Economic Disparities a Growing Concern for Cancer Diagnosis and Treatment

The most recent global cancer data from the WHO highlights the growing differences in mortality rate among regions of the world bearing very different economic circumstances. Given that cancer has been globally responsible for the death of 8.8 million individuals in 2015 and that the number of new cases is expected to rise by about 70% over the next two decades, these new figures are cause for concern looking at the rise of Cancer among economically weak regions.

See the WHO Cancer fact sheet, updated in February 2017, here.

In fact, according to the most recent reports, about 70% of deaths from cancer occur in low and middle-income countries. Furthermore, only 35% of low income countries carry pathology services generally available to the public sector while treatment services are available in less than 30% of low income countries as compared to 90% of high income countries.

“It is not surprising that only one in five of these low- and middle-income countries have the necessary data to drive cancer policies and health interventions,” comments Prof. Antonio Giordano, Director of Sbarro Health Research Organization, a cancer and biomedical research institute based in Philadelphia.

“This problem,” adds prof. Giordano, “is a major driver for the expected increase of cancer cases and deaths, especially among children and children-bearing women in these countries also due to the higher risk connected to specific infective agents for which there are no widespread prevention programs as well as limited access for women and children to what we now consider basic care in other parts of the world.”

“The Limited access to sustainable diagnosis and treatment in economically weak regions disclosed by these reports,” states prof. Pierluigi Scalia, director of ISOPROG Onlus, an Italian non profit research organization, “is not only restricted to third world countries, but it is likely to be witnessed within countries with higher income when comparing different regions of the same country.” “For example,” says prof. Scalia, “we could expect the same trend due to lack of access to basic sustainable care when comparing large cities to the peripheries such it can be seen throughout the US and as it is still a problem in countries like Italy between the northern and the southern regions. In all these cases, the incidence of cancer in children and economically weak part of our society is expected to rise.”

“Research as well as new social entrepreneurial models to manage healthcare,” concludes prof. Giordano, “are desperately needed to face this growing problem.”

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Actors with Disabilities Go to Hollywood Festival, Sbarro Health Research Organization Praises Filmmakers

The Sbarro Health Research Organization at Temple University, under the direction of Dr. Antonio Giordano, usually collaborates with Italian scientists working both in the U.S. and Italy. But today, the organization is praising a group of Italian filmmakers for their contribution to medicine through the arts. Their film, Ho Amici In Paradiso [I Have Friends in Heaven], will screen this week at the Los Angeles Italia Film, Fashion, and Art Fest.

I Have Friends in Heaven is a great achievement in the honest and sympathetic portrayal of people with disabilities,” Dr. Giordano said. “The Sbarro Health Research Organization at Temple University is very interested in participating in research and assisting people with a cognitive impairment, intellectual disability, and mental illness.”

Director Fabrizio Cortese’s film tells the story of a troubled man who finds meaning in life after working with the disabled at the Opera Don Guanella, a Catholic Servants of Charity organization serving people with disabilities in Rome.

After screening at the Rome International Film Festival in 2016 and gaining recognition from Pope Francis, the film will screen at the Hollywood TCL Chinese Theater on February 22. Director Fabrizio Maria Cortese will attend, along with Michele Iannaccone and Stefano Scarfini, two of the disabled actors from the Center who performed in the film.

The festival is supported by the Italian Consulate in Los Angeles to promote Italian excellence in the arts.

Also in attendance will be producer Antonio Maria Cortese, and a delegation from the ‘Opera Don Guanella’ rehabilitation center in Rome, including the Chief of Casa San Giuseppe Don Pino Venerito, and medical director Simonetta Magari. The rest of the cast included five other disabled actors from the Opera Don Guanella, as well as veterans of Italian stage and screen Valentina Cervi, Fabrizio Ferracane, Antonio Catania, Antonio Folletto, Enzo Salvi and Emanuela Garuccio.

Synopsis of the Film
Felice Castriota is an impulsive and superficial person who lives in the South of Italy as an accountant. Both his recklessness and greed for money bring him to tighten ties with crime. One day he is discovered. The State’s attorney of Lecce proposes assignment as a social worker to Felice as an alternative to jail. At Centro Don Guanella, a Catholic charity for the disabled, everything changes. In fact, he gains awareness about his mistakes and the important things in life, thanks to the entire group of disabled people he encounters during his amazing rehabilitation path.

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Micro-RNA May Amplify Effectiveness of Sorafenib in Difficult Liver Cancer Cases

Treatment options for liver cancer are often limited and almost exclusively involve transplantation if possible, or local chemoembolization and radiofrequency ablation. Medical treatments for more advanced stages have been explored during recent decades, but only the drug sorafenib, a small molecule multi-kinase inhibitor, has shown promising results and been approved for use by international medical agencies. Unfortunately, only 25% of patients respond to sorafenib treatment, so researchers have endeavored to understand its mechanism of action and discover a way to boost its effectiveness.

A recent study, published in the journal Journal of Cellular Physiology, describes further scientific insight into the involvement of a small non coding RNA, miR-125a, in the anti-cancer effects of sorafenib in the treatment of liver cancer, or hepatocellular carcinoma. These results are interesting as miRNAs have multiple available intracellular targets and could contribute to the amplification of the effects of sorafenib.

The link between small kinase inhibitors such as sorafenib, and the existing molecular pathways that govern cell proliferation such as miR-125a, may be useful to potentiate the anticancer activity of sorafenib. Clinical applications of this knowledge might seek to identify and increase the number of liver cancer patients that respond positively to the drug.

The study includes work done by Prof. Michele Caraglia and Aniello Russo, of the University of Campania “L. Vanvitelli” in Naples, and Caserta, Italy, in collaboration with Prof. Antonio Giordano, Director of the Sbarro Institute for Cancer Research and Molecular Medicine at Temple University in Philadelphia.

“Sorafenib is still the only drug indicated in the treatment of hepatocellular carcinoma, which highlights the difficulty in the medical treatment of liver cancer,” says Prof. Antonio Giordano. “Sorafenib is effective because it acts upon multiple intracellular targets and interferes with both cancer proliferation and tumor blood supply. However, its activity is limited to only 25% of patients that are sensitive to its effects. This strongly pushes the researchers to define the mechanism of action of the drug,” Giordano concludes.

“MicroRNAs can act as either cancer-fighting tumor suppressors, or as cancer-causing oncogenes,” says Professor Michele Caraglia. “We have found that the expression of miR-125a is strongly involved in the mechanism of action of sorafenib and its ability to regulate cancer cell proliferation. These findings suggest the possible use in the future of miR125a in combination with sorafenib in order to potentiate the anti-cancer activity of the drug,” Caraglia concludes.

The study results open a new scenario of intervention in the treatment of hepatocellular carcinoma in which small molecules such as sorafenib can be used in association to nucleic acids such as miR-125a. The latter could be administered to patients systemically encapsulated in novel drug delivery options such as nanocarriers. Researchers plan to further study the in vivo efficacy of these strategies to increase treatment options for this difficult form of cancer.

NewsWise Release

Citations
Potenza N, Mosca N, Zappavigna S, Castiello F, Panella M, Ferri C, Vanacore D, Giordano A, Stiuso P, Caraglia M, Russo A. MicroRNA-125a-5p Is a Downstream Effector of Sorafenib in its Antiproliferative Activity Toward Human Hepatocellular Carcinoma Cells. J Cell Physiol. 2016 Dec 16. doi: 10.1002/jcp.25744.

PubMed Abstract                           J Cell Physiol Link

Every Diagnosis of Cancer Should Come with One of These, Says Cancer Expert

“Every cancer diagnosis should come with a referral to genetic counseling,” says cancer expert Dr. Antonio Giordano, President of the Sbarro Health Research Organization at Temple University.

Giordano’s comments come in response to a study published this week in JAMA, the journal of the American Medical Association, which showed signs that too few patients are getting genetic counseling. The study described a shortfall of genetic screening for breast cancer patients at risk for mutations of the BRCA1 and BRCA2 genes, with as many as 80% of patients surveyed said they wanted testing, but only about 40% received genetic counseling.

“Genetic counseling is so important,” says Dr. Giordano, “not only for BRCA, but for other testing as well. Sometimes there are incidental findings which can guide the medical oncologist to the right targeted approach. Such as, which hormonal therapies or chemotherapy agents will be most effective.”

The study also indicated a majority of patients surveyed say the reason they didn’t get a genetic screening was because the doctor didn’t recommend it to them.

“Most of the time, this may be because the medical oncologist feels they need to decide for the patient,” says Dr. Giordano, “and they may prescribe genetic counseling if they feel it is called for, but may not explain it to the patient.”

That may be a mistake that needs to change, says Dr. Giordano, for more reasons than just medical.

“Psychologically, it is very important for the patient to participate in decisions about their treatment. They are often scared, and to have more information can help them feel empowered in their medical decisions,” Dr. Giordano said. “It is beneficial for the patients’ overall well-being, as they deal with such a serious disease.”


About
Sbarro Health Research Organization conducts research in cancer, diabetes, and cardiovascular disease. Based in Philadelphia, Pennsylvania on the campus of Temple University, our programs train young scientists from around the globe.

Newswise release

How Red Pigmentation in Foods Helps Fight Lung Cancer

For those of you smokers, we aren’t saying you shouldn’t quit!  However, to help counteract some of the harmful effects of nicotine check out this article for the healing benefits of red pigmentation in certain foods.

https://m.medicalxpress.com/news/2017-01-red-pigment-peppers-oranges-linked.html

 

Researchers find BCX—red pigment abundant in sweet red peppers, paprika, winter and butternut squash, oranges, and tangerines, among other foods—appears to counteract nicotine’s ability to accelerate the growth of lung tumors. Credit: Ingimage

Great News Coffee Lovers!!

#Coffee is addictive but this just maybe one of the few good “drugs” to be addicted to, in moderation!  Did you know that drinking one cup of coffee a day can help lower your risk of diabetes, liver cancer, melanoma, and multiple sclerosis?  It can also help enhance memory, boost your mood, and this one you’ll never guess decrease tooth decay!!  So for all of my fellow coffee addicts out there drink up guilt-free!
#kimbo Kimbo

coffee.jpg

 

http://www.itechpost.com/articles/76352/20170120/why-every-guy-should-drink-coffee-discover-coffees-health-benefits.htm

Treating a cancer patient for a second time

In order to determine whether a growth represents relapse of a previously diagnosed cancer or is a newly developed, separate tumor, doctors obtain a tissue sample from the patient and have it examined by a pathologist.
#prevention #cancer #tumor

ccs-kidney-cf363-13-left

A tumor from a young boy’s kidney (a normal kidney tubule is visible top right).

http://blog.dana-farber.org/insight/2017/01/when-cancer-occurs-in-someone-who-has-already-been-treated-how-do-doctors-determine-whether-its-a-new-tumor-or-the-spread-of-the-earlier-tumor/

Molecular Subgroups of Non-Small Cell Lung Cancer Predict Tumor Behavior, Reveal Treatment Targets

The discovery of several different subtypes of Non Small Cell Lung Cancer (NSCLC), the most frequent form of lung cancer, has been a major breakthrough in the fight against the leading cause of cancer-related death worldwide. With each subtype displaying peculiar clinic-pathological characteristics, they can be associated with outstanding responses to specific targeted agents, such as anti-tumor drugs and immunotherapy. However, to date there are limited data regarding the possible differences in the metastatic distribution of NSCLCs.

A recent study, published in the journal Oncotarget, describes further scientific insight into the metastatic patters of Epidermal Growth Factor Receptor (EGFR) mutated NSCLCs. The authors determined that bio-molecular characteristics and genotype may influence the metastatic process in NSCLC tumors, and might help the development of enrichment strategies for tumor genotyping in these tumors, especially in the presence of limited tissue availability. Furthermore, the understanding that EGFR-mutated NSCLCs metastasize more frequently in certain sites might help clinicians for a more appropriate selection of patients for EGFR mutational testing beyond current clinical parameters, such as tumor histotype, ethnicity or smoking status.

The study includes work done by Prof. Vincenzo Adamo, of the University of Messina, Italy, in collaboration with Prof. Antonio Giordano, Director of the Sbarro Institute for Cancer Research and Molecular Medicine at Temple University in Philadelphia, as well as other colleagues at the University of Siena, Italy

Exploring the link between oncogene status and metastatic behavior in non-squamous NSCLCs, the authors analyzed the different metastatic patterns, at baseline and during the course of the disease in a cohort of 137 Caucasian patients.

They reported unique metastatic distributions between EGFR-mutated and EGFR wild type non-squamous NSCLCs, since EGFR mutated NSCLCs tended to develop at baseline with a higher frequency compared with wild type tumors, brain metastases, lung metastases, pleural involvement, and bone metastases. However, the presence of EGFR mutations is associated with a longer median overall survival (almost double) compared with those without EGFR mutations when treated with specific targeted agents. Moreover, the EGFR mutational status was a predictor of longer overall survival also in the presence of brain metastases, a clinical condition commonly associated with a dismal prognosis.

“In order to move this research into clinical applications for EGFR-mutated NSCLCs, we hope to address the growing list of molecular tests required for an adequate treatment of such patients,” says Dr. Adamo.

“The most pressing challenge is limited tumor tissue availability, due to the disease being commonly diagnosed through small tumor biopsies or cytological samples, given its peculiar localization. Therefore, strategies for the optimal selection of patients for molecular testing are eagerly awaited,” Dr. Giordano concluded.

newswise release

About
Sbarro Health Research Organization conducts research in cancer, diabetes, and cardiovascular disease. Based in Philadelphia, Pennsylvania on the campus of Temple University, our programs train young scientists from around the globe.

CITATIONS
Russo A, Franchina T, Ricciardi GR, Fanizza C, Scimone A, Chiofalo G, Giordano A, Adamo V. Influence of EGFR mutational status on metastatic behavior in non squamous non small cell lung cancer. Oncotarget. 2017 Jan 2. doi: 10.18632/oncotarget.14427.

pubmed abstract    Oncotarget publication page

Combination treatment may be valuable therapeutic option for HER2-negative metastatic breast cancer

Finding the ideal combination of targeted, hormonal and chemotherapeutic agents to treat HER2-negative metastatic breast cancer has been challenging researchers for decades. In tumors which lack expression of the human epidermal growth factor receptor 2 (HER2-), the use of regimens based on the administration of paclitaxel, a taxane, and bevacizumab, a humanized monoclonal antibody directed against VEGF-A, eventually integrated by maintenance therapy with bevacizumab and/or endocrine therapy may represent a valuable therapeutic option. In other words, an initial round of targeted chemotherapy to rapidly halt cancer progression, followed by maintenance therapy to prevent further metastases. The specific drug regimen analyzed in a recent study resulted in better control of disease progression and a higher overall survival rate.

The study, “A Real-World Multicentre Retrospective Observational Study of Paclitaxel-Bevacizumab and Maintenance Therapy as First-Line Treatment for HER2-Negative Metastatic Breast Cancer,” was recently published in the Journal of Cell Physiology an international, peer-reviewed journal focused on cancer-related issues.

Researchers identified 314 patients diagnosed with HER2-negative metastatic breast cancer at 12 Italian cancer centres. From that group, they identified a subgroup of about 180 hormone-receptor positive patients to administer maintenance endocrine therapy following paclitaxel discontinuation, which was eventually combined with bevacizumab maintenance therapy.

“Notwithstanding the overall improvement in the available therapeutic options, metastatic breast cancer is still considered incurable,” says Dr. Maddalena Barba, researcher at the Regina Elena National Cancer Institute of Rome, Central Italy, “with particularly low survival rates in some patient subgroups for whom novel treatment combinations and potential therapeutic targets are urgently needed.”

The authors belong to a multidisciplinary Italian-American team, which has long collaborated with Prof. Antonio Giordano, Director of the Sbarro Institute for Cancer Research, Temple University Philadelphia, USA

“In this study, we observed evidence of the efficacy of first-line paclitaxel-bevacizumab in metastatic HER2 negative breast cancer patients. In addition, both bevacizumab and endocrine maintenance therapy significantly improved slowing disease progression and the overall survival rate, compared to cases with no maintenance therapies,” says Dr Vici, clinical researcher at the division of Medical Oncology 2 of the Regina Elena National Cancer Institute.

“When addressing metastatic breast cancer, pathologists and oncologists work jointly to identify single therapeutic approaches to be used within a wider therapeutic strategy,” says Prof. Antonio Giordano, a scientist with widely recognized expertise in breast cancer with a specific focus on translational research. “Each step of the decision making process is driven by specific disease features, such as the lack or presence of therapeutic important targets, which may be exemplified by HER2 and hormone receptors, along with our patients specific needs. In addition, data collected from real world populations, likewise those commonly involved in our research pipeline on breast cancer, are closer to the routine clinical practice and patient needs compared to the evidence from randomized clinical trials, whose participants are generally highly selected,” Prof. Giordano concluded.

News-Medical Release        PubMed Abstract