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New treatment destroys head and neck cancer tumours in trial

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New treatment destroys head and neck cancer tumours in trial

A new cancer treatment can wipe out tumours in terminally ill head and neck cancer patients, scientists have discovered.

In a landmark trial, a cocktail of immunotherapy medications harnessed patients’ immune systems to kill their own cancer cells and prompted “a positive trend in survival”, according to researchers at the Institute of Cancer Research (ICR), London, and the Royal Marsden NHS foundation trust.

One patient, who was expected to die four years ago, spoke of the “amazing” moment nurses called him weeks after he joined the study to say his tumour had “completely disappeared”. The 77-year-old grandfather is now cancer-free and spent last week on a cruise with his wife.

Scientists found the combination of nivolumab and ipilimumab medications led to a reduction in the size of tumours in terminally ill head and neck cancer patients. In some, their cancer vanished altogether, with doctors stunned to find no detectable sign of disease.

Combining the two immunotherapy drugs could prove an effective new weapon against several forms of advanced cancer, experts believe. Results from other trials of the drug combination have previously suggested similar benefits for terminally ill kidney, skin and bowel cancer patients.

As well as boosting the long-term survival chances of patients, scientists said, the immunotherapy treatment also triggered far fewer side-effects compared with the often gruelling nature of “extreme” chemotherapy, which is the standard treatment offered to many patients with advanced cancer.

The results from the phase 3 trial, involving almost 1,000 dying head and neck cancer patients, were early and not statistically significant but were still “clinically meaningful”, the ICR said, with some patients living months or years longer and suffering fewer side effects.

“These are promising results,” Prof Kristian Helin, the ICR chief executive, told the Guardian. “Immunotherapies are kinder, smarter treatments that can bring significant benefits to patients.”

About 12,000 people in the UK are diagnosed with head and neck cancer every year and many will be diagnosed at advanced stages. There is an urgent need for better, kinder treatments for these patients that can keep them alive longer than the current standard of care.

When Barry Ambrose, 77, from Bury St Edmunds, was diagnosed with throat cancer in 2017, he was told that it had already spread to his lungs – and that hospital palliative care was his only option.

But in a turn of events that saved his life, Ambrose was offered the chance to join the new study. “When I was told about the trial … I didn’t hesitate to join – what did I have to lose? It turned out to be a lifeline.

“Although I had to make biweekly trips from Suffolk to the hospital for the treatment, I had virtually no side-effects and was able to carry on as normal doing the things I love: sailing, cycling, and spending time with my family.”

Within about eight weeks of starting the treatment, scans revealed the tumour in his throat had been eradicated.

“When the research nurses called to tell me that, after two months, the tumour in my throat had completely disappeared, it was an amazing moment,” said Ambrose. “While there was still disease in my lungs at that point, the effect was staggering.”

He later underwent chemotherapy, followed by surgery. He currently has no evidence of disease.

“The treatment I’ve received at the Royal Marsden has been second to none and I’m so fortunate they’ve continued to find treatment that works for me – they’re the gift that keeps on giving,” said Ambrose. Last week he enjoyed a cruise off the coast of the UK with his wife, Sue.

The results of the trial show the immunotherapy combination enjoyed a particularly high success rate in a group of patients whose tumours had high levels of an immune marker called PD-L1.

Survival rates in those with high levels of PD-L1 who received the immunotherapy cocktail were the highest ever reported in a firstline therapy trial of relapsed or metastatic head and neck cancer.

These patients lived an average of three months longer than those having chemotherapy. The median overall survival for these patients was 17.6 months, the highest average ever reported in this group of patients.

Researchers said they hoped future findings from the CheckMate 651 trial, funded by Bristol Myers Squibb, will show further benefits of the therapy in patients with advanced head and neck cancers.

“Despite the lack of statistical significance, these results are clinically meaningful,” said Prof Kevin Harrington, professor of biological cancer therapies at the ICR and consultant clinical oncologist at the Royal Marsden, who led the CheckMate 651 trial. “We will need to do longer follow-up to see whether we can demonstrate a survival benefit across all patients in the trial.”

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Covid Vaccines Saved 20 Million Lives In First Year – Study

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Covid Vaccines Saved 20 Million Lives In First Year – Study

Covid vaccines prevented nearly 20 million deaths in the first year after they were introduced, according to the first large modelling study on the topic released Friday.

The study, published in The Lancet Infectious Diseases, is based on data from 185 countries and territories collected from December 8, 2020 to December 8, 2021.

It is the first attempt to estimate the number of deaths prevented directly and indirectly as a result of Covid-19 vaccinations.

It found that 19.8 million deaths were prevented out of a potential 31.4 million deaths that would have occurred if no vaccines were available.

It was a 63 percent reduction, the study found.

The study used official figures — or estimates when official data was not available — for deaths from Covid, as well as total excess deaths from each country.

Excess mortality is the difference between the total number of people who died from all causes and the number of deaths expected based on past data.

These analyses were compared with a hypothetical alternative scenario in which no vaccine was administered.

The model accounted for variation in vaccination rates across countries, as well as differences in vaccine effectiveness based on the types of vaccines known to have been primarily used in each country.

China was not included in the study because of its large population and strict containment measures, which would have skewed the results, it said.

The study found that high- and middle-income countries accounted for the largest number of deaths averted, 12.2 million out of 19.8 million, reflecting inequalities in access to vaccines worldwide.

Nearly 600,000 additional deaths could have been prevented if the World Health Organization’s (WHO) goal of vaccinating 40 percent of each country’s population by the end of 2021 had been met, it concluded.

“Millions of lives have probably been saved by making vaccines available to people around the world,” said lead study author Oliver Watson of Imperial College London.

“We could have done more,” he said.

Covid has officially killed more than 6.3 million people globally, according to the WHO.

But the organisation said last month the real number could be as high as 15 million when all direct and indirect causes are accounted for.

The figures are extremely sensitive due to how they reflect on the handling of the crisis by authorities around the world.

The virus is on the rise again in some places, including in Europe, which is seeing a warm-weather resurgence blamed in part on Omicron subvariants.

AFP

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WHO considers declaring monkeypox a global health emergency

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WHO considers declaring monkeypox a global health emergency

As the World Health Organization convenes its emergency committee Thursday to consider if the spiraling outbreak of monkeypox warrants being declared a global emergency, some experts say WHO’s decision to act only after the disease spilled into the West could entrench the grotesque inequities that arose between rich and poor countries during the coronavirus pandemic.

Declaring monkeypox to be a global emergency would mean the U.N. health agency considers the outbreak to be an “extraordinary event” and that the disease is at risk of spreading across even more borders. It would also give monkeypox the same distinction as the COVID-19 pandemic and the ongoing effort to eradicate polio.

Many scientists doubt any such declaration would help to curb the epidemic, since the developed countries recording the most recent cases are already moving quickly to shut it down.

Last week, WHO Director-General Tedros Adhanom Ghebreyesus described the recent monkeypox epidemic identified in more than 40 countries, mostly in Europe, as “unusual and concerning.” Monkeypox has sickened people for decades in central and west Africa, where one version of the disease kills up to 10% of people. In the epidemic beyond Africa so far, no deaths have been reported.

“If WHO was really worried about monkeypox spread, they could have convened their emergency committee years ago when it reemerged in Nigeria in 2017 and no one knew why we suddenly had hundreds of cases,” said Oyewale Tomori, a Nigerian virologist who sits on several WHO advisory groups. “It is a bit curious that WHO only called their experts when the disease showed up in white countries,” he said.

Until last month, monkeypox had not caused sizeable outbreaks beyond Africa. Scientists haven’t found any major genetic changes in the virus and a leading adviser to WHO said last month the surge of cases in Europe was likely tied to sexual activity among gay and bisexual men at two raves in Spain and Belgium.

To date, the U.S. Centers for Disease Control and Prevention has confirmed more than 3,300 cases of monkeypox in 42 countries where the virus hasn’t been typically seen. More than 80% of cases are in Europe. Meanwhile, Africa has already seen more than 1,400 cases this year, including 62 deaths.

David Fidler, a senior fellow in global health at the Council on Foreign Relations, said WHO’s newfound attention to monkeypox amid its spread beyond Africa could inadvertently worsen the divide between rich and poor countries seen during COVID-19.

“There may be legitimate reasons why WHO only raised the alarm when monkeypox spread to rich countries, but to poor countries, that looks like a double standard,” Fidler said. He said the global community was still struggling to ensure the world’s poor were vaccinated against the coronavirus and that it was unclear if Africans even wanted monkeypox vaccines, given competing priorities like malaria and HIV.

“Unless African governments specifically ask for vaccines, it might be a bit patronizing to send them because it’s in the West’s interest to stop monkeypox from being exported,” Fidler said.

WHO has also proposed creating a vaccine-sharing mechanism to help affected countries, which could see doses go to rich countries like Britain, which has the biggest monkeypox outbreak beyond Africa — and recently widened its use of vaccines.

To date, the vast majority of cases in Europe have been in men who are gay or bisexual, or other men who have sex with men, but scientists warn anyone in close contact with an infected person or their clothing or bedsheets is at risk of infection, regardless of their sexual orientation. People with monkeypox often experience symptoms like fever, body aches and a rash; most recover within weeks without needing medical care.

Even if WHO announces monkeypox is a global emergency, it’s unclear what impact that might have.

In January 2020, WHO declared that COVID-19 was an international emergency. But few countries took notice until March, when the organization described it as a pandemic, weeks after many other authorities did so. WHO was later slammed for its multiple missteps throughout the pandemic, which some experts said might be prompting a quicker monkeypox response.

“After COVID, WHO does not want to be the last to declare monkeypox an emergency,” said Amanda Glassman, executive vice president at the Center for Global Development. “This may not rise to the level of a COVID-like emergency, but it is still a public health emergency that needs to be addressed.”

Salim Abdool Karim, an epidemiologist and vice chancellor at the University of KwaZulu-Natal in South Africa, said WHO and others should be doing more to stop monkeypox in Africa and elsewhere, but wasn’t convinced that a global emergency declaration would help.

“There is this misplaced idea that Africa is this poor, helpless continent, when in fact, we do know how to deal with epidemics,” said Abdool Karim. He said that stopping the outbreak ultimately depends on things like surveillance, isolating patients and public education.

“Maybe they need vaccines in Europe to stop monkeypox, but here, we have been able to control it with very simple measures,” he said.

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NMA urges NCDC to step up fight against Monkeypox

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NMA urges NCDC to step up fight against Monkeypox

The Nigerian Medical Association (NMA) has urged the Nigeria Centre for Disease Control (NCDC) to step-up its efforts in educating and protecting Nigerians from the increasing cases of the ravaging Monkeypox disease.

It stressed that the Agency, which is saddled with the responsibility of disease prevention and control, must not lose sight of other infectious diseases like monkeypox, even as it focuses on COVID-19.

The doctors’ association, while urging Nigerians to adhere strictly to the preventive measures of personal hygiene, especially hand hygiene because like monkeypox, COVID-19 is still very much in the country, and the situation can become worse if not handled properly, implored religious institutions – churches and mosques – to take up the responsibility of sensitising their followers about the disease.

Recall that yesterday the NCDC announced that the country has recorded 21 confirmed cases of the Monkeypox disease in the last five (5) months, with one death. Also, in the month of May, a total six (6) new confirmed positive cases were reported from four (4) states – Bayelsa (2), Adamawa (2), Lagos (1), and Rivers (1).

Globally, according to reports from the World Health Organization (WHO), as of 26 May, there have been a cumulative total of 257 laboratory confirmed cases, with around 120 suspected cases reported, from 23 non-endemic countries. However, no deaths have been reported.

Speaking with The Nation, the newly elected President of the NMA, Dr Uche Ojinmah, said: “We have the Nigeria Centre for Disease Control (NCDC) that has the responsibility of not just monitoring and controlling COVID-19, but every infectious disease. Therefore, they should step up to the plate. It is the business of the NCDC; they can link up with the Ministry of Information and get people aware.

“They need to start giving us data on this Monkeypox as it happens across the country. With the current awareness coming from a reputable government institution like that, people will sit up. We need to start directing our calls to the appropriate institution, which is the NCDC. We don’t expect President Muhammadu Buhari to give us information on this. Let the NCDC step up to the plate and do their job.

“The Nigeria Centre for Disease Control needs to understand that it is not only COVID-19; it is important. It is however necessary to be combined in the sensitisation of the people. The media also have a role to play in sensitisation. The government needs to bring the will, but we all in our little ways can contribute.

“We have a bit of a problem in this country; we initiate measures, achieve a positive response, and we drop our guards. In 2015 when Ebola came, we took it on as a nation, and we got rid of it, and everybody went back to their normal lives. COVID-19 has come and with us, if you check even in flights now, you force people to wear their masks. Nigerians, therefore, need to be serious and the government needs to play a role.

“Monkeypox is here now and everybody pretends they don’t know – until it becomes a problem. I also expected that the government, civil society, and non- governmental organisations should have started spreading the message by now. Our churches and mosques should take up this course now that it has not become a disaster.

“Doctors should also start to educate patients they see that do not have it. We need to start now to prepare the minds of our people; it may not be as bad as Ebola or COVID-19, but it is still a problem. So, the earlier we start preventive measures, the better we will be.”

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