Cosmetic Surgery in S Korea + 3 New Anti-Cancer Drugs

choi

(1) Calum MacLeod, Medical Tourists Flock to Seoul for New Look; Plastic surgeons help foreign fans mirroer their Korean idols. USA Today, Dec 27, 2011 (title in press)
http://www.usatoday.com/news/wor ... -surgery/52236372/1
("Some 32% of South Korea's medical tourists are from the United States, with China fast rising in second place. A quarter of the U.S. figures include troops stationed in South Korea. Korean Americans and other Asian Americans are the main US target customers * * * Costs * * * are about two-thirds the prices in the United States")

(2) Andrew Pollack, A Push to Tie New Drugs to Testing; Aiming to help only the patients most likely to benefit, and to save on costs. New York Times, Dec 27, 2011.
http://www.nytimes.com/2011/12/2 ... g%20test&st=cse

Quote:

ChemGenex's "drug to treat a subset of leukemia patients whose tumors had a particular genetic mutation.

"One of the drugs, Pfizer’s Xalkori for lung cancer, works wonders — but only for the roughly 5 percent of patients whose tumors have a particular chromosomal abnormality, as determined by a test from Abbott Laboratories.

"The other drug, Zelboraf, from Roche and Plexxikon, can also produce remarkable improvements, but only for the roughly half of melanoma patients whose tumors have a particular mutation.

"But the simultaneous approval of new drugs and tests is still rare. Before August, the only other dual approval was of Genentech’s breast cancer drug Herceptin and Dako’s test for the related HER2 protein in 1998.

My comment:
(a) The report, which there is no need to read, names three new anti-cancer drugs that target specific mutations that cause the cancers.
(i) omacetaxine from ChemGenex is an alkaloid from a plant Cephalotaxus harringtonia, a Japanese yew. Because FDA has not approved it, there is no need to know more. Indeed, at the moment information about it is scant.

(ii) ALK (standing for anaplastic lymphoma kinase), on the cell membrane, normally binds to its ligand and stimulate cellular proliferation. A tiny portion of patients with lung cancer has a gene arrangement (translocation), where part of the ALK gene (on chromosome 2) exchange with part of EML4 (acronym for Echinoderm Microtubule associated protein Like 4; also on chromosome 2), creating EML4-ALK fusion gene (and thus protein), which will cause cellular proliferation in the absence of a ligand.

anaplastic lymphoma kinase
http://en.wikipedia.org/wiki/Anaplastic_lymphoma_kinase
("The EML4-ALK fusion gene is responsible for approximately 3-5% of non-small-cell lung cancer(NSCLC). The vast majority of cases are adenocarcinomas.")

Xalkori, for healthcare professional. Pfizer, undated.
http://www.pfizerpro.com/hcp/xal ... ce=XALKOWE080111001
("XALKORI is a kinase inhibitor indicated for the treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) that is anaplastic lymphoma kinase (ALK)-positive as detected by an FDA-approved test. This indication is based on response rate. There are no data available demonstrating improvement in patient reported outcomes or survival with XALKORI.")

(iii) Zelboraf inhibits B-raf, a protein kinase in the cytoplasm, NOT on the cell membrane. The drug works only in patients with a point mutation (V600E) in B-raf, where, in the 600th amino acid of the protein, the normal valine (shorthand: V) is replaced by glutamic acid (shorthand: E).

(b) The report also mentions an older drug that proves effective for certain types of breast cancer.

Herceptin (trade name: Trastuzumab) is a monoclonal antibody that binds specifically to, and thus interferes with, HER2 (acronym for Human Epidermal growth factor Receptor 2), one of a couple of receptors to human epidermal growth factor (EGF). Normally EGF binds to one of its receptor on the cell surface and stimulate mitogenesis of the particular cell. In some breast cancers, HER2 are overexpressed, driving growth of the cancer cells. Herceptin will not cure but elongate life of those patients by a handful of months.

Treatment With Herceptin. Genentech, undated.
http://www.herceptin.com/hcp/treatment/
("HER2 Testing[:]  Detection of HER2 protein overexpression is necessary for selection of patients appropriate for Herceptin therapy because these are the only patients studied and for whom benefit has been shown. Due to differences in tumor histopathology, use FDA-approved tests for the specific tumor type (breast or gastric/gastroesophageal adenocarcinoma) to assess HER2 overexpression and HER2 gene amplification. Tests should be performed by laboratories with demonstrated proficiency in the specific technology being utilized")

(c) In (a)(ii), (iii) and (b), the three proteins are called kinase, because they promote (like an enzyme) addition of a phosphate ion to its target/substrate proteins, activating the latter.