Tag: Survival

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New Remedy for Aggressive Prostate Most cancers Improves Survival

New Therapy for Aggressive Prostate Cancer Improves Survival

An experimental therapy has prolonged life in men with aggressive prostate cancer that has resisted other treatments, offering new hope to patients with advanced illness and opening the door to a promising new form of cancer therapy.

Among men who received the new therapy, there was a nearly 40 percent reduction in deaths over the course of the clinical trial, compared with similar patients who received only standard treatment, researchers reported on Wednesday.

Prostate cancer is the second-leading cause of cancer death among American men, after lung cancer; an estimated 34,130 men will die of prostate cancer this year. One in eight men will be diagnosed with the disease at some point in their lives. The risk increases with age, and the cancer is more common in Black men.

The new treatment relies on a radioactive molecule to target a protein found on the surface of prostate cancer cells. The study, which followed 831 patients with advanced disease in 10 countries for a median period of 20 months, was published in The New England Journal of Medicine.

“This is something new — you’re driving radiation right to the cancer itself,” said Karen Knudsen, president and chief executive of the American Cancer Society. “It’s a much more sophisticated strategy for targeting the tumor.”

“You’re not just destroying the cancer cells — you’re smart-bombing the place that the tumor has found for itself to live.”

There is no definitive cure for metastatic prostate cancer, and there is an urgent need for new therapies, Dr. Knudsen said. Most life-extending treatments rely on suppressing or blocking androgens, the male hormones that fuel prostate cancer.

“This opens the door to precision radiotherapy targeted at other molecules that are on the surface of other cancer cells,” said Dr. Philip Kantoff, chairman of medicine at Memorial Sloan Kettering Cancer Center in New York.

The investigational treatment, called lutetium-177-PSMA-617, combines a compound that targets a protein on the surface of prostate cancer cells, called prostate-specific membrane antigen, or P.S.M.A., with a radioactive particle that attacks the cells.

The P.S.M.A. protein, which can be detected by imaging scans, is almost exclusively on prostate cancer cells, and so the treatment causes less damage to surrounding tissue, said Dr. Oliver Sartor, the trial’s co-principal investigator and medical director of Tulane Cancer Center in New Orleans.

Though the protein is not ubiquitous in prostate tumors, it is found in more than 80 percent of cases. Among patients screened for the trial, 87 percent were P.S.M.A.-positive. Only those men who were positive for the marker were included in the trial.

The study enrolled men with a form of metastatic prostate cancer called castration-resistant prostate cancer. All the patients had disease that progressed despite treatments with chemotherapy and hormonal therapy to suppress and block androgens.

Participants were randomly assigned to receive the experimental treatment, given every six weeks in up to six doses along with standard treatment, or to continue standard care alone, but without chemotherapy or other isotopes.

After a median follow-up period of 20.9 months, patients given the experimental treatment survived for a median of 15.3 months, compared with 11.3 months for those who received only standard care, a reduction of 38 percent.

Their tumors were more likely to shrink, their prostate-specific antigen levels were more likely to fall, and the risk of their cancer progressing was reduced by 60 percent.

Side effects — most commonly fatigue, dry mouth and nausea — were more prevalent among those receiving the compound than among those who did not, but did not appear to significantly affect quality of life, the researchers said.

The study had some limitations. It was a randomized trial, but because of the difficulties of running a double-blinded trial with a radioactive treatment, the trial was open-label: Both patients and physicians knew whether or not they were getting the treatment. That caused some problems early on, as patients who were disappointed by their assignment withdrew from the trial.

The investigational drug worked where other approaches had failed, Dr. Sartor emphasized. “These patients had received essentially all the available therapies,” he said. “This is the first drug targeted to the tumor that actually results in overall survival benefit among incredibly, heavily pretreated patients.”

Dr. Sartor was a co-principal investigator of the trial, along with Dr. Bernd Krause, of Rostock University Medical Center in Germany. The trial was sponsored by Endocyte Inc. and Advanced Accelerator Applications, which are Novartis companies; Dr. Sartor is a paid consultant to the company. The data were analyzed by the sponsor and provided confidentially to the authors.

Officials with Novartis said the company will apply to the Food and Drug Administration for approval of the new treatment later this year.

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Aspirin doesn’t enhance survival for Covid sufferers: UK research

Aspirin does not improve survival for Covid patients: UK study

A patient suffering from COVID-19 will be treated on May 20th, 2021 in the intensive care unit (ICU) of the Darmstadt Clinic in Darmstadt.

Kai Pfaffenbach | Reuters

LONDON – The cheap and widely available drug aspirin does not improve the survival of patients hospitalized with Covid-19, a UK study found.

Oxford University researchers had hoped the blood-thinning drug could help hospitalized Covid-19 patients who are at increased risk of blood clots forming in their blood vessels, particularly in the lungs, but found that aspirin was not helped prevent deaths.

On the study – part of a larger “RECOVERY” study that looked at various possible treatments for people hospitalized with coronavirus, nearly 15,000 patients were hospitalized with the virus. About half of the patients received 150 mg of aspirin daily compared to the other half who received only the usual treatment.

The study found that “there was no evidence that aspirin treatment reduced mortality” and “no significant difference” in the number of people who died, with 17% of people in both groups dying after 28 days in the hospital.

“The data shows that aspirin was not associated with a reduction in 28-day mortality or the risk of progression to invasive mechanical ventilation or death in patients hospitalized with Covid-19,” said Peter Horby , Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine at the University of Oxford and lead investigator of the RECOVERY study, said the study.

“While aspirin was associated with a slightly increased chance of a live discharge, that does not appear to be enough to justify its widespread use in patients hospitalized with Covid-19.”

Martin Landray, professor of medicine and epidemiology in the Nuffield Department of Population Health at the University of Oxford and a lead researcher on the study, described the results as “disappointing”.

“There was strong evidence that blood clotting could be responsible for deterioration in lung function and death in patients with severe Covid-19. Aspirin is inexpensive and is often used in other illnesses to reduce the risk of blood clots, so it is disappointing that it did. ”Did not have much of an impact on these patients. That’s why large randomized trials are so important – to find out which treatments work and which don’t. “

The RECOVERY study has already made several life-saving discoveries, including that dexamethasone, a cheap and widely used steroid, was able to save lives in seriously ill Covid-19 patients.

The results of the latest aspirin study will be published shortly on the pre-print site medRxiv and have been submitted to a leading peer-reviewed medical journal.

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Crimson Knots in Steepest Decline in Years, Threatening the Species’ Survival

Red Knots in Steepest Decline in Years, Threatening the Species’ Survival

The number of red knots visiting the beaches of Delaware Bay during this spring’s north migration unexpectedly dropped to its lowest level since counts began nearly 40 years ago, adding to concerns about the survival of the shorebird and a sharp setback for a quarter of a century his efforts meant to save him.

Conservationists found fewer than 7,000 of the bird’s rufa subspecies in extensive land, air and water counts on the New Jersey and Delaware side in May. The number is about a third of that found in 2020; less than a quarter of the level for the past two years; and the lowest since the early 1980s when the population was around 90,000.

The numbers were already well below the level that would ensure the bird’s survival. A previous decline had been halted by years of conservation efforts, including a New Jersey ban on harvesting horseshoe crabs, the eggs of which provide essential nourishment for birds on their long-distance migrations.

The recent decline is making the Rufa subspecies – which has been endangered at the federal level since 2014 – even more susceptible to external shocks such as bad weather in their Arctic breeding areas and bringing them closer to extinction, say naturalists.

“I think we need to think about the red knot as a dying species, and we really need immediate action,” said Joanna Burger, a biologist at Rutgers University. Since the early 1980s, she has been studying the knot and other deciduous shorebirds such as ruddy turnstone and semi-palmate sandpipers in Delaware Bay.

She called for an immediate ban on the fishing of horseshoe crabs as bait, an industry that still operates in Delaware, Maryland and Virginia and is subject to quotas from the Atlantic States Marine Fisheries Commission. Although regulators do not allow female crabs to be harvested, naturalists say the rule will not be strictly enforced, resulting in the loss of some of the egg-laying animals and a consequent reduction in the birds’ food supply.

The recent decline also fueled calls by naturalists to urge the pharmaceutical industry to stop using LAL, an extract from the blood of crabs used to detect bacteria in vaccines, drugs and medical devices. A synthetic alternative, rFC, is available and used by at least one pharmaceutical company, but the industry as a whole has been slow to embrace the new technique, resulting in continued demand for horseshoe crabs in the bay.

Although the crabs are returned to the sea after bleeding, conservationists believe that up to a third will die or be unable to reproduce. Ironically, there were plenty of crab eggs to eat on the beaches of the bay this year, but a long-term decline in egg availability has severely dented the bird population and thinned any cushion that would allow the species to survive natural hazards.

Larry Niles, an independent wildlife biologist who has trapped, monitored, and counted shorebirds on New Jersey’s bay beaches for the past 25 years, said he expected this year’s red knots to decline as there was evidence of a bad breeding season in season 2020 but shocked at the size of the decline.

He said it was likely due to low sea temperatures in the mid-Atlantic during the 2020 migration. The cold water delayed spawning of the horseshoe crabs until early June, when the birds had already left Delaware Bay to complete their migration.

Many of the birds, weighing just 4.7 ounces when fully grown, are emaciated after flying from Tierra del Fuego in southern Argentina on one of the longest bird migrations. Some fly non-stop for seven days before reaching Delaware Bay, where they usually stay for about two weeks to rest and gain weight.

But last year many could not find food in the bay and continued north to reach their breeding grounds. Dr. Niles estimates that about 40 percent of migrants died in the last year before reaching the Arctic simply because they ran out of energy.

In that year he also blamed the predation by peregrine falcons, whose growing coastal population was supported by the construction of nesting platforms in New Jersey. They often hunt over the beaches of the bay, making it harder for flocks of shorebirds to feed and gain weight.

The best hope for the species’ survival lies in a complete ban on harvesting female horseshoe crabs until the crab population has recovered, said Dr. Niles.

“Rufa nodes, especially red long-haul nodes, could be lost,” he said in a message to supporters. “We can’t stop bad winds or cold water, but we can increase the horseshoe crab population so that birds that arrive in most of these conditions will find an abundance of horseshoe crab eggs.”

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What My Father’s Covid Survival Taught Me About Safety

What My Father’s Covid Survival Taught Me About Security

My father protects his livelihood but is by nature invisible. For more than two decades he watched the halls of a shopping mall in Koreatown, Los Angeles, as a security guard. The square is a three-story building with salmon-colored walls and a distinctive glass skylight. It is a community landmark for Korean immigrants who have survived financial insecurities, language barriers and other problems with uncharted territory in a strange place. In 1997 my father went there looking for a job. Our family had just arrived from the Philippines and he needed to anchor our landing on a steady income. As an electrician with no experience in safety work, he was immediately hired. Over time, he found purpose in securing his new life, family, and mall.

As a kid, I loved walking in the square to look at foreign goods that made me feel at home: copper bowls that can hold an ocean of stews, K-pop tunes on imported speakers, red bean cookies that bulge like clouds is. I loved to watch my father during his patrols. It was a rare glimpse into his full expression of himself temporarily unrelated to fatherhood. He chased shoplifters a few times a year. He once rescued a shopkeeper who suffered a concussion after a faulty metal grate fell on him while he was closing his booth. My father played peacemakers and tempered business rivalries he barely understood. But as he grew into his job, it made him small. He hardly earned a minimum wage. Buyers passed him, unaffected by his presence. As I got older, it hurt to see him as a silhouette of myself, faceless.

Like him, I took on a profession that was about safety, but there was a great gap between his and my work. I explored one of the most violent forms of destruction invented by human hands: nuclear weapons. I armed myself with the power of speeches and textbooks, political memos and conferences to convince governments to secure nuclear facilities and practice arms control. I envisioned my work to prevent a hypothetical terrorist from building a dirty bomb or an unpredictable politician from threatening nuclear war. Security became a complicated patchwork of policies and diplomatic agreements, all of which in theory would save them from nuclear annihilation. “Everyone” is vaguely defined, but it sounds impressive.

I felt my father’s pride in my career, but we lacked the language to express the depth of our working lives. Over the years we remained silent, convinced that if we talked we would pass each other. It never occurred to me to associate what I do with my father’s work or mine.