New drug shows promise in treating indolent non-Hodgkin lymphomas

Slow-growing, or indolent, non-Hodgkin lymphomas are difficult to treat, with most patients relapsing repeatedly and the disease becoming increasingly resistant to therapy over time.

But a new drug made by Seattle-based Gilead Sciences Inc. appears to offer hope for fighting the disease, according to a study published online today in The New England Journal of Medicine in advance of its March 13 print issue.

The phase 2 study involved 125 patients aged 33 to 87 with indolent non-Hodgkin lymphoma (iNHL) who had not responded to conventional treatments or had relapsed within six months of therapy. The patients, who were from the Seattle area, around the United States and Europe, were given a twice-daily dose of idelalisib, a highly selective oral drug that inhibits phosphoinositide 3-kinase (PI3K) delta. P13K deltas are a family of enzymes seen in many types of B-cell malignancies.

Following treatment with idelalisib, tumor size shrunk by at least half in 57 percent of the patients and 6 percent had no measurable evidence of cancer.

"These are patients who had exhausted current standard therapies," said Ajay Gopal, M.D., a member of Fred Hutchinson Cancer Research Center's Clinical Research Division and the study's lead and corresponding author. "In terms of effective therapy available, there really wasn't much left."

Indolent non-Hodgkin lymphomas comprise about one-third of all cases of NHL. About 20,000 people in the United States were diagnosed with iNHL in 2012 and approximately 7,000 died of the disease. The standard treatment for iNHL is a combination of rituximab, a drug that targets the protein CD20 found on B cells, and chemotherapy.

New drug shows promise in treating indolent non-Hodgkin lymphomas -- ScienceDaily

Scientists develop powerful new animal model for metastatic prostate cancer

Prostate cancer is the most common form of cancer in men. Affecting about 1 in 6 men, it is the second deadliest cancer. Research has been stymied by imperfect animal models of the disease, which are costly, take considerable time to develop, and fail to mimic the most lethal aspects of the illness. Now, Cold Spring Harbor Laboratory (CSHL) scientists have developed a new method to rapidly create much better mouse models for metastatic prostate cancer. This discovery allows scientists to investigate the causes of the disease while at the same time testing new therapeutics to treat it.

More at 

Ref: http://cancerdiscovery.aacrjournals.org/content/early/2014/01/24/2159-8290.CD-13-0346

Scientists develop powerful new animal model for metastatic prostate cancer  

Birch helps wounds heals faster.....

Extracts from the birch tree have served for centuries as a traditional means of helping the damaged skin around wounds to regenerate more quickly. Prof. Dr. Irmgard Merfort from the Institute of Pharmaceutical Sciences of the University of Freiburg and her team have now explained the molecular mechanism behind the wound-healing effect of an extract from the outer white layer of the tree's bark. The scientists published their findings in the journal Plos One. The team cooperated with several other departments and institutes, such as a research group from the Institute of Molecular Medicine and Cell Research and the Institute of Experimental and Clinical Pharmacology of the University of Freiburg as well as a research group from the Dermatological Clinic of the University of Hamburg.

Ref : http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0086147

Birch helps wounds heals faster -- ScienceDaily

US Indian scientist ‘re-engineering’ tulsi "to control breast cancer"

US Indian scientist ‘re-engineering’ tulsi -  to  control breast cancer"

Led by an Indian-American, a team of scientists at a US university are genetically engineering tulsi or basil to enhance its pharmaceutical value, the institute said.

In his lab at the Owensboro facility, Chandrakanth Emani, Assistant Professor of Plant Molecular Biology at the Western Kentucky University and his students are genetically engineering the basil to produce more eugenol, a compound in basil that “has a very great pharmaceutical value because it's shown to  control breast cancer,” the University said in a statement.

“When you grind these basil leaves there is a compound called eugenol that comes out...Eugenol, when they put it on a plate where there are tumor cells, it stopped growth of the tumour cells. That was a proof of concept experiment which was done a long time back,” Prof Emani claimed.

“If I make it make higher and higher amounts of eugenol, that plant, basil plant, will be a storehouse of that anti-cancerous compound,” he said.

The next phase would be to test the compound as an effective cancer treatment. Prof Emani is also working to understand various basic cell functions.

Biology News

New Drug Combo Might Help Older, Sicker Patients With Leukemia

The research, led by German scientists, included nearly 800 older people (average age 73) who had been diagnosed with chronic lymphocytic leukemia. CLL is a cancer of the blood and bone marrow, the tissue inside bones in which blood cells are created.

The study was published online Jan. 8 in the New England Journal of Medicine. Study participants -- none of whom had received treatment for their illness before the start of the research -- were randomly assigned to one of three groups.

One group received an oral medication called chlorambucil (also known by the brand name Leukeran), the standard chemotherapy drug for older patients with CLL.

The second group received chlorambucil plus a drug called rituximab (Rituxan). This drug has been used effectively in combination with other forms of chemotherapy for more than a decade to treat younger, fitter patients with CLL, an expert said.

The third group received chlorambucil plus a new antibody drug called obinutuzumab. The rituximab and obinutuzumab were given intravenously.

The researchers, whose study was funded by the manufacturer of both obinutuzumab and rituximab, reported that the obinutuzumab-chlorambucil combination improved outcomes for the older CLL patients better than the other two treatment options.

The most common side effects for obinutuzumab are infusion reactions, low blood cell counts, fever, cough and musculoskeletal disorders, according to the manufacturer's website.

Dr. William Wierda, a professor in the department of leukemia at the University of Texas MD Anderson Cancer Center, said older patients don't tend to tolerate intensive chemotherapy with rituximab as well as younger patients. That has left older CLL patients with limited drug options, including chlorambucil, he said.

"We've been wanting to find a treatment that is effective and well tolerated in the elderly population," said Wierda, who was not involved with the new research. "A standard treatment for older patients with CLL has been chlorambucil, a type of chemotherapy that's been used for many years."

"The trial shows improvement in outcome remission rates and duration favoring patients who got chlorambucil and obinutuzumab," he said. "This was a head-to-head comparison of the two antibody arms of the study -- the rituximab and the obinutuzumab -- and obinutuzumab won out."

There also was an improvement in overall survival among the patients who received the obinutuzumab-chlorambucil combination treatment versus those who received chlorambucil alone, Wierda said.

New Drug Combo Might Help Older, Sicker Patients With Leukemia - Drugs.com MedNews

New Drug Combo Might Help Older, Sicker Patients With Leukemia - Drugs.com MedNews

Mekinist Plus Tafinlar Approved for Late-Stage Melanoma

The U.S. Food and Drug Administration on Friday approved Mekinist for use with another drug, Tafinlar, to treat advanced melanoma that is spreading or cannot be removed by surgery.

Melanoma is the most deadly form of skin cancer, accounting for an estimated 9,480 American deaths last year, the FDA said Friday in a news release. Mekinist (trametinib) is newly approved to be used in combination with Tafinlar (dabrafenib). Both drugs were first sanctioned in May 2013 to be used by themselves to battle advanced melanoma, the agency said.

The combination therapy is newly approved for people who have certain mutations in the BRAF V600E and V600K genes, the FDA said. About half of melanoma cases have the mutated genes.

The combination therapy was clinically evaluated in 162 people. Of those treated, 78 percent had their cancer shrink or disappear for an average of 10.5 months, the agency said.

Mekinist Plus Tafinlar Approved for Late-Stage Melanoma - Drugs.com MedNews

FDA Approves Anoro Ellipta to Treat COPD

A new inhaled drug to treat a serious lung condition called chronic obstructive pulmonary disease (COPD) has been approved by the U.S. Food and Drug Administration.

GlaxoSmithKline's Anoro Ellipta [Combination of umeclidinium bromide -(see structure-1 left) and vilanterol-structure-2 rightside below) is meant to be used once a day for long-term maintenance of airflow in patients with COPD. The lung disease makes breathing difficult and worsens over time.   

"Anoro Ellipta works by helping the muscles around the airways of the lungs stay relaxed to increase airflow in patients with COPD," Dr. Curtis Rosebraugh, director of the Office of Drug Evaluation II in the FDA's Center for Drug Evaluation and Research, said in an agency news release.

"The availability of new long-term maintenance medications provides additional treatment options for the millions of Americans who suffer with COPD," he added.

FDA Approves Anoro Ellipta to Treat COPD - Drugs.com MedNews

Farxiga Approved for Type 2 Diabetes - Drugs.com MedNews

In continuation of my update on Farxiga

Farxiga (dapagliflozin) has been approved by the U.S. Food and Drug Administration to treat adults with type 2 diabetes, the agency said Wednesday in a news release.

The drug, to be used for blood sugar control along with proper diet and exercise, is designed to prevent re-absorption of glucose by the kidneys. Type 2 diabetes affects some 24 million people, accounting for 90 percent of diabetes cases in the United States, the FDA said.

Farxiga Approved for Type 2 Diabetes - Drugs.com MedNews

Chinese herbal compound relieves inflammatory, neuropathic pain

Working with Chinese scientists, Olivier Civelli and his UC Irvine colleagues isolated a compound called dehydrocorybulbine (DHCB) from the roots of the Corydalis yanhusuo plant. In tests on rodents, DHCB proved to diminish both inflammatory pain, which is associated with tissue damage and the infiltration of immune cells, and injury-induced neuropathic pain, which is caused by damage to the nervous system. This is important because there are no current adequate treatments for neuropathic pain.

Moreover, the researchers found that DHCB did not generate the tolerance seen with continued use of most conventional pain relievers, such as morphine.

"Today the pharmaceutical industry struggles to find new drugs. Yet for centuries people have used herbal remedies to address myriad health conditions, including pain. Our objective was to identify compounds in these herbal remedies that may help us discover new ways to treat health problems," said Civelli, the Eric L. & Lila D. Nelson Chair in Neuropharmacology. "We're excited that this one shows promise as an effective pharmaceutical. It also shows a different way to understand the pain mechanism."

Study results appear in the Jan. 20 issue of Current Biology.

They are the product of a collaboration between two teams separated by the Pacific Ocean. As traditional Chinese medicine gains greater acceptance in Western medical practice, Xinmiao Liang at the Dalian Institute of Chemical Physics in China and his group have been working to create an "herbalome" of all the compounds in plant extracts that display pharmacological properties. The UC Irvine team suggested applying "reverse pharmacology"   a novel drug discovery approach that Civelli devised about 25 years ago   to the herbalome project.

Together they screened 10 traditional Chinese medicines known as analgesics, testing nearly 500 compounds for their pain-relief abilities. Only DHCB in corydalis induced a reproducible effect.

Corydalis is a flowering herbal plant that grows in Siberia, Northern China and Japan. People utilize its root extract to alleviate menstrual cramps, chest pain and abdominal pain. It's been previously studied for its analgesic properties, but this is the first time DHCB has been identified, extracted and tested.

Chronic neuropathic pain affects more than 50 million Americans, yet management of this pain remains a major clinical challenge due to the poor results and severe side effects of conventional analgesics. Civelli said that drawing upon traditional Chinese medical-herbal products could lead to a breakthrough treatment for these patients.

Chinese herbal compound relieves inflammatory, neuropathic pain

2 Pre-Surgery Drug Treatments Show Promise Against Aggressive Breast Cancer - Drugs.com MedNews

This pre-surgical drug therapy boosts the likelihood that no cancer cells will be found in breast tissue removed during either mastectomy or lumpectomy, according to two new studies.

The approach, called "neoadjuvant" chemotherapy, is being given to an increasing number of women with what's known as triple-negative breast cancer. Currently, the approach results in no identifiable cancer cells at mastectomy or lumpectomy in about-one third of patients, experts estimate. In such cases, the risk of a tumor recurrence becomes lower.

"Chemotherapy [before surgery] does work in triple-negative breast cancer. What we want to do is make it work better," said study researcher Dr. Hope Rugo.

Rugo is director of breast oncology and clinical trials education at the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco.

Triple-negative cancers have cells that lack receptors for the hormones estrogen and progesterone. In addition, they don't have an excess of the protein known as HER2 on the cell surfaces. So, treatments that work on the receptors and drugs that target HER2 don't work in these cancers.

In two new studies, researchers got better results by adding drugs to the standard chemo regimen prior to surgery. However, both studies are phase 2 trials, so more research is needed.

Both studies are due to be presented Friday at the annual San Antonio Breast Cancer Symposium.

Rugo compared standard neoadjuvant therapy -- paclitaxel (Taxol, others), doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan, others) -- to standard therapy plus the drugs veliparib (investigational) and carboplatin (Paraplatin)....

2 Pre-Surgery Drug Treatments Show Promise Against Aggressive Breast Cancer - Drugs.com MedNews

Two-drug combo helps adolescents with ADHD, aggression

Prescribing both a stimulant and an antipsychotic drug to children with physical aggression and attention-deficit/hyperactivity disorder (ADHD), along with teaching parents to use behavior management techniques, reduces aggressive and serious behavioral problems in the children, according to a study conducted by researchers at The Ohio State University Wexner Medical Center….

For the "Treatment of Severe Childhood Aggression (TOSCA) Study," 168 children ages 6 to 12 who had been diagnosed with ADHD and displayed significant physical aggression were divided into two groups. All study participants received a psychostimulant drug called OROS methylphenidate (left structure) and their parents received behavioral parent training for nine weeks. The researchers called this treatment combination "basic" because both are evidence-based and have been shown to be helpful for improving both ADHD and aggression.

Researchers wanted to see if they could expand or augment this treatment by adding a second medication. If there was room for improvement at the end of the third week, a placebo was added for the "basic group," while the antipsychotic drug risperidone (right above structure)  was added for participants in the "augmented group."

Compared to the "basic group," the "augmented group" who received the stimulant drug and parent training plus risperidone showed significant improvement (on average with moderately better behavior) on the Nisonger Child Behavior Rating Form (NCBRF) Disruptive-Total Scale, the NCBRF Social Competence subscale and the Reactive Aggression part of the Antisocial Behavior Scale.

While there is always some risk with the addition of a second drug to the treatment package, the two drugs seemed to neutralize some of each other's potential side effects. For instance, children in the augmented group did not seem to have as much trouble falling asleep, once the risperidone was added, Aman said.

"We conducted this study because we viewed the combination of ADHD and significant physical aggression -- especially the aggression -- as a serious situation," Aman said. "It is not uncommon to use more than one medicine for other serious situations, such as when treating cancer or epilepsy for instance. Although doctors have often used stimulants and antipsychotics together in recent years, we did not have good evidence until now that they would work more effectively when carefully staged and given together."

Ref : http://dx.doi.org/10.1016/j.jaac.2013.09.022

Two-drug combo helps adolescents with ADHD, aggression

Malaria drug target raises hopes for new treatments

In a study published in Nature Chemistry, they show that blocking the activity of an enzyme called NMT in the most common malaria parasite prevents mice from showing symptoms and extends their lifespan. The team are working to design molecules that target NMT more potently, and hope to start clinical trials of potential treatments within four years.

A recent study estimated that 1.2 million people died from malaria in 2010. Although a variety of antimalarial drugs are available, some strains of the parasite are resistant to treatment. These strains are becoming more common, with treatment failures reported across multiple frontline drugs. If acute illness is cured, the parasite can remain dormant in the blood and return to cause illness later. Malaria vaccines have been researched intensively, but none have been introduced into clinical practice.

The new study shows that NMT is involved in a wide range of essential processes in the parasite cell, including the production of proteins that enable malaria to be transmitted between humans and mosquitoes, and proteins that enable malaria to cause long-term infection.

The researchers have tested a handful of molecules that block the activity of NMT in the parasite living inside human red blood cells, and in mice, but further refinement will be needed before a treatment is ready to be tested in humans.

Dr Ed Tate, from the Department of Chemistry at Imperial College London, who led the project, said: "The drug situation for malaria is becoming very serious. Resistance is emerging fast and it's going to be a huge problem in the future.

"Finding an enzyme that can be targeted effectively in malaria can be a big challenge. Here, we've shown not only why NMT is essential for a wide range of important processes in the parasite, but also that we can design molecules that stop it from working during infection. It has so many functions that we think blocking it could be effective at preventing long-term disease and transmission, in addition to treating acute malaria. We expect it to work not just on Plasmodium falciparum, the most common malaria parasite, but the other species as well.

Ref : http://www.nature.com/nchem/journal/vaop/ncurrent/full/nchem.1830.html

Malaria drug target raises hopes for new treatments

New role for milk: Delivering polyphenols with anti-cancer activity

Polyphenols found in tea manifest anti-cancer effects but their use is limited by poor bioavailability and disagreeable taste. A new study in the Journal of Dairy Science^® finds that when epigallocatechin gallate (EGCG), the major extractable polyphenol in green tea and the most biologically active, when diluted in skim milk or other milk complexes remains bioactive and continues to reduce colon cancer cell proliferation in culture at concentrations higher than 0.03 mg of EGCG/mL.

Ref : http://www.sciencedirect.com/science/article/pii/S002203021300859X

New role for milk: Delivering polyphenols with anti-cancer activity

Vemurafenib: Result unchanged despite new data

In continuation of my update on Vemurafenib

Longer survival, but also major side effects

The drug approved since February 2012 can be an option for adults whose melanoma cannot be removed by surgery or has formed secondaries (metastases) and in whose cancer a change (mutation) has occurred in a certain gene (BRAF-V600). G-BA had specified the drug dacarbazine as the appropriate comparator therapy.

In its first AMNOG assessment in June 2012, the Institute concluded that vemurafenib had major advantages in overall survival, but also major disadvantages in the form of side effects. Overall, this resulted in an indication of a considerable added benefit.

Vemurafenib: Result unchanged despite new data

Supramolecular high-aspect ratio assemblies with strong antifungal activity : Nature Communications : Nature Publishing Group

Efficient and pathogen-specific antifungal agents are required to mitigate drug resistance problems. Here we present cationic small molecules that exhibit excellent microbial selectivity with minimal host toxicity. Unlike typical cationic polymers possessing molecular weight distributions, these compounds have an absolute molecular weight aiding in isolation and characterization. However, their specific molecular recognition motif (terephthalamide-bisurea) facilitates spontaneous supramolecular self-assembly manifesting in several polymer-like properties. Computational modelling of the terephthalamide-bisurea structures predicts zig-zag or bent arrangements where distal benzyl urea groups stabilize the high-aspect ratio aqueous supramolecular assemblies. These nanostructures are confirmed by transmission electron microscopy and atomic force microscopy. Antifungal activity against drug-sensitive and drug-resistant strains with in vitro and in vivo biocompatibility is observed. Additionally, despite repeated sub-lethal exposures, drug resistance is not induced. Comparison with clinically used amphotericin B shows similar antifungal behaviour without any significant toxicity in a C. albicansbiofilm-induced mouse keratitis model.

Supramolecular high-aspect ratio assemblies with strong antifungal activity : Nature Communications : Nature Publishing Group