Wednesday, June 5, 2013

IMPORTANT TARGET OF IMMUNOTHERAPY
MUNITIAE AT THE CELLULAR MEMBRANE

TO FIGURE OUT THE FOLLOWING EXCERPTS ONE SHOULD REMEMBER THE PHENOMENA OCCURRING DURING INJURY TO THE BLOOD VESSEL. WHEN A BLOOD VESSEL IS OPEN DURING AN INJURY, IT IS THE SUDDEN EXPOSURE OF BLOOD CELL WITH OUTSIDE TISSUE/PROTEIN (COLLAGEN) THAT TRIGGERS COAGULATION, PLATELET ACTIVATION.

NOW IMAGINE A MOLECULE OF ESTROGEN ARRIVING AT CELL SURFACE AND BINDING TO ITS RECEPTOR, 2 THINGS HAPPEN, ONE IS THAT THE LINKAGE CAUSES AN INTERNAL SIGNAL TRANSDUCTION GOING THROUGH A PATHWAY
BUT SOMETIME THE ALL RECEPTOR DETACHES WITH ITS STIMULANT AND IS INTERNALIZED.  AT POINT OF DETACHEMENT, THERE IS CONTACT OF FIBRONECTIN  (EXTRACELLULAR) WITH CYTOSOL CONTENT FOCAL ADHESION KINASES (fak) AND THE REST FOLLOWS (5 BULLETS) 

1.the binding of a neuropeptide to its cognate GPCR triggers the activation of multiple signal transduction pathways that act in a synergistic and combinatorial fashion to relay the mitogenic signal to the nucleus and promote cell proliferation. A rapid increase in the synthesis of lipid-derived second messengers with subsequent activation of protein phosphorylation cascades is an important early response to neuropeptides. An emerging theme in signal transduction is that these agonists also induce rapid and coordinate tyrosine phosphorylation of cellular proteins including the nonreceptor tyrosine kinase p125fak and the adaptor proteins p130cas and paxillin. This tyrosine phosphorylation pathway depends on the integrity of the actin cytoskeleton and requires functional Rho.(ROZENGHURT)

THAT IS AFTER A GROWTH FACTOR HAS LINKED TO ITS RECEPTOR, COUPLING WITH A G-PROTEIN WILL TRIGGER AN EXPLOSION ON PHOSPHORYLATION IN ALL DIRECTION, ON THESE PHOSPHORYLATION HITS A KINASE OF AN IMPORTANT PATHWAY AND THE PATHWAY ENTER INTO ACTION.

2.This effect required the autophosphorylation site of FAK, which is a binding site for Src family kinases. Integrin-mediated phosphorylation of Cas was not, however, compromised in fibroblasts lacking FAK.
FAK seems not to be necessary for phosphorylation of Cas, but when autophosphorylated, FAK may recruit Src family kinases to phosphorylate Cas. Cas was found to form complexes with Src homology 2 (SH2) domain-containing signaling molecules, such as the SH2/SH3 adapter protein Crk, following integrin-induced tyrosine phosphorylation. Guanine nucleotide exchange factors C3G and Sos were found in the Cas-Crk complex upon integrin ligand binding. These observations suggest that Cas serves as a docking protein and may transduce signals to downstream signaling pathways following integrin-mediated cell adhesion.(VUORI ET AL)

3. The focal adhesion kinase (FAK), a protein-tyrosine kinase (PTK), associates with integrin receptors and is activated by cell binding to extracellular matrix proteins, such as fibronectin (FN). FAK autophosphorylation at Tyr-397 promotes Src homology 2 (SH2) domain binding of Src family PTKs, and c-Src phosphorylation of FAK at Tyr-925 creates an SH2 binding site for the Grb2 SH2-SH3 adaptor protein. FN-stimulated Grb2 binding to FAK may facilitate intracellular signaling to targets such as ERK2-mitogen-activated protein kinase. We examined FN-stimulated signaling to ERK2 and found that ERK2 activation was reduced 10-fold in Src- fibroblasts, compared to that of Src- fibroblasts stably reexpressing wild-type c-Src. FN-stimulated FAK phosphotyrosine (P.Tyr) and Grb2 binding to FAK were reduced, whereas the tyrosine phosphorylation of another signaling protein, p130cas, was not detected in the Src- cells.(SCHLAEPFER ET AL)
Src-family binding and phosphorylation of FAK at Tyr-925 creates a Grb2 SH2-domain binding site and provides a link to the activation of the Ras signal transduction pathway. In Src-transformed cells, this pathway may be constitutively activated as a result of FAK Tyr-925 phosphorylation in the absence of integrin stimulation.

4. Pyk2 overexpression enhanced FN-stimulated activation
5.RAFTK/Pyk2 is expressed mainly in the central nervous system and in cells derived from hematopoietic lineages, while FAK is widely expressed in various tissues and links transmembrane integrin receptors to intracellular pathways. This review describes the role of RAFTK/Pyk2 in various signalling cascades and details the differential signalling by FAK and RAFTK/Pyk2. of co-transfected ERK2.(AVRAHAM)
===============================================================

SO 2 MAIN ROUTES
THE ERK2

AND THE GRB2

DO REMEMBER GRB2 IS THE WILD WILD WEST OF GENES!

Function and expression

Grb2 is widely expressed and is essential for multiple cellular functions. Inhibition of Grb2 function impairs developmental processes in various organisms and blocks transformation and proliferation of various cell types, and so it is not surprising that a targeted gene disruption of Grb2 in mouse is lethal at an early embryonic stage. Grb2 is best known for its ability to link the epidermal growth factor receptor tyrosine kinase to the activation of Ras and its downstream kinases, ERK1,2. Grb2 is composed of an SH2 domain flanked on each side by an SH3 domain. Grb2 has two closely related proteins with similar domain organizations, Gads and Grap. Gads and Grap are expressed specifically in hematopoietic cells and function in the coordination of tyrosine kinase mediated signal transduction.

Domains

The SH2 domain of Grb2 binds to phosphorylated tyrosine-containing peptides on receptors or scaffold proteins with a preference for pY-X-N-X, where X is generally a hydrophobic residue such as valine (see [3]).
The N-terminal SH3 domain binds to proline-rich peptides and can bind to the Ras-guanine exchange factor SOS.
The C-terminal SH3 domain binds to peptides conforming to a P-X-I/L/V/-D/N-R-X-X-K-P motif that allows it to specifically bind to proteins such as Gab-1.[4]

Interactions

Grb2 has been shown to interact with Arachidonate 5-lipoxygenase,[5][6] Lymphocyte cytosolic protein 2,[7][8][9][10][11] GAB2,[12][13][14] B-cell linker,[15][16][17][18] Abl gene,[19][20] CD28,[21][22] FRS2,[23][24][25][26] Mitogen-activated protein kinase 9,[27][28] CD22,[29][30] NEU3,[31] ETV6,[12] MAP2,[32][33] Dock180,[34][35] PIK3R1,[36][37] SH2B1,[38][39] CRK,[40][41][42] GAB1,[7][43][44] MST1R,[45][46] DNM1,[47][48] Huntingtin,[49] Src,[50][51] Beta-2 adrenergic receptor,[52] VAV2,[53][54] ADAM15,[55] RAPGEF1,[56][57] VAV1,[58][59][60][61] HER2/neu,[54][62][63] Epidermal growth factor receptor,[2][43][53][62][64][65][66][67][68][69] PDGFRB,[69][70][71] PTK2,[72][73][74][75][76] Erythropoietin receptor,[77][78] Linker of activated T cells,[79][80][81] Dystroglycan,[82] SH3KBP1,[83][84] Granulocyte colony-stimulating factor receptor,[85] DCTN1,[86] CDKN1B,[87] Colony stimulating factor 1 receptor,[88] EPH receptor A2,[89] KHDRBS1,[43][90][91] RET proto-oncogene,[92][93] PLCG1,[94][95][96] TrkA,[97][98] PRKAR1A,[66] Janus kinase 2,[99][100] MUC1,[101] CD117,[78][102][103] Fas ligand,[104][105] Janus kinase 1,[100][106] VAV3,[53][107] BCAR1,[73][108] PTPN1,[109][110] INPP5D,[111] ITK,[112][113] SHC1,[51][53][114][115][116][117][118][119][120][121][122][123][124][125][126][127][128][129][130][131][132] PTPN12,[133] C-Met,[134][135] PTPN11,[71][85][127][136][137][138][139][140][141] Glycoprotein 130,[61] PTPN6,[51][136][142] Syk,[51][136] MAP4K1,[143][144][145][146] Wiskott-Aldrich syndrome protein,[147][148] NCKIPSD,[149][150] PTPRA,[151][152][153] BCR gene,[12][115][154][155][156][157] CBLB,[158][159][160] Cbl gene,[9][24][51][90][124][158][161][162][163][164][165][166][167] SOS1,[8][24][42][43][48][51][53][60][68][90][95][101][115][122][124][131][168][169][170][171][172] IRS1,[100][114][173] TNK2,[116][174] MED28,[175] MAP3K1[176] and HNRNPC.[177]
IN OTHER NEWS

*USE OF GM-CSF BOOSTS IPILIMUMAB ACTIVITY! GO FIGURE THAT...
*NO SURPRISE HERE, CLASSIII BETA-TUBULIN PREDICT GOOD RESPONSE TO TAXANE IN ER NEGATIVE BREAST CANCER 
*MAKES PERFECT SENSE TO TINKLE WITH ANDROGEN RECEPTOR IN APOCRINE SUBTYPE OF CANCERS
*ONE GOOD NEGATIVE STUDY! OR IS IT? SEND COMMENTs!

Bevacizumab and erlotinib in previously untreated inoperable and metastatic hepatocellular carcinoma
American Journal of Clinical Oncology, 05/29/2013  Clinical Article

Govindarajan R et al. – The 28% progression-free survival rate at 27 weeks was not significantly higher than the recent historical control rate of 20% observed on the placebo arm of the Sorafenib Hepatocellular Carcinoma Assessment Randomized Protocol trial (P=0.28). The combination of bevacizumab and erlotinib does not appear to have sufficient efficacy in patients with unresectable and metastatic HCC not amenable to local therapy.
FROM PRACTICE UPDATE, ASCO NEWS

CONFERENCE NEWS
Ganetespib Trial Hints at Survival Benefit in Lung Adenocarcinoma
IMNG Medical Media, 2013 Jun 04, N Osterweil
Selumetinib is First Therapy to Shrink Uveal Melanomas
IMNG Medical Media, 2013 Jun 03, MJM Dales
Sorafenib Emerges as Option for Advanced Thyroid Cancer
IMNG Medical Media, 2013 Jun 03, P Wendling
Bevacizumab Plus Irinotecan Beats Temozolomide in Stalling Glioblastoma
IMNG Medical Media, 2013 Jun 02, N Osterweil
Cervical Cancer Screening With Acetic Acid Saves Lives
IMNG Medical Media, 2013 Jun 02, S London
Nivolumab Activity is Durable in Advanced Melanoma
IMNG Medical Media, 2013 Jun 02, MJ Dales
Oral HPV-related Cancer Risk Not Transmitted to Sex Partners
IMNG Medical Media, 2013 Jun 01, N Osterweil

Tuesday, June 4, 2013

HUGE NEWS FROM MEDSCAPE!  PRACTICE CHANGING! IN ALL FAIRNESS GO TO MEDSCAPE FOR A FULL REPORT!

"Medscape Medical News from the:

This coverage is not sanctioned by, nor a part of, the American Society of Clinical Oncology.

Stop Using Calcium and Magnesium With Oxaliplatin

Zosia Chustecka
Jun 03, 2013
 
CHICAGO, Illinois — The common practice of administering intravenous calcium and magnesium along with oxaliplatin to reduce the side effect of neuropathy should be stopped, experts say.
The first placebo-randomized phase 3 trial of this practice has shown no benefit. The results were presented here at the 2013 Annual Meeting of the American Society of Clinical Oncology (ASCO®) by Charles Loprinzi, MD, from the Mayo Clinic in Rochester, Minnesota.
The trial was conducted in 353 patients with colon cancer undergoing adjuvant therapy with FOLFOX (5-fluorouracil, oxaliplatin, and leucovorin), who were randomized to receive intravenous CaMg (1g calcium gluconate, 1 mg magnesium sulfate) or placebo before and after oxaliplatin. There was also a third arm in the trial, in which patients received CaMg before and placebo after the oxaliplatin.
The results showed no differences between the groups in either acute neurotoxicity or cumulative sensory neurotoxicity, as assessed both by patient and physician questionnaires."
EVIDENCES MOUNT THAT UNIVERSITIES ARE COMING TOGETHER TO TAKE ALL THE MONEY FOR CANCER RESEARCH

READ FOR YOUR SELF!

BIG CANCER RESEARCH CONSORTIUM (from ONCOLOGY TIMES)

CHICAGO – In a new venture, 11 university-based matrix cancer centers are uniting “to transform cancer research through collaborative oncology trials that leverage the scientific and clinical expertise of the Big Ten universities.”

The consortium will allow universities with similar missions, visions, and cultures to create a regional cancer team science initiative to advance research by sharing resources and strengths to form what is hoped will be a lean, efficient, and collaborative effort that will focus on Phase 0 to II clinical trials accruing patients with specific diseases and molecular characteristics.

The news releases sent out on Friday by the individual institutions all had the same information but included no clear direction as to who was the designated point person or spokesperson, which was perhaps in deference to the consortium’s sensitivity to having any one institution overshadow the others.

However, the mention toward the end of the release that the Indianapolis-based Hoosier Oncology Group (HOG) would serve as the administrative headquarters for the Big Ten Cancer Research Consortium (BTCRC) provided a clue that Indiana University’s Melvin and Bren Simon Cancer Center might be a good place to start.

It was, and since the official kickoff of the initiative was slated for June 1 during the time of the American Society of Clinical Oncology’s Annual Meeting in Chicago, I met with Simon Cancer Center Director Patrick J. Loehrer Sr., MD. He explained that part of the impetus for the initiative was related to helping save the “endangered species of assistant professors,” who under current circumstances might have to wait for years to lead a clinical trial through the cooperative group mechanism.

“I remember when I had finished my medical oncology fellowship at Indiana and was a newly minted medical oncologist eager to get involved in clinical trials,” he said, adding that he was dismayed by the limited opportunities.

In 1984, following discussions with Larry Einhorn, MD, and others at Indiana, Loehrer helped establish the Hoosier Oncology Group, aka, the HOG, as it is affectionately called by proud citizens of the Hoosier State, which was modeled to involve more community oncologists in clinical trials.

He said there was originally some resistance from oncologists concerned about losing patients to academic cancer centers, but that the HOG was designed so patients could be treated the same way in their hometowns.

According to Loehrer, every HOG study had co-chairs from both the community and academic centers, and community oncologists were selected to deliver ASCO presentations.

“These were non-NCI funded trials and community oncologists got involved in the whole process.  It was wonderful,” he said, adding that over subsequent years it became more difficult to secure industry funding for clinical trials, and that BTCRC studies will need at least three institutions involved, with one of the principal investigators being a junior faculty member.

So when Steven T. Rosen, MD, Director of the Robert H. Lurie Comprehensive Cancer Center at Northwestern University, suggested in 2011 using the Big Ten’s athletic conference model to bring cancer centers together, the idea resonated with Loehrer and other cancer center directors.

Within a few months the HOG was selected as BTCRC administrative headquarters and by July 2012, 10 cancer centers were committed to participating in the consortium (with an 11th joining later), and a steering committee was formed. Noah Hahn, MD, Associate Professor of Medicine at Indiana University’s Simon Cancer Center and Chief Medical and Scientific Officer with HOG, was named interim Executive Officer of the Big Ten cancer consortium.

HOG, Loehrer said, will serve strictly in a contract research organization (CRO) capacity, providing comprehensive study management and support, and benefits for consortium members including:
  • A single, common contract for all institutions;
  • A planned streamlined IRB review consolidation;
  • Organized clinical trial working groups;
  • Sharing specimens with clinically annotated data;
  • Development of junior faculty; and
  • The opportunity to open trials faster among member institutions.
The venture will also be limited to members of the Big Ten, Loehrer said, and currently includes:
•           Indiana University (Indiana University Melvin and Bren Simon Cancer Center);
•           Northwestern University (Robert H. Lurie Comprehensive Cancer Center);
•           Penn State University (Penn State Hershey Cancer Institute);
•           Purdue University (Purdue University Center for Cancer Research;
•           Rutgers University (the Cancer Institute of New Jersey becomes part of Rutgers on July 1, but Rutgers doesn’t officially join the Big Ten athletic conference until next year);
•           University of Illinois (University of Illinois Cancer Center) ;
•           University of Iowa (Holden Comprehensive Cancer Center);
•           University of Michigan (University of Michigan Comprehensive Cancer Center);
•           University of Minnesota (Masonic Cancer Center);
•           University of Nebraska (Fred & Pamela Buffett Cancer Center); and
•           University of Wisconsin (Carbone Comprehensive Cancer Center).

When I first saw the list, Ohio State University’s James Cancer Hospital and Solove Research Institute seemed conspicuous by its absence. I called center head Michael A. Caligiuri, MD (a member of OT’s Editorial Board), who said that OSU had been asked to join, but was “currently involved in another endeavor that precludes participating at this time.” He did not disclose the nature of that endeavor.

Cross-referencing the cancer Big Ten with its athletic counterpart, I also noticed the absence of Michigan State University’s Breslin Cancer Center, and noted that the University of Maryland was slated to join the athletic conference in 2014 at the same time as Rutgers, but its Greenebaum Cancer Center was not yet on the list.

Loehrer said that all Big Ten members current and future had been asked to join the cancer consortium and the 11 institutions listed above had committed to joining, with each agreeing to pay $14,000 a year over a proposed three-year period to cover infrastructure costs. He also acknowledged that this was a work in progress and that more specific directions would be developed over time.

At the June 1 kick-off event I spoke with Chandra Belani, MD, who represents Penn State University’s Hershey Cancer Institute on the BTCRC steering committee. Belani shared Loehrer’s excitement about the consortium, and the prospect of developing more early phase trials that would also help train the next generation of physician-scientists.

He also talked about the idea of using the Big Ten’s athletic infrastructure to increase awareness about cancer research and clinical trials and the potential of raising funds through small contributions by the thousands of fans attending Big Ten sporting events.

This model, similar to Stand Up To Cancer’s relationship with Major League Baseball, may prove an additional avenue to provide outreach and awareness about cancer research and clinical trials to yet another major grassroots demographic group. 
========================================================

YOU GOT IT RIGHT, YOU PAY $14,000 TO "I DON'T KNOW WHO" AND GET ADMITTED TO THIS CLOSE LEAGUE, WHERE IS THE SUPREME COURT ON THIS! AND WE KNOW WHAT HAPPENED IN TEXAS WITH CPRIT! IF YOU DON'T GET IT, WELL YOU DON'T GET IT!
RANDOM NEWS/THE SUPREME COURT IS NOW INVOLVED WITH YOUR GENES!

*ONARTUZUMAB (METMAb) is being USED NOW IN MET positive lung cancer in combination with Erlotinib in a GENENTECH supported trial, cal to register patients 888-662-6728.

*What makes prostate cancer cell so suited to proliferate in the bone environment?  Bone metastasis is the primary site of metastasis in prostate cancer and it has been reported that mortality is 5 times as likely in those with Bone Metastatsis!  so this is the single most important event that leads to patient's death.  It is a critical issue to address!

*Tivozanib has failed drastically to cross the first hurdle (ODAC) and no one believes it will win approval of the FDA on July 28.  will wait and see!

*THE SUPREME COURT HEARD ORAL ARGUMENT ABOUT WHETHER OR NOT GENES COULD BE PATENTED!  SOON OR LATER, YOU MAY NOT BE ABLE TO LOOK AT YOUR OWN GENES WITHOUT PAYING A FEE TO A COMPANY!  THAT'S HOW UGLY THIS WILL GET!
LET SEE YOU COME TO ME WITH LUNG CANCER, AND I WANT TO CHECK YOUR ROS-1 BUT I CAN'T BECAUSE SEE ROS-1 HAS BEEN PATENTED BY COMPANY X, WE NEED SOME FORM OF CLEARANCE BY A THIRD PARTY BECAUSE THEY HAVE A PATENT ON THAT GENE! CRAZY DOES NOT SEEM TO EVEN BEGIN TO DESCRIBE THE WORLD OF LEGALESE!

CPRIT will be funded if Legislature agrees to operations overhaul












1



4



0





AA
AUSTIN — Texas’ cancer-fighting agency would be able to spend $594 million on programs in the upcoming two-year budget, key legislators announced Monday.
The amount is contingent on lawmakers adopting a bill to overhaul operations of the Cancer Prevention and Research Institute of Texas, said an aide to Sen. Jane Nelson, R-Flower Mound.
“I am grateful to the conference committee for allowing CPRIT to move forward and approving these funds,” said Nelson, who co-wrote the bill which created CPRIT six years ago and is the sponsor of legislation this session to reform the agency.
“I was very disappointed in the poor decision making and mistakes that came to light this session, but believe we must keep up our fight against cancer,” Nelson added.
A committee of House and Senate budget writers made the announcement. The amount is $6 million shy of the maximum $600 million amount that CPRIT can borrow for programs because funding for a cancer registry would move from the small agency’s budget to the Department of State Health Services.
Texas residents voted in 2007 to establish the program and allow it to fund up to $3 billion over 10 years — through bonds — for cancer research and prevention programs.
Three high-ranking officials resigned last year as CPRIT faced allegations of favoritism in awarding grants. CPRIT scrapped a $20 million grant to a Houston business incubator. It halted funds toward an $11 million award to a Dallas-based biotechnology firm that did not receive the required business or scientific review.
Last December, the Travis County district attorney’s office said it would conduct a criminal investigation of CPRIT, and the attorney general’s office launched a civil probe.
Earlier this year, CPRIT pulled the plug on a $25 million grant to create a statewide network to move cancer treatments rapidly from laboratories to patients. A state audit released in late January found flaws in how CPRIT reviewed applications for funds, and it raised questions about the agency’s ethics.
A House committee last week approved Nelson’s bill, which she said “will ensure CPRIT operates in a transparent and accountable way in the future.”
Nelson’s bill would expand the law designed to guard against conflicts of interest involving CPRIT employees, the agency’s governing board and experts who advise the agency or review requests for funds.
If approved by the full House, the legislation will return to the Senate for agreement with House amendments.
 ==========================================================
PLEASE FOLLOW DALLAS NEWS FOR THIS TOPIC!




Monday, June 3, 2013

NEWS FROM ASCO

*Avastin added to progression free and overall survival achieved by chemotherapy in cervical cancers in recurrent and metastatic settings (17 Vs 13.3 months).  But it did fail to improve anything in Glioblastoma  when given in first line ,

*Sorafenib (NEXAVAR)Showed Benefit in Radioactive Iodine-Refractory Differentiated Thyroid Cancer, as reported by Medical News Today, 

"The researchers reported that:
  • 12% of the sorafenib patients experienced tumor shrinkage
  • 0.5% of those on placebo experienced tumor shrinkage
  • 42% of patients in the sorafenib group had stable disease after 6 months
  • 33% of patients in the placebo group had stable disease after 6 months
  • PFS (progression-free survival) in the sorafenib arm was 10.8 months
  • PFS among the placebo patients was 5.8 months
  • In this cross-over trial, 70% of the placebo patients switched over to sorafenib"

*Extending Tamoxifen to 10years is better than 5 years
ASCO News:

"
Compared with 5 years of tamoxifen, a 10-year regimen was associated with a significant 15% reduction in the risk of recurrence (relative risk, 0.85; p = 0.003) and a significant 25% reduction in the risk of breast cancer mortality starting at year 10 (relative risk, 0.75; p = 0.007). These findings aligned closely with those from the recently published ATLAS trial."






Known Targets in Sarcoma and various malignancies!

*"In addition, variations in CD44 are reported as cell surface markers for some breast and prostate cancer stem cells.In breast cancer research CD44+/CD24- expression is commonly used as a marker for breast CSCs and is used to sort breast cancer cells into a population enriched in cells with stem-like characteristics.[15] and has been seen as an indicator of increased survival time in epithelial ovarian cancer patients.[16]
Endometrial cells in women with endometriosis demonstrate increased expression of splice variants of CD44, and increased adherence to peritoneal cells.[17]
CD44 variant isoforms are also relevant to the progression of head and neck squamous cell carcinoma.[18][19]
Monoclonal antibodies against CD44 variants include bivatuzumab for v6." wikipedia

*
-----------------------------------------------------------------------------------------------------------
TEC   Very significant target because down the stream of this gene is DOK1,and most impressively ARHGEF which has activity with 2 well recognised therapeutic targets CD44 and P110 alpha, remember P110alpha deficiency can induce Malformation (Macrocephaly) and you know how we feel about gene inducing malformation

" non-receptor protein-tyrosine kinases containing a pleckstrin homology domain. Tec family kinases are involved in the intracellular signaling mechanisms of cytokine receptors, lymphocyte surface antigens, heterotrimeric G-protein coupled receptors, and integrin molecules. They are also key players in the regulation of the immune functions. Tec kinase is an integral component of T cell signaling and has a distinct role in T cell activation. This gene may be associated with myelodysplastic syndrome.[2]wikipedia

Anti CD44 has just been used in a recent publication

adding a booster of c-AMP may intensify the effect (PRKAR1A related).

Sunday, June 2, 2013

GENES IN SARCOMA (LISTED FIRST AND THEN WE GO TO WORK!)

THE C-KIT CASE

ACTIVATES THE FOLLOWING GENES
PIK3R1
PLCG1
SH2B2/APS
CBL
THE POTENT GRB2
RAS/MAPK
PTPN6/SHP1
PTPRU
CRK
LYN
SRC
SHC1
DOK1
-----------------------------------------------------------------------------------------------------------
TEC   Very significant target because down the stream of this gene is DOK1,and most impressively ARHGEF which has activity with 2 well recognised therapeutic targets CD44 and P110 alpha, remember P110alpha deficiency can induce Malformation (Macrocephaly) and you know how we feel about gene inducing malformation

" non-receptor protein-tyrosine kinases containing a pleckstrin homology domain. Tec family kinases are involved in the intracellular signaling mechanisms of cytokine receptors, lymphocyte surface antigens, heterotrimeric G-protein coupled receptors, and integrin molecules. They are also key players in the regulation of the immune functions. Tec kinase is an integral component of T cell signaling and has a distinct role in T cell activation. This gene may be associated with myelodysplastic syndrome.[2]wikipedia

Anti CD44 has just been used in a recent publication

adding a booster of c-AMP may intensify the effect (PRKAR1A related)
-----------------------------------------------------------------------------------------------------------
PREDISPOSING GENES
NF1
LI-FRAUMENI
HELICASE GENES
P53
CYTOKINES/KITLG/SCF

SPECIFIC GENES FOR SOME SPECIFIC SARCOMA

1.GIST        C-KIT, CD 117, PDGFR-ALPHA
2.ALVEOLAR RHABDOMYOSARCOMA PAX3-FOXO1A
3.EWING SARCOMA   EWSR1-FLI1 AND EWSR-ERG
4.LIPOSARCOMA CDK4,HDM2
5.SYNOVIAL SYT-SSX1,2
6.MYXOID FUS-CHOP DDIT3 



Medscape Medical News from the:

This coverage is not sanctioned by, nor a part of, the American Society of Clinical Oncology.

Sorafenib Potent New Tx for Advanced Thyroid Cancer

Roxanne Nelson
Jun 02, 2013
CHICAGO — The targeted agent sorafenib (Nexavar, Bayer HealthCare Pharmaceuticals) could become the first new drug for metastatic thyroid cancer in 40 years and opens up a new field in medical oncology, says the lead author of a study presented here at a plenary session of the 2013 Annual Meeting of the American Society of Clinical Oncology.
"Up until now, patients in this population haven't even come to medical oncology because there wasn't any treatment for them," commented Marcia Brose, MD, PhD, an assistant professor of otolaryngology and head and neck surgery in the Abramson Cancer Center and the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.
She explained that this is really the beginning of a new field in medical oncology. Previously, thyroid cancer was generally treated by endocrinologists because medical oncology had no effective treatments once a patient became resistant to radioactive iodine.
Thyroid cancer has a reputation of being a "good cancer" because it can be easily cured, Dr. Brose explained. "But that's only for 90% of the patients, and for the other 10%, it will kill them eventually. Once surgery can no longer be used and the tumor no longer takes up radioactive, overall survival drops to about 2 and a half to 3 years."
"It is now important for the doctors who see these patients early on to refer them to medical oncologists, because now we have a treatment," said Dr. Brose. "For medical oncologists, it is important for them to know that we now have a treatment, and hopefully our data will lead to FDA approval."
Dr. Brose presented results from a phase 3 clinical trial, known as DECISION, in 417 patients with progressive RAI-refractory differentiated thyroid cancer. The results show a significant improvement in median progression-free survival to 10.8 months in the sorafenib group compared with 5.8 months in the placebo arm.
Sorafenib has been used off label for this purpose, Dr. Brose noted, but some physicians are not comfortable prescribing off label. "But the added level of rigor from a pivotal phase 3 study that is not just positive but highly significant — a doubling of progression-free survival — will hopefully help more physicians feel comfortable prescribing it," she said.
Chemotherapy Not Effective
"Conventional cytotoxic chemotherapy has not been effective in the management of differentiated thyroid cancers in spite of significant toxicities," commented Yujie Zhao, MD, PhD, assistant professor of oncology, Roswell Park Cancer Institute, Buffalo, New York.
"This randomized, placebo-controlled phase 3 study confirmed previous phase 2 results and also demonstrated a statistically significant progression-free survival improvement of 5 months compared with the placebo arm," said Dr. Zhao, who was not involved in the study.
Dr. Zhao noted that because stable disease of 6 months or longer was also seen in 33% of patients who received placebo, this suggests the importance of proper selection of patients who need treatment.
Sorafenib blocks the enzyme RAF kinase, which is a critical component of the RAF/MEK/ERK signaling pathway that controls cell division and proliferation, and it also inhibits the VEGFR-2/PDGFR-beta signaling cascade. It is currently approved to treat hepatocellular carcinoma and advanced renal cell carcinoma.
The primary endpoint of the study was progression-free survival, which was assessed every 8 weeks. Secondary endpoints included overall survival, response rate (complete and partial response), and drug safety.
Within the cohort, tumor histology was 57% papillary, 25% follicular, and 10% poorly differentiated, and the vast majority (96%) of patients had metastatic disease. The most common target lesions were lung (71%), lymph node (40%), and bone (14%).
The authors note that their primary endpoint of progression-free survival was met (hazard ratio, 0.58; P < .0001). The median overall survival has not yet been reached in either study arm, and 70% of placebo patients have started open-label sorafenib.
All reported responses were partial — 12.2% in the sorafenib group vs 0.5% for placebo (P < .0001). Stable disease ≥ 6 months was 42% and 33%, respectively.
Tolerability was consistent with the known sorafenib safety profile, the authors note. The most common any-grade treatment-emergent adverse events in the sorafenib arm included hand–foot skin reaction, diarrhea, alopecia, rash/desquamation, fatigue, weight loss, and hypertension. There was 1 death in each study arm that was attributed to sorafenib use.
For Select Patients
"There is a huge unmet need for an effective treatment in this population," said Lori Wirth, MD, who was approached by Medscape Medical News for an independent commentary. "While this is a relatively uncommon disease, patients do live for years with it, so there is a sizeable population in need of treatment."
"This was a positive study, and I believe that it will be adapted as standard of care in this population," said Dr. Wirth, medical director, Center for Head and Neck Cancers, Massachusetts General Cancer Center, Boston.
How do some physicians get paid faster than 75% of multi-specialty group practices nationwide as surveyed by the Medical Group Management Association and Healthcare Billing Management Association for Days Revenue in AR?
Information from Industry
However, Dr. Wirth pointed out that this study was designed for patients with progressive disease. "That means that there is a caveat to the excitement over these results," she said. "There was toxicity associated with this treatment, and so it may not be suitable for every patient."
This type of cancer is a "grab bag of different pathologies," she continued, and she noted that some patients will have a low disease burden and be asymptomatic. "Disease progression may not occur for a while, and while sorafenib may shrink the tumor, it can affect their quality of life."
"Patients with a large tumor burden, and for those with symptoms, they will need treatment, and we can justify the side effects," Dr. Wirth explained. "But we need to differentiate who needs to be treated and who doesn't."
This research was supported in part by Bayer HealthCare Pharmaceuticals and Onyx Pharmaceuticals, Inc. Dr. Brose and several coauthors report relationships with industry, including Bayer and Onyx, as noted in the abstract.
2013 Annual Meeting of the American Society of Clinical Oncology. Abstract 4. Presented June 2 2013.