Biotech Strategy Blog

Commentary on Science, Innovation & New Products with a focus on Oncology, Hematology & Cancer Immunotherapy

Posts from the ‘Infectious Diseases’ category

We are living in exceptionally challenging times and our thoughts are very much with all those healthcare professionals at the front line in the battle against Covid–19.

For people living with cancer, particularly those who have stage IV disease, the stark reality – in the UK and even some States in the US – is an ICU bed may not be available if they come down with the severe form of the disease.

When it comes to cancer research most labs, with the exception of those working on Covid–19, are now closed, but there is still data coming out to keep us all going as we work from home. ASCO20 will be a virtual meeting this year, while AACR will likely have some virtual presentations later in April. There are also plenty of publications coming out in journals from work already completed.

In this post we’re looking at newly published research and one possible immunological link between inflammation related to cancer and certain infectious diseases.

Last week we spoke to Dr Kamal Khanna (@Kamal_M_Khanna), Associate Professor at NYU Langone about research from his lab, which has just been published in the journal Science Immunology.

Although science is important, what matters most in these exceptional times is making sure everyone comes through it safely. Dr Khanna kindly spoke to BSB under embargo on Wed 25th March, where we also spoke about the surreal experience going on around him as we asked, how are things going with you in New York?

“It’s crazy. This has become the epicenter now. It just moved so fast here from having no cases and everyone wondering what’s going on to just explosion. Lab is shutdown, unfortunately. They’re allowing one person to go in at one time, in my lab just to maintain mouse colonies and do very limited experiments.

They’re allowing us to do the Covid–19 experiments, which we started just a few days ago, but also in a limited fashion. Those are the things we’re doing right now is simply plaquing the virus, and we have a few strains and we’re just testing growing them and so. We’re getting some limited human samples, but probably that will explode now. Our hospital has the most amount of Covid patients, so much so that they just made a makeshift morgue with a tent, unfortunately, right next to where we are.

So that’s the reality of where we are right now and hoping that this will peak at some point, they’re predicting in about 2 to 3 weeks that it would reach its apex and then all the social distancing and things that we’ve been doing, hopefully that will start to bring some of the numbers down, that’s the hope.”

In this post we offer an extended interview with Dr Khanna where we explore possible immunological links between inflammation in relation to cancer and infectious diseases and how research from his lab could generate new insights into cancer, as well as some potential impacts for Covid–19.

If you’d like to read our latest in-depth expert interview on cancer-related topics, please do consider supporting independent science journalism in these challenging and exceptional times.

To learn more from our oncology expert interview and get a heads up on insights emerging our latest analysis and commentary subscribers can log-in or you can click to gain access to BSB Premium Content.

This content is restricted to subscribers

Today we take a short break from our AACR conference coverage and look at some creative new research that has its roots in oncology, i.e. antibody drug conjugates (ADCs), while being adapted and adopted for use in microbiology and infectious diseases.  Here at BSB, we have always been attracted to innovative science and technology and this latest project certainly fits that bill.

This is not such a stretch as many may think, after all, advanced cancer patients or those in an ICU  tend to be prone to infectious complications, which can, unfortunately, be lethal.

While this work is currently ongoing in the preclinical setting, it could be something we hear a lot more about in the near future as clinical development rolls out and there is a dramatic impact for patients.

Curious as to what all the fuss is about?

Subscribers can learn more by logging in. 

This content is restricted to subscribers

The FDA earlier this week issued a safety alert to doctors that repackaged bevacizumab (Avastin®) had caused serious eye infections in 12 patients in Florida. The New York Times today reports that five patients at the Veterans Affairs Medical Center in Los Angeles have gone blind as a result of an eye infection following injection of compounded Avastin.

I have written previously about the Lucentis v Avastin debate and the results in the Comparison of Age-related macular degeneration treatment trial (CATT) published earlier this year in the New England Journal of Medicine.

It is not good news that contamination has occurred while compounding bevacizumab (Avastin) from sterile100mg/4mL single use preservative-free vials into individual 1mL syringes.

Genentech/Roche may see this news as reinforcing their position that ranibizumab (Lucentis®) should only be used, since it comes in the correct dose for injection in the eye. However, this ignores the reality caused by the fact that Lucentis is approximately 40x the cost of compounded Avastin ($1950 versus $50).

This week’s news does not support the proposition that intravitreal injection of bevacizumab is not safe and effective for the treatment of AMD, nor any suggestion that pharmacies properly accredited and experienced in aseptic techniques are not qualified to do this. Pharmacists compound drugs everyday.

As the FDA notes in their alert:

“Health care professionals should be aware that repackaging sterile drugs without proper aseptic technique can compromise product sterility, potentially putting the patient at risk for microbial infections.  Health care professionals should ensure that drug products are obtained from appropriate, reliable sources and properly administered.”

However, there is no evidence to suggest that the pharmacies who undertook the Avastin compounding that led to the infection were not “appropriate, reliable sources and properly administered.”

The New York Times notes that the the contaminated Avastin came from the pharmacy at the main campus of the V.A. Greater Los Angeles Healthcare System.  There is no mention of whether the VA pharmacists did the compounding themselves or sourced the drug elsewhere.

According to a news report in the Florida SunSentinel, the pharmacy identified as the source of the infection in Florida is InfuPharma. This is not a retail pharmacist in the high street, but a specialist compounding pharmacy that advertises sterile preparations for numerous products. Licensed pharmacists run this specialist company and looking at their website they do appear to be experienced in this area.

Endophthalmitis is a serious eye infection that may lead to loss of vision. The contamination should not have occurred.  These incidents should not, however, be blown out of proportion in the Lucentis v. Avastin debate.

Sadly, infections and contamination happen in hospitals and the healthcare industry all the time. Even the FDA approved manufacturing facilities of pharmaceutical companies have experienced problems in recent years.  Last summer, BMS experienced issues with sterile manufacturing standards at their Puerto Rico plant following FDA inspections.  Earlier this week, Baxter announced they had filed a lawsuit against Teva for indemnification over a hepatitis C outbreak following reuse of oversize propofol vials.

The news of serious eye infections with repackaged Avastin must, therefore, be put in context. There are countless patients around the world who have benefited from intravitreal injections of Avastin for treatment of their age-related macular degeneration (AMD). The issue raised by the infections in Florida and Los Angeles is whether there is adequate inspection and certification of compounding pharmacies, and whether there is a need for more State regulation and inspections in this area.

Disclosure:  I have written freelance articles for Pharmacy Today, the magazine of the American Pharmacists Association.

1 Comment

Nanotechnology is leading to innovation in drug delivery, and new ways to treat diseases.

In an April 3, 2011 online article in Nature Chemistry, researchers from the IBM Almaden Research Center, Institute of Bioengineering and Nanotechnology in Singapore and Zhejiang University in China publish groundbreaking data on how biodegradable nanoparticles could be used to treat infectious diseases such as methillicin-resistant Staphylococcus aureus (MRSA).

The research shows how nanoparticles can selectively disrupt microbial cell membranes, walls and inhibit the growth of gram-positive bacteria, MRSA and fungi.

What makes this research exciting, is that the nanoparticles did not cause haemolysis or break-up of red blood cells.  The authors note that nanoparticles for the treatment of infectious diseases could be “synthesized in large quantities and at low cost” and are therefore “promising as anti-microbial drugs.”

The global market for infectious diseases was $90.4 billion in 2009 and is projected to reach $138 billion in 2014.  In the United States there are now more deaths from MRSA than there are from AIDS (18,650 MRSA deaths in 2005 compared to 16,000 for AIDS according to a paper in JAMA).

With more than 94,000 MRSA infections a year in the United States, and the increasing resistance of MRSA to existing anti-microbial therapies, treatment of infectious diseases is a major public health concern. Hospital acquired MRSA infections particularly target the elderly and those vulnerable through weakened immune systems.

Innovations in nanotechnology and drug delivery, such as the one published by Nederberg, Zhang, Tan & Xu in Nature Chemistry, open the door to potential new anti-microbial therapies.  It will be interesting to see how this research is commercialized and translated into new products and treatments.

ResearchBlogging.orgNederberg, F., Zhang, Y., Tan, J., Xu, K., Wang, H., Yang, C., Gao, S., Guo, X., Fukushima, K., Li, L., Hedrick, J., & Yang, Y. (2011). Biodegradable nanostructures with selective lysis of microbial membranes Nature Chemistry DOI: 10.1038/nchem.1012

Free Email Updates
Subscribe to new post alerts, offers, and additional content!
We respect your privacy and do not sell emails. Unsubscribe at any time.
error: Content is protected !!