Btech News -
MEDMONITOR - Pearls from Recent Medical Journals and Conferences
(2/4/02)
NATURE, January 31, 2002; 415:484-485, 530-536:
DNA microarrays can be used to distinguish between more versus less aggressive breast cancers.
Researchers used the expression patterns of 70 genes to develop a diagnostic
/ prognostic tool that classifies breast cancers into 2 categories: those
cancers that are likely to develop a distant metastasis (spread) and / or
those that have a poor prognosis and those cancers that are associated with
at least 5 years disease free survival. Based on gene expression patterns,
the investigators concluded that only about 20% to 30% of women are at risk
for metastatic disease.
DNA microarray analysis is one of several genetic testing strategies that
are making their way from the laboratory bench to the clinical bedside. The
power of this sort of risk-stratification tool is clear. In breast cancer,
for instance, the vast majority of affected women are treated with chemotherapy or hormonal therapy in addition to surgery in order to prevent
the spread of disease or recurrence. The authors' conclusion that "we are
overtreating 70% to 80% of breast cancer patients," appears to be a reasonable estimate.
The findings of this research will have to be confirmed by more rigorous
studies. The authors hope that their ongoing investigations will lead to a
marketable product within 2 years. Companies producing DNA microarrays will
see an exponential growth in their market when microarray array use becomes
widespread in clinics and hospitals. At the moment, Affymetrix (NASDAQ:
AFFX) is the leader in producing DNA microarrays, although several large
hi-tech companies, including IBM (NYSE: IBM) and Agilent (NYSE: A), have
made moves towards producing DNA microarrays.
--
AMERICAN JOURNAL OF KIDNEY DISEASES, January 2002; 39:67-75:
Treatment with Novartis's (NYSE: NVS) Lescol (fluvastatin) may promote a
significant reduction in LDL cholesterol and other markers of atherosclerosis in patients with chronic renal insufficiency.
Investigators conducted a double-blind, crossover study of 45 patients with
moderate to advanced chronic renal insufficiency. During two 8 week-periods,
study subjects were randomized to daily treatment with fluvastatin 40 mg or
placebo. Fluvastatin recipients experienced significant LDL reduction as
well as significant reductions of other markers for atherosclerosis progression such as apo B, lipoprotein B complex, total cholesterol,
triglycerides, apo E, and lipoprotein B.
Although further investigation will be needed to determine the clinical significance of these findings, it is likely that Lescol and other statins
mediate therapeutic lipid lowering responses in this specific population, as
it does in the general population. Most importantly, reduction of these markers of atherosclerosis is likely to provide favorable treatment effects
relevant to the progression of chronic renal insufficiency as well. This is
yet another avenue of research that may increase the market for statins.
Merck's (NYSE: MRK) Zocor (simvastatin), Merck's Mevacor (lovastatin and
mevastatin in certain non-U.S. markets), Pfizer's (NYSE: PFE) Lipitor (atorvastatin), and Bristol Myers Squibb's (NYSE: BMY) Pravachol
(pravistatin) are likely to have similar effects.
--
STROKE: JOURNAL OF THE AMERICAN HEART
ASSOCIATION, January 2002; 33:147-152: gpIIb/IIIa inhibitors may reduce intracerebral hemorrhage caused by tPA
administration.
Researchers reported that in an animal model, SM-20302 reduced intracerebral
hemorrhage caused by tissue plasminogen activator (tPA) administration. SM-20302 is a non-protein glycoprotein IIb/IIIa platelet receptor
antagonist, or "gpIIb/IIIa inhibitor." The only problem was that co-administration of SM-20302 and tPA tended to increase the amount of
infarcted (dead due to oxygen from blood starvation) tissue underlying the
bleeding.
This investigation demonstrates the need to study platelet inhibitors of the
gpIIb/IIIa inhibitor class as an adjunct therapy to tPA used for early stroke treatment. It is very likely that either a co-dosing strategy or a
third agent will eventually be found that offers sufficient neuroprotection
for brain cells at risk in early stroke progression. Protein-based gpIIb/IIIa inhibitors are marketed by Roche (Swiss: ROG), Eli Lilly
(NYSE: LLY), and Cor Therapeutics (NASDAQ: CORR) and Millennium Pharmaceuticals
(NASDAQ: MLNM). A non-protein gp IIb/IIIa inhibitor is marketed by Merck,
and another is being developed by Bristol Myers Squibb.
BTECH NEWS
by Leon Henderson, M.D.
Bennett Weintraub, Ph.D.
Christopher Martin
www.btechnews.com
February 4, 2002
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