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Cancer, Stanford News, Stem Cells

Stanford study shows stem cell treatment improves survival of patients with metastatic breast cancer

Stanford study shows stem cell treatment improves survival of patients with metastatic breast cancer

Treating Stage IV breast cancer patients with high-dose chemotherapy followed by a rescue with their own, specially purified blood stem cells that had been purged of cancer, could significantly increase their chances of survival, according to new research from Stanford.

The long-term study (subscription required) was published online last week in Biology of Blood and Marrow Transplantation and is the first to analyze the long-term outcomes of women who received their own (autologous) stem cells that had undergone this purification process. According to a release:

High-dose chemotherapy is considered to be an aggressive treatment because, in addition to killing cancer cells, it also destroys a patient’s blood forming system. Therefore, such patients need to be rescued with stem cells that can restore blood production, which includes red blood cells, platelets and infection-fighting white blood cells. To increase the proportion of blood-forming stem cells in the bloodstream patients routinely receive drugs that “mobilize” the stem cells out of the bone marrow into the blood. Unfortunately, studies by many groups have shown that cancer cells often stowaway in the blood as well and may cause an eventual relapse.

As a result, in the mid-1990s Stanford researchers headed by professors of medicine Karl Blume, MD, Robert Negrin, MD, and professor of pathology Irving Weissman, MD, wondered if there was a way to overcome this problem. They opted to use antibodies that recognized newly identified markers on the surface of the blood stem cells to purify the stem cells away from regular blood and any roving cancer cells. They then used this purified population of stem cells in 22 women with metastatic breast cancer who enrolled in the trial from December 1996 to February 1998. Then they waited as the years passed.

Last year, Mueller and the research team began to compare the progression-free and overall survival of their experimental group to those of a group of 74 women who received identical chemotherapy treatments between February of 1995 and June of 1999 but who received unmanipulated, mobilized peripheral blood.

Results showed five of the 22 women (23 percent) who received the purified stem cells are still alive and four have no sign of disease. Their median overall survival was 60 months. In comparison, seven of the 74 women (9 percent) who received the untreated cells are living and five have no sign of disease. Their median overall survival was 28 months. While the overall numbers were small, researchers hope the results will spur the medical community to revisit using such aggressive treatment options for patients with metastatic breast cancer.

The Stanford Blood and Marrow Transplant group are currently planning a larger clinical trial of the treatment, although the details are still being finalized.

Previously: Stanford Women’s Cancer Center opens Monday, Partial breast irradiation could sidestep side effects of traditional radiation therapy, New breast cancer finding suggests limiting surgery and Stanford researchers find new marker to identify severe breast cancer cases

Ethics, In the News, Stem Cells

Bioethicist Arthur Caplan slams unproven stem cell clinics

As my colleague reported, the International Society for Stem Cell Research (ISSCR) has been forced to shutter the portion of its patient education website “A Closer Look at Stem Cells” that promised to investigate clinics offering stem cell treatments directly to patients. The reason? Threatened lawsuits from the very companies that the society hoped to investigate. Nature published a nice summary (subscription required) of the situation last month.

Today, bioethicist Arthur Caplan, PhD, sounds off about the shutdown in a commentary on MSNBC’s Breaking Bioethics blog:

As Heidi Ledford reported in the June 28 issue of Nature, the ISSCR, which facilitates the exchange of research between over, 3,500 scientists worldwide, has suspended its website intended to help patients wade through the more crackpot claims about stem cell therapies and clinics.

All the ISSCR was going to do was to post information on what published evidence existed about claims of cures, which providers had medical-ethics oversight committees and which complied with regulatory agencies such as Food and Drug Administration (FDA) or the European Medicines Agency (EMA). Instead, some in the industry launched a barrage of legal threats at the ISSCR which, as a small scientific organization, felt it could not afford to fight even if, in the end, they would win.

This is sad. I’ve written before about how these clinics prey on desperate patients and parents, and why the ISSCR (under the then-leadership of Stanford stem cell expert Irving Weissman, MD) chose to create the website to help the public understand some basic facts and stem cells and the “therapies” these clinics claim to offer. Without any way to judge whether a clinic is reputable, I expect many more people will spend tens of thousands of dollars to pursue unproven and potentially dangerous experimental treatments. As Caplan, who directs the Center for Bioethics at the University of Pennsylvania,  concludes:

So, the stem cell ‘therapy’ industry — many of whom seem more concerned with their pocketbooks than with giving patients information — and some of whom are involved in medicine that is more voodoo than science have bullied their critics into submission. If you are sick or know someone with an incurable disease, keep this in mind when considering the real value of a trip overseas to find a miracle stem cell cure.

Previously: International stem cell group provides website for patients seeking stem cell treatments, Beware: Stem cell treatments offering “miracle” cures and Stem cell researchers challenge clinics’ questionable practices
Photo by Axel Schwenke

Clinical Trials, In the News, Stem Cells

Two new human embryonic stem cell trials launched

There is much news today about two human embryonic stem cell trials that were launched on Tuesday at UC Los Angeles. That brings to three the number of ongoing human clinical trials of the cells. (The Stanford School of Medicine is a participating site in the first trial - one run by Geron, Corp to test the safety of hESC-derived cells in patients with spinal cord injury – although we haven’t yet treated a patient.) Nature sums up the two new trials in this blog post today:

Now, the second and third hESC trials have been launched. On July 12, in an operating room at the University of California, Los Angeles, the first subject in each of the trials — one for a rare form of blindness that usually begins in childhood, the other for a common cause of blindness in the elderly — was treated with retinal pigment epithelial (RPE) cells derived from hESCs. [...] One of the conditions being treated, Stargardt’s Macular Dystrophy, it is a degenerative disease of the retina that affects roughly 1 in 10,000 US youngsters. The other, a closely related cause of blindness, Age-related Macular Degeneration (AMD), affects millions of Americans. (The trial therapy is attacking “dry” AMD, which account for about 90% of all AMD.)

Both of the two new trials are sponsored by Santa Monica-based Advanced Cell Technology, which announced the procedures this morning.

Previously: Stanford joins first human embryonic stem cell trial

Cancer, Neuroscience, Research, Stem Cells

Could stem cells help brain-cancer patients regain cognitive abilities?

A new study, to be published in Cancer Research on July 15, suggests that stem cells may be the key to restoring cognitive functions such as learning and memory after brain tumor treatment.

Radiation therapy can be highly effective in eliminating otherwise-deadly brain tumors, but rarely without taking a toll on neighboring healthy brain cells. As described in a release, neural radiation can cause patients’ IQs to drop by as many as three points per year.

For this study, researchers from UC Irvine transplanted stem cells into the brains of rats whose brains had undergone radiation two days prior. They measured the rats’ cognitive abilities several months later and found that 15 percent of the stem cells that had survived in the rats’ brains had developed into neurons, while another 45 percent of the cells had developed into equally crucial supporting glial cells. The stem-cell-treated rats exhibited restored brain function, while irradiated rats that didn’t receive the stem-cell treatment showed no improvement.

Radiation oncology professor Charles Limoli, PhD, says the next step would be to test this in humans:

While much work remains, a clinical trial analyzing the safety of such approaches may be possible within a few years, most likely with patients afflicted with glioblastoma multiforme, a particularly aggressive and deadly form of brain cancer.

Podcasts, Stem Cells

New stem cell podcast from UC Davis researcher

A post today from the California Institute for Regenerative Medicine’s blog, Research Results, caught my attention with the announcement that noted UC Davis stem cell researcher and CIRM grantee Paul Knoepfler, PhD, has added a podcast feature to his stem cell blog. According to CIRM communications manager Amy Adams:

Several organizations such as CIRM, the Canadian Stem Cell Network and the Australian Stem Cell Centre also have blogs that promote stem cell science and attempt to put recent scientific advances into context. However, to my knowledge Knoepfler is the only stem cell scientist attempting to reach the public online. I look forward to hearing more podcasts from Knoepfler, and wish him much success in providing accurate information about stem cell research at a time when it is so clearly needed.

I haven’t listened to it myself yet, but it looks like the first 16-minute-long podcast takes on stem cell tourism in the US (a particular interest of mine), recent goings-on at CIRM and, intriguingly ‘stem cell hype on aging’. I’m going to cue it up as soon I can coax my reluctant computer speakers to work again by employing my tried-and-true combination of a reboot plus cursing. If you hurry you can beat me to it.

Photo by Carbon Arc

Ethics, Health Policy, In the News, Stem Cells

Stem cell researchers challenge clinics’ questionable practices

Regenerative medicine such as stem cell therapy has cast a ray of hope into many patients’ lives. Stem cell clinics, however, do not always offer patients the most effective treatments. According to a recent Nature article:

Many of the treatments such clinics offer — injecting a patient’s own stem cells back into his or her body in a bid to treat conditions ranging from Parkinson’s disease to spinal-cord injuries — are at best a waste of money, and at worst dangerous. “There’s real potential to damage the legitimacy of the field,” says Timothy Caulfield, who studies health law and policy at the University of Alberta in Edmonton, Canada.

The potential danger of these clinics is clear: In May, Europe’s largest stem-cell clinic was shut down after its treatments were linked to a child’s death.

Some stem cell researchers are frustrated with these clinics’ proliferation and the FDA’s relatively lax regulation. Last June, the International Society for Stem Cell Research (ISSCR) launched a website dedicated to providing patients with fact-based, on-demand analysis of the treatments that these clinics offer. When the ISSCR approached clinics asking for information on their services, however, many cited their lawyers, challenging the society’s right to question them. The ISSCR, whose resources were too limited to risk litigation, backed down:

At the society’s annual meeting in Toronto, Canada, this month, Irving Weissman, a stem-cell researcher at Stanford University in California, turned to the audience for advice. “What should we do?” he asked. “Should we risk litigation?” The audience could not come to a consensus, and the programme is still on hold.

Researchers still seek a way to educate patients on the dangers of unproven treatments, worrying that in the meantime patients will seek information from unreliable sources or from societies with potential conflicts of interests due to close connections with the regenerative-medicine industry.

For additional reading, my colleague Krista Conger delved into this topic in a recent Stanford Medicine piece.

Previously: Beware: Stem cell clinics offering “miracle” cures, International Cellular Medicine Society evaluates overseas stem cell clinics, The cruelty of fraudulent stem cell therapies

In the News, Science Policy, Stem Cells

A new chair for the California Institute for Regenerative Medicine

A new chair for the California Institute for Regenerative Medicine

My colleague wrote yesterday about the two candidates for chair of the California Institute for Regenerative Medicine. The votes are in, and investment banker Jonathan Thomas, PhD, was selected. The New York Times’ Prescriptions has the story.

Previously: New chair to be selected for the California Institute for Regenerative Medicine

Science Policy, Stem Cells

New chair to be selected for California Institute for Regenerative Medicine

New chair to be selected for California Institute for Regenerative Medicine

The governing board of the California Institute for Regenerative Medicine is scheduled to decide this evening between two candidates for chairman: bond financier Jonathan Thomas, PhD, and cardiologist and business man Frank Litvack, MD. Litvack was nominated by California State controller John Chiang, while Thomas was nominated by California treasurer Bill Lockyer, lieutenant governor Gavin Newson, and governor Jerry Brown.

The two men are very different in terms of both background and expectations as to what role the chair should play in CIRM’s overall governance and mission. Thomas feels the job would require a substantial time commitment and involvement in the day-to-day workings of the agency, whereas Litvack views the job as more of a supervisory position with less hands-on governing. The men are reportedly also seeking vastly different salaries–from about $137,000 for Litvack versus about $400,000 or more for Thomas.

I could list lots of links for background, but David Jensen of the California Stem Cell Report has already done that legwork for me by compiling a thorough reading list that includes links to statements from the candidates, recent news reports about the selection process and a memo from current chairman Robert Klein detailing his opinion as to the role of the chair in CIRM’s future. He also includes a link to a recent Nature report describing the ‘stark choice’ the agency faces with their vote tonight.

The meeting, which starts at 4 pm PST will be webcast to the public. Candidate statements are estimated to begin at around 5 pm. However, I’m thinking much of the juicy discussion will likely be reserved for the governing board’s closed session this evening. Le sigh. That won’t stop me from listening to the public portion of the meeting. If you care about the future of California’s stem cell agency, you should too.

Stanford News, Stem Cells

Champion of stem cell research to headline graduation

A researcher who battles cancer in the lab and fights for the rights of stem cell research in the press headlines this year’s commencement ceremonies for the graduating class of 2011 at Stanford’s School of Medicine.

Nobel Prize-winning molecular biologist Elizabeth Blackburn, PhD, will be the keynote speaker at the medical school graduation 2 p.m. June 11 on the Alumni Lawn, the new green in front of the Li Ka Shing Center for Learning and Knowledge.

A professor at UC San Francisco, Blackburn became a “cause célèbre” among medical researchers, according to USA Today in 2004, when her strong public support of human embryonic stem cell research led to the Bush administration’s removing her from the President’s Council on Bioethics “I don’t feel martyred,” she said at the time. “I wear it as a badge of honor.”

Stanford News, Stem Cells

Embryonic stem cell legislation will affect iPS cell research

Bioethicist Christopher Scott, who directs Stanford’s Program on Stem Cells in Society has an interesting study (subscription required) in tomorrow’s issue of Cell regarding the interplay of human embryonic stem cell research and its less-controversial cousin, induced pluripotent stem cell research. (Embryonic stem cells are made from human embryos, whereas iPS cells are made from adult human tissue such as skin.)  Scott and his colleagues at the Mayo Clinic and the University of Michigan concluded that any legislation that slows or stops human embryonic stem cell research would also harm research on induced pluripotent stem cells. The authors write:

We now have clear evidence showing the real possibility of collateral damage caused by ill-conceived and politically motivated policy prescriptions. Restrictions, regulatory uncertainty and spurious court decisions have undoubtedly retarded progress in the pluripotent stem cell field. Now, an entirely new technology, forged out of the crucible of political controversy, stands at risk.

The study is particularly pertinent in the face of the ongoing district court case regarding the legality of using federal funds to conduct human embryonic stem cell research under consideration by judge Royce Lamberth.

Scott and his colleagues back their assertions with an analysis of the patterns of publication on each of the two types of stem cells. They found that, rather than being widely adopted by many new scientists, most iPS cell studies are conducted by established human embryonic stem cell researchers. They also include a fascinating glimpse of networks of co-authorship in each of the two fields. Check it out. It’s a veritable Who’s Who of the stem cell research field, and it’s a great, pictorial way to illustrate how tightly the two types of research are intertwined.

Scott referred to a “false dichotomy” between the cell types in our release, and stated:

If federal funding stops for human embryonic stem cell research, it would have a serious negative impact on iPS cell research. We may never be able to choose between iPS and ES cell research because we don’t know which type of cell will be best for eventual therapies.

Previously: More on ongoing stem cell court case and Stem cell funding injunction overturned by federal court

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