TAG: "Cancer"

Tai chi reduces inflammation in breast cancer survivors

Practicing the ancient Chinese martial art could potentially lower risk for cancer recurrence.

UCLA researchers have discovered that the Chinese practice of tai chi can reduce inflammation in people who have had breast cancer, thereby reducing a risk factor for the recurrence of the cancer.

Current research indicates that women diagnosed with breast cancer in the past 10 years are three times more likely to suffer from lack of sleep. Insomnia can lead to increases in inflammation, which places breast cancer survivors at risk for cancer recurrence as well as cardiovascular disease.

Led by UCLA Jonsson Comprehensive Cancer Center member Dr. Michael Irwin, researchers conducted a five-year randomized clinical trial from April 2007 to August 2013. His team analyzed blood samples from 90 participants between 30 to 85 years old, before and after they started the tai chi routine.

“When people practice tai chi, there is a decrease in the stress hormones produced by the sympathetic nervous system,” said Irwin, who is professor of psychiatry and biobehavioral sciences at UCLA.

Irwin and his colleagues also discovered that tai chi relaxes the body to a certain point that it can reduce inflammation, which is commonly seen in most breast cancer survivors after treatment.

“We saw that tai chi reversed cellular inflammation, by producing a down-regulation of the genes that lead to inflammation,” said Dr. Irwin. “Tai chi is a movement meditation, and we have found that similar anti-inflammatory effects occur when people practice other forms of meditation.”

Irwin said that he hopes the exercise will gain in popularity, particularly in low-income communities where many do not have immediate access to breast cancer treatment.

Two-time breast cancer survivor Linda Tucker has had many sleepless nights until recently.

“I absolutely did not sleep, my eyes would not stay asleep, my body just would not relax and I found myself awake until six in the morning,” said Tucker.

Desperate to find a cure for her sleeping problems, Tucker decided to participate in Irwin’s tai chi study at UCLA despite her initial skepticism.

“I said to myself, this has to be a joke, this is not going to work or do anything. But after two sessions the insomnia started going away,” she said. “I just felt a sense of peacefulness.”

The study was published online Nov. 4 in the Journal of the National Cancer Institute.

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Software platform bridges gap in precision medicine for cancer

Cloud-based system seamlessly integrates ‘actionable’ genomic insights into EMR.

UC San Francisco has unveiled a new cloud-based software platform that significantly advances precision medicine for cancer. Built in partnership with Palo Alto-based company Syapse, the new platform seamlessly unites genomic testing and analysis, personalized treatment regimens, and clinical and outcomes data, crucially integrating all of these features directly into UCSF’s electronic medical record (EMR) system.

The project was a collaborative venture of UCSF’s Genomic Medicine Initiative (GMI) and the UCSF Helen Diller Family Comprehensive Cancer Center.

“Many major medical institutions, including UCSF, have long had the science and the technology to generate genomic test results,” said Kristen McCaleb, Ph.D., program manager for the GMI. “The problem we’ve had is a lack of IT infrastructure to return those results to the clinicians who order the tests in a clearly actionable format. This new platform creates a doctor-friendly report that physicians can use to put genomics into the context of a patient’s clinical history, to receive guidance based on our institution’s best practices, to query for additional information — including outcomes of prior UCSF patients — and, ultimately, to provide better care for their patients.”

Jonathan Hirsch, Syapse president and founder, said that tight integration with APeX, UCSF’s Epic-based EMR, makes the new platform uniquely powerful. “Genomics has the potential to dramatically improve patient care in oncology, but the full promise of precision medicine cannot be realized without a software platform that brings genomics to the point of care,” said Hirsch. “It is critical that genomic data be integrated with the patient’s medical history and presented to the clinician within the workflow of their EMR.”

Beginning in the spring of 2015, UCSF oncologists will be able to use the new system to order the “UCSF 500,” a panel of more than 500 gene mutations that have been implicated in a range of cancers, with tools built directly into their adult and pediatric patients’ EMRs. When UCSF 500 test results are available, they will automatically appear in a Syapse-powered window in the EMR, and from there, physicians will be able to trigger consultation by a newly formed Molecular Tumor Board, which can recommend customized treatment plans for each patient.

The Tumor Board’s recommendations are recorded in Syapse alongside the physician’s decisions, and the patient’s clinical course will be continuously tracked, with the resulting information, including clinical notes and summaries, displayed to the physician in an easy-to-understand graphical format in the EMR.

Hirsch said that the assembly of the UCSF 500 wouldn’t have been possible without the energetic involvement of UCSF’s medical oncologists. “The clinicians at UCSF have been highly involved in defining what ‘actionability’ truly is — knowing which genomic alterations in which cancer types can be best treated with targeted therapies. They’re sitting down and doing the hard work of creating a cancer genomics knowledge-base, which has allowed Syapse to design automated clinical decision support that reflects UCSF’s leading oncology care.”

Because the Syapse system is cloud-based, implemented on Amazon Web Services (AWS), physicians and members of the Molecular Tumor Board can query a patient’s test results in real time against the latest entries in UCSF’s knowledge-base, which also draws from public genetics, oncology and clinical trial databases, as well as the current scientific literature. Hirsch said AWS was selected for its robust security, support for medical privacy-law compliance, scalability and stability.

A de-identified version of each patient’s clinical history from APeX and information on how patients respond to treatments is simultaneously added to a dedicated clinical research knowledge-base within Syapse, so future recommendations of the Molecular Tumor Board for any patient’s case will always be informed by the latest clinical experience. Because APeX is based on Epic, a widely used EMR system, the new platform is easily scalable, and could easily capture clinical data from many medical centers in a consistent, easily accessible form, Hirsch said.

“Our top priority is benefiting our patients today, but if we can begin to collect and leverage the knowledge we gain from each positive patient outcome, and combine our experience with that of others doing similar work worldwide, future patients may be able to sidestep conventional therapies and go directly to the best targeted therapy as a first-line treatment,” McCaleb said. “And that would be truly powerful.”

Robert Nussbaum, M.D., the Holly Smith Distinguished Professor in Science and Medicine and GMI director, said, “This collaboration is just one example of what the GMI is doing to bring genomics to bear on clinical medicine. The partnership is the product of a large multidisciplinary team of oncologists, molecular pathologists, and IT specialists. We are excited with the results and look forward to using it to improve the care of our patients.”

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Pediatric cancer expert champions innovative treatment at new hospital

UCSF researcher has helped redefine the treatment of neuroblastoma.

The entrance to the new UCSF Benioff Children's Hospital San Francisco at Mission Bay, which will open Feb. 1, 2015.

It offers whimsical works of art by celebrated artists, interactive exhibits designed by the Exploratorium and acres of rooftop gardens. When UCSF Benioff Children’s Hospital San Francisco moves to its new home at Mission Bay, it will even feature a fleet of robots that glide silently across hospital hallways bearing food trays or linens.

For most young patients, visits will be brief and occasional. But physicians like Kate Matthay, M.D., who runs the pediatric malignancies program, recognize that for some patients visits may be lengthy and frequent.

“The hospital is child friendly and family friendly, and that’s important because sick kids need their families close by,” said Matthay, who has been working at UCSF Benioff Children’s Hospital San Francisco since her fellowship in 1979 and is herself the parent of three adults.

Kate Matthay, UC San Francisco

Matthay is uniquely attuned to the needs of very sick children, because her patients include those with neuroblastoma, one of the most challenging pediatric cancers. Neuroblastoma is a rare malignancy of the nerve cells that usually starts in the adrenal glands, abdomen or near the spine by the chest or neck, spreading rapidly and aggressively in some patients. About 50 percent of patients present with advanced disease and require a bone-marrow transplant, follow-up therapy and lifelong specialized medical surveillance. Only 45 to 50 percent of patients over the age of 18 months with metastatic disease survive five years after diagnosis.

Matthay’s mission is twofold: She is committed to researching strategies that boost survival of neuroblastoma as well as other pediatric cancers with low cure rates; and she wants to identify the hallmarks of lower-risk disease that enable physicians to pare down treatment regimens, reducing side effects like hair loss, nausea and compromised immunity. More significantly, it will lower the risk of late effects, such as stunted growth, developmental delays and secondary cancers.

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Environmental carcinogens leave genetic imprints in tumors

Chemically induced tumors bear signatures that differentiate them from genetically engineered cancers.

Genetically engineering tumors in mice, a technique that has dominated cancer research for decades, may not replicate important features of cancers caused by exposure to environmental carcinogens, according to a new study led by UC San Francisco scientists. In addition to pointing the way to better understanding of environmental causes of cancer, the findings may help explain why many patients do not benefit from, or develop resistance to, targeted drug therapies.

In the new research, reported Nov. 2 in the advance online edition of Nature, a team led by UCSF graduate student Peter M.K. Westcott found that chemically induced lung tumors in mice carry hundreds of point mutations — deleterious alterations of single “letters” in the genome — that are not present in tumors induced by genetic engineering. The researchers demonstrated that chemically induced tumors display a starkly different “mutational landscape” even when chemicals cause a tumor-initiating mutation that is identical to that created by direct genetic manipulation.

“Since the 1980s, when genetic engineering came along, the mouse model community has been working on genetically engineered cancer—you put a gene in or take a gene out, and you get a tumor,” said Allan Balmain, Ph.D., the Barbara Bass Bakar Distinguished Professor in Cancer Genetics at UCSF and senior author of the study. “But it’s only now that we’re beginning to analyze what has happened between that first engineered change and the ultimate development of an aggressive tumor.”

The new work made use of next-generation sequencing (NGS) technology, which allows researchers to analyze the genomic sequence of tumors or of normal tissue letter-by-letter. For the Nature study, the group used a form of NGS known as whole-exome sequencing, which comprehensively analyzes the portion of the genome that contains the code for producing proteins.

The findings dovetail well with those from NGS-based studies of human tumors, such as The Cancer Genome Atlas (TCGA) initiative spearheaded by the National Cancer Institute and National Human Genome Research Institute, which have revealed mutational “signatures,” some of which can be definitively tied to environmental exposures. For example, distinctive patterns of point mutations are now known to differentiate lung cancer in smokers from that affecting non-smokers.

The results are also consistent with observations that tumors arising in human organs that are most directly exposed to environmental carcinogens — the skin, gastrointestinal system and lungs — are more prone to point mutations than more “protected” organs such as the brain, breast and prostate gland.

“We humans smoke cigarettes, drink alcohol and spend too much time in the sun, all of which cause us to accumulate point mutations that are major determinants of the behavior of tumors, especially of how a tumor responds to therapy,” said Balmain, co-leader of the Cancer Genetics Program at UCSF’s Helen Diller Family Comprehensive Cancer Center. “All this heterogeneity is being missed with genetically engineered tumors, because they don’t reflect these environmental effects.”

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Cloud Pilot program to boost cancer genomics data sharing, accessibility

UC Santa Cruz, UC Berkeley partner for large-scale analysis of cancer genomics data.

David Haussler, UC Santa Cruz

The UC Santa Cruz Genomics Institute is part of a team led by the Broad Institute of Harvard and MIT that was awarded one of three National Cancer Institute (NCI) Cancer Genomics Cloud Pilot contracts. The goal of the project, which also involves scientists at UC Berkeley, is to build a system that will enable large-scale analysis of The Cancer Genome Atlas (TCGA) and other datasets by co-locating the data and the required computing resources in one cloud environment.

This co-location will enable researchers across institutions to bring their analytical tools and methods to use on data in an efficient, cost-effective manner, thereby promoting democratization and collaboration across the cancer genomics community. Seven Bridges Genomics and The Institute of Systems Biology, in collaboration with Google, are the two other awardees in the NCI Cloud Pilot program.

“Putting genomic data on the cloud for analysis and sharing is a great direction to go in,” said David Haussler, professor of biomolecular engineering at UC Santa Cruz and director of the UCSC Genomics Institute.

CGHub experience

Gad Getz of the Broad Institute is the lead principal investigator of the Broad-University of California Cloud Pilot (BUCCP) and will be leading the Broad team together with Matthew Trunnell and Anthony Philipakis. Haussler brings to the project the UC Santa Cruz team’s experience in building and operating NCI’s Cancer Genomics Hub, a secure repository for storing and accessing cancer genomic data from TCGA and related projects. The BUCCP also leverages the work of UC Berkeley researchers led by David Patterson to develop tools for efficient computing over genomics data. Patterson is also partnering with Haussler in the recently funded Center for Big Data in Translational Genomics led by UC Santa Cruz.

The Cancer Genomics Cloud Pilot effort is firmly rooted in the data-sharing principles set forth by the Global Alliance for Genomics and Health (GA4GH), of which Haussler, Patterson, Getz, and Philipakis are working group members, making it both technically driven and mission-driven from its incipience. The pilot awardees will collaborate with each other and with the NCI Genomics Data Commons (GDC) at the University of Chicago, where the data will be hosted, as well as with the NCI staff and leadership towards a shared vision of a cohesive data and analysis infrastructure to advance the understanding and treatment of cancer.

“We will be working with the Broad Institute and the other two cloud pilot operations and the GDC as part of the Global Alliance for Genomics and Health, which strongly endorses the cloud pilots,” said Haussler, who cofounded GA4GH and co-chairs its Data Working Group.

Large-scale sequencing

Large-scale sequencing efforts are helping researchers understand the genetic changes that lead to cancer and have led to the development of several successful, targeted chemotherapies. These developments show that identifying mutations that drive cancer can translate into therapeutics. However, three main challenges remain: first, processing massive sequence datasets requires costly computational infrastructures for which few groups have the resources; those that do have the resources often end up duplicating each others’ engineering and analysis efforts. Second, data generation is outpacing the development of tools and methods that can be used on such large datasets: already, petabytes of data exist, and exabytes — 1,000 times a petabyte — are to come. Finally, data is being collected and stored in silos, minimizing the potential for synergy, data sharing, and integrated analysis.

To more fully understand the magnitude of a petabyte, if the average MP3 encoding of music requires around 1MB per minute, and the average song lasts about four minutes, then a petabyte of songs would last over 2,000 years playing continuously.

The impetus for the cancer genomics cloud pilots grew from an inquiry the NCI posed in April 2013 asking the NCI grantee community to describe their most frequent computational challenges. From these responses, six general themes emerged: data access, computing capacity and infrastructure, data interoperability, training, usability, and governance. The BUCCP is addressing these gaps in cancer genome analysis by building a platform for data aggregation and analysis on a computing cloud. This will combine a production environment for running analyses with robust security and access control together with a scalable paradigm for distributed data storage and computation. The BUCCP system will host The Cancer Genome Atlas (TCGA) data and will be pre-populated with commonly used computational tools to immediately empower the cancer genomics research and biomedical community. In addition, the team will develop strategies to engage the community and demonstrate the capabilities of the platform.

Exceptional opportunity

Benedict Paten, assistant director of the Center for Big Data in Translational Genomics at UC Santa Cruz, said that developing future cancer therapies based on whole genome sequencing is a major motivation for the center. “Four of our seven driving projects are focused on cancer genomics. The Cancer Genomics Cloud Pilots are an exceptional opportunity to bring the work of TCGA, the definitive cancer genomics project, into the age of the global information commons on the Internet, pioneered by our center and collaborators in the Global Alliance for Genomics and Health,” Paten said.

“The Cancer Genomics Cloud Pilots will allow the cancer research community to collaborate in a way that has not been possible before,” said Getz. “We’ll now be able to share data and tools and jointly learn from the totality of cancer genomics data. Our cloud system will democratize access to computational tools for non-experts as well as empower developers with a platform for creating the next generation of analytical methods.”

This project has been funded in whole or in part with Federal funds from the National Cancer Institute, National Institutes of Health, Department of Health and Human Services, under Contract No. HHSN261201400006C.

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Immunotherapy for cancer can be toxic with obesity

UC Davis researchers link increased body fat and lethal drug reactions in mice.

Annie Mirsoian, UC Davis

Immunotherapy that can be effective against tumors in young, thin mice can be lethal to obese ones, a new study by UC Davis researchers has found. The findings, published online today (Nov. 3) in The Journal of Experimental Medicine, suggest a possible link between body fat and the risk of toxicity from some types of immunotherapy.

The study comes at a time of great excitement about immunotherapy drugs, which are being developed and used increasingly against cancer, particularly in melanoma and kidney and prostate cancers. Immunotherapies use immune components, such as antibodies or cytokines, to stimulate or suppress the immune system to help the body recognize, fight and kill tumors.

Immunotherapies fall into many classes, including systemic stimulatory regimens, inhibitors of checkpoint blockade and cell-mediated vaccines. Despite the progress made in their development in the last decade, many of these agents induce severe, often limiting toxicities in patients, hindering their use. UC Davis researchers have been working with mouse models to determine if there is a subset of patients for whom certain types of immunotherapies are especially toxic.

“Cancer is primarily considered a disease of the aged, and yet preclinical studies generally use young, lean animal models that may not be reflective of the ‘typical’ cancer patient,” said study lead author Annie Mirsoian. “Aging is a dynamic process that is characterized by increases in inflammatory factors, as well as a shift in body composition, where there is a gradual loss of lean muscle mass and an increase in fat accumulation, which effect how the immune system functions.”

Mirsoian, part of the immunology graduate group in the UC Davis Department of Dermatology, said the study sought to determine if by adjusting the mouse model to more closely reflect the cancer patient phenotype (advanced age and  overweight), researchers could better understand the discrepancies between animal study outcomes and those in patients in the clinic. Their studies examined aged mice on standard diets and compared those to aged mice that were calorie-restricted throughout life.

The researchers found that calorie restriction plays a protective role against toxicity. When laboratory aged mice ate their standard diet freely throughout life, they became obese and ultimately experienced lethal adverse reactions after receiving a systemic immunotherapy regimen.

“We know that people who are obese in general are at higher risk for complications from surgery, radiation and chemotherapy,” said study co-author Arta Monjazeb, assistant professor in the UC Davis Department of Radiation Oncology. “We know that obese people have higher levels of inflammatory markers in their blood, but there is a lack of data examining the effects of obesity on cancer treatment outcomes.”

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Study to examine risks, benefits of chemotherapy for early-stage breast cancer

Research aims to better inform physicians, patients about optimal treatment strategies.

Joy Melnikow, UC Davis

Treatment for early stage breast cancer is highly effective, and for many women considering treatment choices, chemotherapy may add little to an already high long-term survival rate. Joy Melnikow, professor in the Department of Family and Community Medicine and director of the Center for Healthcare Policy and Research at UC Davis, is working to define the potential long-term harms of chemotherapy for these patients, so they can be weighed against the potential benefits.

Her study, funded by the National Cancer Institute (NCI), aims to better inform physicians and their patients about optimal treatment strategies. She also hopes to identify gaps in the evidence to date that require additional research.

“It‘s important to know when you can say the evidence is strong and when it is not,” she said.

Melnikow said treatment regimens vary for early-stage invasive breast cancer. In many cases, women opt for a lumpectomy (surgical removal of the tumor) with radiation, or a mastectomy (removal of one or both breasts) with the addition of hormonal therapy and/or chemotherapy and sometimes trastuzumab (Herceptin), a monoclonal antibody treatment.

“The survival from treatment with or without adjunctive chemotherapy is extremely good for many women with early-stage disease, so the incremental benefit of chemotherapy may be small,” she said. “The question is how to balance the benefits with the potential long-term harms of chemotherapy.”

Melnikow and her colleagues are conducting a series of systematic reviews of the published literature to extract and synthesize what is known about a range of potential long-term harms of chemotherapy for early-stage breast cancer. The harms may include congestive heart failure, ovarian failure (for premenopausal women), peripheral neuropathy, cognitive impairment, and secondary cancers from the effects of chemotherapy on the DNA of non-breast cancer cells.

In addition to identifying and reviewing all available published evidence on the topic, Melnikow also is working with her colleagues to mine previously unpublished data from the NCIB-30 trial of chemotherapy regimens for early-stage breast cancer.

“We hope our work will provide new information to help women and their doctors make decisions about breast cancer chemotherapy,” she said. “We also expect to define critical gaps in the evidence that can inform future research in this area.”

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Stem cell therapy coming of age

With first clinical trials, UC San Diego pushes stem cell therapies into new era.

Photos by Erik Jepsen, UC San Diego

In 2004, the therapeutic potential of stem cells persuaded more than 7 million Californians to approve Proposition 71, which allocated a whopping $3 billion for research and development of stem cell-based drugs and therapies that might someday address a medical dictionary’s worth of diseases and conditions.

Now, stem cell research is being put to the test in full force as years of cellular and animal studies make the leap to human clinical trials—a requisite step before any new drug or therapy is approved for market. Nowhere is this progress more visible than at UC San Diego, which in recent weeks has launched the three first stem-cell-based clinical trials in patients to pursue potential treatments for spinal cord injury, Type 1 diabetes and chronic lymphocytic leukemia.

And last week, the California Institute for Regenerative Medicine (CIRM), the state stem cell agency established by Prop.71, named the Sanford Stem Cell Clinical Center at UC San Diego Health System one of three “alpha clinics,” a highly sought-after designation that comes with an $8 million grant to further speed stem cell clinical development. The other two alpha clinic sites are City of Hope hospital near Los Angeles and UCLA, which is partnering with UC Irvine.

“A UC San Diego alpha clinic will provide a vital infrastructure for establishing a comprehensive regenerative medicine clinical hub that can support the unusual complexity of first-in-human stem cell-related clinical trials,” said Dr. Catriona Jamieson, deputy director of the Sanford Stem Cell Clinical Center, director of the UC San Diego Moores Cancer Center stem cell program and the alpha clinic grant’s principal investigator.

“The designation is essential in much the same manner that comprehensive cancer center status is an assurance of scientific rigor and clinical quality. It will attract patients, funding agencies and study sponsors to participate in, support and accelerate novel stem cell clinical trials and ancillary studies for a range of arduous diseases.”

Lawrence Goldstein, director of the UC San Diego Stem Cell Program and Sanford Center

Such work is well underway. Last week, doctors at UC San Diego and Veterans Affairs San Diego Healthcare System, in collaboration with the San Diego-based biotechnology firm ViaCyte, Inc., treated the first patient in an unprecedented phase one-two trial of a stem-cell-derived therapy for patients with Type 1 diabetes. The trial involves implanting specially encapsulated embryonic stem-cell-derived cells under the skin where it’s hoped they will mature into pancreatic beta and other cells able to produce a continuous supply of needed insulin and other substances.

Last month, a 26-year-old woman paralyzed in a car accident a year ago successfully underwent the first experimental procedure to test whether neural stem cells injected at the site of a spinal cord injury is safe and could be an effective treatment. It is hoped that the procedure – the first of four in the phase one trial sponsored by the Sanford Center and Maryland-based Neuralstem Inc. – will ultimately lead to a treatment in which transplanted neural stem cells will develop into new neurons that bridge the gap created by an injury, replace severed or lost nerve connections and restore at least some motor and sensory function.

Also last month, researchers at UC San Diego Moores Cancer Center and the Sanford Center treated the first participant in a novel phase one trial to assess the safety of a monoclonal antibody treatment that targets cancer stem cells in patients with chronic lymphocytic leukemia, the most common form of blood cancer.

“What we are seeing after years of work is the rubber hitting the road,” said Lawrence Goldstein, director of the UC San Diego Stem Cell Program and Sanford Center. “These are three very ambitious and innovative trials. Each followed a different development path; each addresses a very different disease or condition. It speaks to the maturation of stem cell science that we’ve gotten to the point of testing these very real medical applications in people.”

Goldstein noted that the number of patients involved in these first trials is small. Their focus is upon treatment with low doses to assess safety, but also with hope of patient benefit. As these trials progress – and additional trials are launched – Goldstein predicts greater numbers of patients will be enrolled at UC San Diego, the Sanford Center and elsewhere.

Achieving alpha clinic status should help, he said. One element of the new grant is expanded public outreach to raise awareness and understanding of stem cell science, in part to combat what Goldstein calls “stem cell tourism” and the marketing of unproven, unregulated and potentially dangerous therapies.

“Clinical trials are the fastest and safest way to develop therapies that are truly safe and that actually work. You want to prove that a new therapy will work for more than just a single, random patient. These alpha clinic awards not only provide valuable support that will help accelerate experimental stem cell therapies into clinical trials, they also bring with them a ‘stamp of approval’ that our center meets important standards set by peers for testing of stem cell therapy trials.”

The alpha grant reflects CIRM’s continued support for UC San Diego’s stem cell research and development efforts. Since 2004, CIRM has approved 74 awards totaling more than $147 million to UC San Diego stem cell scientists and programs. The three clinical trials launched are just the first of many to come, said alpha clinic principal investigator Jamieson. Other trials for heart failure, amyotrophic lateral sclerosis (Lou Gehrig’s disease) and blindness are in the planning stages.

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‘Treasure in saliva’ may reveal deadly diseases early enough to treat them

UCLA research holds promise for diagnosing Type 2 diabetes, gastric cancer, other diseases.

Xinshu (Grace) Xiao and David Wong, UCLA (Photo by Reed Hutchinson, UCLA)

UCLA research could lead to a simple saliva test capable of diagnosing — at an early stage — diabetes and cancer, and perhaps neurological disorders and autoimmune diseases.

The study, the most comprehensive analysis ever conducted of RNA molecules in human saliva, reveals that saliva contains many of the same disease-revealing molecules that are contained in blood. It was published online today (Oct. 29) by the peer-reviewed journal Clinical Chemistry and will be published in the journal’s January 2015 special print issue, “Molecular Diagnostics: A Revolution in Progress.”

“If we can define the boundaries of molecular targets in saliva, then we can ask what the constituents in saliva are that can mark someone who has pre-diabetes or the early stages of oral cancer or pancreatic cancer — and we can utilize this knowledge for personalized medicine,” said Dr. David Wong, a senior author of the research and UCLA’s Felix and Mildred Yip Endowed Professor in Dentistry.

Wong said the test also holds promise for diagnosing Type 2 diabetes, gastric cancer and other diseases. “If you don’t look in saliva, you may miss important indicators of disease,” Wong said. “There seems to be treasure in saliva, which will surprise people.”

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Arsenic in drinking water linked to 50% drop in breast cancer deaths

‘What we found was astonishing.’

One typically does not hear talk of the health benefits of arsenic, but a new study by researchers from UC Berkeley and the Pontifical Catholic University of Chile has linked arsenic to a 50 percent drop in breast cancer deaths.

The study, published this month in the journal EBioMedicine, presents results of breast cancer mortality data from a region in Chile where residents were inadvertently exposed to high levels of arsenic, a naturally occurring element found in many minerals. Instead of an increase in mortality, as with many other cancer sites, the study found that breast cancer deaths were cut in half during the period that coincided with high arsenic exposure. The effect was more pronounced among women under age 60, with mortality in these women reduced by 70 percent.

“What we found was astonishing,” said study lead author Dr. Allan Smith, UC Berkeley professor of epidemiology and director of the Arsenic Health Effects Research Program. “We’ve been studying the long-term effects of arsenic in this population for many years, focusing on increased disease and mortality attributed to the historical exposure to arsenic in this population.”

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Biopsy quality directly linked to survival in patients with bladder cancer

For about half of those with the disease, doctors don’t get sufficient sample to correctly stage the cancer.

Karim Chamie, UCLA

UCLA researchers have shown for the first time that the quality of diagnostic staging when performing biopsies on patients with bladder cancer is directly linked with survival, meaning those who don’t get optimal biopsies are more likely to die from their disease.

The two-year study found that about half of bladder cancer patients who were biopsied had insufficient material — meaning that no bladder wall muscle was retrieved — to accurately stage the cancer. Additionally, the UCLA research team found that a less-than-optimal biopsies and incorrect tumor staging were associated with a significant increase in deaths from bladder cancer, said the study’s first author, Dr. Karim Chamie, an assistant professor of urology and surgical director of the bladder cancer program at UCLA.

“These findings are very important because while patients know about the stage of their cancer, they rarely question the quality of the biopsy,” said Chamie, who also is a researcher at UCLA’s Jonsson Comprehensive Cancer Center. “We hope these findings will help empower patients to ask about the quality of their biopsy and, if it is suboptimal, then urge their doctors to repeat the biopsy prior to deciding on what type of treatment to prescribe.”

The findings were published Oct. 22 in the early online edition of the peer-reviewed journal Cancer. The study was conducted at UCLA and the Cancer Surveillance Program at USC.

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National Cancer Institute funds study on Western diet, role in GI cancer

UC Davis researchers also will study if friendly bacteria can prevent it.

The National Cancer Institute (NCI) has awarded a $2.7 million grant to UC Davis researchers to investigate how the so-called Western diet, which is high in fat and sugar, increases the risk of developing liver and gastrointestinal (GI) cancers. In addition, the researchers will study whether bifidobacteria, a common family of bacteria in the human gut, can be enriched to prevent cancer.

“We know that people who are obese or diabetic have increased risk for GI cancer,” said Yu-Jui Yvonne Wan, one of three principal investigators and vice chair for research in the Department of Pathology and Laboratory Medicine. “But we need to have a better understanding of how these conditions lead to cancer and how to prevent it.”

Other principal investigators on the study are professors Carolyn Slupsky and David Mills, both in the Department of Food Science & Technology and members of the Foods for Health Institute.

The study’s first goal will be to understand how the Western diet affects metabolism, bile acid and friendly bacteria (microbiota). While researchers already have learned that diets high in fat and sugar generate toxic bile acid, which causes inflammation and damages DNA, the mechanisms of this process are poorly understood.

Perhaps most importantly, the researchers also will investigate whether specific bifidobacteria species can mitigate the Western diet’s negative effects. The team will test whether a combination of complex milk sugars and bifidobacteria can reduce inflammation and short-circuit the mechanisms that generate cancer.

“When we talk about gastrointestinal health, we have to think about microbiota,” said Wan. “We believe that enriching the gut with anti-inflammatory bifidobacteria can protect against GI cancer.”

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