Penn Medicine researcher unveils findings on 2 new weapons against thyroid cancer

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Public release date: 28-Sep-2013 [ | E-mail | Share ]

Contact: Holly Auer holly.auer@uphs.upenn.edu 215-200-2313 University of Pennsylvania School of Medicine

AMSTERDAM -- For many years, patients with advanced thyroid cancer faced bleak prospects and no viable treatment options. But now, building on recent discoveries about the genetics and cell signaling pathways of thyroid tumors, researchers are developing exciting new weapons against the disease, using kinase inhibitors that target tumor cell division and blood vessels. Two recent clinical trials led by a researcher from the Perelman School of Medicine at the University of Pennsylvania showcase the great promise of these new approaches. The work will be presented at the European Cancer Congress (ECCO 17 - ESMO 38 - ESTRO 32) in Amsterdam today.

The first study provides additional data from the phase III DECISION trial of the drug sorafenib, a kinase inhibitor already approved for treatment of kidney and liver cancer, which was presented as a plenary during the 2013 annual American Society of Clinical Oncology meeting. In the newly released findings, lead author Marcia Brose, MD, PhD, an assistant professor in the department of Otorhinolarlyngology: Head and Neck Surgery and the division of Hematology/Oncology in the Abramson Cancer Center, and her colleagues examined the effectiveness of sorafenib on thyroid cancers that harbor BRAF and RAS mutations. They previously reported that for patients who received sorafenib, progression free survival was 10.8 months vs. 5.8 months in the placebo arm. Of the 417 patients enrolled in the trial, 256 had tumors collected for genetic analysis. As they expected, the most common mutations were found in the BRAF and RAS genes. However, the analyses show that all groups, regardless of the presence of a BRAF and RAS mutation benefited from treatment with sorafenib.

"Our results are important because they show that regardless of the presence of these two common genetic changes, the group that was treated with sorafenib did better than the placebo," Brose says. "There was no subgroup that didn't appear to benefit from the intervention with the sorafenib." The use of sorafenib for the first line treatment for advanced differentiated thyroid cancer is now being evaluated for approval by the FDA, which would represent the first effective drug for advanced thyroid patients in more than 40 years.

The second study Brose will present during the European Cancer Congress focused on the subgroup of patients with papillary thyroid cancer (PTC), which is the most prevalent form of advanced thyroid cancer. About half of PTC patients harbor the BRAFV600E mutation, which is also present in melanomas that can be successfully treated with BRAF inhibitor drugs. "In this phase II study, we took the BRAFV600E inhibitor, vemurafenib, and studied it in BRAF-mutated papillary thyroid cancer patients to see if there's an effect," Brose explained. Approximately 50 PTC patients with the BRAFV600E mutation were enrolled in the study, all with progressive disease that had failed to respond to radioactive iodine treatment. The patients were divided into two groups: one that had not received sorafenib or other similar kinase inhibitor, and one that had.

The progression free survival of the treatment nave group was 15.6 months and had a response rate of 35 percent, while the progression free survival in the previously treated group was 6.3 months with a response rate of26 percent. "Our results show that we can effectively treat PTC patients that have progressive disease by targeting a common mutation, and produce clinically meaningful periods of progression free survival," Brose said.

Taken together, the two trials offer substantial new hope for patients with progressive thyroid cancer. "A few years ago there was nothing to offer these patients," Brose says. "By understanding similarities across different types of cancers, we have been able to show that therapies previously shown to be effective in other cancers, such as liver, kidney and bone, can be effectively used to treat a rare cancer, providing significant hope to these patients."

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Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $4.3 billion enterprise.

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Penn Medicine researcher unveils findings on 2 new weapons against thyroid cancer

Tour for Diversity in Medicine stops at Georgetown to support students

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Kathyana Philippe knew she needed to apply to colleges this fall shes a senior from Fort Meade but wasnt sure where to begin, which schools might be a good fit or exactly how to go about learning to be a pharmacist.

So she was excited when she went to Georgetown University School of Medicine on Saturday with about 100 other minority high school students interested in medical careers. College applications are, like, right there, she said. I need to know if this is the right choice.

Georgetown was the latest stop on a bus trip by the Tour for Diversity in Medicine, a national nonprofit group started by two minority physicians who wanted to encourage, inform and inspire young people who are interested in health sciences but might not know how best to pursue their goals.

Its all but impossible to get into medical school without some support and guidance along the way, said Alden Landry, who works at Harvard Medical School and is an emergency physician at a hospital in Boston.

Landry, who started the group with his friend Kameron Matthews, a family physician and lawyer, said there are too many intricacies and intangibles such as knowing how much research experience, volunteer work and letters of recommendation can help vault an application, and preparing for the new medical college admissions test coming in 2015.

You need to have a hand up, someone helping pull you up, and a hand down, to help someone else, he said.

So one of the first things they asked the students on the tour to do was network: Meet strangers at the school and learn how to cultivate mentors. The basement hall buzzed as teenagers with sparkly sneakers chatted with a Georgetown neuroscientist, an Army surgeon, a pediatrician and other professionals, as well as medical students, college students and parents. Its a pipeline, Matthews said, which is why the tour decided to add a day aimed at high school students to their college events.

Philippes questions included: Are all the years of college worth it? Is it rewarding? How can you help people, exactly? How do you feel when you help people? Everyone was easy to talk to, she said, and theyll lead you in the right direction.

Landry, Matthews and the other volunteers told the students on the tour that African Americans, Latinos and Native Americans are about 30 percent of the population but less than 6percent of the medical workforce. They said that racial and ethnic minorities are more likely to go to work in underserved communities and that sometimes cultural differences can be barriers to good care.

The high school students also learned about different fields of medicine. Medical students told them how to apply for admission, financial aid and scholarships, and doctors talked to them about preventing disease through diet and exercise.

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Tour for Diversity in Medicine stops at Georgetown to support students

Health law boosts status of alternative medicine — at least on paper

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Complementary and alternative medicine a term that encompasses meditation, acupuncture, chiropractic care and homeopathic treatment, among other things has become increasingly popular. About four in 10 adults and one in nine children in the U.S. are using some form of alternative medicine, according to the National Institutes of Health.

And with the Affordable Care Act, the field could make even more headway in the mainstream health care system. That is, unless the fine print in state legislation and insurance plans falls short because of unclear wording and insufficient oversight.

One clause of the health law in particular Section 2706 is widely discussed among providers of alternative medicine because it requires that insurance companies shall not discriminate against any health provider with a state-recognized license.

That means a licensed chiropractor treating a patient for back pain, for instance, must be reimbursed the same as a medical doctor. In addition, nods to alternative medicine are threaded through other parts of the law in sections on wellness, prevention and research.

But because under the health care law each state defines its essential benefits plan what is covered by insurance somewhat differently, the wording concerning alternative medicine has to be very specific in terms of who gets paid and for what kinds of treatment, said Deborah Senn, the former insurance commissioner in Washington and an advocate for coverage of alternative medicine.

For example, naturopathic care would not fall under the nondiscriminatory list in Missouri because the state does not recognize it as a licensed practice.

And even if a practice is licensed, that doesnt mean it will receive coverage, said Afua Bromley, a licensed acupuncturist at the Acupuncture St. Louis and Wellness Center.

Some people have the misconception that the (Affordable Care Act) means that acupuncture coverage will be mandated, and thats not the case, she said.

Insurance companies can still decide not to include acupuncture in their plans, so Bromley cannot bill an agency for acupuncture care if coverage isnt provided.

However, because shes licensed, Bromley will be able to bill insurance companies for office visits, just like a medical doctor can bill separately for an office visit, nutritional counseling, exams and more.

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Health law boosts status of alternative medicine — at least on paper

Chinese medicine cancer care hope

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28 September 2013 Last updated at 03:52 ET

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Prof Jiang said they found the Chinese medicine has a significant effect on cancer cells

Combining traditional forms of Chinese and Western medicine could offer new hope for developing new treatments for some cancers, say experts from universities in Cardiff and Peking.

Prof Wen Jiang from Cardiff University said they have discovered how a formula of traditional Chinese medicine works to stop cancer spreading.

The universities have been collaborating for two years.

Prof Jiang described the breakthrough as "ancient medicine, modern thinking".

Experts from the Cardiff School of Medicine joined forces with Peking University in 2012 to test the health benefits of the Chinese herbal medicine called Yangzheng Xiaoji.

Although a few successes, most of the traditional remedies are short of scientific explanation which has inevitably led to scepticism - especially amongst traditionalists in the West

The formula, consisting of 14 herbs, has previously been shown to be beneficial to cancer patients but until this latest research, the way in which it works had remained unknown.

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Chinese medicine cancer care hope