Monday, July 17, 2017

THIS IS IMPORTANT. READ IT.


Carolyn will be here in a few days.  Hooray!

Quite a few years ago I bought some shares of stock in Novartis, a pharmaceutical company based in Switzerland.  I thought I needed some drug company stock to “balance my portfolio”, as my broker is fond of saying.  I would have preferred an American company, but I reasoned that the political climate here was inimical to Big Pharma; too many Elizabeths and Bernies breathing down their collective neck.  The Swiss never let anything stand between them and a healthy profit.  But, whatever.  I wish I had bought a whole lot more.

That by way of providing a somewhat sour introduction to an important cancer story.  We have discussed “immunotherapy” before, many times (29, to be exact).   Well, it appears that the FDA is on the verge of approving an immunotherapy approach to wrestling with a type of leukemia, “B-cell acute lymphoblastic leukemia” to give the malevolent sucker its full name.  In this disease the culprit is cancerous B cells.  B cells are part of the immune system.  The immunological approach involves extracting millions of the patient’s own T cells (another part of the immune system), modify their genetics to teach them that cancerous B cells are “the enemy”, then infusing them back into the patient where, in the pleasing phrase of one Dr. Carl June, they behave like “serial killers”, offing hundreds of thousands of errant B cells.  This treatment is not without side effects and is far from infallible – but it seems to beat alternative treatments (chemo; bone marrow transplants) in most respects.

This type of immunotherapeutic approach has been diddled with using lab animals for at least a decade.  It gives promise of value defending against other cancers as well:  multiple myeloma and aggressive brain tumors are mentioned.

Oh, by the way: the treatment is estimated to cost $300,000.  That’s a lot of Swiss francs, but clearly beats the alternative.

Here is the article.  Read it, dammit!  



Sunday, July 9, 2017

OVARIAN CANCER CONFERENCE


Linda in Yorkshire

The 20th Annual Conference on Ovarian Cancer is going on in Chicago at the moment, and many interesting facets of the fight against the disease are being examined.  Here is a discussion of clinical trials of clinical trials and why they are so important.  Especially important are early-stage trials.  Every woman, and every husband, should be aware of this.

For an overview of the state of the battle against the disease, read this:

Enjoy your summer, and don’t start any fires. 


Friday, July 7, 2017

A USEFUL NEW TEST


Linda at the Seashore

Apparently there is, or has been, a serious problem determining if an anomalous pelvic mass in a woman is or is not dangerous.   I seem to understand that the evidence currently used in diagnosis is concentration of the protein CA125; if it is high enough, the surgeon goes to work.  All too often, though, the post-operation report goes something like “Woops!  Just a benign growth, after all.  Could have been ignored.  That will be $30,000, please.”  In other words, the statistical “specificity” is poor.

Well, a Brit outfit called Angle has developed a “liquid biopsy” (more commonly referred to as a blood test) that has double the previous specificity.  The test is called the Parsortix test, and how it works is not explained, other than it involves RNA somehow.

Not a cure, not prevention – but useful just the same.



Monday, July 3, 2017

PROFILES in RESEARCH EXCELLENCE: Dr. M. ROBYN ANDERSEN


Linda & grand-niece Ella Henner


The Rivkin Center has announced its grant recipients for 2017.  As you will know if you read every word I post to this blog and have a good memory, MRC awards grants in four categories:  Pilot Studies ($75,000) to allow pursuit of new approaches to conquering ovarian cancer; Scientific Scholar Awards ($60,000) to assist talented newly-minted researcher get started on their careers; Bridge Funding Awards ($30,000) to help young scientists successfully swim the moat and scale the wall that stands between them and the glittering hoard of NCI funding;  Challenge Grants ($150,000 for two years) to explore big-picture ideas. 

For 2017 MRC appears from their web site to have given out 14 grants worth just shy of $1 million.  Not bad for an outfit created by a busy oncodoc in his spare time!  Saul, you are my hero.

But what about Robyn Andersen?  She is one on many who submitted proposals that appealed to me.  I chose her in part because I know her.  She worked with Drs. Urban and Drescher on a mega-colossal project – now sadly defunct – for which I attempted to be useful some years ago.  I have “edited” several of her papers and can say two things: she is a psychologist rather than a biochemist, and she can write long and convolute sentences of unmatched complexity.  I can say one other thing, although perhaps I shouldn’t: she is nice to look at, surrounded as she is by male cancer researchers who look more or less like a younger version of me.

Dr. Andersen’s Rivkin-funded project involves using “meditation-like exercises, along with a smartphone-connected feedback system, to reduce symptoms of stress and anxiety in patients who have completed initial cancer treatment.”  This is important; I know from personal experience.  Linda was brave beyond anything I can imagine, so avoided dumping the anxieties she must have felt on me.  Also, she was simply optimistic and cheerful by nature.  However, late at night when I was asleep I know she suffered.  If Dr. Andersen can mitigate this aspect of the cancer ordeal, she will have made an important contribution.

So, Robyn Andersen was educated at SUNY Stoney Brooke (MA), U. Washington (MPH), and Stoney Brooke again (Ph.D).  She has been with Fred Hutch for at least seven years.  In the past nine years she has published 27 papers if I counted correctly, for many of which she seems to have been the principal author.  That sure as hell beats my output when I was her age.  Way to go, Robyn; keep it up!


Sunday, July 2, 2017

MORE USEFUL INFORMATION


Linda in the Mountains

I don’t know what you might do with this information, but potentially it is too valuable to simply delete.  The main part of the article introduces an NCI cancer genome data base that might (should?) be useful for cancer researchers.  Lay-persons such as you and I can give this a skip.  However, running down the side is a list of general cancer topics, and if you investigate them you will find that they are meant for us, not the pros.  A few of the topics are: What is cancer?, Prevention, Early Detection, stuff like that.  Maybe just the thing if you’re stuck indoors on the 4th because of foul weather.




Wednesday, June 28, 2017

A LEARNED ESSAY ON STEM CELLS


Daughters Karen and Kristen will re-visit this country with me next month
Sure wish this lady could be with us

 I have mentioned stem cells 47 times in this blog.  It is time to determine if I really know what they are and what they do.  (The smart money is on:  probably not.)  I am going to write this “learned essay” off the top of my head; not even Wikipedia will be involved.  I expect biologically sophisticated readers (e.g., daughter Kristen Beck, niece Rebecca Hunsinger, great friend and benefactor Dr. Joanne Ingwall, paleontology colleague and occasional social critic Dr. Sharron Sussman) to comment, correct, and even chastise, if appropriate.  Failing that I will continue to muddy the waters and roll science back on its haunches – and it will be your fault, not mine.

So, what’nhell is a stem cell?  Well, it is an “undifferentiated” cell that has the capacity to turn into one or more types of specialized cells – liver, muscle, skin, etc.  You read a lot about “embryonic stem cells”.  These little buggers are derived from embryos, natch, and seem to occupy a realm of constant warfare between science and (some flavors of) religion.  This is because they have the capacity to develop into a whole and complete human being.  (There also are murine embryonic stem cells, but nobody worries much about the immortal souls of mice.  Other mammals have ESCs too, of course.)  As I understand it, there are two kinds of ESCs: “omnipotent ESCs, which can give rise to an embryo plus a placenta to nourish it, and “pluripotent ESCs” which can’t do the placenta thing.  I am far from certain about this, but it doesn’t’ matter anyway.  The overriding problem is that there are lots and lots of well-meaning, intelligent people who regard using ESCs in experiments as murder.  I see their point, but disregard it.

Question:  Is a human zygote also an omnipotent ESC? 

There also exist many other kinds of less “potent” stem cells.  These are specialized stem cells (SSC) which can turn into only a single type of cell: liver, say, or blood, muscle, etc.  Actually, they don’t “turn into” anything; rather, they divide, with one daughter being the specialized, working cell in question and the other an exact (it is hoped) copy of the original SSC.  In this way the SSC is essentially immortal and hangs around doing its thing indefinitely.

Question:  I had always thought that ordinary somatic cells divide to replenish its organ.  For instance, if an old liver cell with tattered telomeres received orders (from where?) to croak, its near neighbor, another somatic liver cell, would receive orders to divide, thereby filling the gap.  That must be wrong, right?

Question:  Cancer is said to result from unlucky mutations or groups of such mutations.  Does this mean that the SSC itself is mutated, or its sister the specialized cell?  Or both?

So, I am vaguely aware that it has proved possible to take an SSC and, using almost magical biological sleight of hand, induce it to climb back up the developmental ladder and become equivalent to am ESC.  They call these things iESCs, which codes for “induced embryonic stem cells”, although maybe they should be called induced pluripotent stem cells (iPSC) because they have little to nothing to do with embryos. 

An asideIf iPSCs are ever used to generate a human being – in effect, a human clone - expect all hell to break loose.

OK, I think that’s all I know about stem cells.  You are to be praised if you read this far.  Thank you.  BUT WAIT:

Overriding big picture question.  When, for instance, a liver SSC divides to make a functional liver cell and a duplicate of itself, if mitosis does its job correctly both daughter cells have identical DNA – although they have profoundly different roles to play.  The difference must be epigenetic. Different genes are silenced in the two sibling cells.  What in Heaven’s name controls this?

Sunday, June 25, 2017

FRANCIS COLLINS, M.D.


A desert hike

Dr. Francis Collins is the Director of NIH and a prolific blogger.  His blogs concern medical matters, as you might guess.  I find them interesting, well written, important, simple – and short.  You could do worse than to subscribe to his newsletter to receive his blogs via email.  To do so, go to



Tomorrow I plan to summarize one of his recent blogs concerning stem cells.  I’d do it now but it is time to pop a beer and go watch golf on TV.