5/15/2007 Edinburgh, Scotland staff TherapeuticsDaily.com A drug treatment given the go-ahead yesterday could help save the lives of head and neck cancer patients, doctors said. Taxotere, used to treat sufferers from the aggressive cancer, has been recommended for use by the Scottish Medicines Consortium (SMC). Trials found that patients taking the drug with their regular treatment had a 30 per cent lower mortality than those receiving the standard treatment alone. Dr Elizabeth Junor, consultant clinical oncologist at Edinburgh's Western General Hospital, said: "Compared with some other tumours, there are fewer treatment options for head and neck cancer. "We hope [SMC approval] will result in many more lives being saved across Scotland." Squamous cell carcinoma of the head and neck is the generic term given to 90 per cent of all head and neck cancers. Around 760 people in the UK are diagnosed with the disease each year. It can affect the mouth, tongue and throat. Ex-Beatle George Harrison and journalist John Diamond, husband of Nigella Lawson, were victims of the cancer. Only around 40 per cent of those diagnosed with the condition survive more than five years. Taxotere is recommended for use in combination with current chemotherapy treatment for patients with inoperable locally advanced head and neck cancer. A typical course of the combined treatment will cost around GBP4500, its manufacturers said.

5/15/2007 Sydney, Australia staff TherapeuticsDaily.com An Australian biotechnology firm said on Thursday it had developed a means of delivering anti-cancer drugs directly to cancer cells, which aims to avoid the debilitating toxicity associated with chemotherapy. The method uses nanotechnology, which involves molecules far smaller than a human cell. Direct targeting of chemotherapy drugs would allow dosages thousands of times lower than that in conventional chemotherapy and be more easily tolerated by patients, said the firm. Writing in the May issue of U.S.-based Cancer Cell journal, the biotech firm EnGeneIC said it had developed nano-cells containing chemotherapy drugs. Via antibodies on their surface, these nano-cells target and latch on to cancer cells. Once attached, the nano-cell is engulfed and the drug is released directly inside the cancer cell. The firm said the bacterially derived nano-cell, called EnGeneIC delivery vehicles, had proven safe in primate trials and resulted in significant cancer regression. It hoped to carry out human trials later in 2007 if it gained approval from Australian, U.S., European and Japanese regulatory authorities. "For the first time there is a real possibility that this technology could lead to the use of multi-drug combinations and eventual custom-made therapies in cancer patients," research scientist Jennifer MacDiarmid said in a statement. "In terms of tumor therapy, most late-stage cancer patients carry tumor cells that exhibit various forms of drug resistance. Our technology may provide the first in-vivo (inside an organism) solution to this serious hurdle."

5/15/2007 web-based article staff EurekAlert.org Cigarette smoking is more strongly associated with head and neck cancers than drinking alcohol, according to a study in the May 16 issue of the Journal of the National Cancer Institute. The study found that smoking is responsible for a quarter of head and neck cancers among individuals who do not drink alcohol. At least 75 percent of head and neck cancers are caused by a combination of cigarette smoking and drinking alcohol, but researchers have not known the individual contributions of these risk factors because people who smoke are more likely to drink than the general population and vice versa. In a new study, researchers sought to tease out the independent effect of each risk factor on head and neck cancer development. Mia Hashibe, Ph.D., of the International Agency for Cancer Research in Lyon, France, and colleagues examined head and neck cancer risk among smokers who never drank alcohol and people who drink but never used tobacco products. They pooled data from 15 case–control studies, which included 10,244 head and neck cancer patients and 15,227 controls. About 16 percent of the patients and 27 percent of the controls never drank, and about 11 percent of the patients and 38 percent of the controls never smoked. Cigarette smoking was associated with an increased risk of head and neck cancer—especially cancer of the larynx—among patients who never drank alcohol. About 24 percent of head and neck cancers were due to smoking among patients who never drank. [...]

5/15/2007 Minneapolis, MN Shari Roan StarTribune.com With human papillomavirus, girls and women have been getting all the attention. Parents nationwide have rushed to have their daughters vaccinated against the virus. States are wrestling with whether to require that adolescents be vaccinated. And recent research found that many more girls and women are infected with human papillomavirus than was previously thought -- more than one-quarter of females ages 14 to 59. Now the attention is turning to boys and men. As many as 60 percent of men ages 18 to 70 are infected with HPV, according to data not yet published, raising the question of whether the new vaccine will be effective in reducing diseases linked to the virus unless men, not just women, are immunized. Several studies are underway to better understand the virus in males and whether the new HPV vaccine, Gardasil, also will work for them. As researchers already know and as the new data confirm, HPV is not just a women's issue. "With any transmittable disease, you want to understand the entire cycle of how things spread," says Thomas Broker, an HPV expert and professor of biochemical and molecular genetics at the University of Alabama in Birmingham. "With HPV, men are clearly part of that equation." Human papillomavirus is best known for causing cervical cancer, with about 9,700 cases diagnosed in women nationwide each year. Gardasil, a three-shot regimen, was approved last year for girls and women ages 9 to 26. It protects against four strains of [...]

5/15/2007 web-based article Carey Cowles Hem/Onc Today (www.hemonctoday.com) Aspirin’s many mechanisms of action against cardiovascular events may also help to explain reported resistance to therapy. Aspirin’s effect on homeostasis is well-known. Low-dose aspirin (acetylsalicylic acid, 81 mg) inhibits the enzyme Cox-1, which produces thromboxane A-2, necessary for platelet aggregation. “The primary effect of aspirin as an anticoagulant is thought to involve platelet function; however, aspirin is also an anti-inflammatory,” said Kenneth Mann, PhD, a professor from the department of biochemistry at the University of Vermont. Less clear are other methods by which aspirin acts as an anticoagulant. In a review article published in "Blood", Mann, Anetta Undas, MD, PhD, and colleagues presented an overview of other possible antithrombotic properties of aspirin. Thrombin formation Thrombin (activated Factor II [IIa]), a serine protease, converts fibrinogen into insoluble strands of fibrin. Fibrin, a protein, crosslinks with Factor XIII enzyme (fibrin stabilizing Factor FXIII) and combines with platelets to form a clot. Studies of microvascular injury models have demonstrated that aspirin at a daily dose of 30 mg administered for one week decreased thrombin formation in healthy patients. Aspirin at higher doses (75 mg and 300 mg) decreased concentrations of thrombin markers similarly, as did a single dose of 500 mg following a period of aspirin therapy. This thrombin-lowering effect was found in healthy individuals and patients with increased risk for coronary artery disease. A seven-day course of low-dose (75 mg) aspirin was associated with slower prothrombin consumption (by 29%), thrombin formation (by 27.2%) [...]

5/15/2007 web-based article Dan Jones Nature Reviews (www.nature.com) With the approval of the first active immunotherapy pending, are we poised to enter the era of clinically effective cancer vaccines? On 29 March this year, the US FDA's Office of Cellular, Tissue and Gene Therapies Advisory Committee met to discuss the fate of Dendreon's leading cancer vaccine candidate Provenge (Sipuleucel-T). The Committee voted by 17–0 that Provenge was safe and 13–4 in favour of its efficacy in the treatment of metastatic, hormone-refractory prostate cancer. If things go in Dendreon's favour, Provenge might be approved as soon as mid-May. Provenge represents an extreme of 'personalized medicine'. Dendritic cells, which mop up antigens and present them to other cells of the immune system to stimulate a response, are taken from patients and then sent to one of Dendreon's repositories where they are treated with the prostate-specific antigen prostatic acid phosphatase (PAP), which is found in 95% of prostate cancers. Once returned to the patient, these activated dendritic cells should, in principle, activate T cells to attack and destroy cancer cells that are expressing PAP, leading to the eradication of the tumours. The cell-based approach taken by Dendreon is one of several options being pursued by cancer vaccine developers. Another popular approach is to use viral vectors to deliver genes encoding proteins that stimulate the immune system to attack cancer cells. Since the first such tumour antigens were identified in the early 1990s by Thierry Boon, a biologist at the Ludwig Institute for Cancer [...]

5/15/2007 Iowa City, IA Min Yao et al. Int J Radiat Oncol Biol Phys, March 20, 2007 Purpose: The objective of this study was to determine regional control of local regional advanced head and neck squamous cell carcinoma (HNSCC) treated with intensity-modulated radiotherapy (IMRT), along with the role and selection criteria for neck dissection after IMRT. Methods and Materials: A total of 90 patients with stage N2A or greater HNSCC were treated with definitive IMRT from December 1999 to July 2005. Three clinical target volumes were defined and were treated to 70 to 74 Gy, 60 Gy, and 54 Gy, respectively. Neck dissection was performed for selected patients after IMRT. Selection criteria evolved during this period with emphasis on post-IMRT [(18)F] fluorodeoxyglucose positron emission tomography in recent years. Results: Median follow-up for all patients was 29 months (range, 0.2-74 months). All living patients were followed at least 9 months after completing treatment. Thirteen patients underwent neck dissection after IMRT because of residual lymphadenopathy. Of these, 6 contained residual viable tumor. Three patients with persistent adenopathy did not undergo neck dissection: 2 refused and 1 had lung metastasis. Among the remaining 74 patients who were observed without neck dissection, there was only 1 case of regional failure. Among all 90 patients in this study, the 3-year local and regional control was 96.3% and 95.4%, respectively. Conclusions: Appropriately delivered IMRT has excellent dose coverage for cervical lymph nodes. A high radiation dose can be safely delivered to the abnormal lymph nodes. There [...]

5/14/2007 Boston, MA staff OakParkJournal.com Pancreatic cancer is the fourth leading cause of cancer death in the U.S.; more than 30,000 Americans are expected to die from the disease this year. It is an extremely difficult cancer to treat and little is known about what causes it. One established risk factor in pancreatic cancer is cigarette smoking; other links have been made to obesity, diabetes type 2 and insulin resistance. In a new study, researchers at the Harvard School of Public Health (HSPH) and Dana-Farber Cancer Institute found that periodontal disease was associated with an increased risk of cancer of the pancreas. "Our study provides the first strong evidence that periodontal disease may increase the risk of pancreatic cancer. This finding is of significance as it may provide some new insights into the mechanism of this highly fatal disease," said lead author Dominique Michaud, assistant professor of epidemiology at HSPH. Periodontal disease is caused by bacterial infection and inflammation of the gums that over time causes loss of bone that supports the teeth; tooth loss is a consequence of severe periodontal disease. Two previous studies had found a link between tooth loss or periodontitis and pancreatic cancer, but one consisted of all smokers and the other did not control for smoking in the analysis, and therefore no firm conclusions could be drawn from these studies. Data for the new study came from the Health Professionals Follow-Up Study, which began in 1986 and includes 51,529 U.S. men working in the health [...]

5/14/2007 London, England staff Telegraph.co.uk Patients suffering from head and neck cancer are to be denied a new drug on the National Health Service because it is claimed it is no more effective than existing drugs. The National Institute for Health and Clinical Excellence (Nice) has rejected Erbitux, also known as cetuximab, for cancer sufferers in England and Wales. The drug is available in Scotland. Nice said the drug, when used in conjunction with radiotherapy, did not offer "better therapeutic value" than existing treatments for locally advanced head and neck cancer. However, according to clinical trials carried out by Merck Serono UK, the drug's manufacturer, patients treated with Erbitux plus radiotherapy survive for an average of 49 months, compared with 29 months for those treated with radiotherapy alone. Campaigners said the move was a blow to patients as the drug is the first licensed in the past 40 years for treating locally advanced head and neck cancer. Andrew Dillon, the chief executive of Nice, said: "The evidence presented to the independent advisory committee did not persuade them that cetuximab works any better or offers better therapeutic value than existing treatments for head and neck cancer. "Sometimes it is possible for the committee to identify a subgroup of patients in whom a drug would be effective, for example, patients for whom other treatments are not suitable. "The committee did consider whether there are any subgroups of patients for whom cetuximab could be clinically and cost effective but they were not presented [...]

5/14/2007 Cape Town, South Africa staff Health24.com A US Food and Drug Administration advisory panel has called for new warnings and additional safety studies on anaemia drugs commonly used to treat patients undergoing kidney dialysis or chemotherapy. These medications have been the subject of controversy since some of their dangerous side effects - including the risk of heart attacks and stroke - came to light earlier this year. In March, the FDA issued stronger label warnings for the popular drugs. On Thursday, the agency's advisory panel of experts voted 15-2 in favour of new prescribing restrictions and 17-0 for new clinical trials to prove the safety of Amgen's Aranesp and Johnson & Johnson's Procrit, Bloomberg reported. "Many of us are concerned on the committee and have a lot of questions," said advisory panel chairwoman Gail Eckhardt, an oncologist at the University of Colorado in Aurora, according to Bloomberg. Insufficient evidence Eckhardt said the questions concerned the design of trials, why regulators have limited access to results from company studies, and why the drugs have been marketed for improving quality of life if there isn't sufficient evidence for the claim. Amgen, of Thousand Oaks, California, claims that 4 million patients have taken the medicines since they were introduced in 1989, and more than 9 000 people have been studied in clinical trials with cancer patients, the Bloomberg report said. "We want to consider the totality of the evidence and consider what's best for patients," Roger Perlmutter, Amgen's head of research and [...]