Tuesday, December 31, 2013

THE CYTOKINE QUAGMIRE!

Times and times again we land in this soft land of unknown, with the future of our patient potentially irreversibly compromised, despite a great response to therapy. And we know or suspect the Cytokines without knowledge of clearly which, and what to do about it.  And wonder if we should have seen it coming by more sophisticated measurements (if the insurance covered it!).  This has happened with Bleomycin use, and now with modern therapies, it is happening again!
You find this great target therapy, you give to a patient, the tumor responds, everybody is happy, there it comes by way of proteinuria, abnormal liver functions and worse this dry cough and ultimately shortness of Breath (SOB !-please take this professionally, not as you please) that impairs our patients despite response to therapy!  Interstitial Bronchitis they call it.  And you know it is the Cytokines. At least the response to steroids strongly suggests it...Then the curve ball is thrown at you.  Did you just affect the response by bringing in the steroids? are they going to mitigate response to therapy, do they compromise future therapy, can you resume the treatment with the now known effective drug.  Warning boxes stop you though!  And how we ended up here without scrutiny? how we are cornered to be sleeping at the wheel?  head in the sand again?  In this environment of limited therapeutic options, it is a true Quagmire we found ourselves in.

CRBCM working on better Bio-markers for predicting side effects!

Oncologist of today must be "MR Clean"

The Beauty of target therapy is that you know exactly, at least you feel like you know, what you have done, and could possibly predict the response.  You can predict what will happen and deviations are expected but within the realm of our understanding.  You could make adjustment and make a somewhat rational decision.  You know you gave Avastin, and you know the escape mechanism can be by way of MTOR (biomarkers needed! don't be surprised and hurt my feelings!).  You know you can use MTOR inhibitor (sequentially) just as the cell as reacted and started resisting.  There is a logical thinking!

On the other hand when Adriamycin or Etoposide, you have your eyes on the DNA, when indeed the action is somehwere in the in the epigenetic events. And BOMMM! you are surprised by a resistance at Mitochondrial level (BCL-2).  In short, you just don't know what to expect.  You are left with the only Inconsequential strategy, the kill all spraying with a combination chemotherapy approach from the dungeons of Oncology.   Beside, the side effects of non specific attacks on cancer cells have manged to give the bad rep to Oncology.  We have to move fast away from these drugs and come back to them in desperate situations.  Oncologists of today must become "Mister clean", with specific target and hit only at will after a careful search of targets for our specific patients.  No collateral damages!  And for that, we need to tease every gene, and know who it is talking to and how to mend the message incognito!

IT WILL MAKE US BETTER FOR IT!

CRBCM, SEEING A BIGGER PICTURE!

AN EXCITING HIDDEN PEARL in triple negative breast cancers.

Hidden beneath the mantle of "triple negative breast cancer", one wonder if there is still to be discovered a sensitivity to Estrogen to be unveiled and used for therapeutic intentions.  One thing for sure there no one but many triple negative breast cancers.  Nothing is always the same when it comes to cancer, There is always and always will be a caveat!  Because of the variety of genes and their isoforms, and the heterogeneity of not only the isoforms but also their mutations.  But for the inquisitive mind, the suspicion that Estrogen can still work is a legitimate inquiry.
That is until you meet the Glucanase, Pectinase, and Polygalaturonases.
Before you start to wonder what in hell these have to do with anything. Let remind ourselves That Estrogen to be important has to meet its receptor.  The Receptor is made mostly of Protein but never forget the GLYCAN moiety that covers it.  For a receptor function, a glycan must be present.  And remember it is this Glycan moiety that triggers immunity (Primary/innate immunity in particular).  Then come the Glucanases that the cell send in the extracellular matrix to destroy the described functionally important covers of receptor and thereby annihilating their (receptor) very existence (CELLULAR DESENSITIZATION MECHANISMS).

In other words the lack of a receptor can be because they are not present enough to be detected by our measurements,  But if you find Pectinases and glucanases, the receptors' absence is deeper or I should say more radical.
There is something peculiar about this radical way of shutting down receptor by destruction through the Glucanases, That is, it is carefully engineered genetically and lead to disturbance of target protein vesicular transport.  ie Estrogen will be hard to travel the cell and will eventually be whisked away for Lysosomal degradation and related ESTROGEN GENE production will be shut down through the miRNA (the gene DND1 is at play here) or through the RUNX1- (interplay with Nuclear Receptor co-repressor1).  But shutting down these genes at production level, triple negative breast cancer cells make sure giving specific hormones will not work.  The noted hormone transport is disrupted, and its destruction assured.

NOW IF YOU ARE STILL IN DOUBT OF THESE PRECEPTS, AND YOU SHOULD BE SINCE IF YOU HAVE THAT RESEARCH INCLINED MIND, JOIN THE CROWD.  AND CHANG FR ET AL...IS A GOOD READING!

CRBCM, ENCOURAGING INTUITIVE MINDS! AND TEASING YOUR BRAIN ALWAYS!

BY THE WAY YOU KNOW WHO KNOWS MORE ABOUT THE GLUCANASES ? BEER MAKERS OF COURSE, THEY FERMENT GLUCOSES ALL DAY!  SMOKERS USE GLUCANASES TO DESTROY QUIETLY THEIR RECEPTORS ALL DAY, LOOK IT UP I AM NOT KIDDING! 

Monday, December 30, 2013

Tankyrase, an important target in triple negative breast cancer!

If the concept is right
and with the advent of the importance of vesicular formation and displacement of cellular protein as a major disturbance in this disease, the role of Tankyrase genes (TNKS1,2) is rapidly growing as target in triple negative Breast cancers.   How can someone come up empty?
Tankyrases are involved in:

1.Telomere length
2.Insulin resistance
3.Spindle assembly and formation
4.Molecular trafficking (AXIN)
5.Catening degradation  (hell the involvement of GSK1 get MUC1,NOTCH, and WNT in this)
6.Cancer cell resistance (Through activity with with MCL1, a BCL-2 family member)
7.Cellular deformation (theses genes through their connection with TERF1 and SALL1 can lead to the famous "Anal-ear syndrome" (so to speak))
8.through the FNBP1 gene, its reach expands exponentially to reach the Grb2 and MITF (through UBE2I)

Just remember our belief that a gene capable of inducing malformation, is a potent oncogene, and that reaching a "wild gene" such as Gerb2 or UBE2I is a dangerous development for all mutation driven processes.

Sunday, December 29, 2013

FARNESYLATION, FRIEND OR FOE

The ascent of KRAS as a therapeutic biomarker in Metastatic Colon cancer has increased the interest in Farnesylation as cellular process because is closely linked with Prenylation, if it is not the same process.
And from wikipedia:

"Proteins that undergo prenylation include Ras, which plays a central role in the development of cancer. This suggests that inhibitors of prenylation enzymes (e.g., farnesyltransferase) may influence tumor growth. In the case of the K- and N-Ras forms of Ras, when cells are treated with FTIs, these forms of Ras can undergo alternate prenylation in the form of geranylgeranylation.[5] Recent work has shown that farnesyltransferase inhibitors (FTIs) also inhibit Rab geranylgeranyltransferase and that the success of such inhibitors in clinical trials may be as much due to effects on Rab prenylation as on Ras prenylation. It should be noted that inhibitors of prenyltransferase enzymes display different specificity for the prenyltransferases, dependent upon the specific compound being utilized." wikipedia

Meaning wild type Ras which benefit from Cetuximab and Panitumumab could be affected if farnesylation is compromised.  Indeed logically, FTI could limit the effect of anti-EGFR because the kind of indrectly "mutate" or disable RAS by making it inattrative to its protein co-activator.  Remember prenylation increases protein-protein interaction.  By the same token, use of statins needs to be carefully reviewed in thiese circumstances since it may impact or block prenylation and there.

Interactions on calcium/ phosphate ratios can impact rate of Alzheimer disease? can we ask if Prenylation has something to do with rates of dementia...a good question to explore fully?

Perturbance of Farnesylation has been linked to Blindness, somewhat contribution to Avastin use in treating some ophthalmic condition (an honest question)?

Lemon derived product are at the source of Farnesol,  is it safe to eat Lemon while with KRAS driven disease?
Many questions to tease our readers!

do remember a gene called PGC1 which interacts
with Farnesoid X Receptor as well as PPARy and the Retinoic X Receptor alpha
PGC1 interect and is down stream from NRF1

All this put Farnesylation at the center of  PI3K pathways in a way!

(IF YOU DON'T REACT TO THIS BLOG, ARE YOU FRIEND OR FOE?)  YOU GOT TO REACT!

Saturday, December 28, 2013

Dupplicity of MITF( microphthalmia-associated transcription factor)

One of the gene that tells us that we are still at the dawn of big genetic discoveries is MITF.
The NCBI tells us "This gene encodes a transcription factor that contains both basic helix-loop-helix and leucine zipper structural features. It regulates the differentiation and development of melanocytes retinal pigment epithelium and is also responsible for pigment cell-specific transcription of the melanogenesis enzyme genes."
But this is just the beginning  of a complex set of interaction that lead to cancers
from Melanoma (TRPM1)to Hodgkin (IKKa, CHUK) disease to various lung cancers (DYNLL1)
Wikipedia tells us this is an example of a gene that can induce malformation
and a "wild gene"
Careful now don't jump in with inhibition
because in activating TRPM1, it blocks the aggressiveness of Melanoma by decreasing its Metastatic potential.  So don't get overexcited here.
But by playing the RAB27A card, MITF could impact on removal the inhibition that drives NF-kB expansion, fueling Hodgkin disease.
Through ZPYVE16/TOM1, MITF could impact lysosomal degradation of Growth factors...
Through its Catenin Connection (CHUK-CTNNB1), it can affect the overall shape of the cell affecting epidermal differentiation.
MITF interacts also with UBE2I, another known target gene
So be careful approaching this gene as a target, patient hair will go "silver gray" on you (MyO5A)...

Friday, December 27, 2013

Current treatment of Gastric cancer (New patient at GECC)

Local disease

Surgery cure rates in node negative diseases 75 to 20%
for stage III (node positive)  5 year survival  20-25%  (the reverse)

In the US, post-operative 5-FU-Leucovorin --RT--5-FU/LV (sandwish) has been standard of care

Neoadjuvant Chemotherapy  (rarely +RT) is used particularly when lesion is obstructive...but certainly not standard.   Most of the time Neoadjuvant chemotherapy is given to shrink the lesion to allow better surgery. Decision to offer this option is made after consultation with the surgeon.


With the results of the DUTCH study, D2 surgery has won the argument and should be offered to our patients!You don't have to be Asian to call for it as a patient

In Metastatic disease

1.DCF is still the main option in good performance patient
but brace yourself for the 30% Febrile Neutropenia rate and use growth factors
otherwise use EOX  (we still use in hospital ECF for poor folks that can't afford Xeloda or can't afford PO medications) I am facing this situation now with an uninsured patient.

2.Her-2 positive patients, will get Trastuzumab and chemotherapy-standard of care now(ToGA trial)

Lapatinib, Panitumumab and Cetuximab (and Irinotican) have a role, particularly in 2nd line therapy,

AT CRBCM, further targets are being actively investigated.
(ASCO-reference)

Thursday, December 26, 2013

Biomarkers' controversy in Medicine

As we see our volume of patients expand by overtaking other Doctor's business, there is this growing notion that we will be alright if we can stick to already defined standards of care, and make sure that patient main diseases have been monitored through current defined and recognized biomarkers.  Yet as an investigator, we live in an environment that we know to be in a transition to better biomarkers as modern medicine and technology continue to advance us rapidly.  As a physician, we are aware that disease biomarkers are very important in determining the cause of the disease that will initiate our patient condition, that some biomarkers will determine the disease status of activity, that some biomarkers will gives us the patient prognosis or clinical outcome in terms of disability or ultimately, fatality.   Level of patient participation in current recommended  prevention endeavors is held today by government institutions as a premier "biomarker" of patient's health.  Yes indeed across the country, the government is monitoring participation in immunization, glaucoma check, colonoscopy, mammogram and bone density screening for patients in defined age. The PSA (Prostate Specific Antigen) and rectal exploration for prostate size have sent us in a world of controversy because of the inadequacy in predicting Prostate cancers that really need to be screened!  Indeed, as it turned out, knowing that Prostate cancer is present is not enough because it is now clear that early detection did not give us clear and palpable benefit in survival.  That what happens when our biomarkers are insufficiently tested.  (new genetic biomarkers are in the work to come to the rescue).

Monitoring level of Testosterone and Vitamin D level has entered current practice and correction measures are being aggressively taken in a world of predominant frequency of cases of associated Hypertension without a clear balance of diseases' related risk.  To make the matter worse, our patients do not have have one single diagnosis.  Most patient carry up to 10 diagnosis to navigate in terms of clinical biomarkers...which biomarker set is important in each individual patient may be a matter of determinant symptoms or perception of medical risk for each individual patient and relevant clinical background as perceived by his doctor who uses insufficient standards of care but best under current circumstances and state of technology.

One area of Puzzling observation that need to be mentioned is the use of anti-inflammatory drugs.  Aspirin has entered the routine medical prevention....to be continued...

Wednesday, December 25, 2013

This year the American Society for Hematology (ASH) took place in New Orleans
and no one participant has left without hearing about CARs
CURRAN et al defines these:
"One promising strategy entails the introduction of genes encoding artificial receptors called chimeric antigen receptors (CARs), which redirect the specificity and function of immune effectors. CAR-modified T cells targeted to the B cell-specific CD19 antigen have demonstrated promising results in multiple early clinical trials, supporting further investigation in patients with B-cell cancers. However, disparities in clinical trial design and CAR structure have complicated the discovery of the optimal application of this technology. Recent preclinical studies support additional genetic modifications of CAR-modified T cells to achieve optimal clinical efficacy using this novel adoptive cellular therapy."
This technology is just another example  of use of our immune system against cancer
It has been made more feasible with the new ability to transfer gene into cells to give them more fighting powers.

"FDA Approval for Sipuleucel-T," was just another example of such manipulation.

* A telomerase inhibitor showed up finally, Imetelsat (geron) at ASH to rock the world of Myelofibrosis, while Obinutuzumab was shaping the CLL world, it could replace Rituxan reportedly.  We know that cd20 expression in CLL is weak, therefore may be a more potent immune based agent is needed in combination with other therapy.  This will be even more important in those cases where Rituxan is used alone!

R PAZDUR:

"

On November 1, 2013, the Food and Drug Administration (FDA) approved obinutuzumab (Gazyva™ injection, for intravenous use, made by Genentech, Inc.; previously known as GA101) for use in combination with chlorambucil for the treatment of patients with previously untreated chronic lymphocytic leukemia (CLL).
The approval was based on demonstration of an improvement in progression-free survival (PFS) in a randomized open-label multicenter trial that compared obinutuzumab in combination with chlorambucil (GClb) with chlorambucil (Clb) alone in patients with previously untreated  CD20-positive CLL. The study also compared rituximab in combination with chlorambucil (RClb) with obinutuzumab in combination with chlorambucil (GClb). The results of the comparison of RClb with GClb will be available at a later stage.
Patients randomly assigned to be treated with obinutuzumab in combination with chlorambucil received 1000 mg doses of obinutuzumab intravenously on day 1 (later divided into 100 mg on day 1, followed by 900 mg on day 2), day 8, and day 15 of the first cycle. Chlorambucil, 0.5 mg/kg, was administered on days 1 and 15.  During treatment cycles 2-6, patients received obinutuzumab, 1000 mg intravenously only on day 1 in combination with chlorambucil, 0.5 mg/kg, on days 1 and 15. Patients received pre-medication with a glucocorticoid, acetaminophen, and antihistamine prior to initial obinutuzumab infusions and subsequently as needed. Patients assigned to be treated with single-agent chlorambucil received 0.5 mg/kg on days 1 and 15 of all treatment cycles (cycles 1 to 6). Cycles were repeated every 28 days.
A total of 356 patients were  randomly assigned (2:1) to receive obinutuzumab plus chlorambucil (n=238) or chlorambucil alone (n=118). The median age was 73 years (range 39 years-88 years). The independent review committee-assessed median PFS was 23.0 months for patients treated with obinutuzumab plus chlorambucil and 11.1 months for patients treated with  chloramucil alone [HR 0.16 (95 percent CI: 0.11, 0.24), log-rank p-value <0.0001].
The most common adverse reactions (at least 10 percent) with obinutuzumab plus chlorambucil (with a higher frequency than in the control arm) were infusion-related reactions, neutropenia, thrombocytopenia, anemia, pyrexia, cough, and musculoskeletal disorder. The most common grade 3-4 adverse reactions (at least 10 percent) were infusion-related reactions, neutropenia, and thrombocytopenia.
Infusion reactions occurred in 69 percent of patients receiving obinutuzumab; 21 percent experienced grade 3 or 4 reactions. Symptoms (greater than 10 percent) included dyspnea, hypotension, nausea, vomiting, chills, flushing, and pyrexia.
Obinutuzumab is approved with a BOXED WARNING regarding Hepatitis B virus reactivation and Progressive Multifocal Leukoencephalopathy. Patients should be advised of these risks and assessed for Hepatitis B virus and reactivation risk. Infusion reactions are included in the WARNING and PRECAUTIONS section of the label.
The recommended dose and schedule for the approved regimen is:
Obinutuzumab:
Cycle 1: 100 mg intravenously on day 1, 900 mg on day 2, and 1000 mg on days 8 and 15 
Cycles 2-6: 1000 mg administered intravenously every 28 days
Chlorambucil:
0.5 mg/kg orally on days 1 and 15 of each cycle"

THIS MEANS ELDERLY PATIENTS WITH POOR PERFORMANCE MAY SEE THIS DRUG COMING TO THEM .

2010 

*Mylotarg (gemtuzumab ozogamicin): Market Withdrawal, adding Myelotarg to Acute Leukemias seem to prolong disease free survival,calling for an FDA second look!

*Wake up to the Calreticulin gene,

remember when we used to ask for JAK-2 to prove the existence of Myeloproliferative diseases, well now it's not just the JAK-2, but also MPL Mutation, and the latest the CALR gene!


FOR THOSE OF US WHO FOLLOW CPRIT LIFE CLOSELY

GO TO THE ARTICLE BY JAMES DREW TO BE FULLY INFORMED (DALLAS NEWS)

Ex-official indicted over $11 million Texas cancer-fund grant

 BY JAMES DREW

TO FIND THE ARTICLE
GOOGLE CPRIT,COBBS
AND READ UNDER COMMUNITY  CRIME


ACTIVITY AT CRBCM 2013

MERRY CHRISTMAS TO ALL
This was the first year of CRBCM
AND WE REGISTERED OVER 33,000 REVIEWS OF OUR BLOG
WHICH NEEDED TO BE CREATED TO FURTHER OUR MISSION.
We did not expect to find an easy road nor did we fool ourselves.
Four our various project, donor institutions have been reluctant to help.   We thank MDHonors for rising above the doubt, and investing in our project.  This led to  a great collaboration with the Local University (UTEP) which is providing us with the scientific support we needed to actually perform molecular research at PCR level.  We thank the University of Virginia tissue Bank for providing samples.  Our project on lung cancer is advancing at deliberate pace.  We intend to develop a KIT and look into why Avastin may fail in cancers.   This year we participated in 2 conferences held in El Paso, with 4 posters accepted at the first ever conference 4 Posters at 1st BIOMED Symposium, El Paso 10/26/2013


AND EVEN BETTER, WE WERE INVITED AS SPEAKER AT

14th Annual Rio Grande Trauma Conference & Pediatric Update - December 5-6, 2013.

our poster was so good, it got stolen!

 

Now we are taking over the practice of DR Ray Lundy who we will miss greatly, this step will mark a dramatic expansion of Greater East cancer center.  A few patients are now streaming from  the University Medical Center, and we are finally on the roster for call at more hospital.

The year has not been pink.  Our failure to convince donor institutions such as CPRIT and the NIH for our committment to research remain the biggest hurdles.  These are big time political institutions.  They are a myth for little guys.  Their leaders, mostly politicians, are tied to games.  Our mission is clear, we move forward deliberately and will work with this knowledge that CPRIT and the NIH are just a side show.  We have gone international where funding institutions are not under local politics.  Science awaits to be teased.  And science is where the answer is...


This year we took over the directorship at the El paso 2 Plasma center (Talecris/Grifols).  Working as a Director required a special training (Certification by CLIA) and now applying the rigorous knowledge of checks and more checks to ensure quality in lab work.


We look forward to an exciting 2014 at the CRBCM and Greater East Cancer Center.

happy holidays, Merry Christmas, happy new year 2014 to all!



Tuesday, December 24, 2013

FOR THE CURE, PROMOTE APOPTOSIS!

For cancer cell killing, no one can do it best but the cell itself through it's programmed death process we come to know as Apoptosis.  The killing here is efficient, long time choreographed as if a dance to death, and without mambo jambo!  No side effects and proper noticia to surrounding cells:"we are dying for this potential reason".  When the BIM, FASL and the BAX role in Apoptosis  has been sufficiently documented, the role of the PAX6, ELK1, MEF2, ATF1...or even ETS/Er81, has not been fully investigated or rephrasing, fully elaborated....I should say MAX is here somewhere....(to be continued)

IN BRAIN CANCER, THE INTRICACY OF THE RAC AND RICS GENES, THEIR DANCE WITH THE TIAM1

There is no underdog gene or gene not fully recognized for its power than RAC-1. yet it is a pivotal gene.  RAC-1 belongs to the Rho family of GTPases and therefore is a Protein kinase activators or enabling molecule.  RAC-1, like any powerful gene, will get its power through its interactions.  Through PAK1, it talks to Raf (Vemurafenib's target ) but it is through RICS and TIAM1 that it reaches its full metastasis potentials in virulent cancers.  Of course I am not going to Hide my penchant for the Wnt and the NOTCH genes, but this RAC-1 puzzles me  (to no end, they say) when it comes to Brain tumors! tell me if I am on the right track...of course you also know about this gene that help (lipid) layers to go to their exact locations in the brain, it intrigues me also...let reconvene on this soon now!  We are zeroing in!

WHAT VITAMIN D GOT TO DO WITH c-MYC ANYWAY?

Yes it is true that there is a potential link between Calcitriol (the active form of Vitamin D) and  the master genetic amplifier c-MYC, a bad prognosis factor in some cancers such as small cell lung cancers. And  in this type of lung cancers, the expression or activation of c-MYC is one the driving forces.  And it is not the only virulent cancer to borrow the power of c-MYC.

"Amplification and expression of the c-myc oncogene in human lung cancer cell lines
Cameron D. Little, Marion M. Nau, Desmond N. Carney, Adi F. Gazdar & John D. Minna
NCI-Navy Medical Oncology Branch, National Cancer Institute, National Institutes of Health, and Naval Hospital, Bethesda, Maryland 20814, USA
Genetic changes involving the c-myc oncogene have been observed in human tumours. In particular, the c-myc gene is translocated in Burkitt's lymphoma1–3 and is amplified in the human promyelocytic leukaemia cell line...."
----------------------------------------------------------------------------------------------------
(If you happen not to find a target for therapy, call CRBCM, immediately!) today VITAMIN D is given at 50,000 IU weekly.
----------------------------------------------------------------------------------------------------

Calcitriol acts through its receptor, the Calcitriol receptor of course, will eventually interact with a Zinc finger and BTB domain-containing protein 16, encoded by the ZBTB16, a popular gene that will engage events in the epigenetic areas which include many receptors (watch out because even the Angiotensin receptor is engaged).  But ultimately the RUNX and the GATA2 are also engaged. The involvement of SN3A and MDX1 however will have the most importance when it comes to c-MYC since these gene impact the Mad-Max complex.  And you know what c-MYC needs to be active (association with MAX),

let Wikipedia tell you:

MXD1

From Wikipedia, the free encyclopedia
Jump to: navigation, search
MAX dimerization protein 1

PDB rendering based on 1nlw.
Available structures
PDB Ortholog search: PDBe, RCSB
Identifiers
Symbols MXD1; BHLHC58; MAD; MAD1
External IDs OMIM600021 MGI96908 HomoloGene1767 GeneCards: MXD1 Gene
RNA expression pattern
PBB GE MXD1 206877 at tn.png
More reference expression data
Orthologs
Species Human Mouse
Entrez 4084 17119
Ensembl ENSG00000059728 ENSMUSG00000001156
UniProt Q05195 Q8K1Z8
RefSeq (mRNA) NM_001202513 NM_010751
RefSeq (protein) NP_001189442 NP_034881
Location (UCSC) Chr 2:
70.12 – 70.17 Mb
Chr 6:
86.65 – 86.67 Mb

PubMed search [1] [2]
MAD protein is a protein that in humans is encoded by the MXD1 gene.[1][2]
MAD-MAX dimerization protein belongs to a subfamily of MAX-interacting proteins. This protein competes with MYC for binding to MAX to form a sequence-specific DNA-binding complex, acts as a transcriptional repressor (while MYC appears to function as an activator) and is a candidate tumor suppressor.[2] The MAD-MAX protein dimer may be a reference to the popular cult classic film Mad Max (1979)."wikipedia

==============================================================
FOR A CAREFUL PREVENTION PROGRAM USING VITAMIN D, OR ASSOCIATION OF VITAMIN D IN TREATMENTS OF MENTIONED CANCERS, LET'S WORK HARD! (whenever focusing on c-MYC, don't forget the FUSE or FUBP1)

Sunday, December 22, 2013

PONATINIB, A COMEBACK KID!

GOOD THERAPIES ARE DIFFICULT TO DIE

A DRUG JUST RECENTLY STOPPED BY THE FDA, IS RETURNING TO THE MARKET FOR SPECIFIC INDICATIONS WITH A WORD OF CAUTION.  ACCORDING TO MEDSCAPE :
"The indications are now limited to 2 groups of patients: adults with T315I-positive chronic myeloid leukemia (chronic phase, accelerated phase, or blast phase) or T315I-positive Philadelphia chromosome (Ph)-positive acute lymphoblastic leukemia (ALL); and adults with chronic-phase, accelerated-phase, or blast-phase chronic myeloid leukemia or Ph-positive ALL for whom no other tyrosine kinase inhibitor therapy is indicated.
The FDA has also revised the Warnings and Precautions section of the label to describe vascular occlusion events, including the observed arterial and venous thrombosis and occlusions that have occurred in at least 27% of patients treated with this drug."

Saturday, December 21, 2013

Description of Spindel Cell Sarcoma and why inflammation and injuries can lead to spread of malignant cells

Spindle cell sarcoma

From Wikipedia, the free encyclopedia
Jump to: navigation, search
Spindle cell sarcoma is a type of connective tissue cancer in which the cells are spindle-shaped when examined under a microscope. The tumors generally begin in layers of connective tissue such as that under the skin, between muscles, and surrounding organs, and will generally start as a small lump with inflammation that grows. At first the lump will be self-contained as the tumor exists in its stage 1 state, and will not necessarily expand beyond its encapsulated form. However, it may develop cancerous processes that can only be detected through microscopic examination. As such, at this level the tumor is usually treated by excision that includes wide margins of healthy-looking tissue, followed by thorough biopsy and additional excision if necessary. The prognosis for a stage 1 tumor excision is usually fairly positive, but if the tumors progress to levels 2 and 3, prognosis is worse because tumor cells have likely spread to other locations. These locations can either be nearby tissues or system-wide locations that include the lungs, kidneys, and liver. In these cases prognosis is grim and chemotherapy and radiation are the only methods of controlling the cancer.
Spindle cell sarcoma can develop for a variety of reasons, including genetic predisposition but it also may be caused by a combination of other factors including injury and inflammation in patients that are already thought to be predisposed to such tumors. Spindle cells are a naturally occurring part of the body's response to injury. In response to an injury, infection, or other immune response the connective tissues will begin dividing to heal the affected area, and if the tissue is predisposed to spindle cell cancer the high cellular turnover may result in a few becoming cancerous and forming a tumor.

Thursday, December 19, 2013

We are not the only ones looking into Sirtuins and how to reduce cellular stress response in the Brain:

Cellular stress response, sirtuins and UCP proteins in Alzheimer disease: role of vitagenes

Carolin Cornelius1, Angela Trovato Salinaro1, Maria Scuto1, Vincenzo Fronte1, Maria Teresa Cambria1, Manuela Pennisi2, Rita Bella2, Pietro Milone3, Antonio Graziano3, Rosalia Crupi4, Salvatore Cuzzocrea4, Giovanni Pennisi2 and Vittorio Calabrese1*
For all author emails, please log on.
Immunity & Ageing 2013, 10:41  doi:10.1186/1742-4933-10-41
Published: 17 October 2013

Abstract

Alzheimer’s Disease (AD) is a neurodegenerative disorder affecting up to one third of individuals reaching the age of 80. Different integrated responses exist in the brain to detect oxidative stress which is controlled by several genes termed Vitagenes. Vitagenes encode for cytoprotective heat shock proteins (Hsp), as well as thioredoxin, sirtuins and uncouple proteins (UCPs). In the present study we evaluate stress response mechanisms in plasma and lymphocytes of AD patients, as compared to controls, in order to provide evidence of an imbalance of oxidant/antioxidant mechanisms and oxidative damage in AD patients and the possible protective role of vitagenes.
We found that the levels of Sirt-1 and Sirt-2 in AD lymphocytes were significantly higher than in control subjects. Interestingly, analysis of plasma showed in AD patients increased expression of Trx, a finding associated with reduced expression of UCP1, as compared to control group.
This finding can open up new neuroprotective strategies, as molecules inducing this defense mechanisms can represent a therapeutic target to minimize the deleterious consequences associated to oxidative stress, such as in brain aging and neurodegenerative disorders.

Too little, too late!

In a living cell, things are constantly happening, nothing is still,  molecules are constantly cross talking
so to believe that lipid deposits from Arteriosclerosis is benign is foolish...the endothelial cell that is covered by this stuff is constantly under pressure and Cytokines are being produced that will come back to hunt us as we plant head in the sand!  When it comes to cholesterol build up "zero tolerance " should be our norm.  But we have no lipase to throw at it we have no easy solution, so we wait that the occlusion be  more that 75% to attempt something...by then Cytokines have done their deeds, irreversible damage may have been done to the blood vessel wall.  Could PGC 1, the master co-activator, have warned us of the real toll on our systesm? or is it the PPARy, the RAR, c-AMP?   What are the true genetic biomarkers of Arteriosclerosis (to be continued)

GENE WORK INVOLVING Breast CANCER SURVIVORS

With significant progress being achieved in cancer therapy, we are finding ourself living with our sisters and few brothers who had gone through the horrific ordeal of Breast Cancer treatments and now live with this doubt on whether or not the disease is going to come back.  While it is true that in most solid tumors, the 5 year survival rule could be applied, and that we can reassure victims of solid tumor disease that once you pass 5 years post treatment, your risk of recurrence is critically decreased and one can venture to call this bench  mark for cure,  Breast cancer remains a mysterious disease that seems to escape this general rule!  Breast Cancer can return when it wants....It seems that for some reasons it can stay dormant, and wake up to disturb its victim once again.  (Clue) What this is reminiscent of, is of course Viral Herpes when it first shows up as chicken Pox and goes to sleep in our nerve roots, and break out as Shingles later on in our peaceful life to disturb and affect it.  (New clue, progress in HIV, it is now a chronic disease)
At gene level, nothing occurs without some genes acting out!  It is time that we answer the questions that survivors need from us.  The genes are there, let take the time to look at them and stop this cancer cell madness of trying to come back in our survivors.  No head in the sand because we don't have an answer, but take the Bull by the Horns and see what happens!  (You know what I mean!)

TRYING OUR BEST TO TALK TO THESE GENES IN BREAST CANCERS: MED1,6 and 12

With the clinical finding that Bicalutamide, a non steroidal anti-androgen, has a role in some of the luminal forms of Breast cancers, genes affecting the Hormones have quickly become the focus of intensive research. So we venture to explores some of the genes having links to Hormone.  At CRBCM we are looking at DAX1 as it interacts with COPS2 and through the thyroid Hormone Receptor alpha gene will affect the MEDs which ultimately the Glucocorticoid Receptors and a slew of other critical receptors and genes (even the BRCA-1) is in the line of fire!
Now how important this observation is in triple negative breast cancer is still a matter of debates.  Proof of concept work is still needed but it is a clear start, join the discussion!

" MED1 has been shown to interact with Thyroid hormone receptor alpha,[4] Androgen receptor,[5] Cyclin-dependent kinase 8,[6][7] Glucocorticoid receptor,[8][9] BRCA1,[10] Hepatocyte nuclear factor 4 alpha,[11][12] Peroxisome proliferator-activated receptor gamma,[13] PPARGC1A,[14] P53,[15][16] Estrogen receptor alpha,[7][17] TGS1[18] and Calcitriol receptor".[6][17] wikipedia


WHERE ELSE COULD THINGS BE HAPPENING BUT HERE!
THE INVOLVMENT IS THE CALCITRIOL RECEPTOR IS ANOTHER AREA OF INTEREST.  THIS MED1 SEEMS LIKE A GIFT THAT KEEP ON GIVING.   THE ANDROGEN RECEPTOR INVOLVEMENT IS A CRITICAL STEP SINCE IT BELONGS TO THE "WILD GENES"


Wednesday, December 18, 2013

Proof that target therapy has come in to change things in cancers!

1.Combining Ibrutinib with R-CHOP is not only feasible but yield 100% response in Diffuse Large cell Lymphoma.

For decades, CHOP had remained King of treatment of diffuse large cell lymphoma
Elaborate combinations of chemotherapy drugs failed to improve on CHOP, until the targeting of CD20 by Rituxan.  And now with the arrival of the almighty powerful Ibrutinib, response rates seem to be overwhelming although not all seems to be complete Responses, at least not yet since analysis of data is still ongoing!

Tuesday, December 17, 2013

Dr. Kankonde MD the new physician and custodian for Dr. Lundy's patients in El Paso Texas

The CRBCM,
expanding its foot print in El Paso.  We are in the right fight because our cause is just!

Collaboration at the CRBCM, good progress in our lung cancer research! We thank MDHonors, UTEP, LCBRN/Univ. of Virginia tissue Bank!

12/16/2013

"Hi Peggy,

Attached is your invoice for the 45 RNA samples and 50 serum samples that you recently requested from the LCBRN.  Once payment has been received, I can set up a shipment date."
=======================================
We thank MDHONORS, funding organization.
We thank UTEP (UNIVERSITY OF TEXAS AT EL PASO) PERFORMING PCR WORK FOR the CRBCM.
and We thank the LCBRN/ UNIVERSITY OF VIRGINIA for their support
and We thank the GREATER EAST CANCER CENTER, our SECONDARY FUNDING ORGANIZATION

PROGRESS IS PAINSTAKING AND SLOW, BUT IT IS THE INGREDIENT OF SUCCESS.
OUR EARLY DETECTION OF LUNG CANCER PROJECT IS ON ITS WAY FOR A SECOND PHASE  (FIRST PHASE WAS COMPLETED ON 5 TISSUE SPECIMENS TO TEST OUR PCR WORK FOR TARGETED GENES).
WITH THIS FIRST PHASE COMPLETED, the CRBCM is deliberately moving forward!
------------------------------------------------------------------------------------------

DON'T WORRY, THE RNA SAMPLES WILL BE QUICKLY PROCESSED (WITHIN 48 HOURS) c-DNA FOR LONGER STABILITY (YOU GET MY DRIFT!).


Monday, December 16, 2013

PIM1, a powerful target in Cytokine dependent diseases

No gene is deep in the bowel of the cellular Beast having such powerful interactions that leads to cytokine production as this one.  Its relation with the NF-KB and the NFATs is a testimony to how critical a gene it is.
Under the management of NUMA1....(to be continued!)

The secret of triple negative breast cancer

Common sense tells us that events happening in your women when they acquire childbearing age contribute significantly to the happening of triple negative breast cancer.   The young woman has gone through infancy when events here are more related to the setting of class I HLA antigens first for self tolerance, then comes exposure to the outside world and the building of defense mechanisms.  Implying development of class II HLA Antigens which we know by now are very much linked in their variations to racial disparity.  Then the young woman enters puberty which brings in the reign of the Estrogen with its extensive methylation of genes dampening the Class I HLA to prepare the young lady's body to receive the foreign "body" of the potential infant.  We have touched in one of our precedent writings about the effects of Estrogen on the immune system.   We have extensively discussed the interaction of Interferon and TNF /TGFs on receptors of Estrogen (Activation followed by desensitization or lack thereof.  The female individual with autoimmune disease will be much more affected by the surge of cytokines above.  Then come the menses with their resulting Iron deficiency which prones the body to the danger of Reactive Oxidative species.  But as far as genes are a concern, the most important event is the development of the breasts.  It is the reign of the PROLACTINS.....
Indeed, it is Prolactins that will happen on this background of Estrogen/Cytokines effects.   Don't think of Prolactin as a hormone, it is a Cytokine!  Yes, it comes in to not only have a direct effect on the Janus Kinase 2 and induce the JAK-2-STAT pathways, but through its Dopamin Receptor, it will pound on the c-MET effect and exert numerous pounding on the PIK (effect include on its regulators (AGAP2) pathway....If you happen to have another genetic abnormality such as BRCA, or too much free Iron stimulating the HIF or any other failure....something wrong is bound to happen....such as ...triple negative breast cancer.....The point is, don't forget the Prolactin reign!!!

Saturday, December 14, 2013

IN THE "EL PASO TIMES"

There is an announcement for the last 2 Sundays,
reporting the Retirement of DR RAY LUNDY, a Dr who has been a pillar in this community.
DR Lundy has chosen the Greater East Cancer Center  (and the CRBCM) to continue the care of his patients.
We are pleased by is careful choice, and promise to continue what he started.  We will make sure patients receive the kind of excellent care they expect from us!


Friday, December 13, 2013

CRITICAL POTENTIAL NOTIONS IN UNDERSTANDING TRIPLE NEGATIVE BREAST CANCERS

It all makes sense that Hypoxia induced by respiratory failure in a predominantly obese population will contribute to generation of Reactive Oxidative Species and that Over eating of sugar based products will worsen the events that will lead to HIF-1 gene excitation and probable amplification, which eventually involve the VHL (justifying the correlation of clear cell Renal cancer with obesity), and eventually amplify angiogenic genes (EGFR,VEGF).  This will end-up through Gerb2 connection gene, amplify the G proteins connected MAPK and could drive to a neoplastic process.  When p38-MAPK is involved there appears that the process will be accompanied by a significant cytokine release leading to an associated inflammatory process.  This is why anti-p38 is more looked into for its anti-inflammatory consequences rather than anti-neoplastic processes. For this inflammatory process to be successful, stimulation of the CREB must be suppressed, which it is in hypoxia. The level of Cyclic-AMP is also dampened as a result.

In the epigenic zone, amplification of the MAPK will ultimately amplify the MIFT (MIFT was first described under these conditions of amplified MAPK) with consequences that lead to dampening of Androgen activity if the MIFT interacts with PATZ1.

 If  MIFT interaction is mediated via PIAS3 binding,, ER will be next to be knocked out


Wikipedia: "This interaction is mediated via PIAS3 binding to the STAT3 DNA binding domain. Hence, STAT3 transcriptional activity is inhibited by the physical prevention of its binding to target genes. Subsequently, PIAS3 was also found to be a regulator protein of other key transcription factors, including MITF,[6] NFκB,[7] SMAD [8] and estrogen receptor.[9] PIAS3 protein also functions as a SUMO (small ubiquitin-like modifier)-E3 ligase"

Pretty soon, you have yourself a triple negative breast cancer!!!
(leading to the question is IL6 elevated in this disease?

MIFT involvement with TFE3 will engage HMGA-2 and prop the metastatic propensity in this disease (triple negative breast cancer).

The involvement of MIFT is obligatory since it will unlock the chromatin to allow access to nuclear material by chromatin modulation

TO BE CONTINUED

An interesting Observation

 Contact QIAGEN OUR SOURCE FOR QUESTIONS!

 A study on a  BRAF(V600E) melanoma cell line treated with RAF, MEK, ERK or combined RAF-MEK inhibitors revealed a cAMP-dependent melanocytic signaling network not previously associated with drug resistance, including G-protein-coupled receptors (GPCRs), adenyl cyclase, protein kinase A (PKA) and cAMP response element binding protein (CREB).
" histone-deacetylase inhibitors suppressed MITF expression and cAMP-mediated resistance (Nature, December 2013" QUIAGEN


This observation from journal nature reported to us by QIAGEN
tells us
1. a second look at a old story does not hurt
BRAF INHIBITION IS A NEW THING HAPPENING TO A OLD STORY
AND LOOK WE HAVE BEEN SITTING ON OUR HANDS IN MELANOMA UNTIL IT SUNK ON US TO TARGET THERAPY! NOW LET'S ENJOY THE SUCCESS OF VEMURAFENIB IN OUR FIGHT FOR THE CURE!
2.THIS IDEA THAT  MITF AND c-AMP MAY HAVE THE POWER IN THEM TO CAUSE DRUG RESISTANCE IS EXTREMELY IMPORTANT, IT MAY BE THE JUSTIFICATION OF 2 IMPORTANT PHENOMENA
2.1 THAT EGFR/VEGF INHIBITION IS TEMPORARY, THAT ULTIMATELY AVASTING WILL FAIL BECAUSE OF THESE ACTORS (OR ARE THEY BYSTANDERS?)
2.2 THAT MTOR INHIBITION CAN STOP THIS RESISTANCE ONCE IT IS DOCUMENTED BY AMPLIFICATION OF THESE 2 GENES.  SO YOU GIVE AVASTIN, AND WATCH THESE 2 GENES, AND IF THEY CREEP UP, YOU KNOW AVASTIN RESISTANCE IS IN PLACE, AND HOP! YOU GIVE MTOR INHIBITOR!  WHAT'S THIS FOR A CONCEPT TO BE PROVEN!

LET'S GO TO WORK!

GENES IN MELANOMA

ERCC6
DDB2
POLH
RAD2
p16/CDKN2A, p14ARF
CDK4
MCIR
NRAS
BRAF
KIT
MITF
PTEN
GNAQ
GNA11
XPA
BRCA
miRNA

1.does amplification of Grb2 influence c-KIT biomarker function...or response to Imitanib/Dasatinib
is Mutation or amplification of Grb2 necessary to predict response to treatment.
2.what is the therapeutic, prognosis roles of Cytokines in triple negative breast cancers and Melanoma for that matter.  We know CyclinD is involved,  But are theyr other Cytokine, Status of Ornithin?  Polygluthamine, Melanine derivative?level of Ketoacids in both serum and Urine?

Thursday, December 12, 2013

Words of caution!

Be careful when targeting these genes, some of them are "wild genes", meaning that they could be leading to the activation of many more genes. As we discussed, handle these with care because you will not be able to control their side effects....Other genes are just critical to so many functions ie. the ELK-1 gene.  You may use it for pro-apotosis, but it is a gene that, once knocked down, can lead to Alzheimer dementia and many more neurologic disturbances.  So read carefully before targeting these genes.  Some could lead to seizures or sudden Neurologic dysfunction, so pick and choose carefully and be prepared to handle Neurologic or cardiac complications...and always start with Phase I as per standard....Indeed you are in the belly of the beast, tread carefully!

Wednesday, December 11, 2013

Deep in the belly of the beast, ARE HIDDEN NICE THERAPEUTIC TARGETS!

As we examine deeper for possible targets for therapy, we are not swayed by media or political pressures which are mounting, but we look at real facts that are scientific and based on real data and deep studies of pathways: 6 targets come out either because they are at the intersection of pathways or because they are critical, obligatory steps to either DNA proliferation or cytokine production.   They are: JNK, P38, ERK, SRF, c-fos, CRE, ELK-1, NLK, oh hell did I say 6...my mistake  but depending on the neoplasia under consideration, the list can be prolonged. 
It will include: Sap1a, NFAT, JUN-D,atf2,p53,GADD53,PRAK,MAX,HSP27/72,PP3C,
GOOD HUNTING!
 SNIFF THE BEST AND TAKE YOUR PICK!  AND GUESS WHAT: THE DEVIL IS NOT VERY FAR (I MEAN THE DVL GENE) !

Interesting genetic concepts

* Immediately post brain trauma,  Blocking DISC1 --- GSK-3 INTERACTION
could affect post traumatic brain disorder.  I wonder if early administration of Cyclosporin can have this effect by affecting the NFAT pathway?

* In small cell, I wonder if the YWHAE and CDK5 should be the focus of our attention?   Definitively looking into the Noonan disease gene since it induces malformation.
Inhibitor of the CDK5 should be the focus since the experience with the Melanoma has brought light on these inhibitors (p16/CDK2A/CDK4)!

* Could Disturbance of DISC1 explain post Radiation syndrome or "chemo-Brain"?
* Could Cyclosporin and various interventions decrease post Radiation encephalopathy?

*Is there a surge in peripheral blood cytokines post Radiation as experienced in Traumatic brain injury? And what cytokine is being observed?

Tuesday, December 10, 2013

CELLULAR PLAY

I strongly believe the cell has multiple plays to hide from us its intrinsic play when it comes to neoplastic process.  I believe we have the cards and each of us has a hand of cards to play with. I believe we have before us confused facts, we need just to make the next step.  yes we have the basic facts, we just need to read them correctly. We know all the genes, and know most of their main roles.  And we have solid leads...

We know that stress leads to Gastric cancer, and we know the NF-kB is wild at play but so far our examination has been incomplete, and clearly we would benefit by looking at this pathway deliberately and completely since that approach would yield various culprit genes and potential targets to treat the ailment.

We know that in triple negative breast cancer the NF-kB must be implicated with disruption at hormone receptors.  BRCA and its full pathways of co-factors and downstream molecules (ie.BABAM-1, HTATIP and  ETV-6). And now the role of Androgen in luminal form of this cancer, the WISP3 in inflammatory Breast.  All these messages have not resounded in our head enough to excite us to cross the bridge...

We have the "wild genes" CRE,Gerb,Lyn,MyH or MyB, Flyn, Ep300, AR, etc.. Basically we know when things reach here, everything goes!

We know full differentiation requires the NOTCH, and MEK is the door to de-diferentiation (under the NOTCH control of the MAPK through the ADAMS10).  We know Ubiquitination is also under NOTCH influence...But we don't still use fully the Info!

Using the "master integrator" to its full potential too in cancer prevention to dampen Reactive Oxide species and reduce EGFR positive lung cancer in non smokers would be a significant new approach.
All this is on the desk at CRBCM as we start 2014.   Wish us luck, the fight is still ahead.

Monday, December 9, 2013

Looking at an earlier find in Melanoma!

For the longest time in Melanoma therapy, only DTIC and interferon were cited in Melanoma therapy.  Interferon was given in adjuvant setting Mostly and DTIC in Metastatic diseases from Melanoma.             Despite our understanding of the working of Interferon, there no clear biomarker that would predict which melanoma would be more snsitive to Interferon.  Therefore integration of Interferon into new combinations with new Target therapies such as Ipilimumab and Vemurafenib, remains a hot topic of investigation.
Interferons can act on tumor cell through the direct JAK-STAT pathway, but for some other reasons, go through the ISGF/GAS/PE-1/p91 pathways.  The interferon can recruit stimulation of the IRF pathways as well as activating the MHC class I to immunologically block progression in Melanoma.   How this will impact the effects of newly found pathways of Ipilimumab and Vemurafenib is anybody guess and a matter of current trials.  It appears that we now have to play catch-up, since earlier investigations to define predictive biomarkers for interferon/DTIC responses were not timely completed.  Turning and returning a old stone needs once again to be completed!

Saturday, December 7, 2013

BURNING QUESTIONS!

1. OH! let me come out and say it!
Don't you believe by now that there is this suspicion that interfering with Iron Receptors could decrease the rate of metastatic disease to the lungs?  Would it be grand to actually prove you could slow down Hepatoma or breast cancers from moving to the lungs by sending an Antibody against Iron receptor?  Let's look closer into the data!  and reconvene in the coming year to get an update!  At the CRBCM, we are working overtime!

2. Could gene interference with EP300 boost anti-VEGF Medication?  It is after all a co-Activator of HIF-1, isn't it?

3. Cataract prevention: what is the standing of the CRYAB gene? What about the RPGRIP-1 gene in retinal damage?

DANCING WITH A GIANT NAMED: "THE SMALL HETERODIMER PARTNER"

There are 25000 genes in human cell approximately or give and/or take they say!
and only 20% are active at one given time they estimate.   But make no mistake about it, the rule of "company you keep" has not been as strong at play as it has in genes!   The Small Heterodimer PARTNER (SHP) really in the thick of it.  See it plays with one of the gene involved with a tissue which, once cancerous, lead to incurable cancer.   SHP interacts with non other than Hepatocyte nuclear factor 4 alpha (HNF4A).  And through this gene, it will reach a "wild gene" called "CREB-binding" which affects in its dealing to close to 50 genes ( Hell! all genes since it it is involved in the "breathing" of the cell!)  This small Heterodimer Partner is a misnomer, it is a GREAT Partner important in the function of all major Hormone from Androgen to Estrogen!  Touch this one, and you will feel the vibe!  If you know What I imply...

Friday, December 6, 2013

ACTIVITY AT CRBCM

ONE COULD NOT STAND THE BEAUTY OF OUR POSTER, WE CAME BACK WITHOUT OUR POSTER ON TRAUMATIC BRAIN INJURY PROJECT, STOLEN AT THE CONFERENCE.
 I GUESS IT IMPRESSED A HECK OUT OF SOMEONE!  STOLEN POSTER, THAT'S JUST IMPRESSIVE AN ACHIEVEMENT FOR ANY POSTER!  LUCKILY, WE STILL HAVE IT ON A MEMORY CHIP!

WHO CARES ABOUT THE TISSUE OF ORIGIN WHEN YOU HAVE THE GENETIC PROFILE OF CANCER?

TIVANTINIB, anti-c-MET
OBINUTUZUMAB, AN ANTI-CD20, FDA APPROVED IN CLL
NINTEDANIB, anti-EGFR
PONATINIB, NOW "DEFUNCT" BECAUSE OF THROMBOTIC COMPLICATIONS

========================================
WHO CARES ABOUT THE ORIGIN OF THE CANCER WHEN YOU KNOW THE DRIVER MUTATIONS?

When you treat triple negative Breast cancer luminal type with Bicalutamide, when you treat Angiosarcoma in the liver with Avastin, even Melanoma with Yervoy, lung cancer with Crizotinib, who really cares about the tissue of origin?  We are now at the stage where chemotherapy will need to be dictated not by the Oncologist, but by a Central Pathology department giving us the gene profile for each cancer diagnosed in town!
The Europeans are now planning this move as we heard from the grapevine!  are we ready?...it will be cost effective and reportedly better for our patient outcome as suggested in recent studies (for the hard believers!).  "New Paradigm" = Not the tissue of origin, but the genes!  Medicine is a shifting field and new technology is rolling in...I got to go to that Nano meeting planned in March...Europe here we come!

Thursday, December 5, 2013

Creating a new path like the CRBCM!

Each time we turn around, people rush to discourage CRBCM that this and that has been studied and therefore there is no point to revisit the question.  It is a weakness to believe that when it comes to cancer biology, revisiting a topic at molecular level always unveil an interesting aspect that had remain hidden or overlooked.  Surprises are everywhere, you just have to keep your eyes open and remain suspicious of the evident...The Retinoic Acid Receptor has been known for long time, but the story of ATRA in Promyelocytic Leukemia does not date that long.  As a matter off fact the story of Targeting therapy is not that old.  It took a second look with new technologies to uncover new aspect of the same story.  For a sole Researcher, going it your way may pay big.  Shackled in large institutions, you have to follow the direction of the chief!  But on your own, just pick up and go, surprises are still awaiting!  There are 25000 genes, each with its habits, reactions and adaptations that are not fully uncovered. To believe otherwise is foolish, work hard and keep at it!  The CRBCM is on that path...we believe is the future!  Passion will take us there!

I was just reading about Lung cancer and what pathological Biomarkers have entered standard therapy (EGFR, ALK, ROS-1,etc...). These are for therapy decision, is that means our patients have stopped their need to know about for early diagnosis, no!  Is that means we don't want to know about prognosis? No...if you work in this area, just keep on plugging along,  until those who doubt come to recognize they are short sighted...things are awaiting your discovery everywhere your mind and heart take you...just keep at it!

ACTIVITY AT CRBCM: BIG DAY TODAY ONCE AGAIN

We are presenting our TBI project at the scrutiny of the staff at the University Medical Center and Faculties at both Texas Tech.and the Paul L.Foster School of Medicine.  We have 15 minutes to convince our audience that Butein an Activator of Sirtuins could limit post traumatic events at gene level that broaden brain lesions.  The task at end is huge because it does not only involve the trauma but extensive genes from regulation of Calcium store in the ER to the involvement of Maf, ICER, p21SFT, GATA, EGR, to OCT, HNF3,IRF4 to the NEF2.

Also DR Ray Lundy has officially announced his Retirement, and Greater East will be taking over his operation, we will be double busy!

The preliminary results on the 5 lung cancer tissues is now available for review with DR Jangh.
CRBCM, advancing in a resisting world but our fight is just!

Wednesday, December 4, 2013

WE ARE READY TO PRESENT ON TBI TOMORROW

Hello all,

Please provide me with your PowerPoint Presentation by today at 3:00pm.  UMC Nursing needs your presentation in advance to in order to provide credit.

Kindly,
Cynthia Ogaz, MBA
Lead Analyst
Office of Continuing Medical Education
TTUHSC – Paul L. Foster School of Medicine
===================================
NOW FULL REHEARSAL INTO MOTION AT CRBCM!

Conformational molecular Targeting wanted.

At molecular level, nature uses a simple language sometime to achieve big things.  Attraction of electron by proton, the unstable nature of a celibate electron looking to couple with another electron, allosteric change of shape of molecules that match an active site of another molecule or chemical based post-translational shape modification to expose active sites of molecules.  All these to phosphorylate, methylate or otherwise tamper with shapes of molecules to allow pathways to unfold!
The surprising success of ATRA in Promyelocytic Leukemia is an outstanding example of the success of this approach in therapeutic medicine.The activity at retinoic acid Receptor, and various shape that could potentially fit into the Active sites at AP-1, occupying sites at NFAT, or Leucine Zipper or even just c-JUn and c-fos all could have potentially profound therapeutic effects in those disease processes that hinges on the NFAT-AP1 interaction.  Particularly the leukemia, and cancer such as Melanoma where the CDK4 gene is important.  Yes you can create an Antibody, but remember a simple matching form can do the trick by a simple lovely lodging of molecule into an activity site, paralyzing it for use!

We need more of this type of intervention...

Tuesday, December 3, 2013

Presenting our TBI project !

14th Annual Rio Grande Trauma Conference & Pediatric Update- Abstract Presentation Information


Ogaz, Cynthia
11:20 AM (8 hours ago)



Please see attached Abstract presentation schedule. May you please be 20 minutes prior to your presentation time in AEC Auditorium A and B.  For those that will bring poster for this conference, you will need to set up your posters by 8:00 am on Thursday, December 5, 2013 and pick them up by 4:45pm on Friday, December 6, 2013.  Feel free to contact me if you have any questions. 


Importance of Hypoxia in cancer Biology

Hypoxia is not unexpected in normal cellular biology and mechanism to deal with are well set even at gene level.  The existence of Hypoxia induced Factor gene is a proof of the such a process.  Its interaction with the Von Hippel Lindau gene well described as it induce the clear cell kidney cancer.  hypoxia result in increased free Radicals and various acids (hypochloric, acetic acids, superoxide, and Hydrogen peroxide).

local conditions may worsen the toxic conditions of these highly "Reactive Oxygen Species" (ROS).  In certain tissues or condition  where there is highly "catalytic Iron or Cupper" (liver or substancia Nigra) the hypoxia (or Alcohol) will yield highly toxic molecules that will "burn" local tissues.  In a attempt to remedy the situation, the body will engage angiogenic genes to bring about new blood vessel to improve the local Oxygen levels.  (VEGF, and subsequently the EGFR will be highly engaged).  In the lungs, there is a typical cancer that happens in non smokers that has high expression of mutations of the EGFR, and respond highly to Gefitinib and Tarceva.  Checking for EGFR Mutation is now standard of care in lung cancer, meaning failure to evaluate EGFR is careless care since there is a unique response of these cancers that should be used prior to considering other therapies!
The Anoxic process happens in the Cytoplasm and the peri-nuclear region popularly knwon these day as epigenetic Zone.  It also involve where the cell breath or the Mitochondria.   With the involvement of the Mitochondria comes the MTOR.  Because the MTOR are here downstream from the EGFR, combination of Anti-EGFR with the MTOR inhibitor failed to show addititive effects in some cancers.  It is now suggested that the MTOR inhibitors follow the anti-EGFR as if the early use of anti-EGFRs prepare the way to the effect (somewhat sensitize) of the MTOR inhibitors.  Further proof of concept is needed although suggestions have been put forth.

The body has mechanisms to dampen the effects of the above toxic agents of which production has been boosted by the wide inconsiderate use of Anti-Oxidants (ignorance of potential presence of highly catalytic iron and Cupper, or Zinc for that matter).  We know what ionized Aluminum does for Parkinson disease...
Glutathion, Nicotinamid Adenine Dinucleotide (NAD), Nerf2, and other dismutase and various Sirtuins are our mechanisms of control.

The report suggesting the almighty Bcl-2 uses depletion of Gluthatione to block Apoptosis from ensuing point to the importance of Gluthatione in biologic events!

(TO BE CONTINUED)

Monday, December 2, 2013

For your better reading about TBI gene based pathophysiology

Once the TBI's injury occurs, data have shown that the size of the lesion is dependent not only on the extent and force of the trauma, but also on amount of  subsequent reactive inflammatory and anoxic event that follow the trauma.  Also the baseline level Activity of the Notch prior to the event is critical in minimizing the incoming effects of the trauma.  As upregulation of the Notch sometime pre-exists in some Nerve cells such as the one in the Retinal cells.  Here such upregulation seems to contribute to allowing de-differentiation proning cell to proliferation. Whether MEK is involved is beside the point, This influence of the Notch seems overall Neuroprotective when it comes to resisting inflammatory reactions.
The force of the Trauma cannot be neglected as it can cause a commotion stretching or changing the axial diameter of the cell sufficiently to induce stress and the c-JUN pathways,  but it can also be sectional, directly killing the pre-synaptic Neuron.  Such a section will disturb profoundly events occurring at the presynaptic membrane with pertubation and release of multiple preexcitatory Glutamate and the like, potentially inducing seizures in the TBI victims.  Evidences suggest, TBI inducing such a trauma induced section of the presynaptic neuron, will impact post synaptic events not only by lack of normal stimulation, a preliminary event to Anoikis of the post synaptic Neuron, but also use free NMDA receptors to potentiate Anoxic events into production of powerful toxic free radical and Oxidant beyond Nitric Oxide.  Without an sufficient upregulation of both the Nrf2 and the Nicotinamid (NAD) systems, the targeted Neuron is at risk of dying more likey through the Caspase 1 pathway.   Anoikis kills more likely through the Caspase 3 apoptotic pathway!
The Anoxia described above is evidently more severe if vascular section resulted from the trauma directly, however vascular compression coming from swelling of the brain tissue may achieve the same Anoxia.  Stimulation of the VRAC by various liberated toxic Peptides may affects ions (including Calcium) channels, leading to significant edema.  It is proposed that Tamoxifen may dampen this reaction and could be of use.  The purported effect of Tamoxifen could be Estrogen Receptor driven since there will more likely be upregulated under the effect of TNF and Interferon (cytokines) coming from inflammatory white cells called into the theater of the TBI.
Indeed, after a trauma that could potention section a blood vessel, or cause erosion of the endothelial surface, extracellular material such as Collagen will trigger Platelet derived events (PDGFR and PDGF) which will also, through CXCL/CCR3 or 4 trigger Macrophage attraction.  The macrophages in turn will expand the reaction by calling T-cells (and this recruitment is worsen by IL1 through its integrin action at Endothelial level) but also secrete several cytokine including TGF alpha which could activate both the p38-MAPK pathways (that upregulate NOTCH dampens) or the PI3K/AKT pathways
leading to downstream Oxidative events that may expand into the pCREB/MTOR paricularly if stress-c-JUN-NF-kB are in play.  This cycle will lead to NADH, Free radicals  That could only be Dampened by the involvement of the Nerf (s) and the Sirtuins and their activators (the Buteins).
And there you have it Buteins are Neuroprotective.  The MTOR inhibitors will be protective through the activation of c-AMP of course!

Genes in TBI /Cytokines/pathophysiology of TBI at gene level!

NOTCH1
Hes1
FGF2
NMDA
ERK 1&2
NF-kB
P38
Nerf-1,2
CXCL4
CCR3,4
NADP
VRAC
Brd-U
PSA-NCAM
SOX9
DAPT
MAPK
TNF
TGF-alpha
RANTES
CRE
Wnt1

Once the TBI's injury occurs, data has shown that the size of the lesion is dependent not only on the extent and force of the trauma, but also on amount of  subsequent reactive inflammatory and anoxic event that follow the trauma.  Also the baseline level Activity of the Notch prior to the event is critical in minimizing the incoming effects of the trauma.  As upregulation of the Notch sometime pre-exists in some Nerve cells such as the one in the Retinal cells.  Here such upregulation seems to contribute to allowing de-differentiation proning cell to proliferation. Whether MEK is involved is beside the point, This influence of the Notch seems overall Neuroprotective when it comes to resisting inflammatory reactions.
The force of the Trauma cannot be neglected as it can cause a commotion stretching or changing the axial diameter of the cell sufficiently to induce stress and the c-JUN pathways,  but it can also be sectional, directly killing the pre-synaptic Neuron.  Such a section will disturb profoundly events occurring at the presynaptic membrane with pertubation and release of multiple preexcitatory Glutamate and the like, potentially inducing seizures in the TBI victims.  Evidences suggest, TBI inducing such a trauma induced section of the presynaptic neuron, will impact post synaptic events not only by lack of normal stimulation, a preliminary event to Anoikis of the post synaptic Neuron, but also use free NMDA receptors to potentiate Anoxic events into production of powerful toxic free radical and Oxidant beyond Nitric Oxide.  Without an sufficient upregulation of both the Nrf2 and the Nicotinamid (NAD) systems, the targeted Neuron is at risk of dying more likey through the Caspase 1 pathway.   Anoikis kills more likely through the Caspase 3 apoptotic pathway!
The Anoxia described above is evidently more severe if vascular section resulted from the trauma directly, however vascular compression coming from swelling of the brain tissue may achieve the same Anoxia.  Stimulation of the VRAC by various liberated toxic Peptides may affects ions (including Calcium) channels, leading to significant edema.  It is proposed that Tamoxifen may dampen this reaction and could be of use.  The purported effect of Tamoxifen could be Estrogen Receptor driven since there will more likely be upregulated under the effect of TNF and Interferon (cytokines) coming from inflammatory white cells called into the theater of the TBI.
Indeed, after a trauma that could potention section a blood vessel, or cause erosion of the endothelial surface, extracellular material such as Collagen will trigger Platelet derived events (PDGFR and PDGF) which will also, through CXCL/CCR3 or 4 trigger Macrophage attraction.  The macrophages in turn will expand the reaction by calling T-cells (and this recruitment is worsen by IL1 through its integrin action at Endothelial level) but also secrete several cytokine including TGF alpha which could activate both the MAPK pathways (that upregulate NOTCH dampens) or the PI3K/AKT pathways
leading to downstream Oxidative events that may expand into the CRE/MTOR paricularly if stress-c-JUN-NF-kB are in play.  This cycle will lead to NADH, Free radicals  That could only be Dampened by the involvement of the Nerf (s) and the Sirtuins and their activators (the Buteins).
And there you have it Buteins are Neuroprotective.  The MTOR inhibitors will be protective through the ctivation of c-AMP of course!