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.

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Studies: http://www.nejm.org

Avastin: http://www.avastin.com

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

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Common substance may fight food poisoning hazard

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NEW YORK (AP) — A substance found in nuts and whole grains may someday help doctors fight the kind of food poisoning that sickened thousands of people in Europe last summer, a study in mice suggests.

While a variety of germs can cause food poisoning, the European outbreak involved a dangerous strain of the bacterium E. coli. It infects people and pumps out a poison called Shiga toxin. Some other bacteria also produce this toxin, which overall causes more than 1 million deaths a year worldwide. The European food poisoning outbreak included about 4,000 people and 50 deaths.

There's no definitive treatment for Shiga toxin. But in Friday's issue of the journal Science, scientists report that they could protect mice against a lethal dose by injecting them with the mineral manganese.

The animals were injected daily, starting five days before they were exposed to the toxin. While untreated mice died within four days, the injected mice remained healthy. The manganese made the toxin vulnerable to being destroyed by cells.

Scientists still need to do more research before they can assess the usefulness of manganese in treating people. Manganese is already approved for medical use and it's inexpensive, they note. So that might make it especially useful in developing countries, where nearly all cases of Shiga toxin poisoning occur, wrote the researchers, from Carnegie Mellon University in Pittsburgh.

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UK boosts tropical disease fight

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21 January 2012 Last updated at 09:16 GMT River blindness is a tropical disease caused by parasitic worms and carried by black flies Foreign aid for efforts to eradicate parasitic diseases which kill and disfigure millions worldwide is to rise fivefold, say ministers.

A total of £245m will be spent fighting diseases such as river blindness and bilharzia.

Such donations, coupled with free drugs from pharmaceutical companies, could help wipe out some illnesses, they predict.

A UK expert said the aim was to offer a billion treatments worldwide a year.

So-called "neglected tropical diseases" receive a tiny fraction of the funding set aside for the fight against major killers such as HIV, TB and malaria.

However, campaigners say that even a relatively small investment could transform the lives of millions of people in poorer tropical countries.

The Department for International Development, announcing the aid package, said that over the next few years, the money would protect an estimated 140 million people from these parasitic infections.

Among the prime targets are elephantiasis, a mosquito-borne parasite which leads to abnormal enlargement of the limbs and genitals, and bilharzia, spread through contaminated water, which impairs child growth, damages internal organs and can lead to death or chronic ill-health.

Continue reading the main story

British support will take the 'neglected' out of 'neglected tropical diseases' and will not just save lives, but transform lives”

End Quote Stephen O'Brien International Development Minister River blindness, the third key disease, is spread by parasitic worms and cause severe discomfort and sight loss.

Finally, Guinea worm, another water-borne infection, can leave people bedridden for months before the parasitic worm, which can grow up to 3ft (91.4cm) long, emerges.

'Debilitating pain'

There are effective drugs to either prevent or treat all of these infections, and the decision by pharmaceutical companies to supply them free of charge in affected countries means it is possible to reach many millions of people.

International Development Minister Stephen O'Brien said: "These diseases thrive on poverty and have horrendous consequences for sufferers, especially children, leaving them in debilitating pain with severe disabilities.

"The world is increasingly coming together to build on the long-standing commitment of the pharmaceutical industry to rid the world of these terrible diseases.

"British support will take the 'neglected' out of 'neglected tropical diseases' and will not just save lives but transform lives."

Professor David Molyneux, from the Liverpool School of Tropical Medicine, a long-standing campaigner for more international funding, said he was "delighted" by the announcement.

He said: "As far as the British taxpayer is concerned, this money will offer more health to more people than anything else - it really is the most effective use of the money.

"Currently we are treating approximately 800 million people a year, and we're aiming for a billion."

Save The Children head of health Simon Wright also welcomed the move. "This is a great start for the millions of children who can't get treatment for basic illnesses which are completely unknown in rich countries.

"The British public should be proud of their role in combating these awful diseases."

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Australia seeks world backing on tobacco legal fight

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A woman smokes on a street in central Sydney April 7, 2011.

Credit: Reuters/Daniel Munoz

By Rob Taylor

CANBERRA | Thu Oct 6, 2011 2:41pm EDT

CANBERRA (Reuters) - Australia is confident the world's toughest anti-tobacco laws will soon pass parliament, but the government warned on Thursday that the anti-smoking fight was not over and urged other nations to reject a possible WTO challenge backed by big tobacco.

Health Minister Nicola Roxon said the minority government was bracing not only for a court challenge to its plan to force cigarettes to be sold in plain packaging from 2012, but also an intellectual property dispute at the World Trade Organization.

"A tobacco company themselves can't bring a claim in the WTO. A state has to do that," Roxon told Reuters in an interview.

"I won't be surprised if tobacco companies are out there looking for a country to claim on their behalf, and we urge countries not to do that."

The new laws, expected to easily pass parliament next week with backing from the conservative opposition and Green crossbench senators, are being closely watched by New Zealand, Canada, the European Union and Britain, which are considering similar restrictions.

The legislation is in two parts, one of which mandates that cigarettes can only be sold in plain olive green packaging and another part restricting tobacco company trademarks.

The pathfinding plan has infuriated tobacco firms including Philip Morris, British American Tobacco and Imperial Tobacco, which have threatened a High Court challenge. Tobacco nations like Nicaragua, Kenya and Ukraine also say the measures breach global trade rules.

Despite political unease at home over potential compensation claims that tobacco companies have said could mount to billions of dollars, Roxon has been a passionate advocate for the laws within the Labor government, which has a one-seat buffer with the backing of Green and independent MPs.

Her father, Jack, a one-time smoker, died of esophageal cancer at 42, when Roxon was just 10, leaving her pharmacist mother alone to raise three daughters.

"Big tobacco companies do have big tentacles that reach far and wide across the world. I've made very clear to my international colleagues that they need to look at this not only from a health perspective, but from a trade perspective," Roxon, now 44, said.

Australia says the new laws reflect its obligations under the World Health Organization's 2005 framework against tobacco, which urges states to consider plain packaging laws. The WHO estimates more than 1 billion around the world are regular smokers, with 80 percent in low and middle income countries.

Industry analysts say tobacco companies are worried that plain packaging could spread to emerging markets like Brazil, Russia and Indonesia, and threaten growth there.

In Britain, tobacco companies have been fighting in courts for the right to sell cigarettes in vending machines, while tobacco companies in the U.S. are challenging more graphic health warnings on cigarette packets, claiming the changes violate their right of free speech.

An Australia parliamentary committee looking into the legislation and possible grounds for a legal contest received submissions from as far afield as Europe and Kenya, and even cigarette retailers in Peru and Rio de Janeiro.

"We don't know how much (tobacco firms) seek to influence other players, but we certainly become suspicious when you see comments made by people apparently completely disconnected to Australia ... when the lines are exactly reflecting -- almost parroting -- tobacco companies," Roxon said.

Australia's tobacco market generated total revenues of around A$10 billion (U.S.$9.6 billion) in 2009, up from A$8.3 billion in 2008, although smoking generally has been in decline. Around 22 billion cigarettes are sold in the country each year.

Australia wants to cut the number of people who smoke from around 15 percent of the population to 10 percent by 2018. Health authorities say smoking kills 15,000 Australians each year with social and health costs of around A$32 billion.

Roxon said she had experienced enormous support from other health ministers at a recent United Nations health meeting in New York, and was sharing Australia's legal preparations with other nations likely to follow Canberra's plain-pack lead.

"Ultimately that's going to be worrying the tobacco companies, but that is absolutely going to be better for consumers and people who would otherwise be future patients," she said.

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The age-old fight against the common cold

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4 October 2011 Last updated at 10:25 GMT By Jon Kelly BBC News Magazine As the weather finally cools, pharmacies brace themselves for the beginning of the "winter remedies" rush. But why are people still searching for a cure for the common cold?

Can you feel it coming on yet - the sore throat, the fever, the streaming nose, the headache?

If so, get well soon. But you can take comfort in the fact that you'll soon be in good company.

October marks the start of the peak season for the UK's "winter remedies" market - the over-the-counter pharmaceuticals used to treat the common cold.

But if decongestants, cough sweets and hot, lemon-flavoured drinks are the modern-day methods by which we tackle the familiar symptoms, humankind has a long tradition of searching out ways to soothing this most familiar of conditions.

From ancient Greece to mediaeval Europe, blood-letting, leeches and more resilient treatments like chicken soup have all been used in attempts to ease recovery.

But though our understanding of the viruses that cause colds has improved over time, and with it our remedies, a cure remains as elusive as ever.

And with the average UK adult suffering two to five colds a year, according to Cardiff University's Common Cold Centre, it is little wonder that un-bunging ourselves is big business.

In 2010, the market research company Mintel says sales of winter remedies were worth £532m - an increase of 10% over five years. In the US, it has been suggested that the cost of colds to the American economy could be as much as $40bn (£26bn).

Continue reading the main story Common cold is not a single disease but caused by up to 200 different virusesBy the time the symptoms - caused by the body's immune system reacting to these viruses - are present it would be too late for an antivirusAny new medication would have to be extremely safe as it would be very popularIt would not be worth taking unless the side effects were extremely mild or non-existent If the medicine was widely used, cold viruses would quickly develop resistance in the same way bacteria have overcome antibioticsThe advice given by doctors to patients suffering from colds may be straightforward - rest, drink lots of fluid, take moderate doses of painkiller and decongestant to ameliorate the symptoms. But treatments have varied wildly down the years.

According to Prof Ronald Eccles of Cardiff's Common Cold Centre, colds have been with us since humans gathered in any sort of community - at least since the Iron Age onwards.

For at least 3,000 years, the Chinese have treated blocked noses with ma huang, a plant often brewed as tea. It contains pseudoephedrine, commonly used in modern over-the-counter cold remedies as a decongestant.

Early thinkers believed cold symptoms were caused by the penetration of low temperatures into the body and warm drinks were used to treat this, Prof Eccles says.

The ancient Greek physician Hippocrates, who pioneered the practice of clinical observation, believed colds were caused by a build-up of waste matter on the brain.

Chicken soup was hailed as a treatment as early as AD60 by Pedacius Dioscorides, a Roman surgeon under Nero, and it was hailed as "an excellent food as well as medication" by the 12th Century physician Moses Maimonides. In fact, neither were far wide of the mark - modern studies have demonstrated that chicken contains the amino acid cysteine, which has mild decongestant proprieties.

James Wong and Sophie Dahl test Mrs Beeton's homemade cold remedy

However, not all early cold treatments had a kernel of science to them.

"Old European ideas related to accumulation of fluid in the body that was expelled via the nose - hence bleeding and medicines that made patients vomit were popular to rid body of excess fluid," Prof Eccles adds.

Despite this, some mediaeval treatments were inadvertently valuable. In the Middle Ages, some Christians believed the soul could leave the body during sneezing, so cold sufferers were urged to cover their mouths - a custom which would have prevented the spread of viruses.

As the early modern period dawned, it was external rather than internal precipitation that became the focus, according to Dr Carole Reeves of University College London's Centre for the History of Medicine.

"The idea of catching cold was that it was about getting wet, getting it in the rain, getting a chill, being out in the cold weather," she says. "The idea of catching it from other people wasn't there in the way it is now."

For this reason, she says, bathing was discouraged for cold sufferers.

"It was believed that it would soften your skin and weaken your body," adds Dr Reeves.

Continue reading the main story

From Mrs Beeton's Book of Home Management, published in 1861

"TO CURE A COLD. Put a large teacupful of linseed [seeds, not oil], with 1/4 lb. of sun raisins [these are just raisins] and 2 oz of stick liquorice, into 2 quarts of soft water, and let it simmer over a slow fire till reduced to one quart; add to it 1/4 lb of pounded sugar-candy [sugar], a tablespoonful of old rum, and a tablespoonful of the best white-wine vinegar, or lemon-juice.

"The rum and vinegar should be added as the decoction is taken; for, if they are put in at first, the whole soon becomes flat and less efficacious.

"The dose is half a pint, made warm, on going to bed; and a little may be taken whenever the cough is troublesome.

"The worst cold is generally cured by this remedy in two or three days; and, if taken in time, is considered infallible.

"COLD ON THE CHEST. A flannel dipped in boiling water, and sprinkled with turpentine, laid on the chest as quickly as possible, will relieve the most severe cold or hoarseness."

These notions were eventually dispelled by none other than Benjamin Franklin, the noted polymath, scientist and Founding Father of the United States, who conducted studies into the common cold and concluded that it was transmitted through the air between individuals.

The dawn of the Victorian era saw no let-up in the search for a cure. In Mrs Beeton's Book of Home Management, a best-seller for decades after it was first published in 1861, there is a chapter on first aid and home remedies - including a hot toddy cold treatment.

Containing linseed, sun raisins, liquorice and rum, Mrs Beeton wrote that the "worst cold is generally cured by this remedy in two or three days". She added that the mixture, "if taken in time, is considered infallible".

Her claim that the mixture could cure colds may have been an overstatement. But according to Prof Eccles, it would certainly have proved soothing.

"Any hot, sweet, tasty remedy will provide good relief from common cold symptoms, especially cough and sore throat," he says.

Many of the treatments we see on the shelves of modern-day pharmacists were developed in the wake of studies carried out by the Common Cold Unit, a research institute near Salisbury, Wiltshire, which operated from 1946 to 1989.

Its founding purpose - to find a cure - may never have been achieved. But the unit deepened scientific understanding of the condition, isolating coronaviruses and rhinoviruses, two of the most frequent causes of colds.

Its research was conducted by studying paid volunteers who would stay at the site for around 10 days at a time. According to Prof Tilli Tansey, a medical historian at Queen Mary University of London, who has studied the unit, it became an oddly popular form of package holiday during the post-war years.

"It was a bit like Butlins," she says. "Some people did see it as a holiday - this was the era of austerity. You'd go off for a couple of weeks, stay in a chalet and have your meals cooked for you."

Such was the basis of our modern "winter remedies". In the 21st Century, however, few are likely to treat a cold as a leisure break.

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Glowing Kittens Help In Fight Against AIDS

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Here's an experiment: Turn off your lights, shine a blue flashlight on the cats in the room and look for the ones that turn neon green, like a glow stick.

That's how scientists at the Mayo Clinic identify cats that they've successfully treated against the feline immunodeficiency virus.

The AIDS epidemic in humans is well-known. Less known is that every year, millions of cats suffer and die from the disease.

To protect cats against feline AIDS, the Mayo Clinic and colleagues in Japan devised a treatment with a peculiar side effect. They took monkey genes that block HIV infection and injected them into cat eggs. Kittens born from those eggs produced AIDS-resistant protein in the same cells that get infected, effectively shielding them from the disease. Their offspring are also immune.

To tell the treated cats from the untreated ones, scientists added another simple ingredient to the mix: jellyfish genes, which make the modified cells glow a green color.

"It allows you to tell whether the gene of interest is in the cell without having to do an invasive test," Dr. Eric Poeschla, a molecular biologist with the Mayo Clinic, tells Guy Raz, host of weekends on All Things Considered. Scientists simply turn off the lights and shine a blue light to tell which cats have the AIDS-resistant gene.

The cats don't feel a thing, Poeschla says. "They're healthy and happy and they're playful."

The feline treatment could help other mammals down the line. The Mayo team isn't injecting human stem cells with the monkey-jellyfish concoction, but it is watching the cats for new insights.

"If they have the power to protect, then they could perhaps be used in the future in human gene therapy," Poeschla says.

Unfortunately, you can't get your own glow-in-the dark kitty just yet.

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Researchers at Crater Lake National Park have been documenting the park's soundscape.

Monkey genes protect cats against HIV infection; jellyfish genes make them glow.

"It's us against the snails," says an official leading the eradication effort.

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HEALTH MANAGEMENT. Video: Home delivery Can fight Malnutrition in Indonesia?

The Indonesia has one of the highest rates of malnutrition of children in the world, with more than a third of all children under 5 suffering from insufficient food. Even if the sudden country of the enormous economic growth and development, is not to improve the rate of malnutrition. Why?
Journalist video time Jacob Templin went to Central Java to discover. The reasons, according to the health workers that he is interviewed, are many. Yuni Susilowati, a volunteer who personally cooks and provides meals to children in need, blamed lack of nutritional education for mothers.
Others such as Dr. Hamam Hadi, Professor of medicine at the University of Gadjah Mada in Yogyakarta, said the problem is a general decline in volunteering in Indonesian society. The fight against malnutrition in the country is still conducted largely by volunteers as Susilowati, a do-gooder body which has been dwindling since the time of former President Suharto.
Video: Oil Palm the Indonesia dilemma: to cash or to fight for the forests?
"I would say that year to the other, the good will of the Indonesian people is decreasing," Hadi said, adding that that the country is developing more capital-intensive, fewer people are willing to work without pay.
Still, fans of volunteers like Susilowati continue to advance, at least in their own communities: in the village of Susilowati, there were 15 children suffering from malnutrition in 2009. Templin reports which have fallen since then to five.
Video: Keep Islamic radicals of recruiting on the campus of the Indonesia
"We live in the society and we want to be useful to others." "We are happy to see others happy," said Susilowati. "That's all."
Meredith Melnick is a journalist in time. Find him on Twitter at @ MeredithCM. You can also continue the discussion on the time Facebook page and Twitter time @.

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