Breakthrough Melanoma Treatment Hailed as Key to Cure

By Beth Greenfield, Shine Staff | Healthy Living – 2 hours 49 minutes ago

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A woman is examined for signs of skin cancer. Photo: Getty ImagesPatients with advancedmelanoma patients may now survive for up to 10 years longer than before, according to new findings about the drug ipilimumab, which first came on the market in 2011. Scientists are finding that patients who respond to the medication are living much longer than originally anticipated, and the drug is being touted as the key to a cure for skin cancer.   

More on Yahoo Shine: Why Are So Many Women Still Getting Skin Cancer?

"This is a major breakthrough," Tim Turnham, PhD, executive director of the Melanoma Research Foundation, told Yahoo Shine about the announcement, which came over the weekend at the 2013 European Cancer Congress in Amsterdam. Though Turnham was careful to note that the drug represents "nothing close to being a cure," he said that it was moving the world closer to one than ever before.

"Melanoma has been a fortress, but we're beginning to see a crumbling of its foundations," he said, adding that, according to these new findings, "at least half of those [with advanced melanoma] will probably be cured within three to five years. It's shocking."

Stephen Hodi, director of the Melanoma Treatment Program at Dana-Farber Cancer Institute in Boston, headed the research behind the latest development, conducting the largest analysis yet of ipilimumab and overall survival in melanoma patients.

“These results are important to healthcare providers and patients with advanced melanoma since they provide a perspective on long-term survival for ipilimumab patients who are alive after three years of treatment,” Hodi said in a press release. “Our data, which represent the longest follow-up of the largest numbers of patients on any globally approved melanoma therapy, will provide a benchmark for future medicines for advanced melanoma.”

More on Yahoo: New Drug for Advanced Melanoma Shows Positive Results

While melanoma is not the most common type of skin cancer, it is the most fatal, killing an estimated 8,790 people in the United States annually, according to the Skin Cancer Foundation. It's also the No. 1 cancer diagnosis for women in their 20s, and it's on the rise. If the cancer is recognized and treated early, it's almost always curable; if not, it can spread to other parts of the body, where it becomes hard to treat and until now was almost always fatal, with most patients living less than 18 months after diagnosis. The American Cancer Society estimates that about 120,000 new cases of melanoma in the United States are diagnosed in a year.

The treatment, ipilimumab, also called “ipi,” and sold in this country as Yervoy, is an antibody that activates the immune system to fight melanoma skin cancer.

It was already known that some patients treated with ipi could survive for long stretches. Because of that, Hodi joined with colleagues from Germany, France and the United States to collect data on a total of 4,846 patients from various studies, aiming to look more closely at survival rates.

Ipi was the first new melanoma drug approved in many years, Turnham explained—and it was the first ever to show an impact on overall survival rates in melanoma patients, which fueled much hope. "Patients were clamoring like crack addicts on the street," he recalled. "And I know people who were literally at death's door who are alive now because of the drug." But, he explained, not everyone responds to the drug; in fact, there is a 20 percent or greater chance that it will have no effect on a patient.

But now, encouraged by the latest hopeful news, scientists can continue to work on ways to get a better rate of response to the drug. That's important not only so that melanoma patients can have a greater chance of living to see a cure, but also so that they can simply live, Turnham said.

"If a man has young children and has been alive for six years [with the cancer], he's seen them go from being first-graders to being in middle school," he noted. "There are all those milestones you wouldn't have otherwise had."

http://shine.yahoo.com/healthy-living/breakthrough-melanoma-treatment-hailed-as-key-to-cure-163831369.html

The Sarcastic Boob

A New Life of Accommodation

Posted on September 27, 2013by Scorchy

It has been a few months beyond a year that I started blogging. And to tell you the truth, it’s been a little difficult for me to get back into the swing after my latest hiatus. Blogging has been the portal through which I unburden myself of corrosive and heavy thoughts. However, right now it’s all I can do to try to empty my head.

When we are beset with a crisis of any kind we long to return to normal when it is over. All I ever thought about when I was home this summer was the day I would return to the office–if just to have the chance to bitch about the things that everyone else bitches about. A chance to be with people, nudge the mind, and be like everyone else. But in reality the return is not so easy because after going through this it is hard to be like you once were. Indeed, it is wholly impossible.

When I was home I was drugged 24/7 with Methadone, Oxycodone, and Lyrica. When you take medications like that on a set schedule and not “as needed” you don’t necessarily think straight. And if you can you’re a far better drug taker than me. Take the day I received a letter from Human Resources informing me of long term disability benefits. I read that letter and thought it meant that I was losing my job. It was completely irrational, of course. But what can I say, folks, this is my brain on drugs. (How I pulled that Facebook petition together I’ll never know.)

Once I returned to work I was happy, but it still wasn’t normal. With the plan my physician rolled out I was essentially working 15 hours per week and gradually lengthening my days. The plan is a sound one and it is working, but I find myself at month’s end still needing another month to lengthen my hours. I never realized that my back was so weak and that it would take so long to build up strength. I guess knitting isn’t the ideal way to strengthen one’s core.

With my return to the office came the realization that I am not the person that I once was. It’s a drag and accepting that will be a process. I taught a class this afternoon and proceeded in my usual way by walking around the room, engaging my students and planting seeds that I hope will take root and grow. When I teach I do nothing else but focus on the subject. Any pain I feel is ignored if not out of my mind completely. But thirty minutes in the pain in my lower back was starting to hold me back. Ten minutes later I needed to sit and finish up my presentation to the students. Gathering up the materials after the students left was arduous. The onerous walk home (all of one block) was rewarded with some Oxycodone and a comfy couch.

So remember that letter from Human Resources about long term disability benefits? Well, I had to revisit it once I realized that I needed another month to adjust. Revisit means that in my irrational drugged state I ignored the initial letter. Well, that is not entirely true. I asked questions, but I was unable to comprehend the complexities. It was overwhelming; every person had a different answer and one even told me not to bother applying. So I finally applied. I can still work part-time, it is retroactive to the period when I didn’t take it (when I should have) and I’m going to be okay. I think. In any case, it’s not forever.

When I spoke with the disability expert I told her my story and how it can be when some folks are alone with no one to assist them with complex information. And although I have no idea how it can be done, my employer–who excels in work/life assistance in many areas–needs to be a part of benefits discussions when individuals are ill. If the employee declines, so be it. But the territory is vast, it is complicated, and it is overwhelming. I am intelligent and can make my own decisions, but I was significantly impaired and that negatively affected the choices that I made.

Cancer just complicates everything. If you’re ahead of it you worry about being behind it. If you’re behind it you desperately push to get in front of it. The day I learned that I had breast cancer I never dreamed that the year to come would be so challenging. I naively believed that I could embrace the pink and I would be okay.

This isn’t what some people term “the new normal.” Nay, it’s just life. It is now driven by medical interventions of all sorts: PET/CT and MRI results, blood work, medications, pain management, and therapies. And, of course, by important financial decisions that in the end are all about quality of life.

All I can do is make the best of it. Suck it up and just do the best that I can, ask for help when I need it, and soldier on. Like my man Marcus Aurelius said: “You have power over your mind, not outside events. Realize this, and you will find strength.”

http://thesarcasticboob.com/2013/09/27/a-new-life-of-accommodation/

‘Pan-cancer’ study unearths tumours’ genetic trademarks

Analyses reveal cancer-associated genomic changes that can occur in many types of tumour.

• Heidi Ledford

26 September 2013

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Researchers are seeking commonalities among different types of tumours, including lung cancer.

VISUALS UNLIMITED, INC./ANNE WESTON/CANCER RESEARCH UK/GETTY IMAGES

Lung cancer is not the same as breast cancer, which is not the same as pancreatic cancer — but at the molecular level they can have much in common, two studies published today have found.

A ‘pan-cancer’ analysis of more than 3,000 genomes across 12 different kinds of tumours has looked for the commonalities that cross tissue boundaries. The earliest results, published in Nature Genetics^1, 2, reveal more than 100 regions of the genome that may contain previously undiscovered drug targets, and that could provide the foundation for a new classification of tumours that better matches individual patients to the treatment most likely to drive their cancer into remission.

Lumping together cancers of different organs can provide insight into common pathways that give rise to the disease. It also allows researchers to boost the number of samples in their data set. More samples often means greater statistical power to find genomic changes associated with cancer.

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• Fifty genome sequences reveal breast cancer's complexity

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“It’s the next wave of cancer genome analysis,” says Tom Hudson, director of the Ontario Institute for Cancer Research in Toronto, who was not involved with the work. “This gives us a lot more power to detect commonalities that could have been missed analysing a single tumour type at a time.”

The approach also adds fuel to the growing movement to stratify tumours on the basis not only of their organ of origin, but also of molecular characteristics — an approach that is gaining importance as pharmaceutical companies roll out a new generation of cancer therapies targeted to treat tumours that have specific genetic mutations.

Combine and conquer

The pan-cancer studies harness data from the Cancer Genome Atlas, a project funded by the US National Institutes of Health to collect genomic information, including the sequences of all genes that encode proteins, from more than 20 cancers represented by up to 500 tumours each. This programme and others like it, including an international effort co-founded by Hudson, have been pumping out a steady stream of data and findings, such as genes newly associated with cancer that could serve as the basis for novel therapies.

But those analyses have generally stuck to a single tumour type. After a while, says systems biologist Josh Stuart at the University of California, Santa Cruz, researchers on the project began to get a sense of déjà vu. While working on a breast-cancer data set, for example, they would see patterns in the data that they had previously seen in an ovarian-cancer data set.

In October 2012, Stuart and others decided to systematically analyse the data across tumour types. While they were organizing a collaboration to do so, Stuart says, they planned ahead, estimating that the project might generate about five papers.

One year later, there are 18 papers slated for publication in the coming weeks, with another 60 at various stages of drafting, says Stuart. In one of the papers appearing today, cancer researcher Rameen Beroukhim of the Broad Institute in Cambridge, Massachusetts, and his colleagues analysed data from 11 tumour types in search of regions of the genome that had been duplicated or deleted in cancerous cells more often than would be expected by chance. Their analysis revealed 140 such regions, each of which could harbor extra copies of genes that fuel the disease, or deletions of genes that suppress tumours¹.

Cancer commonalities

Of those 140 regions, only 35 contained genes previously known to be associated with cancer — a testament, says Beroukhim, to the increased power of analysing a larger data set. “Despite all the data that have been pouring in lately, there’s still much to be discovered about the cancer genome,” he says.

In the other study published today, computational biologist Chris Sander and his colleagues at the Memorial Sloan-Kettering Cancer Center in New York used genomic data to reclassify tumours based on their genomic anomalies they carry, rather than the organs in which they were initially found. The resulting categories sometimes yielded clues to which therapies might work best against those tumours.

The work is a promising first step, but such classifications will need to be tested in clinical trials before they can be used to guide treatment, says Hudson. In the meantime, he adds, he expects to see many such analyses in the coming months.

“I think there’ll be a lot of competition for ideas to find the optimal way of classifying tumours,” says Hudson. “And it’ll have to be updated every six months as we get more data.”

There should be no shortage of data to analyse: Stuart says that there is already talk of expanding the analyses to include full-genome sequences of up to 2,000 tumours. Such a project would allow researchers to explore changes in regions of the genome that do not code for proteins, and to reconstruct all of the genomic rearrangements that can give rise to cancer, he says.

Nature

 

doi:10.1038/nature.2013.13830

http://www.nature.com/news/pan-cancer-study-unearths-tumours-genetic-trademarks-1.13830

New hope for treating cancer? Patterns seen in 12 types of tumors

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A scanning electron microscope image of a breast cancer cell. Scientists are comparing molecular features of different types of cancers to see where unexpected similarities lurk.(National Cancer Institute, NIH )

By Eryn Brown

September 26, 2013, 12:39 p.m.

Examining the molecular profiles of tumors from 12 different types of cancers, scientists working with the National Institutes of Health-backed Cancer Genome Atlas said Thursday they had found striking similarities between tumors originating in different organs.

Their discoveries, made possible by improvements in sequencing technologies and computing methods, could herald a day when cancers are treated based on their genetic profiles, rather than on their tissue of origin, said UC Santa Cruz biomolecular engineer Josh Stuart, a participant in the project and coauthor of a commentary discussing its findings released Thursday by the journal Nature Genetics.

Eventually, such a shift in thinking could lead researchers to new treatments for hard-to-treat cancers, Stuart said, in an interview with the Los Angeles Times.

If scientists can find molecular similarities, say, between a rare form of breast cancer and a form of ovarian cancer, they might be able to use a drug known to target the ovarian tumor to treat the unusual subtype of breast cancer.

"Hopefully fewer patients will be left out on their own," Stuart said.

The Cancer Genome Atlas or TCGA, which has been underway since 2006, seeks to catalog the DNA and other molecular features of thousands of different tumors from a variety of cancer types. (The Los Angeles Times reported onfindings from two earlier Cancer Genome Atlas studies in May.) By identifying how genes are scrambled up in tumors and what effects those changes have in cells, the thinking goes, researchers might be able to understand better how different cancers progress, and find the best treatments for particular tumor types and subtypes.

The Pan-Cancer initiative that Stuart is involved with carries the analysis further, comparing cancers of different types to see what patterns emerge.  The team looked at TCGA data -- gene mutations, changes in the numbers of copies of genes, and measures of how the genes were behaving -- from tumors sampled from thousands of patients who had 12 different cancers (including tumor types in the brain, head and neck, kidney, lung, breast, ovary, cervix, colon and rectum and one type of leukemia.)

The cross-cancer comparison was a project many researchers had wanted to pursue, Stuart said. Some had already noticed similarities as they studied various tumors as part of TCGA. "We'd say, hey, I recognize that copy number profile in that breast cancer.  Didn't we see it in ovarian cancer last month?" he said.

Comparing different types of tumors is useful because it lets scientists learn more about how cancers behave than looking at one type on its own can. Cancers are a jumble of cells.  Looking at just one type of tumor might let a researcher identify the jumble within that certain cancer, but doesn't necessarily point to the mechanism that triggered the cancer in the first place, Stuart said.

But looking at several cancers at once and finding commonalities can help tease out the cell of origin, he added.

Over the coming months, the collaboration will publish dozens of papers detailing what researchers found in the cancers. Two such papers were published Thursday, also in Nature Genetics.  One notedsimilarities in gene copy-number changes across cancers.  The other classified tumors and tumor subtypes according to their molecular profiles, identifying two large classes that had not been identified previously (one set of cancers where genetic mutations predominate, and another where copy number changes predominate.)  Nature Genetics also published a second commentary about the Pan-Cancer initiative, delving into the computing strategies scientists have devised to crunch vast stores of tumor-related genetic data.

Stuart said that while the notion tumors of different origins might share genetic signatures wasn’t a new one, the TCGA Pan-Cancer effort finally lets scientists dig in and see whether it's true.

"We just haven't had the data to step back and look at it all together and connect the dots," he said. Over coming months, researchers will add tumors and tumor types to the dataset, and will also analyze whole genome data.

But changes in medical approaches to treating cancers won't happen overnight, Stuart added.

"There's a lot to put in place," he said, noting therapies would be tested in cells and lab animals before there were trials in people.

Read more about the NIH's Cancer Genome Atlas project.

http://www.latimes.com/science/sciencenow/la-sci-sn-cancer-tumor-genes-patterns-20130926,0,7310104.story

New Survey Reveals U.S. Men with Advanced Prostate Cancer Worry More about Burdening Family and Friends Than Dying

http://www.prnewswire.com/news-releases/new-survey-reveals-us-men-with-advanced-prostate-cancer-worry-more-about-burdening-family-and-friends-than-dying-225327501.html

-- As men live longer with disease, survey findings suggest patients and caregivers need increased opportunities for open dialogue and more comprehensive support --

 

NORTHBROOK, Ill. and SAN FRANCISCO, Sept. 26, 2013 /PRNewswire/ -- Astellas Pharma US, Inc. (TSE: 4503) and Medivation, Inc. (Nasdaq: MDVN) today announced results of a national survey of men with advanced prostate cancer and caregivers of men with advanced prostate cancer.[i] Results showed that while patients who participated in the survey are generally optimistic, a good number may feel isolated in coping with their disease. Forty-five percent reported they keep silent about their prostate cancer and treatments, and 59 percent are concerned about becoming a burden to family and friends. By comparison, only 43 percent of patient respondents have the same level of concern about dying.

Caregivers who participated in the survey expressed a high degree of stress associated with their roles. Nearly three-quarters (73 percent) said there are days when they feel overwhelmed caring for someone with advanced prostate cancer and 85 percent said they experience stress or anxiety related to their loved one's well-being. However, caregiver respondents are more concerned about helping their loved one cope with the physical and emotional effects of advanced disease (83 percent) than they are about their own physical or emotional health (58 percent).

Astellas Pharma US, Inc. and Medivation, Inc. commissioned the Advanced Prostate Cancer Patient and Caregiver Burden of Illness Survey through Harris Interactive, and sponsored four leading cancer advocacy and education organizations to collaborate on the initiative: The Association of Oncology Social Work (AOSW), CancerCare, Prostate Health Education Network (PHEN), and Us TOO Prostate Cancer Education and Support Network. The survey was conducted online among 91 men with advanced prostate cancer and 100 caregivers of such men, and was designed to evaluate the physical and emotional impact of advanced prostate cancer on both patients and caregivers.

"Little, if any, research has been completed to understand the current experience of U.S. men living with advanced prostate cancer or caregivers to these men," said Thomas A. Farrington, founder and president of PHEN. "This survey provides much-needed information that will help us better support them, particularly as there is evidence that men are now living longer with advanced disease."

More than 50 percent of patients who participated in the survey have been living with a prostate cancer diagnosis for at least six years. Nearly one-third of survey respondents (33 percent) reported living with a diagnosis for more than 10 years and 17 percent said they are currently living with another cancer diagnosis in addition to prostate cancer.

Caregiver respondents reported an average caregiving duration of nearly five years. Sixteen percent have been providing care for more than eight years.

Key findings from patients who participated in the survey reveal:

• Forty-one percent do not feel like people understand what they are going through in terms of managing and treating their prostate cancer. Of these, 78 percent* wish people better understood the stress of coping with prostate cancer, and more than half wish others understood the inconvenience caused by prostate cancer (59 percent) or the side effects of treatment (also 59 percent).
• While many patient respondents reported feeling hopeful about their disease (58 percent), the greatest percentage said their disease makes them feel uncertain (62 percent). Among other responses, 33 percent said they feel fearful, 32 percent feel sad, and 20 percent feel lonely or alone.
• There are disconnects in terms of patients' treatment priorities and what they perceive to be the priorities of their physicians. While 66 percent of patients said that the level of discomfort they will experience is important or very important to them when choosing therapies, only 45 percent believe that this factor is important or very important to their physicians.
• Despite the older age of patients who participated in the survey (median age: 70 years), the Internet is an important source of information for them. After their physicians, it is the most highly used source of information for patients and caregivers who participated in this survey.

Caregiver participants expressed considerable stress and anxiety, as well as a desire for more direct support networks. Key findings include:

• Seventy-three percent said they are concerned or very concerned about their ability to continue providing care over a long period of time.
• Caregivers' top areas of concern are their ability to help their patient cope with the physical and emotional effects of the disease (83 percent said they are concerned/very concerned about each).
• Among the 93 percent of caregivers who reported experiencing troublesome feelings as a result of caregiving (e.g., stress, sadness, fear, etc.), 58 percent said they rely most on family members to help relieve these feelings.
• Among caregivers who expressed a desire for additional support, the most common request was for a support network or group.

Survey findings also suggest that many patient and caregiver respondents are overwhelmed by the volume of information available to them. About one-third (35 percent) of patients said there is too much information available about prostate cancer to understand it all, and 47 percent of caregivers agreed with this statement. These findings suggest the need for navigation tools that will help guide patients and caregivers to the information that is most relevant to them over the course of the disease.

The American Cancer Society estimates that one in six U.S. men will be diagnosed with prostate cancer in their lifetime and about 2.5 million are currently living with the disease.[ii]^, Recent studies and analyses have demonstrated that men with advanced prostate cancer are now living longer than ever.[iii],[iv] A 2013 study concluded, "The initial impact of treatments for men with [prostate cancer] is well reported in the literature. Less is known about the psychosocial needs of these men as their journey after diagnosis and treatment continues into months and years."[v]

About the Advanced Prostate Cancer Patient and Caregiver Burden of Illness Survey  The Advanced Prostate Cancer Patient and Caregiver Burden of Illness Study was conducted online within the United States by Harris Interactive on behalf of Astellas Pharma US, Inc. and Medivation, Inc. between August 29, 2012 and March 15, 2013. A total of 91 men age 60+ diagnosed with prostate cancer who have been or are being treated with at least one course of hormone therapy and experienced continued disease progression (i.e., castration-resistant prostate cancer [CRPC]) completed the survey. Simultaneously, Harris Interactive surveyed 100 caregivers of similarly described patients, defined as anyone in regular contact with qualified patients who assist with their care and/or help them make treatment decisions.

About Medivation Medivation, Inc. is a biopharmaceutical company focused on the rapid development of novel small molecule drugs to treat serious diseases for which there are limited treatment options. Medivation aims to transform the treatment of these diseases and offer hope to critically ill patients and their caregivers. For more information, please visit us at www.medivation.com.

About Astellas Astellas Pharma US, Inc., located in Northbrook, Illinois, is a US affiliate of Tokyo-based Astellas Pharma Inc. Astellas is a pharmaceutical company dedicated to improving the health of people around the world through the provision of innovative and reliable pharmaceutical products. The organization is committed to becoming a global category leader in focused areas by combining outstanding R&D and marketing capabilities. For more information about Astellas Pharma US, Inc., please visit our website at www.Astellas.us.

[i] For the purposes of this survey "advanced" disease was defined as prostate cancer that has been or is are being treated with at least one course of hormone therapy and has continued to progress (i.e., castration-resistant prostate cancer [CRPC]). "Caregivers" was defined as anyone in regular contact with qualified patients who assist with their care and/or help them make treatment decisions.

[ii] American Cancer Society. What are the key statistics about prostate cancer? Available athttp://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-key-statistics. Accessed August 5, 2013.

[iii] Omlin, A. et. al. Improved Survival in a Cohort of Trial Participants with Metastatic Castration-resistant Prostate Cancer Demonstrates the Need for Updated Prognostic Nomograms. Euro Uro. 64:2. August 2013

[iv] Mukherji, D. et. al. New treatment developments applied to elderly patients with advanced prostate cancer. Can Trtmnt Rev. 39:578-573. 2013.

[v] O'Shaughnessy, PK, et. al. Cancer Nurs. 2013 Jan 25.

* Caution: Small base size; results should only be interpreted as directional in nature. http://www.prnewswire.com/news-releases/new-survey-reveals-us-men-with-advanced-prostate-cancer-worry-more-about-burdening-family-and-friends-than-dying-225327501.html