Thursday, May 28, 2015

腫瘤免疫微環境(macrophage/ neutrophil) 如何加速癌轉移 (MMP9)!

Tumor surroundings are shown to affect progression of different cancer subtypes Mikala Egeblad's team showed in mice that the progression of different types of breast cancer was influenced differently by the tissue -- the so-called tumor microenvironment -- in which the tumor is embedded. The tumor microenvironment and it turns out it's no different for cancer cells. In work published today in Neoplasia, a team of researchers led by Associate Professor Mikala Egeblad at Cold Spring Harbor Laboratory (CSHL) found that two different mouse models of breast cancer progressed differently based on characteristics of the tumor microenvironment - the area of tissue in which the tumor is embedded. The tumor microenvironment includes cells and extracellular molecules that support the tumor's growth. Egeblad and her team looked at two types of breast cancer driven by different mutations, and found very different microenvironments. One common factor was the presence of an extracellular protein called matrix metalloproteinase 9 (MMP9). It was expressed at similar levels in tumors from both breast cancer mouse models. MMP9 previously has been linked to the progression of many types of cancers. When the researchers deleted the Mmp9 gene, they found that the absence of the MMP9 protein delayed tumor onset only in one mouse model, and had no effect in the other model. Egeblad and her team found that whether MMP9 promoted cancer or not depended on the tumor microenvironment. Specifically, on the presence of another molecule that MMP9 is known to act on, called insulin-like growth factor binding protein 1 (IGFBP-1). "If IGFBP-1 is not there, MMP9 didn't really have an effect, but if it's there, then MMP9 has a role," says Egeblad. This suggests that IGFBP-1 interacts with MMP9 to promote tumor formation. IGFBP-1 binds insulin-like growth factors (IGFs), which play a role in promoting cancer proliferation. "IGFBP-1 keeps the growth factors sequestered so they can't act on the cancer cells and can't make them proliferate," Egeblad says. "But if MMP9 is present, it degrades these IGFBPs and releases the growth factors." The release of the IGFs then accelerates cancer progression. Egeblad and her team looked in human cancer databases to see if the interaction between MMP9 and IGFBPs predicted breast cancer prognosis in humans. "We found that IGF-binding proteins are associated with a good prognosis, but if MMP9 is also present, there's no longer good association with survival," Egeblad says. The study's results have implications for anti-cancer drugs that target MMPs, and may explain why previous clinical trials using MMP inhibitors have failed, Egeblad says. "Maybe you can actually think about using these inhibitors if you better understand their biology," she says. The new study suggests that trials of MMP inhibitors could focus on patients whose tumor microenvironment contains IGFBPs, she says. More broadly, the research suggests that it may not be enough to see if a particular drug target is present in a certain type of cancer; researchers may also need to look for the presence of the molecules that the drug target acts upon. "It complicates things, but I think biologically it makes a lot of sense. You really need to dig deep and understand mechanistically what the target does," Egeblad says. The lab's next goal is to look more generally at the differences in microenvironments in different types of cancer. "What we're starting to learn now is that the microenvironments are different in different tumors, and that there is really a very intricate interplay between what's driving the mutations in cancer cells and the type of microenvironment they build around themselves," Egeblad says.

More information: "Presence of insulin-like growth factor binding proteins correlates with tumor-promoting effects of matrix metalloproteinase 9 in breast cancer " appears online in Neoplasia on May 27, 2105, 2015. The authors are: Jae-Hyun Park, Ph.D.; Morten G Rasch, Ph.D.; Jing Qiu; Ida K Lund, Ph.D.; Mikala Egeblad.



 


MMP9 promotes tumor progression in several mouse models of cancer. Therefore, we next compared the effect of MMP9 on tumor progression between our two models of different breast cancer subtypes, focusing on high-grade carcinomas. We found that in both subtype models, cells infiltrating the central, necrotic areas of the tumors and cells located in the stroma at the periphery of the tumors expressed MMP9. These MMP9-expressing cells co-expressed either the neutrophil/monocyte marker or the macrophage marker (Figure 3, A and B). The percentages of macrophages and neutrophils that expressed MMP9 were similar between the models (53-60% of neutrophils and 7% of macrophages; Figure 3, C and D). However, consistent with the very limited infiltration of neutrophils in the MMTV-Neu model (Figure 1C), most of the MMP9-expressing cells were macrophages in the MMTV-Neu model, while most of the MMP9-expressing cells were neutrophils in the C3(1)-Tag model (Figure 3, E and F).



Neoplasia, May 2015Volume 17, Issue 5, Pages 421–433

跨世代溶癌病毒疫苗FDA 將核准!!! Amgen 皰疹病毒 抗皮膚癌 (T-VEC, Talimogene Laherparepvec)

FDA panel gives a thumbs up to Amgen's T-Vec for melanoma  April 29, 2015 | By John Carroll  Amgen's regulatory team for talimogene laherparepvec (T-Vec) was grilled by a group of outside FDA experts who picked up on some major questions regarding the Phase III melanoma study that was used to back its new drug application. A vigorous defense of the drug, though, helped make a winning case for the therapy, which was ultimately supported by all but one member of the panel. There was considerable sentiment in favor of restricting the drug to certain patient groups, with some of the panelists expressing their frustration that they couldn't register a vote regarding the low likelihood that the drug would work for visceral (internal) tumors or later-stage patients. At the end of the day, though, the expanded panel voted 22 to 1 that the drug has a favorable risk/benefit profile. T-Vec is injected directly into tumors, where it replicates and then ideally ruptures the tumor cells. The rupture causes the release of antigens which in turn spur the immune system response--a kind of one-two punch that represents a different approach to treating melanoma. "There are clearly patients in my clinic I'd like to use this for," noted Patrick Hwu, a professor in the department of Melanoma Medical Oncology at the University of Texas MD Anderson Cancer Center who voted to support T-Vec. A number of the experts noted that the more "arrows" they had in their therapeutic quiver, the better off patients would be. The final decision is being left in the hands of the FDA, though today's vote would make T-Vec an odds-on favorite for approval. If so, Amgen ($AMGN) is on track to score several possible approvals this year, marking some advances after analysts like Geoffrey Porges have criticized the Big Biotech's development strategy and heavy research costs. The day started with FDA reviewers offering some skeptical remarks about their interpretation of the late-stage data. "The evidence that talimogene has a systemic effect was limited and difficult to calculate," FDA reviewer Robert Le told the committee. In particular, committee members noted that there were widely different response rates among different subgroups in the study. For Le, "first line or less advanced patients may have responded better." "Subjects with small lesions may be more likely to respond," he added, "larger lesions less likely." Abigail Luo, who specifically focused on mixed survival benefits, also raised concerns about the removal of 7 patients from the control arm. That change may have skewed the results in favor of the drug arm, raising the prospect that investigator bias may have played a role in shaping the results. And her review "increases uncertainty of overall survival benefits" for the drug arm, though patients in the drug arm did live more than 4 months longer on average than the comparator arm. Another concern was viral "shedding," in which healthcare workers and others could be exposed and infected by the live herpes simplex virus used in T-Vec.

Amgen applied for full approval of T-Vec based on durable response. Amgen execs noted that the comparator treatment in the study, GM-CSF, has some effect, which may have influenced results as well. So overall, the observed results do give an idea of who benefits the most from T-Vec, they noted. Subgroup analysis--which tends to raise all sorts of issues related to statistical significance--also showed some dramatic differences in response, with first-line patients, for example, doing better than second-line patients. Amgen had some big factors playing in its favor. The experts, like the agency, lean heavily on the side of providing physicians and patients as many treatment choices as possible, particularly in the absence of serious toxicity issues. Treating late-stage cancer patients isn't an ideal world, and attitudes to safety and efficacy can be far more flexible in oncology than, say, chronic diseases. The agency also keeps an open mind when it comes to last-ditch efforts, after other treatments have failed.

"Metastatic melanoma continues to be a major challenge to patients and caregivers," Amgen stated after the vote Wednesday. "It is a complex and heterogeneous disease that often requires the use of multiple treatment modalities. Despite recent advances, the five-year survival rate for metastatic melanoma is still unacceptably low and nearly 10,000 patients are expected to die in the U.S. this year. It is clear from today's discussion that the committee recognized the importance of the need for new therapeutic options for patients with metastatic melanoma. We look forward to talking with the FDA about how to best make talimogene laherparepvec monotherapy available to patients as they complete their review of the Biologics License Application."


治療皮膚癌 基改皰疹病毒試驗見成效  2015-05-27 18:51:51根據今天公布的臨床試驗結果,基因改造的皰疹病毒可有效對抗皮膚癌。法新社華盛頓27日報導,研究結果顯示,以T-VECTalimogene Laherparepvec)藥物治療後,患者存活時間可大大增加,這可望讓美國與歐洲藥物管制機構核准。試驗中超過16%的病患接受施打後,出現維持超過半年的治療反應;相較之下,對照組只有2%的病患可達相同效果。(陳淑娟編)【中央網路報】


Amgen to Acquire BioVex for Up To $1B, to Obtain Cancer-Killing Virus Therapy Luke Timmerman  1/24/2011 Amgen is sticking its scientific neck out, and potentially $1 billion of its cash, to buy a company in Woburn, MA that hopes to deliver the first FDA-approved virus engineered to specifically kill cancer cells. Thousand Oaks, CA-based Amgen (NASDAQ: AMGN) said today it has agreed to pay $425 million upfront, plus another $575 million in additional development and sales milestones, to obtain privately-held BioVex. Amgen, which has significant research and development operations in South San Francisco, Seattle, and Cambridge, MA, said it expects to close this deal before the end of March. BioVex, which we last wrote about in November 2009, raised $70 million in venture capital that year to carry out the final steps of development with its oncolytic virus therapy. BioVex is seeking to harness decades of science, in which researchers have sought to genetically modify viruses to replicate inside tumors, while sparing healthy tissue. Once inside, the treatment (OncoVex GM-CSF) is supposed to cause tumor cells to burst. But it doesn't stop there—it is also designed to provoke the immune system to mount an attack in the cancerous growth itself, and hunt down any cancer cells that have spread throughout the body. BioVex, as I noted in these pages just over a year ago, has attracted interest from scientists and investors based largely on one study of 50 patients with forms of melanoma, a deadly skin cancer, that have spread through the body. That study found that 13 of the 50 patients (26 percent) had their tumors shrink after they got the BioVex treatment. Even more interesting, eight of the 13 initial responders had their tumors completely disappear, and their responses were long-lasting. Although patients who entered the trial had terminal diagnoses, usually giving them six to nine months to live, according to BioVex CEO Philip Astley-Sparke, more than half of the patients were alive after one year (58 percent) and two years (52 percent), according to data presented at the American Society of Clinical Oncology in June 2009. Side effects were mostly mild-to-moderate flu-like symptoms, researchers said. The company is now in the midst of gathering more proof from a Phase III clinical trial which, if successful, could be the basis for it to win FDA approval of the first such oncolytic virus therapy. BioVex is running a trial expected to enroll as many as 430 patients, according to a posting on clinicaltrials.gov. The goal will be to show the BioVex drug offers an advantage in tumor shrinkage that lasts six months or more, compared to an immune-boosting compound."OncoVex has demonstrated encouraging anti-tumor activity in clinical studies for the treatment of melanoma and head and neck cancer, and BioVex is currently enrolling patients into pivotal Phase 3 trials in both indications," said Roger Perlmutter, Amgen's executive vice president of R&D, in a statement. "Amgen is particularly excited about joining with BioVex and its talented staff to focus on advancing this late-stage investigational therapy, with the hope of bringing it to market within the next few years." No one has ever developed such an oncolytic virus treatment for cancer, although many, such as South San Francisco-based Cell Genesys, have tried before. While BioVex may have the candidate most advanced in clinical trials at the moment, it's not the only company generating new interest in the field. San Francisco-based Jennerex Biotherapeutics, led by a veteran of the early days at Emeryville, CA-based Onyx Pharmaceuticals, is also hot on the trail. So is Calgary, Canada-based Oncolytics Biotech. Amgen has been pushing for years to become a bigger player in anti-tumor drug development, after making its fortune largely on treating some of the side effects of cancer chemotherapy. It won FDA approval in 2006 for panitumumab (Vectibix), and saw limited success. Last year, it followed that up with an FDA clearance of denosumab (Xgeva) as a treatment for bone-related tumors. We'll find out soon enough whether this new bet on oncolytic viral therapy puts Amgen on the leading edge of a new field of science, or ends up being a costly debacle.

Biovex  Formed in 1999, Biovex is a private biotech company, based near Oxford, developing a new class of potent vaccines to treat and prevent cancer and certain viral diseases. The company has two vaccine platforms; OncoVEX and ImmunoVEX, and a functional genomics platform for gene target validation in neurons and other tissues (NeuroVEX). The Company`s lead product has completed Phase I clinical trials with Phase II studies in melanoma, breast cancer and head and neck cancer begun in October 2006. Amgen acquired Biovex in February 2011





Source:   Wikipedia



健保署2014 醫療費用6000億_TOP 10花費: 慢性腎衰竭453億點/ 牙科389億點/ 糖尿病249億點/ 高血壓231億點/ 成人急性上呼吸道衰竭144億點/ 椎間盤突出及下背痛135億點/ 肺炎126億點/ 精神疾病119億點/ 腦出血118億點

醫療費用排名 洗腎第一 發稿時間:2015/05/27 19:48 最新更新:2015/05/27 19:48 (中央社記者龍珮寧台北27日電)健保署公佈去年醫療費用支出,全年約6000億元以上,第一名是洗腎,其次是牙科及糖尿病。整體都有成長,糖尿病成長8%最多。中央健康保險署企劃組專門委員王復中表示,去年醫院申報的醫療用品整體費用約超過新台幣6000億元,健保點值約6150億點,每點約0.9元、慢性腎衰竭是10.82,整體醫療用品支出高於前一年。同時,健保署公佈前十名依次為慢性腎衰竭(453億點)、牙科相關(389億點)、糖尿病(249億點)、高血壓(231億點)、成人急性上呼吸道衰竭(144億點)、椎間盤突出及下背痛(135億點)、肺炎(126億點)、精神疾病(119億點)、腦出血(118億點)。王復中說明,排序和前一年差不多,只是高血壓與呼吸道感染互換。總體而言、較前年成長1-3%,比較明顯差距是糖尿病成長8%,原因可能病人增加,由於疾病不可逆而投入較多資源,也可能有其他原因。慢性病及重大傷病佔比高。台大醫院腎臟科醫師姜至綱說,糖尿病健保給付增加,與藥物推陳出新有關。目前洗腎患者有7萬多人,其中45%是糖尿病患,洗腎是果,糖尿病是因,應控制血壓、血糖、血脂,惡化就來不及了。王復中說,全民健保開辦至今已20年,已累積相當多的醫療相關資料,健保署已在「政府資料開放平臺」建置120項資料集,如前述資料來自「國人全民健康保險就醫疾病資訊」,此資料集可查詢健保醫療費用前20大疾病及其占率、成長率排名變化。

”唐獎”出錢 給科技部做面子 !!! 陳振川: 怪怪的!

比照諾貝爾/唐獎補助三級跳 科技部修法惹議 2015-05-28 〔記者湯佳玲、吳柏軒/台北報導〕為了補助自詡為「東方諾貝爾」的唐獎,科技部竟修法將其得主來台短訪禮遇比照諾貝爾獎,補助頭等艙機票與每天一萬三千元生活費,遭學界批評「才一屆的唐獎,怎麼跟具百年歷史的諾貝爾獎相比!」
得主來台短訪禮遇比照諾貝爾 學界轟怎麼比 以往國際科技人士受學研機構之邀來台短期訪問,科技部補助共分為三等級,最高等級是創立超過百年的諾貝爾獎(Nobel Prize)級,與之同級者還有國際學術界相當推崇的沃爾夫獎(Wolf Prize1976年創立)、費爾滋獎(Fields Medal1936年首次頒獎);其次是國家院士級學者,再來是一般學研機構的學者專家。機票補助各為頭等艙、商務艙、經濟艙,日支酬金各為一萬三千餘元、一萬一千餘元、六千餘元。 科技部上月修正「科技部補助邀請國際科技人士短期訪問作業要點」,新增將才設立不到三年、由潤泰集團總裁尹衍樑捐資創立的「唐獎」納入最高等級類別,與諾貝爾獎同級。這個修法過程引發「砲聲隆隆」,反對者認為,唐獎迄今才頒發一次,難以媲美行之百年的諾貝爾獎等經國際學術界普遍認同的大獎,其學術權威性及公信力尚待時間驗證;也有人質疑,最高等級中,「唯獨唐獎最不具國際知名度」。
科技部︰推廣台灣學術地位 並非壞事 科技部次長林一平坦言,國家學術美譽不可能一步登天,任何一個獎項都需要一段時間的累積;將唐獎比照諾貝爾獎是為推廣台灣學術地位,並非壞事。每個國家都努力贊助本國的學術獎項,以提高國際能見度。中研院副院長王瑜表示「贊成」對唐獎補助,唐獎成立初衷就是希望能涵蓋到諾貝爾獎不及的領域,樂見政府加入推廣,「好事一樁,為何不做?以後若發現不妥,隨時修改也行。」 中研院院士陳建德認為,唐獎和諾貝爾獎彰顯的領域不同,首屆得主雖是頗受學界肯定的「好名單」,但畢竟才一屆、未經足夠時間考驗,科技部直接修訂拉高標準,可想見會引起反彈。 陳建德建議,不如由唐獎基金會或尹衍樑反過來每年捐助科技部兩百萬元,再由科技部以國家名義補助唐獎的學者,不必額外動用到人民納稅錢,將可「贏了面子、又得裡子」 唐獎基金會執行長陳振川則表示,科技部是政府單位,本就有其推動科教政策,補助學者來訪即其中一環。基金會該做的國際交流還是會做,但若要民間去捐贈補助政府政策,感覺「怪怪的!」

寶僑(P&G)/ 萊雅 各自搶進 組織3D列印!!

寶僑 搶進3D生化列印市場 20150527 04:10 記者鍾志恆/綜合外電報導 金融時報報導,3D列印早已不再是一般人印像中應用於廉價塑像和小玩意,其應用技術已進入列印活的人體組織領域。全球最大日用品生產商寶僑(P&G)也投入這個領域,藉此找出更快和更便宜方法來測試其產品效果。寶僑周二在新加坡發起一項大競賽,邀請全球各大專學院提出3D生化列印應用的研究計畫。寶僑負責全球生命科學開放創新業務的盧克(Elena Lurie-Luke)說,希望能研究出生化列印的各種可能,因為這是非常巨大的新興領域。生化列印的運作,是以人工培殖的人體細胞來製造生物墨水(bio-ink),然後把生物墨水灌入裝有壓縮噴嘴注射器的墨水匣來列印。3D生物列印機會一層層列印來堆疊出細胞的形態,再以水凝膠包覆,充當撐托著細胞的框架。當列印出來的人體組織能自然成長後,就會抽掉水凝膠。寶僑並非唯一著眼這項新興技術的公司,法國化妝品集團萊雅5月初,就跟美國新創立的生物列印公司Organovo合作,研發3D列印人體皮膚的技術。萊雅在2011年已於法國里昂成立實驗室,專注生產試管內的皮膚組織,讓化妝品不再依靠動物來測試。盧克說,由於寶僑有大量保養品產品,因此已發展出多個不同試管內皮膚組織的模型。只要寶僑不斷創新和有新工具的協助,生物列印將大有可為。不少藥廠也在開發生物列印技術,以加快醫藥研發與測試速度。全球首家上市3D生物列印公司Organovo,已針對醫藥研究和臨床實驗研發出活的肝組織。雖然專家相信,終有一天能以3D生物列印供移殖用的人體器官,但由於該技術仍在研發階段的初期,因此列印人體器官的技術在未來20年內不可能實現。

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