New cancer drug has few side effects

There's an interesting article in the New England Journal of Medicine (NEJM) that talks about a novel new cancer agent called olaparib. In a phase 1 study, this drug was found to have few adverse effects (compared to conventional chemo) and displays antitumor activity in certain tumors. Here's the brief conclusion: Olaparib has few of the adverse effects of conventional chemotherapy, inhibits PARP, and has antitumor activity in cancer associated with the BRCA1 or BRCA2 mutation.

Technology Review has a nice article on this titled, "New Drug Kills Cancer with Few Side Effects." Sounds simple, doesn't it?

Compare that to the NEJM title: "Inhibition of Poly(ADP-Ribose) Polymerase in Tumors from BRCA Mutation Carriers." Did you catch all that? What's PARP?

Did you learn about PARP in medical school? The inhibition of poly(adenosine diphosphate [ADP]–ribose) polymerase (PARP) is a potential therapeutic strategy for the treatment of cancers with specific DNA-repair defects, including those arising in carriers of a BRCA1 or BRCA2 mutation. Olaparib (AZD2281) is an orally acting PARP inhibitor.

As cancer therapy becomes more tailored in our evolving world of personalized medicine, it's exciting to see all this research that combines molecular biology, genomics, and targeted therapies. Advances in medical technology and drug development are leading to innovative treatments in the world of oncology.

Olaparib (AZD2281), previously known as KU-0059436, began to be manufactured by AstraZeneca after the company acquired KuDOS Pharmaceuticals.

Novel Cancer Biomarkers, Oncogenes, and Targeted Therapies

Since I graduated from medical school (many years ago), we have discovered so many new cancer biomarkers and oncogenes. The world of genomics has really taken off! As I think about the future of medicine, I often wonder about how many more biomarkers and oncogenes we will discover. How many new drugs will get developed to specifically target the overexpression of specific oncogenes? Human genetics and molecular biology are becoming more fascinating topics because we now have the ability to engineer drugs that target specific genes and gene products.

Here are a few examples of some of the newer areas of cancer research:

• DNA Methylation Biomarker, Septin 9, (Colorectal Cancer)
• Non-codingRNA (microRNA)
• Metabolomics-derived Biochemical Markers (Prostate Cancer)

We all know about BRCA1 and BRCA2. We also know that HER2 overexpression can be targeted by an anti-HER2 humanized monoclonal antibody (called trastuzumab or Herceptin). The topic of personalized medicine has been gaining tremendous traction, especially in the oncology world. What if there was a way to prevent hereditary cancers? If we can identify ways to target the specific gene (or genes) that are causing cancer, then we might be able to prevent those malignancies. Advances in drug development have led to many biologic agents (targeted therapies) that act on specific pathways like VEGF (vascular endothelial growth factor) and block the formation of new blood vessels. You've probably heard of bevacizumab or Avastin, which is a VEGF-inhibitor.

Speaking of biologic drugs, I still remember when the first tyrosine kinase inhibitor (TKI) came out. Remember when Gleevec (imatinib) came out? TKIs have now evolved into agents that target multiple different tyrosine kinase pathways and even inhibit EGFR (epidermal growth factor receptor). We now have nilotinib (Tasigna), dasatinib (Sprycel), erlotinib (Tarceva), gefitinib (Iressa), and several more coming. How do medical students keep up with all these drugs? Students today are even learning about new compounds like histone deacetylase inhibitors (HDAC inhibitors or HDIs). We've certainly come a long way in the world of cancer biomarkers, oncogenes, and targeted therapies. What will the future look like as we learn how to target these biomarkers and oncogenes? Image source:

The ACLU Sues Over Patents on Cancer Genes

CNN: "Patents on two human genes linked to breast and ovarian cancers are being challenged in court by the American Civil Liberties Union (ACLU), which argues that patenting pure genes is unconstitutional and hinders research for a cancer cure." According to the ACLU, "Myriad's patents give it exclusive right to perform diagnostic tests on the genes -- forcing other researchers to request permission from the company before they can take a look at BRCA1 and BRCA2."

What do you think about this?

Scientists are identifying more cancer genes all the time. We already know that several forms of breast and ovarian cancers are linked to specific genes (like BRCA1 and BRCA2) that can be detected through special genetic tests. Oncologists and geneticists often struggle with the ethical dilemmas that frequently complicate genetic testing. Image source: CNN