Lymphoma drug failure frustrates experts
Tue, 01 May 2007 01:40:12 GMTBy LAURAN NEERGAARD, AP Medical Writer
WASHINGTON - Only a fraction of patients with hard-to-treat lymphoma ever try two breakthrough "smart-bomb" drugs that bring radiation straight to cancerous cells — with just two shots a week apart, not the usual months of care. The marketing failure has a manufacturer trying to sell off one of the drugs, and increasingly frustrated specialists worry it will jeopardize attempts to expand this promising new field to fight other cancers, too.
It's called radioimmunotherapy, harnessing homing device-like immune cells — antibodies — with a radioactive drug. The antibodies zero in on cancer and drop their payload, without as much damage to surrounding healthy tissue as chemotherapy can cause.
Only two such drugs are sold today, the lymphoma fighters Zevalin and Bexxar. But more than half a dozen early stage studies of others — against some particularly deadly malignancies, including pancreatic cancer, brain cancers, and advanced prostate cancer — are under way.
The issue: Despite research showing they work well, fewer than 10 percent of lymphoma patients who are candidates for Zevalin and Bexxar ever use them, says Dr. Mark Kaminski of the University of Michigan, a hematologist who co-invented Bexxar.
Why? Specialists cite a complex list of reasons, including that most oncologists aren't licensed to administer the radioactive infusion and must send their patients to a nuclear-medicine doctor. There's also confusion about the risks of radiation, which studies suggest are minimal, and when the drugs work best — early, not as a last-ditch therapy.
"There's lots of reasons to use them, and seems to be an inertia against them," says Dr. Mitchell Smith, lymphoma chief at Fox Chase Cancer Center in Philadelphia. "I do see it as unfortunate."
Indeed, sales are so weak that Zevalin maker Biogen Idec announced in December it was hunting a buyer to take over the drug. While the company insists Zevalin won't come off the market, the move is prompting fear on cancer blogs and from patients considering radioimmunotherapy that the option may disappear.
"Basically, they hit a home run" scientifically, says Kaminski. "The shock wave that goes through here is that if you can't get this to work in the marketplace, what's the sense of developing anything else along this line?"
Kaminski laments that about once a month, a patient seeks him after other doctors discouraged the therapy or advised it only after exhausting other options, including a rigorous bone marrow transplant.
Adds Dr. Bruce Cheson, hematology chief at Georgetown University Hospital: "When patients are presented this option, they say it's too good to be true: 'It's only a week, and I have a 70 percent chance of responding to it.'"
At issue are so-called low-grade forms of non-Hodgkin's lymphoma that strike thousands of Americans each year. They're incurable, but patients typically live a long time, beating back increasingly hard-to-treat recurrences every few years.
The leading treatment is Genentech and Biogen Idec's blockbuster seller Rituxan, a stand-alone antibody — no drug attached — that by itself kills cancer cells, and often is used together with chemotherapy to prolong a first remission. Rituxan is considered to have revolutionized lymphoma care.
But patients will relapse. When that happens, Zevalin and Bexxar are government-approved options. They use the same antibody target but with different radioactive drugs attached to give lymphoma a one-two punch. Studies suggest they fight the cancer's return at least as well as months of standard chemo.
More intriguing, about 20 percent of those patients have extremely long remissions, five to eight years. That's more likely when the drugs are used for a first relapse, not later when repeated chemo has ravaged the immune system, says Fox Chase's Smith.
Also, there's mounting evidence from small studies that even more patients have long-term remission if they use radioimmunotherapy first, instead of waiting to relapse. A closely watched government trial is trying to prove that, by comparing Bexxar plus standard chemotherapy to Rituxan plus chemo in about 500 newly diagnosed patients. Results are due in two years.
If that study pans out, "it'll have a huge impact on practice," predicted Dr. James Armitage of the University of Nebraska Medical Center, who tries to calm worried patients that the option won't disappear before that question is settled.
With radioimmunotherapy at a crossroads awaiting that science, proponents are talking up the drugs, to medical journals and patient advocacy groups. A petition pending before the Nuclear Regulatory Commission seeks to allow more oncologists to administer the shots. And Biogen Idec spokeswoman Naomi Aoki says her company is working to get more community oncologists licensed to use the drug, and plans to sell it to a company "also committed to making sure it's available."
___
EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
Gravity machines on rise at health clubs
Tue, 01 May 2007 01:40:23 GMTBy MICHAEL HILL, Associated Press Writer
SARATOGA SPRINGS, N.Y. - America might not need yet another exercise machine. Treadmills, weights and resistance equipment already jam the health clubs. Yet Gravity machines have found a niche at the YMCA in this resort town.
On a recent weekday morning, a dozen women and men push, pull and grunt on the machines' slanted glideboards. They push with their legs, then pull with their arms — up and down diagonally.
"Keep those legs up!" trainer Yonka Perkins tells her straining students. "Keep those glutes nice and tight!"
The $17.6 billion health club industry is always open to something new. The YMCA is one of roughly 30 health clubs in the United States to add Gravity machines since the start of the year. It's not clear if this relatively new device will lead to a hot new trend like Spinning, a popular indoor cycling program, but so far it offers a glimpse into an industry always looking to entice exercisers with new ways to stay tone and trim.
"We're always looking for ways to make exercise more effective, more fun, less time, more pop for your time," said Brooke Correia of the International Health, Racquet and Sportsclub Association.
Gyms have come a long way since the low-tech days of Indian clubs and medicine balls. Rudimentary machines like the motorized belts that jiggled users' bellies have given way to sophisticated machines that keep tabs on cardiovascular activity and simulated distance.
Gravity equipment competes for precious floor space not only with standbys like StairMasters and Pilates equipment, but with newer machines that feature everything from video screens to vibrating bases. Gravity's hook is that it can offer a range of cardio and strength-training exercises — you can even do Pilates on it — in a short period of time. The track is adjustable; the steeper the incline, the harder the workout.
"It's very intense," said Joanne Leiser after a 30-minute workout at the Saratoga YMCA. "It's quick and it's cool."
The machines were introduced in 2003 by San Diego-based efi Sports Medicine, creator of the Total Gym. Jesse Campanaro, national sales manager, said sales have been brisk recently, climbing from 130 clubs to more than 160 in the United States since the start of the year.
These are small numbers compared to the estimated 12.65 million people who used resistance machines in 2005, or the 10.5 million who ran on treadmills. But as Campanaro put it, "We're getting a lot more traction."
The machines are essentially a health club version of the company's less expensive Total Gym, a home and rehabilitation machine known to many for the TV infomercials featuring martial arts actor Chuck Norris confidently gliding up and down slantwise.
No infomercials for Gravity, though the system has clearly benefited from the enthusiasm of health club fitness trainers. Jon D'Alessio, group fitness director at The Jungle Club in Vero Beach, Fla., said it's a fast, efficient way to provide both personal training or group sessions. To keep the interest of men, he developed exercises that simulate golf swings and kayak paddling.
"It's much more fun than whatever else I've been doing for the last 15 years," he said.
The machines are often given studio space for group classes of up to a dozen.
The Saratoga YMCA placed its machines in a semicircle inside the hairpin bend of the indoor track, where Perkins regularly leads group sessions there to the beats of Beyonce and Shakira. The 30-minute "total body strengthening" classes have been so popular she has had to add sessions. People show up at 5:30 a.m. to sign up for a 6 a.m. class.
"It's not beating the heck out of your body," said student Lori Tynan. "The machine keeps everything smooth."
___
On the Net:
YMCA: http://www.ymca.net
International Health, Racquet and Sportsclub Association: http://www.ihrsa.org/
Mo. university to lead smallpox study
Tue, 01 May 2007 01:39:50 GMTBy CHERYL WITTENAUER, Associated Press Writer
ST. LOUIS - Saint Louis University said Monday it will lead a national study of a new vaccine for smallpox, once one of the world's most feared diseases and now considered a threat to re-emerge as a bioweapon.
The university's Center for Vaccine Development and six other U.S. centers will examine how quickly the test vaccine stimulates an immune response and whether it would be as effective as a vaccine used in previous global smallpox eradication efforts.
The study is sponsored by the http://www.nih.gov/
Saint Louis University Center for Vaccine Development: http://medschool.slu.edu/vaccine/
Bavarian Nordic: http://www.bavarian-nordic.com/
Scientists prepare for study on cherries
Tue, 01 May 2007 01:39:38 GMTANN ARBOR, Mich. - After getting promising results from experiments with rats, University of Michigan scientists say they're preparing for a clinical study of whether eating tart cherries can help people reduce risk of heart disease and diabetes.
"There is still a long way to go before we can advocate any course of action for humans," said Dr. Steven Bolling, a cardiac surgeon and director of the university's Cardioprotection Research Laboratory. "Still, the growing body of knowledge is encouraging."
Researchers discussed their findings Monday at the Experimental Biology 2007 meeting in Washington, D.C.
During the experiments, lab rats were fed a diet including 1 percent by weight powdered tart cherries. After 90 days, those rates had lower cholesterol and blood sugar than rats that didn't get cherries.
Rats fed the cherries also had less fat stored in the liver, lower levels of a type of cell damage called oxidative stress and increased production of a molecule that helps the body handle fat and sugar, the researchers said.
The measures on which the two groups of animals differed are linked to risk factors for heart disease and Type 2 diabetes. The study suggests the factors are affected by high concentrations of antioxidant compounds found in tart cherries, the scientists said.
A Michigan team soon will begin a clinical trial to determine whether a diet rich in cherries would have the same effect on people. Additional research is planned on animals prone to obesity and diabetes.
Michigan is the nation's top producer of tart cherries. The Lansing-based Cherry Marketing Institute, an industry trade association, funded the research but had no influence over its design or findings, the university said.
___
On the Net:
University of Michigan: http://www.umich.edu/
