobulins are measured to see if any are abnormally high or low. In WM the level of IgM is high but the IgG level is often low.
  

  Electrophoresis

  The immunoglobulin produced in WM (IgM) is abnormal because it is monoclonal -- meaning that it is just many copies of the exact same antibody. Serum protein electrophoresis (SPEP) is a test that measures the total amount of immunoglobulins in the blood and finds any abnormal (monoclonal) immunoglobulin. Then, another test, such as immunofixation or immunoelectrophoresis, is used to determine the type of antibody that is abnormal (IgM or some other type). Finding a monoclonal IgM immunoglobulin in the blood is necessary to make a diagnosis of WM. The abnormal protein in WM is known by several different names, including monoclonal immunoglobulin M, IgM protein, IgM spike, IgM paraprotein, and M-spike. Other types of monoclonal immunoglobulins, like IgA or IgG, are seen in different disorders (like multiple myeloma and some lymphomas).
  Sometimes pieces of the IgM protein are excreted by the kidneys into the urine. The procedure used for finding a monoclonal immunoglobulin in the urine is called urine protein electrophoresis (UPEP).
  

  Viscosity

  Viscosity measures how thick the blood is. If the IgM level is too high, it will cause the blood to become thick (viscous) so that it can't flow freely. Think about pouring honey compared to pouring water. If the blood becomes too thick, the brain doesn't get enough blood and oxygen. This can be treated with plasmapheresis (see below).
  

  Cryocrit

  This tests the blood for a cryoglobulin (a protein that causes the blood to clump together in cool temperatures).
  

  Beta-2-microglobulin

  This is another protein produced by the malignant lymphoplasmacytoid cells. This protein itself doesn't cause any problems, but it is a useful indicator of a patient’s prognosis (outlook). High levels mean a poor outlook.
  
  WM is a rare disorder with an incidence of approximately three per million people per year with 1400 new cases diagnosed in the United States each year. The median age at diagnosis is 64 years; less than 1 percent of patients are under 40 years of age, and approximately 60 percent are males . WM is much more common in Caucasians than in other ethnic groups . Specifically, it is uncommon in Blacks and those of Mexican descent who make up approximately 5 percent of cases .
  The majority of patients with the histopathologic finding of lymphoplasmacytic lymphoma (LPL) have a circulating monoclonal IgM consistent with the diagnosis of WM. In the past, LPL and WM have been arbitrarily differentiated from each other based on the level of the monoclonal IgM protein. Currently, the preferred terminology in cases of LPL with circulating monoclonal IgM is WM, rather than lymphoplasmacytic lymphoma, regardless of the size of the monoclonal IgM protein.
  
  
  
• For more information:  www.medscape.com, www.uptodate.com, www.cancer.org
  
  
  
  
  
  
  
  
  
   
   

Good News In The Advancement of A Breast Cancer Vaccine

Over the past few years scientists have worked on a vaccine to help breast cancer patients. This new E75 vaccine that is in the final phases of clinical trials. Through the testing it has shown that women injected with E75, who have experienced the trauma of breast cancer, prevented recurrence in 50% of the patients. U.S. Army Col. George Peoples, chief of surgical oncology, at San Antonio Military Medical Center is the developer of this vaccine.
This is what Peoples has said in a recent interview:
"What I have been the most interested in doing in how to engage the engage the patients immune response, to help the patient's immune system to fight off the cancer,” said Col. George Peoples, a cancer surgeon and director of SAMMC's cancer vaccine development program, who's leading the study.
Like any vaccine, E75 primes the immune system to recognize a target — in this case a substance called human epidermal growth factor receptor 2, or HER2. Most breast cancers produce some level of HER2, which fuels their growth.
And most breast cancer patients are tested for HER2, because those with the highest levels — about 20 percent of patients — can be helped by a drug called Herceptin.
But E75 seems to work best in patients who produce low to medium levels of HER2 — a group that makes up maybe 60 percent of breast cancer patients, and who usually aren't eligible for Herceptin.
Peoples has been studying different parts of the HER2 protein as potential vaccine targets since 1995, first as a civilian and then after a return to Army medicine at Walter Reed Army Medical Center and SAMMC.

“Within the first year or two of starting that trial, we could tell there was a benefit because the control arm (the comparison group that didn't get the real vaccine) started having recurrences, and the vaccine group was not,” Peoples said.
“The promise of cancer vaccines for many years has been solely a promise,” said Dr. Kim Lyerly, director of the Duke Comprehensive Cancer Center in Durham, N.C., and a scientific adviser to Susan G. Komen for the Cure. “Our understanding of what it takes to mount an immune-system response and to create a vaccine is getting better and better. So that's why this (E75) study, based on really solid Phase 2 data, is very exciting.”
Most experimental drugs and vaccines are first tested in very sick people. Peoples focused instead on healthy women — those successfully treated but at high risk of seeing their cancers return.
“The whole point of the vaccine is to engage the host immune system to get an immune response against a cancer,” Peoples said. “Well, an end-stage patient's immune system is not healthy.”
Early studies also showed the vaccine's protection waned over time. It was a group of Peoples' own patient volunteers who insisted he include a booster shot in the trial. He agreed, adding booster shots at six-month intervals that have kept immunity strong.
“It was breast cancer advocacy at its best,” Peoples said. “They came to me as a group and said, with every other vaccine we know of you have to get a booster inoculation. Why aren't we? I said, it's not part of the trial. They said, make a part.”
If the current study confirms the vaccine is effective in preventing a recurrence of cancer, the next question would be if it can prevent the disease in the first place.
“Eventually if we can prove that a vaccine can work in that situation, then hopefully during my lifetime we will go and do a true prevention trial,” he said.
And HER2 isn't only found in breast cancer. Other tumors, including prostate, ovarian and colon also produce medium amounts."

Read more: http://www.mysanantonio.com/news/local_news/article/E75-vaccine-s-final-tests-start-in-S-A-2653101.php#ixzz1k77aXtqo

Colon Cancer -New Patient Friendly Testing

Dr. David Ahlquist explains in detail about the new DNA testing from a person's stool and does not require any preparation .  The ultimate plus is that because this new testing is such patient friendly that many lives will be saved.

                                              David M. Martin - Colon Cancer


Mayo clinic and Exact Science of Madison ,WI have collaborated together to develop a highly accurate and sensitive DNA test that will  in detecting pre-cancerous tumors in the colon and the early stages of cancer.
 Go to the following link to watch Dr. David Ahlquist on video.
http://www.youtube.com/watch?v=c6x1tQeoX5A&feature=player_embedded

Also you can read more at http://newsblog.mayoclinic.org/

New Diagnostic Biological Cancer Treatment

Two reputable research and medical companies have joined together to develop molecular companion diagnostic intended to identify patients patients most likely to benefit from Bayer antibody-drug conjugate (ADC). Ventana,the other company, diagnostic immunohistochemistry platform aims to analyze the expression level of certain tumor targets serving as biomarkers in clinical trials for patient selection.  This is why it is important to participate in clinical trials. Roche,another company, is committed to personalize healthcare in the field of oncology treatment.

At Ventana our mission is to improve the lives of all patients afflicted with cancer," said Mara G. Aspinall, President of Ventana Medical Systems, Inc. "We are pleased to be Bayer's partner of choice to facilitate the worldwide development of this ADC. As new biomarkers and diagnostic tests become increasingly available, they provide valuable information about potential positive recipients for these novel agents. Translating excellence in science into effective, targeted treatments for patients is at the core of Roche's scientific vision for 'Personalised Healthcare' (PHC), and it is our highest priority now and into the future."

"We are very excited to partner with Ventana to develop a companion diagnostic for one of our ADC projects," said Prof. Dr. Andreas Busch, Head of Global Drug Discovery and Member of the Executive Committee of Bayer HealthCare. "This constitutes another step for Bayer towards personalized medicine in cancer treatment as the selection of patients most likely to benefit from an ADC will increase the overall probability of therapeutic success for patients suffering from cancer." 

About Antibody-drug conjugates (ADCs)Antibody conjugation to potent cytotoxic drugs is a promising way to increase efficacy and reduce systemic toxicity of drugs by targeting them selectively to tumor tissue. The antibody-drug conjugates (ADCs) are comprised of three distinctive features: an antibody, a cytotoxic drug (toxophore) and a linker, which give ADCs their characteristic properties. The monoclonal antibody is able to recognize surface proteins selectively over-expressed on cancer cells. This targeting ability allows the ADCs to deliver its cytotoxic payload, the toxophore, right into the tumor. Here, after internalization and release, the toxophore interferes with intracellular processes leading to the programmed death of the tumor cells. The linkers are designed to keep the toxic agent attached to the antibody until the target cancer cell is reached. The targeted nature of ADCs to specific tumor surface proteins or antigens make them good candidates for co-development with the VENTANA immunohistochemistry-based companion diagnostic assays that measure those antigens.  

For more information: www.marketwatch.com

Researchers Find A Familal Genetic Mutation in Prostate Cancer

Genetic testing for predisposition to certain cancers has really advanced in the past few years. The most popular genetic testing is for breast cancer called BRAC testing.  Now the cancer that targets men which is prostate cancer can result of a gene mutation. Some men with prostate cancer have a strong hereditary predisposition due to the gene mutation.
Men with prostate cancer were 20.1 times more likely than controls (P=8.5×10⁻⁷) to carry a mutation in HOXB13, which plays a key role in prostate development, Kathleen A. Cooney, MD, of the University of Michigan in Ann Arbor, and colleagues found.
The HOXB13 G84E mutation was significantly more common in early-onset, familial prostate cancer than in cases that developed later in life in men without a strong family history of the disease (3.1% versus 0.6%, P=0.000002).
The mutation won't explain many prostate cancer cases but is a good start, the group noted in the Jan. 12 issue of the New England Journal of Medicine.
"Although the variant accounts for a small fraction of all prostate cancers, this finding has implications for prostate-cancer risk assessment and may provide new mechanistic insights into this common cancer," they wrote.
Men whose family has a history of prostate cancer can now be tested for the gene mutation. When the kit becomes available one need to see the cost and if insurance will pay for the testing.

For more inforamtion: www.medpagetoday.com

Pathwork Tissue Origin Test Helps Prolongs Life Of Lung Cancer Patients

The Pathwork Tissue of Origin Test is the only FDA-cleared, Medicare-covered molecular diagnostic for identifying tissue of origin. It uses a tumor’s own genomic information to help pathologists and oncologists diagnose challenging cancer cases such as those that are metastatic or that have a complex clinical history.
“The Tissue of Origin Test significantly altered clinical practice patterns for treating metastatic cancer,” explained John Hornberger, M.D., M.S., CEO/President of Cedar Associates LLC and Principal Investigator of the study. “We saw an increase in overall survival and quality-adjusted life years, resulting in an expected cost per QALY of less than $50,000 per patient, which is within the generally accepted threshold of <$100,000 for cost-effectiveness in the United States.”^1,2

The Pathwork Tissue of Origin Test, available through the Pathwork Diagnostics Laboratory, measures gene expression levels of 2,000 genes and uses proprietary algorithms to compare the tumor’s gene expression pattern to that of 15 tumor types, representing 58 morphologies and 90% of all solid tumors. The test provides objective genomic information to help the physician diagnose what type of cancer the patient has. An accurate diagnosis allows oncologists to match therapy to the cancer.
The Pathwork Tissue of Origin Test has been extensively evaluated in multiple independent studies involving more than 1,100 patient specimens, including large validation studies published in the Journal of Clinical Oncology and the Journal of Molecular Diagnostics.
A retrospective study of 111 cases from 66 academic and community oncology practices illustrates the use of the test in management of cancer patients. Over two thirds of the cases reviewed showed cancer management changed after the Pathwork Tissue of Origin Test result was received. The majority of the oncologists identified the Tissue of Origin Test results as influencing the decision to make a change in therapy.

For more information:  
http://www.genengnews.com/industry-updates/pathwork-tissue-of-origin-test-cost-effective-for-increasing-cancer-patient-survival/139175622/