Studies: Avastin may fight early breast cancers

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Surprising results from two new studies may reopen debate about the value of Avastin for breast cancer. The drug helped make tumors disappear in certain women with early-stage disease, researchers found.

Avastin recently lost approval for treating advanced breast cancer, but the new studies suggest it might help women whose disease has not spread so widely. These were the first big tests of the drug for early breast cancer, and doctors were cautiously excited that it showed potential to help.

In one study, just over one third of women given Avastin plus chemotherapy for a few months before surgery had no sign of cancer in their breasts when doctors went to operate, versus 28 percent of women given chemo alone. In the other study, more than 18 percent on Avastin plus chemo had no cancer in their breasts or lymph nodes at surgery versus 15 percent of those on chemo alone.

A big caveat, though: The true test is whether Avastin improves survival, and it's too soon to know that — both studies are still tracking the women's health. The drug also has serious side effects.

"I don't think it's clear yet whether this is going to be a winner," Dr. Harry Bear of Virginia Commonwealth University said of Avastin. But he added, "I don't think we're done with it."

Bear led one study, in the United States. Dr. Gunter von Minckwitz of the University of Frankfurt led the other in Germany. Results are in Thursday's New England Journal of Medicine.

Avastin (uh-VAS'-tihn) is still on the market for some colon, lung, kidney and brain tumors. In 2008, it won conditional U.S. approval for advanced breast cancer because it seemed to slow the disease. Further research showed it didn't meaningfully extend life and could cause heart problems, bleeding and other problems. The government revoked its approval for breast cancer in November.

Now doctors can prescribe Avastin for breast cancer but insurers may not pay. Treatment can cost $10,000 a month. The drug is made by California-based Genentech, part of the Swiss company Roche. It is still approved for treating advanced breast cancer in Europe and Japan.

The new studies tested it in a relatively novel way — before surgery. This is sometimes done to shrink tumors that seem inoperable, or to enable women to have just a lump removed instead of the whole breast.

The women in the studies had tumors that were large enough to warrant treatment besides surgery. Their cancers were not the type that can be treated by Herceptin, another widely used drug.

In the U.S. study, 1,200 women were given chemo or chemo plus infusions of Avastin. By the time of their surgery, no cancer could be found in the breasts of more than 34 percent of those given Avastin versus 28 percent of the others. (Surgeons still have to operate because they don't know the tumor is gone until they check tissue samples.)

The German study involved 1,900 women including some with larger tumors. It used a stricter definition of cancer-free at surgery: no sign of disease in the breast or lymph nodes rather than just the breast. No cancer was seen in 18 percent of women on Avastin versus 15 percent of those given only chemo. Different chemo drugs were used — a factor that might change Avastin's effectiveness.

The U.S. study was paid for by the National Cancer Institute with some support from drug companies. The German study was sponsored by drug companies. Some researchers consult for Genentech or other makers of cancer drugs.

If even one of these studies shows a survival advantage for Avastin "that would be a game changer" although side effects remain a concern, said Dr. Gary Lyman. He is a Duke University researcher who was on the federal advisory panel that recommended revoking Avastin's approval.

However, von Minckwitz said side effects are more justifiable in early breast cancer patients because "the intention is cure" rather than in late-stage disease where cure isn't usually possible.

Of the more than 200,000 women in the U.S. diagnosed each year with breast cancer, about 30,000 are like those in the new studies, Lyman estimated.

But the studies' impact could be far greater: The participants' tissue samples are being analyzed for genes and biomarkers to predict which women are most likely to respond to Avastin. That could lead to a relook of using the drug for certain women with advanced disease, too.

Three other studies are under way testing Avastin in early breast cancer; one is expected to have results by the end of this year, said Dr. Sandra Horning, global development chief of cancer drugs for Roche and Genentech. The company does not plan to seek any change in Avastin's use until more results are available, she said.

___

Online:

Studies: http://www.nejm.org

Avastin: http://www.avastin.com

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Associated Press

Source AP

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‘Early growth’ linked to asthma

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20 January 2012 Last updated at 08:21 GMT Researchers studied over 5,000 children Babies who grow rapidly in the first three months of life may be more likely to develop asthma as children, say Dutch researchers.

They found "accelerated weight gain" was linked to a higher chance of symptoms such as wheezing.

The study of 5,125 children by the Erasmus Medical Center in Rotterdam suggested no connection with earlier impaired growth in the womb.

Asthma UK said parents should keep following official baby-feeding advice.

The origins of asthma are still not fully understood, although many researchers believe there is some connection with the way the foetus develops and grows through pregnancy.

The study in the American Journal of Respiratory and Critical Care Medicine compared pregnancy and baby records measuring foetal and postnatal weight gain.

'Critical period'

The babies were then followed up at yearly intervals and their parents questioned about breathing symptoms, as the presence of these can be a reasonable indicator of whether or not a child will go on to develop full blown asthma.

They found that, compared with babies whose growth followed the normal pattern in the months after birth, babies who gained weight rapidly were 44% more likely to suffer wheezing, 22% more likely to have shortness of breath and 30% more likely to have persistent phlegm.

There was no apparent relationship between the fast-growing babies and being underweight in the womb.

Although routine foetal measurement can be imprecise, this suggested that the sudden weight gain was not necessarily the baby "catching up" from reduced growth in the womb.

Dr Liesbeth Dujits said that early infancy might be a "critical period" for asthma development.

She said: "We know that low birth weight is associated with an increased risk of asthma symptoms, but the effects of specific foetal and infant growth patterns had not been examined yet.

"Our results suggest that the relationship between infant weight gain and asthma symptoms is not due to the accelerated growth of foetal growth-restricted infants only.

"While the mechanisms underlying this are unclear, accelerated weight growth in early life might adversely affect lung growth."

Leanne Metcalf, from Asthma UK, said that while the study offered more insight into the possible development of asthma, it was too early for parents to change the way they cared for their children.

"This is an interesting preliminary study, but parents should follow existing advice from health professionals when it comes to feeding their babies in the first few months.

"We know that early life does appear to influence the risk of developing asthma later on, but there are a lot of other potential factors that have to be taken into consideration."

Source BBC

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In African Cave, An Early Human Paint Shop

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Enlarge Science/AAAS

This abalone shell was found with ocher and a grinding stone. The iron oxide was used as a pigment to paint bodies and walls, as well as to thicken glue.

Science/AAAS

This abalone shell was found with ocher and a grinding stone. The iron oxide was used as a pigment to paint bodies and walls, as well as to thicken glue.

Apparently one of the earliest human instincts was to paint things, including bodies and cave walls. That's the conclusion from scientists who have discovered something remarkable in a South African cave — a tool kit for making paint. It looks to be the oldest evidence of paint-making.

Over in southern Africa 100,000 years ago, Homo sapiens was pretty new on the scene. A favorite hangout was a cave named Blombos near the Southern ocean.

Archaeologists like Christopher Henshilwood have spent decades finding stuff there that our ancestors left behind. Recently, Henshilwood uncovered two abalone shells with ocher ground into the shell. "Above and below each shell and to the side of each shell was a complete kit that was used for producing a pigmented mixture," he says.

In addition to the shells were stone flakes, grinding stones and bits of bone with reddish ocher on them. Ocher is a kind of iron oxide dug from the ground that early humans used as a pigment and to thicken glue.

I think we're going to find that these early people were smarter than we think.

- Alison Brooks, anthropologist, The George Washington University

Henshilwood, a professor with the University of the Witwatersrand in South Africa and the University of Bergen in Norway, says his discovery points to decoration.

"I think the most likely explanation for this is that they were producing paint," he says. "This really was the smoking gun."

Henshilwood says for a short time, the cave was a paint shop — the earliest ever seen. The makers added bone and charcoal to a liquid mixture to make it oily and viscous so it would stick. The ocher provided color and a matrix. It was complex chemistry but stirred by hand.

"We can see where the small quartz grains that had adhered to the finger had left a very tiny trace in the shell," Henshilwood says.

Enlarge Science/AAAS

Archaeologist Christopher Henshilwood excavates at the 100,000-year-old levels of the Blombos cave in South Africa.

Science/AAAS

Archaeologist Christopher Henshilwood excavates at the 100,000-year-old levels of the Blombos cave in South Africa.

Higher-Order Thinking

In a laboratory at George Washington University, anthropology student Andrew Zipkin opens a bag of ocher and puts it into a mortar, where he grinds it with a pestle.

"You need to sort of tap it and break it up first," he explains. "The finer-grain material here is quite powdery now. This is ready to use. I can mix this with water and I'll have a pretty nice paint out of this."

Zipkin's Ph.D. work focuses on ocher and how to make stuff with it the way ancient humans did.

Lately, he has been exploring the other ancient use for ocher: He's gluing stone points onto arrowheads. Then he tests how well the glue works.

"I went to an Ethiopian butcher in Falls Church, Va., and tracked down a goat carcass they had there," he says. Then he shot the arrows into the carcass. He found that the arrowheads with ocher stayed on better than those without.

Enlarge Magnus Haaland

Researchers found paint and tools in the Blombos cave, marked with the white arrow on the left side of the image, on the southern coast of South Africa.

Magnus Haaland

Researchers found paint and tools in the Blombos cave, marked with the white arrow on the left side of the image, on the southern coast of South Africa.

Zipkin makes a lot of ocher mixtures — you can tell by looking at his hands and his clothes. He says the recipe has to be followed exactly right, a process that takes planning.

"I think we're going to find that these early people were smarter than we think," says Alison Brooks, an anthropologist at George Washington University. She says working with ocher reflects higher-order thinking, and using it as paint probably represents an early form of symbolic thinking as well.

"The ultimate purpose of putting something on yourself, your house, your walls is to make a statement about who you are," she says. "So it would have been important to identify yourself as a friend."

Whoever these people were — primitive Picassos or house painters — their handiwork lasted 100,000 years, and is described in the journal Science.

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Eating solid foods early doesn't affect baby growth

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By Linda Thrasybule

NEW YORK | Wed Oct 12, 2011 11:18am EDT

NEW YORK (Reuters Health) - Infants raised on formula who are introduced to solid foods before four months of age tend to gain more weight within the first year than infants who start later, a recent study suggests.

But the age at which babies were given solid foods didn't seem to influence much of their longer-term growth.

"It's not about how fast they grow, but whether the children are likely to be overweight," said Dr. Berthold Koletzko, a study co-author who studies nutrition at the Dr. von Hauner Children's Hospital in Munich, Germany. "And they're not more likely to be overweight by two years if they receive solids earlier."

Researchers tracked nearly 700 European infants for two years. Infants between six and seven pounds raised on formula received solid foods starting a little over three months, between three and four months, between four and five months, or six months or later.

Babies who started solid foods at three months weighed less but caught up in growth within six months compared to those who started solid foods at six months and grew slowly within three months.

By two years, there were no differences between groups in weight or length.

Infants eating solid foods also consumed more calories during the first eight months.

Among children born at lower weights, "researchers found an association between lower birth weight and introducing solid foods earlier," said Dr. Lindsey Sjaarda, a researcher at Children's Hospital of Pittsburgh, who was not part of the study.

"It's something that needs to be explored. Recent research seems to indicate that catch-up growth isn't always a good thing," she told Reuters Health.

The study applies to populations in industrialized countries, where "a large fraction of children" have "already been introduced to solid foods before four months of age," according to the authors, not developing countries.

Previous studies have shown conflicting results on whether infants who start eating solid foods earlier are more likely to become obese.

Childhood obesity has tripled over the past three decades, with about 12.5 million American children and adolescents obese, according to a 2007-2008 report from the U.S. Centers for Disease Control and Prevention.

Though Koletzko agreed that children who grow faster will demand more food, and possibly gain more weight, he didn't think they will likely become obese.

He recommended introducing solid foods when a baby shows interest by sitting up and reaching for food or opening their mouths when they see their parents eating. But he cautioned that some infants may need more calories than others.

"At this age, communication happens between infants and parents," he told Reuters Health. "They give a lot of signals to parents. But if the baby is not signaling, don't force it, just wait."

SOURCE: bit.ly/qZMqeA American Journal of Clinical Nutrition, online September 14, 2011.

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HEALTH MANAGEMENT. Lose a baby increases risk of early death for parents, mothers in particular

Losing a child during his/her first 12 months of life can considerably raise the parents' risk of dying early, researchers from the University of York, England and Stirling University, Scotland reported in BMJ Supportive & Palliative Care.
Dr Mairi Harper and team examined 5% of UK death registrations of parents who had lost a child aged 1 year or more, as well as parents who had lost a child aged less than 12 months. They were randomly selected from data from 1971 to 2006. Stillborn babies were included in the study
The data obtained from Scotland found that parents who lost a child under 12 months of age ran twice the risk of dying early or becoming widowed compared to parents who lost no children.
The impact of child bereavement was found to be greater on mothers, although fathers had a higher risk of early death too, the authors wrote.
In England and Wales, mothers who lost a child run four times the risk of dying within 15 years of the child's death, compared to other mothers. Even 25 years after the loss of a child, the risk of early death was 1.5 higher.
Dr. Harper said that "dying of a broken heart" does not only apply to the loss of a spouse or partner, it also happens to people who lose a young child.
The investigators had not had enough data to determine what impact, if any, suicides had on the figures. They believe bereavement may have a biological effect on the parents, such as undermining their immune system.
Dr. Harper said:

"Bereaved parents may also be more likely to use maladaptive coping strategies, such as alcohol misuse."

Harper explained that alcohol misuse may raise the risk of developing alcohol-related illnesses, or accidental injuries.
The authors added that perhaps some parents whose child is stillborn or dies early may themselves have poor health.
Dr. Harper said:

"It is imperative that cause of death be further investigated in order to establish the factors leading to increased mortality in bereaved parents."

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