Pharma Strategy Blog

Commentary on Pharma & Biotech Oncology / Hematology New Product Development

Posts tagged ‘MD Anderson’

Slowly but surely, we are seeing more use of social media in one area where I really think it can help a lot – clinical trials.

Regular readers will know of my passion for use of biomarkers in studies to ensure that the patients most likely to respond and therefore benefit will get treatment, thereby sparing those unlikely to respond of the debilitating systemic side effects. This also helps to reduce false hope and raise more realistic expectations.

I was therefore delighted to see a new video from the folks at MD Anderson Cancer Center where Dr Anas Younes, a lymphoma expert, is explaining about the new trials they have open in a rare form of lymphoma, Peripheral T-Cell Lymphoma (PTCL), with some new agents in development.

The groups stated mission is abundantly clear and admirable:

“Our mission is to improve the cure rate of patients with PTCL and reduce treatment-related toxicity by developing novel targeted therapy using rationally designed small molecules, antibodies and combination regimens of biologic agents.”

Check out the short video below – if you can’t see it, you can click this link to take you directly to it:

http://youtu.be/UTCBWQtk65s

PTCL is very rare indeed, but…

  • It is good to see companies invest in clinical trials to continue to improve outcomes
  • Social media sharing through YouTube, Facebook, Twitter and blogs is a great way to aid awareness of clinical trials for those are suffering
  • More awareness will hopefully lead to faster enrolment and earlier readouts that can be publicly shared with all
  • Dr Younes is a fellow believer in targeted agents in a targeted fashion based on the underlying biology of the disease.  Love this – using targeted agents in an untargeted fashion is both silly and a waste of time/research dollars
  • Academia is probably the ideal way to provide this sort of education – are you more likely to believe or be persuaded by a passionate medical specialist from a top cancer center or a pharma company advertising clinical trials?

There has been some excellent research from Pew Internet recently that showed, as Susannah Fox summarised for me via Twitter:

“Most patients say professionals are more helpful than peers for diagnosis, Rx, treatments.”

She has also published another in-depth report that looked at Peer-To-Peer healthcare.  I particularly liked the aims:

“This report shows how people’s networks are expanding to include online peers, particularly in the crucible of rare disease.”

Those online peers could be connections from all walks of life, who like me, like to share fascinating stuff from reputable sources such as Pew Internet, Manhattan Research and top cancer centers such as MD Anderson.  The beauty of social media is that we can all share information and help improve medical education and awareness across a broad church.  As Thomas Friedman said, the world is indeed getting flatter.

For those of you who know someone who has been diagnosed with PTCL or other rare lymphomas and is in need of treatment, do share Dr Younes’ video with them – they may be able to help.

 

 

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On Thursday this week I’m off to the GI Carcinogenesis meeting hosted by MD Anderson Cancer Center, you can find out more about the event here.

It’s a brand new meeting for me, but according to the program:

“The ISGC is comprised of basic, translational and clinical scientists.  This conference will encourage and develop research and communication in the areas of gastroenterological biology and oncology in both basic and clinical aspects through joint meetings with international and national gastroenterologists.”

I’m particularly looking forward to hearing what Lee Ellis has to say on cancer stem cells and the microenvironment, as well as Emanuel Petricoin on molecular profiling in GI cancers.  There are a whole host of other really interesting talks too, as you can see from the program agenda.

When I first looked at the faculty, my initial reaction was, “Oh my!” It’s a quite serious line-up of some of the top GI cancer researchers and certainly not easy to get them all in the same place together, so it will be fun to chat with them in the poster sessions and get their perspective on the latest happenings in this field.

The meeting runs through Saturday, so I’ll try and post a daily synopsis, as time permits.

If I hadn’t been following Dr Raymond DuBois, the MD Anderson Provost and Co-Chair of the meeting on Twitter, I would have missed this altogether – the power of social media in spreading and communicating awareness of these special events is very much here to stay.

If you have any burning questions in this area, please do add them in the comments below and I will do my best to ferret out some answers.

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A while back I wrote about how circulating tumour cells (CTC’s) see here and here, can be used as a potential new surrogate measure for prostate cancer, so it was with great interest that I read an excellent article (free public link courtesy of AACR) on abnormal circulating cells in non-small cell lung cancer (NSCLC) late last week.

Essentially, this new research from three academic institutions (MD Anderson TX, Manchester UK and Baltimore, MD) set out to:

“Determine if a fluorescence in situ hybridization (FISH)–based assay using isolated peripheral blood mononuclear cells (PBMCs) with DNA probes targeting specific sites on chromosomes known to have abnormalities in non–small cell lung cancer (NSCLC) cases could detect circulating genetically abnormal cells (CACs).”

In the recent discussion about fluid-based blood biomarkers, we saw how people could be spared invasive and inconvenient tumour biopsies, which are not always practical in advanced lung cancer, particularly if the patient is elderly or frail.  In this study, the researchers demonstrated that detection of circulating epithelial cells (CECs) or CTCs using a simple blood test may assist in early detection of lung cancer at diagnosis and relapse and provide a minimally invasive way to monitor results of therapy.

Now in this study, only a small number of people with NSCLC were evaluated (NSCLC n=59 plus n=29 controls), but they do give us an indication of what could be looked at in larger scale clinical trials (first find your needle in the haystack!)  The presence or increased numbers of these circulating abnormal cells confers a poorer prognosis, ie associated with relapse of disease and poorer survival, so the ability to pick them up earlier and more easily would be an advantage clinically.

The approach used in this research was a commonly used technique called fluorescence in situ hybridization (FISH) to detect abnormal circulating cells that have aberrations found in non-small cell lung cancer. FISH detects and quantifies abnormal cells by using dye-labeled DNA probes of cell chromosomes that cause cells with the targeted genetic abnormalities to light up when viewed under a fluorescent microscope.

The researchers chose 12 biomarker probes that target aberrations previously connected to lung cancer to analyze both the controls (people without lung cancer) and people with NSCLC, including both smokers and non-smokers.  In the analysis they found the following:

  • Highly significant differences in the average number of abnormal cells in the bloodstream between patients and controls.
  • Abnormal cells were significantly associated with disease stage, with cells that contained certain abnormalities increasing significantly as cancer progressed from early to advanced stage disease.
  • Eight of the biomarkers had a strong overall correlation between abnormal circulating cells and tumors.  Chromosomal gain of the EGFR gene in circulating cells was significantly associated with the same gain in tumors, particularly in patients with stage III or stage IV disease.

No doubt work will soon be underway to develop a commercial clinical test based on FISH, which would then be able to be used in the Community Oncology setting, where the majority of patients are treated in the US.  Validation in clinical trials will be crucial to this process.

In an MD Anderson news release, the lead author, Ruth Katz, was quoted as saying:

“Blood tests for these circulating tumor cells could be used to diagnose lung cancer earlier, monitor response to therapy and detect residual disease in patients after treatment.”

Source: MD Anderson Cancer Center

Having an easier to use test to monitor responses more accurately to products in development will be particularly useful for pipeline drugs.

References:

ResearchBlogging.org Katz, R., He, W., Khanna, A., Fernandez, R., Zaidi, T., Krebs, M., Caraway, N., Zhang, H., Jiang, F., Spitz, M., Blowers, D., Jimenez, C., Mehran, R., Swisher, S., Roth, J., Morris, J., Etzel, C., & El-Zein, R. (2010). Genetically Abnormal Circulating Cells in Lung Cancer Patients: An Antigen-Independent Fluorescence In situ Hybridization-Based Case-Control Study Clinical Cancer Research, 16 (15), 3976-3987 DOI: 10.1158/1078-0432.CCR-09-3358

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