Monthly Archives: April 2008

The role of PET in head and neck cancer

  • 4/28/2008
  • Heidleberg, Germany
  • LG Strauss and A Dimitrakopoulou-Strauss
  • Hell J Nucl Med, January 1, 2008; 11(1): 6-11

PET and PET/CT are the procedures of choice for molecular imaging in the head and neck area. The current data of the literature show, that functional imaging with fluorine-18-deoxyglucose ((18)F-FDG) provides the possibility to obtain information about the viability of malignant lesions.

The use of hybrid systems, PET/CT, enables physicians to assess both, morphology and function, and achieve a high diagnostic accuracy exceeding 90%. PET with (18)F-FDG is the most sensitive method to detect tumor recurrence. However, false positive results must be considered due to unspecific changes following treatment, especially radiotherapy.

The use of quantitative PET scans as well as the application of a second tracer, enhance the capability of PET to assess questionable masses more accurately. Follow up examinations with PET and (18)F-FDG provide data about early changes in the tumor metabolism due to chemotherapeutic treatment. Studies in patients undergoing surgery and radiotherapy demonstrated, that PET with (18)F-FDG can be used for the prediction of individual survival.

April, 2008|Archive|

MR Imaging Criteria for the Prediction of Extranodal Spread of Metastatic Cancer in the Neck

  • 4/28/2008
  • Nagasaki, Japan
  • Y Kimura et al.
  • AJNR Am J Neuroradiol, April 10, 2008

Background and Purpose:
The presence of extranodal spread in metastatic nodes significantly affects treatment planning and prognosis of the patient with head and neck cancer. We attempted to evaluate the predictive capability of MR imaging for the extranodal spread in the neck. MATERIALS AND

Methods:
We retrospectively studied MR images from 109 patients with histologically proved metastatic nodes, of which 39 were positive for extranodal spread. We assessed 47 extranodal spread-positive and 130 extranodal spread-negative metastatic nodes by using the following MR imaging findings as the possible criteria for extranodal spread: 1) nodal size (short-axis diameter); 2) obliterated fat spaces between the metastatic node and adjacent tissues, such as the muscles and skin on T1-weighted images (“vanishing border” sign); 3) the presence of high-intensity signals in the interstitial tissues around and extending from a metastatic node on fat-suppressed T2-weighted images (“flare” sign); and 4) an irregular nodal margin on gadolinium-enhanced T1-weighted images (“shaggy margin”). Multivariate logistic regression analysis was conducted to identify independent predictive criteria for extranodal spread.

Results:
Nodal size, shaggy margin, and flare sign criteria were independent and significant MR imaging findings suggestive of extranodal spread in the metastatic nodes. We obtained 77% sensitivity and 93% specificity with the flare sign, 65% sensitivity and 99% specificity with the shaggy margin, and 80% sensitivity and 85% specificity with the size criterion (cutoff point = 16 mm).

Conclusion:
Fat-suppressed T2-weighted and gadolinium-enhanced T1-weighted images are useful for the detection of extranodal spread in metastatic nodes in the neck.

Authors:
Y Kimura, M Sumi, N Sakihama, F Tanaka, H Takahashi, and T Nakamura

Authors’ affiliations:
Department of Radiology and Cancer Biology, Nagasaki University School of Dentistry, Nagasaki, Japan; and Department of Otolaryngology, Nagasaki University School of Medicine, Nagasaki, Japan

April, 2008|Archive|

Vaccine May Treat Lung Cancer

  • 4/28/2008
  • web-based article
  • Salynn Boyles
  • WebMD.com

An experimental vaccine that works by training the immune system to kill specific tumor cells is showing promise for the treatment of early lung cancer, researchers report. The immune-system-boosting vaccine targets a protein expressed in certain cancer cells, but not in normal cells, known as MAGE-A3.

About 35% of non-small-cell lung cancers (NSCLC) have this protein, which is also present in some melanomas and head and neck cancers.

In a trial of early-stage lung cancer patients whose tumors expressed MAGE-A3, treatment with the vaccine was shown to reduce the risk of relapse after surgery.

Long-term follow-up results from the early trial of the immunotherapy were presented at the 1st European Lung Cancer conference in Geneva, Switzerland.

“The principle behind this approach has potential for many different types of cancer,” researcher Johan Vansteenkiste, MD, PhD, tells WebMD. “The principle is that you teach the patient’s immune system to eliminate cancer cells that express certain proteins.”

MAGE-A3 Vaccine
The vaccine therapy has not been compared head-to-head with chemotherapy, which is often given to surgically treated lung cancer patients to reduce their risk of relapse.

But Vansteenkiste says the immunotherapy-treated patients in the phase II study had outcomes similar to those seen among chemotherapy-treated patients, with almost no side effects.

“Many surgically treated lung cancer patients are not able to tolerate the side effects of chemotherapy, either because of their age or because of other health issues,” he says. “This approach is a promising alternative.”

A total of 182 patients with NSCLC were included in the early study, sponsored by drugmaker GlaxoSmithKline, which is developing the vaccine therapy. All the patients had cancers that expressed MAGE-A3.

After having surgery to remove their tumors, 122 patients were randomly assigned to treatment with the MAGE-A3-targeting vaccine and 60 patients got placebo vaccines.

The patients were given five injections every three weeks at the beginning of treatment and then eight injections every three months later on for a total of 27 months, Vansteenkiste says.

After 44 months of follow-up, 69 of the 182 patients had cancer recurrences, including 57 deaths. The researchers report that the treatment was well-tolerated. The MAGE-A3-treated patients seemed less likely to have recurrences and die from their disease than the placebo-treated patients, although this is being further evaluated in an ongoing phase III study for efficacy.

Immunotherapy vs. Chemotherapy
This year in the U.S., 215,000 new cases of lung cancer will be diagnosed and close to 162,000 people will die from the disease, according to National Cancer Institute projections.

Surgery is the standard treatment for patients with early-stage disease, but about 50% of patients who have surgery end up dying of their lung cancer, Vansteenkiste says.

He says adding chemotherapy to surgery boosts the survival rate by about 10%, a rate similar to that seen in the MAGE-A3 trial.

Last year, GlaxoSmithKline began recruitment for a phase III study of the cancer vaccine, which will include more than 2,000 patients whose cancers express MAGE-A3.

The placebo-controlled trial will include patients treated with the vaccine both instead of and in addition to chemotherapy.

“We want to see if there is an extra benefit to adding the immunotherapy to chemotherapy,” he says.

Len Lichtenfeld, MD, of the American Cancer Center, tells WebMD that it remains to be seen if the MAGE-A3 vaccine will prove to be a useful treatment for lung cancer.

“The study suggests that there may be some benefit here, but clearly a larger trial will tell us more,” he tells WebMD.

He adds that it will not be clear if the immunotherapy works as well as chemotherapy until the two treatments are compared head-to-head.

April, 2008|Archive|

Possible Viral Links to Lung Cancer Risk Uncovered

  • 4/27/2008
  • Washington, D.C.
  • Alan Mozes
  • WashingtonPost.com

Although smoking is well-established as an independent risk factor for lung cancer, two new studies suggest that two different viral infections might boost a smoker’s already substantial risk for developing the disease.

While the specific viruses at issue — human papillomavirus (HPV) and measles — may not directly cause lung cancer, they seem to aggravate the negative impact of tobacco, American and Israeli researchers say.

Both findings were presented Friday by separate research teams attending the European Lung Cancer Conference in Geneva.

“In terms of HPV, our finding is pretty controversial,” said study author Dr. Arash Rezazadeh, a fellow of medical oncology and hematology at the University of Louisville in Kentucky. “And this is just the beginning of the road. There is much more work to be done. But it’s important to know that being infected with this virus does appear to increase lung cancer risk.”

As for the role of measles, the second study’s lead author, Dr. Samuel Ariad, from the department of oncology at Soroka Medical Center in Beer Sheva, Israel, said that infection — perhaps even asymptomatic infection — seems to be associated with half of the lung cancer cases he tracked.

“Measles virus by itself is unlikely to be carcinogenic,” he said. “[But] it probably modifies previous damage to DNA caused by smoking.”

Both studies specifically focused on the viral impact on non-small cell lung cancer (NSCLC) risk. According to the American Cancer Society, 85 percent to 90 percent of all lung cancers are of this variety. Estimates regarding all forms of lung cancer indicate that 215,000 new cases will be diagnosed in the United States this year alone.

In the HPV study, Rezazadeh and his colleagues analyzed lung tissue samples taken from 23 lung cancer patients being treated in Kentucky. Kentucky, they noted, is the state with the highest rate of adult and teenage smoking in the United States, as well as the highest rate of NSCLC.

Among the patients — all of whom were smokers — five were found positive for infection with a variety of HPV strains.

The authors said this frequency of infection “supports the assumption that HPV contributes to the development of NSCLC.” They point out that HPV is already known to be the cause of all cases of cervical cancer, a vaccine for which has recently become available. It has also recently been implicated as a possible cause for head and neck cancer.

Further studies are planned to look for signs of HPV infection in the respiratory tract of lung cancer patients and to explore the possibility for using HPV infection as a screening indicator for the disease.

In the measles study, Ariad and his team analyzed lung tissue samples taken from 65 Israeli lung cancer patients between the ages of 40 and 84. Ninety percent were smokers, and most were in the early stages of the disease.

The authors found evidence of measles infection in 54 percent of the patients. The likelihood of viral infection, they observed, went up with age.

They concluded that “a possible association” exists between measles and NSCLC.

Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, described both research efforts as “interesting.” But he cautioned that more research needs to be done on each front.

“The question I have for the measles association has to do with vaccination, since in the U.S., at least, we have near universal coverage,” he noted. “So although the measles vaccine may lose some of its effectiveness over time, it would be interesting to know if this finding would apply to a country such as ours where most people are vaccinated.”

“But I think the HPV study is the more interesting of the two,” Lichtenfeld added, “since HPV is obviously already implicated in other cancers. But this is a small study, and it only suggests a possible link to lung cancer without answering a lot of questions. I would like to know, for example, whether patients who are not smokers but who develop lung cancer have a higher rate of HPV. But for now, I would not yet conclude that HPV increases risk, nor would I tie the HPV vaccine to any risk.”

Sources:
Arash Rezazadeh, M.D., fellow, medical oncology and hematology, University of Louisville, Kentucky; Samuel Ariad, M.D., department of oncology, Soroka Medical Center, Beer Sheva, Israel; Len Lichtenfeld, M.D., deputy chief medical officer, American Cancer Society; April 25, 2008, presentation, European Lung Cancer Conference, Geneva

April, 2008|Archive|

Hopkins Doctor Urges Early Diagnosis To Avoid Cancer’s Forgotten Killer

  • 4/22/2008
  • Baltimore, MD
  • staff
  • www.webwire.com

On average, two Marylanders each day are diagnosed with potentially fatal oral cancers that are often curable if identified and treated early. The Maryland Department of Health and Mental Hygiene’s Office of Oral Health reports that the state ranks in the country’s top 10 for number of deaths caused by oral cancers. Nationally, statistics show that the death rate from these cancers is higher than those of cervical cancer, Hodgkin’s lymphoma, testicular cancer, and thyroid and malignant melanoma.

A sore in the mouth that doesn’t heal could be a warning sign of oral cancer, which kills more than 8,000 people a year. Of the 34,000 Americans newly diagnosed with oral cancer annually, only half will be alive in five years. According to the American Dental Association, early diagnosis and treatment could boost that rate to 75 or 80 percent.

John O’Brien, 70, who had not smoked a cigarette in 33 years, was adamant about maintaining proper oral hygiene. But, in 2006, O’Brien, a national sales manager for an advertising agency, father of four and a grandfather of five, found a small lump that turned out to be a cancerous tumor at the base of his tongue. After 45 radiation treatments and six chemotherapy sessions, O’Brien says he is grateful to be alive. “I was just in disbelief. Nobody wants to hear that they have cancer,” says O’Brien. “But, for me I was lucky because the doctors caught it quickly.”

“Often, oral cancer is not diagnosed until it’s advanced because symptoms—sore throat, non-healing ulcer, white or red patches on the gums or tongue, or a neck mass—are easy to dismiss as something less serious,” says Christine G. Gourin, M.D., associate professor at the Johns Hopkins School of Medicine Department of Otolaryngology—Head and Neck Surgery and director of the clinical research program in head and neck cancer. “But oral cancer can be life threatening mostly due to the fact that it’s detected too late.”

According to Gourin, smokers and tobacco users are at the highest risk. “Smokers are six times more likely than non-smokers to develop oral cancer, and those who use chewing tobacco also increase the risks of cancers of their cheek, gums, and inner surfaces of the lip, by 50 percent,” Gourin adds. Gourin also warns that frequent alcohol consumption significantly increases the risk of oral cancer by a factor of four.

Gourin and other experts say that while oral cancer is mostly linked to tobacco and alcohol use, oral cancer in non-smokers is a growing problem as well. Sun exposure is another risk factor, with nearly a third of patients with cancer of the lips having a history of outdoor work and prolonged exposure to UV radiation.

The American Cancer Society recommends that adults, especially smokers, tobacco users or consumers of high amounts of alcohol, check their mouth, gums and tongue monthly as a way of prevention, self-care and catching oral cancers in the early stages. Gourin suggests all adults ask their physicians or dentists to perform a head and neck exam at least once a year, and to personally pay close attention for any unusual symptoms in the mouth, such as sores that do not heal; a lump or thickening in the cheek or lip; white or red patches on the gums, tongue, tonsil or lining of the mouth; chronic sore throat; difficulty in chewing or swallowing; or a lump or mass in the neck.

In recognition of Head, Neck and Oral Cancer week, Mon. Apr. 21 through Fri. Apr. 27, Johns Hopkins Hospital is holding an oral cancer screening on Thurs., April 24 from 10 a.m. to 4 p.m. at the 6th floor of the Johns Hopkins Outpatient Center located at 601 North Caroline St. The screening is FREE, but an appointment is necessary and can be made by calling 410-955-1080. No walk-ins accepted.

April, 2008|Archive|

Opening up – Innovative physical therapy helps keep cancer survivor

  • 4/22/2008
  • Knoxville, TN
  • Kristi L. Nelson
  • knoxnews.com

A long, deep yawn.

A bite of a chocolate bar or crab meat.

A vigorous brushing and thorough flossing.

For 2 1/2 years, Esther Cahal has forgone these and other small pleasures most people take for granted.

An unusual complication from a rare form of particularly aggressive tongue cancer left Cahal’s mouth locked shut, able to open barely wide enough to insert her little finger. She stays alive by hooking herself up to a feeding tube unit each night and sleeping in an upright position while she “eats” a liquid nutritional supplement for eight hours through a port in her stomach.

A little more than a year ago, Cahal, facing a recurrence of her cancer, “decided that before I die, I’m going to eat again,” Cahal said. “If this cancer’s going to kill me, at least I’m going to have something good down my throat.”

But Cahal has had two “clear” scans for cancer – and now an innovative physical therapy treatment is helping open her up to experiencing food again.

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It started in February 2004, when Cahal’s dentist found an ulcer on the right side of her tongue. She thought the skin was irritated by a tooth, but when the tooth was fixed, the ulcer still didn’t heal. So she had a biopsy.

“It came back as extremely aggressive cancer,” Cahal said. “It was a surprise for everybody, because I didn’t have any risk factors.”

The type of cancer Cahal had most commonly affects men older than 60 who drink alcohol, smoke or use oral tobacco products (“dip”). Not only did Cahal not have any of those habits, she had no family history of any type of cancer. In fact, she’d been out sick from work only two days in her then-22-year career as a physician’s assistant.

Cahal had surgery to remove the cancer, followed by six weeks of weekly chemotherapy and seven weeks of daily radiation, a course designed to minimize the chance the rare cancer would come back.

The radiation burned her skin badly, and by the second week she couldn’t swallow. That’s not a common complication of radiation, and Cahal’s doctors weren’t sure why it happened. But by the fall of 2004, not only could Cahal still not swallow, she couldn’t open her jaw because of scarring from the radiation, which badly burned her skin.

Then, almost a year to the day, her cancer came back. This time, surgeons removed a third of Cahal’s tongue. She had eight more weeks of chemotherapy. A few months later, a test showed the cancer in her lymph nodes. She had all the nodes removed from her neck. Seven months of weekly chemotherapy followed, then Cahal finished up five more weeks of radiation to just her neck area in December 2006.

During the radiation treatments, Cahal was burned so badly that when she turned her head, the skin would crack and bleed all the way down her neck. Her daughter, now 11, was so distressed by her mother’s appearance that Cahal sent her to stay with a friend for three weeks.

“She asked the really hard questions: ‘Are you going to be there when I graduate from high school? Are you going to be there when I have my baby? Are you going to be there when I get married?'” remembered Cahal, who said she was always honest with her children. “I said: ‘I don’t know. I’m trying.’ That’s all I could tell her.”

Cahal had PET scans in July and December 2007, and neither showed any cancer. It was the first time since diagnosis that she’d had two “clear” scans in a row.

But she couldn’t open her mouth to shout for joy; her jaw was still locked tight.

Since moving to Knoxville from Johnson City, Cahal has been under the care of otolaryngologist Dr. Mark Overholt. Overholt recommended physical therapy to try to solve Cahal’s problem; he even tried to manually force her jaw open when he was operating on her cancer. He had to stop for fear of breaking the jaw.

“We tried a lot of different things to treat Esther,” Overholt said. “None of the things seemed to work very well.”

Then last September a colleague in the neurosurgeon’s office where Cahal works as a P.A. heard about a local seminar being given by Indiana physician Dr. Thomas Sevier, on a rehabilitation system, ASTYM, that he developed to treat chronic tendon disorders, scar tissue and fibrosis. Because Cahal couldn’t attend, her co-worker brought her some material.

She contacted Sevier to ask him if he thought his system could help her. He’d not used it for her particular problem, he said, and told her, “‘I don’t know if you can swallow again, but I can probably get your jaw open,'” she said. “I said, ‘Well, if you can get my jaw open, I’ll be happy.'”

Cahal agreed to try 10 sessions of ASTYM, formerly called ASTM for “Augmented Soft Tissue Mobilization” (the “Y” was added later to aid with pronunciation). She made an appointment with physical therapist Susan Daugherty of Benchmark Physical Therapy in Farragut. Daugherty was the first of about 25 PTs in Benchmark’s 55-clinic network to become ASTYM-certified. She’d enjoyed success using the method to treat patients with chronic tendinopathy, postoperative scarring, Achilles tendinitis, carpal tunnel syndrome and plantar fasciopathy, which is notoriously frustrating for both patients and PTs because of its difficulty to treat.

During the manual ASTYM treatment, a PT uses acrylic tools to locate and put pressure on scar tissue, increasing blood flow to the scar and ultimately helping the tissue heal, Daugherty said. The tools allow a PT to feel “bumpy” scar tissue more easily and to work on a larger area without tiring out, as happens when doing deep tissue massage with the hands alone. It works on patients who have immobility problems caused by scarring; patients whose problems are caused by inflammation won’t benefit, she said.

Daugherty hadn’t used the method on a patient’s face, however, and Cahal had little confidence it would work for her. Still, she thought, “It can’t hurt.”

She was wrong. The therapy did hurt – a lot. Though Daugherty isn’t pressing especially hard, Cahal’s facial tissue is very tender.

“She’s not gentle,” Cahal said, laughing. After a session, “I look like I’ve been slapped around,” because the increased blood flow to the scar tissue makes her skin red.

But it also worked. Within two weeks, Cahal was already seeing improvement. A visit to Overholt confirmed it: she could open her mouth wide enough that he could get his finger in the back of her throat.

By November, Cahal was able to eat her first food in more than two years. She had a bowl of vanilla pudding.

Cahal is now regularly eating soft foods, such as soups and mashed potatoes. She still has some trouble; enough of her tongue is missing that she can’t move food around in her mouth, and she lacks sensation at the back of her throat. Daugherty also takes her through exercises to strengthen muscles she hasn’t used in years. But she’s not complaining.

“You don’t realize until you lose the ability to eat, how social that is,” said Cahal, who said waiters have asked her why she didn’t like their restaurant’s food, and people have accused her of being anorexic: “I was always having to explain why I wasn’t eating.”

She still has to supplement with her “liquid supper” at night, since she can’t yet take in enough calories by mouth. But it’s “a big breakthrough when you can’t eat anything at all,” said Overholt, adding, “Six to eight months ago, I thought she probably would be dependent on a feeding tube for the rest of her life. Now I’m optimistic that she won’t.”

Cahal’s next goal is to be able to open wide enough to go to the dentist. A tooth that’s been bothering her will now probably have to be removed, because her mouth has been closed too tightly even for pediatric dental instruments. She also hopes to be able to yawn, and to swallow a pill. Right now when she gets a headache, Cahal must either dissolve a pill, which takes about an hour, or have on hand specially ordered ibuprofen that has been compounded into liquid form at about $50 for 10 800-mg doses.

And maybe someday she’ll be able to eat more of the foods she misses, like chocolate.

“I miss being able to bite a chocolate bar,” Cahal said. “But if I can never eat regular food, that’s fine. I never really thought I’d eat again.”

Since the radiation also left Cahal’s tongue scarred, her sense of taste is diminished. Daugherty has begun using the smallest ASTYM instrument to massage Cahal’s tongue, on the off chance it might help bring some of that back.

“Her story is so inspiring,” Daugherty said. “It makes you really glad for the profession you’re in. … Really changing someone’s life in big ways is just so awesome.”

Cahal hopes others with similar problems will learn from her experience and start ASTYM treatment earlier; her scar tissue was already quite calcified when Daugherty began treating her. Had she known it would be so effective, she said, she would have started during radiation.

“I’m just glad she was willing to go off the road” of tried therapy to help, Cahal said.

April, 2008|Archive|

Understanding the biological basis of autofluorescence imaging for oral cancer detection

  • 4/21/2008
  • Austin, TX
  • I Pavlova et al.
  • Clin. Cancer Res., April 15, 2008; 14(8): 2396-404

Purpose:
Autofluorescence imaging is increasingly used to noninvasively identify neoplastic oral cavity lesions. Improving the diagnostic accuracy of these techniques requires a better understanding of the biological basis for optical changes associated with neoplastic transformation in oral tissue.

Experimental Design:
A total of 49 oral biopsies were considered in this study. The autofluorescence patterns of viable normal, benign, and neoplastic oral tissue were imaged using high-resolution confocal fluorescence microscopy.

Results:
The autofluorescence properties of oral tissue vary significantly based on anatomic site and pathologic diagnosis. In normal oral tissue, most of the epithelial autofluorescence originates from the cytoplasm of cells in the basal and intermediate regions, whereas structural fibers are responsible for most of the stromal fluorescence. A strongly fluorescent superficial layer was observed in tissues from the palate and the gingiva, which contrasts with the weakly fluorescent superficial layer found in other oral sites. Upon UV excitation, benign inflammation shows decreased epithelial fluorescence, whereas dysplasia displays increased epithelial fluorescence compared with normal oral tissue. Stromal fluorescence in both benign inflammation and dysplasia drops significantly at UV and 488 nm excitation.

Conclusion:
Imaging oral lesions with optical devices/probes that sample mostly stromal fluorescence may result in a similar loss of fluorescence intensity and may fail to distinguish benign from precancerous lesions. Improved diagnostic accuracy may be achieved by designing optical probes/devices that distinguish epithelial fluorescence from stromal fluorescence and by using excitation wavelengths in the UV range.

Authors:
I Pavlova, M Williams, A El-Naggar, R Richards-Kortum, and A Gillenwater

Authors’ affiliations:
Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas.

April, 2008|Archive|

Swedish tobacco tied to premature death

  • 4/21/2008
  • Gothenburg, Sweden,
  • staff
  • www.upi.com

A form of moist Swedish tobacco known as snus has been linked to premature death in users, a new longitudinal study has found.

Dr. Ann Roosaar at the Odontological Institute said the study found snus — it rhymes with moose — posed a significant health risk to those who used it even when compared to normal tobacco, the Swedish news agency TT reported Saturday.

“Even if smoking is without question a much greater threat to health than snus our research rejects the view that the use of Swedish snus is in principle without risk,” the researcher said.

The study examined the use of snus in the Swedish municipalities of Enkoping and Habo during a 30-year period, along with residents’ use of other tobacco products and alcohol.

Snus is generally used by placing a pinch of it inside the mouth under the upper lip. Inhabitants’ mouths were examined prior to the study and its final results indicated that snus users were more likely to have mouth and throat cancers than non-snus users, the news agency said.

April, 2008|Archive|

Qiagen keeps purchase powder dry for now

  • 4/19/2008
  • Hilden, Germany
  • Patricia Gugau and Mantik Kusjanto
  • www.guardian.uk

Qiagen plans to keep its powder dry for major acquisitions for now as it focuses on integrating its $1.6 billion purchase of rival Digene, its finance chief said.

“We still have sufficient firepower (for purchases),” Roland Sackers told Reuters in an interview.

But Qiagen first wanted to integrate Digene, which has made it the second-largest molecular diagnostics company in the world after Roche.
Digene helped boost cash flow at Qiagen, which has a high equity-to-assets ratio of 50 percent, he said. Qiagen also had a credit line for an undisclosed amount.

Digene’s flagship product is a test for detecting human papilloma virus (HPV), the cause of almost all cervical cancers. The market for HPV testing is estimated at more than $1 billion.
In the HPV field, Digene is the market leader. Roche and smaller rival Third Wave Technologies are also tapping the lucrative and fast-growing market.

Digene shares were up 0.8 percent at 1240 GMT, compared with a 0.2 percent rise in pan-European DJ Stoxx drug index.
Sackers said the company was still in talks about payments from health authorities in Europe for its HPV test kits, which have proven to be more accurate than the traditional Pap smear test. Only private health insurers have been willing to pay for its HPV test kits in Europe.

“I believe there will be a breakthrough,” he said.
Qiagen also dominates the genetic test kit industry. They are used to isolate nucleic acid — building blocks of living organisms like DNA or RNA — in biological samples for analysis.
Sackers added that he remained comfortable with the company’s earnings guidance for this year.

The company expected revenue of $875-$905 million, a rise of up to 40 percent from 2007, and adjusted earnings per share of 76-80 cents.
“We are on track,” Sackers said, adding the company is also looking to expand in Brazil, Mexico and India.

Asked whether the company could be a takeover target, Sackers said Qiagen could grow faster by staying independent than by being part of a bigger group.

“We are certainly growing by far the fastest and we are addressing one of the most attractive markets in the life science area,” he said. “The speed at which we are growing could not be faster if Qiagen were part of a bigger organisation.”

Qiagen, with a market value of around $4 billion, has not been the subject of any takeover speculation.

Morgan Stanley analysts said in a recent report that major drugmakers needed to reallocate capital into sustainable business areas like vaccines, molecular diagnostics and animal health to deal with structural problems facing conventional drug discovery.
Earlier this month, Swiss drugmaker Novartis said it would acquire Nestle’s stakes in eye care company Alcon for $39 billion.

April, 2008|Archive|

Introgen Therapeutics phase 3 study of cancer drug confirms earlier findings

  • 4/19/2008
  • London, England
  • press release
  • CNNMoney.com

Introgen Therapeutics Inc. said Monday its Advexin phase three clinical trial data in patients with recurrent head and neck cancer has confirmed earlier phase two results of the drug’s efficacy.

‘Advexin provides therapeutic benefit by restoring p53 tumor suppressor function which is blocked in the majority of head and neck cancers,’ Robert E. Sobol, senior vice president, medical and scientific affairs, Introgen said in a statement.

A comprehensive analysis of Introgen’s phase three data and additional studies of Advexin will be presented at medical conferences later this year. These and other data will be the basis for regulatory submissions in the United States and in Europe as previously reported, the company said.

April, 2008|Archive|