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Anchor lead: Liquid biopsies likely shouldn’t be used to guide clinical decisions for men with prostate cancer, Elizabeth Tracey reports

Being able to monitor for cancer progression with a blood test- that’s the promise of liquid biopsy. But for men with prostate cancer, two commercially available tests don’t pass muster, according to a study by Kenneth Pienta, a prostate cancer expert at Johns Hopkins, and colleagues, showing that only 10% of the time did these labs get the same results.

Pienta: The other thing that’s a little bit scary for us is that because mutations, if you find them, can allow patients to be on certain clinical trials or get treated with certain drugs now, we actually found discrepancies between the two tests, where here this test said the patient could get the drug and this test said they couldn’t. well who’s right? In our push for precision medicine we’re still lacking that tool of being able to say the liquid biopsy is ready to be used.  :32

Pienta feels confident that as the science progresses liquid biopsies will be very useful, but cannot recommend them now. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Liquid biopsies for prostate cancer aren’t ready for prime time, Elizabeth Tracey reports

Most biopsies are no fun, but right now for prostate cancer, liquid biopsy, which relies on the presence of cancer DNA in the blood, is no substitute. That’s according to research by Kenneth Pienta, a prostate cancer expert at Johns Hopkins, and colleagues, in a study where blood samples from the same patients were sent to two different commercial labs.

Pienta: Much to our surprise what we discovered was that the two tests didn’t agree very often at all. In fact, about 25% of the time they both showed no mutations, no DNA. But only in about 10% of the time did they actually agree with each other if there was a mutation. We’ve concluded from that that the tests aren’t very good yet. Especially if you’re talking about low volumes of cancer.   :29

Pienta says these tests are certified by a laboratory certification organization, but are not approved by the FDA. He notes that each test costs about $4000, with samples typically being sent to only one lab. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What can you do right now to protect yourself from the flu? Elizabeth Tracey reports

The flu this year is especially severe, having caused many deaths in both children and adults. What can you do to help protect yourself? Andrew Pekosz, a flu expert at Johns Hopkins, outlines a plan.

Pekosz: It’s not too late to get the vaccine. It does take anywhere from two to four weeks for the vaccine to really kick into gear. Remember the vaccine protects against more than just H3N2, it protects against this H1N1 virus and flu B. so you can still give yourself protection against strains of flu that might be circulating towards the tail end of the season, if you get the vaccine now. If you’re feeling sick, and you have to go to work, use a tissue when you’re sneezing and coughing, wash your hands frequently, try to minimize your exposure to people. Because even when you have mild symptoms or sometimes no symptoms,  you can still transmit particularly flu but also other respiratory viruses.  :36

Pekosz notes there’s no substitute for washing your hands, and avoiding touching your hands to your nose and mouth. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Why is the flu vaccine falling short this year? Elizabeth Tracey reports

The flu vaccine is produced in chicken eggs, and takes a long time. That’s one problem with current vaccines according to Andrew Pekosz, a flu expert at Johns Hopkins.

Pekosz: The second thing, which is particularly a problem with the H3N2s is sometimes when we put those viruses into eggs, they start to change. And they change in ways that may make those surface proteins look a little bit more different, from the circulating virus that it started with, and then when the vaccine is used it generates an immune response that doesn’t completely cross react with the circulating virus. :22

Pekosz insists these problems can be overcome.

Pekosz: There are ways that we can make better flu vaccines. It’s as much of a manufacturing problem as it is a scientific problem. There’s a lot of infrastructure devoted to making flu vaccine the way it is right now, it takes a lot of investment by those companies to change the way they make flu vaccines and that’s been a sticking point. :20

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Why is combatting the flu so challenging? Elizabeth Tracey reports

The flu season is hard upon us, in spite of the great number of us who receive the flu vaccine each year. What gives? Andrew Pekosz, a flu expert at Johns Hopkins, tries to make sense of the complexity for the rest of us.

Pekosz: There’s really three viruses that cause influenza as we describe it. They’re divided into type A and B, there’s only really one type B and that usually comes at the end of the flu season. For the type As, they come in two flavors: H1N1, and H3N2. And those are just simple ways for us to keep track of what the surface proteins of those viruses look like. Antibodies to H1N1 won’t protect you from H3N2, and visa versa. So they really are very different unrelated viruses that we have to keep track of.  :30

What’s happened this season is the H3N2 virus is predominant, and this one is usually associated with more severe symptoms. It’s also clear from how early the flu season began that the vaccine isn’t as protective as was hoped. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: How can the benefits of depression treatment be maximized? Elizabeth Tracey reports

Electroconvulsive therapy, or ECT, can be a lifesaver for people with severe depression. Now research by Irving Reti, an ECT expert at Johns Hopkins, and colleagues, shows the response to therapy may be mediated via a specific gene. Reti says knowing this may allow more efficacious treatments to be developed that may also be more durable.

Reti: The durability of ECT is a major issue for patients who have undergone an acute course. We have good evidence now that tapering ECT in conjunction with starting an antidepressant medication perhaps with the addition of lithium, helps reduce the risk of relapse after that acute course, compared with simply giving patients medication after an acute course and stopping the ECT cold turkey so to speak.  :28

Reti says avoiding some of the side effects of ECT, such as memory impairment, would also be a good thing. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Could a specific gene help explain how certain therapies work for depression? Elizabeth Tracey reports

Electroconvulsive therapy, or ECT, is known to help people with severe depression but can have side effects like memory loss. Now research by Irving Reti, an ECT expert at Johns Hopkins and colleagues, has shown in a mouse model that a certain gene in a specific area of the brain is activated following ECT therapy.

Reti: It’s certainly possible that the level of expression of this gene in patients, after all this gene is expressed in humans, that that could influence the development of the antidepressant response clinically in patients undergoing a course of ECT. We are certainly interested in that and in fact interested in trying to monitor at least blood levels of this particular gene at least in its protein form in patients before and after a course of ECT.  :27

Reti says defining the mechanism by which ECT works could allow therapies to be developed that wouldn’t involve delivering shocks to the brain. At Johns Hopkins, I’m Elizabeth Tracey.

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