More research

[Guest guest]

One thing leads to another and in researching found some information on

PCR Arrays and recent publications.

RT² ProfilerT PCR Arrays are the most reliable and sensitive gene

expression profiling technology for analyzing a panel of genes in signal

transduction pathways, biological process or disease related gene networks. The

PCR Arrays can be used for research on cancer, immunology, stem cells,

toxicology, biomarker discovery and validation, and phenotypic analysis of cells

and transgenic animals. See the complete list of PCR Arrays.

http://www.sabiosciences.com/howpcrarrayworks.php

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Sprycel Across a series of Phase II and III Trials and recent publications

on treatment responses.

Cancer. 2009 Feb 4;

Khoury HJ, Guilhot F, TP, Kim DW, Cortes JE

Dasatinib is a highly potent Bcr-Abl inhibitor that is approved for the

treatment of imatinib-resistant or -intolerant Chronic myeloid leukemia (CML)

and Philadelphia chromosome-positive acute lymphoblastic leukemia. Across a

series of phase 2 and 3 trials, dasatinib was associated with durable treatment

responses in all phases of the disease and was well tolerated. For this article,

the authors reviewed available information on specific side effects associated

with the use of dasatinib. On the basis of more than 2 years' experience of

dasatinib treatment during clinical trials, they provide practical

recommendations for side-effect management. Cancer 2009. © 2009 American

Cancer Society.

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Eur J Haematol. 2008 Dec 17;

Bianchini M, De Brasi C, Gargallo P, M, Bengió R, Larripa I

Abstract Imatinib mesylate has proven to be the most effective treatment

in Chronic myeloid leukemia. Nevertheless, Imatinib resistance has raised

concern and prompted interest in additional strategies to achieve disease

eradication. Resistance to Imatinib is mainly associated with 3 mechanisms:

acquired mutations in the kinase domain of BCR-ABL protein, genetic

amplification and transcript overexpression of BCR-ABL rearrangement. Therefore

an accurate assessment of resistance mechanism is particularly important to

improve strategies to overcome resistance. In order to determine overexpression

of BCR-ABL, we propose a method that correlates qRT-PCR and FISH data from the

same peripheral blood sample. The ratio between both methodologies permits to

calculate the Expression Index (EI) for each patient. EI estimates the rate of

BCR-ABL transcription per rearrangement. The median EI value, including all

cases (n=123), was 0.288; those cases (n=13) included in percentile 90 showed an

increment of EI above 1 Log (> 2.88) with respect to the median value and were

considered as cases with overexpression. We also evaluated the EIs using ROC

curve; choosing an EI cutoff of 1.836 we obtained a sensitivity of 95% and a

specificity of 61%. Using this EI cutoff value, more patients (n=17) were

included in the overexpression group. Patients within this group were resistant

to Imatinib and also showed a worse overall survival if compared with the

remaining. http://tinyurl.com/cbw7tp

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This is a subject that we have repeatedly discussed about physicians not

following treatment guidelines and better communication.

A recent survey suggests that a notable proportion of physicians do not

follow treatment guidelines and that broader communication is required. Recent

recommendations state that, in patients whose response to imatinib at 400 mg/d

is suboptimal, the dose should be increased, whereas alternative therapies, such

as dasatinib, nilotinib, and allogeneic stem cell transplant (in eligible

patients), and imatinib dose escalation should be considered after imatinib

failure. However, clinical data are lacking to confirm this sequence of

treatments, and introducing alternative therapies at an earlier stage of

treatment, for example, after a suboptimal response, may produce better

long-term outcomes in a higher proportion of patients. Patient and disease

characteristics should be carefully considered to optimize treatment strategy

for CML.

http://tinyurl.com/cbw7tp

Blessings,

Lottie