An HIV Drug Helps Cancer Patients

NEJM paper: http://www.nejm.org/doi/full/10.1056/NEJMoa1201248

http://www.forbes.com/sites/matthewherper/2012/07/11/immune-reversal-unsuccessful-pfizer-aids-drug-might-help-transplant-patients/

Immune Reversal: How A Pfizer AIDS That Disappointed Investors Drug Might Help Transplant Patients

A Pfizer drug that failed to thrive as a treatment for HIV may now present a great hope for a deadly consequence of the bone marrow transplants used to treat blood cancers such as leukemia, myeloma, and lymphoma, according to a small study of 38 patients published this evening in the New England Journal of Medicine.

Transplants of stem cells found in the bone marrow can treat and even cure these cancers. Cells from a donor, often a family member, are injected into the patient after their own bone marrow has been wiped out. The result is that the patient has a new immune system that can attack cancer cells.

But sometimes – in fact, all too frequently – that new immune system attacks the patient, too. This occurs at least 30% of patients where the stem cells are “matched,” coming from a family member, and at least 50% when they are not. The main step to prevent this internal attack, called graft versus host disease, is giving the patient medicines to suppress the immune system, increasing the risk of infection.

Ran Rashef, an assistant professor of medicine in the blood and bone marrow transplant program at the University of Pennsylvania, thought there might be a better way. Instead of just shutting down immune system cells like white blood cells, why not tell them where not to go? These cells “don’t just wander around randomly into tissues and the blood stream,” he says. “There is a very well orchestrated process.”

The key to that process, earlier studies had shown, was the C-C-chemokine receptor type 5 (CCR5), a cellular switch on the surface of white blood cells that detects chemical signals coming from damaged cells. Blocking CCR5, Rashef thought, might prevent graft-versus-host disease. Luckily, the Pfizer drug, Selzentry, was already on the market. Pfizer provided the drug for his study and helped fund the clinical trial.

Rashef expected mainly to be able to see that the CCR5 inhibitor was affecting the movement of white blood cells. But the results were incredibly encouraging. Instead of the a third or more of the patients having graft-versus-host disease, only about 15% did – far fewer than expected, and a sign that the medicine may be extremely effective. “We were surprised we got some good efficacy for the study,” he says. “This was a pilot study that went wild.” Still, he emphasizes, larger clinical trials will need to be done to confirm the result. A Pfizer spokeswoman adds: “These findings are preliminary and it is too early to speculate on any future plans.”

Selzentry was approved in 2007 as a treatment for HIV patients whose HIV had entered their cells using CCR5 as a gateway. At the time, industry analysts expected Selzentry would generate $500 million in annual sales in 2011. In 2010, it generated only $128 million, far short of those expectations and far less than other AIDS medicines such as Merck‘s $1.1 billion Isentress and Gilead’s $6 billion HIV drug franchise.

If the results pan out, it will be one of the best examples yet of an idea known as drug rediscovery. One of the potentially big results from research emerging from the study of human genetics, this is the idea that existing drugs could treat new diseases. In some case, as with Merck’s Cozaar, which has shown promise against Marfan syndrome, a hereditary disorder, this can mean a relatively cheap medicine can help a population of people who were not thought of as large enough to warrant a big pharmaceutical research effort.

But the idea of “rediscovering” a drug can also create business challenges, because drugs are priced based on the diseases they treat. In one case, Celgenedramatically raised the price of thalidomide after it was found to be effective not just against complications of HIV and leprosy, but the blood cancer multiple myeloma. If Selzentry is effective against graft versus host disease, Pfizer might have reason to try a similar approach. The U.S. patent on Selzentry lasts at least until the end of 2019.

Informative Questions and Answers at TheBody.com

Gynecomastia problems: http://www.thebody.com/Forums/AIDS/Aging/Q223555.html

Shingles Vaccine for HIV+ People:
http://www.thebody.com/Forums/AIDS/Aging/Q222619.html

Recently Diagnosed with HIV:
http://www.thebody.com/Forums/AIDS/Nutrition/Q223309.html

Taking Egrifta and Gaining Weight:
http://www.thebody.com/Forums/AIDS/Nutrition/Q223414.html

How Do I Improve my Sperm Count?
http://www.thebody.com/Forums/AIDS/Nutrition/Q223473.html

Wormwood and HIV
http://www.thebody.com/Forums/AIDS/Nutrition/Q223420.html

Parotid Gland Inflammation and HIV
http://www.thebody.com/Forums/AIDS/Nutrition/Q221140.html

Winstrol (Anabolic Steroid) and HIV Medications
http://www.thebody.com/Forums/AIDS/Nutrition/Q220965.html

Other Options for Lipodystrophy Besides Egrifta
http://www.thebody.com/Forums/AIDS/Nutrition/Q221875.html

How to Gain Muscle
http://www.thebody.com/Forums/AIDS/Nutrition/Q217583.html

Today's Supreme Court Decision on Health Care Reform- The fight is not over and it is now up to the states

The fight over healthcare is not over.

Today's decision means that state lawmakers will have to pass legislation to establish insurance exchange that will allow uninsured people and small businesses to access quality healthcare coverage at affordable prices. If the state Legislature fails to do so, people will have to buy insurance through a federally created exchange. Additionally, the state Legislatures will be forced to make a decision on how to provide healthcare for their uninsured people. If a state turns down the billions of federal dollars it is set to receive through a Medicaid expansion, local hospital districts funded through local property taxes will continue to bear the burden of funding care for indigent people.

Fw: Hot Topics at TheBody.com's "Ask the Experts" Forums

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From: "News at The Body" <update@news.thebody.com>

Date: 26 Jun 2012 18:04:25 -0400

To: <nelsonvergel@yahoo.com>

ReplyTo: "News at The Body" <update@news.thebody.com>

Subject: Hot Topics at TheBody.com's "Ask the Experts" Forums

If you have trouble reading this e-mail, you can see the online version at: www.thebody.com/topics.html

June 26, 2012 Visit the Forums "Hot Topics" Library Change/Update Subscription
Living With HIV/AIDS Mixed-Status Couples Insurance, Workplace & Legal Concerns HIV/AIDS Treatment Other Health Issues & HIV/AIDS Understanding HIV/AIDS Labs HIV Transmission  How Long Can I Live Healthily With HIV? I see people that look healthy and have been HIV positive for 20 years or more. I'm so scared that I'll live that long, but look and feel sick. Can you tell me how long an HIV-positive person can stay healthy? Also, how long can a person stay on the same HIV med regimen? Benjamin Young, M.D., Ph.D., responds in the "Choosing Your Meds" forum  What's the Deal With the Green Coffee Bean? Have you heard about this green coffee bean craze for losing weight and controlling your sugar spikes and carb cravings? I saw something on Dr. Oz about it being packed with antioxidants and better for you that regular coffee beans. What have you heard? Are there any interactions between these special coffee beans and HIV meds? Nelson Vergel responds in the "Nutrition and Exercise" forum More Questions About Living With HIV/AIDS: Does HIV Make You Sterile? Is My Hair Loss Medication Affecting My Sex Drive?  My Sex Partner's Positive, but He Pulled Out: Am I at Risk? I had unprotected sex with a man who has HIV. He didn't inform me of his HIV status before our sexual encounter, and assures me now that I wasn't at risk since he pulled out well before he came. Is this true? If I am at risk, what can I do at this point? Richard Cordova responds in the "Safe Sex and HIV Prevention" forum  Can I Keep the Insurance I Got Before I Was Positive? I signed up for and received group life insurance coverage through my employer's plan, as well as a short-term disability plan of my own, several months prior to my HIV-positive diagnosis. I haven't received any notification of cancellation. Is my coverage still valid since I hadn't been diagnosed positive when I applied, and therefore nothing fraudulent took place? Jacques Chambers, C.L.U., responds in the "Workplace and Insurance Issues" forum Got thoughts about HIV accusations and prosecutions? We bet you do! The SERO Project would like to hear from people living with HIV, their partners, friends and family, workers in HIV fields, advocates and allies in response to a survey gathering opinions about HIV criminalization. Take the survey, and let your ideas be heard.  What Could Replace Reyataz in My Regimen? I've been taking Norvir (ritonavir), Reyataz (atazanavir) and Truvada (tenofovir/FTC) for a year. Ever since that time I've dealt with gut side effects like indigestion and nausea for hours after I take my meds. The side effects are taking a toll on my daily life as I can't drink or eat anything after taking my meds. I also can't drink milk anymore. My doctor advised me to switch the Norvir-boosted Reyataz in favor of Edurant (rilpivirine). Is this the best option for me? What about Prezista (darunavir), or something else? What are my next steps toward switching? Joseph P. McGowan, M.D., F.A.C.P., responds in the "Choosing Your Meds" forum  Can I Take My Meds Only on Weekends? My CD4 count is 515 and my viral load is undetectable. I'll be going to a live-in academy soon and will not be able to take my HIV meds there. I didn't list Atripla (efavirenz/tenofovir/FTC) when asked which medications I am currently taking, because I'm afraid I'll face discrimination at the school for being HIV positive. Should I continue taking the pill on my nights off -- Friday, Saturday and Sunday? Or should I completely discontinue the medication? Benjamin Young, M.D., Ph.D., responds in the "Choosing Your Meds" forum  Are My New Meds Known for Causing Night Sweats? I've been taking Isentress (raltegravir) and Truvada (tenofovir/FTC) since January with good results; my viral load is undetectable and my CD4 count is 500. I also take generic Lexapro (escitalopram) for depression. However, I have consistent night sweats that have me up and soaking my clothes several times each night, and it's wearing me out. Is this normal? Keith Henry, M.D., responds in the "Managing Side Effects of HIV Treatment" forum  Why Am I So Exhausted All the Time? I'm very active, I eat healthily and get plenty of sleep every night, but I always wake up exhausted. My lab results are extremely good -- my viral load is undetectable and my T-cell count is between 700 and 800. My weight is proportionate to my height and I drink very little caffeine. I've told my doctor about my fatigue but she finds nothing in my blood work that would indicate anything abnormal. I take Atripla (efavirenz/tenofovir/FTC) but have never had the vivid dreams. I doubt it's the meds but I'm not sure what else it might be. Any thoughts? David Fawcett, Ph.D., L.C.S.W., responds in the "Mental Health and HIV" forum  What Are Some Side Effects of Deca Durabolin? I have cytomegalovirus (CMV) and I'm also on Deca Durabolin (nandrolone decanoate, Deca). CMV has been the source of many problems for me, including muscle loss and swollen glands. I went on Deca to counter the muscle loss, and I've noticed that my arms and legs are veinier. I'm also noticing headaches and bulging, pulsating veins in my temples. It's hard for me to tell which symptoms are side effects of Deca and which are caused by CMV. What are some possible effects of taking Deca? Nelson Vergel responds in the "Nutrition and Exercise" forum To commemorate U.S. National HIV Testing Day on June 27, we asked community members to reflect on their HIV testing experiences. Their stories are funny, heartbreaking, frustrating, empowering, and everything in between. Read other people's experiences, and share your own in the comments section of the article!    Should I Be Concerned About My Liver Lab Results? I feel like I always get conflicting info about my liver labs. I get varying opinions on what's considered "normal." My liver enzyme levels are always in the normal range. Sometimes they are on the low end of normal, but most times they are at the higher end of normal. However, I've had a few folks and even a doc say that being on the high end of normal means there is some irritation and you really want to be on the low end of normal. Is this true? Does it really matter? How is the decision made as to what's normal? Benjamin Young, M.D., Ph.D., responds in the "Choosing Your Meds" forum  Is Protected Sex Really Protected? Is sex while wearing a latex condom that doesn't break or fall off throughout anal sex really "protected sex"? I ask because several experts I have read online say the risk is low, not nonexistent, so that has me freaked out a little. I have always heard that condom-protected sex is safe sex and not to worry. I am a top and have never had unprotected sex or had a condom break or fall off, but reading that it is only "low risk," not "no risk," has me concerned. Can you give me some insight? David Wohl, M.D., responds in the "Safe Sex and HIV Prevention" forum Worried Your Spam Filter Might Trash Our Mailings? The Body's e-mail updates are especially prone to being caught up in spam filters, since our newsletters tend to refer frequently to sex, drugs, the human anatomy and so forth. To make sure you never miss one of our mailings because anti-spam software labeled it as junk mail, add update@news.thebody.com to your address book, talk to the person who manages your e-mail security or check your anti-spam program's instructions for more information. About This E-mail This e-mail update has been sent to nelsonvergel@yahoo.com. Want to change your subscription? Click here or send us a message at updates@thebody.com. Missed an update? Our archive of past updates will keep you in the loop. 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