Nivolumab and Ipilimumab: Latest Significant Advance In Melanoma Therapy?

Hailed as the most significant advance in melanoma treatment of the past 50 years, will nivolumab and ipilimumab proved to be the proverbial “magic bullet” in the treatment of melanoma?

By: Ringo Bones 

Hailed as the significant advance for medical in science in the treatment of melanoma of the past 50 years when the results of the medical trials were first published in The New England Journal Of Medicine back in June 1, 2015, the recent trials for chemotherapy drugs nivolumab and ipilimumab as a two-drug therapy on the treatment of melanoma showed really promising results. The medical trials were described as promising because the recent results of the medical trials have shown that the two chemotherapy drugs have shown to prevent melanoma metastasis to the liver and lungs. Also, the two-drug therapy enables our body’s own immune system to better destroy the malignant tumor cells themselves and the two drugs prevent tumors from avoiding the body’s immune response and the two drugs also trains our own body’s immune system to better identify and destroy cancer cells. 

Nivolumab is a programmed death 1 [PD-1] checkpoint inhibitor while ipilimubab is a cytotoxic T-lymphocyte-associated antigen 4 [CTLA-4] checkpoint inhibitor; both of the chemotherapy agents have shown to have complementary activity in metastatic melanoma. In this randomized, double-blind, phase 3 study, nivulomab alone or nivolumab plus ipilimubab was compared with ipilimubab alone in patients with metastatic melanoma. 

The trials were assigned in a 1:1:1 ratio, 945 previously untreated patients with unresectable stage III or stage IV melanoma to nivolumab alone, nivolumab plus ipilimumab, or ipilimumab alone. Tumors in 58 percent of the cases were stopped using the new treatment. Among previously untreated patients with metastatic melanoma, nivolumab alone or combined with ipilimumab resulted in significantly longer progression-free survival than ipilimumab alone. In patients with PD-L1-negative tumors, the combination of PD-1 and CTLA-4 blockade was more effective than either agent alone. 

Boron: The Least Glamorous Health Supplement?

Better known as a composite structural material in 1990s era high-end tennis racquets and phonograph cartridge cantilevers, is the element boron the least glamorous of all the health supplements?

By: Ringo Bones

Does anyone even remember when was the last time his or her general practitioner / doctor / or the online shopping health supplement promoter recommended hat he or she should be taking boron pills? To the not-so-well-informed, the name of the chemical element boron is derived from borax and carbon. The element was discovered back in 1808 by Joseph Louis Gay-Lussac and Louis Jacques Thénard. Chemical symbol B, boron is a semi-metallic chemical element and is a member of the aluminum family which also includes aluminum, gallium, indium and thallium. Even though it is exploited by 1950s era Madison Avenue “Mad Men” to make adverts for boron gasoline that is based on the “futuristic” jet fuel of the XB-70 Valkyrie. It seems that the general public’s perception of boron has faded into relative obscurity by the 21^st Century.

From the high-school chemistry textbook’s perspective, boron is best known as a constituent in borax (sodium borate) and in boric acid – the one acid that is good for the eyes - though the benefits of regular use of boric acid eye-drops have yet to be exploited by health supplement manufacturers. About a million tons of boron is used in the U.S. industry each year. In agriculture, boron serves both as a plant food and weed killer.

It may be one of the least glamorous and most esoteric of the health supplements but boron could actually help reduce the risk of prostate cancer. In the first epidemiologic study of this trace element, researchers have recently found out that men who consume the most boron – a “mere” 1.8 micrograms a day – have a 62 percent lower chance of developing prostate cancer, compared with those who get half that amount. But which everyday foods are rich source of the chemical element boron? Recent studies have shown that nuts, wine and fruits and vegetables like grapes, prunes and avocado contain significant amounts of boron of high bioavailability.       

Are Rapid HIV-1 Antibody Tests Prone To Inaccuracies?

Even though over-the-counter kits had been available for sometime now, are rapid HIV-1 antibody tests still “prone to inaccuracy problems”?

By: Ringo Bones

Even before it’s over-the counter kit counterparts were granted approval, rapid HIV-1 antibody tests had been providing “point of care” results that made the need of laboratory facilities unnecessary, but researchers in Uganda have found out some time ago that such tests could result in “possible misrepresentation of results”. R.H. Gray and his team had noticed in practice of the limitations of rapid HIV-1 antibody tests during screening for trials in Uganda diagnostic test accuracy study that was published in the British Medical Journal back in 2007.   

A total of 1,517 males aged 15 to 49 years of age were screened for trials of circumcision to prevent HIV infection. They used an algorithm with three different rapid tests – i.e. first test negative – HIV-negative diagnosis; first and second test positive – HIV positive; first test positive, second test negative – diagnosis based on result of third test. These diagnoses were compared with diagnoses based on enzyme immunoassay and western blotting.

The sensitivity of the rapid tests for a diagnosis of HIV infections was 98-percent. The strength of any positive bands was coded for 639 samples. Among these samples, 125 tested positive and 37 of these were weak-positive. In this subgroup of 639 samples, the specificity was only 94-percent and the positive predictive value of 74-percent (26-percent false-positives). Among the 37 samples that were weakly positive, 86-percent were HIV-negative on laboratory testing and 8-percent gave indeterminate results on western blotting. When the 37 weak-positives were excluded, specificity was almost 100-percent, as in 99.6-percent, and the positive predictive value was 98-percent. Given the “convoluted statistics”, weak-positive bands on rapid tests should be confirmed by enzyme immunoassay and western blotting. Standard serological assays should be used for quality control in all programmes using rapid HIV-1 antibody tests.

Loose Baby Teeth: A Good Source of Stem Cells?

Maybe the “Tooth Fairy” has been to busy in telling medical researchers, but are loose baby teeth a good source of pluripotent stem cells?

By: Ringo Bones

It might spell good news to conservative right-wingers in America who are the most vocal critic of stem-cell research citing the moral implications of destroying human embryos for medical research after it was found out that loose baby teeth could be a good source of pluripotent stem cells. Should healthcare providers start offering to cryogenically store loose baby teeth in addition to umbilical cord blood for future medical use?

Songtai Shi – a dentist and a medical researcher at the National Institutes of Health – experimented with his then –year-old daughter Julia’s loose baby tooth 12 years ago after noticing a little piece of red pulp was still attached. This gave Shi the idea to try to culture the cells of the loose baby tooth’s pulp to check for potential to produce stem cells. Back at the lab, he extracted the pulp and found out that it contained a number of stem cells – those special progenitor cells that can be used to replenish various types of tissue.

Unlike stem cells found in human embryos, which can become anything from skin to nerves to muscles, the stem cells in baby teeth seem to transform themselves only to into bone, nerve and fat cells, limiting their usefulness. They do, however, grow more quickly than in stem cells found in full-grown adults. Given current research results, It may be too early yet to suggest that families should start saving their young children’s baby teeth in an organ bank for future stem cell therapeutic use but given that baby teeth sourced stem cells doesn’t involve the destruction of human embryos – future research and therapeutic use could use religious conservatives’ criticisms on stem cell research and therapy might be put a ease. 

Can Early Childhood Peanut Exposure Prevent Peanut Allergies?

Even though the idea is somewhat counter-intuitive, but does exposing your infants to peanuts really prevent them from acquiring peanut allergies later in life? 

By: Ringo Bones 

A recent study conducted in the UK involving 628 participating infants shows that infants introduced to eating peanuts cuts incidences of peanut allergies later in life. It may seem counter-intuitive but the study shows that early childhood exposure to peanuts by introducing peanuts into their diet cuts peanut allergies a few years later. 

The King’s College London researchers said it was the “first time” that allergy development had been reduced. Trials on 628 babies prone to developing peanut allergy found the risk was cut by over 80 percent. Specialists said that the findings could be applied to other allergies and may change diets around the world, but warned parents not to experiment at home without medical supervision. 

The research team in London had previously found that Jewish children in Israel who started eating peanuts earlier in life had allergy levels 10 times lower than Jewish children in the UK. The trial reported in the New England Journal of Medicine, focused on babies as young as four months who had already developed eczema – an early warning sign of allergies. Skin prick tests were used to identify these who had not yet developed peanut allergy or had only a very mild response. 

Children under five should not eat whole peanuts without parental supervision because of an increased risk of choking, so half were given a peanut based snack. The other half continued avoiding peanuts. The trial indicated that for every 100 children, 14 would normally go on to develop an allergy by the age of five. But this fell by 86 percent to just 2 out of every 100 children with the therapy. Even children who were already becoming sensitive to peanuts benefited. Their allergy rates fell from 35 percent to 11 percent. 

Lead researcher Prof. Gideon Lack told the BBC: “(It was) exciting to us to realize in the first time that in allergy, we can actually truly prevent the development of the disease. It represents a real shift in culture.” Prof. Lack also said that high-risk children “need to be evaluated, have skin-prick testing and dietary advice (before), in most cases, early introduction of peanut.” Until 2008, at risk families were told to actively avoid peanut products and other sources of allergic reactions, looks like early childhood exposure therapy really does represent a paradigm shift in the culture of peanut allergy treatment.  

Gene RADAR: Instant Medical Diagnosis For The Masses?

Even though it still awaits a substantial venture capital investment for mass implementation, is Dr. Anita Goel’s Gene RADAR the future of instant medical diagnosis for the world’s poor?

By: Ringo Bones

Even though her invention is a 500,000 US dollar XPRIZE Foundation Challenge winner, Dr. Anita Goel’s Gene RADAR still awaits substantial venture capital investment for it to begin benefitting the medical diagnostic cost burden to those over a billion people around the world who earns less than 2 US dollars a day. Current reliable medical diagnostic tests to find out if whether someone has HIV / AIDS, the dreaded Ebola virus or just your garden variety flu used to take about a month for results, while the upcoming Gene RADAR was recently demonstrated to accurately do the same feat within an hour using just a drop of blood from the patient.

Dr. Anita Goel received a Ph.D. in physics from Harvard University and is globally recognized for her pioneering research in nano-biophysics particularly for the study of molecular mechanisms behind the reading and writing information in DNA.  Currently the chairwoman and CEO of Nanobiosym Diagnostics, the Harvard-M.I.T. trained physicist and physician now eagerly awaits for substantial venture capitalist investment to make her Gene RADAR a commercially viable product that could benefit patients who earn less than 2 US dollars a day.

The nanotechnology platform based Gene RADAR developed by Nanobiosym Diagnostics is the first medical diagnostic tool of its kind that is not only as accurate and reliable as existing medical diagnostic lab equipment used in testing HIV / AIDS, Ebola and the flu, but can also produce reliable results within an hour at a fraction of the costs of current similar medical diagnostic tools. When deployed in Ebola hot-spots in the near future, Gene RADAR could make the 2014 West African Ebola Pandemic a thing of the past. 

Can Robots Help Stop The Spread Of The Ebola Virus?

Even though the worse is over but global health policymakers warn the dangers of a reemergence, can robots help health workers stop the spread of the dreaded Ebola virus? 

By: Ringo Bones 

As of late, epidemiologists recently found out that the Ebola virus strains that affected Liberia and neighboring countries in Africa had somehow mutated. Given that by only stopping the further spread of the dreaded Ebola virus is the only viable way to prevent it from further mutating, would robots in conjunction with health workers help stop the spread of the Ebola virus? 

Back in November 2014, three leading U.S. robotics universities and the White House got into a meeting to discuss if they can design a new batch of robots that could lessen the risks of health workers’ exposure to the Ebola virus. One idea presented by Worchester Polytechnic Institute (WPI) in Massachusetts is to avoid designing new robots from scratch because it involves a huge investment in time and money that governments around the world in search of ways to control the spread of the dreaded Ebola virus cannot currently afford. Rather, WPI says existing robots should be repurposed on Ebola specific tasks. The other universities involved in the discussion are Texas A&M and the University of California, Berkeley.   

One of the robots WPI has begun repurposing into an Ebola virus decontaminating robot is the AERO or Autonomous Exploration Rover. It was originally designed for space exploration but is now being converted to help with decontamination work by adding decontamination sprayer tanks and sprayers to its body. The idea is that a health worker will be situated safely outside an Ebola virus contaminated area and would control most of the hazardous decontamination work remotely. “We’re trying to pull the workers further away from the disease,” says Velin Dimitrov, a robotics engineer and Ph.D. candidate. “Ebola doesn’t (yet?) spread through the air, so if you can tele-operate a robot from just outside, it reduces the risk to workers”. WPI’s team hopes to deploy AERO in conjunction with other Ebola virus decontamination robots like the Baxter automotive assembly robot now repurposed as an Ebola virus decontamination robot and scores of former bomb disposal robots that are formerly used to disarm IEDs in Iraq to help with the decontamination efforts in West Africa.