IMMUNO-ONCOLOGY: Targeting the immune system, not the tumor

Immuno-oncology is based on the concept of harnessing the body’s own immune system to fight cancer.

One of the most exciting areas of cancer research today is immuno-oncology, and while it’s an approach that scientists first considered more than 100 years ago, recent scientific discoveries and clinical advances have ushered in a truly historical time in cancer research.

Immuno-oncology Video Capture

Image Courtesy of PhRMA (Video Capture)

Recently, PhRMA released a new video highlighting immuno-oncology, which is currently being researched and developed by Bristol-Myers Squibb and several other bio-pharmaceutical companies.

Cancer is clever and has found ways to outwit the immune system. Rather than killing these cancer cells directly with traditional tools like radiation or chemotherapy, immunotherapy seeks to intensify the immune system’s power to eliminate them. Immuno-oncology is already improving outcomes and survival rates for some patients, including melanoma, kidney and lung cancer, and researchers are urgently working to gain new insights into the complex interactions between patients’ immune systems and the cancer cells growing in their bodies with the goal of markedly improving outcomes in many more tumor types.

While the science has advanced rapidly in recent years, there is more work to do. Researchers hope to replace chemotherapy as the first line treatment for many cancers and help as many patients as possible achieve long-term survival. This new treatment approach has the potential to help patients live longer, healthier lives.

Learn more about advancements in science at From Hope to Cures.

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New Drug Holds Promise Against Zika

MV-4 Based On Research That Unlocks Key to Breaking Down Viruses

A New York pharmaceutical company, TGV-Laboratories, says it has unlocked the key for breaking down the protective barriers of viruses, a breakthrough that it believes can be developed into antiviral drugs to treat Zika and host of life-threatening viruses, including Ebola, HIV and Bird Flu.  The company’s lead researchers, Victor and George Tetz, said lab tests show their discovery, called MV-4, can break down the protective barriers of both enveloped and non-enveloped viruses, indicating it can be developed into targeted synthetic antiviral drugs to kill a wide variety viruses.

ZIKA Virus WordleArtIn laboratory tests, the researchers said they were able to kill influenza viruses, HIV, Herpes viruses, polio and adenoviruses, and are eager to test their discovery against Zika, Ebola and Bird Flu.  In a letter to the CDC, the researchers outlined their findings, and offered their help in developing new treatments against these global health threats.

“We are very excited about our findings to date, and are eager to expand the testing of our drugs on these dangerous and highly contagious viruses,” said Victor Tetz, scientific head of TGV-Laboratories. The Zika virus is primarily a mosquito-transmitted infection. However, it was recently isolated from semen, and there is evidence it can be transmitted through sexual intercourse — opening new frontiers for global spreading and raising the need for an antiviral drug that can attack it at many levels. “The studies we have conducted to date show MV-4 can inactivate viruses in the outer environment, on human skin and at intravenous administration, so we believe discovery shows huge promise against Zika, Ebola and Bird flu.”

TGV Laboratories, along with its Institute of Human Microbiology, are finalizing a paper that details their discovery and what they believe to be its strong potential for safely treating a broad range of life-threatening and non-life threatening viruses. Currently, there are no broad-spectrum antiviral drugs.  MV-4 is the second broad-spectrum drug candidate developed by TGV Laboratories, whose Mul-1867 has shown potential for being developed into drugs that can treat an extensive range of antibiotic-resistant bacterial and fungal infections. TGVs subsidiary, TGV-Inhalonix, recently filed an application with the Food and Drug Administration seeking Orphan Drug Status for Mul-1867 to be tested on cystic fibrosis patients with life-threatening antimicrobial-resistant pulmonary infections.

“Developing broad-spectrum drugs that can treat viruses and the growing list of antibiotic-resistant infections is one of the most important, but elusive, goals in infectious research today,” said George Tetz, head of research for the Institute of Human Microbiology. “With MV-4 and Mul-1867, we believe we have unlocked the key for developing the next-generation of antibiotics and anti-viral drugs.”

The drugs in TGV’s pipeline were discovered as the result of years of research by Victor and George Tetz using a new concept they developed called Pangenome, (http://www.ncbi.nlm.nih.gov/pubmed/15990697), which acts like a guide that helps mark new therapeutic targets for drugs. The Institute of Human Microbiology assisted TGV with Mul-1867’s discovery.

TGV-Laboratories Group of Companies. (http://tgv-labs.com) is a research-based pharmaceutical company headquartered in New York that provides a broad range of innovative products to treat currently untreatable infectious, autoimmune and neurodegenerative diseases. TGV operates under two divisions: the Division of Drug Discovery & Development and the Division of Medical & Industrial Microbiology.

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Quick Takes: the Pharma C-Suite with John Hudak, President: Outsourcing & Strategic Partnerships

In the recent PharmaVoice Feb 2016 PV MagCover FEB16 issue highlighting Outsourcing, PV asked Pharma’s KOL’s to answer some key questions regarding the current state of Outsourcing & Strategic Partnerships.

John Hudak, President & Founder of Criterium Inc Global CRO

John Hudak, President & Founder of Criterium Inc Global CRO

John M. Hudak, President and Founder, Criterium Inc., Global CRO answered these 2 questions for them:

  • What barriers continue to limit CROs and sponsors from becoming true development partners?

Sponsors can have unrealistic expectations of CRO partners. Most partnerships work top-down at both Sponsors and CROs, and are evidenced in timelines and budgets. But top-down management may not always translate into trickle-down commitment. There are some discouraging figures out there about the high percentage of studies that don’t meet their timelines. When timelines and budgets are estimated to satisfy board members or project committees, it’s imperative to include all key factors that affect early planning stages, and be grounded in fiscal reality.

  • What are the key ingredients to a successful outsourcing partnership?

Planning needs transparency and communication, in concert. Sponsors can sometimes have impractical expectations regarding timelines and budgets. And CROs can end up having the same unrealistic expectations of study sites. Everyone wants to meet expectations and win the job – but this sometimes results in unworkable time estimates and budgets. There needs to be more open discussion among stakeholders, Sponsors, CROs and sites regarding the environments in which studies are conducted — and realistic strategies for successful completion.

About John M. Hudak, MBA, President and Founder
John has more than 40 years of experience in the pharmaceutical research and business development arena serving the pharmaceutical and contract clinical services sectors. He has extensive expertise in strategic planning and competitive analysis, market development, promotional planning and tracking, proposal design and custom-services development, international project management and clinical study completion, protocol design and implementation, electronic data capture, and market communications and has worked with drugs, biologics, generics and medical devices.

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Study Shows Many People With Obesity Still Consider Themselves Healthy

New study finds that many people with obesity consider themselves healthy despite having obesity-related comorbidities

fat-shadow-man-1168363 by Michal Zacharzewski FREEPIK

Photo courtesy Michal Zacharzewski via FREEPIK.com

Initial data from Awareness, Care & Treatment In Obesity MaNagement (ACTION), the first nationwide U.S. study to investigate barriers to obesity management, were presented on November 6 at ObesityWeek 2015, the 3rd annual combined congress of the American Society for Metabolic and Bariatric Surgery and The Obesity Society. Notably, results highlight a general lack of understanding of obesity as a disease and its impact on the body, with the majority of people with obesity (75%) indicating that they perceive themselves as “healthy,” although nearly three-quarters had obesity-related comorbidities. 1

“People with obesity often struggle to successfully manage their weight and obtain the help they need to maintain weight loss and improve their health,” said Joseph Nadglowski, president of the Obesity Action Coalition, a non-profit coalition helping individuals affected by obesity. “The findings from the ACTION study indicate that the challenges many people with obesity face may stem from their misperception that obesity is a lifestyle issue that can be overcome simply by eating less and exercising more, instead of a complex disease that requires a comprehensive care approach.”

Other findings from this early qualitative phase of the ACTION study highlight differences in perception of obesity between people with obesity and health care professionals. While people with obesity and health care professionals considered obesity a combination of disease and lifestyle, their primary emphasis differed widely—the majority of people with obesity (65%) considered obesity primarily a lifestyle issue, while the majority of health care professionals (88%) considered obesity a disease. 1 All results were drawn from focus groups and interviews conducted with people with obesity (n=43) and health care professionals (n=24).

“These variances in perception of obesity and its causes may be one reason why patients and clinicians are not engaging in the necessary conversations that lead to solution-based strategies to address weight-related health problems and its long-term management. The aim of ACTION is to gain a better understanding of all the barriers that prevent effective obesity care and to devise successful approaches to overcome modifiable barriers,” said Dr. Nikhil Dhurandhar, president of The Obesity Society and member of the Steering Committee for the ACTION study.

Additional disparities between people with obesity and health care professionals related to perceptions of key barriers to weight management were identified in this initial qualitative phase of the ACTION study. The disparities relate to food habits, social relationships, and limited understanding of how to lose weight. 1

The initial qualitative findings of the ACTION study indicate that multiple barriers prevent effective obesity care; this will be further investigated on a larger scale in the subsequent phase of quantitative research. Currently underway, the quantitative study draws from an online survey conducted with 3,000 people with obesity, 600 health care professionals, and 150 employers. The full results of the ACTION study will be released in 2016.

The ACTION study is conducted in the United States and led by a multidisciplinary Steering Committee consisting of representatives from The Obesity Society (TOS), the Obesity Action Coalition (OAC), Integrated Benefits Institute (IBI)—representing employers, as well as obesity experts in the fields of primary care, endocrinology, psychology and nursing. The study is sponsored by Novo Nordisk.  For more information, visit novonordisk-us.com

About Obesity    Obesity is a disease 2 that requires long-term management. It is associated with many serious health consequences and decreased life expectancy. 3, 4 It is a complex and multifactorial disease that is influenced by genetic, physiological, environmental and psychological factors. 5  The global increase in the prevalence of obesity is a public health issue that has severe cost implications to health care systems. 6,7 In the United States, approximately 35% of adults, or nearly 79 million adults, live with obesity. 8,9 Despite the high prevalence of obesity, many people with obesity lack support in their efforts to lose weight and the disease remains substantially underdiagnosed and underreported. 10

About ACTION    Awareness, Care & Treatment In Obesity MaNagement (ACTION) is a U.S. study investigating the barriers to obesity management by examining the perspectives of three groups: health care professionals, people with obesity and employers. The ultimate objectives of ACTION are to create a better understanding of the barriers that prevent people with obesity from receiving the medical care and support they need to improve health, to generate insights to guide collaborative action to improve care, education and support for people with obesity, and to create a platform for communication, to help change how patients, health care professionals and employers approach obesity care.

References  1 Kaplan L Golden A, O’Neil P, et al. Divergence of patient and clinician perceptions of obesity and weight management. Poster presented at: ObesityWeek 2015; November 2-6, 2015; Los Angeles, CA. 2 American Medical Association. Business of the American Medical Association House of Delegates 2013 Annual Meeting annotated reference committee reports: reference committee D. http://www.ama-assn.org/assets/meeting/2013a/a13-addendum-refcomm-d.pdf. Approved June 8, 2014. Accessed September 8, 2014.  3 Guh DP, Zhang W, Bansback N , et al . The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9(88):1-20. 4 Peeters A, Barendregt JJ, Willekens F, et al . Obesity in adulthood and its consequences for life expectancy: a life-table analysis. Ann Intern Med. 2003;138:24-32. 5 Wright SM, Aronne LJ. Causes of obesity. Abdom Imaging. 2012;37(5):730-732. 6 World Health Organization. Fact sheet no. 311: obesity and overweight. http://www.who.int/mediacentre/factsheets/fs311/en/. Updated January 2015. Accessed October 6, 2015. 7 Cawley J, Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. J Health Economics. 2012;31(1):219-230. 8 Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311(8):806-814. 9 Centers for Disease Control and Prevention. Adult obesity facts. http://www.cdc.gov/obesity/data/adult.html. Updated September 21, 2015. Accessed October 26, 2015.  10 Crawford AG, Cote C, Couto J, et al. Prevalence of Obesity, Type II Diabetes Mellitus, Hyperlipidemia, and Hypertension in the United States: Findings from the GE Centricity Electronic Medical Record Database. Popul Health Manag. 2010;13:151–161.

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Clinical Trials Monthly Case Study Analysis: Cost Reductions / Hematology

Each month, we investigate a different Clinical Trial Case Study that posed us with a challenging question – this time it’s a look at an orphan indication in HEMATOLOGY, and significant cost reductions for the sponsor:

We asked ourselves:

Scenario: A Phase IV study was required by the FDA as a condition of approval of an orphan drug. The sponsor was faced with monitoring, managing, and locking data for a 12-month study conducted at 100 sites.

•    Criterium offered an integrated technology-enhanced solution that allowed the sites to register ePRO Patient Diaries Input-Output Diagrampatients and allowed the patients to record their event data directly into our remote systems.
•    Criterium’s solution enabled the client to eliminate most of the scheduled monitoring visits. Criterium’s diligence and centralized system meant that monitors only had to visit sites that had problems.

What If:  If the client had used traditional methods, the cost would have soared for a product that has modest revenue and it would have taken much longer to provide the data to the FDA and the prescribing community.

Results:  Criterium’s centralized real-time data accession utilizing Automated CRFs and Interactive Voice Response (IVR) medical history and patient diary application saved the client $1 million to $1.5 million in clinical monitoring and data management costs. In addition, the data were satisfactory for rapid submission to the FDA for conditional approval, were provided to the medical community to support the indication for which the drug was approved and numerous publications resulted from this fairly large body of data for this orphan indication.

Read more of our successful case studies: http://www.criteriuminc.com/case_studies.php

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For Cancer Patients, The Possibility Of DNA-Tailored Care

Holly Boehle looked at the expression on the face of her radiologist and knew something was wrong. Boehle had felt a lump just before the holidays and had decided to schedule a mammogram, even though she wasn’t due to start standard screening for another eight years. The mammogram was followed up with an ultrasound, and then a biopsy. Finally, she was given the formal diagnosis: invasive ductal carcinoma, the most common type of breast cancer.

The next week she traveled to Mayo Clinic’s oncology office in Rochester, Minn., where she met with clinical breast surgeon Dr. Judy Boughey who suggested Boehle consider participating in a new, ongoing study. She quickly agreed and became one of 140 women to take part in the Breast Cancer Genome-Guided Therapy Study, affectionately called “BEAUTY.”

By the end of the month, the first phase of the study was underway. Tumor tissue was taken from Boehle, and promptly brought into a lab where the sample was injected into mice with compromised immune systems. With her tumor tissue growing inside of them, the avatar mice are given different chemotherapy drugs in order to test the efficacy of treatment before they try it out on human Boehle.

BEAUTY’s Beginnings

Each patient in BEAUTY was given a biopsy, imaging, and chemotherapy treatment, followed by a second round of biopsy and imaging before they headed into the operating room. This gave researchers information on each patient’s blood and genetic makeup, and the sequencing information for their tumor before, during, and after chemotherapy treatment. The mouse avatars, known as patient xenografts, took up the patient’s individualized tumor 40 percent of the time, ultimately serving as a preview into the patient’s treatment outcome.

DNA Strand Free CCLicenseA class of chemo drug called taxanes are the standard of treatment for breast cancer, but doctors currently don’t have a genetic marker to indicate who will respond to taxane therapy and who won’t. That’s why anthracyclines and cyclophosphamide, a separate chemotherapy drug regimen, are typically given in conjunction as the first step in treatment followed by taxane therapy. However, Boughey’s team reversed the sequence for BEAUTY patients whose mice reacted well to the taxane treatment first. It turned out that those patients who responded best to the flipped treatment sequence also shared the same gene in their genetic makeup.

Based on how her mice reacted to treatment, Boehle was one of those patients who were treated with a reverse chemotherapy schedule than what the typical patient with invasive ductal carcinoma is treated with. Within six months of her diagnosis, Boehle’s tumor shrank considerably as a reaction to the chemotherapy.

Being part of the trial has long-term implications for Boehle, too. If the cancer were to recur, she says, “we would already know…what works for me and what doesn’t. It really opens up a whole new world for me and other breast cancer patients in terms of individualized medicine and knowing that I don’t need to be the person who they experiment on and say, ‘Let’s try this medication or chemotherapy and see if it works and we hope that it does.’”

Four years ago, when Boughey and her team began setting up the BEAUTY study, they wanted to be able to design a treatment plan with a relatively accessible patient population. Because breast cancer is so common among women, the research team chose to start work on individualized medicine with those patients with plans to eventually work their way to other solid tumor cancers such as prostate.

By sequencing the genome for both the tumor and the patient’s inheritable DNA, researchers are able to pull the curtain back and see what’s driving the tumor to grow, why it’s different from another tumor, and how the tumor might react to drug treatments. Harnessing the genetic sequence of a tumor in conjunction with a person’s DNA will allow doctors to expand personalized cancer treatments beyond breast cancer.

Standard of Care Tumor Sequencing

Sequencing a tumor for its complete genetic information can take as little as a few days, and as long as several weeks, depending upon the stage of cancer. Once they have the results, researchers then compare them to a patient’s individual germline cells, which contain hereditary mutations that occur during conception. Patients born with germline mutations can pass on to future generations. Somatic mutations can be caused by a number of different environmental factors and can occur spontaneously. As researchers unravel which gene mutations are responsible for causing each corresponding disease, it sets the foundation for creating individualized treatments through trial-and-error.

“From there potential drugs can be identified that act on genes and/or pathways,” Boughey and her colleague Dr. Matthew Goetz, a clinical oncologist at the Mayo Clinic, told Medical Daily in an email. “One novel aspect of the BEAUTY clinical trial is our ability to link drug response in the patients with both germline and somatic genomic information and validate using the patient derived xenografts [mouse avatars].”

Mayo Clinic’s research team is currently writing the protocol for BEAUTY 2 based on the types of tumors they identified, and the drug resistance and successes discovered in BEAUTY 1. Because they were able to prove mouse avatars, when administered the same drug that patients were treated with, mirror the drug response seen in patients, pharmaceutical companies will be involved with this next stage by designing medications based on study participants’ response to treatment.

BEAUTY, Boughey says, will “drive forward breast cancer treatments for the future.”

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‘Second Cancers’ Are On The Rise, But It’s Kind Of A Good Thing

The number of “second cancer” patients, or individuals who develop two unrelated forms of cancer at different times in their lives, is on the rise. Although the news may sound grim, doctors say the increase is not due to patients’ poor health, but rather a sign that we’re getting better at detecting and beating cancer.

In the United States, nearly one in five new cases of cancer occur in individuals who have already had the disease. That’s a 300 percent increase since the 1970s, The Associated Press reported. While this figure may be startling, the fact remains that no matter what type of cancer a person has had, it’s possible to develop a new, unrelated cancer. According to the American Calab-test-tubes_227ncer Society, increasing numbers of second cancer cases are a sign that advances in early detection and treatment are saving an unprecedented amount of lives. In other words, people getting second cases of cancer means that more people than ever are actually surviving their first case.

Cancer is caused by mutations within the DNA that cause cells to no longer function correctly. These cells may eventually become cancerous. For some, the same mutations that led to the first cancer inevitably spur a second or even third case. This can occur even after the patient has made a full recovery. For example, doctors know women who have the BRCA1 mutation and have already experienced breast cancer are at a higher risk of developing an unrelated type of cancer, such as colon cancer. Because of this genetic risk, these patients will need to be monitored and screened for signs of other cancers for the remainder of their lives.

For others, the treatment that saved their life ends up being the reason their life is once again at risk. For example, although cancer treatments have become effective at destroying cancer without compromising the patient’s health, some treatments, such as radiation treatment, can actually give rise to new mutations and therefore new cancers.

Translational Science ResearchBattling cancer the second time can be trickier than the first because many treatments are ineffective or even deadly when given over a longer period of time.  Along with the medical limitations, experts agree that a second bout of cancer can be mentally difficult for patients to deal with. “I think it’s a lot tougher” for most people, Julia Rowland, director of the federal Office of Cancer Survivorship, told AP. “The first time you’re diagnosed, its fear of the unknown. When you have your next diagnosis, it’s fear of the known.”

Those who have survived past bouts of cancer need to be hypervigilant about cancer screening throughout their lives in order to ensure that if they do develop the disease again, they are able to detect it at the earliest possible stage. Although it may be daunting, patients should remember that cancer treatments are advancing on nearly a daily basis.

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Ophthalmology Devices Global Market Forecast (to 2021)

Ophthalmology is a segment of medical science associated with study of anatomy, physiology, diseases of human eye, and developing various therapeutic methods to treat eye diseases.

SUMMARY:  Some of the major eye diseases are either age-related or caused due to chronic disorders. They include various degenerative eye diseases like macular degeneration, cataract, ocular hypertension (glaucoma), and refractive errors among others. Revolution in the field of medical science has led to the rapid development of ophthalmology devices that are invented to effectively treat ocular defects and disorders.

Ophth Devices REPORTOphthalmology devices market is segmented on the basis of products type as diagnostic devices, surgical devices and vision care. Based on the applications the ophthalmology devices market is segmented into cataract, glaucoma, age-related macular degeneration, diabetes retinopathy and others (refractive errors, amblyopia, and strabismus). End-users are segmented into hospitals, academic and research laboratories, and others (private eye clinic and vision care outlets).

The global ophthalmology devices market is expected to grow at a CAGR of around 5.8% from 2015 to 2021. Increasing incidence of degenerative diseases of eyes, increasing baby boomer population, increase in R&D activities in ophthalmology key players and extensive use of high-end technologies involving use of software and computer aided devices and platforms in ophthalmology drives the market of ophthalmology devices market. Lack of ophthalmologists, economic slowdown and saturation of the market in developed countries are the factors hampering the market growth.  (Access the full report: http://www.reportlinker.com/p03086455-summary/view-report.html)

Lifestyle changes owing to increase in ocular cancer, diabetes and macular degeneration patients, early diagnosis and treatment of diseases, advancement of technology with its wide application areas shows that ophthalmology devices market has vast opportunities in the coming years.

North America accounts for the highest market share followed by Europe. Steep rise in aging population, increase in minimally invasive surgeries and favorable government policies makes U.S. the leader of ophthalmology devices market. However, Asian countries especially India and China’s are the fast growing regions with its growing demand for ophthalmology devices and increasing research investments.

Major players in ophthalmology devices market include: Abbott Medical Optics, Inc. (USA), Alcon Laboratories, Inc. (USA), Bausch & Lomb, Inc. (USA), Carl Zeiss (Germany), Essilor International SA (USA), Haag-Streit Holding AG (Switzerland), Hoya Corporation (Japan), Nidek Co. Ltd (Japan), STAAR Surgicals (USA), Topcon Corporation (Japan).

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HIV Uses Immune System’s Own Tools to Suppress Itself

Canadian scientists make a significant discovery on HIV persistence

A Canadian research team at the IRCM in Montréal, led by molecular virologist Éric A. Cohen, PhD, made a significant discovery on how HIV escapes the body’s antiviral responses. The team uncovered how an HIV viral protein known as Vpu tricks the immune system by using its own regulatory process to evade the host’s first line of defense. The findings pave the way for future HIV prevention or cure strategies.

The study’s goal was to determine how HIV manages to compromise antiviral responses in the initial period of infection, also called the acute infection stage, during which the virus establishes itself in the body. The acute infection is considered a critical period in determining the complexity, extent and progression of the disease. It is also during this stage that HIV establishes latent infection in long-lasting cellular reservoirs. These viral reservoirs, which harbor the virus out of sight from the immune system and antiviral drugs, represent the primary barrier to a cure.

“An important component in this process is a group of proteins collectively called type 1 Interferons, which are the immune system’s first line of defense against viral infections and are known to have a beneficial role in the early stages of HIV infection,” says Dr. Cohen, Director of the Human Retrovirology research unit at the IRCM. “The problem is that HIV has developed mechanisms to suppress the Interferon response and, until now, little was known about how this was achieved.”

PHIL-18143 PubDomLic SEM HIV Particles courtesy NIAID

SEM HIV Particles courtesy NIAID PHIL-18143

Most of the Interferon is produced by a very small population of immune cells called pDCs (plasmacytoid dendritic cells), responsible for providing immediate defense against infections. PDCs patrol the body to detect invaders and, when they recognize the presence of a pathogen, they secrete Interferon. The Interferon then triggers a large array of defense mechanisms in nearby cells, creating an antiviral state that prevents the dissemination and, ultimately, the expansion of the virus.

“When pDCs encounter HIV-infected cells, the production of Interferon is regulated by a protein located on the infected cell’s surface called BST2,” explains Mariana Bego, PhD, first author of the study and research associate in Dr. Cohen’s laboratory. “BST2 has the ability to bind to and activate a receptor called ILT7, found on the surface of pDCs, which, in turns, sends a signal that suppresses the production of Interferon and halts its defensive functions. Interestingly, BST2 is also responsible for restricting HIV production by trapping the virus at the cell surface before it can exit infected cells and disseminate. However, HIV uses the viral protein Vpu to counteract BST2 antiviral activity.”

“With this study, we uncovered a unique mechanism whereby HIV exploits the regulatory process between BST2 and ILT7 to limit the body’s antiviral response, which allows the virus to spread and leads to persistent infection,” adds Dr. Bego. “We found that HIV, through Vpu, takes advantage of the role played by BST2 by maintaining its ability to activate ILT7 and limit the production of Interferon, all the while counteracting its direct antiviral activity on HIV production.”

“The hope for a definitive cure and an effective vaccine has been frustrated by HIV’s endless propensity to subvert the host’s defenses and persist in small populations of long-lasting reservoirs despite antiretroviral therapy,” describes Dr. Cohen, who also leads CanCURE, a team of leading Canadian researchers working towards an HIV cure. “Our findings can provide tools to enhance antiviral responses during the early stages of infection. By blocking Vpu’s action, we could prevent early viral expansion and dissemination, while also allowing pDCs to trigger effective antiviral responses. We believe that such interventions during primary infection have the potential to limit the establishment and complexity of viral reservoirs, a condition that seems required to achieve a sustained HIV remission.”

“The discovery by Drs. Bego and Cohen, which explains how the virus can’t be held down or wiped out during early periods of infection, will bring us closer to ending HIV/AIDS,” says Robert Reinhard, CanCURE Community Liaison. “By filling an important gap in knowledge, this new study will advance research for an HIV cure.”

About the study
The research project was funded by the Canadian Institutes of Health Research (CIHR), the Canadian HIV Cure Enterprise (CanCURE) through a partnership between CIHR, the Canadian Foundation for AIDS Research (CANFAR) and the International AIDS Society (IAS), as well as by a pilot project from the FRQS AIDS and Infectious Disease Network. The study’s authors also include Édouard Côté and Johanne Mercier from the IRCM, as well as Nick Aschman and Winfried Weissenhorn from the Université Grenoble Alpes in France. For more information on the study, please refer to the article published online by PLoS Pathogens

Findings from this study presented by Dr. Cohen on July 21 at the Vancouver Convention Centre as part of the 8th IAS Conference on HIV Pathogenesis, Treatment and Prevention.

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2015: Lung Cancer Research Outside the USA

Female Lung Cancer Deaths to Surpass Breast Cancer in Europe

In January 2015, a study by researchers from Switzerland and Italy revealed that lung cancer deaths among women in Europe would overtake those from breast cancer in 2015.[1] Lung cancer is the most common type of cancer, accounting for 13% of all cancer deaths worldwide. That represents a death toll of 1.6 million people, over 80% of who are tobacco users.[2]  While European men have been more afflicted by the disease due to higher smoking rates, the rates among men have been on the decline in the recent past. Meanwhile, the rates among women have been on an upward trend. This year, the prevalence of lung cancer among women in Europe is expected to rise by 9% over 2009 levels to reach 14.24 per 100,000 of population. Meanwhile, the death rate from breast cancer over the same period will fall by 10.2% to 14.22 deaths per 100,000 of population.[3]

The rise is attributed to the delayed effect of the surge in smoking among European women during the period after the 2nd World War and extending to the late 1960s.[4] The UK is one of the main drivers of this trend. Of all the countries surveyed independently, the UK had the highest level of lung cancer deaths, 21 per 100,000 of population.[5] Professor Carlo La Vecchia of the University of Milan, who is also the lead researcher attributed this to the fact that, “…British women started smoking during the second world war, while in most other EU countries women started after 1968.”

Research Shows Personalized Treatments are Underutilized

An international survey conducted between December and January 2015 revealed that the rates of patients receiving personalized treatment for advanced non-small cell lung cancer (NSCLC) remains low despite a large proportion of them (81%) having been tested for EGFR mutations. The results of the study were released in April in Ingelheim Germany, the seat of the Boehringer Ingelheim Pharmaceutical group which is the main sponsor of the study. The results were collected from 562 oncologists from 10 developed countries across Asia, Europe and North America. In Europe, 30% of advanced NSCLC patients were put on first-line treatment before their test results were ready, displaying a huge disparity with Asia (12%). The average global rates were 25%. The main reasons cited by oncologists for non-testing were insufficient tissue, poor patient fitness and protracted process of acquiring results once samples had been taken. Additionally 51% of all oncologists involved in the study stated that their treatment decisions were not dependent on EGFR mutation subtype of their patients. EGFR mutations are present in 40% of East Asian and 10-15% of white NSCLC patients.[6] ESMO clinical practice guidelines[7] recommend the use of EFGR mutation testing results to guide treatment decisions according to each patient’s specific cancer type as this has been shown to improve survival rates at least with the Del 19 mutation[8], the most common type of mutation.[9]

Sources:
[1] http://annonc.oxfordjournals.org/content/early/2015/01/24/annonc.mdv001.full
[2] http://www.cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-cancer/smoking-facts-and-evidence#smoking_facts0
[3] http://annonc.oxfordjournals.org/content/early/2015/01/24/annonc.mdv001.full
[4] http://www.theguardian.com/society/2014/oct/07/smoking-falls-lowest-level-uk-recording-started-1940s
[5] http://annonc.oxfordjournals.org/content/early/2015/01/24/annonc.mdv001.full
[6] https://www.boehringer-ingelheim.com/news/news_releases/press_releases/2015/17_april_2015_oncology.html

[7] http://annonc.oxfordjournals.org/content/early/2014/08/11/annonc.mdu199.full.pdf+html
[8] Afatinib versus cisplatin-based chemotherapy for EGFR mutation-positive lung adenocarcinoma (LUX-Lung 3 and LUX-Lung 6): analysis of overall survival data from two randomised, phase 3 trials
    Yang, James Chih-Hsin et al., The Lancet Oncology , Volume 16 , Issue 2 , 141 – 151
[9] http://link.springer.com/article/10.1007/s00330-015-3697-0/fulltext.html

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