Potential for Cancer Cell Errors Puts Research in Doubt

The validity of dozens of cancer studies have come under question following tests that indicate scientists have been unwittingly using the incorrect types of cancer cells for their research

All research studies in question involve the use of esophageal adenocarcinoma cancer cell lines. Cell lines are a specific type of sample that is grown in a laboratory. While this is advantageous in that it increases the supply of cells for research, it also results in different studies receiving cells that are all culled from a single patient.

While this isn’t an issue in and of itself, recent tests show that many samples labeled as esophageal cells actually consisted of alternate tumor types such as lung, stomach and bowel cancer.

Given the broad usage of single cell lines, this finding has placed numerous major drug trials in a gray area of unreliability. These trials are intended to provide accurate results on whether or not a drug is both safe and effective. However, if the wrong cell types are used, this can result in faulty data that can essentially negate any research involved.

As stated in a formal report created by the University Medical Centre in Rotterdam, “Experimental results based on these contaminated cell lines have led to ongoing clinical trials recruiting patients, to more than 100 scientific publications, and to at least three cancer research grants and 11 U.S. patents.”

The most notable drug that may have been tested based on false cell lines is sorafenib.(Nexavar).

Sadly, the problem of mixing up laboratory cell lines is not a new one. According to a spokesperson for the Health Protection Agency, ” The use of wrongly identified human cancer cell lines is a problem that was first recognized more than 20 years ago.”

Due to the prevalence of the problem, scientists are encouraged to validate the samples supplied for research through DNA testing prior to beginning a research program.

Resources:

http://news.bbc.co.uk/2/hi/health/8460049.stm

Presence of Abnormal Glycoproteins May Help Early Cancer Detection

Antibodies that latch on to abnormal glycoproteins may serve as a new biomarker for early cancer detection, according a recent study conducted at Copenhagen University in Denmark and supported in part by the National Cancer Institute (NCI).

Glycoproteins are a specific class of proteins that are connected to sugar molecules. Within this class of proteins, researchers specifically looked at mucins, a sub-category of glycoproteins that can be found on the outer surface of cells. As has been previously identified, cancer cells display different amounts of mucins within a cell structure. Some cancer mucins have uniquely altered sugar groups that are different from those found on healthy cells.

With this in mind, the Copenhagen team hypothesized that specialized antibodies within the body would target these unique cancer mucins. Antibodies are a type of protein manufactured by the immune system that are designed to detect antigens within the body. By targeting these antigens, antibodies signal an autoimmune response to harmful substances in the body. While many antibodies target foreign substances in the body, some are drawn to an individual’s own molecules and tissue. These antibodies are defined as autoantibodies.

After considerable trial and error, the Copenhagen team successfully identified autoantibodies that were drawn to these glycoproteins.

Armed with the ability to detect the presence of these autoantibodies, the team then screened blood samples from patients who had previously been diagnosed with breast cancer, ovarian cancer and prostate cancer. The results were positive, with detection of the unique antibodies in all three cases. In contrast, these antibodies were not present in control blood samples that did not come from cancer patients.

The study provides a promising new means for identifying cancer in its early stages. However, larger-scale studies are still necessary to validate the results.

Results from the study were reported by head researchers for the Copenhagen team – Hans H. Wandall, M.D., Ph.D. and Ola Blixt, Ph.D. The study was the result of an international collaboration made possible by the trans-NIH Alliance of Glycobiologists for Detection of Cancer and Cancer Risk.

Resource:

http://www.cancer.gov/newscenter/pressreleases/autoantibodysignatures

Facts About Generic Cancer Drugs

Many cancer patients struggle with the high costs of cancer treatment. One way to reduce monthly treatment bills is by opting to use generic alternatives to name brand prescription drugs. In general, these more affordable drugs offer the exact same effectiveness as their more expensive alternatives.

According to the U.S. Food and Drug Administration (FDA), a generic drug is identical to “a brand name drug in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use.”

When receiving a prescription from an oncologist, patients are encouraged to ask about potential generic alternatives. To find out if generic options are available for a particular prescription, online resources are also available. For example, the Electronic Orange Book allows patients to search by either the brand name of their drug or the active ingredient present in the medication.

Due to a lag in database updates, the most recently approved generic drugs can also be found at the FDA’s First Generics webpage.

Patients will find that not all cancer drugs have a generic equivalent. This is because new drugs tend to come with a drug patent that limits the ability for competing manufacturers to develop generic alternatives for a period of 20 years. This patent period is intended to reward the drug developer by creating exclusive rights to sales. Once the patent expires, other companies are then free to produce equivalent medications.

For those who are curious as to why generic drugs cost less, it is because the developers of such drugs do not have to cover the costs associated with researching and developing the initial proprietary drug. The patent period is intended to protect the original manufacturer from being undercut on price before a profit can be made.

Resource:

http://www.fda.gov/Drugs/ResourcesForYou/Consumers/QuestionsAnswers/ucm100100.htm

Occupational and Environmental Health

Issues related to environmental and occupational health have an important role to play in emergency medicine, pediatrics, primary care practice, and the various medical specialties. Work-related or environmental exposures may be associated with symptoms experienced by a patient. The environmental exposure history of a patient may prompt necessary interventions in order to prevent potential injuries or illnesses. Work-related illnesses and injuries may necessitate physicians to make assessment of disability, impairment and workers’ compensation.

Concerns about biological or chemical terrorism, and also industrial disasters, have made it necessary for physicians that they are able to immediately identify patterns linked to exposures to primary chemical agents (for instance, nerve agents and cyanide) and biological agents (for example, anthrax).

In order to be effective, it may be necessary for physicians to know how to have a good occupational/environmental history and practical understanding of most prevalent environmentally related illnesses. Moreover, physicians can also contribute significantly towards environmental and occupational issues which are outside the purview of office practice, thereby helping prevent occupational illness amongst other employees at the workplace and supporting global environmental health.

Mexico’s Wealthiest Man Pledges $65 Million for Medical Research

A 3-year genomics projects intent on studying the genetic nature of cancer, type II diabetes and kidney disease has been initiated by Carlos Slim – one of the wealthiest men in the world.

Recently, Slim pledged $65 million to be received by the Slim Initiative for Genomic Medicine. The initiative is a joint partnership between the Carlos Slim Health Institute, the Broad Institute of MIT and Harvard, and the Mexican National Institute of Genomic Medicine.

According to Eric S. Lander, president and director of the Broad Institute, the program is not designed to develop treatments, but rather focused on gaining improved insight into the genomic bases of these three diseases.

To accomplish this goal, scientists will use 10,000 samples to analyze the DNA of diabetes, kidney disease and seven types of cancer. The cancers to be studied have yet to be announced, however breast cancer will likely be included.

In response to the announcement, Carlos Slim said, “Only with the development of this genomic science and surrounding technology will it be possible, as it was before with vaccines, to face these diseases and prevent these diseases through their early detection, their early diagnosis.”

Ultimately, Slim hopes the initiative will provide insights that lead to improved cancer treatments in the future.

Slim is a telecommunications tycoon that serves as the head of the Grupo Carson conglomerate. He began the Carlos Slim institute in 2007 with the infusion of $500 million. The organization was created with the goal of educating Latin American and Caribbean citizens about important health issues. The Institute also assists in funding health-related research.

Slim is one of several billionaires who have recently made headlines for their contributions to medical research. Other examples include Bill Gates, who pledged $34 million to the Bill and Melinda Gates Foundation to study malaria, tuberculosis and HIV, and Mort Zuckerman, who recently set aside $100 million to build a cancer research center in New York.

Resources:

http://blogs.forbes.com/billions/2010/01/20/carlos-slim-funds-genomics-research/

http://www.google.com/hostednews/canadianpress/article/ALeqM5ieVAZmshWKmINeKIMoNP01hqGWLQ

Pediatric Environmental Health History

The physiology and behavior of children makes them more susceptible to the adverse effects of a variety of toxins. In decades past, most issues related to environmental exposure amongst children focused primarily on lead poisoning and second-hand smoke. Off late, the focus has shifted to health effects of other types of exposures as well, for instance, chemical irritants and allergens (eg. formaldehyde resins), pesticides, and other toxins including indoor and outdoor air pollutants. The pediatric history covers a variety of screening questions that are asked during the first as well as follow-up visits, as relevant to the development stage of a child. Questions focus on finding the type of home and surrounding environment most frequented by the child as well as the occupation of the parents.

Hazardous Materials and Chronic Illness

Work and environmental exposures can lead to or worsen several different types of common diseases, for instance asthma, dermatitis, hepatitis B, carpal tunnel syndrome, and cancer. In a number of cases, the environment or work-related illnesses do not show distinctive clinical presentations: asthma resulting from a cat allergy does not differ from asthma caused by latex allergy; median nerve entrapment associated with repetitive motions has the same set of signs and symptoms as carpal tunnel syndrome arising due to pregnancy; headache caused by inhalation of carbon monoxide can be diagnosed as severe headache or migraine. Symptoms associated with hazardous exposures can be similar to normal complaints involving any body system and other common medical diseases. There are certain exposures that can lead to immediate or subacute symptoms (for instance acute chemical reaction and allergic reactions), whereas others can result in more delayed outcomes (for example pneumoconiosis and cancer). The differentiating feature is the association to an occupational or environmental exposure. The history of occupational and environmental exposures can play a significant role in the identification, treatment, and prevention of occupational/environmental injuries and illnesses.

Measuring Occupational Injuries

It is difficult to measure the magnitude of occupational illnesses and injuries. The United States Bureau of Labor Statistics (BLS) that provides statistics based on surveys of private companies having more than 11 employees (an underestimate of the real totals), reported 5,488 fatal accidents related to work (3.7 for every 100,000) and around 4.0 million nonfatal illnesses or injuries (4.2 for every 100 equivalent full-time workers in 2007). Approximately 2.1 million illnesses and injuries necessitated recuperation away from workplace, restricted duties at work, or job transfer.

Examination of data gathered from a number of data sets (including the BLS) to generate the following approximation of the total number of occupational illness and injury occurring annually in the United States: 6500 fatalities from job-related injuries; 13.2 million nonfatal injuries; 60,300 deaths resulting from job-related disease; and 862,200 illnesses (work-related). The entire costs involved were approximately $171 billion. It was noticed in a study of health maintenance organization (HMO) members diagnosed with adult-onset asthma that 21 percent of cases were associated with occupational exposure.

Epidemiological studies involving firefighters and first responders are worth noting. For instance, the World Trade Center (WTC) disaster in the United States in September 2001 created controversy over conditions associated with exposure to toxic gases and dusts. Studies involving first responders within the first month after the WTC disaster revealed that bronchial reactivity was three times more in case of individuals who were at the site in the morning when the disaster occurred, in comparison to those who came later. Studies in the following year that focused on pulmonary function of rescue workers belonging to the NYC Fire Department showed significant reduction in average FEV1 in comparison to pulmonary function studies that were undertaken five years earlier. It has been reported that the incidence of “sarcoid-like” granulomatous pulmonary disease has increased. Also, an increased occurrence of fatal coronary heart disease has been noticed while comparing firefighters who were assigned emergency firefighting duties with those who were not assigned urgent duties.