Monthly Archives: June 2022

Scientists at Yale Cancer Center have found that patients with breast cancer and high levels of insulin in the blood may be responsive to metabolism-targeting treatments, which in turn may improve the effectiveness of subsequent chemotherapy treatments.

Scientists at Yale Cancer Center have found that patients with breast cancer and high levels of insulin in the blood may be responsive to metabolism-targeting treatments, which in turn may improve the effectiveness of subsequent chemotherapy treatments. The findings were published today in Communications Biology.

The incidence of breast cancer is projected to increase more than 50% between 2011 and 2030. This forecast is partially attributable to rising rates of obesity, which accelerate the incidence and progression of breast cancer in postmenopausal women. At the same time, metabolism-targeting therapies such as the diabetes drug metformin have gained increasing popularity in breast cancer treatment, with mixed outcomes in clinical trials.

Using a new class of diabetes drug, SGLT2 inhibitors, Yale researchers studied the SGLT2 inhibitor dapagliflozin as an alternative to metformin. The research was done in animal models to determine the responsiveness to dapagliflozin in addition to chemotherapy in breast tumors. Their findings were mutation-specific. The study revealed that dapagliflozin improves the effectiveness of chemotherapy in slowing breast tumor growth in models with breast cancer driven by mutations upstream of the insulin signaling pathway. Models with breast cancer driven by mutations downstream of the insulin pathway or in pathways with other driver mutations were not improved with the combined therapy.

Our data supports the development of insulin-lowering approaches to breast cancer treatment in hyperinsulinemic patients, said Rachel Perry, PhD, Assistant Professor of Medicine (Endocrinology) and Cellular and Molecular Physiology at Yale Cancer Center and lead author on the paper. The next step will be to move this research into early clinical trials at Smilow Cancer Hospital, which should position SGLT2 inhibitors as an attractive target to fill this niche.

Funding for the study was provided by the Lionheart Foundation.

The following Yale authors contributed to this study: Ngozi D. Akingbesote, Aaron Norman, Wanling Zhu, Alexandra A. Halberstam, Xinyi Zhang, Julia Foldi, and Maryam B. Lustberg.

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Yale Scientists Develop Precision Medicine Approach to Metabolic Therapy for Breast Cancer - OncLive

Pitt employees who reached the milestones of 20, 30, 40 and 50 years of service between Jan. 1, 2021 and June 30, 2022, were honored at an in-person ceremony on June 2 at the William Pitt Union.

The longer than normal list reflects a year and a half of work anniversaries. Last June, the ceremony, which is normally held each year, honored those who hit milestones in 2020. That ceremony had been delayed because of the pandemic.

The one person marking 50 years at Pitt Torran King hit that mark last year and then decided to retire after a long career in Facilities Management.

Torran A. King, work-in process labor, Facilities Management

Marissa Arlet, Institutional Animal Care & Use Committee, SVC Research

David P. Bolette, Veterinary Services, Division of Laboratory Animal Resources, Health Sciences

Marie Elena Bresz, Office of the Dean, School of Computing and Information

Carl Daugherty, Animal Husbandry, Division of Laboratory Animal Resources, Health Sciences

Robin A. DeAngelo, Radiology, School of Medicine

Judith L. DeNinno, Animal Husbandry, Division of Laboratory Animal Resources, Health Sciences

Trudy Newring Evans, Office of the Dean, School of Computing and Information

Charles Fleishaker, Research Support Services, Dietrich School of Arts and Sciences

Edward Gyurisin, University Center for Teaching and Learning

Susan E. Johnson, fiscal, UPMC Hillman Cancer Institute

Edward F. Kuchar, Medicine, School of Medicine

Leigh Ann Kuchar, Pitt IT Telecom

Lisa Kubick, Office of the Dean, Dietrich School of Arts and Sciences

Sandra G. Latini, Office of Technology Management, SVC Research

Judy Malenka, Infectious Diseases & Microbiology, Graduate School of Public Health

John F. McKnight, Johnstown Physical Plant, maintenance

Mary Murock, Animal Husbandry, Division of Laboratory Animal Resources, Health Sciences

Karen O'Brien, Facilities Management AVC

Dave Rahuba, Moving Services, Business and Auxiliary Services

James J. Roskowski, Prosthodontics, Dental Medicine

Jim Segneff, Information Technology, Swanson School of Engineering

Bruce Steele, Office of University Communications

Joanne Stumme, Student Financial Services, CFOs office

Frederick W. Tylka, Information Technology, Swanson School of Engineering

Karen A. Whitehead, Operations and Quality Administration, SVC Philanthropic and Alumni Engagement

John Ziats, Johnstown Office of Student Life

Douglas Ziegler, University Center for Teaching and Learning

Greg L. Adametz, Pediatrics Research Administration, School of Medicine

Lisa M. Bailey, Microbiology and Molecular Genetics, School of Medicine

Karen Bassett, Office of the Dean, School of Education

Donna L. Baxter, Student Financial Services, CFOs office

Sharon Hixson Bindas, Office of the Dean, School of Computing and Information

Natalie K. Bird, Departmental Libraries, University Library System

David J. Browning, Dental Instruments, School of Dental Medicine

Carmella Campbell, Basic Research Administration, UPMC Hillman Cancer Institute

Katheryn Carr, Office of Sponsored Programs, SVC Research

Lynda M. Connelly, University Center for Social and Urban Research

Roy Cooper Jr., University Store, Business and Auxiliary Services

Robert A. Crawford, Facilities Management Pittsburgh Campus Buildings

Babeth V. Crockett, Public Safety and Emergency Management

Allen A. DiPalma, Office of Trade Compliance, SVC Research

Kelly L. Dornin-Koss, Educational and Compliance Office, SVC Research

Janet Famiglietti, UPCI National Surgical Adjuvant Breast and Bowel Project, UPMC Hillman Cancer Institute

Donald J. Fedor Jr., Facilities Management Pittsburgh Campus Buildings

Timothy Fitzgerald, Pitt IT Enterprise Applications

Amy Flaugh, Epidemiology, Graduate School of Public Health

Michael Gaber, Office of the Dean, School of Medicine

Paul A. Guglielmo, Facilities Management Work-in Process Labor

Nadine M. Hamlett, Clinical Programs, School of Law

Scott David Harley, Scaife Hall Waste Processing

Matthew J. Harr, Johnstown Information Systems

Fang He, Pathology, School of Medicine

Richard H. Henderson, Office of Administration, Health Sciences

Carol M. Herko, Real Estate Administration, Planning, Design and Real Estate

Rich Holmes. Office of University Counsel

Nancy Hood, Psychology, Dietrich School of Arts and Sciences

Roy Humphrey, WPTS Radio/Panther Prints, Student Affairs

Wendy M. Jameson, Pathology, School of Medicine

Anthony Jones, Pitt IT Operations

Diane Kline, program coordinator, Graduate School of Public & International Affairs

Shari D. Kubitz, Learning Research & Development Center

Michele Leahy, Craniofacial Regeneration, School of Dental Medicine

Kimberly A. Livingston, Johnstown Operations-Registrar

David Malicki, Biological Sciences, Dietrich School of Arts and Sciences

Darla J. McGivern, Critical Care Medicine, School of Medicine

Jayne McGoey, Internal Audit , Chancellors office

Elizabeth McNally-Martin, Education Technology and Innovation, School of Nursing

Maureen McNulty, Annual Programs, SVC Philanthropic and Alumni Engagement

Kellie Mitchell, Office of the Dean, Swanson School of Engineering

Jeff Morrison, Office of Administration, Health Sciences

Cara Svitko Nestlerode, Epidemiology, Graduate School of Public Health

Cindy Niznik, Physics & Astronomy, Dietrich School of Arts and Sciences

Jane Ann Ondo, Pitt IT Portfolio and Project Management Office

Marianne Page, Psychology, Dietrich School of Arts and Sciences

Nancy M. Patuc, Pitt IT Financial Systems

Glenn Peterson, Bioengineering, Swanson School of Engineering

Nancy I. Petro, Medicine, School of Medicine

George Petrucci, Housing Administration, Business and Auxiliary Services

Paul A. Poland, Medicine, School of Medicine

David Puccio, University Center for Teaching and Learning

Pamela Rall-Johnston, Scaife Hall Housekeeping

Douglas J. Remmick, Pitt IT Telecom

Susan L. Ronczka, Office of the Controller, CFOs office

Elizabeth A. Rush, UPCI Research Lab-Kirkwood, UPMC Hillman Cancer Institute

Laura Schmid, Office of Human Resources

Laurel Ann Povazan Scholnick, Departmental Libraries, University Library System

Adrian Starke, Chemical/Petroleum Engineering, Swanson School of Engineering

Kevin Starke, Payment Processing & Compliance, CFOs office

Jody Stockdill, Medicine, School of Medicine

Carla D. (Crawford) Takacs, Innovation Institute, SVC Research

Jeffrey A. Toporcer, Pitt IT Software Site License

Carol Kinlough Truschel, Medicine, School of Medicine

Pamela D. Vincent, Pediatrics, School of Medicine

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Longtime employees honored at in-person ceremony | University Times | University of Pittsburgh - University Times

Bacterial sampling is now underway to assess the abundance and types of antimicrobial resistance (AMR) in bacteria on Welsh dairy, beef and sheep farms.

The study, which researchers at the University of Bristol are coordinating, is part of Arwain DGC a project designed to help combat antimicrobial-resistant bacteria in animals and the environment in Wales.

Launched last year, Arwain DGC aims to reduce the need to use antimicrobials such as antibiotics by improving productivity, animal health and welfare through new and innovative technology and 'good practice'.

Data obtained by analysing environmental faecal samples from a selected group of Welsh farms over 12 months will assist researchers in learning more about what factors are associated with AMR on farms. These data will also help inform the design of a robust AMR surveillance system for Wales in the future.

Participating farms have volunteered to be part of the study and the samples and information from accompanying farmer questionnaires along with data on antimicrobial sales to the farm - are anonymised. A core of 50 farms (20 dairy, ten beef, ten sheep, and ten beef/sheep farms) from across Wales have been recruited.

Environmental faecal samples are taken monthly from various locations on each farm by vets from 14 veterinary practices involved in the study. Samples are taken from areas such as animal housing, collection yards, pens and pasture.

The samples are then cultured to identify the presence of antibiotic-resistant Escherichia coli (E. coli) bacteria, which are used in such studies to give an indication of the level of AMR on each farm.

The study is led by Professors Kristen Reyher and Matthew Avison from the University of Bristol, who lead Bristol AMR.

Matthew Avison, Professor of Molecular Bacteriology in Bristol's School of Cellular and Molecular Medicine, said: "Sample collection started in mid-April, and we are very pleased with how it is going. Farmers have been engaging well with the study, and we are very grateful to them and the vets who have important relationships with the farms and are out collecting the monthly samples.

"Over the next 12 months, we aim to get a cross-section of animal samples young, old, mixed species to give us a real-time picture of what is happening on farms at different points throughout the year.

"From our previous experience sampling dairy farms in the southwest of England, we know that, in February, there is very little AMR on farms, but in September, it is easily detectable. However, we have not sampled beef and sheep farms before, so to start seeing the samples come in is exciting."

He added, We hope this work will be used as evidence to recommend to Welsh Government how best to take samples from farms to look at AMR should they ever want to introduce a surveillance system.

Kristen Reyher, Professor of Veterinary Epidemiology and Population Health at Bristol Veterinary School, added: "Farmers and vets have done so much together in the last few years to ensure they are being good stewards of important medicines like antibiotics. Our work comparing their antibiotic use and other management factors with the AMR we find on farms continues to help us unpick the relationships between what happens on farms and in the environment as well as better understand the selection and transmission of AMR. The Arwain DGC project is a great example of Wales leading the way on providing important information about AMR to the world, and we stand ready to get to work on these data that are now rolling in."

Arwain DGC is closely aligned to the Welsh Governments five-yearAMR in Animals and the Environment Implementation Plan (2019 2024). This project has received funding through the Welsh Government Rural Communities - Rural Development Programme 2014-2020, which is funded by the European Agricultural Fund for Rural Development and the Welsh Government.

About antimicrobial resistanceOver-reliance on antimicrobials has led to some antibiotics losing their efficacy and ability to fight infections.

Globally, in 2019, 1.2 million people are estimated to have died from bacterial infections that did not respond to antibiotics.

AMR is classed as a global 'One Health' challenge and described by The World Health Organization as an issue where "without urgent action, we are heading for a post-antibiotic era, in which common infections and minor injuries can once again kill."

About Arwain DGCArwain DGC (Defnydd Gwrthfaicrobaidd Cyfrifol/Responsible Antimicrobial Use) builds on the pioneering work of an earlier project - Arwain Vet Cymru (AVC) - which focused on improving antibiotic prescribing in cattle and sheep through a Wales-wide network of Veterinary Prescribing Champions. AVCs work has subsequently become the blueprint for similar schemes across the UK and globally.

Arwain DGC comprises a schedule of activities and brings together experienced collaborators to deliver a wide-ranging programme addressing AMR in animals and the environment.

Included are key Welsh agricultural stakeholders (Menter a Busnes, Welsh Lamb and Beef Producers Ltd and Welsh Agricultural Organisation Society), academic institutions (University of Bristol and Aberystwyth University School of Veterinary Science) and veterinary delivery partners (Iechyd Da and Milfeddygon Gogledd Cymru).

The overall Arwain DGC project is led by Menter a Busnes, with each partner responsible for specialist elements of its delivery, including:

About Bristol AMRBristol AMR is a cross-faculty Research Strand funded by the Elizabeth Blackwell Institute for Health Research, through the University's Wellcome Trust Institutional Strategic Support Fund (ISSF). AMR research at the University of Bristol focuses on interdisciplinary approaches to tackling AMR with research conducted across all of our six faculties.

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June: Welsh farms AMR study | News and features - University of Bristol

With a targeted disruptive innovation biotechnology-related exchange traded fund strategy, investors can focus on companies driving change in targeted therapeutics, bioinformatics, CRISPR technology, and more.

In the recent webcast, Change the DNA of Your Portfolio: Growth Opportunities Through Genomics, Nicholas Grous, associate portfolio manager at ARK Invest, highlighted five innovation platforms that will experience long-term growth, including artificial intelligence, energy storage, robotics, DNA sequencing, and blockchain technology. These five sub-categories are expected to enjoy long-term growth. For instance, gene sequencing is expected to expand to $3.6 trillion in 2030 from $125 billion in 2020. Overall, ARK Invest projects disruptive innovation technologies could grow to $210 trillion by 2030, compared to $14 trillion in 2020.

The increased adoption of disruptive innovation technologies will not just be a one-off event as these innovative ideas will cover a broad swathe of industries and touch upon many facets of the global economy. For example, Grous believed that the convergence of next-generation DNA sequencing, artificial intelligence, and gene therapies should boost returns on investment significantly, potentially creating a golden age of health care likely to rival that of the 1980s and 1990s.

Simon Barnett, research analyst at ARK Invest, explained that researchers had historically been forced to choose between accuracy with short-read sequencing or comprehensiveness with long-range sequencing to break the genome into smaller segments to analyze with high-resolution optics, which is then reassembled with computer algorithms. According to Wrights Law, for every cumulative doubling in data produced on its reinstalled base, the cost of synthesis-based LRS has declined and will continue to decline by 28%. Looking ahead, ARK projects the cost to sequence a whole human genome with long-read technology will drop to $100-$200 and its accuracy will be superior to SRS across all variant types by the end of 2025.

According to our research, gene editing breakthroughs are creating more effective therapies at a faster rate than historically has been the case, Barnett said.

For example, compared to zinc finger nucleases (ZFNs), which moved from discovery to the first human dose in roughly eight years, the relatively new CRISPR technology took less than half the time, three years, and can address 48% of known diseases, or almost twice ZFNs 28%. Prime and base editing CRISPR derivatives address even more diseases, 79% and 59%, respectively. Consequently, Barnett argued that CRISPR may be seen as a superior gene-editing method going forward, and it already shows as CRISPR has been dominating recent academic research and clinical trials.

Looking ahead, ARK expects gene editing and gene therapy companies to grow to $1.1 trillion in market capitalization by 2026. Given potential cures for diseases, the share of research and development funding for gene therapy innovations should continue to rise. By 2026, the share of total R&D spending devoted to gene editing and therapy companies could grow from 3% to 17%.

Additionally, Barnett noted that routine blood-based, multi-cancer screening combined with improvements in single-cancer screening could prevent 40% of metastatic diagnoses and increase loco-regional diagnoses by 10%. Even without improvements in cancer therapy, ARK estimates that earlier intervention could prevent 66,000 cancer deaths per year in the US alone.

The Central Dogma could help describe how biotechnology moves forward. The Central Dogma states that DNA (the genome) is transcribed into RNA (the transcriptome), which ultimately is translated into protein (the proteome). Proteins carry out virtually all critical-to-life functions but, when altered, can cause disease.

Understanding the interactions between and among the pillars of the Central Dogma, we will improve our ability to make predictions, diagnoses, and leaps of fundamental, biological insight, Barnett said.

We believe the future of molecular biology is based on multi-omics techniques that integrate pillars of the Central Dogma. Based on our research, multi-omics including life science tools, basic and translational research, population health efforts, and molecular diagnostics could impact oncology, organ health, and population health, scaling from $110 billion to roughly $300 billion during the next five years, he added.

As a way to capture this potential growth opportunity, investors can turn to theARK Genomic Revolution Multi-Sector Fund (NYSEArca: ARKG), an actively managed strategy that seeks long-term growth of capital by investing in domestic and foreign equity securities of companies across multiple sectors, including health care, information technology, materials, energy, and consumer discretionary, that are relevant to the funds investment theme of the genomics revolution.

ARKG aims for thematic multi-cap exposure to innovative elements including gene therapy bio-informatics, bio-inspired computing, molecular medicine, and pharmaceutical innovations. The ETF aims to capture long-term growth with a low correlation of relative returns to traditional growth strategies and a negative correlation to value strategies. Additionally, the fund offers a tool for diversification due to little overlap with traditional indices. It can be a complement to traditional value/growth strategies.

Financial advisors who are interested in learning more about growth opportunities in the biotech segment can watch the webcast here on demand.

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An Innovative ETF Opportunity That Taps Into Our Increased Understanding of the Human Genome - ETF Trends

SHREVEPORT, La. (KTAL/KMSS) Residents in the Shreveport area will now be able to get several high-level lifesaving treatments for some conditions closer to home.

The Center for Molecular Imaging and Therapy is a brand new state-of-the-art imaging center using PET imaging to diagnose and assess diseases such as cancer, dementia, and heart disease sooner. PET imaging can also monitor for the possible recurrence of many cancers.

Targeted radiopharmaceuticals produced by CMIT will help diagnose diseases more precisely and accurately and will help physicians in choosing more effective treatment options and guide better outcomes for patients, said CMIT Executive Director Dr. Pradeep Garg.

Director of Imaging Sciences Stephan Lokitz says the new $20 million facility will set them up for the next phase of medicine.

Officials say the new center will promote economic development and expand the workforce in the area over the next five years.

The new Center for Molecular Imaging and Therapy will enhance Louisianas position in the increasingly competitive life sciences sector by attracting contracts from out-of-state entities that drive revenue streams and create high-paying jobs, said Louisiana Economic Development Secretary Don Pierson.

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State of the art medical center opens in Shreveport - KTALnews.com

Research funded by the grant will capitalize on the development of biomarkers and advanced imaging by scientists at the Keck School of Medicine of USC to launch studies tracking changes in the blood-brain barrier, neurovascular function and cognition.

By Hope Hamashige

Blood vessels in the brain (Credit: Stevens INI)

The National Institute on Aging, a division of the National Institutes of Health, awarded Berislav Zlokovic, MD, PhD, director of the Zilkha Neurogenetic Institute, and Arthur W. Toga, PhD, director of the USC Mark and Mary Stevens Neuroimaging and Informatics Institute (Stevens INI), $16.1 million to continue research on the role that blood vessel dysfunction plays in the development of dementia and Alzheimers disease.

Berislav Zlokovic, MD, PhD, director of the Zilkha Neurogenetic Institute (Photo USC)

There is increasing evidence that neurovasculature has a major role in early cognitive decline, said Zlokovic, chair and professor of physiology and neurosciences at the Keck School of Medicine of USC. This grant allows us to continue important research on how changes in the blood-brain barrier and blood flow interact with amyloid-beta and tau pathology to trigger structural and functional changes in the brain leading to cognitive impairment and early Alzheimers disease.

More than 30 years ago, Zlokovic was among the first to propose that flaws in the blood-brain barrier, which keeps harmful substances in the blood from moving into brain tissue, could be the early, underlying cause of most cognitive disorders, rather than the accumulation of amyloid beta plaque, which had long been the focus of Alzheimers research. With this award, he and his colleagues can further test this so-called neurovascular hypothesis.

This work will build on our earlier work, which has shown that people can progress to mild cognitive impairment, independent of amyloid beta and tau if the blood-brain barrier is damaged, said Zlokovic.

Documenting Alzheimers disease progression

The funding will allow the team of researchers to launch longitudinal studies comparing the progress of more than 400 people who have a genetic variant putting them at high risk for developing Alzheimers disease known as apolipoprotein E4 (APOE4) with more than 450 people with APOE3, a different variant which puts them at lower risk for developing Alzheimers disease.

About 75% of the participants will be cognitively unimpaired at the start of the study and about 25% will have only mild impairment. The researchers will follow them for five years, tracking changes in the blood-brain barrier, blood flow and the brains structure and function while monitoring participants for cognitive impairment, using neuroimaging and molecular biomarkers indicating blood vessel dysfunction, which were developed by Zlokovic, and advanced brain imaging technology developed by Toga.

Perivascular spaces in the brain highlighted using data from the Stevens INIs ultra-high field 7T MRI scanner Credit: Stevens INI

Using our ultra-high field 7T magnetic resonance imaging (MRI) scanner has transformed our understanding of how fluid-filled regions in the brain perivascular spaces impact brain health. Here at the Stevens INI, we have successfully used this advanced imaging to facilitate breakthroughs, including the central role that perivascular space plays in brain changes associated with aging, including neurodegenerative disorders, said Toga, Provost Professor of Ophthalmology, Neurology, Psychiatry and the Behavioral Sciences, Radiology and Engineering at the Keck School of Medicine. Our imaging capabilities have allowed us to create a multimodal assessment of the role of neurovasculature in cognitive decline, a comprehensive research program on perivascular spaces, and numerous close-up investigations of how fluids travel through the brain, including via the blood-brain barrier. Im thrilled to have received this funding to continue our work in partnership with Dr. Zlokovic.

Arthur W. Toga, PhD, director, Mark and Mary Stevens Neuroimaging and Informatics Institute Director. (Photo INI)

Researchers hope the work will lead to a better understanding of the onset and progression of Alzheimers disease and the identification of the best interventions for different stages of the disease.

Testing treatments in the lab

Simultaneously, the team will conduct complementary laboratory research using mice that have been genetically altered to carry human APOE gene variants to help document changes in the brain that lead to cognitive decline and to test a potential treatment.

The treatment is an experimental neuroprotective enzyme co-developed by Zlokovics team, in collaboration with John Griffin, PhD, from the Scripps Research Institute, called 3K3A-APC, an engineered form of human activated protein C. Researchers will test it in the altered mice to see if it can protect the integrity of the blood-brain barrier and prevent cognitive decline. In addition they hope to examine whether this type of intervention is effective at the earliest signs of vascular dysfunction or at later stages of disease in mouse models that also have amyloid beta and tau. The National Institute of Neurological Disorders and Stroke (NINDS) recently awarded funding for a pivotal Phase 3 clinical trial of 3K3A-APC in stroke patients, led by Patrick Lyden, MD, professor of physiology and neuroscience at the Zilkha Neurogenetic Institute.

We hope that the results of this research will eventually lead us to new treatments for people with the APOE4 gene, said Zlokovic.

Turning biomarkers into a blood test for Alzheimers disease

Zlokovic added that they continue to improve on key molecular biomarkers, and he hopes eventually to discover biomarkers detectible in blood, which would make the process of identifying people at risk for Alzheimers disease simpler and more accessible.

We have been pursuing several avenues of research that all complement one another, said Zlokovic. We believe that this research will contribute to important new findings about the pathogenesis of cognitive decline and will also lead to development of important new therapies for cognitive impairment, dementia and Alzheimers disease.

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NIH awards USC more than $16 million for research on vascular dysfunction and Alzheimer's disease | Keck School of Medicine of USC - University of...

The patients had metastatic breast cancer that had been progressing despite rounds of harsh chemotherapy. But a treatment with a drug that targeted cancer cells with laserlike precision was stunningly successful, slowing tumor growth and extending life to an extent rarely seen with advanced cancers.

The new study, presented at the annual meeting of the American Society of Clinical Oncology and published on Sunday in the New England Journal of Medicine, would change how medicine was practiced, cancer specialists said.

This is a new standard of care, said Dr. Eric Winer, a breast cancer specialist, director of the Yale Cancer Center and head of the A.S.C.O. Dr. Winer was not involved with the study. He added that it affects a huge number of patients.

The trial focused on a particular mutant protein, HER2, which is a common villain in breast and other cancers. Drugs that block HER2 have been stunningly effective in treating breast cancers that are almost entirely populated with the protein, turning HER2-positive breast cancers from those with some of the worst prognoses into ones where patients fare very well.

But HER2-positive cases constitute only about 15 percent to 20 percent of breast cancer patients, said Dr. Halle Moore, director of breast medical oncology at the Cleveland Clinic. Patients with only a few HER2 cells a condition known as HER2-low were not helped by those drugs. Only a small proportion of their cancer cells had HER2, while other mutations primarily drove the cancers growth. And that posed a problem because the cancer cells evaded chemotherapy treatments.

The clinical trial, sponsored by the pharmaceutical companies Daiichi Sankyo and AstraZeneca and led by Dr. Shanu Modi of Memorial Sloan Kettering Cancer Center, involved 557 patients with metastatic breast cancer who were HER2-low. Two-thirds took the experimental drug, trastuzumab deruxtecan, sold as Enhertu; the rest underwent standard chemotherapy.

In patients who took trastuzumab deruxtecan, tumors stopped growing for about 10 months, as compared with 5 months for those with standard chemotherapy. The patients with the experimental drug survived for 23.9 months, as compared with 16.8 months for those who received standard chemotherapy.

It is unheard-of for chemotherapy trials in metastatic breast cancer to improve survival in patients by six months, said Dr. Moore, who enrolled some patients in the study. Usually, she says, success in a clinical trial is an extra few weeks of life or no survival benefit at all but an improved quality of life.

The results were so impressive that the researchers received a standing ovation when they presented their data at the oncology conference in Chicago on Sunday.

Trastuzumab deruxtecan was already approved for patients with HER2-positive breast cancer, but few expected it to work because other drugs for such cancers had failed in HER2-low patients.

The drug consists of an antibody that seeks out the HER2 protein on the surface of cells. The antibody is attached to a chemotherapy drug. When trastuzumab deruxtecan finds a cell with HER2 on its surface, it enters the cell, and the chemotherapy drug separates from the antibody and kills the cell.

But what is unique and distinct about trastuzumab deruxtecan, Dr. Modi adds, is that the chemotherapy drug seeps through the cells membrane. From there, it can move into nearby cancer cells and kill them as well.

Like all chemotherapy, trastuzumab deruxtecan has side effects, including nausea, vomiting, blood disorders and, notably, lung injuries that led to the deaths of three patients in the trials.

But, Dr. Winer said, if I were a patient with metastatic breast cancer, and if I were to get a drug with chemotherapys side effects, Id prefer this drug.

Doctors have said they are planning to try the treatment in their breast cancer patients who have metastatic HER2-low cancers.

We are all going back and looking at our patients right now, said Dr. Susan Domchek, a breast cancer specialist at the University of Pennsylvanias Abramson Cancer Center. She says that even before the Food and Drug Administration approves trastuzumab deruxtecan for HER2-low patients, she will see if the data from the new study will be enough to convince insurers to approve the drug, which has a wholesale price of about $14,000 every three weeks.

Dr. Winer emphasized that trastuzumab deruxtecan is not a drug for earlier stage breast cancer; it still must be tested in that group of patients. But that is a likely next step, as is testing the drug in other cancers and extending its strategy beyond HER2.

This strategy is the real breakthrough, he said, explaining that it would enable researchers to zoom in on molecular targets on tumor cells that were only sparsely present.

This is about more than just this drug or even breast cancer, Dr. Winer said. Its real advantage is that it enables us to take potent therapies directly to cancer cells.

One patient in the current study, Mary Smrekar, age 55, of Medina, Ohio, said she felt she got a temporary reprieve from certain death.

She was diagnosed with breast cancer in 2010 and has undergone surgery, chemotherapy and radiation. Her cancer went into remission.

I thought I was free and clear, she said.

But in 2019, the cancer came back. It had spread to her pelvis. She had chemotherapy, but this time, there was little improvement.

Two years ago, she entered the trial at its Cleveland Clinic site. Her cancer has not gone away, but the tumors stopped growing.

Im so happy I got another two years, Ms. Smrekar said. My daughter is getting married next month. I didnt think Id make it to the wedding.

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Enhertu Breast Cancer Drug Results in Unheard-of Survival Rates - The New York Times