Hope for liver cancer

A crying researcher woke Gunnar Riemann, the head of Bayer's $10 billion drug business, from his bed Feb. 9. They were tears of joy: A study had found that Nexavar, a drug Bayer invented and developed with tiny biotech Onyx Pharmaceuticals of Emeryville, Calif., extended the lives of patients with advanced liver cancer, the first time a treatment has been demonstrated to be effective for the hard to treat disease. Onyx shares jumped almost 10%, to $33.83, in early morning trading Monday.

Over the past 30 years, doctors have conducted about a 100 studies on various treatments to help these very sick patients, to no avail. However, in the case of Nexavar, Phase III clinical trials with 602 patients showed that it extended the life of the average patient by 2.8 months to 10.7 months, as compared to patients who received a placebo. Side effects were benign for a cancer drug, with the most common being severe diarrhea and rashes on the hands and feet. The data were set to be presented here Monday morning at the annual meeting of the American Society of Clinical Oncology.

"The results are a breakthrough," says Josep Llovet, a liver specialist with the Hospital Clinic of Barcelona and the Mount Sinai School of Medicine in New York who helped organize and conduct the trial for Bayer. "The difference in survival is completely unprecedented. You are freezing the tumor and delaying the progression of the disease."

Liver cancer is one of the deadliest of cancers. It afflicts 19,000 people in the U.S. each year, killing the vast majority. For many patients with the advanced form of the disease, Nexavar will now become the standard treatment, eventually generating hundreds of millions in sales for the partners. Liver cancer is far more prevalent overseas, with 600,000 new cases a year worldwide. The highest rates are in Asia, where hepatitis B and C are common. Nexavar is still being tested there.

Bayer and Onyx have been working toward this victory for 13 years. Bayer chemists developed Nexavar based on proteins Onyx identified that showed promise for halting tumor growth. The drug has already been approved and marketed for treating kidney tumors, and the two companies last year spent $160 million testing it in new diseases.

While the promising results for Nexavar may bring tears to the eyes of Bayer researchers and hope to cancer patients, doctors have lately become used to such breakthroughs, with pharmaceutical giants like Pfizer, GlaxoSmithKline and AstraZeneca testing dozens of new targeted cancer pills. Bayer recently bought German rival Schering AG partly to get its hands on that company's cancer drug pipeline.

This year's meeting of the American Society of Clinical Oncology (ASCO) is a "building year," says David Parkinson, head of oncology at Biogen Idec. David Schenkein, a Genentech vice president, says the advances are "incremental."

Pfizer's kidney cancer drug Sutent has been outpacing Nexavar, with sales of $102 million versus $60 million for Nexavar in the first quarter of 2007. But study results for Sutent on liver cancer look less promising, and an abstract already presented here seems to point to a far worse side-effect profile for Sutent than Nexavar in treating that form of the disease. Reduced white blood cell and platelet counts were common, and there were five patients who developed very serious problems, including liver problems and bleeding. Pfizer notes that the study is small and early.

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Another angle to the attack on Foie gras

Mostly speculation, of course

FOIE GRAS, enjoyed as a luxury since ancient Egyptian times, may be linked to the onset of diseases including Alzheimer's, type 2 diabetes and rheumatoid arthritis, researchers have suggested. The scientists who carried out the study say those with a family history of such illnesses should consider avoiding foie gras.

The possible risk comes from "amyloid" proteins found in the delicacy, which is made from the swollen livers of force-fed geese and ducks. The proteins have been linked to the onset of all these conditions. In their study, the researchers found mice fed on foie gras started growing amyloid proteins in various organs. They observed a similar result when extract of foie gras was injected into the rodents' bloodstream. "It may be hazardous for individuals who are prone to develop other types of amyloid-related disorders such as Alzheimer's or type 2 diabetes to consume such products," said Alan Solomon, an expert in amyloid diseases at the University of Tennessee medical school, who led the research.

Foie gras has long been controversial because of the way food is forced down the birds' throats. In Britain it fetches premium prices with Fortnum & Mason offering a 310g goose liver - enough to make starters for four or five people - for 60 pounds. But one department store chain, House of Fraser, recently announced it would stop stocking foie gras.

Amyloid disease occurs when proteins that would normally be soluble undergo a change in shape. This makes them form insoluble clumps in organs that damages the way they work. Such abnormal behaviour by proteins seems to play a role in many diseases, including BSE, Alzheimer's, type 2 diabetes and rheumatoid arthritis. There appear to be many triggers for creating such rogue proteins in the body - one of them is eating foods that already contain them. It was, for example, the consumption of brains from cattle infected with BSE that transmitted the disease to humans, killing 161 Britons since 1995.

The possible link between food and amyloid diseases needs to be confirmed by further studies, for example comparing populations to see how disease prevalence varies with diet. The stakes could be high. In Britain, out of a population of 60m, there are already 700,000 people with dementia. France, with a similar population, has 1m sufferers. But there are many causes and the difference in prevalence is not being linked to far higher French consumption of foie gras. [How restrained!]

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Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.

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