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Worms and Slugs for Mesothelioma Care

Could Creepy Crawlers Someday Be Useful in Mesothelioma Care?

While MesotheliomaHelp has reported numerous times about research that looks to nature, mostly in fruits and vegetables, to bring new treatments to mesothelioma patients, researchers are now looking at shiver-inducing worms and slugs for patient care. In two separate studies, researchers looked to the slimy critters for inspiration in developing medical products that can aid in patient care.

Slug Mucus Inspires Medical Glue

Researchers from Harvard University report that they developed a glue inspired by the slime from slugs that can be useful in surgery, according to July 28 article from the BBC. Trying to find a tissue adhesive, or glue, that can be used instead of stitches or staples on patients, researchers from Harvard University turned to the “Dusky Arion” slug, whose body is covered in a sticky mucus, as guidance.

The challenge of developing an adhesive product that can stick to damp surfaces, such as organs and skin, is flexible enough to move freely and is less damaging to the healthy tissues, had stymied researchers until they discovered the characteristics of slug mucus could be copied.

“We engineered our material to take on the key features of slug mucus and the result is really positive,” said Dr. Jianyu Li, Wyss Technology Development Fellow, Harvard University. “I’m really amazed by this system. We have solved a big challenge and opened up big opportunities in the medical setting.”

The “bio-glue” is incredibly strong, moves with the body and sticks to wet surfaces. According to the researchers the glue is not toxic and is three times stronger than current options, with adhesion occurring within minutes. They indicate that this family of adhesives could be useful for tissue adhesives, wound dressings, and tissue repair.

This finding can be especially useful for mesothelioma patients who undergo surgery as a form of treatment. One option is the extrapleural pneumonectomy, a surgery to remove a diseased lung and its surrounding layer of tissue known as the pleura. The alternative to EPP is the lung-sparing radical pleurectomy/decortication surgery, a complicated surgery that involves stripping away the diseased membrane lining the lung but keeping the lung intact. Both surgeries require extensive incisions that are typically sewn back up – bio glue might be a great alternative.

Wyss Founding Director Donald Ingber, who is also the Judah Folkman Professor of Vascular Biology at Harvard Medical School and the Vascular Biology Program at Boston Children’s Hospital, as well as a Professor of Bioengineering at Harvard SEAS, said of the bio glue:

“Nature has frequently already found elegant solutions to common problems; it’s a matter of knowing where to look and recognizing a good idea when you see one. We are excited to see how this technology, inspired by a humble slug, might develop into a new technology for surgical repair and wound healing.”

The glue has proven effective in the lab on mice and on a pig’s heart, but significantly more research is required.

Read about the Harvard discovery in the July 28 issue of the journal Science.

Worm Could Be Universal Blood Donor

In another study, researchers from France found that the lugworm, a marine worm that burrows in the sand at low tide, has an “extraordinary ability to load up with life-giving oxygen” which may lead to a blood substitute that could save lives.

Researchers from Aquastream, a fish-farming facility on the Brittany coastline, and Hemarina, a French biotechnology company centered on the development of universal marine oxygen carriers, have partnered in this unique venture to find a way to harness the blood from the lugworm. This is the first collaboration into the medical use of lugworms. The companies must find a way to grow and harvest the worms, as well as finding a way to harvest the blood.

“The haemoglobin of the lugworm can transport 40 times more oxygen from the lungs to tissues than human haemoglobin,” says Gregory Raymond, a biologist at Aquastream, in a July 31 article on MedicalXpress. “It also has the advantage of being compatible with all blood types.”

While Aquastream focuses on bringing a “sustainable supply of the worms” to market, so far they can produce 1.3 million lugworms a year, Hemarina researchers are focusing on ways to extract the drops of hemaglobin from each worm.

“There is nowhere else in France or the world that has the capacity to produce lugworms in a controlled environment to ensure a supply of their haemoglobin,” said Aquastream director Nathalie Le Rouilly.

Mesothelioma patients are susceptible to anemia, a decrease in red blood cells that limits oxygen supply, often caused by the cancer itself or from the effects of  chemotherapy, according to CancerConnect.com. Red blood cells contain the protein hemoglobin, which carries oxygen to all parts of the body, and in severe cases, patients may need a blood transfusion.

Harnessing this hemoglobin could transform medicine by providing a blood substitute that could save lives, speed recovery after surgery and help transplant patients, according to the research team.

There is still plenty more work to do in the lab, but if the researchers are able to bring it to market, there are plenty of other life-saving uses for the lugworm. The team even envisions using “freeze-dried lugworm blood” as blood supply backup after disasters and in combat zones.

Sources 

  • BBC
    http://www.bbc.com/news/health-40730875
  • Wyss Founding Director Donald Ingber
    https://wyss.harvard.edu/sticky-when-wet-strong-adhesives-for-wound-healing/
  • journal Science
    http://science.sciencemag.org/content/357/6349/378
  • MedicalXpress
    https://medicalxpress.com/news/2017-07-story-worm-bringer-medical-miracles.html
Drug Therapy for Pleural Mesothelioma Care

Combination Drug Therapy Approval for Lung Cancer Opens Door For Targeted Care for Pleural Mesothelioma

Lung cancer patients with a specific genetic mutation just received good news with the approval of a combination drug treatment. The U.S. Food and Drug Administration announced in June that it approved dabrafenib and trametinib as a combination therapy for use in non-small cell lung cancer patients expressing the BRAF V600E mutation. Certain pleural mesothelioma patients may also benefit from this recent approval.

The FDA approved the two drugs from Novartis Pharmaceuticals Inc., Tafinlar (dabrafenib) and Mekinist (trametinib), based on success in a clinical trial of 93 patients with a median duration of response that ranged from six months to 12.6 months (depending on previous treatment status), according to a June 22 press release. The FDA also approved the Oncomine Dx Target Test to select those patients with NSCLC with the BRAF V600E mutation for treatment.

Novartis reports that “there is an urgency to treat people with this mutation, as BRAF V600E mutation-positive tumors have been shown to be more aggressive and may lead to a poorer prognosis.” According to Novartis, BRAF mutations are in just one to three percent of NSCLC cases worldwide. One study shows that BRAF is also a rare type of mutation in pleural mesothelioma, however, for an already rare disease with few treatment options, this approval brings a glimmer of hope to patients.

“Patients with BRAF V600E mutation-positive metastatic NSCLC have responded less favorably to standard chemotherapy, suggesting that there is a critical need for a targeted therapy,” said Bruno Strigini, CEO, Novartis Oncology, in a June 22 press release.

Treatment for pleural mesothelioma, an asbestos-caused cancer affecting the lining of the lungs, and non-small cell lung cancer is often similar, with chemotherapy being one of the primary treatment modes. Chemotherapy is used to manage symptoms and to slow the growth of the disease, but both cancers are notably aggressive and often develop resistance to the drugs, and, eventually, the treatment fails.

This double therapy oral treatment is another step towards personalized cancer care that could benefit those battling mesothelioma. Personalized care targeted to a patient’s unique characteristics and genetic makeup, such as the BRAF biomarker, optimizes the potential for success of the treatment.

“This is an important milestone for the lung cancer community as we are continuing to better understand the genomic drivers of cancer and develop effective treatments targeted for these biomarkers,” said Bruce Johnson, MD, Professor of Medicine, Chief Clinical Research Officer, Dana-Farber Cancer Institute and Harvard Medical School at Dana-Farber Cancer Institute.

This is the first approval for targeted treatment in the U.S. specifically for BRAF V600E mutation-positive metastatic NSCLC.

Talk to your mesothelioma care team to find out if this combination therapy will work for you.

Two Gene Therapys Brings Hope to Mesothelioma

Two Gene Therapy Approaches Pending Approval from FDA Bring Hope to Mesothelioma Community

Nearly five years ago, MesotheliomaHelp reported about a breakthrough treatment called gene therapy. At the time, it was touted as the “next frontier” in medicine, and cancer patients from around the world watched closely in the hopes that the treatment could bring a cure to even the rarest of cancers, such as mesothelioma. Now, all eyes are on the U.S. Food and Drug Administration as it is poised to approve two types of gene therapy.

The Oncologic Drugs Advisory Committee (ODAC) sent its recommendation to the FDA on July 12 for CTL019 (tisagenlecleucel) for the treatment of a form of leukemia. Then, on July 17, the FDA accepted a Biologics Licensing Application from Spark Therapeutics for gene therapy for a rare inherited eye disease that causes blindness, approved the name Luxturna for the treatment, and assigned priority status to the treatment for accelerated review.

To better understand these two pending landmark approvals and the future of gene therapy, MesotheliomaHelp turned to Ricki Lewis, a New York-based geneticist and author.

“It’s not right for every disease,” said Lewis. “But it is an approach that can be considered some day along with drugs, surgery and everything else.”

CTL019: CAR-T Treatment for Leukemia Ramps Up the Immune System

Tisagenlecleucel is an investigational chimeric antigen receptor (CAR) T cell therapy from Novartis, developed by researchers at the University of Pennsylvania. The pharmaceutical company wants to use the therapy to treat a rare form of leukemia, B-cell acute lymphoblastic leukemia affecting children and young adults under the age of 25, according to NPR.

Lewis explains that CAR-T therapy is not “conventional” gene therapy, which has been in clinical trials to treat single-gene diseases since 1990. However, she notes that “CAR T cell technology has had astonishing success in treating a form of leukemia and it’s being tested for multiple myeloma, brain cancer, breast cancer, and soft tissue cancers.”

“Although both approaches deliver DNA in viruses, classical gene therapy adds a working copy of a single mutant gene, restoring a specific protein’s function,” says Lewis. “Revving up a not-naturally-occurring immune response isn’t the same thing as replacing an enzyme,” which is what Luxturna does.

According to the National Cancer Institute, in CAR-T treatment, T cells are removed from the patient’s blood and genetically altered in a lab to have chimeric antigen receptors on their surface. The T cells are then multiplied, into the billions, in the lab and infused back into the patient’s blood, where they seek out the cancer cells and launch a precise immune attack against them.

Lewis offers the following explanation of CAR-T:

“CAR operates like a drone, targeting and obliterating cancer cells. It introduces a gene manufactured to contain instructions for making two immune system components in one, something that doesn’t exist in nature: an antibody and a T cell receptor. When delivered in a virus, the CAR enters the person’s T cells, which then manufacture the hybrid (chimeric) protein.

The engineered receptor portion guides the T cells to a specific target – such as cancerous B cells – where the antibody part binds. The action alerts the immune system to respond and kill the cancer cells.”

Ultimately, CAR-T, also described as a process that genetically alters a patient’s own cells to fight cancer, could be used for many more diseases and cancers, and bring an effective treatment to mesothelioma patients.

In a 2013 article for MesotheliomaHelp, Lewis wrote about CAR-T treatment saying, “An ingenious technique that has vanquished leukemia in a handful of patients is also being applied to mesothelioma.”

Lewis highlighted the CAR-T process being used in a mesothelioma clinical trial from the University of Pennsylvania that uses the “doctored T cells,” known as chimeric immune receptor (CIR) instead of CAR, against mesothelin, a protein that is found to be in excess in mesothelioma and other cancers. The idea is that T cells led to the mesothelioma cells will attract an immune response, said Lewis.

Find out more about the mesothelioma clinical trial from the University of Pennsylvania here.

Luxturna Gene Therapy Treats Blindness, Could Lead to Treatment for Other Inherited Diseases

In her book The Forever Fix, Lewis followed the journey of the use of gene therapy to restore the vision of a young boy who was nearly blind from a hereditary disorder. The doctors added a working copy of a single defective gene in the New York boy’s eyes that prevented his eyes from using vitamin A to send visual signals to his brain. The treatment was a success: the boy’s vision was restored and no further treatments or surgery were required.

“Last week’s FDA advisory committee’s greenlight for CAR technology overshadowed a milestone for what is likely to be the first approval of classic gene therapy – for a form of inherited blindness,” Lewis told MesotheliomaHelp. “That’s the Leber congenital amaurosis type 2 – renamed ‘RPE65-mediated inherited retinal dystrophy’ – that I wrote my book about.”

In an interview with Lewis last week, Dr. Katherine High, MD, President, Chief Scientific Officer, and a founder of Spark Therapeutics, said of the future of gene therapy:

“I hope we will see continued accumulation of successful clinical results in a range of target tissues and continued progress in bringing gene therapy products to licensing. When gene therapy products are licensed, there will be increased interest in the medical community, and that will help to expand opportunities.”

Mesothelioma patients typically show disease symptoms years or even decades after exposure to asbestos, a known carcinogen. The cancer is eventually fatal, but aggressive therapy may prolong the lives of patients who are diagnosed early. Approximately 3,000 Americans are diagnosed with the cancer each year.

“Getting at the basis of why one person develops mesothelioma and another person doesn’t, that is going to hold a clue to really fighting it,” Lewis said, referring to a clinical trial conducted at Wake Forest University in 2013 to determine whether some mesothelioma patients are genetically predisposed to developing mesothelioma. “Then we will know what to do the gene therapy on.”

The pending FDA approvals could bring groundbreaking treatment to cancer patients and to patients with genetic diseases. Perhaps someday, mesothelioma patients will enjoy long, productive lives through gene therapy.

The FDA is not bound to follow the ODAC’s recommendations, however, the Agency nearly always follows the recommendation. Approval for CTL019 is expected in November. The FDA will decide on Luxturna in January, 2018.

About Ricki Lewis,PhD

Ricki Lewis is a science writer with a PhD in genetics. The author of several textbooks and thousands of articles in scientific, medical, and consumer publications, Ricki’s first narrative nonfiction book, “The Forever Fix: Gene Therapy and the Boy Who Saved It,” was published by St. Martin’s Press in March 2012. In addition to writing, Ricki provides genetic counseling for parents-to-be at CareNet Medical Group in Schenectady, NY and teaches “Genethics” an online course for master’s degree students at the Alden March Bioethics Institute of Albany Medical Center.

Read more about gene therapy on Ricki Lewis’s DNA Science blog.

Find out more about Ricki Lewis at her website.

Sources:

  • Spark Therapeutics
    http://blogs.plos.org/dnascience/2017/07/20/luxturna-a-giant-step-forward-for-blindness-gene-therapy-a-conversation-with-dr-kathy-high/
  • DNA Science blog
    http://blogs.plos.org/dnascience/
Qualcomm Tricorder XPRIZE competition

Contest Could Bring Handheld Medical Tool to Mesothelioma Patients

One of the props used by Dr. McCoy, of the iconic 1960s television series Star Trek, was the Tricorder. With a point, swipe, and beep, the doctor could examine and diagnose the USS Enterprise’s crew members. Now, thanks to a contest, this science fiction device may soon become a reality bringing “healthcare to the palm of your hand,” and helping mesothelioma patients avoid some of their countless medical appointments.

The Qualcomm Foundation, along with the world’s leading visionaries, hold a three-day summit each year to brainstorm ideas to help mitigate some of the challenges facing the world. The goal is to create an incentivized global competition that could lead to a solution to the problem. In 2012, the summit attendees focused on healthcare.

With all the technological advances, the team thought, it is inconceivable that an individual has to physically go to a healthcare facility, clinic, or doctor for a diagnosis of any condition. They felt this model of health care has led to bottlenecks to access of care, backlogs in laboratories, and a rise in healthcare costs. The visionaries agreed that a medical device, for consumers, could be designed to address this problem. The Qualcomm Tricorder XPRIZE competition, with a total prize package of $10 million, was conceived to spur the creation of Dr. McCoy’s Tricorder.

U.S. Team Takes Top Prize

On April 12, 2017, the U.S. team, Final Frontier Medical Devices, based in Pennsylvania, was announced the winner of the nearly five-year competition netting them $2.6 million to help bring the prototype to reality. Led by two brothers, Dr. Basil Harris, an emergency medicine physician, and George Harris, a network engineer, the team created DxtER.

The second place winner, Dynamical Biomarkers Group of Taiwan, received $1 million to help bring their device to fruition.

“It is very exciting that our vision of mobile, personalized patient-centric healthcare is getting closer to becoming a reality thanks to the great work of the Qualcomm Tricorder XPRIZE teams,” said Dr. Paul E. Jacobs, executive chairman of Qualcomm Incorporated, in an April 13 press release announcing the winner. “Creating technology breakthroughs in an industry as complex as healthcare is quite a milestone, and what these teams accomplished is a great stepping stone to making mobile healthcare a viable option across the world.”

The field began with 312 teams from 38 countries all working to create a Tricorder prototype.  During the multi-year competition the field was narrowed to 29 teams from nine countries, and finally to two finalists from two countries. The two final teams, representing the U.S. and Taiwan, were chosen in December 2016.

Five-Pound Device Houses Complex Functionality

“Our device is smart and simple, giving people the help and answers they need when they need this input the most,” said Dr. Basil Harris, founder of  Basil Leaf Technologies, in a press release announcing his team’s success.

The final product had to adhere to strict requirements such as allowing an individual to determine if and what care is required without leaving home; it should weigh no more than five pounds; it must collect, store, and share vital health data via the internet; and cause no harm to the consumer either by thermal or electrical energy, needles, lancets, or infections.

Expert Insight

Dr. Basil Harris

“There is nothing like it in existence, and we believe this technology will change the face of health care.”

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In order to diagnose patient conditions, the device must be capable of collecting key health metrics like blood pressure, respiratory rates, and temperature over time and in various health states. The volume of data accumulated over time will allow the device to determine the consumers health conditions without expensive or invasive laboratory tests.

The winning prototype was to capture five real-time health vital signs, blood pressure, heart rate, oxygen saturation, respiratory rate, and temperature and identify 10 health conditions. The health conditions include: anemia, A-fib, COPD, diabetes, leukocytosis, pneumonia, otitis media, sleep apnea, urinary tract infection, and shingles. It must also be able to determine the absence of any condition allowing the patient to avoid unnecessary medications.

DxtER, the winning tool, is capable of diagnosing 34 health conditions.

Tricorder Benefits for Mesothelioma Patients

For mesothelioma patients and their caregivers, being able to determine, from the comfort of their home, what and if medical care is required, has significant benefits. Early detection of pneumonia, for example, can mean the difference between treatment at home and complications requiring hospitalization.

Mesothelioma, a rare cancer causally linked to asbestos exposure, is typically diagnosed in patients over the age of 65. At that age, many patients may have unrecognized medical problems that also need to be addressed. However, with the toll mesothelioma takes on a patient, symptoms that may mean a heart condition or diabetes often go ignored simply because of the burden of another round of doctors’ appointments and tests.

With the possibility of having their own diagnostic device at home that can collect their health data, assess the illness, and determine the appropriate course of action, whether that requires medical intervention or not, mesothelioma patients will feel more empowered, less stressed and may realize a better quality of life.

The device “gives users access to continuous, reliable health data – the information patients and providers need to more effectively manage chronic health conditions, such as diabetes and congestive heart failure,” according to Basil Leaf’s website.

With the advancements in mesothelioma care bringing the cancer closer to being a chronic disease, this device can allow patients to focus more on their lives and less on their illness.

The Qualcomm Foundation, and other strategic partners, are committed to seeing the Tricorder competition bring marketable products into the hands of consumers, and they have pledged millions of dollars in initiatives to support the teams.

To find out more about this exciting project visit the Qualcomm Tricorder XPRIZE website.

Photo Credit: Qualcomm Tricorder XPRIZE

Sources:

  • Qualcomm Tricorder XPRIZE competition
    http://tricorder.xprize.org/
  • Basil Leaf’s website
    http://www.basilleaftech.com/dxter/
  • Basil Leaf Technologies
    http://www.basilleaftech.com/blog-1/
  • Dr. Paul E. Jacobs, executive chairman of Qualcomm Incorporated
    http://tricorder.xprize.org/press-release/family-led-team-takes-top-prize-qualcomm-tricorder-xprize-competition
Rare Disease Day - Mesothelioma as the Spotlight

Rare Disease Day Brings Mesothelioma into the Spotlight

MesotheliomaHelp will be joining the National Organization for Rare Disorders (NORD), and countless other organizations, in the fight to raise awareness of the more than 7,000 rare diseases on Rare Disease Day tomorrow, Feb. 28. For the ninth year, NORD will focus a spotlight on rare diseases as a global public health concern. Mesothelioma, an asbestos-related cancer, is one of the rare, or “orphan,” diseases or conditions affecting one in ten Americans.

In the United States an orphan disease status is assigned to a disease or disorder if it affects fewer than 200,000 Americans at any given time. In the case of mesothelioma, 3,000 Americans are diagnosed with the disease each year.

This year’s focus is on research. Research brings hope to people living with rare diseases and while there is ongoing research to find new treatments or a cure, many of the diseases still do not have effective treatments. There is  no cure for mesothelioma and the cancer is resistant to many of the available treatments.

Rare Disease Day is an annual event observed worldwide on the last day of February dedicated to raising awareness among the general public and decision-makers about rare diseases and the impact on patients’ lives. The day was started in 2008 by EURORDIS-Rare Disease Europe. In 2016, more than 85 countries participated, including France, Canada, Greece, and first time participants Aruba, Tanzania, and Zimbabwe.

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NORD

People with rare diseases struggle to get a proper diagnosis, find information, and get treatment.

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The organizers want to educate the public about the inequalities in medical care suffered by people with orphan diseases. According to NORD, patients with orphan diseases are often faced with difficulty in finding medical experts, delay in receiving an accurate diagnosis, and access to few, if any, treatment options. In the U.S., malignant mesothelioma patients often have to travel to large cities where the mesothelioma experts practice in order to receive adequate treatment.

Due to the relative rarity of mesothelioma, and other orphan diseases, managing the disease and trying to find appropriate treatment can be overwhelming to the patients and their families. In fact, according to government statistics, between 85 and 90 percent of orphan diseases are serious or life-threatening, yet only about 200 of them currently have any effective treatments.

Rare Disease Day 2017 activities in the U.S. include state legislature awareness events, a Handprints Across America photo gallery on the national website, and events in communities across the U.S.

For more information about Rare Disease Day activities in the U.S, see www.rarediseaseday.us. For information about global activities, see www.rarediseaseday.org.

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Free Mesothelioma Patient & Treatment Guide

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