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Cervical cancer vaccine: key questions

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Cervical cancer vaccine: key questions

Cervical cancer is malignant neoplasm of the cervix uteri or cervical area. It may present with vaginal bleeding but symptoms may be absent until the cancer is in its advanced stages. Treatment consists of surgery (including local excision) in early stages and chemotherapy and radiotherapy in advanced stages of the disease.

Pap smear screening can identify potentially precancerous changes. Treatment of high grade changes can prevent the development of cancer. In developed countries, the widespread use of cervical screening programs has reduced the incidence of invasive cervical cancer by 50% or more.

The initial post mortem said was “most unlikely” the vaccine was the cause of death. It could have been nothing more than a coincidence, although one scenario that has been presented is she had a very rare severe allegric reaction to the vaccine, known as anaphylaxsis, which can be fatal.

Signs and symptoms

The early stages of cervical cancer may be completely asymptomatic. Vaginal bleeding, contact bleeding or (rarely) a vaginal mass may indicate the presence of malignancy. Also, moderate pain during sexual intercourse and vaginal discharge are symptoms of cervical cancer. In advanced disease, metastases may be present in the abdomen, lungs or elsewhere.

Symptoms of advanced cervical cancer may include: loss of appetite, weight loss, fatigue, pelvic pain, back pain, leg pain, single swollen leg, heavy bleeding from the vagina, leaking of urine or faeces from the vagina, and bone fractures.

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Arena weight-loss data expected to underwhelm

Beauty With Apple

Arena weight-loss data expected to underwhelm

Upcoming trial results for lorcaserin, the experimental obesity drug being developed by Arena Pharmaceuticals Inc, will likely show it is about 4 percentage points more effective in promoting weight loss than a dummy pill

But that is well short of the 9.4 percent placebo-adjusted weight loss reported last week by Vivus Inc, which is developing Qnexa — a combination of phentermine and epilepsy treatment topiramate, both now sold as generics, that is designed to minimize side effects from the two drugs.

But Wall Street is not discounting the value of a viable treatment for obesity, a health-damaging condition afflicting more than one-quarter of all Americans. “Right now physicians have pretty much nothing,” said JMP Securities analyst Jason Butler.

Piper Jaffray has forecast lorcaserin sales of $3 billion in 2015.

One-year results from Vivus’ Qnexa trials sent the company’s stock up more than 70 percent on Wednesday.

“There is a lot less opportunity for that to happen with this (Arena) trial,” Butler said. “We’ve seen so much data already.”

Shares of Arena, which ended Nasdaq trading at $5.30 on Friday, closed as low as $2.26 in April and as high as $7.42 in February.

The phentermine used in Vivus’ Qnexa is a stimulant that was part of the fen-phen diet drug cocktail. Other drugs used in the cocktail, flenfluramine and dexfenfluramine, were recalled in 1997 after they were linked to heart valve damage.

SIDESTEPS HEART PROBLEMS

Lorcaserin is a serotonin activator like fenfluramine, but it is designed to selectively target only one variety of the chemical — and thereby sidestep heart-related side effects.

Earlier studies have found no heart problems associated with the drug. “There is no reason to expect anything different safety-wise,” from the new trial results expected this month, said Carol Werther, an analyst at Summer Street Research.

The company earlier this year said a large, year-long trial found that lorcaserin patients, on average, lost 5.8 percent of their body weight, while placebo patients lost 2.2 percent of their weight — a percentage point difference of 3.6 percent.

“No single agent has consistently shown a 5 percentage point difference,” said Werther.

U.S. Food and Drug Administration guidelines for obesity drugs require a 5 percent improvement in weight loss between the test drug and placebo or that the number of subjects who lose at least 5 percent of their body weight be at least 35 percent, and double the proportion in the placebo group, with a statistically significant difference between the groups.

The earlier lorcaserin trial found that 48 percent of patients on the drug lost 5 percent or more of their weight, while 20.3 percent of placebo patients achieved that goal

Dominic Behan, chief scientific officer and co-founder of Arena, said a major advantage of lorcaserin is that it is a single agent, and that doctors do not need to adjust doses for patients.

Moreover, he said lorcaserin improved cholesterol levels in patients. And data from earlier trials suggest it can be safely taken on a chronic basis, Behan said. By contrast, he said phentermine is currently approved only for short-term use.

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How broccoli can protect your arteries

in.reuters.com

How broccoli can protect your arteries

It’s long been thought that broccoli is good for your heart, and now British scientists think they know why.

Researchers at Imperial College London have found evidence a chemical in broccoli and other green leafy vegetables could boost a natural defense mechanism that protects arteries from the clogging that can cause heart attacks.

In a study funded by the British Heart Foundation charity and conducted on mice, the researchers found that sulforaphane — a compound occurring naturally in broccoli and other brassicas — could “switch on” a protective protein which is inactive in parts of the arteries vulnerable to clogging.

“We know that vegetables are clearly good for you, but surprisingly the molecular mechanisms of why they are good for you have remained unknown for many years,” said Paul Evans of the National Heart and Lung Institute at Imperial College.

“This study provides a possible explanation for how green vegetable consumption can promote a healthy heart.”

Scientists already know that arteries don’t clog up in a uniform way, but that there are bends and branches of blood vessels — where blood flow is disrupted or slower — which are much more prone to the build-up of fatty plaques that cause heart disease.

Evans said his research found that in the more vulnerable areas, a normally protective protein known as Nrf2 is inactive.

“What our study showed was that sulforaphane can protect those regions by switching on the Nrf2,” he said.

The research, reported in the journal Arteriosclerosis Thrombosis and Vascular Biology, was conducted using purified sulforaphane, not broccoli. Researchers said the next step was to test the effect of the chemical as it is found in vegetables.

We now need to go and test this with broccoli smoothies, as it were, and compare that with the effect of purified sulforaphane,” Evans said, adding that if the vegetable form proved less effective, there could be an argument for taking sulforaphane in pill form.

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