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- ACMG’s Genetics in Medicine Journal Receives Impact Factor of 8.904 for 2019–Journal is Ranked 13th of 177 Journals in Genetics & Heredity -…
- Researchers Discover Genetic Variants Linked to Type 2 Diabetes – HealthITAnalytics.com
- Illumina Intros Genomic Analysis Workflow Software to Speed Diagnosis of Genetic Conditions – Clinical OMICs News
- Could induced pluripotent stem cells be the breakthrough genetics has been waiting for? – The New Economy
- Edgewise Therapeutics Appoints Abby H. Bronson, M.B.A., as Vice President, Patient Advocacy and External Innovation – Business Wire
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Category Archives: Gene Medicine
Hansa Biopharma announces exclusive agreement with Sarepta Therapeutics to develop and promote imlifidase as pre-treatment ahead of gene therapy in se…
Hansa grants Sarepta exclusive license to develop and promote imlifidase as a potential pre-treatment prior to the administration of gene therapy in Duchenne muscular dystrophy and Limb-girdle muscular dystrophy, for patients with neutralizing antibodies (NAbs) to adeno-associated virus (AAV).
Under the terms of the license: Hansa will receive a USD 10 million upfront payment and is eligible for up to USD 397.5 million in development, regulatory and sales milestone payments. Hansa will book all sales of imlifidase and would be eligible for royalties in the high single-digits to mid-teens on any gene therapy sales enabled through pre-treatment with imlifidase in NAb-positive patients.
Lund, Sweden July 2, 2020. Hansa Biopharma (Hansa), the leader in immunomodulatory enzyme technology for rare IgG mediated diseases, announced today that it has entered into an agreement with Sarepta Therapeutics Inc. (Sarepta), the leader in precision genetic medicine for rare diseases, through which Sarepta is granted an exclusive, worldwide license to develop and promote imlifidase as a pre-treatment to enable Sarepta gene therapy treatment in Duchenne muscular dystrophy (DMD) and Limb-girdle muscular dystrophy (LGMD). The pre-treatment is intended for patients with pre-existing neutralizing antibodies (NAb-positive patients) to adeno-associated virus (AAV), the technology that is the basis for Sareptas gene therapy products.
Sarepta will be responsible for conducting pre-clinical and clinical studies with imlifidase and any subsequent regulatory approvals. Sarepta will also be responsible for the promotion of imlifidase as a pre-treatment to Sareptas gene therapies following potential approval.
Under the terms of the agreement, Hansa will receive a USD 10 million upfront payment, and is eligible for a total of up to USD 397.5 million in development, regulatory and sales milestone payments. Hansa will book all sales of imlifidase, and earn high single-digit to mid-teens royalties on Sareptas incremental gene therapy sales when treating NAb-positive patients enabled through pre-treatment with imlifidase.
Sren Tulstrup, President & CEO of Hansa Biopharma comments,We see significant potential for our enzyme technology in the gene therapy space overall, and we are excited to partner with Sarepta, a leading player in the field, to use the unique features of imlifidase to potentially enable gene therapy treatment in patients who today arent eligible for these breakthrough therapies due to pre-existing neutralizing antibodies in two conditionswith a very high unmet medical need.
Doug Ingram, President & CEO, Sarepta Therapeutics said,As we expand our leadership position in genetic medicine and build out our gene therapy engine, one of Sareptas central ambitions is to find scientific solutions that bring our potentially life-saving therapies to the greatest number of the rare disease patients we serve. One of the current limitations of gene therapy is the inability to treat patients who have pre-existing neutralizing antibodies to the AAV vector. While our AAVrh74 vector has been associated with a low screen out rate for neutralizing antibodies, even that low rate is inconsistent with our mission.
In pre-clinical and clinical models, Hansas technology has shown the ability to clear the IgG antibodies that prevent dosing AAV-based gene therapies. If successful, this could offer the potential of extending our gene therapy treatments to DMD and LGMD patients who would otherwise have been denied access due to pre-existing antibodies.
Hansa Biopharma will be hosting a conference call with President & CEO Sren Tulstrup, CSO & COO Christian Kjellman and CFO Donato Spota.
Conference Call Partnership agreement with Sarepta TherapeuticsA conference call will take place July 2nd, 2020 at 10:00am CET. The audio cast will be recorded and subsequently be available on the Hansa website https://hansa.eventcdn.net/202007
Participants dial-in numbersSE: + 46 81 241 09 52UK: + 44 203 769 6819US: + 1 646 787 0157
This is information that HansaBiopharma AB is obliged to makepublic pursuant to the EU MarketAbuse Regulation.
About imlifidaseImlifidase is a unique antibody-cleaving enzyme originating from Streptococcus pyogenes that specifically targets IgG and inhibits IgG-mediated immune response. It has a rapid onset of action, cleaving IgG-antibodies and inhibiting their activity within hours after administration. CHMP/EMA has adopted a positive opinion, recommending conditional approval of imlifidase for the desensitization treatment of highly sensitized adult kidney transplant patients with a positive crossmatch against an available deceased donor. Endorsement of the positive opinion by the European Commission is expected in the third quarter of 2020.Hansa has also reached an agreement with the FDA on a regulatory path forward for imlifidase in kidney transplantation of highly sensitized patients in the U.S. and has three ongoing phase 2 trials in autoimmune diseases and post-transplant indications.
About gene therapy and neutralizing antibodiesGene therapy is a growing and revolutionizing treatment technology in which healthy gene sequences are inserted into cells of a patient. The treatments are potentially curative in monogenic diseases like hemophilia and muscular dystrophy through a single dose. Harmless recombinant viruses are used to carry the healthy genes into the cell. Due to the partial viral origin of the gene therapy constructs, a certain subset of patients carry neutralizing anti-AAV antibodies towards gene therapy products, depending on what AAV serotype being used, forming a barrier for treatment eligibility.Antibodies prevent effective transfer of healthy gene sequence and can be a safety concern. Imlifidase as a pre-treatment may have the potential to eliminate neutralizing antibodies prior to gene therapy. Similarly, imlifidase may have the potential to enable any potentially necessary re-dosing of gene therapy for all patients.
About Duchenne Muscular Dystrophy (DMD)Duchenne muscular dystrophy is a rare genetic disease caused by mutation in the DMD gene, encoding for the protein dystrophin. Duchenne is an irreversible, progressive disease that causes the muscles in the body to become weak and damaged over time. It is eventually fatal and there is no cure. DMD affects one in 3,500 to 5,000 males born worldwide (approximately 400-500 annual cases in the US) and causes muscles in the body to become weak and most patients use wheelchair by the age of 12.
About Limb-Girdle Muscular Dystrophy (LGMD)Limb-girdle muscular dystrophy or (LGMD) is a genetically and clinically heterogeneous group of rare muscular dystrophies. It is characterised by progressive muscle wasting which affects predominantly hip and shoulder muscles. LGMD has an autosomal pattern of inheritance and currently has no known cure or treatment. It can be caused by a single gene defect that affects specific proteins within the muscle cell, including those responsible for keeping the muscle membrane intact. LGMD has a global prevalence of approximately 1.63 per 100,000 individuals worldwide.
For further information, please contact:Klaus Sindahl, Head of Investor RelationsHansa Biopharma Mobile: +46 (0) 709-298 269E-mail: firstname.lastname@example.org
About Hansa BiopharmaHansa Biopharma is leveraging its proprietary immunomodulatory enzyme technology platform to develop treatments for rare immunoglobulin G (IgG)-mediated autoimmune conditions, transplant rejection and cancer.The Companys lead product candidate, imlifidase, is a unique antibody-cleaving enzyme that potentially may enable kidney transplantation in highly sensitized patients with potential for further development in other solid organ transplantation and acute autoimmune indications. CHMP/EMA has adopted a positive opinion, recommending conditional approval of imlifidase for the desensitization treatment of highly sensitized adult kidney transplant patients with a positive crossmatch against an available deceased donor. Endorsement of the positive opinion by the European Commission is expected in the third quarter of 2020. Hansas research and development program is advancing the next generation of the Companys technology to develop novel IgG-cleaving enzymes with lower immunogenicity, suitable for repeat dosing in relapsing autoimmune diseases and oncology.Hansa Biopharma is based in Lund, Sweden and also has operations in Europe and US.
AVROBIO: On Monday, clinical-stage gene therapy company AVROBIO, headquartered in Massachusetts, announced the appointment of Kim Raineri as chief manufacturing and technology officer.
I am thrilled to join AVROBIO, a leader in lentiviral gene therapy and a true pioneer in driving manufacturing advances that address the gene therapy fields need for faster, more scalable and more automated production, Raineri said. The AVROBIO team has created a state-of-the-art gene therapy platform and is clearly committed to continuous innovation on behalf of the patient communities they strive to serve. I am excited to contribute to that work.
Raineri will be replacing AVROBIO co-founder Kim Warren in the position, who will be retiring at the end of July. Before joining AVROBIO, Raineri served as the vice president of operations for Nikon CeLL Innovation Co.
Scenic Biotech: On Wednesday, Netherlands-based Scenic Biotech announced the appointment of their new chief executive officer. Newly appointed CEO Oscar Izeboud brings more than 20 years of life sciences and finance industry experience.
Prior to joining Scenic, Izeboud served as managing director at NIBC Bank in Amsterdam, where he led its corporate finance and capital markets team with a focus on innovation and growth companies.
Former acting CEO and scientific co-founder Sebastian Nijman takes on the role of chief scientific officer.
Akari Therapeutics: Biopharmaceutical company Akari Therapeutics on Wednesday announced the appointment of Torsten Hombeck as chief financial officer and a member of the company's executive team.
Torsten brings a deep understanding of financial strategy, the capital markets and business development to Akari. We are delighted to have him as a permanent member of Akaris executive leadership team," said Clive Richardson, Chief Executive Officer of Akari Therapeutics. "His appointment comes at a time of significant company opportunity and growth. His business and financial expertise will be instrumental in helping us to further develop the Company."
Hormbeck joins Akari with over 20 years of biopharmaceutical industry experience in financial and strategic planning.
Sarepta Therapeutics: Earlier this week, Cambridge-based Sarepta Therapeutics announced the retirement of Sandy Mahatme, the company's executive vice president, chief financial officer and chief business officer. Mahatme will be leaving the company effective July 10.
The Sarepta from which Sandy retires is a very different one from the organization he joined as our chief financial officer some eight years ago. And the Sarepta of today a financially solid biotechnology organization with perhaps the industrys deepest and most valuable pipeline of genetic medicine candidates with the potential to extend and improve lives would not have been possible without Sandys business acumen and dedication, said Doug Ingram, president and chief executive officer of Sarepta Therapeutics.
Sarepta has launched a search to identify the future chief financial officer.
BioMarin: On June 29, BioMarin, a global biotechnology company, announced a pair of promotions. Brian Mueller was promoted to executive vice president, chief financial officer and Andrea Acosta was promoted to group vice president, chief accounting officer.
Mueller has been with BioMarin since 2002, during which he has taken on roles of increasing responsibility. Acosta has been with BioMarin since 2017 as vice president, corporate controller.
Theravance Biopharma: Dublin-based Theravance Biopharma on Thursday announced the appointment of Deepika Pakianathan to its Board of Directors. Pakianathan serves as a managing member at Delphi Ventures, a venture capital firm focused on biotechnology and medical device investments.
"We are honored to welcome Dr. Pakianathan to our board of directors," said Rick Winningham, chief executive officer of Theravance. "We believe her vast experience in the biotechnology sector, translating breakthrough science and taking important therapies from pipeline to patients, will further enhance our already talented Board of Directors."
Novavax: On Thursday, Maryland-based Novavax announced the appointment of Frank Czworka as senior vice president, global sales. Czworka will be responsible for leading sales planning and distribution for the company. He brings more than 20 years of biopharmaceutical experience to the company, with his most recent experience being as vice president, global customer enngagement at U.S. Pharmacopeia.
Novavax also announced the promotion of Brian Webb to senior vice president, manufacturing. Webb will be responsible for overseeing antigen manufacturing and supply activities in support of the company's vaccine candidates. Webb has been with Novavax since May 2014.
eGenesis: On Wednesday, Massachusetts-based eGenesis announced that it appointed Peter Hanson as chief operating officer. Hanson will be in charge directing eGenesis' day-to-day organizational and operational activities including production and manufacturing.
Peter is a highly experienced biopharmaceutical executive across multiple disciplines, which will be critical to support our next phase of growth as we integrate production and R&D, said Paul Sekhri, President and Chief Executive Officer of eGenesis. Peters operational leadership and veterinary knowledge will help us accelerate our product development as we move closer to IND filing for human clinical studies. We are very grateful for Kenneth Fans many contributions as our founding COO. I am delighted that he will continue to serve as an advisor to the company.
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Movers & Shakers, July 3 | BioSpace - BioSpace
There was a time when modern medicine was primitive. There were no antibiotics, so every infection took its own course, leading to decline in health. Hypertension and diabetes were largely untreatable. X-ray was new, and remedies had changed but little from medieval times. No one ever embarked on the goodness of preventative treatment, not to speak of predictive medicine, beyond taking a distasteful cod liver oil capsule.
During the last hundred years, modern medicine has undergone a sea change. Just think of it an ever-expanding repertoire of medicines, high-tech procedures, therapies and reams of clinical data to employ when one gets sick. Yet modern medicine remained (in)complete, notwithstanding the therapeutic advances.
Things are now changing thanks to the integration of all such advances, from how a persons diet interacts with ones unique genetic profile to how environmental pollutants affect our thinking, not to speak of preventative medical approaches in health and wellness. The bigperestroikahas begun, and it is poised to transform health care for a growing number of people in the near future. Welcome to a whole new world of personalized, bespoke medicine.
Personalized medicine is, in essence, tailored or customized medical treatment. It treats while keeping in mind the unique, individual characteristics of each patient, which are as distinct as ones fingerprint or signature. It also includes scientific breakthroughs in our understanding of how a persons unique molecular and genetic profile makes them susceptible to certain illnesses. Personalized medicine expands our ability to envisage medical treatments that would not only be effective but also safe for each patient while excluding treatments that may not provide useful objectives.
Personalized medicine is, in simple terms, the use of new methods of molecular scrutiny. It is keyed to help better manage a patients illness or their genetic tendency toward a particular illness or a group of diseases. In so doing, it aims to achieve optimal therapeutic outcomes by helping both clinicians and patients choose a disease management approach that is likely to work best in the context of the patients unique genetic and environmental summary. In other words, it allows to accurately diagnose diseases and their sub-types while prescribing the best form and dose of medication most suited to the given patient.
Personalized, or precision, medicine is not rocket science it is, in essence, an extension of certain traditional approaches to understanding and treating disease. What jazzed up the therapeutic fulcrum of personalized medicine are tools that are more precise. This is what also offers clinicians better insights for selecting a treatment protocol based on a patients molecular profile. Such a patient-specific methodology, as has been practiced for long in certain complementary and alternative medical (CAM) or integrative approaches, not only curtails harmful side effects but also leads to more successful outcomes, including reduced costs in comparison to the current trial-and-error approach to treatment, which has distressingly come to the fore during these extraordinary and unprecedented times of COVID-19.
It is still early days, but the fact remains that personalized medicine has changed the old ways of how we all thought about, identified and managed health issues. As personalized medicine increasingly bids fair to an exciting journey in terms of clinical research and patient care, its impact will only further expand our understanding of medical technology.
What personalized medicine has done is bring about a paradigm shift in our thinking about people in general and also specifically. We all vary from one another what we eat, what others eat, how we react to stress or experience health issues when exposed to environmental factors. It is agreed that such variations play a role in health and disease. It is also being incrementally accepted that certain natural variations found in our DNA can influence our risk of developing a certain disease and how well we could respond to a particular medicine.
All of us are unique individuals, perhaps with the exemption of identical twins, albeit the genomes are unique in them, too. While we are genetically similar, there are small differences in our DNA that are unique, which also makes us distinctive in terms of health, disease and our response to certain medicinal treatments.
Personalized medicine is poised to tap natural variations found in our genes that may play a role in our risk of getting or not getting certain illnesses, along with numerous external factors, such as our environment, nutrition and exercise. Variations in DNA can, likewise, lead to differences in how medications are absorbed, metabolized and used by the body. The understanding of such genetic variations and their interactions with environmental factors are elements that will help personalized medicine clinicians to produce better diagnostics and drugs, and select much better treatments and dosages based on individual needs not as just fixing a pill or two, as is the present-day conventional medical practice.
It is established that a majority of genes function precisely as intended. This gives rise to proteins that play a significant role in biological processes while allowing or helping an individual to grow, adapt and live in their environment. It is only in certain unusual situations, such as a single mutated or malfunctioning gene, that our apple cart is disturbed. This leads to distinct genetic diseases or syndromes such as sickle cell anemia and cystic fibrosis. In like manner, multiple genes acting together can impact the development of a host of common and complex diseases, including our response to medications used to treat them.
New advances will revolutionize bespoke medical treatment with the inclusion of drug therapy as well as recommendations for lifestyle changes to manage, delay the onset of disease or reduce its impact. Not surprisingly, the emergence of new diagnostic and prognostic tools has already raised our ability to predict likely outcomes of drug therapy. In like manner, the expanded use of biomarkers biological molecules that are associated with a particular disease state has resulted in more focused and targeted drug development.
Molecular testing is being expansively used today to identify breast cancer and colon cancer patients who are likely to benefit from new treatments and to preempt recurrences. A genetic test for an inherited heart condition is helping clinicians to determine which course of treatment would maximize benefit and minimize serious side effects while bringing about curative outcomes.
Such complexities exist for asthma and other disorders too. This is precisely where molecular analysis of biomarkers can help us to identify sub-types within a disease while enabling the clinician to monitor their progression, select appropriate medication, measure treatment outcomes and patients response. Future advances may make biomarkers and other tools affordable and allow clinicians to screen patients for relevant molecular variations prior to prescribing a particular medication.
It is already clear that personalized medicine promises three strategic benefits. In terms of preventative medicine, personalized medicine will improve the ability to identify which individuals are predisposed to develop a particular condition. A better understanding of genetic variations could also help scientists identify new disease subgroups or their associated molecular pathways and design drugs to target them. This could also help select patients for inclusion, or exclusion, in late-stage clinical trials. Finally, it will allow to work out the best dosage schedule or combination of drugs for each individual patient.
Yet not everything is hunky-dory for personalized medicine. Critics of precision medicine believe that the whole idea is too much of overhyped razzmatazz, among other things. Proponents, however, argue that when it comes to managing our own health, most of us are used to the idea of taking a one-size-fits-all approach be it medicines, supplements, diets and diagnoses. This may be wrong.
What works, as they put it, for one may be a gaffe for another. As the award-winning oncologist and medical technology innovator, Dr. David B. Agus, author of the groundbreaking bookThe End of Illness, puts it, each patients individual risk factors are based on ones DNA, the environment and a preventative lifestyle plan in response. He begins with simple, profound pointers: How is your sense of smell? and Is your ring finger longer than your middle finger? He explains with statistics-backed guidelines that moving and walking regularly is mandatory because exercising and then sitting is equivalent to smoking cigarettes, while eating and sleeping at consistent hours is imperative because irregularity causes inflammation.
The inference is obvious: We should all understand our physiology and quiz doctors with the thorough, exploratory frame of mind of a gadget buyer. This holds the key to making medicine truly personal, more humane, effective and safe while keeping in mind the individual in us all as unique and distinctive, the sum of the whole not just the parts.
The views expressed in this article are the authors own and do not necessarily reflect Fair Observers editorial policy.
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The Future of Medicine Is Bespoke - Fair Observer
Research on Gene Editing Service Market (impact of COVID-19) with Top Players: Caribou Biosciences, CRISPR Therapeutics, Merck KGaA, Editas Medicine,…
Global Gene Editing ServiceMarket: Trends Estimates High Demand by 2027
The Gene Editing ServiceMarket 2020 report includes the market strategy, market orientation, expert opinion and knowledgeable information. The Gene Editing ServiceIndustry Report is an in-depth study analyzing the current state of the Gene Editing ServiceMarket. It provides a brief overview of the market focusing on definitions, classifications, product specifications, manufacturing processes, cost structures, market segmentation, end-use applications and industry chain analysis. The study on Gene Editing ServiceMarket provides analysis of market covering the industry trends, recent developments in the market and competitive landscape.
It takes into account the CAGR, value, volume, revenue, production, consumption, sales, manufacturing cost, prices, and other key factors related to the global Gene Editing Servicemarket. All findings and data on the global Gene Editing Servicemarket provided in the report are calculated, gathered, and verified using advanced and reliable primary and secondary research sources. The regional analysis offered in the report will help you to identify key opportunities of the global Gene Editing Servicemarket available in different regions and countries.
The final report will add the analysis of the Impact of Covid-19 in this report Gene Editing Serviceindustry.
Some of The Companies Competing in The Gene Editing ServiceMarket are: Caribou Biosciences, CRISPR Therapeutics, Merck KGaA, Editas Medicine, Thermo Fisher Scientific, Horizon Discovery, Genscript Biotech, GeneCopoeia, Integrated DNA Technologies, Eurofins Genomics, DNA 2.0 (ATUM), BBI Life Sciences, Genewiz, Gene Oracle, SBS Genetech, and Bio Basic
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The report scrutinizes different business approaches and frameworks that pave the way for success in businesses. The report used Porters five techniques for analyzing the Gene Editing ServiceMarket; it also offers the examination of the global market. To make the report more potent and easy to understand, it consists of info graphics and diagrams. Furthermore, it has different policies and improvement plans which are presented in summary. It analyzes the technical barriers, other issues, and cost-effectiveness affecting the market.
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What questions does the Gene Editing Servicemarket report answer pertaining to the regional reach of the industry?
The report claims to split the regional scope of the Gene Editing Servicemarket into North America, Europe, Asia-Pacific, South America & Middle East and Africa. Which among these regions has been touted to amass the largest market share over the anticipated duration
How do the sales figures look at present how does the sales scenario look for the future?
Considering the present scenario, how much revenue will each region attain by the end of the forecast period?
How much is the market share that each of these regions has accumulated presently
How much is the growth rate that each topography will depict over the predicted timeline
A short overview of the Gene Editing Servicemarket scope:
Global market remuneration
Overall projected growth rate
Marketing channel trends Now and later
Sales channel evaluation
Market Competition Trend
Market Concentration Rate
Reasons to Read this Report
This report provides pin-point analysis for changing competitive dynamics
It provides a forward looking perspective on different factors driving or restraining market growth
It provides a six-year forecast assessed on the basis of how the market is predicted to grow
It helps in understanding the key product segments and their future
It provides pin point analysis of changing competition dynamics and keeps you ahead of competitors
It helps in making informed business decisions by having complete insights of market and by making in-depth analysis of market segments
TABLE OF CONTENT:
Chapter 1:Gene Editing ServiceMarket Overview
Chapter 2: Global Economic Impact on Industry
Chapter 3:Gene Editing ServiceMarket Competition by Manufacturers
Chapter 4: Global Production, Revenue (Value) by Region
Chapter 5: Global Supply (Production), Consumption, Export, Import by Regions
Chapter 6: Global Production, Revenue (Value), Price Trend by Type
Chapter 7: Global Market Analysis by Application
Chapter 8: Manufacturing Cost Analysis
Chapter 9: Industrial Chain, Sourcing Strategy and Downstream Buyers
Chapter 10: Marketing Strategy Analysis, Distributors/Traders
Chapter 11: Gene Editing ServiceMarket Effect Factors Analysis
Chapter 12: GlobalGene Editing ServiceMarket Forecast to 2027
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A special thank you to Kathleen Dickson and Dr. John Bergeron for pointing out that yes, indeed, there are also many women who have made and continue to make significant contributions to health. We have added their additions below, but this list is by no means complete.
From open heart surgery to child-resistant containers, prestigious awards and bombs (not that kind), Canada has a long history of Canadians whose ideas and inventions have played huge roles in defining this nations healthcare.
DNA and cancer
Nada Jabado at McGill affiliated Childrens Hospital is a pioneer in pediatric cancer and her discovery of the role of what is known as the epigenome that marks the DNA in our genes in cancer. She is a leader in innovation in Health research and recognized for her leadership in the application of discoveries to address brain tumours in children.
Perhaps the most famous health innovation to come out of Canada, if such a thing can be measured. The arrival of insulin has saved countless lives since its creation in 1922 when Frederick Banting and Charles Best isolated and extracted insulin from the pancreas of dogs. Their Nobel Prize arrived swiftly thereafter in 1923.
Patients can pick from a growing array of treatments, from same-day- results surgery to game-changing immunotherapy, to fight the most common type of cancer.
BY By Beth Fand Incollingo and Kristie L. Kahl
In an interview with CURE, Dr. Jeremy Brauer, a dermatologist at NYU Langone Health in New York City and a spokesperson for the Skin Cancer Foundation, reviewed the latest strategies for treating these cancers, which include squamous cell and basal cell carcinomas, as well as the less common but more aggressive melanoma.
CURE: What surgical strategies are used to treat skin cancers?
Brauer: The intervention with the highest cure rate for surgical procedures is Mohs micrographic surgery. This is ideal for nonmelanoma skin cancers specifically, but there also is growing interest and use in certain melanomas, depending on the skin cancer and its location.
(Tissue is removed and tested a little at a time until the area being treated is free of cancerous cells).
Theres no leaving the office and waiting a week for your results; everything is done on-site in real-time. We process the tissue, and a Mohs surgeon also functions as the pathologist to read the slides and map out where the tumor is or isnt. The benefit of this is that it allows for tissue conservation, (especially on) the tip of the nose and ears. Also, it has a higher cure rate with the good cosmetic outcome because you are sparing tissue.
Another surgical intervention is a standard excision. You excise, take a big piece of skin and put stitches in, just like you would with Mohs, but its not a staged procedure. In general, its just one procedure.
Could you describe some of the nonsurgical therapies?
Nonsurgical treatments include electrodesiccation and curettage. These tend to be reserved for individuals who have a superficial basal cell carcinoma or what we call in situ squamous cell carcinoma, where the lesion is very superficial and on the uppermost part of the skin. Here, we use a sharp tool called a curette to scrape the area of involvement, but we also use electrodesiccation to burn the surrounding skin. This is often repeated in series a few times to remove the majority, if not all, of the tumor.
The goal here is to avoid having to cut and sew. The drawback is that you cant evaluate the tissue under the microscope because youre scraping and burning the remaining tumor cells.Another nonsurgical option is radiation therapy. This is sometimes used in conjunction with surgical treatment if it is determined that the subtype of skin cancer warrants it.
If involvement of the nerves is found during the course of Mohs surgery or when the specimen comes back after incision, we refer the individual to receive concurrent radiation therapy.
Radiation therapy is also good for (skin cancer that is not being treated with surgery). In certain instances, the individual might not able to tolerate (surgery) or declines the procedure. Similarly, certain tumors that dont heal well may be better candidates for a nonsurgical option.
Which medical options do you consider the most exciting?
I really do believe immunotherapy and targeted therapies for metastatic disease have been game changers. We consider immunotherapy an option for melanoma. Its been a game changer for ... survival in advanced cancers. That has definitely prolonged life for many individuals who unfortunately otherwise would not have fared as well.
Another interesting and promising area is targeted therapy. Here, were looking at the identification within the tumor of a mutation, specifically in a gene or pathway, and then targeting that gene or pathway (with medication). This has also led to increased survival rates and really allowed for a change in the way we approach some of the more advanced tumors.
That said, early intervention is key. Once weve detected these skin cancers, early intervention results in very high cure rates and, hopefully, prevents some of these local tumors from becoming metastatic or advanced.
What is on the horizon for patients with skin cancer?
Patients can be encouraged by the fact that medicine, technology and innovation are all moving at a very fast pace. More immunotherapy and targeted therapies will be made available to individuals with metastatic melanoma and advanced squamous cell carcinoma.
Also, right now, a biopsy is invasive. There is numbing and taking a blade to the skin. But there are other imaging techniques, and as our ability to detect skin cancer becomes better and greater, well begin to see additional noninvasive biopsy techniques.
How can patients become empowered to be their own best advocates when making treatment decisions?
It starts with education. Knowledge is power. A great resource is a board-certified dermatologist, who can discuss in detail the diagnosis and expectations. Also, reputable websites like that of the Skin Cancer Foundation offer information. Within dermatology, the American Academy of Dermatology and other societies can be great resources.
Going back to prevention, people need to understand that skin cancer is serious. You can die from skin cancer. But the good news is that these are preventable tumors and cancers. You have to take action to prevent it.
How do you do that? (It takes) appropriate use of UVA- or UVB-spectrum sunscreen, sun-protected behaviors when outdoors and screening, not just seeing a dermatologist once a year but also doing monthly self-skin examinations. Look for something new, unusual or changing and bring that to the attention of a dermatologist. Early detection results in early intervention, which results in very high cure rates.