1.PFE Pfizer announces that the Phase 3 EMBRACA trial in patients with germline (inherited) BRCA1/2-positive (gBRCA+) locally advanced and/or metastatic breast cancer (MBC) demonstrated superior progression-free survival (PFS) in patients treated with talazoparib, compared to patients who received physician's choice standard of care chemotherapy(35.50 )
2. Blood Test May Help Predict Which Breast Cancers Will Recur
A blood test five years after breast cancer treatment helped identify some women who were more likely to relapse, long before a lump or other signs appeared, a preliminary study found.
It was the largest experiment so far to use these tests, called
liquid biopsies
, for breast cancer. Results suggest they someday may help reveal which women need longer preventive therapy and which ones can be spared it.
"It could be providing an early warning sign" for some women that cancer is returning, said Dr. Joseph Sparano of Montefiore Einstein Center for Cancer Care in New York.
On the other hand, "if you had a negative test, there was a 98 percent chance you would not have a recurrence in the next two years" and perhaps could skip further treatment, he said.
Sparano led the study and gave results Friday at the San Antonio Breast Cancer Symposium.
The test — CellSearch, sold by Menarini-Silicon Biosystems — looks for stray cancer cells in the blood.
Breast cancer survivors may be tempted to rush out and get it, but doctors say it's too soon for that. Although it's been used for about a decade to monitor certain patients with advanced cancer during treatment, its value for helping to predict breast cancer relapse risk is not well established, and insurers won't pay the $600 to $900 tab.
The new study should spur more research on this right away, said Dr. Massimo Cristofanilli, a breast cancer specialist at Northwestern University in Chicago who has used these tests and consults for another company developing one.
"Clearly, to me, we have to do something" now that this study suggests a wider role for them, he said.
It involved 547 women in long-term follow-up from an earlier cancer drug study. Two-thirds of them had cancers fueled by estrogen, and in most cases it had spread to lymph nodes but not more widely.
All had surgery and chemotherapy followed by hormone-blocking medicines for five years. Guidelines now recommend considering hormone blockers for up to 10 years, but they have side effects and their benefit beyond five years is fairly small. So finding a way to tell who really needs that would be a big help.
Women in the study had a CellSearch test five years on average after their cancer was found and treated.
Among those with estrogen-fueled disease, 5 percent had cancer cells in the blood test, and they turned out to have a 22-fold higher risk of recurrence within roughly two years compared to women whose blood test was negative.
About 65 percent of women with hormone-positive disease and a positive blood test did not have a new breast cancer within two years, but that doesn't mean the blood test gave a false alarm, Sparano said.
"We haven't followed the patients long enough" — it could be that more tumors become evident with more time, he said.
The blood test seemed to do a good job of identifying which of these hormone-positive patients were at low risk of recurrence, suggesting that women who test negative may be able to forgo an additional five years of hormone-blocking medicines.
The test did not predict recurrence risk in the rest of the women in the study, whose tumors were not fueled by estrogen. They have a lower risk of recurrence after five years to start with.
The study was funded by the Breast Cancer Research Foundation, Susan G. Komen Foundation and the National Cancer Institute.
在治愈癌症的路上（3） 科普闲谈 2017年12月08日
新一代治愈癌症的理想药应该如何评估？简单地说，判据至少有三条： （1） 只损伤癌细胞，对正常细胞的危害小，其他副作用不引起不良后果。 （2）局部和全局范围内的靶向性或递送性好，无论癌细胞扩散与否，疗效不变。 （3）药品价格公道，人人用得起。 上哪里找这种药？其中一类就在人体内。内源病由内源物来治，逻辑上讲得通。虽然机理有一点点相似，但它们不是单抗药那样免疫型的蛋白大分子，而是各种类型的内源小分子，在更细小的尺度上维护着细胞的正常运行。
在进一步探讨主题之前，根据网友们的反馈，先把药物和人体相互作用的定律再进一步地作些说明：
i）定律给出的量化结果与已知药物的疗效吻合得很好並发现不少药的新用途，比如说青霉素（Penicillin）、阿西匹林 (Aspirin）、布洛芬（Advil）、二甲双胍（Metformin-糖尿病）、美金刚（Memantine-老年痴呆）、顺铂（Cisplatin-癌症）等等。与上亿人次服用过的大量药物在疗效上保持准确的一致性，应该是理论与实验相符的一个至关重要的证据。有意思的是，好药就是好药，错不了；其天赋特质，从它们的疗效机理上可以一览无遗。
ii) 在物理、化学和生物学的范畴里，人体内分子群所展现出的各种数学规律，优美、严谨、完善，令人叹为观止。由于医药学一直以实验为主线来进行研究与发展，让俺这样从理论入门的扫地僧福至心灵，见识了一个新天地。为让更多的人受益，与知名的药一起，有些结果已经放在一个英文公益网站上，请大家自己鉴别和探讨.
iii）挑选出内源分子之后，遵循常规的实验程序是必不可少的。没有一个定律是完美无缺的，它的背后都有必要的预设条件。一个定律的主要功能之一是它的指导意义。实验不仅能确认定律的预测是否准确可靠，还能修正不同条件下引起的偏差。从选出分子到商品药，还有数不尽的工作要做，在这儿就不说了。
攻克癌症是大家的事，希望每个有心人都尽份力；不论大小，心动神知，没有过不去的坎。 究竟怎么找药？把人体内的各种内源分子当作药物，让虚拟人体服药，然后启动电脑进行评估工作。输出的结果表明，有些分子的功能表现与已知的抗癌药很相似。将这些分子存储起来，等待下一步筛选。这项工作比较细致，至今合格的只有四十几个分子，有待增加。如果选出的分子能成为药，它们至少有三个优点。第一，它们本来就是人的一个微小单元，在体内的局部或全局的活动范围明确，因此靶向偏离度小。第二，它们与其它正常分子与生俱来就是同伴，即使有互动和交流，彼此不会伤害。第三，它们对自己的主要功能之一，防止DNA/RNA分子失控生长，意识清楚。使用这些药的方法不受限制，可以单用，也可以组合起来用。
由于环境恶化、生活节奏和习惯的变动，致癌因素在人体内的积累率有可能会不同以往，使那些内源类分子的掌控能力变为弱势的一方。尤其是上了年纪后，器官、组织、细胞等有机体的活性相对减缓，健康养生应该得到重视。这种情况下，适当补充一些这类分子，对防癌应该会起积极作用。
有一个需要回答的问题：在理想药物进入市场之前，在短时间内有没有可供选择的新药，它们在疗效和副作用小两方面都有明显的优点？有，就在多年来大家服用的普通药物中。研究结果指出，很多非处方和处方药都有潜力成为优质的抗癌药。这些药一直用来医治其它症状的病，有的已有几年甚至几十年的历史，现在只是让它们再治另一种病而已。个别药本身的经历就是一个传奇：它有应对癌症、老年痴呆、糖尿病三大难症的资质，却被派去干些不挨边的事；时间一长，也就边缘化了，真可惜。我劝天公重抖擞，不拘一格降药材。
俺现在做研究的方向之一就是找出每种药可能医治的癌症类型。希望不久的将来给大家带来好消息。 其他治愈癌症的新途径，以后再介绍。
此文是原创，转载请注明出处。
1.PFE Pfizer announces that the Phase 3 EMBRACA trial in patients with germline (inherited) BRCA1/2-positive (gBRCA+) locally advanced and/or metastatic breast cancer (MBC) demonstrated superior progression-free survival (PFS) in patients treated with talazoparib, compared to patients who received physician's choice standard of care chemotherapy(35.50 )
2. Blood Test May Help Predict Which Breast Cancers Will Recur
A blood test five years after breast cancer treatment helped identify some women who were more likely to relapse, long before a lump or other signs appeared, a preliminary study found.
It was the largest experiment so far to use these tests, called
"It could be providing an early warning sign" for some women that cancer is returning, said Dr. Joseph Sparano of Montefiore Einstein Center for Cancer Care in New York.
On the other hand, "if you had a negative test, there was a 98 percent chance you would not have a recurrence in the next two years" and perhaps could skip further treatment, he said.
Sparano led the study and gave results Friday at the San Antonio Breast Cancer Symposium.
The test — CellSearch, sold by Menarini-Silicon Biosystems — looks for stray cancer cells in the blood.
Breast cancer survivors may be tempted to rush out and get it, but doctors say it's too soon for that. Although it's been used for about a decade to monitor certain patients with advanced cancer during treatment, its value for helping to predict breast cancer relapse risk is not well established, and insurers won't pay the $600 to $900 tab.
The new study should spur more research on this right away, said Dr. Massimo Cristofanilli, a breast cancer specialist at Northwestern University in Chicago who has used these tests and consults for another company developing one.
"Clearly, to me, we have to do something" now that this study suggests a wider role for them, he said.
It involved 547 women in long-term follow-up from an earlier cancer drug study. Two-thirds of them had cancers fueled by estrogen, and in most cases it had spread to lymph nodes but not more widely.
All had surgery and chemotherapy followed by hormone-blocking medicines for five years. Guidelines now recommend considering hormone blockers for up to 10 years, but they have side effects and their benefit beyond five years is fairly small. So finding a way to tell who really needs that would be a big help.
Women in the study had a CellSearch test five years on average after their cancer was found and treated.
Among those with estrogen-fueled disease, 5 percent had cancer cells in the blood test, and they turned out to have a 22-fold higher risk of recurrence within roughly two years compared to women whose blood test was negative.
About 65 percent of women with hormone-positive disease and a positive blood test did not have a new breast cancer within two years, but that doesn't mean the blood test gave a false alarm, Sparano said.
"We haven't followed the patients long enough" — it could be that more tumors become evident with more time, he said.
The blood test seemed to do a good job of identifying which of these hormone-positive patients were at low risk of recurrence, suggesting that women who test negative may be able to forgo an additional five years of hormone-blocking medicines.
The test did not predict recurrence risk in the rest of the women in the study, whose tumors were not fueled by estrogen. They have a lower risk of recurrence after five years to start with.
The study was funded by the Breast Cancer Research Foundation, Susan G. Komen Foundation and the National Cancer Institute.
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