Lung Cancer Personalized Treatment

The new direction of cancer treatment is becoming personalized to the characteristics of individual patients. Instead of treating specific cancers the same way for all patients researchers are focusing on the characteristic's of each patient and their tumors.
These new ways of treatment was presented at the Third European Lung Cancer Conference in Geneva.

A major goal of lung cancer treatment is to tailor the treatment to the individual," says Dr Fiona Blackhall from The Christie NHS Foundation Trust in Manchester, UK. "The studies that will be presented at ELCC 2012 are important practical steps to achieving this in the clinic. Methods ranging from convenient blood-based molecular tests, detailed genetic analysis of tumors and functional imaging techniques have been applied in patient populations receiving a range of treatments. These findings provide impetus to continue developing a personalized medicine approach to lung cancer with the overall aim of selecting the most effective treatment for the individual."


Proteins provide clues to outcomes

An international group of researchers report promising results with a test that may identify patients likely to benefit from first-line therapy with a particular drug combination.
Dr Oliver Gautschi from the Swiss Group for Clinical Cancer Research (SAKK), and collaborators from The Netherlands and the US company developing the test, conducted a retrospective analysis of two phase-II trials with a serum proteomic classifier called VeriStrat-. Their aim was to evaluate the prognostic value of the test in patients with advanced non-small cell lung cancer receiving first-line treatment with bevacizumab and erlotinib.
VeriStrat- uses mass spectrometry to measure proteins in pre-treatment blood and assigns a result that correlates with outcome from treatment with a class of drugs known as EGFR inhibitors, which includes erlotinib and gefitinib. The test was initially developed and validated in patients who had already been treated with chemotherapy, and who then received an EGFR inhibitor in second line, Dr Gautschi explains.
"We conducted this project to see if the test is also prognostic in untreated patients who received an EGFR inhibitor in the first line. Until now, this has not been clear."
The researchers used VeriStrat- to analyze blood samples from 117 patients previously enrolled in two phase II trials and compared the results to the patients' progression-free survival and overall survival. The analysis showed that those classified by the test as likely to have better outcomes on EGFR inhibitor therapy did indeed live longer.
"The difference in overall survival between patients classified by the test as likely to have better or worse outcomes when receiving EGFR inhibitors was clinically relevant," Dr Gautschi said. However he noted that definitive conclusions about the use of this test in previously untreated patients requires further studies.
"There is an unmet need for reliable blood-based markers in patients with lung cancer, because lung tumors are harder to biopsy than breast tumours for example. The current study indicates that modern technologies, such as proteomics, are promising tools, which need further validation in large trials," he said. In this context, the European Thoracic Oncology Platform (ETOP) is currently launching a prospective phase-III trial to futher validate this test in patients with lung cancer.

                                            Gene Based Lung Cancer Treatment

For more information:
http://www.news-medical.net/news/20120419/New-studies-on-personalized-lung-cancer-treatment-presented-at-3rd-ELCC.aspx

The Scripps Research Institute Developing New Blood Test To Detect Certain Cancer Cells

This new test will be able to detect certain cancer cells before they spread. The blood test by Scripps Research would find cells not seen with biopsy.

"It's very exciting," said Dr. Kelly Bethel, a pathologist with the Scripps Clinical Group.  Right now the tissue of lung and breast are obtained through biopsy samples.  This procedure can be painful for patients.

Angel O'Brien knows that pain all too well. She is currently undergoing treatment for breast cancer and received both a biopsy of the breast and her lymph nodes for testing.

"It was a very quick process," O'Brien said. "When they do it, it's just a little injection, very quick. But the lymph node was quite tender and that one hurt."The blood test would find cells not normally seen with a biopsy. Researchers explained that sometimes cancer cells escape from the main tumor, flow through the blood and spread."They're just too elusive. You can't catch them. You can't capture them," said Bethel.Doctors were not able to detect those runaway cells in tissue cancers until now.

"Every time you come to the doctor or every time you get a new therapy … we can check and see what's going on," Bethel said.
"A primary biopsy is a very invasive procedure, whereas a blood sample is something that you can get very easily and it's not just easy, you can take it again and again and again," said Peter Kuhn, a Scripps Research professor of cell biology.O'Brien is hopeful about a blood test to watch her health."I think it's wonderful ... I think every step they make it puts another piece of the puzzle," O'Brien said.Kuhn said the blood test could reach final approval in the next couple of years.

 

Kaposi Sarcoma

Kaposi sarcoma is a tumor caused by Human herpesvirus 8.  It has been known widely as the Aids defining illness in the 1980's.  Persons with a severely weakened immune system are easily susceptible to this sarcoma.

                                                     Kaposi Sarcoma on skin

                                                        Kaposi Sarcoma of the mouth


The viral cause for this cancer was discovered in 1994.  There is widespread lack of awareness of this even among persons at risk for KSHV/HHV-8 infection. 
It was originally described by Moritz Kaposi (KA-po-she), a Hungarian dermatologist practicing at the University of Vienna 1872.
Since Moritz Kaposi first described this malignant neoplasm, the disease has been reported in five separate clinical settings, with different presentations, epidemiology, and prognoses

1. Classic Kaposi Sarcoma
2. African cutaneous Kaposi sarcoma
3. African lymphadenopathic Kaposi sarcoma
4. AIDS-associated Kaposi sarcoma
5. Immunosuppression-associated Kaposi sarcoma


KS lesions are nodules or blotches that may be red, purple, brown, or black, and are usually papular (i.e., palpable or raised).
They are typically found on the skin, but spread elsewhere is common, especially the mouth, gastrointestinal tract and respiratory tract. Growth can range from very slow to explosively fast, and is associated with significant mortality and morbidity.

Blood tests to detect antibodies against KSHV have been developed and can be used to determine whether a patient is at risk for transmitting infection to their sexual partner, or whether an organ is infected prior to transplantation. However, these tests are not available except as research tools, and, thus, there is little screening for persons at risk for becoming infected with KSHV, such as transplant patients.

If you have been diagnosed with KSHV by biopsy and the tissue is prepared by a histologist and read under the microscope by a pathologists.  CD4 and viral loads are performed on blood samples.

CD4 cells are a type of lymphocyte (white blood cell). They are an important part of the immune system. CD4 cells are sometimes called T-cells. There are two main types of CD4 cells. T-4 cells, also called CD4+, are "helper" cells. They lead the attack against infections. T-8 cells (CD8+) are "suppressor" cells that end the immune response. CD8 cells can also be "killer" cells that kill cancer cells and cells infected with a virus.
Researchers can tell these cells apart by specific proteins on the cell surface. A T-4 cell is a T-cell with CD4 molecules on its surface. This type of T-cell is also called "CD4 positive," or CD4.

The viral load test is a quantitative measurement of HIV nucleic acid (RNA) that provides important information that is used in conjunction with the CD4 cell count:

• to monitor the status of HIV disease,
• to guide recommendations for therapy, and
• to predict the future course of HIV.

Evidence shows that keeping the viral load levels as low as possible for as long as possible decreases the complications of HIV disease, slows the progression from HIV infection to AIDS, and prolongs life.
There are several methods for testing viral load; results are not interchangeable so it is important that the same method be used each time.

you have Kaposi's sarcoma, your doctor will try to determine how far it has spread by examining you and asking you several questions:

• Do you have a cough, or are you short of breath? (This could indicate that the cancer has reached the lungs.)
  
• Do your legs swell up? (This suggests the cancer has reached lymph nodes.)
  
• Do you experience nausea, vomiting, or abdominal pain? Do you have blood in your stool? (This suggests the cancer is affecting the gastrointestinal tract.)
  

Expected Duration

There is no cure for Kaposi's sarcoma. It is a lifelong condition. However, the symptoms will improve with treatment (such as HAART for people with HIV/AIDS.)

http://www.drugs.com/health-guide/kaposi-s-sarcoma.html or   http://www.wikipedia.org

Skin Cancer; What You Need to Know To Save Your Life Video

This is an educational video that shows what skin looks like and other irregularities concerning the shape of the tumor.  You will have understanding as to what the pathologist views under the scope to determine a person's diagnosis of melanoma. 

Advancing Histology To Determine Cancer Diagnosis Video

Histology is extremely important in the diagnosis of all cancers.  Tissues from biopsies procedures from any part of the body are processed in the histology department. After the tissues are processed the pathologist will view the prepared tissue on slides to determine if cancer is present.

Peter Kilner demonstrates a whole new way of approaching tissue processing with the Thermo Scientific Securesette cassette making it easier and more efficient to carry out biopsies and other tests in the histology lab. http://www.thermoscientific.com/pathology

Bone Marrow Biopsy

I wanted to educate about why a Bone Marrow is needed in diagnosing the reason of abnormal complete blood count results.  The Bone Marrow is the spongy tissue that is inside some of your larger bones such  as iliai crest which is the on the side of hip area.  Cells are produced in the bone marrow and should have normal amounts. If you have leukemia then there will be abnormal amount of cells.
In order to diagnose your medical condition the oncologist must do a Bone Marrow aspirate. Inside your bone is a fluid portion and a solid portion and this needs to be aspirated with a larger needle.

                                           Educational video of a Bone Marrow Aspirate





If your diagnosis is a blood cancer then you may have other bone marrow biopsies to see if your treatment is succeeding .  Your bone marrow will be put into several tubes and the core(bone part) will be put in formalin.
 The will perform genetic testing, flow cytometry , histology and stains.

  Complications to bone marrows are rare.  I would not take any aspirin and always make the doctor aware if you are taking any blood thinners.