Release date: 2017-04-28

Cervical cancer is often fatal when it recurs. Doctors want to know if a new therapeutic vaccine can prevent or reduce the recurrence of high-risk patients.

Vaccines are being studied in high-risk patients because there is evidence that cancer cells have spread to the pelvic lymph nodes, or because the disease was already diagnosed when it was first diagnosed. The vaccine is believed to cause an immune response that allows women to use their bodies to better get rid of the disease.

Dr. Sharad A. Ghamande, Director, Department of Obstetrics and Gynecology Oncology, Georgia Medical College, Georgia, and Dr. Sharad A. Ghamande, Associate Director of Clinical Research, Georgia Cancer Center, Augusta University, said: "When cervical cancer occurs, standard treatment usually fails.

"If we can prevent it from recurring, would it be great?"

Axalimogene Filolisbac, a therapeutic or therapeutic vaccine administered intravenously, primarily utilizes the ability of Listeria to infect cells. In this case, the type of weakening of the bacteria that normally spreads food does not make the patient feel sick, but has the added benefit of further stimulating the immune system's attention and reducing the ability of the tumor to self-defense, Ghamande said.

Once absorbed by antigen-presenting cells, this helps to concentrate the immune system on the invaders, which releases a factor that specifically increases its attention to the oncogenic protein E7, a so-called cancer protein, not only The human papilloma virus is multiplied, and the same is true for cervical cancer cells. E7 is expressed in tumors together with viral protein E6.

Infectious transmission of HPV is the most common cause of cervical cancer. HPV-16 and 18 cause about 70% of cervical cancer worldwide, and the Food and Drug Administration has approved vaccines to prevent infection by both strains. Researcher Ghamande said the FDA needed a new three-stage cervical cancer vaccine study for wider use.

Study participants will receive a vaccine every three weeks for the first three months and then receive the dose every eight weeks until five additional doses are received or until the disease relapses. Two-thirds of patients will be vaccinated and the rest will be placebo. There are approximately 450 participants worldwide who will be tracked for three to five years. Study participants must complete the current standard of care procedures. The most common side effects of a vaccine are fever and other flu-like symptoms.

MCG / AU Health is the only site in the first phase of the trial to test the safety of vaccines and to observe the tumor response in patients with persistent, recurrent and/or metastatic disease. The second phase of the therapeutic vaccine is currently being conducted in other centers in patients with recurrent disease to determine if a 12-month survival can be extended. Early results suggest that the average survival time of these patients can be roughly doubled, Ghamande said.

Ghamande said: "The second phase of the study provides some early evidence that patients with recurrent disease may remain stable for a long time. "For this new trial, we are looking for patients without recurrent disease. The dose in the first phase trial is five to ten times the dose administered in this trial.

The American Cancer Society estimates that approximately 12,900 invasive cervical cancers are diagnosed each year in the United States, with approximately 4,100 women dying of the disease. Classical symptoms include bleeding of unknown origin, such as sexual intercourse or postmenopausal bleeding, as well as vaginal discharge. According to the Centers for Disease Control and Prevention, the average age of diagnosis of HPV-related cervical cancer is 49 years.

Today's frontline treatments include external radiation in the pelvic region and internal radiation through the vaginal region. Adjuvant chemotherapy regimens typically include the widely used cisplatin, which improves the effectiveness of radiation and helps kill cells that have left the main site of radiation. Gamande said that doctors may be able to do a thorough hysterectomy (a complicated procedure), including removing the connective tissue and lymph nodes in the uterus and the pelvis, but retaining the ovaries. This may allow patients to avoid chemotherapy and radiation, which may permanently alter the flexibility and function of the vagina and other organs in the pelvic region, and even induce young women to menopause.

When the cancer recurs, it has almost no treatment options, mainly chemotherapy cocktails, which may extend lifespan for several years, Ghamande said. "When you fail, there is really nothing. This is an orphan disease, which is why immunotherapy is really important," he said.

According to the National Institutes of Health, more than 80% of cervical cancer cases occur in developing countries with fewer screenings. Today, it is still one of the most common cancers affecting American women. Until the mid-20th century, this was the leading cause of death among women of childbearing age in the United States. Pap smear was introduced in the 1950s. According to the NIH, the incidence and mortality of cervical cancer decreased by more than 60% between 1955 and 1992.

"I still see advanced cervical cancer," Ghamande pointed out. In fact, about 60% of patients have not had a Pap smear within five years of cervical cancer diagnosis. “This is not necessarily a problem for individuals living in more rural areas without insurance,” he said. "The patients I have are doctors, pharmacists, and very young people. They believe that they are healthy, but they don't go to the doctor for preventive care."

Ghamande is the exact advocate of Pap smear. He said that it is relatively cheap and accurate. It is one of the "best tests for cancer prevention in the world". You are in a precancerous stage, you can attack and fix it, so it will not Become an invasive cancer, he said that the classic cervical cancer changes discovered by Pap are very slow to develop.

Source: Noble

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