Saturday, October 21, 2017

$373,000 per regimen for new treatment

FDA gives its okay to a second gene therapy that can send blood cancer into remission

The FDA has approved a new gene therapy for adults with aggressive non-Hodgkin's lymphoma.

According to a recent story by Denise Grady in The New York Times, Yescarta was okayed for patients who've undergone two regimens of chemotherapy that failed.

The Times article notes that the therapy "is part of the rapidly growing field of immunotherapy, which uses drugs or genetic tinkering to turbocharge the immune system to fight disease. In some cases the treatments have led to long remissions."

The therapy, which turns cells into "living drugs," is made by Kite Pharma.

Approval by the Federal Drug Administration was its "second in a radically new class of treatments that genetically reboot a patient's own immune cells to kill cancer."

The first was Kymriah, made by Novartis. It was okayed in August "for children and young adults with an aggressive type of acute leukemia."

That one costs $475,000 per dose, although the company has said "it will not charge patients who do not respond within the first month after treatment."

Yescarta isn't quite as expensive — $373,000 per treatment.
Dr. Frederick L. Locke
Dr. Frederick L. Locke, a leader of a study of Yescarta (and a specialist at the Moffitt Cancer Center in Tampa in blood cancers), is quoted as saying, "We're excited. We think there are many patients who may need this therapy."

Grady's story says "about 3,500 people a year in the United States may be candidates for Yescarta," which is intended "to be given once, infused into a vein, and must be manufactured individually for each patient."

Side effects, as with many therapies, can be daunting.

Life-threatening issues that stem from the Yescarta treatment can include "high fevers, crashing blood pressure, lung congestion and neurological problems," the story indicates.

According to Grady, two patients in the study that led to the drug's approval, "died from side effects," although doctors — through training and experience — apparently "have learned to manage them better."

The study, which was conducted at the Dana-Farber Cancer institute and Brigham and Women's Cancer Center in Boston, involved 111 patients at 22 hospitals.

"Initially," Grady's piece delineates, "54 percent [of the 101 who received Yescarta] had complete remissions…Another 28 percent had partial remissions [and] after six months, 80 percent…were still alive. With a median follow-up of 8.7 months, 39 percent of the 101 were still in complete remission — a much higher rate that achieved with earlier treatments — and 5 percent still had partial remissions."
Dr. Caron A. Jacobson

Says Dr. Caron A. Jacobson, who helped do the study: "You're really seeing people get their life back. After a couple weeks in the hospital and a couple weeks at home, they go back to work. On its face, it's quite remarkable and revolutionary."

The treatment, the Times explains, "was originally developed at the National Cancer Institute, by a team Dr. Steven Rosenberg led. The institute entered an agreement with Kite in 2012, in which the company helped pay for research and received rights to commercialize the results."

The drug giant Gilead reportedly bought Kite two months ago for $11.9 billion.

"In just several decades, said Dr. Scott Gottlieb, the FDA commissioner, "gene therapy has gone from being a promising concept to a practical solution to deadly and largely untreatable forms of cancer."

A look at many treatments and clinical trials can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at caregivers.

Thursday, October 12, 2017

African-American health care being undermined

Breast cancer mortality rate remains higher for whites than blacks, new study shows

Despite strides in meds and treatments, black women are still at a much greater risk of dying from breast cancer.

A recent story on the Huffington Post website by Suzy Strutner points out that while total survival rates for the disease are improving, a new study shows a huge gap remains. 

The new report, from the American Cancer Society, finds that "breast cancer death rates declined 39 percent between 1989 and 2015" but whites have a 39 percent greater chance of survival than blacks."

The gap, the study says, "emerged in the early '80s, widened through 2015 and has remained steady since."

Why the gap?

Because of "biological differences in breast cancer tumors, along with health care policy."

Regarding the latter, Strutner's story indicates that "unequal access to preventive screenings and treatment" includes black women getting mammograms "slightly more often than white women nowadays, but they had lower screening rates in the past, which 'may be one possible reason for the difference in survival rates today,' according to the Susan G. Komen website."

Not to mention "access to follow-up care [possibly differing] among the races."

Beth Glenn, Ph.D.
The HuffPost story goes on to explain that "less screening means black women might wait longer between  mammograms, be diagnosed late or be unable to follow up altogether when a mammogram comes back abnormal," according to Beth Glenn, Ph.D. associate director for the UCLA Kaiser Permanente Center for Health Equity.

Besides, "for black women who live in poverty, clinics might be too far away," the story adds. 

Christine Ambrosone, Ph.d.
The story also quotes Christine Ambrosone, cancer prevention chair at the Roswell Park Cancer Institute, about poverty blocking black women from care: "Things like transportation for cancer treatment can be a barrier, particularly for women who need radiation therapy, a treatment that needs to be given daily, and who cannot get that time off from work."

Strutner also cites "racial discrimination in health care settings."

As to the biological differences, her HuffPost story says "black women are twice as likely to be diagnosed with triple negative breast cancer, an aggressive form that's harder to treat. And tamoxifen, a drug that's hugely responsible for the overall improvement in death rates, treats another type of breast cancer, called hormone-receptor-positive breast cancer, that black women are less likely to get."

At the same time, Strutner's story indicates, Native American, Latina and Asian women all have lower rates of breast cancer and death from the disease than white women.

It also cites the report mentioning the states of Massachusetts, Connecticut and Delaware as managing to "close the gap, likely by widening health care access so it's easier for everyone to get treatment when they need it" — including Massachusetts passing "a health care reform that requires all residents to have health insurance and offering free health insurance to poor residents who qualify."

The story quotes Glenn as saying that "in general, states with more coverage for low-income women tend to have better outcomes."

Further information on different situations for different races can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Friday, October 6, 2017

How high-risk men's lives may be extended 37%

UK clinical trial shows that two prostate cancer therapies can be much better than one

Can combining two existing therapies extend the life of men with advanced, high-risk prostate cancer by 37%?

A new study seems to answer that question with a "yes."
Nicholas James
"These are the most powerful results I've seen from a prostate cancer trial," reported Nicholas James, professor of clinical oncology at Queen Elizabeth Hospital in Birmingham, United Kingdom, lead author of an abstract presented to the American Society of Clinical Oncology, in a recent story by Jessica Glenza in The Guardian. 

It's a "once in a career feeling," he noted. "This is one of the biggest reductions in death I've seen in any clinical trial for adult cancers."

Researchers, the Glenza story indicated, "combined standard hormone therapy with a drug called abiraterone, which is typically used only for cancer patients whose disease has stopped responding to standard hormone therapy."

Patients who received both medications did have "slightly stronger side effects," however — "especially cardiovascular and liver problems."

The study, which looked at a group of 2,000 men, was done as part of an ongoing randomized trial conducted in the United Kingdom and Switzerland.

James also was quoted as saying that "abiraterone not only prolonged life, but also lowered the chance of relapse by 70% and reduced the chance of serious bone complications by 50%."

More than 27,000 men in the United States, and 11,000 men in the UK, die of prostate cancer each year.

Details about many clinical studies on cancer can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Friday, September 29, 2017

Former 'Seinfeld' star urges universal health care

'Veep' multiple Emmy winner Julia Louis-Dreyfus reveals that she's fighting breast cancer

Julia Louis-Dreyfus
Julia Louis-Dreyfus, 56-year-old multiple Emmy-winning star of "Veep" and "Seinfeld," has breast cancer.

The actress disclosed her diagnosis on Twitter yesterday "in a signed message snapped on personal stationery," according to a Huffington Post story by Sara Boboltz.

Her note began, "1 in 8 women get breast cancer. Today, I'm the one."

She also took the opportunity to plug universal health care: "The good news is that I have the most glorious group of supportive and caring family and friends, and fantastic insurance through my union. The bad news is that not all women are so lucky so let's fight all cancers and make universal health care a reality."

Actress Deborah Messing, who again is starring in the TV sitcom "Will and Grace," tweeted that "you are incredible to use this moment as an opportunity to support others."

And actress Anna Kendrick tweeted, "I don't think I realized how much I love this woman, who I don't know. Love her more for speaking up for others in this moment."

Christina Applegate, an actress who had a double mastectomy in 2008 after she was diagnosed with breast cancer, said Louis-Dreyfus could contact her if she wanted to talk.

Former vice president Joe Biden, whose son Beau died of cancer in 2015, tweeted that "we Veeps stick together. Jill and I, and all of the Bidens, are with you, Julia." 

Just under 240,000 women are diagnosed with breast cancer each year.

Louis-Dreyfus, who did not immediately announce what treatments she's contemplating, won her sixth consecutive Emmy for playing bumbling politico Selina Meyer on "Veep," a political satire, earlier this month, a record. 

Her latest award came the day before her diagnosis. 

More information on the disease, as well as reactions to diagnoses, can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Thursday, September 21, 2017

2nd opinions, knowing right questions are key

Hospital network offers cancer patients, especially those in advanced stage, four tips

Sometimes good information comes from unexpected places.

Like an old ad.

Case in point: I just found a piece on a Time magazine website that was reprinted from Cancer Treatment Centers of America,  a network of five hospitals in five states.

It contends that "breakthroughs unimaginable a generation ago are now saving lives as a matter of course."

And it suggests "four things every cancer patient must do."

They are: Get a second opinion, find the right doctors, know the questions to ask, and stay strong for the fight.

Regarding second opinions, the piece maintains that those consults provide an opportunity "to better understand additional needs like nutritional planning, the management of side effects, and the power of family support during cancer treatment.

Dr. George Daneker Jr.
The piece quotes Dr. George Daneker Jr., CTCA's chief medical officer, to the effect that "more advances in cancer treatment have been made in the past five years than in the past 50" but initial diagnoses are not always right. 

Twelve percent of patients are actually misdiagnosed, the article says.

As to finding the right docs, it notes that "fully one out of five patients who receive a cancer diagnosis learn their disease is already advanced stage [and] frequently require more comprehensive care from a dedicated team that should include a medical oncologist, surgical or radiation oncologist [if appropriate], registered dietitian, naturopathic oncology provider, and other clinicians."

When it comes to knowing what to ask, the CTCA lists 10 questions it considers crucial, including "What happens if a treatment approach doesn't work for me?"

Staying strong may not be an easy task, the article inidicates, because "69% of cancer patients have health issues beyond their cancer…and fully eight out of ten people living with cancer are also malnourished."

The treatment centers also assert that "the one consistent enabling truth in the fight against cancer throughout the years has always been this: Knowledge is power."

I certainly concur.

And in that regard, I'd like to promote my VitalityPress book, "Rollercoaster: How a man can survive his partner's breast cancer," which I aimed at male caregivers and which I'm convinced is chock full of information that can become powerful knowledge.

Wednesday, September 13, 2017

Mistaken diagnoses plague patients, doctors

DNA 'fingerprinting method' might lower risk of lab errors on thousands, N.Y. Times says

Lab mixups and mistaken diagnoses (both positive and negative) may be happening to thousands of patients each year.

That's what Gina Kolata indicated recently in The New York Times.

Her article focuses on how to avoid those errors — a "high-tech solution: a way to fingerprint and track each sample with the donor's own DNA." 

But it's costly: About $300 per sample. So labs are reluctant to employ them.
Dr. John Pfeifer

Kolata, however, quotes Dr. John Pfeifer, vice chair of clinical affairs in the pathology and immunology department at Washington University School of Medicine in St. Louis as saying, "All the process improvement in the world does not get rid of human errors…Millions get biopsies every year. Is society going to say, 'Yeah, mistakes happen but we're not going to look for them?"

When the fingerprinting method is used, the lab tries to match the DNA from a swab taken from a patient's mouth. If it doesn't match, that signals a lab mix-up.

Errors, according to Kolata, "may lead a patient down a life-altering path, to a grueling treatment that was unnecessary, or to the neglect of a cancer that may or may not prove deadly."

Pfeifer actually reviewed more than 13,000 biopsy results from men evaluated for prostate cancer at a number of labs. The results were supplied by the chief exec at Strand Diagnostics, the company that's marketing the fingerprinting method.

More information about research into lab results can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Friday, September 8, 2017

'Triple negative breast cancer' treatment studied

African scholarship student is working on potential cure for a subtype of cancer for blacks 

A Sierra Leonean student reportedly is developing an alternative breast cancer treatment for black women.

Sandra Musujusu
According to a recent story by Taryn Finley on the Huffpost website, the research of Sandra Musujusu, a student at the African University of Science and Technology in Abuja, Nigeria's capital, is focusing on "triple negative breast cancer, which is actually the aggressive subtype of breast cancer that is common with women from African ancestry."

The Huffpost piece references an article in the Nigerian Tribune that reported the research centering on "the development of biodegradable polymers for treatment of breast cancer."

A variety of African publications have been sanguine about Musujusu's research potentially leading to a cure.

She apparently is using macro molecular science as her basic tool.

Breast cancer, the Huffpost story indicated, "is the most commonly diagnosed caner among women around the world. In 2012, there were 1.7 million new cases worldwide, according to World Cancer Research Fund International."

An online article on the Rollingout website says that "about 1 in 8 U.S. women "will develop invasive breast cancer over the course of her lifetime, according to"

The National Cancer Institute has reported that approximately 1,211,690 black people have a history of cancer.

In the United States alone, the Huffpost story notes, "black women with breast cancer have the highest mortality rate than any other race, according to the Susan G. Women Foundation."

And the National Cancer Institute has said approximately 1,211,690 black people have a history of cancer.

Musujusu is a World Bank scholarship student.

More information about breast cancer and black women can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Thursday, August 31, 2017

Prediction: Price of drug therapies will skyrocket

New FDA-approved cancer gene therapy to cost $475,000 for a single course, reports say

Are pharmaceutical companies gouging the public?

Very possibly, as evidenced by a new gene therapy for childhood leukemia that will cost almost half a million dollars for a single course.

Reports yesterday about Federal Drug Administration approval for Novartis' Kymriah, which is the first gene therapy for cancer that it's okayed, say it will cost at least $475,000.

Although some oncologists have described the CAR-T drug as revolutionary, critics fear the price tag could pave the way for future drug costs to skyrocket.

According to a story by Catherine Ho in the San Francisco Chronicle, the way the treatment works is this: A patient's cells are extracted from his or her blood, then sent to a site where they'll be genetically modified. The altered cells are then re-infused into the patient's body.

The FDA this week approved Kymriah as a treatment for childhood B-cell acute lymphoblastic leukemia, a cancer of the blood and bone marrow that's the most common childhood cancer.

The National Cancer Institute has estimated 3,100 patients up to 20 years old are diagnosed with the disease annually. Although the survival rate is 90 percent, that figure drops to as low as 10 percent for those who relapse after a bone marrow transplant. It is that subset of patients who are eligible for cell therapy, whose rate of success is said to be between 70 and 80 percent.

Only a few hundred children and young adults are expected to be treated with Kymriah each year.

Bruno Strigini
A Guardian story, supplemented by Associated Press reporting, said that Bruno Strigini, Novartis' head of oncology, has explained that the high cost of the treatment is an attempt to balance patient access to the drug with ensuring a return on the company's investment.

The Guardian piece also cited a Novartis statement to the effect that the company "was collaborating with Medicare on a plan in which the government would only pay for the treatment if patients responded to them by the end of the first month."

Side effects of the drug include high fevers, diarrhea, vomiting, delirium, loss of balance, and difficulty speaking and understanding.

More information about the exorbitant costs of cancer treatments can be found in  "Rollercoaster: How a man survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.