New ASCO Guidelines for Treatment of Stage IV NSCLC.


The American Society for Clinical Oncology (ASCO) has issued a new guideline for the treatment of stage IV non-small cell lung cancer. The new guidelines call for the use of 2 new monoclonal antibodies in patients whose disease has progressed after treatment with a platinum-based therapy.

ASCO has issued a new “Systemic Therapy for Stage IV Non-Small-Cell Lung Cancer Guideline.” The new guidance calls for the use of two new monoclonal antibodies in patients with non-small cell lung cancer (NSCLC) whose disease has progressed after treatment with a platinum-based chemotherapy.

The new guidance was developed in order to answer the following question: “What systemic therapy treatment options should be offered to patients with stage IV NSCLC, depending on the subtype of the patient’s cancer?”

The ASCO committee conducted a systematic review of the literature and developed a “clinical practice guideline update targeted at health care providers (including medical oncologists, nurses, social workers, and any other relevant members of comprehensive multidisciplinary cancer care teams), and patients and their caregivers in North America and beyond.”

A Major Shift

ASCO issued a Special Announcement on October 19, 2015:

The U.S. FDA approved a monoclonal antibody agent for patients with NSCLC non-squamous histologies with progression on or after platinum-based chemotherapy on October 9, 2015, expanding upon the FDA’s previous approval for patients with metastatic squamous NSCLC with progression on or after platinum-based chemotherapy on March 4, 2015. The FDA also approved a second monoclonal antibody for the treatment of patients with metastatic NSCLC whose tumors express PD-L1 with disease progression on or after platinum-containing chemotherapy on October 2, 2015. ASCO guidelines are updated on a regular basis and the data accompanying these approvals will be examined during the next guideline update.

Other agents have also been approved for patients whose tumor has grown during or following treatment with platinum-based chemotherapy.

The More Things Change …

These new guidelines give clinicians more freedom in how patients are treated, and which patients receive treatment. The guidelines stress that “Decisions on chemotherapy should not be made on the basis of age alone. They also reiterate that “there is no cure for patients with stage IV NSCLC.”

Given that there is no cure, the guidelines can help clinicians extend both the lifespan of patients with stage IV disease as well as their healthspan.

Read the full reeport. URL:http://jco.ascopubs.org/content/early/2015/08/31/JCO.2015.62.1342.full

Global TB report reveals rate of diagnosis for multi-drug resistant TB (MDR-TB) cases is heading in the wrong direction.


According to the World Health Organization’s World Tuberculosis Report 2015, released 28 October, only one in four (26%) of the 480,000 people estimated to have developed multidrug-resistant TB (MDR-TB) in 2014 was diagnosed.  Worse, the total number of people diagnosed with MDR-TB globally in 2014 was actually lower than the previous year (123,000 in 2014 vs 136,000 in 2013), although the total estimated number of people who developed MDR-TB remained the same. In 2014, only 58% of previously treated MDR-TB cases were tested for drug resistance; while this marks an improvement over 2013’s rate of 17%, it’s far from the 100% target set for 2015 in the Global Plan to Stop TB (2011-2015). While the number of people put on MDR-TB treatment increased slightly from 97,000 in 2013 to 111,000 in 2014, the cure rate remains desperately low at 50%.

Statement by Dr. Grania Brigden, Interim Medical Director, MSF Access Campaign:
“Yet another year of disheartening statistics, such as TB’s persistent annual 1.5 million death toll, should serve as a wake-up call that enormous work still needs to be done to reduce the burden of this ancient, yet curable disease.
“When it comes to the deadlier forms of the disease – such as multidrug-resistant TB – the news is particularly bleak.  Despite progress in rolling out better diagnostics such as rapid molecular tests, fewer people were detected with MDR-TB in 2014 than in 2013, even though the estimated number of new cases remained steady.

“We’re losing ground in the battle to control drug-resistant forms of TB, and without considerable corrective action, the vast majority of people with MDR-TB won’t ever be diagnosed, put on treatment, or cured.  Today, a person with multidrug-resistant TB has worse than a one in four chance of being properly diagnosed.  Diagnosis is just the first step: people who do access today’s standard treatment have only a one in two chance of being cured, while two newer drugs remain out of reach for the vast majority of people who need them.

“Drug-resistant forms of TB will continue to spread unless the gap is narrowed between people with undiagnosed TB disease and people who are diagnosed.  What’s needed is widespread rollout and optimal use of existing rapid molecular tests, while preparing for use of new diagnostic tools that can allow further decentralisation of services.  We need to improve access to, and scale up, drug-resistance testing with affordable point of care tests.” – See more at: http://www.msfindia.in/global-tb-report-reveals-rate-diagnosis-multi-drug-resistant-tb-mdr-tb-cases-heading-wrong-direction#sthash.u8q75Col.dpuf

HPV vaccine alert: Lead developer warns that it is all a big scam


At the 4th International Conference on Vaccination in Reston, Virginia, Dr. Diane Harper, the leading expert responsible for the Phase II and Phase III safety and effectiveness studies which secured the approval of the human papilloma virus (HPV) vaccines, Gardasil™ and Cervarix™, used her speech time to not only make note that cervical cancer is extremely rare in the U.S and 70% of cases resolve themselves naturally without treatment, but also bluntly came clean about the documented and often downplayed side effects directly associated with the vaccine.

Since coming forward with the truth about the devastating consequences of the HPV vaccine, Dr. Harper has been the victim of a relentless campaign, attempting to discredit the validity of her claims. But she has not backed down, and even further clarified her point that, “If we vaccinate 11 year old’s and the protection doesn’t last … we’ve put them at harm from side effects, small but real, for no benefit. The benefit to public health is nothing, there is no reduction in cervical cancers, they are just postponed, unless the protection lasts for at least 15 years, and over 70% of all sexually active females of all ages are vaccinated.”

Detecting cancer from just a single drop of blood


We’re learning more and more about what information can be gleaned by looking at blood samples. This new finding could be a major victory in the battle against cancer for many.

Dutch researchers at the VU medical centre have developed a method of detecting various forms of cancer using only a single drop of blood. The new method even works for very early stage detection, and has been tested to up to 95% accuracy for most types of cancer.

Researchers screened blood samples of a thousand cancer patients of various diagnoses and prognoses. They were able to determine not only the presence of cancerous cells, but also the type, whether it had metastasised, and in the latter case, where the original tumor was located. This is all vital information when trying to fight the disease, especially in the early stages.

Brain cancer proved less reliably detectable, but still showed an improvement over existing methods.

The researchers note that while intestinal cancer showed the highest reliability figures, the opposite was true for types of brain cancer. Here, the reliability dropped to in the region of 85%. That’s still very good compared to existing tests. The researchers suspect that the blood-brain barrier might be the reason for the lower accuracy for detecting forms of brain cancer. This barrier has the function of protecting the brain from influences like viruses and parasites present in the rest of the body.

Current estimates for developing a market-ready test point to as early as 2020. Early detection is hugely important with this treacherous condition, so we’re pleased to see that it may not be far off at all.

Exosome Scouts Help Tumors Populate Distant Organs


When certain types of cancer spread, they seem to prefer particular organs in the body, a choosiness that led Stephen Paget to propose the “seed and soil” hypothesis. This hypothesis, now more than 100 years old, suggests that different organs are somehow more receptive to certain types of cancer, just as different soils seem to allow some seeds, but not others, to find purchase.

While this hypothesis is as expressive as ever, it still lacks detail. It doesn’t suggest what mechanisms might drive organ-specific metastasis, or organotropic metastasis. The hypothesis, however, is being taken farther by researchers based at Weill Cornell Medicine. These researchers suggest that the old seed-and-soil idea, which sounds as haphazard as the dispersal of seeds by uncultivated plants, could be updated to describe a process that is more directed.

Essentially, a tumor metastasis may proceed the way settlers cultivate new land. First, scouts and pioneers are dispatched to identify fertile spots and develop basic infrastructure. Then, once the ground is prepared, settlers establish new communities.

In this scenario, the scouts are tumor exosomes. These exosomes are released by tumors in the millions, and they carry samples of the tumors’ proteins and genetic content. They fuse preferentially with cells at specific locations, and they ensure that recipient organs are prepared to host the tumor cells they represent.

Most important, this updated view of organotropic metastasis includes a mechanism to explain how exosomes are directed to specific organs. The exosomes, it turns out, are outfitted with particular sets of integrins, proteins that serve as a kind of destination label.

Supportive findings appeared October 28 in the journal Nature, in an article entitled, “Tumour exosome integrins determine organotropic metastasis.” This article described how the Weill Cornell researchers, in collaboration with scientists from the Memorial Sloan Kettering Cancer center and the Spanish National Cancer Research Centre (CNIO), examined exosomes from mouse and human lung-, liver-, and brain-tropic tumor cells. These exosomes were seen to fuse preferentially with resident cells at their predicted destinations, namely, lung fibroblasts and epithelial cells, liver Kupffer cells, and brain endothelial cells.

“Exosome proteomics revealed distinct integrin expression patterns, in which the exosomal integrins α6β4 and α6β1 were associated with lung metastasis, while exosomal integrin αvβ5 was linked to liver metastasis,” wrote the authors. “Targeting the integrins α6β4 and αvβ5 decreased exosome uptake, as well as lung and liver metastasis, respectively.”

In other words, the study demonstrated the importance of integrins in metastatic nesting by blocking specific integrins in tumors that metastasize to specific organs. For example, when integrins were blocked in breast cancer, metastasis to lungs was reduced. Similarly, when integrins were blocked in pancreatic cancer, metastasis to liver was reduced.

In addition, the study showed that a tumor could be “tricked” by changing the integrin destination code of its exosomes. For example, a tumor that would normally go to the bones could be directed to the lungs instead.

“The integrin-specific signature that we identified may have significant value clinically, serving as a prognostic indicator for metastasis to specific organ sites,” said senior author David Lyden, M.D., Ph.D., the Stavros S. Niarchos Professor in Pediatric Cardiology and a professor of pediatrics and of cell and developmental biology at Weill Cornell Medicine. “Instead of waiting for late-stage metastasis, we can now initiate preventative strategies at an earlier point of disease progression with the hope of preventing its spread. This really changes the treatment paradigm.”

10 INTRIGUING EXOPLANETS


In celebration of the 20th anniversary of the first confirmed planet around a sun-like star, more than 60 leaders in the field of exoplanet observations chose their favorites among the nearly 2,000 known exoplanets. Some of the exoplanets are rocky, some are gaseous, and some are very, very odd. But there’s one thing each one of these strange new worlds has in common: All have advanced scientific understanding of our place in the cosmos.

Check out the astronomers’ top 10 list of exoplanets below, along with artist’s concepts depicting what they might look like.

1. Kepler-186f

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Kepler-186f was the first rocky planet to be found within the habitable zone — the region around the host star where the temperature is right for liquid water. This planet is also very close in size to Earth. Even though we may not find out what’s going on at the surface of this planet anytime soon, it’s a strong reminder of why new technologies are being developed that will enable scientists to get a closer look at distant worlds.

Credits: NASA Ames/SETI Institute/JPL-Caltech

2. HD 209458 b (nickname “Osiris”)

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The first planet to be seen in transit (crossing its star) and the first planet to have it light directly detected. The HD 209458 b transit discovery showed that transit observations were feasible and opened up an entire new realm of exoplanet characterization.

 

3. Kepler-11 system

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This was the first compact solar system discovered by Kepler, and it revealed that a system can be tightly packed, with at least five planets within the orbit of Mercury, and still be stable. It touched off a whole new look into planet formation ideas and suggested that multiple small planet systems, like ours, may be common.

4. Kepler-16b

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A real-life “Tatooine,” this planet was Kepler’s first discovery of a planet that orbits two stars — what is known as a circumbinary planet.

5. 51 Pegasi b

Scientists have reported the first conclusive discovery of water vapor in the atmosphere of an exoplanet, or a planet beyond our Solar System. This artist's impression shows a gas-giant exoplanet transiting across the face of its star. Infrared analysis by NASA's Spitzer Space Telescope of this type of system provided the breakthrough. The planet, HD 189733b, lies 63 light-years away in the constellation Vulpecula. It was discovered in 2005 as it transited its parent star, dimming the star's light by some three percent.

This giant planet, which is about half the mass of Jupiter and orbits its star every four days, was the first confirmed exoplanet around a sun-like star, a discovery that launched a whole new field of exploration.

6. CoRoT 7b

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The first super-Earth identified as a rocky exoplanet, this planet proved that worlds like the Earth were indeed possible and that the search for potentially habitable worlds (rocky planets in the habitable zone) might be fruitful.

7. Kepler-22b

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A planet in the habitable zone and a possible water-world planet unlike any seen in our solar system.

8. Kepler-10b

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Kepler’s first rocky planet discovery is a scorched, Earth-size world that scientists believe may have a lava ocean on its surface.

9. Kepler-444 system

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The oldest known planetary system has five terrestrial-sized planets, all in orbital resonance. This weird group showed that solar systems have formed and lived in our galaxy for nearly its entire existence.
10. 55 Cancri e

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55 Cancri e is a toasty world that rushes around its star every 18 hours. It orbits so closely — about 25 times closer than Mercury is to our sun — that it is tidally locked with one face forever blisters under the heat of its sun. The planet is proposed to have a rocky core surrounded by a layer of water in a “supercritical” state, where it is both liquid and gas, and then the whole planet is thought to be topped by a blanket of steam.

BLACK HOLE HAS MAJOR FLARE


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The baffling and strange behaviors of black holes have become somewhat less mysterious recently, with new observations from NASA’s Explorer missions Swift and the Nuclear Spectroscopic Telescope Array, or NuSTAR. The two space telescopes caught a supermassive black hole in the midst of a giant eruption of X-ray light, helping astronomers address an ongoing puzzle: How do supermassive black holes flare?

The results suggest that supermassive black holes send out beams of X-rays when their surrounding coronas — sources of extremely energetic particles  — shoot, or launch, away from the black holes.

“This is the first time we have been able to link the launching of the corona to a flare,” said Dan Wilkins of Saint Mary’s University in Halifax, Canada, lead author of a new paper on the results appearing in the Monthly Notices of the Royal Astronomical Society. “This will help us understand how supermassive black holes power some of the brightest objects in the universe.”

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Supermassive black holes don’t give off any light themselves, but they are often encircled by disks of hot, glowing material. The gravity of a black hole pulls swirling gas into it, heating this material and causing it to shine with different types of light. Another source of radiation near a black hole is the corona. Coronas are made up of highly energetic particles that generate X-ray light, but details about their appearance, and how they form, are unclear.

Astronomers think coronas have one of two likely configurations. The “lamppost” model says they are compact sources of light, similar to light bulbs, that sit above and below the black hole, along its rotation axis. The other model proposes that the coronas are spread out more diffusely, either as a larger cloud around the black hole, or as a “sandwich” that envelops the surrounding disk of material like slices of bread. In fact, it’s possible that coronas switch between both the lamppost and sandwich configurations.

The new data support the “lamppost” model — and demonstrate, in the finest detail yet, how the light-bulb-like coronas move. The observations began when Swift, which monitors the sky for cosmic outbursts of X-rays and gamma rays, caught a large flare coming from the supermassive black hole called Markarian 335, or Mrk 335, located 324 million light-years away in the direction of the constellation Pegasus. This supermassive black hole, which sits at the center of a galaxy, was once one of the brightest X-ray sources in the sky.

“Something very strange happened in 2007, when Mrk 335 faded by a factor of 30. What we have found is that it continues to erupt in flares but has not reached the brightness levels and stability seen before,” said Luigi Gallo, the principal investigator for the project at Saint Mary’s University. Another co-author, Dirk Grupe of Morehead State University in Kentucky, has been using Swift to regularly monitor the black hole since 2007.

In September 2014, Swift caught Mrk 335 in a huge flare. Once Gallo found out, he sent a request to the NuSTAR team to quickly follow up on the object as part of a “target of opportunity” program, where the observatory’s previously planned observing schedule is interrupted for important events. Eight days later, NuSTAR set its X-ray eyes on the target, witnessing the final half of the flare event.

After careful scrutiny of the data, the astronomers realized they were seeing the ejection, and eventual collapse, of the black hole’s corona.

“The corona gathered inward at first and then launched upwards like a jet,” said Wilkins. “We still don’t know how jets in black holes form, but it’s an exciting possibility that this black hole’s corona was beginning to form the base of a jet before it collapsed.”

How could the researchers tell the corona moved? The corona gives off X-ray light that has a slightly different spectrum — X-ray “colors” — than the light coming from the disk around the black hole. By analyzing a spectrum of X-ray light from Mrk 335 across a range of wavelengths observed by both Swift and NuSTAR, the researchers could tell that the corona X-ray light had brightened — and that this brightening was due to the motion of the corona.

Coronas can move very fast. The corona associated with Mrk 335, according to the scientists, was traveling at about 20 percent the speed of light. When this happens, and the corona launches in our direction, its light is brightened in an effect called relativistic Doppler boosting.

Putting this all together, the results show that the X-ray flare from this black hole was caused by the ejected corona.

“The nature of the energetic source of X-rays we call the corona is mysterious, but now with the ability to see dramatic changes like this we are getting clues about its size and structure,” said Fiona Harrison, the principal investigator of NuSTAR at the California Institute of Technology in Pasadena, who was not affiliated with the study.

Many other black hole brainteasers remain. For example, astronomers want to understand what causes the ejection of the corona in the first place.

NuSTAR is a Small Explorer mission led by Caltech and managed by NASA’s Jet Propulsion Laboratory in Pasadena, California, for NASA’s Science Mission Directorate in Washington. NuSTAR was developed in partnership with the Danish Technical University and the Italian Space Agency (ASI). The spacecraft was built by Orbital Sciences Corp., Dulles, Virginia. NuSTAR’s mission operations center is at UC Berkeley, and the official data archive is at NASA’s High Energy Astrophysics Science Archive Research Center. ASI provides the mission’s ground station and a mirror archive. JPL is managed by Caltech for NASA.

Lack of sleep linked to risk factors for diabetes and heart disease.


People who get less than six hours of sleep a night may be more likely to have risk factors that increase their odds of diabetes, heart disease and strokes, a Korean study suggests.

This combination of risk factors – including high blood sugar, high cholesterol, extra fat around the midsection, high blood pressure and excess amounts of fats in the blood – is known as metabolic syndrome.

“The ‘short’ sleepers should be aware of the risks of developing metabolic syndrome, which could lead them to suffer from life threatening and chronic diseases,” lead author Dr. Jang Young Kim of Yonsei University in South Korea said by email.

Kim’s team followed about 2,600 adults for more than two years and found that participants who didn’t get at least six hours of sleep a night were 41 percent more likely to develop metabolic syndrome than individuals who got six to eight hours of shuteye.

The findings are drawn from two lifestyle surveys that included questions about sleep habits. The surveys were administered once between 2005 and 2008 and again sometime between 2008 and 2011. Study participants also underwent medical exams and shared their medical history.

After an average follow-up of 2.6 years, about 560 people in the study, or 22 percent of participants, developed metabolic syndrome, according to the results in the journal Sleep.

Short sleep duration was linked to about 30 percent increased risk of high blood sugar and excess belly fat, as well as 56 percent higher odds of hypertension, compared to those who slept longer.

One shortcoming of the study is its reliance on participants to accurately recall and report on their sleep habits, medical conditions and lifestyle behaviors, the authors acknowledge. It also lacked data on the quality of sleep.

Still, the findings are consistent with other studies that have found an association between sleep duration, cardiovascular disease and metabolic syndrome, said Kristen Knutson, a sleep researcher at the University of Chicago who wasn’t involved in the study.

“The strength of this study is that it is a prospective study, which means short sleep was associated with the development of metabolic syndrome,” Knutson said by email. “This is important because the sleep duration was measured before the people had the disease.”

To avoid the ill effects of insufficient sleep, patients should take a close look at their daily routines and make sure they allow enough time in their schedule for rest, Knutson said. Some things like time for work, school or childcare may not be optional, but other things like time for television or movies might be replaced with more rest.

“We don’t know yet if it is possible to reverse the effects” of too little sleep, Knutson added. “Still, adopting a healthy lifestyle which includes appropriate sleep, a healthy diet and sufficient exercise will be beneficial to your health.”

This Tractor Beam Uses Holograms Made Of Sound To Move Objects.


Every day it seems like Star Trek is looking more like actual science than science fiction. We’re working on holographic doctors, transporter beams, andtricorders–and intelligent sliding doors are now a reality.

Acoustic Tractor Beam

But what about the real-world status of the under-appreciated workhorse of the Trek world, the humble tractor beam? Scientists had already been working on models that can push tiny objects small distances using light, but a new version of a tractor beam uses sound instead.

In a new paper published today in Nature Communications, researchers figured out a way to manipulate a tiny physical object using what they call, acoustic holograms.

The researchers used a grid of tiny loudspeakers to levitate, rotate, and otherwise manipulate a tiny ball in mid air. They did this by programming the speakers to send out high intensity sounds that create a kind of force field around the object. In the GIF above, you see one of their tractor beam models, which can move a small object around the grid as though it were held by human fingers, (aka, the ‘hologram’ the researchers were talking about). Other variations of their model involve creating a twister-like cone of sound that can suck an object up into the heart of the beam.
Previous research created an acoustic tractor beam that could work underwater, but this new research only needs air. The researchers think this delicate manipulation might one day be used to create sound-based assembly lines or help manipulate drugs in a patient’s body.

18 artificial intelligence researchers reveal the profound changes coming to our lives.


This is a good read and these researchers see some profound changes. I do believe this will occur because this space is growing rapidly and we’re talking about technology that learns. Here’s more:


Artificial intelligence (AI) has been changing our lives for decades, but never has AI felt more ubiquitous than now.

It seems as though not a week passes without yet another AI system overcoming an unprecedented hurdle or outperforming humans.

Here’s some of the things the Researchers say:

Pieter Abbeel says robots will keep us safer, especially from disasters.

Shimon Whiteson says we will all become cyborgs.

Yoky Matsuoka says these implants will make humans better at everything.

Thomas Dietterich doesn’t stop there, he hopes AI will turn us into superhumans.

The truth is, we need these machines to learn. Data is growing so fast, it will take humans years to go through the data and make connections and in some cases it might be impossible because there’s not enough time. Machine learning algorithms can go through data in a few months that might take humans 4 or 5 years.

Just imagine the explosion of knowledge. It will increase very rapidly and as a species we will be smarter. The downside is, we will use these intelligent machines for everything and we will come to rely on it just like we rely on the internet today. It will be different because it will learn for us.

I fully believe this is the trend of the future. I’ve always believed the “mark of the beast” will be altered DNA and biological tech enhancements to the point that we could no longer be considered “human”. It’s amazing and scary to watch this process getting closer to fruition.