'Belly fat' linked to development of asthma

Belly fat, known clinically as central obesity, has been linked to the development of asthma in a new study. The findings, presented at the European Respiratory Society's Annual Congress in Amsterdam, have shown central obesity as a risk factor for the disease.
Excess abdominal fat has been linked with a number of health effects, such as diabetes and heart disease, but there has been little focus on its link with lung disease.
Previous studies have found a link between asthma and body mass index (BMI), which is a marker for overall obesity. This new study looked at waist circumference, which is a marker for central obesity, to see whether this form of obesity could also contribute to asthma risk. The research is one of the first prospective studies to investigate the individual and combined effect of central and overall obesity on incident asthma in adults.
Researchers followed 23,245 adults without asthma, aged 19-55 years from the second Norwegian Nord-Trondelag Health Study (HUNT), for 11 years. The participants had their BMI measured along with their waist circumference to test overall obesity and central obesity, respectively. They were also asked to report incidence of asthma.
The results showed that people who were centrally obese but not overall obese were 1.44-times more likely to develop asthma. Additionally, people who were both centrally obese and obese overall were 1.81-times more likely to develop asthma.
Ben Brumpton, from the Norwegian University of Science and Technology, said: "Asthma can affect people of all sizes, but our study has highlighted both the individual and combined effect of central obesity and overall obesity on asthma development. Both these measures have an individual impact on asthma and an additive effect when they are combined.
It is not yet clear why this association exists. Central obesity is closely associated with insulin resistance and metabolic syndrome. These factors may play important roles concerning central obesity-related asthma. We will evaluate the effects of these factors on the development of asthma in future studies."

*Source: European Lung Foundation

El mejor antivirus está en el hígado del tiburón

La aleta del tiburón tan codiciada en Asia, podría quedar relegada a un segundo plano si los orientales reciben de buen grado los beneficios descubiertos en el hígado de los escualos. Porque, según científicos de la Universidad de Georgetown de Washington (EE UU), la escualamina (sustancia producida en este órgano) podría ayudar a combatir virus como la hepatitis o la fiebre amarilla.

No es nuevo. A principios de los 90 esta sustancia ya era conocida por sus propiedades anticancerígenas y sus beneficios en el tratamiento de dolencias oculares. Pero el trabajo estadounidense que publica ahora la revista «Proceedings of the National Academy of Sciences» es el primero en el que se ha analizado minuciosamente su posible impacto contra algunos virus. Los investigadores descubrieron que la escualamina logró frenar la progresión de infecciones virales en animales (roedores) y en algunos casos logró curarlas.

Así, observaron su capacidad de proteger a las células contra el dengue o la hepatitis B y D. Michael Zasloff, director del Instituto de Trasplante de la Universidad de Georgetown cree que «la escualamina pertenece a una familia de compuestos que protegen de ciertos virus a los tiburones y a otros vertebrados “primitivos” del océano, como la lamprea de mar». El experto matiza que esta sustancia «protege frente virus que atacan el hígado y el tejido sanguíneo, ya que solamente es capaz de entrar en ciertas células, como arterias, venas, capilares y las células hepáticas».

Aconsejan ingerir antitumorales con «el estómago lleno»

La tendencia de recomendar a los pacientes con cáncer que tomen sus fármacos orales en ayunas, aumenta el riesgo de sobredosis y los fuerza «a tirar por el retrete costosas medicinas». Así lo asegura Mark Ratain, director del Centro de terapias personalizadas en la Universidad de Medicina de Chicago (EE UU). Y así lo ha reflejado en el «Journal of Clinical Oncology».
El investigador afirma que tomar la medicación en las comidas «podría ser más seguro, eficaz y económicamente más eficiente, si estudiaran bien los fármacos que se absorben mejor con la comida. En vez de tomar altas dosis con el estómago vacío –que es como se administran la mayoría– sería mejor tomar cantidades menores con algo en el estómago».
Por su parte, la farmacéutica Patricia Brañas García, explica que «cada medicamento tiene un pH de absorción óptimo para lograr su máxima biodisponibilidad en el organismo. Existen ciertos fármacos para los que el pH o algunos alimentos tomados conjuntamente apenas afecta, pero para otros es crítico, como ocurre con los antitumorales. Su índice terapéutico (diferencia entre la concentración en sangre necesaria para obtener el efecto y los niveles tóxicos) es tan estrecho que ligeras variaciones en la absorción a nivel gastrointestinal condicionan el éxito o la toxicidad». Para cada fármaco, «habría que estudiar la dosis en presencia o no de alimento. Y en este tipo de fármacos sería recomendable escoger la que fuese menor», explica Brañas. Así «obtendremos menos efectos indeseables derivados del metabolismo de estas moléculas», concluye la experta.

**Publicado en "LA RAZON"

Abiraterone acetate improves fatigue in prostate cancer patients, says international clinical trial

Men with prostate cancer that has spread to other parts of the body and that is resistant to hormone therapy suffer less from fatigue if they are treated with a combination of abiraterone acetate and prednisone, according to results from a phase III clinical trial presented today.
Dr Cora Sternberg told the 2011 European Multidisciplinary Cancer Congress, in Stockholm today, that the significant improvements in fatigue were important for this group of difficult-to-treat patients who had few available therapeutic options.
"Metastatic castration-resistant prostate cancer is cancer that has spread from the prostate and that develops resistance to therapies targeting the male sex hormones such as androgen that drive the cancer’s growth. It is a chronic, progressive disease and, until now, men have few treatment options and poor prognosis. If treatment with androgen deprivation and docetaxel chemotherapy fails, then the average survival is only around 18-19 months," said Dr Sternberg, head of the Department of Medical Oncology at the San Camillo and Forlanini Hospitals in Rome, Italy.
"One of the most distressing issues these metastatic castration-resistant prostate cancer patients face during hormone treatment is extreme fatigue. Our results show that abiraterone acetate therapy has the potential to reduce cancer-related fatigue in this patient population, in addition to the previously demonstrated survival benefit," she said.
Abiraterone acetate (ZYTIGA™) is a new oral drug that specifically blocks the production of the male sex hormones (androgens) by the prostate tumour itself, as well as the testes and adrenal glands, all androgen sources which can fuel prostate cancer progression.
Dr Sternberg and her colleagues carried out a retrospective analysis assessing the effect of abiraterone acetate therapy on patient-reported fatigue using data from the COU-AA-301 international Phase III study. The study randomised 1195 patients with metastatic castration-resistant prostate cancer, who had previously received the chemotherapy drug docetaxel, to receive the steroid prednisone with either abiraterone acetate (797 patients) or placebo (398 patients). Patient-reported fatigue was measured using the Brief Fatigue Inventory (BFI) questionnaire at various times during the study.
"We conducted a series of analyses to assess different aspects of the impact of abiraterone acetate on both fatigue intensity and interference with general activity, mood, walking, work, relationships and enjoyment of life," she said. "We also employed different analytical approaches to test our hypotheses. The results are clinically meaningful and remain robust after adjusting for non-random missing data."
The data indicated that patients who received abiraterone acetate had significantly better patient-reported outcomes for fatigue than the placebo group over the study duration. Indeed, the progression of fatigue intensity and interference with general activity, mood, walking, work, relationships and enjoyment of life was significantly delayed in patients who received abiraterone acetate.
At a later stage, Dr Sternberg and her colleagues are planning to explore potential associations between the improvements in patient-reported fatigue and other clinical variables such as overall survival and disease progression.
Dr Sternberg added: "The future looks brighter for men with this disease and with several new therapies recently approved for advanced prostate cancer, we have more hope for our patients, because they are not only living longer, they are also living better. I think this is a huge step forward in the treatment of metastatic castration-resistant prostate cancer."
Cancer of the prostate is the second most commonly reported cancer in men, with more than 890,000 cases diagnosed worldwide every year. It usually occurs in older patients, and globally more than 250,000 men died from the disease in 2008.
"It is very important that research into new anti-cancer strategies not only evaluates its impact on prevention of tumour progression and improvement of survival time, but also evaluates in detail whether and how the treatment affects quality of life and the activity of patients," said Professor Michael Baumann, President of ECCO. "Severe fatigue is a very distressing side effect of some therapies against prostate cancer and research into therapeutic options leading to less fatigue is of great value for patients and their families."

Aromatase inhibitor letrozole guards against breast cancer relapse for up to eight years

Results from the longest-running trial comparing tamoxifen with the aromatase inhibitor letrozole show unequivocally that letrozole has withstood the test of time and continues to prevent breast cancer recurrences and reduce the risk of death in post-menopausal women with hormone receptor-positive early breast cancer.
Professor Richard Gelber told delegates at the 2011 European Multidisciplinary Cancer Congress , in Stockholm today (Monday 26 September) that a 12-year update of results from the Breast International Group (BIG) 1-98 trial showed that if women with early breast cancer (cancer that has not spread from the breast) were given letrozole after surgery for at least five years, they continued to do better and have fewer recurrences of the disease than those who were given tamoxifen.
"Over a median of eight years of follow-up, women who were assigned to receive five years of letrozole after surgery had an 18% reduced risk of relapse and a 21% reduced risk of death compared with those assigned to receive tamoxifen," said Prof Gelber, Director of the International Breast Cancer Study Group (IBCSG) Statistical and Data Management Center at the Dana-Farber Cancer Institute, Boston, MA, USA.
"The current 12-year update is the longest follow-up to date and includes much more information than we had after ten years. For instance, there have been 32% more relapses and 39% more deaths since the ten-year update, which increases substantially the reliability of the results and provides reassurance regarding the long-term value of letrozole. This additional follow-up and accumulation of information on relapses and deaths show that the overall survival advantage for adjuvant letrozole compared to tamoxifen continues to be statistically significant."
Adjuvant therapy (treatment that is given after surgery), using drugs that target hormones such as oestrogen, is given to patients with early breast cancer who have hormone receptor-positive tumours. These tumours occur in approximately 75% of breast cancer cases. Tamoxifen has been the "gold standard" hormone treatment for women with early, oestrogen-receptor-positive breast cancer and works by blocking the growth-promoting action of oestrogen on the cancer cells. Aromatase inhibitors, such as letrozole, are newer and alter the function of aromatase, an enzyme involved in oestrogen production. They can be used in sequence with, or as an alternative to tamoxifen for post-menopausal women.
In the BIG 1-98 trial, researchers enrolled 8,010 patients to receive letrozole and tamoxifen either alone or in sequence, with a total of 4,922 patients included in the monotherapy arms of the study.
Efficacy analyses comparing the treatment groups were conducted every two years following the initial report of results, because the patients had a long-term risk of recurrence. This 12-year update shows that, among all 8,010 patients, there were 2,074 relapses and 1,284 deaths, compared with 1,569 relapses and 923 deaths at the ten-year update.
"The data also show that the sequential use of letrozole and tamoxifen (two years of one agent followed by three years of the other) provided similar outcomes compared with five years of letrozole alone for patients who are not at high risk for recurrence," said Prof Gelber.

Radiotherapy between or during chemotherapy cycles reduces risk of breast cancer recurrence

A major UK trial has produced firm evidence that giving radiotherapy between or during chemotherapy cycles to women with early breast cancer significantly reduces the risk of the cancer recurring in the breast or chest wall. The treatment, known as synchronous chemoradiation, has minimal adverse side-effects and no detrimental effect on the patients’ quality of life.
Findings from the SEquencing of Chemotherapy and Radiotherapy in Adjuvant Breast cancer (SECRAB) study, which was carried out at 48 centres in the UK and is the largest study to investigate the treatment, will be presented today (Sunday) in Stockholm, to delegates at the 2011 European Multidisciplinary Cancer Congress.
"The results show that synchronous chemoradiation reduces the risk of local cancer recurrence by 35% in women with early breast cancer. After a follow-up of over eight years, only 41 patients in the synchronous chemoradiation group had suffered a recurrence compared with 63 patients in the sequential chemoradiation group," says Dr Indrajit Fernando, a Consultant Clinical Oncologist at University Hospitals Birmingham NHS Foundation Trust and Honorary Senior Lecturer at the University of Birmingham, UK.
Radiotherapy and chemotherapy are usually given after breast cancer surgery to destroy any remaining cancer cells in the breast, chest wall or underarm area, in order to reduce the risk of a local cancer recurrence. Sequential chemoradiation is the standard treatment schedule where chemotherapy is given first followed by radiotherapy.
Dr Fernando, the principal investigator of the study, will say: "The five-year local recurrence rates were 2.8% and 5.1% in the synchronous and sequential chemoradiation groups, respectively. This difference of 2.3% between treatment groups was statistically significant."
He will add: "According to the Early Breast Cancer Trialists' Collaborative Group (EBCTCG), one breast cancer death can be avoided for every four local recurrences prevented. Therefore, even a 2.3% reduction in local recurrence rates will have an impact worldwide when we consider that this is a very common cancer."
The optimal timing of radiotherapy with chemotherapy has been a subject of debate among cancer experts. The aim of this trial was to determine the best schedule for giving radiotherapy with cyclophosphamide/methotrexate/fluorouracil (CMF) or anthracycline–CMF chemotherapy after surgery to women with early breast cancer.
This randomised Phase III trial enrolled 2,296 women who had undergone breast conserving surgery (1,285 women) or mastectomy (1,011 women) to remove their tumour. All the patients received chemoradiation after surgery, either sequential (1,146 patients) or synchronous, where the radiotherapy was given in the gaps between chemotherapy cycles (1,150 patients). More than 60% of patients received 40Gy in 15 fractions over three weeks.

Phase II study shows new cancer drug combination significantly delays breast cancer progression

The first randomised trial to investigate the use of trastuzumab emtansine (T-DM1) – an antibody-guided drug – for the initial treatment of HER2- (human epidermal growth factor receptor-2) positive metastatic breast cancer has shown that it makes a significant difference to the time women live without their disease worsening.
Dr Sara Hurvitz, one of the trial investigators, will tell the 2011 European Multidisciplinary Cancer Congress in Stockholm today: "Our results showed that patients with metastatic breast cancer who received T-DM1 had a 41% improvement in the time they lived without their breast cancer worsening compared to those who received standard docetaxel chemotherapy plus trastuzumab. These provocative Phase II data illustrate that first-line treatment with T-DM1 provides a longer time for patients to live without cancer progression and with fewer side effects than standard chemotherapy plus trastuzumab."
Trastuzumab emtansine (T-DM1) is a novel type of cancer therapy known as an antibody drug conjugate (ADC). It combines the monoclonal antibody, trastuzumab, with a potent cytotoxic agent DM1 through a stable linker and uses the HER2 targeting properties of trastuzumab to deliver the cell-killing agent DM1 into the cancer cells.
Dr Hurvitz, Director of the Breast Oncology Program for the Division of Hematology/ Oncology at The University of California, Los Angeles (UCLA), USA, will say that "T-DM1 is unique because it retains the cancer fighting properties of trastuzumab and delivers the DM1 agent directly to the tumour cell for destruction, while limiting exposure of the free DM1 drug to normal cells. This explains why patients who received T-DM1 had fewer side effects compared to those assigned to the chemotherapy-containing control arm in this study."
T-DM1 is specifically designed to attach trastuzumab to DM1 using a stable linker. The bound DM1 has little toxicity, but when it is delivered to the HER2-positive cancer cells, DM1 is released and its potent cytotoxic effect is enabled. The trastuzumab monoclonal antibody delivers its anti-cancer effects after targeting T-DM1 to the cancer cell.
About one in five breast cancer tumours are HER2-positive, meaning that the cancer cells overproduce the protein called HER2, which plays an important role in promoting cancer growth. This type of breast cancer is often more aggressive and difficult to treat than other types of breast cancer. HER2-positive tumours are usually treated with targeted therapy.
Dr Hurvitz will say: "The majority of patients with HER2-positive metastatic breast cancer will face resistance to the currently available HER2-directed therapies. Therefore, dealing with resistance to HER2-targeted therapy remains an unmet need and new, effective therapies for HER2-positive breast cancer are still necessary."
Dr Hurvitz and her colleagues enrolled 137 patients, who had never received chemotherapy or HER2-targeted therapy for locally advanced or metastatic HER2-positive breast cancer, in the open-label, randomised, Phase II clinical trial. Patients were randomly assigned to receive treatment with either T-DM1 or standard therapy (trastuzumab plus the chemotherapy drug docetaxel).
The median progression-free survival (time that elapses before the cancer worsens) was 14.2 months for women who received T-DM1 compared to 9.2 months for those who received trastuzumab plus docetaxel. Two deaths that were not due to disease progression occurred in the study, one in each treatment arm. The percentage of women who discontinued treatment due to side-effects was 7.2% in the T-DM1 arm and 28.8% in the standard therapy arm of the study.
Dr Hurvitz will say: "T-DM1 is unique in that it allows the targeted delivery of chemotherapy to cancer cells. Based on the results of this Phase II study, T-DM1 appears to be not only safer than the docetaxel/trastuzumab combination, but it may allow patients to live without disease progression for a significantly longer period of time. A safer, more effective treatment is likely to enhance patient quality of life and it may ultimately translate into fewer hospitalisations for complications more commonly reported with docetaxel/trastuzumab use."
"It is important to realise that while the current data are encouraging, results from the ongoing Phase III studies (EMILIA and MARIANNE) will be needed to more fully characterise the efficacy and safety profile of T-DM1 compared to the current therapy regimens used to treat HER2-positive metastatic breast cancer."
Professor Michael Baumann, president of ECCO said: "This is a very important trial which indicates that the more selective delivery of anticancer drugs, by conjugating them to antibodies which dock to cancer cells, bears considerable promise for personalised cancer treatment."
Commenting on the study, which he was not involved with, ESMO member Dr Angelo Di Leo from the Hospital of Prato, Istituto Toscano Tumori, Italy, said: "These promising data do not yet allow us to consider T-DM1 as a new standard of care for the first-line treatment of HER-2 positive breast cancer. The results from ongoing Phase III trials are eagerly awaited. Ongoing studies are also exploring the possibility of combining T-DM1 with other biological agents targeting receptors belonging to the HER family. It is expected that combining T-DM1 with these agents will further improve the level of care for women affected by HER-2 positive breast cancer."