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Vol. 8, No. 1 · February 2004 · Editor: Martha L. Golar, Esq.
DATE: Tuesday, February 24, 2004 TIME: 6:30 P.M. PLACE: Skadden Arps Slate Meagher & Flom Four Times Square, 37th Floor (between 6th Avenue & Broadway) New York, NY GUEST SPEAKER: Mitchell L. Gaynor, M.D. Senior Medical Oncology Consultant, The Strang Cancer Prevention Center, and Assistant Clinical Professor of Medicine, Weill-Medical College of Cornell University Dr. Gaynor is a board certified medical oncologist, internist and hematologist. His practice, Gaynor Integrative Oncology, offers a variety of integrative services as well as tailoring the use of treatments to individual patient needs. He is the author of numerous scientific books, including, in 2002, “The Healing Power of Sound: Recovery from Life-Threatening Illness Using Sound, Voice, and Music.” · January Program -- "Novel Approaches to Treating Cancer: From Science to Market" · Adelphi NY Statewide Breast Cancer Hotline & Support Program · News from the NYS Attorney General'sOffice · Current News Items · Calendar of Events January Program -- "Novel Approaches to Treating Cancer: From Science to Market" On January 20, JALBCA was treated to a presentation by Elma Hawkins, PhD and Vice Chairman of Antigenics, Inc., a New York City based biotechnology firm. Ms. Hawkins spoke generally about the development of vaccinations as a treatment for cancer and about Oncophage, a specific product being made and tested by Antigenics for cancer treatment. As background, Ms. Hawkins identified the current treatments for cancer, the majority of which have serious side effects. These include surgery, radiation, chemotherapy, hormone therapy and immunotherapy. As to immunotherapy, the FDA has only approved two products for cancer treatment, i.e., interleukin-2 and interferon, both of which also are associated with severe side effects. Vaccinations would be a type of immunotherapy with little or no side effects, if and when approved by the FDA. The focus of Antigenics is on a personalized, or autologous, vaccination, which would represent a departure from the trend in medicine to offer a “one size fits all” model. The vaccination would be patient-specific and applicable to all types of cancers for this reason. With respect to cancer tumors, Ms. Hawkins explained that tumors are comprised of antigens, with each tumor being different from every other tumor. This unique antigen profile results from random mutations taking place. Antigenics focuses on certain products called heat shock proteins, which it isolates after fragmentation of a cancer cell obtained after the tumor is removed from the patient (through surgery and, perhaps in the future, through simple aspiration). These heat shock proteins are ubiquitous, non-polymorphic and inducible; they act as natural adjuvants and are the chaperones for tumor antigens. A personalized vaccination is developed by Antigenics after which it is injected into the cancer patient over a series of weeks. The personalized vaccination contains all the antigens from the patient’s tumor, rather than merely the most prevalent antigen or some combination of antigens -- the latter two methodologies being ones which represent failed methodologies in vaccinology with cancer tumors. The injection of the personalized vaccination is done as far away as possible from the tumor site, and usually close to lymph nodes, where it would best activate the patient’s immune system. Presently, use of Antigenics’ vaccination is considered experimental therapy so that patients who participate in the company’s clinical trials are people who have not been successful with the standard of care cancer treatments. Clinical trials for Oncophage first started in 1997 at Memorial Sloan-Kettering Cancer Center with pancreatic cancer patients. Ongoing clinical trials for this product exist for the following types of cancers: kidney, colorectal, pancreatic, NHL, gastric and melanoma (which is notorious for being receptive to immunotherapy). The kidney and melanoma clinical trials are now in Phase III. Clinical trial endpoints for Oncophage are initially “time to recurrence” rather than survival, which is the FDA’s optimum endpoint for a clinical trial, but Ms. Hawkins explained that there should be later endpoints as Antigenics does follow-up with the patients who participate in its clinical trials. Prospectively, the company views a second wave of trials for lung and breast cancer, which involve tumors smaller in size than the cancers identified above. Adelphi NY Statewide Breast Cancer Hotline & Support Programs The Adelphi organization has compiled “The Pink Ribbon Cookbook,” which contains over 580 favorite recipes submitted by people who have been touched by breast cancer. The book includes the favorite recipe of columnist Liz Smith, recipes for apple muffins from Governor George Pataki and Senator Hillary Clinton, and a chicken recipe from Dr. Lora Weiselberg. The price is $18 each, and $30 for two books. If interested in ordering the book, please contact Keisha Johnson at 516.877.4320. News from the NYS Attorney General's Office The NYS A.G.’s office recently entered into a settlement agreement with Empire BlueCross BlueShield relating to its improper denial of certain claims for coverage of nutritional supplements. The agreement, among other things, calls for Empire to review its records, identify cases of previously denied coverage for nutritional supplements and post instructions on its website and its newsletter for affected members in order for them to make claims. As reported by the A.G.’s office, insurers in New York may not deny coverage for nutritional supplements when medically necessary. Current News items Teen Exercise to Prevent Breast Cancer On December 23, 2003, The Wall Street Journal reported on a research study that would suggest that young women who exercise a few hours a week during their teenage years could lower their chance of developing a common type of breast cancer later in their life by 30 - 35%. Teen exercise appears to interfere with monthly ovulation, which in turn means less estrogen production, which has been tied to the stimulation of the growth of cancerous breast tumors. The article indicated that, while the importance of exercise as a means of prevention against breast cancer has been documented in other studies, this new research is more specific in that it suggests that preventive characteristics of physical activity are particularly effective during the adolescent and teenage years. Leslie Bernstein, a researcher at the University of Southern California, led one of the new studies and was quoted as saying that “We believe less estrogen at a time when women’s duct cells in the breasts are growing fastest, in the teen years, is protective.” Duct cells, which produce milk after pregnancy, are the site where most breast cancer tumors arise. Dr. Bernstein’s study adds to other recent “energy balance” studies which indicate that excess weight and a lack of routine physical exertion strongly predispose women to breast cancer. Reportedly, the American Cancer Society and the World Health Organization, based on these recent research findings, issued separate reports in 2003 which, for the first time, identified extra weight and lack of exercise as important predictors of breast cancer. The NCI is also involved with a project to determine with greater precision how these factors -- the amount of physical exertion, the amount of weight loss, and the times during a woman’s life -- can provide women with the best defense against this disease. Exercise is also relevant for post-menopausal women, although the mechanism is different. As explained by Dr. Anne McTiernan of the Fred Hutchinson Cancer Research Center in Seattle, for these women excess estrogen seems to come from fat cells so that exercise would reduce fat and thereby estrogen. Dr. Anne McTiernan is presently involved with a small study which examines women who engage in 45 minutes of aerobic exercise five times a week. Conclusions, however, have not yet been reached as to the amount and type of exercise which is most beneficial. Study – Positive Attitude Does Not Improve Cancer Survival In was reported that a February 2004 issue of Cancer (published by the American Cancer Society) contained the conclusions of Australian researchers who followed 179 nonsmall cell lung cancer patients for over five years in order to determine if optimism would improve their chances of survival. The study concluded that an optimistic attitude does not prolong survival for lung cancer patients (which is a kind of cancer that apparently offers a low, i.e., less than 15 percent, chance of survival beyond five years) and that pressure from physicians to have a positive outlook might add to the patients’ burden, causing them to conceal their distress and limit honest conversation. Penelope Schofield, a research fellow at the Peter MacCallum Cancer Centre in Melbourne, added that the results may not hold true for other cancers, such as breast cancer or prostate cancer, which have a better prognosis since a positive outlook could affect the way these patients care for themselves, causing them to eat a healthier diet, exercise more, drink less or quit smoking. It is acknowledged, however, that optimism could influences a patient’s quality of life. This was apparently the first scientifically valid study to examine optimism and cancer. Calendar of Events JALBCA MARCH PROGRAM NYS Legislative Update on Health Law
MEMORIAL SLOAN-KETTERING POST-TREATMENT RESOURCE PROGRAM Call 212.717.3527 to register for the following programs: Living with Lymphedema: A Group Discussion
BRCA1 and BRCA2: Managing Your Care After Testing
Managing Health Care Insurance
Awareness, Connection & Education (ACE) for Children
To assist children in talking to peers about fears, confusion, and anger in reaction to illness in the family. Group sessions. For more information, call Nola Royce at 845.439.5975. SHARE (SELF-HELP FOR WOMEN WITH BREAST OR OVARIAN CANCER) 1501 Broadway, Suite 1720 NYC Call 212.719.0364 for further information. SHARE HOTLINE: Breast: 212.382.2111 Ovarian: 212.719.1204 Research Update: The Issue of Tissue Collection
Introduction to human tissue specimen collection and the use of human tissue for research. The program will address the impact of tissue sampling and banking (storing) on research and will include patient benefits and risks, as well as methods used for protecting patients. JALBCA does not endorse the content or efficacy of any workshops or programs listed in the Calendar of Events; listings are for informational purposes only, so that our readership is aware of current offerings. |
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