Too Much Folic Acid May Cause Cancer

Over the past couple decades, folic acid has been largely heralded as a wonder vitamin. In the 1980s, studies began to show that folic acid might help prevent some cancers. Taking the vitamin has also been linked to reduced birth defects. In fact, since cereals and grains fortified with folic acid began hitting the market in the 1990s, rates of birth defects such as spina bifida and anencephaly have dropped by as much as 50 percent.While no one disputes that pregnant women should be taking folic acid, new studies are indicating that too much folic acid may help spur the growth of certain types of cancer.

Studies show that the same mechanism that helps fight cancer may also be accelerating the growth of cancer cells once they begin to form in the body. The benefits of folic acid stem from the vitamins ability to help the body manufacture and maintain new cells. Unfortunately, this benefit seems to translate to cancerous cells as well. This is partly why antifolate drugs are used to treat cancer.

In several animal studies, it was concluded that folic acid accelerated the formation of cancer once normal cells became locked on a path to become cancerous.

So if too little folic acid is not healthy, and too much folic acid isn’t either, then what’s the right amount that people should be taking? Researchers are still investigating this. However, most experts presently recommend a daily intake of approximately 400 micrograms. For pregnant women, that number increases to 600 micrograms.

Unfortunately, with the wide range of cereals, breads and snack bars on the market that are fortified with folic acid, individuals are at a risk to consume much more than 400 micrograms each day. Multivitamins also often over deliver on the amount of folic acid present in each daily dose.

This overdosing may have dramatic consequences. In one study, 1,000 people who had developed precancerous colon polyps were given a daily 1-milligram folic acid supplement – an amount 2.5 times greater than the recommended daily dosage. Years later, it was discovered that these people were more than twice as likely to develop three or more new polyps.

Though no clear numbers have been offered as far as healthy folic acid intake rates, Marian Neuhouser of the Fred Hutchinson Cancer Research Center in Seattle suggest “not to get more than 1,000 micrograms” a day.

Resources:

http://www.chicagotribune.com/features/chi-090607folicacid-story,0,868233.story

http://www.latimes.com/features/printedition/health/la-he-folate11-2009may11,0,1923701.story

Long Development Times Linked to Low Patient Accrual Rates for Cancer Trials

A recent study from Oregon Health and Science University (OHSU) indicates that 40 percent of all cancer trials do not achieve the minimum accrual goals necessary to achieve a statistically significant conclusion. Additionally, it was found that the longer the preparation time required to develop the clinical trial, the harder it was to accrue enough participants to complete the study.

The findings stem from an evaluation of more than 550 therapeutic, non-pediatric phase I, II and III clinical trials that took place from 2000 to 2007. All trials were sponsored by the National Cancer Institute’s Cancer Therapy Evaluation Program (CTEP). For the study, trial development time was defined as the time from initial CTEP submission to the time enrollment of patients began.

Among all trials reviewed, the median development time was 15 months. Those with a relatively fast development time (9 to 12 months) achieved minimum accrual requirements 77 percent of the time. In contrast, studies with lengthy development times (more than 27 months) achieved minimum accrual requirements just 22 percent of the time.

The team at OHSU, headed by Dr. Steven K. Cheng, is now looking at how current efforts to shorten clinical development times may improve accrual rates.

Finding patients to participate in cancer trials has become a growing concern among the cancer community. Though 1.5 million people are diagnosed with cancer each year, only three to five percent ever enroll in a clinical trial.

Oncologists Take Cancer Treatment Personal

At present, cancers are by and large treated based what part of the body the tumor has infected. To put it another way, breast cancer patients, colon cancer patients and lung cancer patients all undergo different treatment methods.However, this type of categorization seems to be on the shift. While location of the cancer tumor will always be important, it is becoming increasingly apparent that patients among a specific type of cancer can benefit from further, more precise levels of grouping.

Specifically, doctors are looking into a number of ways to personalize cancer treatment based on molecular origin rather than tumor location. The thinking is, that if the molecules that are causing the cancerous tumor (which can vary among patients with the same type of cancer) can be targeted, then a more precise and effective treatment method can be pursued.

Several studies have already been released that indicate such methods are effective. For example:

  • Head-and-neck cancer tumors with high levels of epidermal growth factor receptors (EGRFs) are more likely to return following surgery.
  • The presence of a BRCA2 variant gene increases the probability for breast cancer
  • The KRAS biomarker gene can indicate whether cetuximab will be an effective treatment method for colorectal cancer

These are only a few examples of the burgeoning and promising field of personalized cancer treatment. The more oncologists begin to look for differences among cancer categories, the more variations they find. Understanding these differences and how they affect traditional cancer methods can lead to customized drugs or therapies that ultimately work great for some segments of patients, and terribly for others.

Of course, the goal in each case is to find the best customized treatment for each individual patient. As cancer treatment continues in the 21st century, the majority of experts believe that the abandonment of the “one drug fits all” approach will be a key factor in improving cancer treatments and, ultimately, survival rates.

Resources:

http://thestar.com.my/health/story.asp?file=/2009/5/3/health/3576818&sec=health

http://www.newscientist.com/article/mg20227042.100-cancer-treatments-get-personal.html

http://www.economist.com/science/tm/displaystory.cfm?story_id=13642045

Men Estimated to be 40 Percent More Likely to Die From Cancer

Overall, men are 40 percent more likely to die from cancer, according to a recent study. Additionally, men are 16 percent more likely to contract cancer in the first place. The study, which was initiated by Cancer Research UK, suggests alarmingly different expectations of cancer survival between men and women.When looking specifically at cancers that affect both men and women, males fared even worse. In such instances, Cancer Research UK estimates that men are 60 percent more likely to contract the cancer, and 70 percent more likely to die from it.

The study cites two factors that likely result in the higher cancer risks among men – unhealthy lifestyle choices and a reluctance to visit the doctor.

The dramatic results of the study were a surprise to the research team, which had expected to see similar mortality rates between the two sexes. Indeed, there is no known biological reason why men would die more frequently from cancer than women.

Experts say that the study is a strong indicator that men need to be made aware of the consequences of not taking care of their bodies. Through simple lifestyle changes, it is believed that half of all cancers could potentially be prevented.

Some of the manageable factors that contribute to increased cancer risk include smoking, high alcohol intake, unhealthy diet and excessive weight in the mid-section.

Perhaps the easiest lifestyle change for men to make is to simply visit the doctor on a regular basis. Even if cancer cannot be prevented, routine doctor visits may help catch the cancer in an early stage of development. When caught early, the chances for survival dramatically improve for most types of cancer.

Resources:

http://news.bbc.co.uk/2/hi/health/8097639.stm

http://www.foxnews.com/story/0,2933,526344,00.html

Direct Chemo Delivery Shows Signs of Prolonging Patient Survival

Malignant gliomas are an especially difficult type of cancer to treat. Manifesting in the brain or spine, patients diagnosed with this deadly form of cancer have only a 3 percent likelihood of surviving five years or more. Now, a new method for delivering chemotherapy drugs is showing early signs of prolonging survival times among patients with malignant glioma.This new delivery process, called convection enhanced delivery, uses two catheters that are stereotactically placed in the tumor tissue to directly deliver Topotecan to the cancerous area.

Of the 16 patients who received the Phase 1 trial treatment, the median survival was 59 weeks. Furthermore, the median time to tumor progression was recorded at 20 weeks, and more than three-fourths of all patients survived for at least 6 months. These figures were statistically much better than those found in present treatment processes.

The direct chemotherapy process was formulated to overcome a poor penetration rate of intravenous and oral cancer drugs related to brain tumors. Due to a blood-brain barrier, the majority of drugs in the bloodstream never enter the brain. Additionally, surgery is not typically an effective treatment method because gliomas tend to grow tentacles that make them very difficult to remove completely.

Topotecan, a chemo drug currently used for lung cancer and sold by GlaxoSmithKline, was chosen for the trial because it has been shown to be effective in killing malignant glioma cells. However, the amount of Topotecan required in standard treatment procedures to adequately penetrate the brain was deemed too toxic for normal cells.

Though the new treatment has achieved early success, additional studies are required. Phase 2 clinical trials will begin in the coming months. Side effects presently linked to the new treatment include weakness in the upper extremities and neurological issues that occur due to brain damage.

Resources:

http://www.forbes.com/feeds/hscout/2009/05/04/hscout626712.html

http://www.newswise.com/articles/view/550842/

Headline: Lilly Gets Fourth FDA Approval for ALIMTA

A spokesperson for Eli Lilly and Co. (LLY), one of the leading US pharmaceutical manufacturers, released a statement last week that the US Food and Drug Administration (FDA) has granted a fourth approval for the cancer drug ALIMTA to be used as an upkeep therapy for locally advanced or metastatic non-small cell lung cancer (NSCLC).

NSCLC is among the most frequently occurring varieties of lung cancer. More than one hundred eighty thousand new cases are diagnosed each year in the US.

The company said that the most recent approval allows for the role of ALIMTA as a maintenance therapy for NSCLC, especially for those patients with nonsquamous tumors and in cases where the disease has not advanced after the patient has received up to four cycles of chemotherapy. ALIMTA is not suggested for use in treating patients with squamous cell non-small cell lung cancer.

Richard Gaynor, VP of cancer research and global oncology platform leader for Lilly, said this about the approval:

“It represents an important paradigm shift for NSCLC treatment – maintenance therapy as a way of extending survival in nonsquamous patients, using histology as a way of determining which NSCLC patients may benefit and which may not.”

The firm also commented that Dr. Chandra Belani, who holds the posts of both the deputy director of Penn State Cancer Institute at Penn State University’s S. Hershey Medical Center and the Miriam Beckner distinguished professor of medicine, delivered the outcomes from the worldwide trial at the yearly meeting of the American Society of Clinical Oncology’s on May 31 in Orlando.

The double-blind trial compared effectiveness concerning survival rates between a routine of ALIMTA plus the finest supporting care, and a routine with a combination of placebo with finest supporting care. In the 663 patients who participated in the trial, the results confirmed those of earlier studies examining the use of histology to custom-fit therapy routines for patients with severe nonsquamous NSCLC.

The company also mentioned that during 2004, ALIMTA obtained FDA approvals for combination therapy with cisplatin to care for patients that had contracted malignant pleural mesothelioma. In many cases, the disease is inoperable or many patients may not be strong enough to undergo surgery. The firm also received FDA approval for the use of ALIMTA as an individual agent for treating patients with locally advanced or metastatic NSCLC after the patient had received earlier chemotherapy treatments.

Last year, the combination of ALIMTA and cisplatin received FDA approval as a treatment method for locally advanced or metastatic NSCLC in cases where patients displayed nonsquamous histology. ALIMTA is currently approved as an individual agent for the treatment of cases of locally advanced or metastatic, nonsquamous NSCLC after earlier chemotherapy.

Lilly’s stock closed the pre-July Fourth holiday trading day at $33.90 on the New York Stock Exchange.

Source: http://www.rttnews.com/Content/BreakingNews.aspx?Node=B1&Id=997246%20&Category=Breaking%20News&pageNum=2592_2660_2

Protein Helps Indicate Progression of Rare Lung Disease

Idiopathic pulmonary fibrosis (IPF) is a rare lung disease with an expected survival time of about three to five years. Now, the link between a specific protein in the lungs and the progression of the illness may help doctors make better decisions about treatment methods for each individual patient.

The name of the protein is serum surfactant protein A, and doctors report that it is one of the best independent predictors of patients dying within the first year of IPF diagnosis. Head of research for the study, Dr. Brent W. Kinder of the University of Cincinnati Interstitial Lung Disease Center, reports that “this protein was more useful in predicting outcome than age, pulmonary function tests, or other conventional clinical markers of the disease.”

The new research suggests that a simple blood test to check for the presence of the protein can help determine the best course of treatment for IBF patients. For cases in which the protein suggests a short survival time, more informed decisions can be made about whether or not the undergo difficult treatment. Urgency of enrollment in clinical trials can also be gauged. In extreme cases, the new predictor may also help indicate the most optimal time to schedule a lung transplant.

IPF is a disease that results in scarring of the lung tissue. Overtime, healthy lung walls become replaced with fibrotic scar tissue. This fibrosis reduces the ability of the lungs to transfer oxygen into the bloodstream. This eventually leads to respiratory failure, heart failure, pulmonary embolism or similarly severe body malfunctions that result in death.

The new screening method is expected to assist in the roughly 50,000 new cases of IBF each year. The disease is most likely to affect individuals between the ages of 50 and 75.

Resources:

http://www.oncolink.org/resources/article.cfm?c=3&s=8&ss=23&Year=2009&Month=06&id=16309

http://www.sciencedaily.com/releases/2009/06/090604095117.htm

Opioid Pain Reliever Approved for Breakthrough Pain in Cancer Patients

 Pain is an infamously difficult cancer symptom to treat. Even when potent pain relievers are used, waves of pain often flare up and break through the effects of the medication. This type of pain is known as breakthrough pain.

Now, doctors and patients have a new tool to help combat breakthrough pain. Recently, the U.S. Food and Drug Administration (FDA) approved a drug specifically designed to minimize breakthrough pain. This new drug, called Onsolis, is a potent medication that is part of a class of drugs known as opioid fentanyls. Onsolis is meant to be used in conjunction with other opioid medicines.

Onsolis is not a traditional prescription pill. Rather, it is administered through an absorbable film that is placed inside the mouth. Onsolis sticks to the side of the cheek, and the opioids transfer into the bloodstream from there.

Because of the high potency of Onsolis, the drug is only intended for cancer patients who are “opioid tolerant.” This typically means that tolerance to opioid drugs is reduced due to round the clock use of pain relievers.

The potential for misuse and abuse places additional caveats on Onsolis prescription approval. For example, the patient’s age must be 18 years or older. Additionally, Onsolis was only allowed approval with the inclusion of a Risk Evaluation and Mitigation Strategy (REMS). An REMS requires a drug to have heightened plan of action that reduces risks associated with the drug.

In the case of Onsolis, the REMS calls for restricted distribution through the FOCUS program. This means that only patients, pharmacies and prescribers who are registered with the program will be granted access to the drug.

The heightened measures of approval are intended to reduce the potential for drug abuse. The Onsolis box also includes a warning that states the drug should not be used for the management of traditional pain, or by patients that use opioids intermittently. For those that are not opioid tolerant, Onsolis has the potential to lead to overdose and death.

Cancer Cells Rely on Healthy Genes for Survival

Cancer cells incorporate a number of mutated genes to wreak havoc on our healthy human bodies. However, findings from a recent study now indicate that cancer cells also rely heavily on the presence of non-mutated genes for survival. Researchers at Harvard Medical School and Brigham and Women’s Hospital carried out the study.

The researchers made their discovery through a technique known as RNA interference (RNAi). Through this process, the production of thousands of proteins are blocked, and then cells are monitored to see which proteins are the most necessary for survival.

As it turns out, many normal proteins are vital to the life of cancer cells. When some of these proteins were dropped sufficiently, the cancer cells died. Interestingly, normal cells did not appear to be as dependent on these proteins, often surviving under conditions where the cancer cells did not.

Researchers believe this dependence on non-mutated genes serves as a type of stress reduction for the cancer cells. Abnormal tumor cells are subject to higher levels of DNA replication and protein production. Researcher Ji Luo states that normal genes “probably help them deal with the problems that develop as a result of the inappropriate presence of growth and survival signaling in tumor cells.”

Through the research, the team identified 50 proteins that kill cancer cells (but not normal cells) when normal production is blocked. These proteins now serve as new potential avenues for cancer treatment.

The hope is that drugs may be produced that effectively augment the levels of these proteins so that cancer cells are killed and normal cells survive.

Funding for the project came from several different sources, including the AACR Prevent Cancer Foundation AstraZeneca Fellowship in Translational Lung Cancer Research, the Damon Runyon Cancer Research Foundation, the National Institutes of Health, the Department of Defense and the Susan G. Komen for the Cure Foundation

Resource: http://web.med.harvard.edu/sites/RELEASES/html/052809_elledge.html

“Trojan Horse” Proves Effective in Lowering Cancer’s Resistance to Chemotherapy

During chemotherapy, it is not uncommon for a tumor to become resistant to treatment over time. This fact has proven to be a major obstacle in cancer treatment and, with few alternatives for treatment, patients with chemo-resistant cancer often experience limited timeframes for survival.

In an effort to reduce a cancer’s ability to resist chemotherapy medicines, a team of scientists in Australia has developed a new therapy that serves as a “Trojan horse” on the microscopic level.

The new method uses nanotechnology to breach cancer resistant cells and destroy them. To accomplish this, a bacterially-derived nano cell first infiltrates the cell. Once inside, the nano cell releases ribonucleic acid molecules (siRNA), a chemical which hinders the production of chemo-resistant proteins. Then, a second nano cell utilizes chemotherapy to kill the cell.

The method has proven remarkably promising in clinical trials, with the Australian team reporting a 100-percent survival rate in mice with human cancer cells.

The nanotechnology has been likened to a Trojan horse because the initial nano cells are masked so that the cancer cell willingly allows it to enter inside. Just as important, the technology only breaches and kills cancer cells. This is an improvement over traditional chemotherapy drugs, which can attack both cancer cells and normal healthy cells.

The team hopes that the treatment will one day be used to transform cancer from a deadly disease to a manageable, chronic illness. Human clinical trials for the method began in early July at the Peter MacCullum Cancer Center at the Royal Melbourne Hospital and The Austin at the University of Melbourne.

Resources: http://www.reuters.com/article/topNews/idUSTRE55R1Q320090629

http://www.abc.net.au/am/content/2009/s2610923.htm