Approval of the Lymphoseek system for detecting sentinel lymph nodes has been extended to cover all solid-tumor cancers, its manufacturer said Wednesday.

The FDA is also permitting the radiolabeled tracer system to also now be used with or without lymphoscintigraphy, according to Navidea Biopharmaceuticals.

Previously, Lymphoseek had been approved in conjunction with melanomas, breast cancers, and head and neck tumors.

The product uses a technetium-99 labeled tracer to identify lymph nodes serving areas near primary tumors, allowing oncologists to select for excision and analysis those nodes most likely to harbor emigrating cancer cells. The tracer is called tilmanocept, and it binds to CD206 receptors in lymph nodes.

Navidea said the expanded approval was based on data collected in the company’s melanoma, breast cancer, and head-and-neck cancer trials. “An integrated analysis of data from all three studies showed positive diagnostic performance of Lymphoseek across the solid tumor types studied,” the firm said in announcing the new approval.

The FDA has requested a postmarketing study to be performed in pediatric cancer patients, to be completed by 2018, the firm added.

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It’s pretty much standard practice in cancer research to search for genes that could serve as leads for new tumor-fighting drugs. But Cigall Kadoch, a 29-year-old assistant professor of pediatric oncology at the Dana-Farber Cancer Institute (yes, that means she’s already on the tenure track at Harvard) is following a new lead for anti-cancer medicines: exploring the genes that regulate the molecular structure of DNA itself.

Kadoch will be on stage at the Forbes Under 30 Summit on October 21, as part of a panel on the future of medicine, called Tomorrow’s Medicine Today.

A quick review of basic biochemistry: DNA is a molecular ladder in which a code made of molecules called bases (adenine, thymine, cytosine, and guanine or A, T, G, C) create recipes for all of the proteins that make up every part of the body, as well as instructions for when to make them.

But as with a computer’s hard drive, the code isn’t all that matters. The physical structure that reads the code and translates it for the body matter, too.

This DNA-reading structure, called chromatin, is constantly being modified as a way of determining what bits of DNA code get read. And the chromatin remodeling complex, which makes these modifications, is itself controlled by genes written into the DNA.

Kadoch, as a graduate student at Stanford, found that genes related to a chromatin remodeling complex called BAF, were, when mutated, the cause of a rare pediatric cancer: synovial sarcoma, usually found around major joints. Approximately 800 new cases occur in the U.S. each year.

Now, she has a 12-person team in her Boston lab looking for new drugs targeted at BAF, which might help not only kids with synovial sarcoma but also other patients. Kadoch guesses that 25% of cancers might be caused in part by BAF-related mutations. “It’s an amazing thing going from leading your own efforts to leading with a whole group behind you,” she says.

Original Article

Dr Andrew Pendleton makes his rounds. The Pediatric Cancer Specialist at Memorial Health says for these kids, its not just about the medicine, but their attitude.

“The most important thing is hope,” explains Dr Andrew Pendleton. “The 4 letter word hope. All the majority of patients will be cured depending on the type of cancer, but there is always reason for hope.”

Hope, and good medicine, is what helps keep a smile on these youngsters faces. No easy task considering what they are going through. But Pendleton says kids actually make better patients than adults.

“I think its easier for me to work with them because they are pure, they didn’t cause it, whatever we do will be beneficial,” said Dr Pendleton.

“Children do not complain about things,” said Dr Pendleton. “They never lived through life and know what normal life is. To them this is normal life, they adjust, they adapt, they thrive.”

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“People ask me all the time how can you do this Doctor?” explains Pendleton. “How can you not do this? The patients, the children didn’t deserve anything they get. They go through life, not just the steps of life, eating breathing, going through the day. They live life, they play when they feel good they smile, they bring life to us, they bring a joy to us.”

Joy, and a cure. That’s what Dr Pendleton and everyone here want to bring to these families.

“Hope. All the reason to hope. No reason not to hope for a better future,” said Pendleton.

Despite the success rate and growing number of children with cancer, the national funding has been cut almost 30% in the past few years.

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Dr. Charles Roberts has a photograph of Mary Eisnor hanging in his office so he never forgets what he’s fighting for.

Mary, whose family lives in Bridgewater, died in 2010 at the age of 8 of hepatoblastoma, a form of liver cancer.

Roberts, an associate professor in the department of pediatrics at Harvard Medical School and in pediatric oncology at Dana-Farber Cancer Institute, attended Mary’s funeral.

“Every time we lose a patient to cancer it makes us want to go back and work that much harder,” Roberts said.

Roberts spends about 80 percent of his time running a research lab and 20 percent taking care of the kids who stand to benefit from that research.

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But we are only just beginning to understand how the human body works at the genetic level, Roberts said.

“It’s an incredibly complex choreography,” he said.

Roberts compared cancer to typos in a book – only the stakes are much higher.

“The mistakes that happen in genes are causing kids to die,” Roberts said.

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Roberts said childhood cancer research could absolutely benefit from more funding.

Pharmaceutical companies generally don’t focus on childhood cancer because there is not a large return on their investment, he said. That is due to the fact that – fortunately – childhood cancer is relatively rare, Roberts said.

Research companies also tend to be a little reticent to test drugs on children, so drugs tend to be tested on adults first, but the people developing treatment protocols for children are pediatric oncologists familiar with the unique needs of young patients, Roberts said.

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