Wednesday November 21, 2018

Immunotherapy Drugs Show Significant Improvement Against Breast Cancer: Study

Side effects need a close look, both doctors said. Nearly all study participants had typical chemo side effects such as nausea or low blood cell counts.

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Breast Cancer
This undated fluorescence-colored microscope image made available by the National Institutes of Health in September 2016 shows a culture of human breast cancer cells. For the first time, one of the new immunotherapy drugs has shown promise against breast cancer in a large study that combined it with chemotherapy to treat an aggressive form of the disease. VOA
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For the first time, one of the new immunotherapy drugs has shown promise against breast cancer in a large study that combined it with chemotherapy to treat an aggressive form of the disease. But the benefit for most women was small, raising questions about whether the treatment is worth its high cost and side effects.

Results were discussed Saturday at a cancer conference in Munich and published by the New England Journal of Medicine.

Drugs called checkpoint inhibitors have transformed treatment of many types of cancer by removing a chemical brake that keeps the immune system from killing tumor cells. Their discovery recently earned scientists a Nobel Prize. Until now, though, they haven’t proved valuable against breast cancer.

Breast Cancer
Weight loss may lower breast cancer risk for post-menopausal women. Pixabay

In the study

The new study tested one from Roche called Tecentriq plus chemo versus chemo alone in 902 women with advanced triple-negative breast cancer. About 15 percent of cases are this type, their growth is not fueled by the hormones estrogen or progesterone, or the gene that Herceptin targets, making them hard to treat.

Women in the study who received Tecentriq plus chemo went two months longer on average without their cancer worsening compared with those on chemo alone, a modest benefit. The combo did not significantly improve survival in an early look before long-term follow-up is complete.

Failed protein test

Previous studies found that immunotherapies work best in patients with high levels of a protein that the drugs target, and the plan for the breast cancer study called for analyzing how women fared according to that factor if Tecentriq improved survival overall.

breast cancer
FILE – A patient receives chemotherapy treatment for breast cancer at the Antoine-Lacassagne Cancer Center in Nice, July 26, 2012. VOA

The drug failed that test, but researchers still looked at protein-level results and saw encouraging signs. Women with high levels who received the combo treatment lived roughly 25 months on average versus about 15 months for women given chemo alone.

That’s a big difference, but it will take more time to see if there’s a reliable way to predict benefit, said Dr. Jennifer Litton of the MD Anderson Cancer Center in Houston. She had no role in running the study but enrolled some patients in it and oversees 14 others testing immunotherapies.

“We’re really hopeful that we can identify a group of women who can get a much bigger and longer response,” she said.

Another breast cancer specialist with no role in the study, Dr. Michael Hassett at Dana-Farber Cancer Institute in Boston, said he felt “cautious excitement” that immunotherapy may prove helpful for certain breast cancer patients.

Breast Cancer
Breast cancer cell, Wikimedia Commons

Side effects and cost

Side effects need a close look, both doctors said. Nearly all study participants had typical chemo side effects such as nausea or low blood cell counts, but serious ones were more common with the combo treatment and twice as many women on it stopped treatment for that reason.

Three of the six deaths from side effects in the combo group were blamed on the treatment itself; only one of three such deaths in the chemo group was.

Also Read: New DNA Tool To Predict People’s Height And Risk For Cancer

Cost is another concern. Tecentriq is $12,500 a month. The chemo in this study was Celgene’s Abraxane, which costs about $3,000 per dose plus doctor fees for the IV treatments. Older chemo drugs cost less but require patients to use a steroid to prevent allergic reactions that might interfere with the immunotherapy. Abraxane was chosen because it avoids the need for a steroid, said one study leader, Dr. Sylvia Adams of NYU Langone Health.

The study was sponsored by Roche and many study leaders consult or work for the company or own stock in it. (VOA)

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Growth Hormone Deficiency May Also Hit Healthy Children

Since he started getting these injections two years ago, Spencer has grown about 15 centimeters.

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FILE - UNICEF staff measure a girl's height to see if she is stunted in a village health clinic of South Hamgyong province, North Korea. VOA

Most healthy children between the ages of four and 10 grow about five centimeters (two inches) a year. So, one family knew something was wrong when their son fit into the same clothes, season after season. Doctors were able to get him growing once again after testing for a growth hormone.

Eleven year-old Spencer Baehman is passionate about baseball.

“My goal is to play college baseball,” Spencer said.

There was only one problem. Spencer was the shortest player on his team. It didn’t stop him from playing, but the height difference was noticeable. And it made Spencer feel different.

“I want to be as tall as these kids,” Spencer said.

At first, Spencer’s parents thought their son was just small, but gradually, they suspected something was wrong. His mom, Stephanie Baehman, became worried.

“It really set in one year coming out of winter into spring when he got out his cleats for spring baseball and he put them on, and they fit. And they never should have fit. Those were from the spring prior,” Baehman said.

Spencer’s parents set up an appointment with Dr. Bert Bachrach, the chief of pediatric endocrinology at University of Missouri Health Care. Nurses measured Spencer’s height.

After careful testing, Dr. Bachrach determined a growth hormone deficiency was causing Spencer’s growth failure. Hormones are basically chemicals that send messages from one cell to another.

“Growth hormone just doesn’t affect your growth, it affects your muscle mass and fat distribution, so that affects your cholesterol, that affects you overall, it also affects your overall sense of wellbeing,” Bachrach said.

Young Kids learning
Young Kids learning. pixabay

Growth hormone insufficiency is a disorder involving the pituitary gland which is a small, pea-sized gland located at the base of the brain. It’s this gland that produces human growth hormone, among others.

Also Read: Poor Aerobic Fitness Increases Risk of Diabetes in Kids

Every day, Spencer’s mother gives him a daily hormone injection. Since he started getting these injections two years ago, Spencer has grown about 15 centimeters (six inches). But just in case he doesn’t grow tall, he has a reminder written in each of his baseball caps.

“It says HDMH, which means height doesn’t measure heart,” Spencer read.

And heart is something Spencer has plenty of. (VOA)