5/2/2008 United Kingdom staff Economist.com The prospects for using genes as a therapy may be improving For around 40 years scientists have understood how genes work. They have known the structure of genes, how they replicate, how they are controlled and expressed and, crucially, how to manipulate them. Such knowledge has been the basis of a genetic revolution that offers the power to rewrite the material from which all living organisms are made. There has been great progress in realising some of this promise, in the form of genetically modified organisms. But ways to correct the genetic mistakes that cause many human diseases have been slower to arrive. Gene therapy has been plagued with problems—naivety, false promises, over-optimism and fatalities. Although thousands of patients have received gene therapy for a variety of conditions, only a few have shown any clinical benefit. Could that be about to change? There was news this week of a successful attempt to correct a faulty gene that leads to blindness. An international team of scientists, led by a group at the University of Pennsylvania, used a genetically engineered virus to introduce the correct version of a gene called RPE65 into six people suffering from a retinal disease known as Leber's congenital amaurosis. In four patients vision improved. Earlier work with the same technique on dogs suffering from a naturally occurring form of blindness has also been successful. Katherine High, of the Howard Hughes Medical Institute in Maryland, and one of the directors of the study, [...]

5/1/2008 New York, NY Tara Parker-Hope New York Times (nytimes.com) Cancer patients and their doctors often focus on beating the disease first. But new research shows they also benefit by early monitoring for lymphedema, a devastating side effect of cancer treatment that can show up years later. Lymphedema is a painful swelling of an arm or leg that can occur months or even years after cancer treatment. Breast cancer patients, who often have lymph nodes removed during diagnosis and treatment, are particularly susceptible. But any cancer patient whose lymphatic system has been damaged by radiation or the removal of lymph nodes is vulnerable. That includes patients treated for prostate and gynecological cancers, head and neck cancers, testicular cancer, bladder cancer, colon cancer and melanoma. The lymphatic system normally helps transport body fluids, but in someone with a compromised system, fluid can build up in an arm or leg, depending on where the lymph nodes were removed. If lymphedema sets in, a limb can swell far out of proportion to the rest of the body, and if not treated quickly, the condition can be irreversible. But an important new study conducted by the National Institutes of Health and the National Naval Medical Center shows that cancer patients benefit if their treatment plans include early interventions to monitor risk for lymphedema. During the five-year study, researchers measured the upper limb volume of 196 newly diagnosed breast cancer patients to establish a baseline before they had surgery. After surgery, doctors developed a lymphedema [...]

5/1/2008 web-based article staff money.cnn.com A Phase I clinical trial, using a DUSA Pharmaceuticals, Inc. product, has been launched by the National Cancer Institute (NCI) to study an entirely new approach for the prevention of oral cancer, which may affect more than 30,000 Americans this year.(1) Chronic mouth lesions, the most common of which is a condition known as oral leukoplakia, are early indicators of oral cancer. There is currently no effective treatment for preventing the progression of oral leukoplakia to cancer. The long-term goal is to examine aminolevulinic acid (ALA) photodynamic (PDT) therapy as a preventive treatment for oral cancer by the selective removal of oral leukoplakia. Oral leukoplakia is a condition involving the formation of white spots on the surfaces of the mouth and tongue. Previous studies have shown that ALA PDT may be used to identify and treat the condition.(2)(3)(4) ALA, the active ingredient in DUSA's product, Levulan®, is a chemical that is produced naturally at low levels in humans. If ALA is given to the body at higher levels, the drug can build up inside of pre-cancerous cells. When a laser light is pointed at a pre-cancerous cell, ALA may increase the effect of the laser causing the cell to die. This is called photodynamic therapy (PDT). The purpose of the present trial is to examine the safety and tolerability of orally administered ALA PDT and to determine the optimal dose of light therapy. "The commencement of this trial is a critical first step towards identifying [...]

5/1/2008 web-based article staff dentistry.co.uk The National Institute for Health and Clinical Excellence (NICE) has today issued a Final Appraisal Determination (FAD) recommending the use of cetuximab (Erbitux®) in combination with radiotherapy for the treatment of locally advanced head and neck cancer in patients for whom platinum-based chemoradiotheraphy is inappropriate. Cetuximab is the first new treatment in more than 40 years that significantly prolongs patient's survival and control of the disease. This news follows the Mouth Cancer Foundation's successful appeal last year to the Appeal Panel of NICE to ask its Appraisal Committee's to reverse its previous appraisal decision not to recommend the drug for head and neck cancer patients in England and Wales in May 2007. The Appraisal Committee accepted that cetuximab plus radiotherapy caused less severe adverse effects than the chemoradiotherapy regimens. This announcement means that patients with head and neck cancer in England and Wales will soon have access to this life-saving treatment like patients in Scotland already do. Once the full guidance has been published, expected on 29 May 2008, it will be available across the NHS within three months. Dr Vinod Joshi of the Mouth Cancer Foundation said: ‘The Mouth Cancer Foundation welcomes NICE's decision. "It is something that oncologists and patients alike have been fighting for. It will go a long way to correcting the present postcode lottery in head and neck cancer for patients in the UK."

5/1/2008 Birmingham, AL press release www.newswise.com A new surgical procedure for head and neck cancer at the University of Alabama at Birmingham offers improved accuracy for surgeons and reduced post-operative pain for patients. The new procedure uses robotic surgery, and results have shown it lessens the scarring, breathing problems and damage to speech that can happen with treating head and neck cancers, said William Carroll, M.D., a scientist in the UAB Comprehensive Cancer Center. Initial tests have shown the new procedure also shortens recovery times for cancer patients. "This application takes robotic surgery to new places in the body," said Carroll, a head and neck surgeon within UAB's Division of Otolaryngology, and one of the first surgeons to begin using the procedure for head and neck cancers. "There is an option for patients to have a more minimally invasive surgery, and one that could effectively remove the cancer while causing fewer side effects," he said. Robotic surgery is an alternative to traditional open surgery and a refinement on the concept of laparoscopic surgery, Carroll said. The robot most commonly used in cancer treatment is called the da Vinci, which is sold by Intuitive Surgical. UAB was the first medical center in Alabama and among the first in the United States to begin using the da Vinci for head and neck cancers more than a year ago. Since that time, 40 UAB patients have had the new operation. Offering the new procedure to patients first involved adapting operating techniques and robot-arm [...]

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.

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 [...]

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 [...]

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 [...]

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 [...]