TAG: "Cancer"

Bariatric surgery decreases risk of uterine cancer

Findings indicate obesity may be a modifiable risk factor for endometrial cancer.

Researchers at the UC San Diego School of Medicine and Moores Cancer Center report that bariatric surgery resulting in dramatic weight loss in formerly severely obese women reduces the risk of endometrial (uterine) cancer by 71 percent and as much as 81 percent if normal weight is maintained after surgery.

Published in the April issue of Gynecologic Oncology, the official publication of the Society of Gynecologic Oncology, the findings indicate obesity may be a modifiable risk factor for endometrial cancer, and bariatric surgery a viable option for eligible patients. They are based on a retrospective cohort study of 7,431,858 patients in the University HealthSystem Consortium database, which contains information from contributing academic medical centers in the United States and affiliated hospitals. Of this total, 103,797 patients had a history of bariatric surgery and 44,345 had a diagnosis of uterine malignancy.

Obesity is a widespread public health problem in the United States, with an estimated two-thirds of the U.S. adult population considered to be overweight or obese. The condition is strongly linked to a host of health risks, among them heart disease, diabetes and cancer, in particular endometrial cancer.

“Estimating from various studies that looked at increasing BMI and endometrial cancer risk, a woman with a body mass index (BMI) of 40 would have approximately eight times greater risk of endometrial cancer than someone with a BMI of 25,” said first author Kristy Ward, M.D., the senior gynecologic oncology fellow in the Department of Reproductive Medicine at UC San Diego School of Medicine. “This risk likely continues to go up as BMI goes up.”

Bariatric surgery is often the last resort for obese patients after all other non-surgical weight loss efforts have failed. To qualify, patients must be an acceptable surgical risk and be defined as either severely obese with a BMI of 40 or greater or have a BMI of 35 or greater with at least one related condition: diabetes, obstructive sleep apnea, obesity-related cardiomyopathy or heart muscle disease or severe joint disease.

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Breast cancer endowment funded at UC Davis

Placer Breast Cancer Endowment reaches goal after nine-year effort.

UC Davis Comprehensive Cancer Center director Ralph de Vere White with KXJZ's Beth Ruyak, a long-time volunteer with the Placer Breast Cancer Endowment at the ACRE event in Sacramento.

After nine years and countless fundraising events, the Placer Breast Cancer Endowment on Thursday reached its goal of $1.5 million for breast cancer research at UC Davis Comprehensive Cancer Center.

The effort concluded at an annual event sponsored by Association of Commercial Real Estate (ACRE) that drew more than 600 people in the real estate industry from around the greater Sacramento region.

“We are absolutely thrilled,” said Ralph de Vere White, cancer center director. “We owe a debt of gratitude to the selfless women of the Placer Breast Cancer Endowment, who tirelessly fought to fund a position dedicated to breast cancer research at UC Davis.”

De Vere White said recruitment for a physician-researcher to fill the position will begin immediately.

The Placer Breast Cancer Endowment was started by two friends, both of whom had been diagnosed with and treated for breast cancer: Carol Garcia, now a Roseville City Council member, and Teri Munger, who has spent 30 years in the high-tech industry and lives in Granite Bay. The organization had initially hoped to complete the endowment by 2010, but the economic downturn took a toll on fundraising efforts.

Garcia credited Virgil Traynor of the Auburn Community Cancer Endowment Fund for inspiration to drive the breast cancer endowment effort. Traynor’s group fulfilled its mission to fund a basic cancer research chair at UC Davis.

“If not for his connecting us with UC Davis and Dr. de Vere White, we would not have known to do this,” Garcia said. “We are also grateful to Dr. de Vere White and the people at UC Davis. We always knew they were there waiting for us to succeed and were cheerleaders along the way.”

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Potential lung cancer vaccine shows renewed promise

Tecemotide a potential maintenance therapy to prolong survival, improve quality of life.

Michael DeGregorio, UC Davis

Researchers at UC Davis have found that the investigational cancer vaccine tecemotide, when administered with the chemotherapeutic cisplatin, boosted immune response and reduced the number of tumors in mice with lung cancer. The study also found that radiation treatments did not significantly impair the immune response. The paper was published on March 10 in the journal Cancer Immunology Research, an American Association for Cancer Research (AACR) publication.

Though tecemotide, also known as Stimuvax, has shown great potential at times, the recent Phase III trial found no overall survival benefit for patients with non-small cell lung cancer (NSCLC). However, further analysis showed one group of patients, who received concurrent chemotherapy and radiation followed by tecemotide, did benefit from the vaccine. As a result, tecemotide’s manufacturer, Merck KGaA, is sponsoring additional post-clinical animal and human studies, so far with good results.

“There aren’t any good options for patients with inoperable stage III lung cancer following mainline chemotherapies,” said UC Davis professor of medicine and lead author Michael DeGregorio. “We are looking at tecemotide as a potential maintenance therapy to prolong survival and improve quality of life.”

Tecemotide activates an immune response by targeting the protein MUC1, which is often overexpressed in lung, breast, prostate and other cancers. The vaccine stimulates production of interferon gamma and MUC1-targeted killer T-lymphocytes, which seek out and destroy MUC1 cancer cells.

The team, which included investigators from the UC Davis School of Veterinary Medicine and the Department of Radiation Oncology, wanted to know if cisplatin/tecemotide treatments, along with radiation therapy, could boost the immune response and alter lung cancer’s trajectory, stabilizing the disease.

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Joint cancer center study finds barriers to minority clinical trial participation

New strategies for data collection recommended.

Moon Chen, UC Davis

A new study involving researchers from UC Davis and four other National Cancer Institute-designated cancer centers reveals important barriers that limit minority group participation in cancer clinical trials, findings that will be used to refine and launch more effective strategies to assure that more minorities benefit from clinical trials.

The study, published online today (March 18) in Cancer, found variations in how the cancer centers gather patient demographic information and other relevant data. The research was part of a national effort to recruit more racial/ethnic minorities into therapeutic clinical trials and, ultimately, to reduce the disproportional incidence of many cancers among those populations.

UC Davis is one of five National Cancer Institute-designated comprehensive cancer centers united in the endeavor, known as EMPaCT – Enhancing Minority Participation in Clinical Trials. Funded by the National Institute of Minority Health and Health Disparities, the consortium is in the second phase of its work to address barriers that limit the representation of minorities in therapeutic trials.

“Racial and ethnic minorities make up more than half the nation’s population, but language, culture, and other barriers historically have suppressed their involvement in clinical trials,” said UC Davis professor Moon Chen, who leads the UC Davis EMPaCT team. “Clinical trials are critical to our development of effective cancer therapies, and we must have participation by meaningful numbers from all racial/ethnic groups to ensure those therapies are based on specific characteristics of these populations.”’

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UCSF names acclaimed British scientist head of Helen Diller Cancer Center

Alan Ashworth will start in his new position in January 2015.

Alan Ashworth

One of the world’s pre-eminent cancer scientists, Alan Ashworth, Ph.D., FRS, has been appointed the new director of the UCSF Helen Diller Family Comprehensive Cancer Center.

Ashworth is chief executive of The Institute of Cancer Research, London, one of the world’s most influential cancer research organizations. Together with its partner hospital, The Royal Marsden NHS Foundation Trust, the ICR is one of the top-rated cancer centers globally.

He will formally assume his new position at UC San Francisco in January 2015.

Ashworth, whose major contribution to cancer research has been his work on genes involved in cancer risk, was a central part of the team that in 1995 discovered the gene BRCA2, which is linked to a heightened risk of some types of cancer. A decade later, Ashworth identified a way to exploit genetic weaknesses in cancer cells, including mutated BRCA2, leading to a new approach to cancer therapy. In 2008, he was elected as a Fellow of the Royal Society (FRS).

As the new director of the UCSF Helen Diller Family Comprehensive Cancer Center, Ashworth will lead a premier program that combines basic research, clinical research, epidemiology/cancer control and patient care, with a strong emphasis on translational science that moves discoveries toward new therapies.

“Alan Ashworth is the ideal leader to carry forward UCSF’s cancer enterprise in this era of genomic and precision medicine,” said Sam Hawgood, M.B.B.S., dean of the UCSF School of Medicine and incoming interim chancellor for UCSF. “Alan was at the forefront of the world’s understanding of the genetic principles behind cancer biology and using that information to change the way patients are treated. He is renowned for both his research into the genetics of breast cancer and cancer susceptibility, and for his leadership at The Institute of Cancer Research. He will be a phenomenal addition to the UCSF community.”

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Nursing school hopes to improve care for cancer patients with social network

Participating patients will use a tablet device as part of UC Davis project.

Several chemotherapy patients at the UC Davis Comprehensive Cancer Center will be invited to use tablets with a unique social networking tool as part of their treatment plan. Researchers at the Betty Irene Moore School of Nursing at UC Davis hope to prove that mobile health technology improves the care experience for patients as well as the quality of care while also reducing cost.

The project is part of a two-year, $199,854 grant from the McKesson Foundation and its national Mobilizing for Health Initiative. Research on mobile health technology in cancer care is new, said Jill Joseph, the associate dean for research at the nursing school. Other cancer-related mobile applications are available, but are limited to education and awareness and don’t provide disease management tools or real-time communication.

“We have ample evidence that cancer patients often receive fragmented care, experience significant distress, and may needlessly require care in emergency departments or inpatient settings, particularly during chemotherapy,” Joseph said. “Little research and development has focused on providing novel technologies to support cancer care coordination.”

Participating patients will use a tablet device, such as a Google Nexus or iPad, to connect to their unique and private Personal Health Network that includes a nurse coordinator — who manages the their care — along with family, caregivers, clinicians and other desired partners. These people can connect with one another through real-time messaging, video and audio components as well as schedule appointments, assign tasks, store and track information and more.

A nurse coordinator is assigned to support each chemotherapy patient who uses the mobile application. This coordinator monitors the patient’s care plan, triages issues and communicates with caregivers. Unlike electronic health records and other information systems common in hospitals, the social networking platform allows patients, their families and caregivers to not only access information but communicate with another and make decisions about care and health management.

“This is a new tool designed with the patient and family at the center of care,” said Katherine Kim, a recent doctoral graduate of the UC Davis nursing school who is now a visiting faculty member and project director.

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Taxpayer donations give boost to cancer research

Checking a box can help save lives.

By Wallace Ravven

Nobody looks forward to the April 15 tax-filing deadline, but it’s not all gloom. Every year, thousands of Californians brighten the outlook for cancer prevention and treatment by using tax time to make a donation to research and community-based education.

Donations help support a wide range of programs, from leading-edge research aimed at early detection of lung cancer to exploring with teens the toxins found in everyday beauty products.

Taxpayers can support research and community education through the California Breast Cancer Research Program (CBCRP) with a check-off on line 405 of California Tax Form 540. Line 413 furthers projects funded by the Tobacco-Related Disease Research Program (TRDRP), which focuses on cancer and other diseases caused by tobacco products.

The University of California administers both programs, and puts a priority on projects aimed at communities that are disproportionately at risk for cancer.

Reducing breast cancer risk among young Latinas

An innovative community health partnership in East Salinas, for example, teaches young Latinas about the potential breast cancer risk posed by the chemicals that are found in some cosmetics, shampoos and other personal care products.

Funded by the CBCRP, the project has brought together UC Berkeley public health professor Kim Harley with Kimberly Parra at the Clinica de Salud del Valle de Salinas to carry out cancer-risk research and offer health education and practical training to teens.

Harley focuses her work on chemicals that can act as endocrine disrupters, meaning they mimic or block the normal effects of hormones such as estrogen. Endocrine disrupters are suspected of being a key factor in the development of breast cancer.

Young girls and minority women tend to have higher levels of the chemicals in their blood than non-Hispanic whites.

Sixteen local youths have been trained to design and carry out research to determine what products local teens use, the amount of endocrine disrupters they are exposed to in these products, and whether switching to low-chemical alternatives will decrease their exposure.

“Working with teens in this community has been really rewarding,” Harley says.  “We have watched them learn that science can be accessible and fun, and relevant to their lives.

“At the same time, we have learned from them about what environmental health issues are important to them. It has really helped us conduct effective, appropriate research that can affect change among youth.”

The prevention message is spreading beyond the teens involved: Two local TV news stations — one English-language, the other Spanish-language — have reported on the project. And both the teen researchers and their subjects are sharing what they learn about endocrine disrupters with friends and family.

Targeting cancer in the brain

Prevention holds the greatest promise for reducing cancer illness and death, but treatment forms the crucial second line of defense.

When breast cancer cells spread to the brain, the disease becomes particularly difficult to treat. The body’s natural physiological buffer, known as the blood-brain barrier, prevents bacteria and other blood-borne invaders from entering the brain, but also closes the door to chemotherapy targeting the brain.

At the University of Southern California, Axel Schönthal is applying CBCRP tax check-off funds to developing a novel strategy that would allow chemotherapy drugs to reach the brain through inhalation.

The drug, commonly known as temozolomide, has been proven effective against particularly aggressive brain tumors, but it must be given orally and can cause severe side effects throughout the body.

Schönthal predicts that inhalation of the drug will increase effectiveness in destroying cancer cells in the brain while reducing side effects. He expects that the intranasal treatment can work well against many types of breast cancer that have metastasized to the brain, particularly cancers that have proved resistant to most other drugs.

Such difficult-to-treat cases, called triple-negative breast cancer, are particularly prevalent in African-American women.

As federal NIH budget cuts have increased, Schönthal says, the tax check-off contributions for CBCRP-funded projects have become a lifeline for research aimed at treating and curing a range of cancers.

He especially values the fact that patient advocates are often part of the team that evaluates CBCRP research proposals.

“It is important that funding focuses on research of importance to affected communities,” Schönthal says.

Early detection of cancer’s leading killer

Lung cancer is the leading cause of cancer death in both men and women in the U.S., and smoking accounts for more than 80 percent of lung cancer cases.  Many smokers contract a less familiar but debilitating disorder called chronic obstructive pulmonary disease, or COPD, before they are diagnosed with lung cancer.

Lung cancer and COPD don’t strike all smokers, and genetics almost certainly influences disease vulnerability.

Identifying the genetic underpinnings common to both lung cancer and COPD vulnerability may reveal the biological processes that are triggered by smoking — creating new avenues for early warnings and novel interventions.

Cancer epidemiologist Lori Sakoda at the Kaiser Permanente Division of Research has launched a study supported by TRDRP to search for genetic traits shared by people with either or both diseases.

Although resisting smoking or breaking the habit are the surest way to prevent cancer and COPD, “once lung cancer develops, it is potentially curable if it is caught before it metastasizes, so early diagnosis is crucial,” Sakoda says.

Low-dose CT scans have become an accepted early detection strategy, but like any screening test, it carries risks. Sakoda’s research seeks to identify genetic markers that might help clinicians zero in on which subgroup of chronic smokers is at highest risk for either or both diseases, and so, pinpoint them as strong candidates for CT screening.

The study focuses on former or current smokers from a large, ethnically diverse cohort of Kaiser Permanente Northern California members.

Lowering the dose

A second TRDRP-funded study aims to determine the lowest possible CT dose that can reliably detect small nodules that mark the early stages of lung cancer.

“We want to find just how far we can ‘dial down’ CT dose without losing critical sensitivity,” says UCLA’s Michael McNitt-Gray. Drawing on CT scans of patients that already show telltale cancer nodules, his team applies imaging software to simulate the clarity that would be provided by scanning with lower CT exposures.

“It’s like trying to see how low you can turn down the light in a room and still clearly see,” he says.

McNitt-Gray hopes the exposure can be reduced significantly beyond currently accepted methods for screening CT exams — “possibly by as much as 50 to 75 percent without sacrificing our ability to detect those small nodules.”

“Detecting lung cancer in its earliest stages can save lives,” says Bart Aoki, Ph.D., director of the Tobacco-Related Disease Research Program. “We are very pleased to be able to support projects that foster awareness in underserved communities as well as research by the outstanding scientific community in California.”

Both the Tobacco-Related Disease Research Program and California Breast Cancer Research Program receive financial support from a California tax on tobacco products. As smoking rates decline, so too, does their funding for these important projects.

“Reduced smoking is of course great news for improving public health, but it threatens our ability to fund significant research,” says Marion Kavanaugh-Lynch, M.D., MPH, director of the California Breast Cancer Program. “We depend on California taxpayers to help offset this decline by voluntary contributions on their tax returns.”

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UCSF professor wins European Union Prize for Women Innovators

Laura van ‘t Veer honored for developing diagnostic test.

Laura van 't Veer receives her 2014 European Union Prize for Women Innovators Award from Mark Rutte, the prime minister of the Netherlands, who flew to Brussels for the occasion.

Laura van ‘t Veer, Ph.D., was honored this week as one of the top female scientific innovators in Europe.

The European Union Prize for Women Innovators recognizes women who have combined their scientific excellence with a head for business to set up innovative enterprises. Van ‘t Veer was one of three who were presented the award on Monday in Brussels.

Van ‘t Veer, of the Netherlands, was honored for developing MammaPrint, a diagnostic test that will help determine the likelihood that a breast tumor will metastasize to other parts of the body. This helps physicians determine whether or not each patient can benefit from chemotherapy.

Van ‘t Veer, a professor in the UCSF Department of Laboratory Medicine, leads the breast oncology program at the Helen Diller Family Comprehensive Cancer Center. Her current research focuses on precision medicine, specifically how the molecular basis for early response to therapy can guide the development of therapy-specific companion diagnostics.

“From my perspective, many people talk about translational science, but few actually take a finding that can impact care and actually change practice,” said Laura Esserman, M.D., M.B.A., director of the UCSF Carol Franc Buck Breast Care Center. “Laura’s work is a shining example of the best of translational science.”

Esserman says she recruited van ‘t Veer to UCSF a few years ago to help set up the I-SPY trial. Esserman developed molecular tests that have been approved by the FDA which allow UCSF and others to tailor treatment for women with breast cancer. Van ‘t Veer developed a platform to stratify high-risk tumors in the I-SPY trial, and now a new study to stratify low-risk tumors.

Mark Rutte, the prime minister of the Netherlands, traveled to Brussels to present van ‘t Veer with the award at the opening ceremony of the Innovation Convention 2014. Van ‘t Veer won 50,000 euros for her second-place win.

Other honorees include first-place winner Saskia Biskup of Germany and third-place winner Ana Maiques of Spain. The three winners were selected by an independent panel of experts from a total of 67 applications.

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Researchers one step closer to ovarian cancer marker

UC Davis researchers verify that glycans can be used to detect ovarian cancer.

Gary Leiserowitz, UC Davis

The hunt is on to find biomarkers that detect cancer, but it’s a challenging process. Early successes often are followed by heartbreaking failures. But now, researchers at UC Davis have verified that glycans (sugars attached to proteins) can be used to detect ovarian cancer. The study was published online in the journal Cancer Epidemiology, Biomarkers & Prevention.

“This is one of many papers we’ve done to see if glycans can distinguish between women who have ovarian cancer and those who don’t,” said senior author Gary Leiserowitz, chief of the Division of Gynecologic Oncology. “So far, the results have been consistent and promising.”

Creating a diagnostic tool that identifies ovarian cancer early through analysis of a blood sample would be an enormous benefit. Because the disease produces indistinct symptoms, such as bloating, ovarian cancer is often diagnosed late, making it difficult to treat.

The answer may be glycans, which are attached to over 50 percent of all proteins and often are altered when patients have cancer. By measuring these changes, the UC Davis team hopes to create a blood test that will find these cancers early.

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How an entrepreneurial engineering education nurtured a biotech startup

UC San Diego alum Michael Benchimol is working to make chemotherapy more effective.

Michael Benchimol

Identify a real-world problem. Engineer a solution. And, if the solution works, figure out how it can be commercially viable. That’s what Michael Benchimol said he learned over seven years of working in the laboratory of Sadik Esener, a professor in the departments of nanoengineering and electrical and computer engineering at the University of California, San Diego. In Benchimol’s (Ph.D., electrical engineering, ’12) case, it specifically means building a company to advance a targeted drug delivery platform that could make chemotherapy more effective and less toxic to the healthy tissue in the body.

“I like to build things. That’s the engineering side of me,” said Benchimol, who also earned a master’s in electrical engineering at UC San Diego in 2008. “Creating a company was just a different form of creating something from nothing. I always had that interest and I saw that there was an opportunity here.”

The opportunity is a method of delivering chemotherapy drugs directly to cancerous tumors in the body, a longtime goal of next-generation cancer therapy research due to the toxic effects the drugs can have on the rest of the body. The field is enjoying a research heyday in part thanks to advances specifically in the area of nanotechnology. Benchimol says nanotechnology is enabling cancer researchers to leverage the best properties of cancer drugs and biocompatible materials, in a single therapy that can circulate undetected by the body’s immune system.

His company, Sonrgy, recently entered an exclusive licensing agreement with UC San Diego to further develop the company’s technology, which resulted from his Ph.D. and postdoctoral research at the Jacobs School of Engineering and UCSD Moores Cancer Center, where Esener, also directs the NanoTumor Center. Benchimol’s solution is unique in that it doesn’t rely on “tumor receptors” that the nanoparticle can seek out and “stick to” before releasing the drug. Rather, the Sonrgy platform, called SonRx, uses nanocarriers smaller than human cells that carry chemotherapy drugs through the body where they can be released at the tumor site by a doctor deploying ultrasound. The technology is in the preclinical stage.

“The SonRx technology addresses longstanding challenges related to stability and controlled release in nano-scale drug delivery,” said Michael Benchimol, who is Sonrgy’s chief technology officer, in a company statement about the licensing agreement.

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UV light aids cancer cells that creep along outside of blood vessels

Scientists confirm spider-like metastatic activity of melanoma cells outside the bloodstream.

Claire Lugassy, UCLA

A new study by UCLA scientists and colleagues adds further proof to earlier findings by Dr. Claire Lugassy and Dr. Raymond Barnhill of UCLA’s Jonsson Comprehensive Cancer Center that deadly melanoma cells can spread through the body by creeping like tiny spiders along the outside of blood vessels without ever entering the bloodstream.

In addition, the new research, published March 6 in the journal Nature, demonstrates that this process is accelerated when the skin cancer cells are exposed to ultraviolet light. The husband-and-wife team of Barnhill and Lugassy collaborated on the study with a team from Germany’s University of Bonn led by Dr. Thomas Tuting.

It is well known that melanoma cells from an initial tumor can travel through the bloodstream to other parts of the body, where they accumulate and form new tumors. Through such metastasis, a small skin cancer can become life-threatening by spreading to the brain, lungs, liver or other organs.

Fifteen years ago, Lugassy and Barnhill first discovered and described an alternative metastatic process, which they called extravascular migratory metastasis, or EVMM, by which melanoma cells could move along the outside, or abluminal, surface of blood vessels by way of angiotropism — a biological interaction between the cancer cells and the blood vessel cells. Since then, Lugassy and Barnhill have continued to assemble a body of scientific evidence confirming the existence of this metastatic pathway of cancer cells.

Raymond Barnhill, UCLA

With angiotropism and EVMM, the cancer cells may replace tendril-like cells called pericytes, which are normally found on the outsides of blood vessels, through a process called pericytic mimicry. Imitating the pericytes, the melanoma cells creep along the length of blood vessels until they reach an organ or other point where they accumulate to form new tumors, “potentially explaining the delay between the detection of the primary cancer and the appearance of distant metastases,” said Barnhill, a professor of pathology at UCLA.

“At first our idea was controversial,” said Lugassy, a UCLA associate professor of pathology. “But mounting evidence confirming angiotropism and EVMM has revolutionized the knowledge of how cancer spreads through the body to the point that other scientists have confirmed the process in other solid-tumor cell types, such as pancreatic cancer.”

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Anti-psychotic medications offer new hope vs. glioblastoma

Researchers use shRNA platform to test how genes contribute to glioblastoma growth.

Clark Chen, UC San Diego

Researchers at the UC San Diego School of Medicine have discovered that FDA-approved anti-psychotic drugs possess tumor-killing activity against the most aggressive form of primary brain cancer, glioblastoma. The finding was published in this week’s online edition of Oncotarget.

The team of scientists, led by principal investigator, Clark C. Chen, M.D., Ph.D., vice chairman of UC San Diego School of Medicine’s Division of Neurosurgery, used a technology platform called shRNA to test how each gene in the human genome contributed to glioblastoma growth. The discovery that led to the shRNA technology won the Nobel Prize in Physiology/Medicine in 2006.

“ShRNAs are invaluable tools in the study of what genes do. They function like molecular erasers,” said Chen. “We can design these ‘erasers’ against every gene in the human genome. These shRNAs can then be packaged into viruses and introduced into cancer cells. If a gene is required for glioblastoma growth and the shRNA erases the function of that gene, then the cancer cell will either stop growing or die.”

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