April, 2006
ArchivesMutated gene predicts resistence to Erbitux therapy and poorer overall survival
Erbitux™ (cetuximab) blocks EGFR, a receptor on colorectal cancer cells that promotes the growth of the cell. Some patients who are treated with Erbitux™ will respond to the drug, and their tumors will get smaller. For these patients, survival time is increased. Others show no response and have no improved survival.
French scientists explored some of the genes that are associated with the EGFR (epidermal growth factor receptor) pathway for mutations that might affect response to Erbitux™. Looking at 30 patients with metastatic colorectal cancer, they found that 11 (37%) responded to Erbitux treatment.
One mutated gene — KRAS — was significantly associated with lack of drug response. None of patients who responded had mutated KRAS, while nearly 70% of those who had no objective reductions in their tumors did have KRAS mutations.
In addition to Erbitux™ response, KRAS mutations predicted poorer survival. Patients with mutated KRAS in their tumor had a median overall survival time of 6.9 months compared to those without mutations whose median survival was 16.3 months.
Study results were reported in the April 15, 2006 issue of Cancer Research.
The research team, headed by Astrid Lievre, reported:
In conclusion, in this study, KRAS mutations are a predictor of resistance to cetuximab therapy and are associated with a worse prognosis.
Posted by Kate Murphy on April 21st, 2006
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Waist fat increase colon cancer risk in women
Women who have excess fat around their waists, so-called central adiposity, have an increased risk for colon cancer according to a study in the March 2000 issue of the International Journal of Cancer.
Studying 24,000 women over 10 years, researchers in Australia measured waist circumference and waist-to-hip ratios (WHT) ratios at the beginning of the study. During the ten years, there were 212 colon cancers. Women whose waist measurements were larger than their hips, a sign of central adiposity, were about 30% more likely to have colon cancer than women with narrow waists. Larger waist measurements (waist circumference) increaed colon cancer risk by about 15%.
There was some evidence that additional central fat predisposed women in the study to cancers in the proximal colon or the first section of colon. Given their increased risk for colon cancer and the stronger possibility that the cancer might be located near the beginning of the colon, women with excessive waist fat probably should consider screening tests like colonoscopy that examine the entire colon.
Other studies have showed a similar increase in colorectal cancer risk for men with excess waist fat.
An article about the study is available from Reuters Health..
waist fat colon cancer risk colon cancer in women
Posted by Kate Murphy on April 20th, 2006
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Manufacturers can provide free drugs to low-income patients receiving Medicare Part D
Health and Human Services officials have clarified ways that drug manufacturers can continue to provide free medications to needy patients, even if those patients are enrolled in Medicare Part D prescription coverage.
HHS Inspector General Daniel Levinson clarifed his position on Tuesday, April 19, 2006 that there are “lawful avenues” for pharmaceutical companies to give financial assistance to needy Medicare patients.
Critical to such programs are:
- No Medicare payment is sought for free drugs.
- Assistance is based solely on financial need.
- There is a methodology for assistance that does not take into account the patient’s choice of a Medicare Part D drug plan.
In January 2006, HHS provided guidance to pharmaceutical companies and patient assistance programs to ensure that the programs operated legally and did not pressure any patient to take a particular drug.
There has been confusion over whether patients could be required to drop out of Part D in order to receive drug assistance or help with co-pays. In addition, some pharmaceutical company patient assistance programs have required that patients enroll in Part D. However, patients do not need to drop out of Part D or be compelled to enroll to meet federal requirements.
Pharmaceutical companies can help with Medicare Part D co-pays as long as there is no company pressure to persuade a patient to use a particular drug. Many companies are turning to not-for-profit organizations to provide counseling and financial help with co-pays through unrestricted grant programs to those organizations.
Posted by Kate Murphy on April 20th, 2006
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Getting Ready for the Budget Battle
Past posts have discussed the impact of the 2006 funding cuts on cancer research and prevention. The President’s Budget proposal for 2007 would increase the cuts.
Members of Congress on the respective Appropriations Committees cannot adequately fund programs in FY 07 if they are not allocated the money necessary to administer these programs. As we saw last year, the House and Senate Appropriations Committees can only spend as much money as the overall Budget Resolution allocates.…The Specter-Harkin and DeLauro amendments sought to restore funding for the health andeducation functions in the respective Senate and House Budget Resolutions to the levels provided just two years ago (Fiscal Year 2005). It is important that health and education advocates support the restoration of these critical funds this year, or the trend will only get worse as additional reductions are made with each passing year
On an inflation-adjusted basis, the current NIH appropriation is smaller than it was four years ago. In constant dollars, NIH funding has declined by more than $1 billion since 2003 …Scientists across the country have seen delays in processing grant applications, elimination of cost-of-living allowances for multiyear grants and cuts in continuing grants previously awarded. For young researchers, there is the real danger that they may not receive any NIH funding. Some of our best and brightest young investigators … may leave the profession. What a loss that would be for American biomedical research.
Posted by Nancy Roach on April 19th, 2006
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Older adults have better outcomes when they complete full course of chemotherapy
Patients over 65 with stage III colorectal cancer who completed the full 6 month course of chemotherapy were almost twice as likely to survive as those who stopped treatment early. However, about 30% dropped out of therapy early.
Examing data for 1,600 people over 65 receiving 5FU-based chemotherapy between 1995 and 1999 and lived at least 8 months, researchers found that those who were able to complete 5 to 7 months of treatment were 40% less likely to die from any cause and 47% less likely to die of colon cancer.
Older age, being unmarried, and having other health problems all contributed to those who didn’t finish chemotherapy.
Alfred I. Neugut and his colleagues from Columbia University and New York Presbyterian Hospital reported the results of their study in the Journal of Clinical Oncology published early online on April 17, 2006.
More than 30% of elderly patients who initiated FU-based chemotherapy for stage III colon cancer and survived for at least 8 months discontinued treatment early. Mortality rates among such patients were nearly twice as high as among patients who completed 5 to 7 months of treatment. If the association we observed between duration of treatment and survival is confirmed, additional investigation is warranted to determine whether dose-intensity, cumulative dose, or other factors related to receipt of full adjuvant treatment are responsible.
Posted by Kate Murphy on April 18th, 2006
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