Wednesday, November 27, 2019

Little DNA SpaghettOs splashing around in your nuclei.

\Linda and her life-long friend Pat

Long, long ago I blogged that it seemed as though biomedical research was a babushka doll; every time you solved a problem another emerged.  Well, it still seems that way; the deeper we probe into how our system works, the more mystifying it appears.  If you don’t believe me, read this:


You already know that our DNA comes in distinct linear segments called chromosomes, and that when a cell divides these chromosomes are duplicated and divvied up evenly.  You also know that our cells have elaborate means of selecting which genes are activated at the correct time and place; we call these controls epigenetic markers.  You may not have known that one of these epigenetic controls involves tightly wrapping the linear chromosomes around little knots of things called histones, thus preventing the messenger RNA strips from translating selected genes into proteins.
 
Well, now it appears that a cell’s entire DNA is not contained in chromosomes; there exist numerous small circles of “extra chromosomal” DNA swimming around in the nuclear cytoplasm.  Moreover, when a cell splits these little circles don’t necessarily divide evenly.  These little circles come in many sizes, and are numerous.    What they do is not at all clear, but you can bet your MAGA cap that they’re doing something; probably several things in fact, and some of them important.  Inevitably, much research is underway.

Babushka  dolls.  Full employment for molecular biologists until the end of time.

Monday, November 25, 2019

METASTASIS: NOT A CHEERFUL SUBJECT


AT THE SONNY BONO BIRD REFUGE

This is not a lighthearted blog.  Read it anyway.

Linda, my beautiful wife, died of ovarian cancer.  However, it was not the primary tumor that killed her; it was a metastasis – probably in the brain.  Such is the case with most fatal tumors.  This link gives you valuable insight into how metastasis works.  Simplistically, metastasis occurs when a bit of the primary tumor breaks off and is transported by the blood or lymph system to a place with the correct “micro-environment” where it can lodge and grow.  Much research has and is being done on this question of micro-environment – and how to make it less hospitable.  This link concerns brain cancer and is a bit technical in places – but you will persevere. 



Sunday, November 24, 2019

A GLIMMER OF HOPE


I don't know what's going on here
This is our new house
Maybe we only had one chair

If you read these things you will know that I have immense enthusiasm for immunotherapy in general, but am pessimistic about the pace with which it is being applied to solid tumors, and specifically OVCA.  Well, these two articles signal hope just over the horizon.  It appears that French and a Japanese research outfits have made significant progress on applying  immunotherapeutic techniques to ovarian cancer – in mice.  The method requires sequencing the tumor’s genome, then devising an individualized drug to croak it.  HOW this works remains several notches above my pay grade, but the FDA seems to be smiling upon it so there is reason for optimism.  A Phase 1 trial is in the offing. 






Wednesday, November 20, 2019

SIDE EFFECTS


Linda, not quite enjoying a camel ride
2009

Our immune system has evolved for hundreds of millions of years  - heck, billions of years if we’re related to stuff like blue-green algae.  It is a fearsome weapon against would-be invaders: bacteria, virus, fungi, prions (look them up).  The immune system keeps us on our feet and going about our business, most of the time.  One thing it hasn’t been proof against until very recently is the internal threat known as cancer.  But now, thanks to the genius of those many people in white coats, immune treatments for many types of cancer have been developed.  If you read this blog you’ll know what they are.  Immunotherapy has yet to be successful against OVCA, but someday it will be.  Have faith.

Bur, as you might expect, there are problems.  If you start fiddling around with something as powerful and complicated as the human immune system, you should expect unintended consequences - some quite nasty.  And, of course, such is the case.  Read below to catch up on observed side-effects of various immunotherapies.  They range from trivial to catastrophic.


Monday, November 18, 2019

ENTICING BUCKETS OF SNAKE OIL


Linda and Carolyn
Hippy-chick era

Sorry.  In the incredible excitement surrounding my 86th birthday six months ago I neglected to alert you to this valuable contribution.  However: no harm, no foul; it still works.  

It seems that the “stem-cell clinic” boom continues and, in fact, is prospering.  This link will fill you in, and you should read it before you pay anybody to squirt stuff into one of your joints.  

None of these so-called “stem-cell cures” has received FDA approval; but neither have they been banished.  Most evidence cited by the stem-cell purveyors  is purely anecdotal; a few clinical trials have been initiated, but not successfully completed.  My guess is that there may be something in this “therapy”, but it won’t be obvious any time soon.  In the meantime:  Don’t toss a lot of your hard-earned money into what very well might be just a fancy bucket of snake oil.



Sunday, November 17, 2019

FOR MY SERIOUS READERS


On an outing, long ago

This is for the serious student of ovarian cancer – I hope there are a bunch of you out there, faithfully following my blog.  Even if initially you were as ignorant as I was back in 2012, if you have paid moderate attention (and have the power of memory I no longer have!) you will be able to follow this very useful discussion.  I recommend that you try.


By the way, that same subset of followers should benefit from subscribing to a web site called Onclive.  It mainly caters to professionals, but on registering you can identify yourself as “Patient/Other”.  For “year of graduation” enter anything reasonable – I used 2012, the year I started this blog.  I suspect that, if you join, Onclive will flood you with so much stuff you will be tempted to stop reading this blog.  Please don’t.

Friday, November 15, 2019

EXERCISE AND CANCER


Linda and Amanda
The latter now is the mother of my three great grandsons
How time does fly!

If, God forbid, you contract cancer, should you exercise – or not  This link advises you to work up some sweat.  Lots of clinical trials agree.



As I advised earlier, you may have to cut-and-paste to read this thing.

Sunday, November 10, 2019

DESIGNER BABIES? Oh, Lord!


Linda and her wonderful sister, Carolyn

The newest edition of The Economist has an article you can’t afford to miss.  Read it here:


(Tangentially, my computer won’t let me open links like this simply by clicking on them.  Instead, I must cut-and-paste.  If you have such a recalcitrant machine, do likewise; this link is worth reading.)

So, this article attempts to bring us up to snuff (an odd phrase) on recent advances in human engineering.  It explains how it now is possible to screen embryos for susceptibility to many diseases.  That being true, how long before (designer babies) we are flooded with blue-eyed blonds with perfect teeth.  Thank the Lord I won’t live to see it.

Well, yeah, those last sentences are way over the top.  Nevertheless, the pace of advancement in genetic manipulation is such that it becomes important for people to take notice, and form opinions.  This article is a little bit heavy, I admit.  To ease your passage, here are some tidbits:

SNPs:  Single nucleotide polymorphisms. This is the substitution of a  single base (T, say) for another (A, for example).  These substitution can be located in a gene (where it may or may not wreak havoc), or in the non-coding part of the genome, part of which regulates gene expression.  It turns out that many human traits are dependent on a combination of a large suite if SNPs.  This can be studied only through….

GWAS:  Genome-wide Association Studies.  As far as I can tell, these involve the statistical evaluation of suites of SNPs in light of human phenotypic variations.  For instance, after analysis of thousands of genomes it should be evident that people like Tom Brady carry a package of SNPs that differ substantially from the package carried by people like me.  It turns out that most characteristics are conditioned by the cooperation of large numbers of SNPs. 

Despite the possibility of designer babies (which society soon  must confront), GWAS and study of things like SNPs ultmately are valuable.  That’s why, when 23andMe,  Ancestory.com, or similar outfits ask if they can contribute your genome to research, you should agree.

By the way, I have purchased a 23andMe kit, but have yet to send it in.  I expect them to tell me that I am northern European, male - and too old to worry about anything else.



Friday, November 8, 2019

PRIME EDITING, A PROMISING NEW TOOL


Linda and her Mom
Before I came along

Well, by this time you know all about the more popular twists and turns of immunotherapy:  PARP inhibitors, CRISPR-Cas9, tumor-infiltrating lymphocytes – that sort of thing.  If you are at all like me, you have a vague idea of what they do – but are completely mystified by how they do it.  Well, here is another mystery to add to your list – prime editing.  It’s all the buzz.

Seems that folks at the Broad Institute of MIT, and other folks at Harvard, have devised a precise and delicate way to edit the genome.  Unlike previous CRISPR techniques, which were good for destroying genes, prime editing enables the investigator to fix them, by engineering  a swap of a single base – T for A, say, or A for C, etc.  There are 12 possible ways that genomic coupling can go wrong, and prime editing can fix them all.  Where CRISPR Cas9 is a chain saw, prime editing is a pair of tweezers.

This work has been published in Nature very recently and has created a stir.  There are articles discussing it everywhere you turn.  The link given below is easy going.  I am planning to read around and, hopefully, figure out how prime editing actually works.  Stay tuned.  But, in the meantime Google "prime editing", and see what you find.




Saturday, November 2, 2019

FASCINATING ADVENTURES IN PARP-INHIBITION


AN EARLY CAMPING TRIP
Wasn't she beautiful

Faithful readers of this blog (and there are at least six of you – not counting my 176 avid  Italians, of course) will know that immunotherapy is the current big thing in the war against cancer, but that it hasn’t moved the ball much where ovarian cancer, and many other solid tumors are concerned.  Those same faithful followers will know about PARP inhibitors (PARPi) and how they work to stifle cancer by “inhibiting” nature’s way to repair things known as double-stranded DNA breaks.  Since these broken double-stranded things occur as mistakes made during cellular reproduction, and as cancer does a lot of reproducing, inhibiting PARP is a good way to slow down tumor growth.

Well, the article cited below reports on encouraging clinical trials that show that PARPi drugs  used as “maintenance  therapy” extend remission times in OVCA by quite significant amounts – several years in some cases.  It also appears that PARPi drugs may be useful as front-line therapy, as well.  Neither way is it a cure (yet), but PARPi drugs certainly can be useful.  Here are some of the drugs discussed:  niraparib (Zejula), olaparib (Lynparza), and valiparib.  There were three massive clinical trials involved in this research.  More wrinkles are being investigated; stay tuned

The moral of the story is that, if you brush up against OVCA, remember that there are things to do, and maybe trials to join.  Make sure your medical support is up to snuff.

Friday, November 1, 2019

THE LATEST HUTCH NEWSLETTER


HARD AT WORK

The latest issue of the Fred Hutch newsletter is out.  Lots of interesting articles, including:
A tricky new way to make HIV vaccine
More on diet and cancer
How mutations drive development of cancer
Vaping
CAR-T cell therapy
And much more

TAKE A BREAK FROM TRUMPISH CHATTER!