Treating liver cancer

I would like to write today about two different approaches to treat liver cancer, which have been recently presented in the news, both coming from Southampton in UK.

I read about the first one last 12th of November in BBC News. It is about a "chemo-bath", consisting of isolating the organ so the chemotherapy drugs don't reach other parts of the body. In words of Dr Brian Stedman, a consultant interventional radiologist at Southampton General Hospital: "To cut off an organ from the body for 60 minutes, soak it in a high dose of drug and then filter the blood almost completely clean before returning is truly groundbreaking."

The procedure was baptised as Chemosaturation with Percutaneous Hepatic Perfusion (CS-PHP) and it was used for the first time in UK in two patients with a cancer that had spread to the liver. The method had already been used in Germany, Italy, Ireland, France and the US. Furthermore, a study carried out in the US showed that patients who received this treatment survived 5 times longer than patients who received the best alternative care. 

Image copyright: DELCATH SYSTEMS INC - FORM 8-K - EX-99.1 - EXHIBIT 99.1 - June 3, 2011

This approach could save lives of patients whose cancer has spread to the liver from a primary tumor, for example the melanoma of the eye. Once the cancer reaches the liver, there is no effective treatment and survival is usually no more than four months, with one in ten patients living for a year. However, with this new treatment the time these melanoma patients can live is extended without the disease progressing.

In this new treatment the chemo drug is infused directly into the liver via catheter into the artery. Blood in the veins leading out of the liver is then captured and filtered through a specially designed, double-balloon catheter to filter out the drug before the cleaned blood is returned to the body. The approach allows the drug to be delivered, at a higher dosage than usual, directly to the liver and target the cancer tumor there, but in a minimally invasive manner.

Secondly, researchers at the University of Southampton led by Professor Salim Khako hepatology and Aymen Al Shamkhani immunologist, reported on 12th October that they will investigate how to boost innate immunity in humans to treat liver cancer. The idea is to stimulate the participation of NK cells (Natural Killer cells) to eliminate hepatocellular carcinoma cells.

Professor Khako highlights that hepatocellular carcinoma accounts for 90% of all primary liver tumors and to date is a very difficult condition to treat, in addition to being one of the growing mortal diseases in the world.

In a first phase the professor proposed a clinical trial using these NK cells in the treatment. He announced that three types of patients will have the formation of this cell stimulated to find the most appropriate method. When the team manages to find the most efficient system to stimulate NK cells, trials will be carried out in order to determine the best treatment for liver cancer, the university reported.

The BBC article:

http://www.bbc.co.uk/news/world-20270400

More on anticancer drug delivery using nanoparticles

I just came across an article in http://www.medicalnewstoday.com which goes over the use of  use of gold nanoparticles carrying drug molecules to target and treat cancer cells, something that was already presented in this post last February. This confirms that scientist keep foreseeing nanotechnology as new treatment against cancer, which might also replace radiation, chemotherapy, etc... in a near future.

In the study presented, the researchers used a single-stranded DNA aptamer called AS1411 which does two jobs. The first is to bind with the "shuttle" protein nucleolin, which is over-expressed in cancer cells and present inside the cell and on the cell surface. The second job is, once it is released from the nanostar, is to act as the drug itself. The results were quite more than satisfactory, as scientist observed death and decline in cancer cell population, exactly the intended objective.

You can find the whole article at this address: 
http://www.medicalnewstoday.com/articles/243856.php

See you in the next biomedipost :)

A pharmacy inside the body

The results of tests conducted by researchers at the Massachusetts Institute of Technology (MIT) and the company MicroCHIPS in a group of women with osteoporosis opens the door to the widespread use of remote administration of drugs. This was achieved by inserting a microchip under the skin which is capable of administering a medicine, thus allowing the patient to avoid daily injections of drugs.

And can’t patches do that already? Well, there are two main differences: the microchip allows remote control of drug release and also it can be used to administer more than one drug. The chip acts like a pharmacy inside the human body, a technology that can be used to treat from cancer to multiple sclerosis. Thinking further, I also envisaged the possibility of using the chip to administer vaccines automatically at the different stages of human development. And all this in a device with the size of a small pen drive!

And how does it work? The chip contains a daily dose of medication in small wells that are covered by a thin layer of gold nanoparticles which protects and prevents the drug from coming out.  The chip can be programmed to administer the medication according to a programmed schedule or commands sent wirelessly through a special frequency. These commands cause the gold to dissolve and allow the drug entering the bloodstream.

For testing, a group of seven women aged between 65 and 70 had the chip implanted through a simple procedure performed under local anesthesia. For four months the chip administered them an osteoporosis drug called teriparatide in doses comparable to those provided by injections, without any negative side effects.

“We hope this really is the dawn of a whole new way of thinking about delivering medications,” said co-author Robert Langer, a professor of cancer research at the Massachusetts Institute of Technology.  However, for he and his and colleagues, “the ‘hairpin’ road to the clinic might be long and winding, but a versatile implantable device that exploits the microchip approach for controlled drug delivery will be well worth the wait for patients with chronic diseases,”

Nanotechnology against cancer

As today is the World Cancer Day, I would like to draw your attention to what I believe will be the upcoming revolution in the fight against cancer: the nanotechnology.

Nanotech, as it is usually known, can be used to treat diseases like cancer by using nanoparticles which are 1000 times smaller than the thickness of a human hair. These nano particles have the ability to work at a molecular level, targeting the cancer cells and sparing the healthy ones contrary to traditional methods such as chemotherapy. Nanotech is intended to bring improvement to diagnostic and drug administration.

First, it allows better detection of cancer in its early stages and in specific parts of the body that could be missed by the traditional diagnostic methods, such as PET, SPECT, CT and MRI. The nanoparticles used in this case are made of gold and contain an antigen used to attach the nanoparticle to the cancer cell that contains receptors for that antigen. The gold is chosen because in reaction with red light it heats emitting an acoustic wave that can be detected by the medical imaging device. Secondly, the gold nanoparticle could also contain drug molecules with the purpose of killing the cancer cell once attached to it, for example using chemotherapy drug molecules. This kind of treatment brings much more efficient use of the drug, at the same time that it spares the normal cells. Also, another possibility is to heat the gold particles by using radio waves to destroy the cancer cells (Kanzius method).

As you can see, the nanotechnology is a field with enormous potential that will surely change the way we diagnose and treat cancer in the upcoming years. Cancer has won many battles against humanity, but nanotechnology is for the moment one of our biggest hopes of winning the war.

Sources:

http://nano.cancer.gov/

http://www-aarf.syr.edu/news/articles/2011/nanoparticles-10-11.html

http://www.kanziuscancerresearch.org/research/research_updates/

Very interesting video that explains how to use nanoparticles to target cancer cells: