When cancer drug marketing sneaks into a soap opera plot

"General Hospital" character Anna Devane ponders her diagnosis.

“General Hospital” character Anna Devane ponders her diagnosis.

Polycythemia vera is an uncommon blood cancer that can be controlled with long-established treatments. So it seemed more than a little suspicious to Vinay Prasad, M.D., M.P.H., when the disease took center stage in an episode of “General Hospital” – the longest running daytime drama on American television.

“I felt there had to be some backstory,” Prasad, an OHSU Knight Cancer Institute hematologist-oncologist told listeners of  the public radio program Think Out Loud. “What we found was that a company called Incyte Corporation, which actually manufactures a very costly new drug for polycythemia vera, was in a partnership with ‘General Hospital’ and had helped craft this plot line in an effort to raise awareness for this condition.”

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Outsmarting treatment-resistant prostate cancers

Aggressive prostate tumors can rapidly evolve to resist PARP inhibitors, but it may be possible to detect resistance early enough to counteract.

 

Protein_PARP1_PDB_1uk0Two views of the structure of the DNA-repair protein PARP1

It was a surprising discovery that opened up a new avenue for treating prostate cancer. In recent years, studies have revealed that gene mutations long associated with breast and ovarian cancers – BRCA1 and BRCA2 – also play a significant role in driving aggressive prostate cancers

Men with these mutations (about 20 percent of prostate cancer patients with metastatic tumors) have shown very high response rates to a new class of drugs called PARP inhibitors, three of which have already gained FDA approval for use in ovarian cancer.

The bad news: Prostate cancers can rapidly evolve to resist PARP inhibitors.

The good news: It may be possible to detect the emergence of resistant cancer cells with just a blood test, researchers have now found, and that could provide earlier information about PARP inhibitor resistance and important clues about how to overcome resistance.

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Widely used prostate cancer treatment may worsen risk of falls

man falling

Men with prostate cancer became more vulnerable to falls if they used androgen deprivation therapy, and the heightened risk of falling persisted for more than a year after ending therapy, a study has revealed.

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Riveting survival stories from the early clinical trials of Gleevec

(Left to right) Judy Orem, 73, of Lake Oswego, Oregon, Doug Jenson, 83, of Canby, Oregon, and Dori Mortensen, 79, of Bend, Oregon, inside Multnomah Pavilion at Oregon Health & Science University in Portland, Oregon on Thursday April 20, 2017.

(Left to right) Judy Orem, Doug Jenson and Dori Mortensen were diagnosed with chronic myeloid leukemia in the 1990s, when few survived more than five years. They were among the earliest participants in clinical trials of Gleevec. (Stat News/Meg Roussos)

Medicine had never seen anything like it before, Brian Druker, M.D., recalled. “These are people who’d been told to get their affairs in order. And now their blood counts are normal,” the director of the OHSU Knight Cancer Institute told Stat News reporter Bob Tedeschi.

“But here’s the problem: When can you celebrate? I felt a little bit like walking on eggshells, because it’s like, OK, is this going to be a flash in the pan, or is this going to last? And there’s only one way to find out: wait and see.”

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Oregon’s precision medicine pioneer targets earlier cancer detection

OHSU Knight Cancer Institute Director Brian Druker talks with Medscape about breaking out of one-size-fits-all thinking in cancer screening and prevention

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Brian and Eric

Knight Cancer Institute Director Brian Druker, M.D., recorded an interview in La Jolla, California, with Medscape Editor-in-chief Eric Topol, M.D.

“We are now in the process of building an entire program on what I call precision early detection of cancer,” said Brian Druker, M.D., “We are trying to be more accurate in taking the same precepts of precision medicine for advanced cancer and using them earlier.”

If it works, Druker told Medscape’s editor-in-chief, Eric Topol, M.D., the early detection initiative at OHSU will find a way out of the big conundrum of cancer screening: technologies that too often fail to find dangerous cancers while at the same time raising too many alarms about essentially harmless tumors and driving overdiagnosis and unnecessary treatment.

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Oregon’s Death with Dignity Act, 20 years later

PAD trend

Number of prescriptions and assisted deaths under the Oregon Death with Dignity Act. (Blanke et al. from Oregon Health Authority data)

In 1997, Oregon became the first state to make it legal for terminally ill patients to self-administer a prescription to hasten death.

A review of 991 cases of lethal self-medication through 2015 shows that the law’s impact has remained largely predictable. Three-fourths of the people were dying of cancer, nearly all were white and around 70 percent had attended college. More than 90 percent had health insurance, were receiving hospice care and died at home.

Still, some findings surprised first author Charles Blanke, M.D., a professor of medicine in the OHSU Knight Cancer Institute and chair of the SWOG research consortium.

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A new way to guide cancer immune therapy

Scrutinizing the immune cells infiltrating a tumor may reveal the cancer’s vulnerability or resistance to immune-based therapies.

 

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Lessons from Oregon about end-of-life care

Tolle et al

Deaths among Medicare enrollees in Oregon, Washington, and the rest of the U.S. (Tolle and Teno)

At the end of life, people in Oregon are more likely to have their care wishes honored, less likely to be hospitalized and more likely to use home hospice services compared with people in Washington and the rest of the U.S.

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With foundation help, an Oregon doctor roots out low-value medical practices

Vinay Prasad (OHSU/Kristyna Wentz-Graff)

Vinay Prasad (OHSU/Kristyna Wentz-Graff)

Physicians have started to face up to an uncomfortable truth: their profession has often embraced new treatments that don’t really help patients.

“When you look at the balance of benefit and harm, some therapies provide no net benefit,” says OHSU assistant professor Vinay Prasad, M.D., M.P.H., who has landed a $2 million grant to go after the problem.

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A Native American health focus at the OHSU Knight Cancer Institute

Knight Cancer physician Amanda Bruegl, M.D., is leading an effort to understand health issues among Native American tribes and communities in the Pacific Northwest, with a special focus on gynecologic cancer.

 

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Amanda Bruegl, M.D. (OHSU/Fritz Liedtke)

Throughout medical training, Amanda Bruegl’s commitment to work with Native Americans never faltered. As a member of the Oneida and Stockbridge-Munsee tribes, she is one of two Native American gynecologic oncologists in the United States.

“When I was looking for a job,” she says, “it was really important to me to do something to advocate for Native American women’s health.” She saw a need for that in the Pacific Northwest.

“I was looking for places where there was a significant Native American population and the opportunity to do outreach,” she says.

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Targeting leukemia with drug combinations

Targeting leukemia with drug combinations

Cancer researchers have devised a way to rapidly screen combinations of drugs to identify pairs of agents most likely to work synergistically against some of the most difficult to treat forms of leukemia.