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Test IDs Who Benefits From Cancer Drug

By EMMA ROSS
AP Medical Writer

LONDON (AP) -- A simple genetic test can identify which patients with deadly brain tumors will be helped by a treatment hailed as the first significant advance against the disease in decades and in which patients the drug is a waste of time, scientists said Wednesday.

A study by Swiss doctors, presented Wednesday at a cancer drug conference in Geneva, found that 46 percent of patients with the right genetic profile were still alive after two years if they got the drug, temozolomide, as well as radiotherapy, whereas the chance of survival among patients with the wrong genetic signature was only 14 percent - not much better than with radiotherapy alone.

Experts say the test could avoid the raising of false hopes in patients with glioblastomas who would not benefit, freeing doctors to try other approaches. The finding is another step in the quest for the individual tailoring of cancer treatment, they say.

"The problem we've had with temozolomide is that if it's not working, then you're left to watch the disease progress," said Dr. Ralph Vance, national president of the American Cancer Society, who was not involved with the research.

"This is a wonderful thing if we could test the glioblastoma, then we won't be guessing and wasting time for people in whom this won't work because ... we could get them in another trial that would at least give them a chance," said Vance, a professor of medicine at the University of Mississippi in the United States.

Radiation and surgery have been the first-line treatments for glioblastomas, but even with them the disease usually kills within a year or less. Intravenous chemotherapy available since the 1970s improves these odds only marginally and can have serious side effects.

Unlike most cancer, which kills by spreading through the body, glioblastomas grow quickly inside the head, destroying everything in their path. They are the most aggressive of the 100 or so forms of cancer that originate in the brain and account for half or more of all cases. Around the world, 175,000 cases are diagnosed annually, killing 125,000.

Earlier this year, the Swiss scientists reported that giving temozolomide to patients early in treatment could prolong the lives of some patients. About 26 percent of the patients that got the drug were still alive after two years.

However, they could not tell which patients the drug worked for or whether the results would look even better if the drug was given just to those who responded to it.

In the latest experiment reported Wednesday, the researchers, led by Dr. Monika Hegi, head of the tumor biology and genetics lab at University Hospital in Lausanne, Switzerland, examined the genetic makeup of 106 people given the drug in the earlier study.

They found that the key to predicting which patients would benefit from the drug was a gene involved in DNA repair and its status in the patient's tumor. If the gene was switched off, the drug worked, but if the gene was active, the drug had little effect.

"These results are important because temozolomide is a drug that acts directly against DNA to slow down the replication of cancer cells. So it is bad news if the patient has (active gene) status because the DNA in these rogue cancer cells is being repaired as fast as the drug causes damage. This means the cancer cells are able to survive the drug's onslaught," said Hegi.

In patients with the silent gene, the chance of being alive after two years was 46 percent. Only 14 percent of those with the active gene survived the two years.

It is too early to say whether the drug will cure some patients, Hegi said, but temozolomide is the latest drug to be added to an arsenal of medicines that will be given only to people with a certain genetic profile that doctors know will respond well.

Other targeted drugs include the breast cancer treatment Herceptin, which is given only to women whose key gene is overactive, and Iressa, a drug that scientists have recently found seems to work only in lung cancer that has mutated in a certain way.

"It's a new day for medical oncology," Vance said. "We now know that we're not going to be using a shotgun approach. It's honing down and using more specific targeted therapy."

© 2004 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

 

Health Highlights: Sept. 29, 2004

 

September 29, 2004 02:01:52 PM PDT , HealthDay

 

Here are some of the latest health and medical news developments, compiled by editors of HealthDay:

Colorectal Cancer Screening Underused in United States

Even many health conscious adults in the United States aren't getting screened for colorectal cancer, says an American Cancer Society study.

An analysis of 1997 data collected from more than 184,000 adults aged 50 to 74 found that just 58 percent of men and 51 percent of women reported ever having either a sigmoidoscopy or colonoscopy.

These adults were taking part in the Cancer Prevention Study II Nutrition Cohort and were considered to be more health conscious than the U.S. population at large.

The findings indicate that colorectal cancer screening tests are underused, even among health-minded adults. This, despite the fact that colorectal screening guidelines have been widely published and screening has proven effective in reducing colorectal cancer deaths.

"Efforts to increase colorectal cancer screening need to target women, all persons aged 50-64 years, and those with colorectal cancer risk factors," the study authors wrote.

-----

FDA Launches Review of Adult Antidepressant Trials

Data on approximately 40,000 depressed adults in 234 clinical trials of antidepressants will be examined to see if the drugs increased suicidal thought or behaviors, said the U.S. Food and Drug Administration.

The move comes after a similar analysis found that antidepressants increased suicidal thoughts or behaviors in children.

The FDA can't say how long the analysis of the adult data will take, the Associated Press reported.

The review will be conducted using an analysis technique developed at Columbia University that was used in the review of pediatric antidepressant clinical trials.

-----

Caffeine Withdrawal a Medical Disorder

Caffeine withdrawal is a disorder that should be included in the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), according to a Johns Hopkins study.

The study authors reviewed more than 170 years of research on caffeine withdrawal. They found that the more caffeine a person consumes, the more severe the withdrawal symptoms. As little as one standard cup of coffee a day can lead to caffeine addiction, the Johns Hopkins study concluded.

Along with inclusion in the DSM, considered the bible of mental disorders, caffeine withdrawal should be updated in the World Health Organization's International Statistical Classification of Diseases and Related Health Problems, the researchers said.

"Caffeine is the world's most commonly used stimulant, and it's cheap and readily available so people can maintain their use of caffeine quite easily," Roland Griffiths, professor of psychiatry and neuroscience at Johns Hopkins, said in a prepared statement.

"The latest research demonstrates, however, that when people don't get their usual dose they can suffer a range of withdrawal symptoms, including headache, fatigue, difficulty concentrating. They may even feel like they have the flu with nausea and muscle pain," Griffiths said.

-----

Toxic By-Product Found in Mothers' Milk

A toxic substance used in flame retardants has been found in the breast milk of 100 percent of nursing mothers tested in the Northwest, the Seattle Post-Intelligencer reports.

The toxin, polybrominated diphenyl ethers (PBDEs), is used in the manufacture of foam furniture padding, textiles, and hard plastics used to encase electronic equipment. It was detected in 40 of 40 milk samples taken from women in Oregon, Washington state, Montana, and British Columbia, the newspaper said.

The study, conducted by the nonprofit group Northwest Environment Watch, found levels ranging from six to 321 parts per billion. These amounts are consistent with similar studies conducted elsewhere in North America, but are up to 40 times higher than levels found in Sweden and Japan, where the chemicals are being phased out, the Post-Intelligencer said.

A spokesman for the environmental advocacy group told the newspaper that levels in the United States have risen 15-fold over the past two decades. Researchers are still studying the health effects of exposure, and exactly how people are being exposed.

-----

After 4 Storms, Floridians Are Stressed Out

After four major hurricanes in six weeks, more than Floridians' homes have been torn apart.

Mental health centers across the state have been deluged with calls from distraught, depressed, and anxious residents who can't handle the unprecedented stress, the Associated Press reports.

And mental health experts predict the situation will only get worse, as reality sinks in and people grasp the devastating impact of Hurricanes Charley, Frances, Ivan, and Jeanne. Experts warn of an upsurge in alcohol and drug use, child abuse, and other forms of violence, the wire service said.

Suicides in the southwestern part of the state are up 13 percent from previous years since Charley struck on Aug. 13, the CEO of a mental health insurer told the AP. Calls to Coastal Behavioral Healthcare are up 150 percent from last year, the executive told the wire service.

Counselors are urging people as best as possible to return to their regular routines, even if it means sticking to a normal bedtime in a motel or having cereal for breakfast on the front porch, the AP said.

-----

Medicare Widens Coverage for Heart Device

Medicare has agreed to expand coverage by one-third for implantable cardiac defibrillators (ICDs) -- devices used to steady hearts that beat irregularly -- to 500,000 patients, the Minneapolis Star Tribune reports.

In the first year alone, the increase will mean at least 25,000 more patients will be covered for defibrillator implantation at a cost of about $20,000 each, the newspaper said. The stopwatch-sized devices, positioned in the upper chest, shock the fluctuating heartbeat back into a normal rhythm.

Medicare's decision to expand coverage was bolstered by a government-funded study released in March that found ICDs reduced death by 23 percent in patients with moderate heart failure.

The study also found the devices benefited those with even mild heart failure, whereas ICDs had traditionally been implanted in only the sickest heart-failure candidates, the newspaper said.

 

Back to Original Article : News You Can Use

 

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Mexico Spreading Organic Eating at Home By LISA J. ADAMS Associated Press Writer MEXICO CITY (AP) -- Creamy fresh yogurt from hormone-free cows, coffee untainted by chemicals and avocados plucked from pesticide-free trees line the shelves of The Green Corner market, whose earthy feel suggests organic food stores north of the border.

Cabinet Members Promote Healthier Habits By MARYCLAIRE DALE Associated Press Writer PHILADELPHIA (AP) -- Three U.S. Cabinet secretaries fanned out across the country Tuesday to promote healthier lifestyles, especially among the nation's snack-filled, exercise-starved youth.

 

Asia Bird Flu Death Toll Climbs to 30 By VIJAY JOSHI Associated Press Writer BANGKOK, Thailand (AP) -- Vietnam confirmed a new bird flu death to bring Asia's human toll to 30 on Wednesday, while Thailand rued its flawed efforts to control the epidemic after reporting its first likely case of the virus jumping from one person to another.

 

 

 

 


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