Innovative Immunotherapy Approach Eliminates Woman’s Breast Cancer

Immunotherapy is valuable at reversing cancer outcomes, as shown in the past months with the cancer “vaccine” that eliminated tumors in mice and now this immunotherapy that worked when other approaches didn’t.

“We’ve developed a high-throughput method to identify mutations present in a cancer that are recognized by the immune system,” Dr. Rosenberg said. “This research is experimental right now. But because this new approach to immunotherapy is dependent on mutations, not on cancer type, it is in a sense a blueprint we can use for the treatment of many types of cancer.”

The new immunotherapy approach is a modified form of adoptive cell transfer (ACT). ACT has been effective in treating melanoma, which has high levels of somatic, or acquired, mutations. However, it has been less effective with some common epithelial cancers, or cancers that start in the lining of organs, that have lower levels of mutations, such as stomach, esophageal, ovarian, and breast cancers.

In an ongoing phase 2 clinical trial, the investigators are developing a form of ACT that uses tumor-infiltrating lymphocytes (TILs) that specifically target tumor cell mutations to see if they can shrink tumors in patients with these common epithelial cancers. As with other forms of ACT, the selected TILs are grown to large numbers in the laboratory and are then infused back into the patient (who has in the meantime undergone treatment to deplete remaining lymphocytes) to create a stronger immune response against the tumor.

A patient with metastatic breast cancer came to the trial after receiving multiple treatments, including several chemotherapy and hormonal treatments, that had not stopped her cancer from progressing. To treat her, the researchers sequenced DNA and RNA from one of her tumors, as well as normal tissue to see which mutations were unique to her cancer, and identified 62 different mutations in her tumor cells.

The researchers then tested different TILs from the patient to find those that recognized one or more of these mutated proteins. TILs recognized four of the mutant proteins, and the TILs then were expanded and infused back into the patient. She was also given the checkpoint inhibitor pembrolizumab to prevent the possible inactivation of the infused T cells by factors in the tumor microenvironment. After the treatment, all of this patient’s cancer disappeared and has not returned more than 22 months later.

“This is an illustrative case report that highlights, once again, the power of immunotherapy,” said Tom Misteli, Ph.D., director of CCR at NCI. “If confirmed in a larger study, it promises to further extend the reach of this T-cell therapy to a broader spectrum of cancers.”

Simple Lung Cancer Scans That Could Save Thousands of Lives a Year

Cancer can be exponentially easier to treat or cure when it’s caught early.

A new study found that fewer than 2 percent of heavy smokers in the U.S. get recommended lung cancer screenings, an imaging test that can catch tumors when they are small and potentially curable. The numbers fall far short of screening for other types of cancer, including mammograms and colonoscopies—both procedures that are much more uncomfortable than the CT scan used to detect tiny tumors in the lungs.

Lung cancer is the leading cause of cancer death in the U.S., killing an estimated 150,000 Americans each year. For the past five years, such groups as the U.S. Preventive Services Task Force and the American Society of Clinical Oncology have urged people aged 55 or older who have smoked a pack a day (or the equivalent) for three decades or more to get checked for early stage disease. Medicare, the U.S. government’s insurance program for the elderly, pays for the procedure. None of it has made an impact.

“It’s still truly abysmal,” said Danh Pham, chief fellow of hematology/oncology at the University of Louisville’s cancer center in Kentucky, who will present the findings at the ASCO cancer meeting next month in Chicago. “We would like to make this a true call to action, whether it’s for more education or more research, to know why this disparity exists for lung cancer.”

It took a while for public health officials to start recommending routine lung cancer screening, because of questions about its accuracy and its ability to make a difference once the disease was detected. Subsequent studies confirmed the benefits for the heaviest smokers, with the use of screening intended for those most vulnerable to tumors.

The researchers analyzed registry data for everyone who underwent lung cancer screening in 2016 and found that 141,260 of the 7.6 million people eligible, or 1.9 percent, received it. By comparison, from 60 percent to 80 percent of eligible people get screening for breast, cervical and colon cancer, said Bruce Johnson, president of the American Society of Clinical Oncology and chief clinical research officer at the Dana-Farber Cancer Institute in Boston.

The testing shortfall could stem from primary care doctors’ failure to refer high-risk patients to one of 1,800 approved centers nationwide which provide the service. Psychological issues could also play a role, including fear of being diagnosed with a disease that smokers are constantly reminded of, Pham said.

“It’s very difficult to get patients to have this conversation with their doctors because of the stigma,” he said. “People may not want to know if they have lung cancer because it could confirm they’ve made bad lifestyle choices.”

Lung cancer deaths exceed those from breast, colon, pancreas and prostate cancer combined. There are very compelling reasons to get screened, said Johnson.

“If you screened the entire population of the U.S. who fit the criteria for having smoked enough and being the appropriate age, which is about 8 million people, you could save about 12,000 lives a year,” he said. “The majority of lung cancers picked up are early stage,” and finding them before the malignant cells spread reduces the risk of dying by about 20 percent, he said.

Saving a Few Hundred Billion Dollars a Year on Prescription Drugs in America

Cost savings of a few thousand dollars per household that are eminently possible — if Big Pharma can be defeated or at least constrained much more. The main basic problem is the patent monopolies that allow pharmaceutical companies to charge exorbitant prices, and a main solution is to use direct public funding as a more efficient process at producing innovation.

Broadly speaking, a prescription drug in the United States goes through three main stages of development: On the front end, researchers make a scientific breakthrough in their labs, discovering the building blocks of a new drug. Then it goes through the second stage, which includes the often-costly process of clinical research and trials. Last, once the FDA has reviewed and approved it, the drug goes on the mass market, sold at drugstores and doctor’s offices.

The United States is already involved in the earliest stages of drug development. It’s the top funder of basic science research in this country through the National Institutes of Health, which has an annual budget of $37 billion, more than what the federal government pays for Head Start and Pell Grants combined. Most agree that this is money well spent: Every one of the 210 new drugs approved between 2006 and 2010 trace their origins back to government funding.

The government is also involved in the third stage, as a top purchaser of medicines. Through Medicare, Medicaid, the Department of Veterans Affairs, and other programs, the federal government pays for $300 billion worth of prescription drugs each year.

Where the system runs into trouble is in the middle of the process, when the government hands over a glittering prize: the multi-decade patents that give private companies a monopoly on life-essential products. Through a mechanism established by the Bayh-Dole Act of 1980, private companies are allowed to claim patents on promising compounds discovered with government funding–and that means exclusive rights to manufacture and sell the resulting drug for a period of 20 years and often longer.

This isn’t just an outdated model; it’s also deeply inefficient. Companies can price medicines at hundreds of times what it costs to make them (it’s how a hepatitis C medicine could cost $1,000 for each pill that is manufactured for a few dollars), and with the government providing a guaranteed market for the drugs, companies like Gilead and Pfizer have had years where their reported profit margins exceeded a staggering 40 percent. All of the Big Pharma companies average between 15 and 20 percent profit each year. Most Fortune 500 companies are happy to claim half of that. There is “absolutely no reason why the taxpayer should be forced to subsidize a private monopoly and have to pay twice: first for the research and development and then through monopoly prices,” Senator Russell Long insisted when Bayh-Dole was passed in 1980.

[…]

If the United States were to move towards a NASA system, the federal government would have to find up to $75 billion in its budget to replace what private industry spends on R&D. But that’s not an insurmountable obstacle. There should be plenty of money available. Baker and other economists calculate that a NASA for drug development, which would eliminate patents and the price markups for prescription drugs that come with them, would save Americans hundreds of billions of dollars every year thanks to drugs being generic-level cheap from day one. The savings to government spending alone would be more than enough to pay for every penny of the $75 billion that the private pharma industry claims it spends on R&D–and replace it with research that is more widely shared and targeted more at public health than at quarterly profits. In this alternate universe, scientists and labs could switch their focus away from developing yet another iteration of an erectile dysfunction drug towards tackling challenges like tuberculosis.

 

New Bill to Lessen the Pain of the Dysfunctional U.S. Healthcare System is a Reminder of Its Critical Flaws

Massachusetts Senator Elizabeth Warren has introduced a bill that attempts to “curb pain” emanating from the corrupted for-profit healthcare system of the United States. Among other things, the bill’s provisions would implement helpful but admittedly inadequate measures, such as making it illegal for insurance companies to revoke a patient’s plan during their course of treatment. There could of course be many reminders about the more critical flaws of U.S. healthcare made in relation to this.

For one, the U.S. spends about twice as much on healthcare compared to other wealthy countries such as Canada, Britain, and Germany. If that spending — which is annually $3.4 trillion ( about 18 percent of annual U.S. GDP) — was reduced by around half, it would be an enormous savings that (all else unchanged) would actually have the U.S. running substantial budget surpluses.

That isn’t to say that budget surpluses are necessarily good (budget deficits can be helpful and natural), but it’s to point out that subtracting the almost $700 billion ($5550 per U.S. household) in budget deficit totals that the U.S. ran in fiscal year 2017 from a $1.7 trillion in healthcare savings would still be about a trillion dollars of budget surplus. It’s strange how rarely this simple point enters the mainstream press, what with the irrational and even harmful attention corporate media such as the Washington Post has given to budget deficits. More importantly though, it’s over a trillion dollars that could be spent productively elsewhere in the economy instead of harmfully allowing health insurance corporations receive it.

Interestingly enough, Berkshire Hathaway, Amazon, and JP Morgan Chase announced plans earlier this year to jointly form a healthcare company for their employees that’s “intended to be free from profit-making incentives.” This is another revealing insight into why a for-profit healthcare system is too flawed to function well — building a healthcare system around corporate profits simply raises the costs too much. The executives at those three corporations aren’t the only parts of the business community to understand this as they seek to reduce their own expenses.

Businessman Warren Buffett has even admitted that single-payer is “probably the best” healthcare system for the U.S. He has made a comparison between U.S. healthcare in 1960 and in 2017 — in 1960, U.S. healthcare spending was only five percent of annual GDP, and almost 60 years later there’s been almost a four fold GDP-based increase in healthcare spending. This reveals again that the amount of resources being devoted to the overall mediocre U.S. healthcare system is excessive.

The for-profit element of the system has other consequences outside of direct economic costs though. One of them is unnecessarily lost lives, with strong evidence finding that over 20,000 people die a year in the U.S. due to being unable to afford health insurance. It is simply a major moral disgrace that world history’s wealthiest country suffers from such a problem.

Also disgraceful is the staggering number of medical bankruptcies per year in the United States. The amount of those per year has been estimated at hundreds of thousands in the U.S. alone (far more than other wealthy countries) and medical bills have been a leading cause of Americans filing for bankruptcy for years. All other OECD countries besides Mexico have universal healthcare and have a much more efficient healthcare system to prevent many of those problems to begin with.

For a practical example, Medicare (a predominantly single-payer healthcare service run by the government) has administrative overhead costs of about 1 to 2 percent, which is usefully contrasted to the 12 to 20 percent overhead costs typically run by the for-profit health insurance industry. This is because inefficiently having thousands of different healthcare payer plans necessitates higher bureaucratic costs with too much paperwork.

And another notable part of the high U.S. health costs is due to the ridiculous prices of prescription drugs there. In 2017, the U.S. spent $450 billion (2.4 percent of GDP) on prescription drugs, an amount that could almost certainly be reduced by about $370 billion ($2930 per U.S. household) by having prescription drugs sold without patent monopolies and other unjust protectionist measures. In a time when at least nearly one in five Americans are unable to afford their medications adequately, this proposal for savings should be considered much more.

It should also be noted what happens an extreme amount of undeserved resources are diverted to harmful corporations such as the pharmaceutical ones. Pharmaceutical companies — such as Purdue Pharma — have used their excess profits to manufacture an opioid crisis (to seek even more profits) through flooding economically downtrodden communities with highly addictive opioids. This has resulted in opioids becoming the leading cause of death for Americans under 50, and it’s also largely been what’s resulted in a decline in the average U.S. life expectancy rate, a phenomenon that’s probably otherwise unheard of in other wealthy nations in the 21st century.

In all, the U.S. healthcare system suffers from significant problems that will require more than tweaking around the edges to solve. Its system requires a major alteration, and the sooner that happens, the less health-based suffering among its people there can be.

Developing Edible QR Codes for Future Medications

Quite a different approach than how medicine is administered today. There will need to be safeguards, however, such as by ensuring the legitimacy of the scans through cryptographic verification.

For the last 100 years, researchers have constantly pushed the boundaries for our knowledge about medicine and how different bodies can respond differently to it. However, the methods for the production of medicine have not yet moved itself away from mass production. Many who have a given illness get the same product with equal amount of an active compound.

This production might soon be in the past. In a new study, researchers from the University of Copenhagen together with colleagues from Åbo Akademi University in Finland have developed a new method for producing medicine. They produce a white edible material. Here, they print a QR code consisting of a medical drug.

“This technology is promising, because the medical drug can be dosed exactly the way you want it to. This gives an opportunity to tailor the medication according to the patient getting it,” says Natalja Genina, Assistant Professor at Department of Pharmacy.

Potential for reducing wrong medication and fake medicine

The shape of a QR code also enables storage of data in the “pill” itself.

“Simply doing a quick scan, you can get all the information about the pharmaceutical product. In that sense it can potentially reduce cases of wrong medication and fake medicine,” says Natalja Genina.

The researchers hope that in the future a regular printer will be able to apply the medical drug in the pattern of a QR code, while the edible material will have to be produced in advance to allow on-demand production of medical drug near end-users.

“If we are successful with applying this production method to relatively simple printers, then it can enable the innovative production of personalized medicine and rethinking of the whole supply chain,” says professor Jukka Rantanen from Department of Pharmacy.

The researchers are now working to refine the methods for this medical production.

U.S. Childhood Mortality Rate is 70% Higher Than Other Wealthy Countries

It is a moral disgrace for world history’s wealthiest country to have such a high child mortality rate. That’s part of the consequence of the U.S. lacking a national single-payer healthcare system, and it’s also a consequence of the U.S. Congress having prioritized support for the rich over reducing the plight of children.

American kids are 70 percent more likely to die during childhood compared with children in other wealthy, democratic nations, according to a peer-reviewed study published Monday by Health Affairs.

“This study should alarm everyone,” Dr. Ashish Thakrar, the study’s lead author and an internal medicine resident at Johns Hopkins Hospital and Health System, told CNN.

“The U.S. is the most dangerous of wealthy, democratic countries in the world for children,” he added. “Across all ages and in both sexes, children have been dying more often in the U.S. than in similar countries since the 1980s.”

The most common causes of death among children renews concerns about the American healthcare system, access to guns, and vehicle safety.

The risk of death is even higher for American infants and teenagers compared with their counterparts abroad. Babies in the U.S. are 76 percent more likely to die during their first year of life—often because of sudden infant death syndrome (SIDS) or complications related to being born prematurely—while 15- to 19-year-olds are 82 times more likely to die from gun violence, which Thakrar called “the most disturbing new finding.”

Thakrar and his fellow researchers examined the childhood mortality rates from 1961 to 2010 for the United States as well as 19 other nations in the Organization for Economic Cooperation and Development (OECD), including Australia, Canada, Japan, and several European and Scandinavian countries.

Thakrar told Vox‘s Sarah Kliff he believes the study’s findings are tied to a rise in childhood poverty in the U.S. during the 1980s, but also is in large part “the impact of our fragmented healthcare system” in the United States. For example, he said, “Mothers who are qualifying for Medicaid for the first time because they’re mothers might be seeing doctors for the first time. They might not have a family physician, or a clear support system.”

As numerous analyses and studies have shown over the years, the lack of a universal healthcare system in the U.S. has led to higher mortality rates and poorer healthcare outcomes than in countries that have robust systems that cover all people.

While the Republicans’ tax plan, which passed Congress and was signed by President Donald Trump late last year, partly dismantles the American healthcare system, lawmakers continue to put off refunding the national Children’s Health Insurance Program (CHIP)—which serves 9 million children—and Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program, which expired at the end September.

Although federal lawmakers passed a short-term spending measure that provided some funds for CHIP just before the New Year, states are continuing to warn recipients that without further funding, they will soon run out of money and no longer be able to provide necessary healthcare services.

“Multiple states have sent out letters warning families that their kids’ health insurance could end on January 31,” Kliff detailed in another article. “Congress did pass a temporary bill that it expected to extend CHIP’s life span until March—but it turns out they got the math wrong, and states may run out of funding as early as January 19. Eleven days from now.”

Thakrar told Kliff he is concerned about how funding instability for programs that provide healthcare to American kids will continue to impact childhood mortality rates in the United States.

“We’re seeing the effects of instability right now,” he said. “All across the country families are waiting to hear if CHIP will be reinstated, whether they’ll continue to have health insurance, their household visitations are at risk. Programs that have proven their benefit in the country still face constant instability.”

Artificial Sweeteners Harmful to Metabolism and Stimulate Fat Growth, Study Finds

Reducing sugar intake in general is probably a good idea. Artificial sweeteners haven’t received enough scrutiny though.

Artificial sweeteners have an effect on the body’s metabolism and can lead to excessive fat accumulation in people, especially those who are already obese, according to a recent study.

Dr. Sabyasachi Sen, an associate professor of medicine and endocrinology at George Washington University, led the study, explaining in a press release by the Endocrine Society that while many people rely on these artificial sweeteners as a low-calorie alternative to natural sweeteners, “there is increasing scientific evidence that these sweeteners promote metabolic dysfunction.”

Sen and his colleagues tested the popular low-calorie sweetener sucralose on stem cells taken from human fat cells. They placed these cells in Petri dishes for 12 days, adding 0.2 millimolars of sucralose. The dosage is based on the concentration of sucralose in the bloodstreams of people with high consumption levels of the artificial sweetener — about four cans of diet soda per day.

The researchers observed increased expression of genes that produce fat and inflammation. They also saw an increased accumulation of fat droplets in the cells, especially when they increased the concentration of sucralose.