Neuroblastoma Immunotherapy Trial

Scientists in the UK are studying immunotherapy as a possible weapon in the fight against the childhood cancer, neuroblastoma. The cancer, which affects the nervous system and is most commonly found in children less than five years of age, currently accounts for approximately 17 percent of cancer deaths in children.

The disease is caused by the development of cancerous cells in neural crest nerve cells, which play a key role in the development of the nervous system. This leads to the growth of tumors in nerve tissues in areas such as the adrenal glands, neck, chest, abdomen and pelvis.

Neuroblastoma Treatments

Currently the cancer is treated through a variety of means including surgery, chemotherapy, radiotherapy and stem cell replacement with six in ten patients experiencing a successful outcome from these traditional methods of treatment. However, a recent study in the US appears to indicate that immunotherapy may improve a patient's long-term chances of outwitting the disease.

Immunotherapy for Neuroblastoma

The study, led by Dr Alice Yu, a professor of pediatric hematology and oncology at the University Of California San Diego School Of Medicine and the Moores UCSD Cancer Center, examined the effects of immunotherapy on the relapse rate of neuroblastoma patients.

Immunotherapy involves boosting the body’s immune system by introducing agents that attach themselves to neuroblastoma cells that may have survived previous treatments. The agents operate as antibody markers for the patient’s own immune system, encouraging it to attack and destroy the lingering cancer cells, thus reducing the risk of relapse.

After two years, 66 percent of the surviving study patients receiving the immunotherapy were deemed free of cancer as compared with 46 percent of those who did not receive the treatment. As a result, all of the patients involved in the trial were started on a course of immunotherapy alongside the standard treatment. Dr. Yu noted, “This is the first time in many years that we have been able to improve the 'cure rate' for neuroblastoma patients. This new therapy can help us improve care and perhaps offer new hope to many patients and families."

UK Immunotherapy Trial for Neuroblastoma Patients

The encouraging result has paved the way for further investigation of the effects of immunotherapy on neuroblastoma patients, with Cancer Research UK now funding a four year trial involving 160 young patients in the UK.

The UK trial is to be led by Dr. Penelope Brock, consultant pediatric oncologist at Great Ormond Street Children’s Hospital. Dr. Brock stated, “The launch of this trial in the UK is really fantastic news for our patients. Early results from the US trial found that children who received the immunotherapy treatment had less chance of the disease coming back two years later, compared with the patients who did not receive the immunotherapy. We need to build on these results and devise better immunotherapy approaches that improve survival further. We have worked very closely with the doctors involved in the US trial to design the European study and we very much hope that it will lead to another treatment option for children with high risk neuroblastoma, who have more chance of the disease coming back.”

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Radioactive Seed Implants to Cure Prostate Cancer

Prostate Cancer

Prostate cancer is one of the more common cancers among men, especially as they age. Physicians are continually looking for ways to combat the cancer, either to prevent it completely, or to find ways to treat it once a patient has been diagnosed. There are a number of treatments to choose from, but understanding which one is right for you requires a better understanding of what prostate cancer is, and how it progresses. Your opinion will be determined in part by the advice of your healthcare provider or your personal physician, but the more that you know, the more informed decision you can make.

Prostate cancer initiates in the prostate gland, as its name suggests. Cells may spread from the prostate to other parts of the body, most dangerously the bones and the lymph nodes. Diagnosing prostate cancer early is extremely important. The earlier the disease is discovered, the better the chances of successful treatment and avoidance of metastasizing. This form of cancer can cause pain, erectile dysfunction, difficulty urinating, and worse. Detection rates vary around the world, but the United States is generally the leader in diagnostic techniques. Due to the manner in which cancer spreads, and the fact that most men do not develop this form of cancer until the age of 50, it often goes completely undiagnosed. Ironically, even though it is one of the most prevalent types of cancer in men, many of the victims never present with symptoms, never undergo therapy, and many eventually die of other causes. The only positive of prostate cancer is that it is extremely slow growing and while there are symptoms, they are generally mild.

There are a variety of methods used for treating prostate cancer, although the primary therapies are surgery and the use of radiation. Individuals may also undergo hormone therapy, chemotherapy, proton therapy, cryosurgery, high-intensity focused ultrasound, or the latest cutting edge treatment, radioactive seed implants.

It is unknown exactly what causes prostate cancer; a man's risk is related to age, genetics, race, diet, lifestyle, and medication, among other factors, with the primary one being age. Prostate cancer is fairly uncommon in men under the age of 45, but the risk increases as one ages, with the average age of diagnosis at 70 years of age.

What is a Radioactive Seed Implant?

Radioactive seed implants are a form of radiation therapy prescribed to patients who have been diagnosed with prostate cancer. It is also described as internal radiation therapy, or brachytherapy. The traditional method is permanent, although there is a newer technique simply called temporary brachytherapy.

The permanent method, which has been used in the past, requires a doctor or physician to implant radioactive seeds into the prostate. The number of seeds and their specific location within the prostate is determined by the severity of the cancer. A treatment plan is specifically tailored for each patient, generally involving 40 to 100 seeds. These implants are permanent, eventually becoming biologically inert after a few months. They are specifically useful because they allow a high dose of radiation to be delivered to the prostate while limiting damage to the surrounding tissue.

With the newer method, a hollow needle is inserted into the prostate gland for a period of anywhere from five to 15 minutes, with the seeds inside the needle. This is repeated several times over a period of a few days. Eventually the implants remain permanently within the prostate, becoming biologically inert after approximately 10 months. Both methods have been growing in popularity in recent years because of the time and convenience of the treatment. External radiation generally requires eight to nine weeks of daily treatments, while seed implantation can either be over the course of a few days or in one procedural visit. Its effects last for a period of several months.

Research

Dr. Louis Potter MD, Chairman of Radiation Medicine at North Shore University Hospital and LIJ Medical Center, recently supervised a study observed 2,119 prostate cancer patients between 1992 and 2005, narrowing their selection to men under 60 years old. The study looked at treatments that were completed with permanent brachytherapy and those with and without hormone therapy, external beam radiation, permanent prostate brachytherapy, or any combination of the above. The goal of this study was to determine whether there was a difference in rates of progression among treatments and whether those rates had anything to do with the age of the patient. They followed 237 patients for a period of 56 months after treatment. According to the findings of Dr. Potter published in the Journal of Urology, age did not seem to play a part. “There is a whole politics to prostate cancer treatments,” he added. “But the bottom line is that brachytherapy is an appropriate option for men at any age”. The debate in recent years has been whether prostate brachytherapy is effective as a surgery in reducing the risk of disease progression in younger men. Dr. Potter stated, “There is no gold standard for outcomes in younger men with prostate cancer. Outcomes are impacted by disease related risk factors but not by age.”

His research has been picked up by the Feinstein Institute for Medical Research and the North Shore LIJ Health System and is currently being continued. Adam P. Dicker, MD/PhD from the Kimmel Cancer Center is currently researching the field of prostate brachytherapy, focusing mainly on the definition and evaluation of the actual dose of radiation required. Their most recent comprehensive text was published by Frances and Taylor in 2005, “Basic and Advanced Techniques and Prostate Brachytherapy.” In it, they addressed all aspects of prostate cancer and brachytherapy, specifically discussing the practical techniques and issues that can be incorporated into daily practice. His research is ongoing at the Prostate Brachytherapy Program at Thomas Jefferson University Hospital.

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