Potential Therapeutic Target Discovered For Cushing's Disease

Main Category: Cancer / Oncology
Also Included In: Neurology / Neuroscience;??Endocrinology
Article Date: 10 May 2013 - 0:00 PDT Current ratings for:
Potential Therapeutic Target Discovered For Cushing's Disease

Scientists at the Salk Institute for Biological Studies have identified a protein that drives the formation of pituitary tumors in Cushing's disease, a development that may give clinicians a therapeutic target to treat this potentially life-threatening disorder.

The protein, called TR4 (testicular orphan nuclear receptor 4), is one of the human body's 48 nuclear receptors, a class of proteins found in cells that are responsible for sensing hormones and, in response, regulating the expression of specific genes. Using a genome scan, the Salk team discovered that TR4 regulates a gene that produces adrenocorticotropic hormone (ACTH), which is overproduced by pituitary tumors in Cushing's disease (CD). The findings were published in the early online edition of Proceedings of the National Academy of Sciences.

"We were surprised by the scan, as TR4 and ACTH were not known to be functionally linked," says senior author Ronald M. Evans, a professor in Salk's Gene Expression Laboratory and a lead researcher in the Institute's Helmsley Center for Genomic Medicine. "TR4 is driving the growth and overexpression of ACTH. Targeting this pathway could therapeutically benefit treatment of CD."

In their study, Evans and his colleagues discovered that forced overexpression of TR4 in both human and mouse cells increased production of ACTH, cellular proliferation and tumor invasion rates. All of these events were reversed when TR4 expression was reduced.

First described more than 80 years ago, Cushing's disease is a rare disorder that is caused by pituitary tumors or excess growth of the pituitary gland located at the base of the brain. People with CD have too much ACTH, which stimulates the production and release of cortisol, a hormone that is normally produced during stressful situations.

While these pituitary tumors are almost always benign, they result in excess ACTH and cortisol secretion, which can result in various disabling symptoms, including diabetes, hypertension, osteoporosis, obesity and psychological disturbances. Surgical removal of the tumors is the first-line therapy, with remission rates of approximately 80 percent; however, the disease recurs in up to 25 percent of cases.

Drugs such as cabergoline, which is used to treat certain pituitary tumors, alone or in combination with ketoconazole, a drug normally used to treat fungal infections, have been shown to be effective in some patients with Cushing's disease. More recently, mefipristone-best known as the abortion pill RU-486-was approved by the FDA to treat CD. Despite these advances in medical therapy, the Salk scientists say additional therapeutic approaches are needed for CD.

"Pituitary tumors are extremely difficult to control," says Michael Downes, a senior staff scientist in the Gene Expression Laboratory and a co-author of the study. "To control them, you have to kill cells in the pituitary gland that are proliferating, which could prevent the production of a vital hormone."

Previous studies have found that, by itself, TR4 is a natural target for other signaling molecules in the pituitary. Small-molecule inhibitors that have been developed for other cancers could be potentially applied to disrupt this signaling cascade. "Our discovery," says Evans, a Howard Hughes Medical Institute investigator and holder of the March of Dimes Chair in Molecular and Developmental Biology, "might lead clinicians to an existing drug that could be used to treat Cushing's disease."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our cancer / oncology section for the latest news on this subject. Other researchers on the study were Li Du, Marvin Bergsneider, Leili Mirsadraei, Stephen H. Young, William H. Yong and Anthony P. Heaney of the David A. Geffen School of Medicine at the University of California, Los Angeles, and Johan W. Jonker of the University of Groningen.
The study was supported by the National Institutes of Health, the Leona M. and Harry B. Helmsley Charitable Trust, the Samuel Waxman Cancer Research Foundation, the Jonsson Comprehensive Cancer Center at UCLA, and Ipsen/Biomeasure.
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Identify the social needs of young people with Cancer

Main category: Cancer / Oncology
Also included in: Pediatrics / children's health;??Psychology / Psychiatry
Article date: May 13, 2013 - 1:00 PDT current ratings for:
Identify the social needs of young people with Cancer

Research done by Xiao Cheng Wu, MD, PhD, Associate Professor and Director of the tumor registry Louisiana at the LSU Health Sciences Center New Orleans School of Public Health and colleagues, reports adolescents and young adults with cancer may be at greater risk of social isolation and a proportion of them with unmet social needs that could harm their health.

The research is published online in the Journal of adolescent and young adult Oncology. More than 500 participants in teen and Young Adult Health Outcomes patient study experience (AYA HOPE) conducted a survey on 6-14 months after diagnosis including questions about two social information needs - how about their experience of cancer with family and friends and meet other teens or young adults cancer patients/survivors. Patients have been identified through seven Surveillance, Epidemiology and End results (SEER) program sites: the States of Iowa and Louisiana. the metropolitan areas of Detroit, Michigan and Seattle/Puget Sound, Washington; and three metropolitan areas in California: Los Angeles County, San Francisco/Oakland and Sacramento County. Participants were from 15 to 39 years at diagnosis and were diagnosed with cancer in this age group. The researchers examined variables such as the age at diagnosis, sex, ethnicity, education and status of health insurance at the time of diagnosis. They have studied the clinical factors, including treatment (radiation, chemotherapy and surgery), current overall health, the overall quality of care and the number of symptoms the previous month. Participants were invited on the global impact of their cancer on specific areas of their lives.

The research team found that the social information needs were higher among those who were in their twenties at the time of diagnosis - with 25% of statement needing help to talk about their cancer. About 43% of those Hispanics or 'other' ethnic group expressed the need to meet survivors peer. Those who were not in support of the group, had a large number of symptoms or other diseases, as well as the low perceived quality of care also need more help.

"Our results identify subgroups of teenagers and young adults who most need additional social support and suggest targets for clinical intervention," notes Dr. Wu.

Research has shown that cancer may limit the ability of these young patients at your new or maintain relations both in their development when homologous binding is the norm. Even when the patient support network is strong, current friends may not be able to meet the psychosocial needs because they do not understand the problems that come with a cancer diagnosis and treatment, further isolating the patient. Existing resources can be unknown, out of their financial reach, or unsuitable for these young people.

Proposed actions include the development of capable support programs for different phases of the cancer experience of providing services for a diverse age group, overcome geographical and financial barriers and lack of cultural diversity in the offerings, but also to increase awareness and access to support groups peer with other cancer patients and survivors. Improve awareness and access to a connection online through social media, as well as assistance to learn to share their experiences with their loved ones would also support support. The researchers say that the development of communication tools specifically for them can help these young patients express their needs and gain emotional relatives and friends support. It is also important to awareness of health and other professionals to these resources.

"With very little research in this area, understand what subgroups of the adolescent and young adult cancer patients have the most need and what they perceive their greatest must be is extremely important to adapt the interventions and programmes of support for them," note Dr. Wu, who leads one of the 18 cancer registries in the SEER registries are designated by the National Cancer Institute in the United States.

Article adapted by Medical News Today press release original. Click on "references" tab above for the source.
Visit our cancer / Oncology section for the latest news on this subject. In addition to Mr. Wu at the LSU Health Sciences Center New Orleans School of Public Health, other authors of the AYA hope study Collaborative Group: researchers from the National Cancer Institute, Cancer Prevention Institute of California, Stanford University School of Medicine, University of Iowa, University of Southern California Keck School of medicine, Wayne State University School of Medicine, and Fred Hutchinson Cancer Research Center.
The study was funded by the National Cancer Institute, with the support of the Lance Armstrong Foundation.
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Chemists Demonstrate Nanoscale Alloys So Bright They Could Have Potential Medical Applications

Main Category: Medical Devices / Diagnostics
Also Included In: Cancer / Oncology
Article Date: 16 May 2013 - 0:00 PDT Current ratings for:
Chemists Demonstrate Nanoscale Alloys So Bright They Could Have Potential Medical Applications

Alloys like bronze and steel have been transformational for centuries, yielding top-of-the-line machines necessary for industry. As scientists move toward nanotechnology, however, the focus has shifted toward creating alloys at the nanometer scale - producing materials with properties unlike their predecessors.

Now, research at the University of Pittsburgh demonstrates that nanometer-scale alloys possess the ability to emit light so bright they could have potential applications in medicine. The findings have been published in the Journal of the American Chemical Society.

"We demonstrate alloys that are some of the brightest, near-infrared-light-emitting species known to date. They are 100 times brighter than what's being used now," said Jill Millstone, principal investigator of the study and assistant professor of chemistry in Pitt's Kenneth P. Dietrich School of Arts and Sciences. "Think about a particle that will not only help researchers detect cancer sooner but be used to treat the tumor, too."

In the paper, Millstone presents alloys with drastically different properties than before - including near-infrared (NIR) light emission - depending on their size, shape, and surface chemistry. NIR is an important region of the light spectrum and is integral to technology found in science and medical settings, said Millstone. She uses a laser pointer as an example.

"If you put your finger over a red laser [which is close to the NIR light region of the spectrum], you'll see the red light shine through. However, if you do the same with a green laser [light in the visible region of the spectrum], your finger will completely block it," said Millstone. "This example shows how the body can absorb visible light well but doesn't absorb red light as well. That means that using NIR emitters to visualize cells and, ultimately parts of the body, is promising for minimally invasive diagnostics."

In addition, Millstone's demonstration is unique in that she was able to show - for the first time - a continuously tunable composition for nanoparticle alloys; this means the ratio of materials can be altered based on need. In traditional metallurgical studies, materials such as steels can be highly tailored toward the application, say, for an airplane wing versus a cooking pot. However, alloys at the nanoscale follow different rules, says Millstone. Because the nanoparticles are so small, the components often don't stay together and instead quickly separate, like oil and vinegar. In her paper, Millstone describes using small organic molecules to "glue" an alloy in place, so that the two components stay mixed. This strategy led to the discovery of NIR luminescence and also paves the way for other types of nanoparticle alloys that are useful not only in imaging, but in applications like catalysis for the industrial-scale conversion of fossil fuels into fine chemicals.

Millstone says that taken together these observations provide a new platform to investigate the structural origins of small metal nanoparticles' photoluminescence and of alloy formation in general. She believes these studies should lead directly to applications in such areas of national need as health and energy.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our medical devices / diagnostics section for the latest news on this subject. The paper, “Photoluminescent Gold-Copper Nanoparticle Alloys with Composition-Tunable Near-Infrared Emission,” first appeared online April 3 and later in print April 10 in JACS (Journal of the American Chemical Society). Funding was provided by the University’s Central Research Development Fund and administered by Pitt’s Office of Research and University Research Council.
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Exercise Lowers Risk Of Lung And Colorectal Cancer Among Middle Aged Men

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Academic Journal
Main Category: Prostate / Prostate Cancer
Also Included In: Cardiovascular / Cardiology;??Cancer / Oncology;??Sports Medicine / Fitness
Article Date: 17 May 2013 - 0:00 PDT Current ratings for:
Exercise Lowers Risk Of Lung And Colorectal Cancer Among Middle Aged Men

New research conducted by researchers at the University of Vermont reveals that middle-aged men who engage in a lot of cardiovascular exercise are at a reduced risk of suffering from lung and colorectal cancer. In addition, those who exercise are less likely to die from prostate cancer (although their risk of contracting the disease remained the same).

According to the lead author of the study, Susan Lakoski, MD, assistant professor of medicine at the University of Vermont:

"While poor fitness is already known to predict future cardiovascular disease, this is the first study to explore fitness as a marker of future cancer risk prognosis.

This finding makes it clear that patients should be advised that they need to achieve a certain fitness level, and not just be told that they need to exercise. And unlike exercise behavior, which relies on patient self-reporting, fitness can be objectively and accurately measured in a clinical setting."

A total of 17,049 men participated in the study. They each received a cardiovascular fitness assessment from the Cooper Institute at a median age of 50. The test involved walking on a treadmill with a variation of different speeds and elevations. They recorded the men's performance with the ratio of metabolic rate (the rate of energy consumption), known as metabolic equivalents or METs.

The team divided the participants into different groups based on their level of fitness. The researchers then analyzed their medical histories to determine whether they had developed either lung, colorectal, or prostate cancer.

In this study, men who were in their 40s who achieved 13.5 minutes in the fitness test belonged to the lowest quintile for fitness as well as men in their 50s who achieved less than 11 minutes.

During the follow-up period of 20 to 25 years, a total of 2,332 men were diagnosed with prostate cancer, 277 were diagnosed with lung cancer and 276 were diagnosed with colorectal cancer.

They adjusted the results of the study for factors such as BMI, smoking habits and age.

The risk of lung or colorectal cancer decreased by 68 and 38 percent among men who were the most physically fit and active compared to those who were not active at all.

The researchers found that physical activity did not have any effect on the rate of prostate cancer diagnosis.

Although it's been shown that exercise can reduce the risk of dying from prostate cancer. Previous research has indicated that men with prostate cancer who exercise vigorously have a notably reduced risk of dying from the disease compared to other diagnosed men.

Men who were physically fit at the time they developed cancer had a much higher survival rate and lower risk of dying from the cancers compared to men who were not fit. In fact, a 1MET increase in fitness was associated with a 14 percent reduced risk of dying from the cancer, as well as a 23 percent reduced risk of dying from cardiovascular disease.

In addition, the researchers noted that patients who weren't fit yet not obese were still at an increased risk of cardiovascular disease (CVD), suggesting that people should be aware that fitness also impacts risk.

Exercise has been shown to have huge beneficial effects on people diagnosed with cancer and it's also been found to help minimize the risk recurrence, or another cancer developing.

ASCO President Sandra M. Swain, said:"This important study establishes cardiorespiratory fitness as an independent and strong predictor of cancer risk and prognosis in men. While more research is needed to determine if similar trends are alid in relation to other cancers and among women, these results indicate that people can reduce their risk of cancer with relatively small lifestyle changes."

Written by Joseph Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our prostate / prostate cancer section for the latest news on this subject. "Cardiorespiratory fitness and risk of cancer incidence and cause-specific mortality following a cancer diagnosis in men: The Cooper Center longitudinal study."
Susan G. Lakoski, Carolyn Barlow, Ang Gao, Laura DeFina, Nina Radford, Steve Farrell, Benjamin Willis, Jeffrey M. Peppercorn, Pamela S. Douglas, Jarett Berry, Lee Jones
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Analysis Shows Cancer Biorepository Speeds Clinical Trials, Drug Development

Main Category: Cancer / Oncology
Also Included In: Clinical Trials / Drug Trials;??Pharma Industry / Biotech Industry
Article Date: 10 May 2013 - 1:00 PDT Current ratings for:
Analysis Shows Cancer Biorepository Speeds Clinical Trials, Drug Development

Researchers at Moffitt Cancer Center say identifying and selecting participants for phase II cancer clinical trials from a centralized warehouse of patient-donated biological data expedites participant accrual, reduces trial size, saves money, and may speed test drugs through the drug development pipeline.

Their study, which analyzed datasets from recent clinical trials conducted at Moffitt, was published online recently in Statistical Methods in Medical Research.

Launched at Moffitt in 2005, Total Cancer CareR is a comprehensive approach to cancer that enables physicians, researchers and caregivers to identify and meet all the needs of a patient and their family during the patient's lifetime and for future generations. At the heart of this approach is the Total Cancer CareR Protocol, which allows patients at Moffitt and its partner institutions to donate excess tumor tissue and biological samples for research. The samples are analyzed for biomarkers and other unique qualities and stored in a biorepository for study. Researchers can also use the information to quickly identify potential candidates for clinical trials based on a patient's biological and molecular profiles.

Total Cancer CareR enables evidence-based cancer care and helps usher in an era of personalized medicine, a concept the National Institutes of Health has invested in heavily. The authors also note that the National Cancer Institute has funded efforts to develop information and biospecimen infrastructure projects.

Efforts to discover biomarkers for disease and the identification of genetic signatures that can guide treatment selection are driving efforts to create patient biorepositiories. And the future of molecular-based, personalized medicine will uncover new innovations, adding to the body of information available for designing clinical trials, the authors said.

Unlike Moffitt, few institutions have established the infrastructure necessary for the systematic collection and maintenance of biosamples, related molecular analysis, electronic medical records and other data from their patient populations, said study co-author Benjamin M. Craig, Ph.D., associate member of Moffitt's Health Outcomes and Behavior Program.

"By taking a systems approach, biomarker and genetic profile information not only enables personalized medicine, but also promotes comparative effectiveness research," Craig said. "The contribution of a data warehouse that integrates clinical, biospecimen and molecular data for conducting clinical trials is essential for making good decisions about resource allocation."

By conducting a "value of information" study on the effectiveness of data warehousing in conducting phase II clinical trials, the authors found that patient accrual for trials was quicker when using data from the Moffitt biorepository. They also found that fewer patients needed to be enrolled in a study and that the amount of information recovered was equal to the amount of information gleaned from trials with greater numbers of participants.

"Our study provides evidence that programs, such as the Total Cancer CareR Protocol, that follow patients and collect clinical data for storage in a common warehouse can reduce the number of patients needed for a clinical trial without compromising the results of the study," said study lead author David Fenstermacher, Ph.D., chair of the Biomedical Informatics Department at Moffitt. "Another positive impact of using the biorepository for clinical trial participation is that phase II trials that test new cancer treatments being developed by the pharmaceutical industry move more quickly and cost less."

According to the authors, the effective assessment of new molecular-targeted therapies for tumors will be an essential part of stratified clinical trials design as trials become smaller, shorter, cheaper and more individualized. They also suggested that the development of new, molecular-targeted treatments will require the use of clinical, molecular and biospecimen data generated from the point of care.

Their analysis of the effectiveness of the Total Cancer CareR Protocol, through which more than 96,000 patients have consented to donate tissue samples and clinical data for biowarehousing and analysis has shown the benefit to those conducting clinical trials and the patients participating.

"The knowledge gained from our study and other studies under way at Moffitt are providing the foundation for creating the next generation of data management infrastructure to support personalized medicine," Fenstermacher said. "As these resources mature, data assessment strategies, such as 'value of information' studies, will be imperative to understand how data can be used to enhance patient care and improve treatment outcomes through evidence-based guidelines."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our cancer / oncology section for the latest news on this subject. The study was funded by National Cancer Institute grants 5K25CA122176 and 5UC2CA148332.
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Molecular Profiling Timely For Tailoring Cancer Therapy

Main Category: Cancer / Oncology
Also Included In: Genetics
Article Date: 17 May 2013 - 0:00 PDT Current ratings for:
Molecular Profiling Timely For Tailoring Cancer Therapy

A clinical trial has shown that patients, and their physicians, are eager to jump into next-era cancer care - analysis of an individual's tumor to find and target genetic mutations that drive the cancer. Results of the study, CUSTOM, are being presented at the 2013 annual meeting of the American Society of Clinical Oncology* years before investigators thought they would be ready.

CUSTOM is the first completed prospective clinical trial that used genetic analysis alone to assign cancer treatment for patients with one of three different cancers.

"We expected it would take five years to enroll 600 patients into CUSTOM. But in less than two years, 668 patients were recruited," says the study's lead investigator, Giuseppe Giaccone, MD, PhD, associate director for clinical research at Georgetown Lombardi Comprehensive Cancer Center.

"This was a surprise to all of us, especially since patients with advanced cancer who already had biopsies needed to undergo an additional biopsy for the study. But we found patients and their doctors are quite interested in this type of personalized medicine. They know that the molecular profile of the tumor is important," says Giaconne, who is also director of clinical research for the MedStar Georgetown Cancer Network, a regional oncology affiliation between MedStar Health and Georgetown Lombardi.

CUSTOM has proved to be a model for more efficient clinical trials, he adds. It showed that patients want to participate in this kind of research, and that it is feasible to do extensive genetic testing on a tumor biopsy in a timely manner - in this case, taking only two weeks to complete. It also demonstrated that it is safe to take new biopsy from patients with advanced cancer to provide the tissue needed for the analysis.

One of the other endpoints of the study, however, was not achieved. Researchers discovered that, in many cases, they did not have enough patients with rare cancer mutations to provide an accurate statistical analysis of response to novel drugs, says Giaccone.

Giaccone led the clinical trial while at the National Cancer Institute where he was the Chief of the Medical Oncology Branch, before he joined Georgetown in January. Researchers at Oregon Health & Science University also participated.

CUSTOM enrolled patients diagnosed with advanced stage non-small cell lung cancer, small cell lung cancer or thymic cancer. Researchers used next-generation sequencing, which was novel at the time, to look at almost 200 genes. From this, patients were assigned to different treatment groups based on genetic mutations or amplification.

Results from the largest group - patients with non-small cell lung cancer - had either an EGFR or a KRAS mutation, and results showed that those with EGFR mutations had a very high response to the drug erlotinib. "This is nothing new; we essentially confirmed what was already known," Giaccone says. But they also discovered that patients with KRAS mutations did not benefit from the single agent investigational drug selumetinib, which is being studied for use in a number of cancers, including non-small cell lung cancer.

Results for the patients with small cell lung or thymic cancers were inconclusive, primarily because the investigated mutations were rare -not enough patients had specific mutations to adequately test response to therapy. "When we started the study, we didn't know how frequently the mutations occurred," Giaccone says. "Now we know that many mutations represent only 1 to 2 percent of patients and to do this right, you need to screen thousands of patients. That is only possible with a global study that involves, potentially, hundreds of institutions.

"The CUSTOM trial demonstrates both the feasibility of the approach for common mutations - that it is possible to have a real-time genetic analysis that guides treatment - as well as the difficulty of studying treatment for rare mutations," he says.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our cancer / oncology section for the latest news on this subject. ASCO Annual Meeting: May 31-June 4, 2013 | McCormick Place | Chicago, Illinois

The Intramural Program of the National Cancer Institute funded the study. Giaccone reports having no personal financial interests related to the study.

Georgetown University Medical Center

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Blocking The Protein-Protein Interaction Which Causes Ewing Sarcoma

Main Category: Cancer / Oncology
Also Included In: Genetics
Article Date: 17 May 2013 - 0:00 PDT Current ratings for:
Blocking The Protein-Protein Interaction Which Causes Ewing Sarcoma

Continuous infusion of a novel agent not only halted the progression of Ewing sarcoma in rats, while some tumors also regressed to the point that cancer cells could not be detected microscopically, say researchers at Georgetown Lombardi Comprehensive Cancer Center. Their study, which will be presented at the 2013 annual meeting of the American Society of Clinical Oncology*, provides pre-clinical evidence necessary to initiate a clinical trial.

"This agent has the potential to be more effective, and considerably less toxic, than the current drugs now used to treat this rare cancer," says the study's lead investigator, Jeffrey Toretsky, MD, a pediatric oncologist and researcher at Georgetown Lombardi, part of Georgetown University Medical Center.

The agent, (S)-YK-4-279, was developed by Toretsky and his colleagues, including scientists in GUMC's Center for Drug Discovery. Based on early promising studies of the compound, Toretsky established TDP Biotherapeutics, Inc. to manufacture the agent. Toretsky says TDP Biotherapeutics, Inc. is preparing a U.S. Food and Drug Administration (FDA) investigational new drug (IND) application for (S)-YK-4-279 so that a clinical trial can be initiated.

In the United States, about 500 children and young adults are diagnosed with the cancer annually, and they are treated with a combination of five different chemotherapy drugs. Between 60 to 70 percent of patients survive more than five years, but with many late effects from therapy. Few treatments lead to a cure for patients whose cancer progresses, Toretsky says.

Ewing sarcoma is caused by the exchange of DNA between two chromosomes. The resulting EWSR1-FLI1 gene produces a fusion protein, EWS-FLI1, responsible for development of the cancer. In 2006, Toretsky and his team discovered that the fusion protein binds to another protein, RNA helicase A (RHA), which is important for cancer progression.

The (S)-YK-4-279 agent they developed is considered unique because it stops the two proteins - EWS-FLI1 and RHA - from interacting. "Scientists have long thought it impossible to block protein-protein interaction because the surface of these proteins are too slippery and flexible for a drug to bind to," Toretsky says. "Our agent challenges that conventional thinking."

To test the agent, the researchers developed a rat model of Ewing sarcoma and figured out how to deliver a continuous drip of the drug to the animals. "We found that cancer cells need a continuous exposure at low concentrations for the drug to be of maximum effectiveness," Toretsky says. "And this strategy works extremely well in these animal models. The drug appears to be very successful."

Toretsky is an inventor on a patent application that has been filed by Georgetown University related to the technology described. He has an ownership interest in TDP Biotherapeutics, to which the technology has been licensed for research and development.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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The FDA has granted the TDP Biotherapeutics company orphan drug status (Orphan Drug Act), which qualifies the sponsor of a product to receive tax credit and marketing incentives. The study was funded by a grant from the National Cancer Institute (RC4 CA156509) issued under the American Recovery and Reinvestment Act (R01CA138212).

Georgetown University Medical Center

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