Levoleucovorin's supplemental New Drug Application (sNDA) for colorectal cancer...

We know that  Levoleucovorin (see structure; source : chemspider) is  used to treat or prevent toxic effects of methotrexate in people who have received methotrexate to treat bone cancer.

Recently, Spectrum Pharmaceuticals announced that it has met with the FDA regarding it’s supplemental New Drug Application (sNDA) for FUSILEV^® (levoleucovorin) for injection for the treatment of patients with advanced metastatic colorectal cancer. The company is expected to  to submit in the third quarter of 2010. The FDA did not request any additional efficacy studies. Hope the FDA will  approve the drug  for advanced metastatic colorectal cancer...

Ref  : http://investor.spectrumpharm.com/releasedetail.cfm?ReleaseID=439605

Rapamycin as a potential treatment for kidney disease (ADPKD).........

I did  mention about the use of Rapamycin (see structure)  to improve the  efficacy of tuberculosis vaccine in my earlier blog. This drug has been already  used as an immunosuppressant drug to prevent rejection in organ transplantation,  especially useful in kidney transplants.

 Rapamycin, was originally developed as an antifungal agent. However, this was abandoned when it was discovered that it had potent immunosuppressive and antiproliferative properties. Some researchers have  also reported that  the drug prolong the life of mice and might also be useful in the treatment of certain cancers.

Researchers from UC Santa Barbara  earlier claimed that, rapamycin has  a potential to treat  kidney disease,  however  concluded  that the  mice had different genes affected than human patients. Interestingly, the same researchers recently found that  "rapamycin is also highly effective in a new mouse model in which the same gene is affected as in most human patients".

As claimed by the lead researcher, Thomas Weimbs currently, no treatment exists to prevent or slow cyst formation and most ADPKD patients require kidney transplants or lifelong dialysis for survival. I think this will boost the confidence of the several international groups,  who are undertaking the  clinical trials  to test the safety and efficacy of rapamycin and related drugs in polycystic kidney disease. Though the  researchers are hopeful of positive results  they caution that,  it will be critical to balance any benefits against the expected side effects to judge whether these drugs should be recommended for the treatment of polycystic kidney disease. Let us be optimistic.....

Ref : http://www.ia.ucsb.edu/pa/display.aspx?pkey=2164

Positive results from Phase 2 trial of picoplatin for colorectal cancer...

In continuation of my update on picoplatin,.......

Poniard Pharmaceuticals, Inc,  claims that Phase 2 trial  study met its primary objective, that is picoplatin in combination with 5-fluorouracil and leucovorin (FOLPI regimen) was associated with a statistically significant reduction in neurotoxicity (p <0.004) compared to oxaliplatin given in combination with 5-fluorouracil and leucovorin (FOLFOX regimen). More...

FDAs approval of fampridine-SR for multiple sclerosis...

In continuation of my  update on MS, I found this info useful to share with. Multiple sclerosis (MS, also also known as disseminated sclerosis or encephalomyelitis disseminata) is a disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms. Disease onset usually occurs in young adults, and it is more common in females. MS affects the ability of nerve cells in the brain and spinal cord to communicate with each other. Nerve cells communicate by sending electrical signals called action potentials down long fibers called axons, which are wrapped in an insulating substance called myelin.

In MS, the body's own immune system attacks and damages the myelin. When myelin is lost, the axons can no longer effectively conduct signals. The name multiple sclerosis refers to scars (scleroses, better known as plaques or lesions) in the white matter of the brain and spinal cord, which is mainly composed of myelin. (see, picture, source : URMC).

Now FDA has approved fampridine-SR (see structure, source : chemspider),  for the treatment of multiple sclerosis. Most interesting part of the research lies in the fact that Researchers at the University of Rochester Medical Center (URMC) have been evaluating the effects of the drug in MS for more than 10 years- it is the first medication shown to enhance some neurological functions in people with the disease and I think their efforts helped pave the way for action by the FDA.

Researchers at URMC helped develop the study protocols and lead the clinical trials  that demonstrated consistently improved mobility - timed walking speed- in more than a third of patients with MS. This is the first instance in which a drug for multiple sclerosis was found to improve function lost as a result of the disease. Goodman and his colleagues published the results of a Phase 3 clinical trial of the drug in the journal Lancet. Fampridine-SR is being developed by Acorda Therapeutics and marketed under the name Ampyra. The company submitted a new drug application to the FDA in February 2009. An expert advisory panel recommended approval of the drug in October and that recommendation was adopted by the FDA on 23. January 2010.

As per the claim by the researchers, fampridine improves the transmission of signals in the central nervous system of some multiple sclerosis patients by blocking potassium ion channels in nerve cells and restoring signal conduction( have covered an article in the same lines).

The authors claim that, 35% of patients taking the drug were responders who consistently improved their walking speed by an average of about 25%. While walking was the primary measure, patients also reported that they could walk farther distances, climb stairs better, and stay on their feet longer. Except for the mild seizure, at the FDA approved dosage, the drug is safe. Hope, people with MS will have some sort of relief......

Ref : http://www.urmc.rochester.edu/news/story/index.cfm?id=2744

Naproxcinod a better NSAID.....

I knew  about Naproxen, because my first job was with Rallis India  Limited and the pharma division (sold to Shreya Group) was selling it as  a gel. It works by inhibiting both the COX-1 and COX-2 enzymes and that is the reason, why it has side effects. It has  been established already that the selective inhibitors of  COX-2 & 5 -LO will be the best drugs with least or no ulcerogenecity. We have  some drug like Celecoxib with selective inhibition of COX-2 (cyclo oxygenase enzyme), still we need to have selective inhibitors of both COX-2 & 5 -LO, so that  there will not be any cases like Rofecoxib withdrawal.

Naproxcinod, is a nitroxybutyl ester of naproxen. The ester group allow it to also act as a nitric oxide donor. Interestingly, this second mechanism of action makes naproxcinod the first of a new class of drugs, the cyclooxygenase inhibiting nitric oxide donators (CINODs), that are expected to produce similar analgesic efficacy to traditional NSAIDs, but with less gastrointestinal and cardiovascular side effects.  Now NicOx S.A announced that European Medicines Agency (EMEA) has validated the Marketing Authorization Application (MAA) for naproxcinod. NicOx is seeking approval for an indication for the relief of the signs and symptoms of primary osteoarthritis. This follows the acceptance for filing of a New Drug Application (NDA) by the US Food and Drug Administration (FDA) in November 2009.

More interestingly, in addition to naproxcinod, NicOx's pipeline includes several nitric oxide- donating NCEs, which are in development internally and with partners, including Merck & Co., Inc., for the treatment of widespread eye diseases, cardiometabolic diseases, hypertension and dermatological disease.

Details of the press release, one can read at the link....

LOAD - a better combination therapy against Helicobater pylori....

In continuation of my update on Helicobater pylori infection and its treatment, I found this info interesting to share with. Dr. Patrick Basu and his colleagues at Columbia University College of Physicians and Surgeons found that,  a shorter course of the four-drug combination (LOAD), seven days vs. a ten-day treatment, is equally effective. As per the claim by the researchers  Helicobater pylori, a bacteria implicated in peptic ulcers and gastritis, was eradicated in 95 percent patients who took a 7-day course of combination therapy with  levofloxacin (L), omeprazole (O), nitazoxanide (Alinia®) (A) and doxycycline  (D) (LOAD) compared to eradication in only 80.9 percent of patients on lansoprazole, amoxicillin and clarithromycin (LAC) for seven days.

The study included 135 patients with treatment naïve Helicobacter pylori infection, who were randomized to LOAD (7 or 10 days) vs. LAC (10 days). There was a total wash out period of six weeks from any prior antibiotic and PPI use prior to the initiation of therapy.

Ref : http://www.acg.gi.org/media/releases/09ACGReleaseLOADTherapyforHPylori.pdf

SPC3649 ( LNA- locked nucleic acid) - a new hope for hepatitis C.....

When  I was working with Innovasynth Technologies, Khopoli, I had an opportunity to do literature survey about  Lock Nucleic Acids (LNAs) and Peptide Nucleic Acids (PNAs) (we were supposed to work on the preparation of  some of the LNAs & PNAs for US based companies). In my opinion though these class of compounds (including oligonucleotides) are  still emerging,  I think in the days to come there will be more and more drugs from oligonucleotides, Locked Nucleic Acids (LNAs) and Peptide Nucleic Acids, (PNAs) class of compounds.

LNAs : A locked nucleic acid (LNA) (see the right side general structure), is a modified RNA nucleotide. Ribose moiety of an LNA nucleotide is modified with an extra bridge

connecting the 2' oxygen and 4' carbon. The bridge "locks" the ribose  in the 3'-endo (North) conformation, which is often found in the A-form of DNA or RNA. LNA nucleotides can be mixed with DNA or RNA bases in the oligonucleotide whenever desired. This locking  significantly increases the thermal stability (mp) of oligonucleotide.

LNA nucleotides are used to increase the sensitivity and specificity of expression in DNA microarrays, FISH probes, real-time PCR probes and other molecular biology techniques based on oligonucleotides. For the in situ detection of miRNA the use of LNA is currently the only efficient method. A triplet of LNA nucleotides surrounding a single-base mismatch site maximizes LNA probe specificity unless the probe contains the  G-T mismatch. We have already seen some antisense drugs (oligonucleotides from Geron & Isis) and some are into clinical trials.

Now its interesting to see that Santaris Pharma   is currently advancing LNA based compounds within infectious diseases, metabolic disorders, oncology, inflammatory and rare genetic disorders.

Santaris Pharama, has developed a LNA,  SPC3649 - which captures a small RNA molecule in the liver, called microRNA122, that is required for HCV replication.

As per the claim by the company, SPC3649 works by altering the environment in the host liver cell to inhibit viral replication rather than inhibiting the virus itself. This subtle difference (in comparison  with other therapies) may have significant implications, as it may reduce the risk of the virus becoming resistant to therapy – a major concern with current therapies.

As per the claim by Dr. Robert Lanford,  (who has collaboration with Santaris Pharma), that in a preclinical study  SPC3649 successfully inhibited miR-122, a liver-expressed microRNA important for Hepatitis C viral replication. By inhibiting miR-122, SPC3649 dramatically reduced Hepatitis C virus in the liver and in the bloodstream in chimpanzees chronically infected with the Hepatitis C virus. Four HCV chronically infected chimpanzees were treated weekly with 5 or 1 mg/kg of SPC3649 for 12 weeks followed by a treatment free period of 17 weeks. The two animals that received the 5 mg/kg dose had a significant decline in viral levels in the blood and liver of approximately 2.5 orders of magnitude or approximately 350 fold. Hope the new therapy could potentially replace interferon (interferon and ribavirin is  approved by FDA for hepatitis C and this treatment is very toxic, requires 48 weeks with 50% success) in future cocktails, since it provides a high barrier to resistance. This antiviral could be used alone to treat disease progression and there are indications that it can convert interferon non-responders to responders, so that non-responders to the current therapy could be treated with the combination of this drug with interferon.   More....

Those interested  can see the video demo with the link

Apple pectin as a novel prebiotic substance, that helps the intestinal microbiota....

We know the proverb "An apple a day keeps the doctor away" because of the fact that apple has been  addressing the health effects of the fruit, dates from 19th century. Interestingly apples have shown reduce the risk of  colon cancer, prostate cancer and lung cancer.Compared to many other fruits and vegetables, apples contain relatively low amounts of Vitamin C, but are rich source of other antioxidants.  The fiber content, while less than in most other fruits, helps regulate bowel movements and may thus reduce the risk of colon cancer. They may also help with heart disease, weight loss,  and controlling cholesterol, as they do not have any cholesterol, have fiber, which reduces cholesterol by preventing re absorption, and are bulky for their caloric content like most fruits and vegetables . There is  in vitro evidence that  phenolic compounds in apples (quercetin, epicatechin, and procyanidin B2) are  cancer-protective and  also demonstrate antioxidant activity.

Apples can be canned or juiced and the juice can be fermented to make apple cider (non-alcoholic, sweet cider) and cider (alcoholic, hard cider), ciderkin, and vinegar. Alcoholic beverages are produced such as applejack (beverage) and Calvados.  Apple wine can also be made. Pectin is also produced. 

Now microbiologists at the University of Denmark's National Food Institute,  tested the effect of apple consumption by feeding rats a diet of whole apples as well as apple-derived products such as apple juice and puree. The researchers then checked the bacteria in the guts of the rats to see if consuming apples affected levels of "friendly" bacteria, which are beneficial for digestive health and may reduce the risk of some diseases. Researchers found that rats eating a diet high in pectin, a component of dietary fiber in apples, had increased amounts of certain bacteria that may improve intestinal health.

As per the claim by the researchers, consuming apples affected levels of "friendly" bacteria, (bacteria that are beneficial for digestive health) and there by  reduce the risk of some diseases. And bacteria help produce short-chain fatty acids that provide ideal pH conditions for ensuring a beneficial balance of microorganisms. They also produce butyrate, which is an important fuel for the cells of the intestinal wall. Interestingly, consumption of apple pectin (7% in the diet) increases the population of butyrate and beta-glucuronidase producing Clostridiales, and decreases the population of specific species within the Bacteroidetes group in the rat gut. Similar changes were not caused by consumption of whole apples, apple juice, puree or pomace....

Ref : http://www.biomedcentral.com/content/pdf/1471-2180-10-13.pdf

New class of drugs for hepatitis C .....

Eiger BioPharmaceuticals, Inc., has come up with a novel class of compounds as HCV Inhibitors. The  research validates a domain, termed 4BAH2, within the non-structural protein (NS4B) of the HCV genome, as essential for HCV replication and describes the development of a high-throughput screen leading to the identification of small molecule inhibitors of 4BAH2.

 Interestingly, the researchers claims that 4BAH2 is the second new domain within NS4B now proven necessary and essential for HCV replication, and which has been shown to be susceptible to pharmacologic inhibition.  Eiger is developing small molecule inhibitors of both NS4B-RNA binding and small molecule inhibitors of NS4B-AH2, each of which has significant activity alone and significant synergy when combined. The researchers have tried the following two compounds (a pyrazolopyrimidine derivative and an amiloride derivative see the below structures). Mechanistic studies reveal that the inhibitors target 4BAH2 function by preventing either 4BAH2 oligomerization or 4BAH2 membrane association. 4BAH2 inhibitors represent an additional class of compounds with potential to effectively treat HCV.

The researchers  claims that like AIDS and tuberculosis, future effective therapy for HCV is expected to require a cocktail of several independent classes of drugs, each designed against a different viral target.

Eiger is focused on the discovery and development of new antiviral agents  against novel targets for the treatment of hepatitis virus infections. Eiger's pipeline includes repurposed clinical stage therapeutic agents as well as preclinical NCEs from discovery that exhibit antiviral activity against Hepatitis C, Hepatitis D, and other viruses.

Ref : http://stm.sciencemag.org/content/2/15/15ra6.abstract

Alternative therapy ?

This is my off the  subject topic, but some how felt interested to share with. As a chemist and science student  still,  I have  many doubts about this  therapy i.e., "past-life therapy".

Now a days, many  Indian TV channels [as for as my knowledge goes NDTv (Hindi),  Kasturi and TV9 (both in Kannada)] have started programs  about this therapy. Most of the persons having been treated by this therapy claimed that,   they have been able to get solutions to the problems they have faced for many months/years.  Out of curiosity, I tried to know about Reiki and other alternative therapies, but  to  my surprise there is no scientific evidence  (1 & 2) for reiki (a systematic review of randomized clinical trials conducted in 2008 did not support the efficacy of reiki or its recommendation for use in the treatment of any condition).

Recently, TV9 has an interview with a doctor (a neurosurgeon), a psychologist and Sri. Balakrishna Guruji of SOMBO. Though the discussion was inconclusive, Guruji, referred to a book by Dr. Brian Weiss titled  "Many Lives, Many Masters: The True Story of a Prominent Psychiatrist, His Young Patient and the Past-life Therapy That Changed Both Their Lives.

This book is all about Dr. Brian Weiss's (traditional psychotherapist - presently Chairman Emeritus of Psychiatry at the Mount Sinai Medical Center in Miami) experience in treating his patient Catherine. For 18 months, Dr. Weiss used conventional methods of treatment to help Catherine overcome her traumas. When nothing seemed to work, he tried hypnosis, which, he explains, “is an excellent tool to help a patient remember long-forgotten incidents" As per the claim by Dr.Weiss, it is just a state of focused concentration. Under the instruction of a trained hypnotist, the patient’s body relaxes, causing the memory to sharpen eliciting memories of long-forgotten traumas that were disrupting their lives.”

As a reviewer says "Dr. Weiss’s experience and Catherine’s transcendental knowledge might be awe inspiring to the Occidental, but to a Hindu, a Buddhist  these methods were followed traditionally and still being followed.

One reviewer  concludes like this : Many Lives, Many Masters makes for an unstoppable read and, like Dr. Weiss, we too realize that "life is more than meets the eye. Life goes beyond our five senses. Be receptive to new knowledge and to new experiences. Our task is to learn, to become God-like through knowledge."... ..............

In fact,  I was in dilemma whether or not publish this article, but read an article titled "Medical Students Supportive of Alternative Medicine"....so am publishing this...

Those interested reading his other books can visit the link