"Breast cancer affects about 450,000 women and girls in the United States alone," observed reproductive endocrinologist Kutluk Oktay. "Of these patients, 15 percent to 20 percent are in their reproductive age. As a consequence," Oktay continued, "many of these women will be given chemotherapy regimens containing cyclophosphamide and taxanes, which in a significant majority of these patients can result in premature ovarian failure and infertility."
Oktay practices at the Weill Medical College of Cornell University in New York. A current online article in The Lancet tells his story.
(Taxanes and paclitaxel, a drug derived from the Pacific yew tree, are marked by adverse side effects. Alternatively, radiation therapy and various radical cancer surgery approaches are at hand. However, in recent years a new strategy has emerged for coping with some breast cancers.)
"We and other researchers," Oktay stated, "report promising findings of a technique that could potentially help women to regain fertility after premature menopause due to cancer therapy. We recount the technique in a 30-year-old woman in a fast-track study, published online March 9, 2004, ahead of print appearance in the March 13, 2004, issue of The Lancet. Our new technology prevents chemotherapy that causes ovarian failure in breast cancer patients.
"This young woman is not our first and only patient," Oktay went on. "We have done four ovarian transplants and have cryopreserved tissues from up to 60 patients. But this is our first patient," he added, "in whom ovarian function was restored after cryopreservation for six years. And the first bearing a four-cell embryo from transplanted ovarian tissue. You can also say," Oktay pointed out, "that this is done not only for breast cancer patients, but for any cancer where the ovaries are not involved and the patients are subjected to anti-cancer drugs with adverse side effects on infertility.
"Our findings," Oktay concluded, "show that fertility and ovarian endocrine function can be preserved in women by long-term ovary-tissue banking."
An accompanying commentary in the journal makes the point that "cryopreservation and transplantation technique for certain cancer cases are not risk-free. In light of the current uncertainty," it warns, "about the effectiveness and safety of ovarian cryostorage and grafting, the whole procedure should still be presented to patients as experimental. Only a small part of the ovarian graft can be screened with sensitive techniques for the detection of hosted cancer cells.
"For those that colonize the ovary, or can metastasize into the ovary, it will be difficult to detect the presence of such cells in the graft. To provide an evidence-based approach in future practice, a multicenter trial could be proposed in which girls or young women, at intermediate risk of sterility, would be randomized between storage of gonadal tissue or nonintervention. Such a prospective study would show which of two options gives the best chances for obtaining a normal child."
Two Proteins Better Than One And Likely Prevent Alzheimer's Brain Plaques From Taking Form
Scientists at Washington University in St. Louis suggest that two proteins, apolipoprotein E (Apo E) and clusterin act as "chaperones," orchestrating clearance of potentially hazardous molecules from the brain. Ironically, those same molecules also are implicated in a key stage of plaque formation (a hallmark of Alzheimer's disease). Their report appears in the Jan. 22, 2004, issue of Neuron. Its title is "Apo E and clusterin cooperatively suppress A-beta levels & deposition: Evidence that Apo E regulates extracellular A-beta metabolism in vivo."
"This is one of the first demonstrations in living animals that these proteins affect amyloid clearance," notes neurologist David Holtzman, who leads the journal article. "Our findings," he told BioWorld Today, "suggest it is worthwhile to explore the use of drugs or therapies that may alter or increase the expression of these proteins as a potential treatment for AD."
A key step in the development of AD is formation of cerebral plaques. Holtzman's team reports that those plaques form when A-beta converts from its soluble to insoluble form and coalesces into hair-thin fibrils Those eventually clump into plaques. Their journal article in Neuron confirms that in transgenic mice genetically engineered to develop AD-like brain plaques, those lacking Apo E and/or clusterin develop fewer fibrils. The co-authors expected the mice, lacking both proteins, would generate fewer fibrils. However, the opposite turned out to be true. Such extreme A-beta deposition at a young age is akin to that of humans with the rare, genetic form of the disease - a familial version of Alzheimer's. Without its chaperones, the protein settles in the brain and eventually clusters into plaques.
Journal Testing Civacir, A Drug Created By Nabi For Treatment Of Liver Disease
Hepatitis C virus is a major cause of chronic liver disease, including liver transplant. An estimated 5 percent of patients develop hepatic cancer and require an organ replacement to survive. The World Health Organization estimates that 170 million people - 3 percent of the world's population - are chronically infected with HCV. In North America and Europe, some 30 percent to 40 percent of liver transplants are due to HCV infection.
Nabi Biopharmaceuticals, of Boca Raton, Fla., announced Feb. 23, 2004, preliminary results of its Phase I/II trials with Civacir (hepatitis C immune globulin [human]). The antibody-based drug is under development to prevent hepatitis C virus re-infection of transplanted livers with chronic HCV. "Detailed results," Nabi has announced, "are being prepared for submission to a peer-reviewed medical journal, and thus are not available at this time."