New Drug Shows Promise in Treating Ovarian Cancer

Olaparib Shrinks Tumors in Women With Few Treatment Options

Aug. 22, 2011 -- An experimental drug that has been shown to be effective in treating ovarian cancer in patients with BRCA1 or BRCA2 gene mutations also appears to work in some patients without the mutations.

The drug olaparib is one of several experimental treatments that block the activity of the protein PARP, which, like BRCA, is involved in DNA repair.

In earlier trials, PARP inhibitors have been shown to promote tumor cell death in breast and ovarian cancer patients with BRCA mutations by preventing the cells from repairing their DNA.

But the new study is the first to suggest the drugs may prove effective in a broader group of patients with non-inherited cancers who have few treatment options, lead researcher Karen Gelmon, MD, of Vancouver, Canada’s BC Cancer Agency tells WebMD.

The study included 65 ovarian cancer patients and 26 breast cancer patients with highly aggressive, advanced forms of the diseases.

Prior to entering the study, the patients had been treated with an average of three different chemotherapy regimens, and some had received as many as 10 different treatments.

Some of the patients carried the BRCA1 or BRCA2 mutations while others did not.

All of the patients were treated with 400 milligrams of olaparib twice a day for a month between July 2008 and September 2009. Side effects were described as well tolerated and included fatigue, nausea, vomiting, and decreased appetite.

Ovarian cancer patients who took part in the trial had high-grade serous tumors, which share similar traits to tumors in women with BRCA mutations.

After taking the experimental drug for four weeks, 41% of the ovarian cancer patients with BRCA mutations and 24% of those without a mutation showed substantial shrinkage in the size of their tumors.

Responses were not seen in breast cancer patients with triple-negative tumors -- tumors that do not respond to hormonal treatments or those targeting HER2 receptors.

While the response in these breast cancer patients was disappointing, the response in the ovarian cancer patients suggests that the drug may have a role in the treatment of patients without BRCA mutations, oncologist Melinda Telli, MD, tells WebMD.

Telli is an assistant professor of medicine in the division of medical oncology at Stanford University in Stanford, Calif.

“We thought this class of drugs might have a larger role to play, and this is the first study to confirm that this might be the case,” she says.

The study was published online and will appear in the September issue of The Lancet Oncology. Drug manufacturer AstraZeneca, which hopes to market the drug pending FDA approval, funded the research.

Earlier this year, another PARP inhibitor, Sanofi-Aventis’ iniparib, failed to extend overall survival in a study involving women with advanced, triple-negative breast cancer when added to a standard chemotherapy regimen.

Telli says PARP inhibitors may still prove useful for the treatment of this type of highly aggressive, hard-to-treat cancer.

“There is a lot more to this story and a lot more research to be done,” she says.

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Posted in: Cancer,Ovarian,Promise,shows,Treating

Research shows thousands of patients could be taking statins needlessly

Scientists said they have found a much better way to work out which people are in danger of developing heart problems.

Half of the middle-aged adults they studied were found to have no coronary artery calcium, and only a handful went on to suffer a heart attack or a stroke.

They said the findings have “important public health implications” and could mean significant cost savings if cholesterol-lowering drugs are prescribed only for those who would genuinely benefit.

But other experts point out that the test for coronary artery calcium is an expensive scan that involves exposing the patient to radiation, so is unlikely to be used widely. In addition, they say statins do have long-term benefits, such as slowing hardening of the arteries, so doctors are unlikely to take patients off them.

However the paper, published in The Lancet today, is the latest in a series suggesting too many people are taking the medicine once seen as a wonder drug. Up to 7million middle-aged and older people in England are thought to take statins, at a cost of ?500million a year to the NHS. There are growing fears many are the “worried well” at low risk of heart problems, and other studies have linked statins to liver or kidney problems.

In the latest paper, Dr Michael Blaha at Johns Hopkins Hospital in Baltimore and colleagues studied 2,083 people with an average age of 67 who had low cholesterol, were not on statins and did not have diabetes. Of those, 46 per cent had high levels of high-sensitivity protein, which a previous study known as Jupiter had suggested would make them suitable for statin therapy.

The researchers used cardiac scans to work out the levels of calcium in the arteries of the patients, and followed up their progress about six years later. They found 47 per cent of the patients had low levels of arterial calcium, and hardly any had suffered heart complications.

Only six per cent of the coronary heart disease events (interruption of the blood supply, leading to heart attacks) and 17 per cent of the cardiovascular disease events (heart attacks or stroke) were in those with no signs of calcium in their arteries. The researchers concluded just one person in every 549 with a low calcium score would be stopped from having a heart attack by taking statins for five years. The study suggests statins may be best prescribed just for those with higher levels of calcium in their arteries.

The experts said their findings show doctors should try to measure atherosclerosis – thickening of the artery walls – by calculating calcium levels rather than just using blood tests and traditional risk factors such as family history or obesity. They added this may “represent a more appropriate allocation of resources, and reduce overall health-care cost”.

Prof Peter Weissberg, the medical director at the British Heart Foundation, said: “The greatest challenge for preventive medicine is identifying people who are at highest risk of heart disease and who should be given drugs, particularly statins, to reduce that risk.

“The study shows coronary artery calcium is better than protein for identifying people at highest risk of a heart attack. But the former is expensive and involves radiation so is unlikely to be offered as a screening test for everyone.”

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Posted in: could,needlessly,patients,Research,shows,statins,taking,thousands

F1 fan shows off prosthetic arm from Mercedes team

The limb, made from high-grade plastic with a black silicone socket, literally plugs into Matthew's arm.

Two electrodes on the inside of the socket detect electrical impulses made by the muscles in Matthew's lower arm.

The signals are then beamed to a mini-computer in the palm which translates the messages into movements, replicating a normal hand.

After being fitted with the hand last Friday Matthew said: "It is just amazing.

"My old artificial hand was not great, it had a pretty basic open close mechanism similar to a clamp.

"But with this one I can do everything, it is just like the real thing.

"It is going to make such a big difference to my life."

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Posted in: Mercedes,prosthetic,shows