Saturday, December 16, 2006

Top 10 Health Stories of 2006

Having recently posted a note on physics stories of 2006, I guess I should do health/medicine news next. So there's this: The Top 10 Health Stories of 2006.

I won't quibble with inclusion of any of the choices, but I do have comments on some of them (numbers keyed to items in the article):

  • 1. HPV vaccine – This isn't exactly a vaccine "against cancer". Cancer vaccines are under active development, but they're a different animal. This is a vaccine against human papillomavirus (HPV), which is responsible for about 70% of cervical cancers. I've written about it here.

  • 4. Treatment for macular degeneration – Since macular degeneration is caused by misplaced and uncontrolled growth of blood vessels in the eye, any drug that can inhibit angiogeneisis may be a potential treatment for the problem. It just so happens that anti-angiogenesis drugs are also possible treatments for solid cancers, since the drugs can inhibit blood supply to a tumor. Such a drug, with the trade name Avastin, was approved by the FDA in 2004. Avastin is a monoclonal antibody developed by Genentech, and may become a blockbuster drug for many types of cancer.

    Not coincidentally, the new macular degeneration drug, Lucentis, that the FDA approved this year is also from Genentech. It consists, essentially, of a portion of the Avastin antibody. Avastin has actually been used off-label to treat macular degeneration, and there is some controversy about the fact that Genentech hasn't run clinical trials of such use, even though Avastin is sold for a considerably cheaper price than Lucentis.

    Both Avastin and Lucentis target a protein called vascular entothelial growth factor (VEGF). A number of other drug companies are working on anti-angiogenic drugs that target VEGF. Some of them may be much more powerful than Avastin and Lucentis, such as one called a VEGF trap, from Regeneron Pharmaceuticals. (More information about that.)

  • 6. Vaccines – Vaccines are of two kinds: preventive and therapeutic. Both types work by conditioning the immune system. The former, more familiar, type wards off infectious diseases by stimulating the immune system to attack the agent of infection (usually a virus). Therapeutic vaccines are designed to mobilize the immune system in order to treat an existing disease condition. Of course, vaccines of both types are aggressively being sought to combat AIDS and cancer. But there's also a lot of research and development going into vaccines for conditions you might not expect, such as nicotine addiction and alcoholism. See this news article for an example dealing with nicotine.

  • 10. Vitamin D – The article mentions reports of beneficial effects of vitamin D for cancers of the breast and pancreas. This has been suspected for some time, as this story from 2004 indicates. Other studies have shown beneficial effects in prostate cancer (see here, here, here), ovarian cancer (see here, here), and colon cancer (see here, here).

There's one thing I think that the article misses. Even though it discusses cancer in relation to HPV and vitamin D, there has actually been an absolute flood of new research results on cancers of all types. Much of the research has dealt with the basic biology of cancer, such as the roles played by many different genes, the process of metastasis, and the involvment of stem cells in the onset of cancer. Although such research hasn't yet led to clinical trials of new drugs and therapies, I see this as a very important sign for the future. I'll try to write about "top stories of 2006 in cancer biology" some time after the new year.

Also related to cancer, there have been some new drugs approved for bone/blood cancer-like diseases such as multiple myeloma and myelodysplasia (e. g. Revlimid).

There has also been a lot of progress in understanding the biology of Alzheimer's disease. Not enough, yet, to fully understand the disease mechanism, but quite a lot is being learned. There may be some breakthroughs here before too long.

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