Cyrus Khan, MD

Hematologist

Allegheny Health Network Cancer Institute

Pittsburgh, PA

CASE SUMMARY

A 43-year-old woman presented with fatigue and worsening, burning back pain. She had a medical history of mild hypertension that was well controlled with medication and her physical exam showed a 1.5-cm left posterior cervical node, a 2.5-cm right anterior cervical node, and a 2.0-cm left supraclavicular node. A CT scan of multiple enlarged mesenteric and retroperitoneal nodes showed that the largest measuring was 5.3 cm 3.1 cm.

Biopsy confirmed diffuse large B-cell lymphoma (DLBCL) and her immuno-histochemistry was positive for:

Her lactate dehydrogenase was within normal limits and she had an ECOG performance status of 0. Fluorescence in situ hybridization was negative for chromosomal abnormality, so R-CHOP (rituximab [Rituxan], cyclophosphamide, doxorubicin, vincristine, and prednisone) was initiated for 6 cycles and back pain resolved. Cerebrospinal fluid was negative for lymphoma and a posttreatment PET scan demonstrated a complete response (CR) with a Deauville score of 2.

DISCUSSION QUESTIONS

KHAN: Have you communicated with or worked with a CAR T center and then used certain therapies before the patients go on to cell collection, or even used bridging therapy?

BARSOUK: Im on the referring side, but if CAR T-cell therapy is not available now, while waiting it would not be uncommon to use a second-line therapy until the CAR T-cell therapy becomes available, then after collection of T cells, while the product is manufactured, that [second-line therapy] would be used. Unlike with stem-cell transplant, you dont need a strong CR or very good partial response. I dont think its required, correct me if Im wrong, for CAR T-cell therapy. So when it becomes available, the patient can proceed, right?

KHAN: Yes, you are right. You dont need to push the patient into a CR; you just need to control the disease so its not blowing up before we have the opportunity for all those things. Typically, what Ive seen in the community and [in my prior experience] would be drugs like gemcitabine [Infugem] plus oxaliplatin [Eloxatin; GemOx], and the newer therapies as well, of course.

FAROUN: To the question of if the patient is waiting for almost 2 months for CAR T-cell therapy, how to cool the disease off, it depends on the transplanter or the CAR T-cell center. Usually, I cool them off with either GemOx or even the anti-CD19 drug tafasitamab-cxix [Monjuvi].

I would like to use tafasitamab without lenalidomide [Revlimid] as lenalidomide might affect the recovery. Polatuzumab vedotin-piiq [Polivy] also could be used, but I dont know if you have any other options and these are the new medications that I use for bridging.

KHAN: Exactly, you are doing it right. Do you have an idea of how long it takes, over there, from T-cell collection to the infusion?

FAROUN: A year ago, we had a hard time, and recently we might have it within 30 to 45 days of collection.

CASE UPDATE

Eleven months after completion of therapy, the patient complained of fever, night sweats, and back pain. A palpable lymph node in left groin was discovered on physical examination. Another PET/CT scan showed a new left inguinal lymph node, increase in size of residual node, as well as multiple metabolically active lesions in lymph nodes of the retroperitoneum, abdomen, and pelvis.

A biopsy revealed DLBCL and the patient was referred to a transplant center. R-ICE (rituximab, ifosfamide (Ifex), carboplatin, and etoposide) salvage therapy was initiated, and a postsalvage PET/CT scan gave her a Deauville score of 5. The patient was referred for CAR T-cell therapy and was placed on a waiting list. The patient opted to continue receiving treatment locally while waiting for availability at a cellular therapy center.

KHAN: Does anybody else have a different experience? Has anybody seen a 3- or 4-month lag [when looking to use CAR T-cell therapy] or any [have seen] astounding speed [in getting it], maybe even within a month?

BARSOUK: Whats the manufacturing time of the product? In your experience, what is the variation?

KHAN: Well, 3 weeks is the soft standard. About 20 to 21 days is the time it takes, depending on how close the manufacturing center is to you and what the shipping time is. Typically, it takes about 3 weeks for the whole manufacturing process to take place.

FAROUN: The question that we have to ask ourselves and to ask you, as an expert in lymphoma, is what kind of bridging therapy do you use for patients who are candidates for CAR T-cell therapy?

KHAN: I typically have used either GemOx or single-agent polatuzumab, which is common. If you go to any center, these are the 2 most common regimens that people use.

DISCUSSION QUESTIONS

KHAN: The first question is important: Who is involved in the decision-making? Is it you recommending it? Do you work with a CAR T-cell center to make that call about what to give? Do you discuss it with the patient? Do logistics come into play?

SANDHU: Typically, after the first-line therapy, [we] refer these patients out to our main site for specialists, and we try to get that available for the patient locally. Initially, with the first relapse or refractory disease or a relapse within 12 months, I typically end up referring the [patient] for CAR T-cell therapy.

KHAN: And the treatment that you would give before CAR T-cell therapy, or for bridging, if you are helping locally, do you just take their recommendations in what you would use?

SANDHU: Yes, I typically take their recommendations and we usually end up using GemOx.

KHAN: Thats how we work, too, and that is the most common. Dr Faroun, have you used tafasitamab before CAR T-cell therapy?

FAROUN: Yes, I have experience with tafasitamab. Again, its indicated for patients who are not candidates for transplant or who were not cleared for CAR T-cell therapy later, but I think tafasitamab is a good regimen. However, the dose of lenalidomide is, in my opinion, prohibitive.

A lot of patients will end up with pancytopenia with 20 mg oral daily, 3 weeks on, 1 week off. So I back off, especially if the patient is old [or has some renal failure] and usually I start with 15 mg, or down to 10 mg, but I have never had any luck with 20 mg.

KHAN: Yes, youre right. The starting dose was 25 mg in the trial, and almost two-thirds of the patients required a dose reduction.1 So youre right: Especially in the beginning, when the tafasitamab is on the weekly schedule, its a little tough to tolerate everything.

Has anybody used polatuzumab, or polatuzumab plus bendamustine and rituximab [pola + BR], in that preCAR T stage, or for bridging, for example? Probably not. Ive used polatuzumab somewhat, too, and we talk about all these issues, but generally, we go by the NCCN guidelines.2

I think everybody takes patient preference and comorbidities into account. Has anybody come across a patient whom youve recommended for CAR T-cell therapy but, for whatever reason, they havent made it, or they dont want to go, and [you] just do something different?

VARADI: Yes. I had a patient who was referred and the patient and the patients family declined.

KHAN: What was that for? Was it because it was far, or they just didnt like the idea about the toxicity maybe? Or [something else]?

VARADI: I think it was mainly social issues.

KHAN: Do you remember what you chose to do with that patient, then?

VARADI: Its actually ongoing. He is getting rituximab plus GemOx and we are discussing with them, again, the CAR T-cell therapy option or maybe autologous bone marrow transplant.

KHAN: Got it, so trying to convince them still.

VARADI: But I cant force it.

KHAN: Yes, as it is with everyone. At least there are options now to keep things at bay until they can make that final decision.

CASE UPDATE

The patient received pola + BR.

DISCUSSION QUESTION

KHAN: Can anyone share [their] experience using [pola + BR]? Did the patient respond? Any toxicity issues? And I mean in any setting. It doesnt have to be in a preCAR T setting.

FAROUN: I have used it, again, according to the guidelines, in a third-line setting. So the only thing I see a lot with this regimen is neuropathy and the need for dose reduction. If the patient is a candidate for CAR T-cell therapy, I would not use this regimen with bendamustine; I use it [only] with rituximab.

KHAN: Thats how most of us would do it, too. For those of you who have used it, and for those of you who havent used it, do you have any reaction to these updated data [NCT02257567]?3

What stood out to you? Are there any surprising data that you saw in this? Have you had similar experiences, as far as the responses are concerned?

COSTELLO: In this relatively highly pretreated group, which had a fair number of comorbidities and they werent candidates for [autologous stem cell transplant] or [CAR T-cell] therapy, the response rates were pretty impressive, especially that CR rate [42.5%].3 I wish it were a more durable CR, but in this patient population, this is still an impressive number.

KHAN: Have you used pola + BR, by any chance?

COSTELLO: I have not yet, and many times, as other people have commented, as patients get into the second-line setting, we refer these patients to a tertiary center to consider CAR T-cell therapy, and these sorts of medicines often get treated, still, down at the tertiary center.

KHAN: Is there anybody else who has had a different experience or who was surprised by these data, or who has any other thoughts?

SAMHOURI: I like that high-risk patients are represented in the trials. We have a good number of patients with activated B-cell subtype, approximately half of them. We have approximately 80% with primary refractory disease, or at least who relapsed quickly, within 12 months.3 Those are the patients that are difficult to treat and putting the response rate and the long follow-up in context, it gives us a good option for treatment for patients, at least those who are not going for transplant or CAR T-cell therapy.

KHAN: Is there anybody who thinks its a great advantage to have just 6 cycles, not something that you have to continue for too long?

FAROUN: Yes, thats an advantage, 6 cycles and you stop, but the question is, to be honest with you, I am not that impressed with these data. The progression-free survival is only 9 months.3 I think we have better agents at this time, but not when the study was conducted. CAR T-cell therapy would be much better, in my opinion, and even tafasitamab is much better as a second-line therapy. I had some questions from the insurance company if the patient has CD79 [expression] on the malignant cells.

KHAN: Yes, they shouldnt [ask you], because CD79 is naturally expressed in everyone. So different experiences, and youve had a good experience with tafasitamab plus lenalidomide.

FARON: My question then is, is CD79 100% overexpressed on diffuse bulky cells?

KHAN: Yes, typically its like CD20, and most of the patients will have it expressed. [It is one of the B-cell markers.]

DISCUSSION QUESTIONS

KHAN: How do you manage [the adverse events (AEs)]? How do you manage cytopenias? How do you manage the peripheral neuropathy [From the Data3]?

BARSOUK: I havent used it, but I would do exactly what is [suggested] here. For significant thrombocytopenia or neutropenia, I would hold until [the patient] recovers to a certain level of platelets and then implement dose reduction. And the same goes for peripheral neuropathy.

KHAN: I follow some of these protocols and work with pharmacists and advanced practice providers, and they make sure we are keeping a closer eye on the labs, and everything, and treat them appropriately. But, yes, thats typically how we would follow these.

REFERENCES

1. Salles G, Duell J, Gonzlez Barca E, et al. Tafasitamab plus lenalidomide in relapsed or refractory diffuse large B-cell lymphoma (L-MIND): a multicentre, prospective, single-arm, phase 2 study.Lancet Oncol. 2020;21(7):978-988. doi:10.1016/S1470-2045(20)30225-4

2. NCCN. Clinical Practice Guidelines in Oncology. B-cell lymphomas, version 2.2023. Accessed March 5, 2023. https://bit.ly/3YFDw8W

3. Sehn LH, Hertzberg M, Opat S, et al. Polatuzumab vedotin plus bendamustine and rituximab in relapsed/refractory DLBCL: survival update and new extension cohort data.Blood Adv. 2022;6(2):533-543. doi:10.1182/bloodadvances.2021005794

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PRESS RELEASE

Published April 18, 2023

In 2022, the net worth of the global Canine Arthritis Treatment Market size was valued at US$ 2.39 Billion. It is projected that the demand for medications to treat canine arthritis will increase at a CAGR of 4.2%, resulting in a market valuation of US$ 3.05 Billion by 2028. In 2021, canine arthritis treatment medications held a 17.2% share of the global rare inflammatory disease treatment market.

Canine arthritis is a degenerative joint disease that causes inflammation in dogs joints due to constant rubbing, cartilage deterioration, and long-term joint problems. The most commonly affected joints in animals are the knees, elbows, shoulders, hips, and spine. Injuries, obesity, and poor bone formation are some of the causes of canine arthritis in dogs.

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The global canine arthritis treatment market is expected to grow significantly during the forecast period, according to Future Market Insights, due to the increase in dog ownership worldwide, the development of veterinary healthcare infrastructure, and the expansion of treatment options for canine arthritis. The rising prevalence of obesity-induced arthritis among dogs and increased awareness about companion animal health are key factors driving this growth. Furthermore, the FDAs ease of approval for innovative and novel canine arthritis treatment drugs will create growth opportunities for market players.

Key Takeaways from Canine Arthritis Treatment Market Study

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Competitive Landscape

Elanco, Ceva Sante Animale, Boehringer Ingelheim are among the leading players in the canine arthritis treatment market. These manufacturers continue to dominate the market landscape of canine arthritis treatment by ensuring product availability, collaborating with the local distributors, strengthening manufacturing facilities, and strategizing R&D for diversification of product portfolio.

Key Segments Of Canine Arthritis Treatment Industry Survey

Canine Arthritis TreatmentMarketbyTreatment:

Canine Arthritis TreatmentMarketbyRoute of Administration:

Canine Arthritis TreatmentMarketbyDistribution Channel:

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Canine Arthritis Treatment Market is anticipated to reach a valuation ... - Digital Journal

If you're partial to a scientific or technical way of thinking, you might be well-suited for a career in STEM, which stands for science, technology, engineering and mathematics.

The technology portion, in particular, is filled with pathways that require varying skills and experiences.

As rapid technological advances dictate the future of work, you may wonder how you can best prepare yourself for your first role in the field and the one after that.

Heres a guide to get you started.

The path into tech isnt a one-way street, but there are certain credentials and experiences that can make you more competitive, including a college degree and a combination of technical and soft skills.

To break into the tech field, youll want to earn at least a bachelors degree. To be a competitive candidate, a bachelors degreeis a must, said Ahlam Alhweiti, a senior software development engineer and information technology faculty member at Southern New Hampshire University (SNHU).

According to the U.S. Bureau of Labor Statistics (BLS), most computer and information technology occupations list a bachelors degree as the required entry-level education. However, Alhweiti said masters degreesare often preferred.

What you choose to major in can vary, though. Some bachelors degrees you might consider obtaining include:

If you cant commit to a full-time course load, you dont have to. SNHU faculty trainer and STEM adjunct Steve Villone completed some of his education part-time as he raised his family and built his career in tech.

And if you earn your degree online, you may find greater flexibilitythan at traditional brick-and-mortar colleges.

While you earn your college degree, you may have an opportunity to complete an internship. An internship allows you to gain hands-on experience inside an organization. Not only can this help you develop practical skills, but it can also add valuable experience to your resume and lead to more networking opportunities.

If you are a student, do at least one, if not two, internships, said Faryal Humkar, an SNHU career advisor who supports STEM students and alumni.

If youre already working full-time and going to school, you may wonder when youll have time to also complete an internship. Some schools allow you to turn your internship experiences into college credits, which can alleviate some of that stress. At SNHU, for example, you can often earn three credits toward your degree if you complete a set number of hours and a supplementary internship course that helps you connect your experiences to your education.

Humkar said employers are generally flexible with their interns, too, meaning you might be able to create a schedule that works for you and your supervisor. You may also have the option to complete a remote internship, meaning you dont need to travel to an office setting to gain professional experience.

If youre not having luck landing a posted internship, Humkar suggests creating your own. Almost everyone has a tech department these days, right? Your hospitals, your school district, city, colleges, anywhere just call and say, hey, I'm a full-time student. I'd love to do an internship with your department. Can I email you my resume? Humkar said. A lot of them will welcome you with open arms.

You might also consider volunteering at local nonprofits. The great thing about technology is that there are so many places that need help, said Brooke Goggin, a solutions engineer and computer science faculty member at SNHU. Although unpaid, you can still count these types of volunteer work as professional experiences.

Volunteer work can also help you grow your network. "You can make connections and have the opportunity to get good references that will benefit (you) in (your) job search," said Dave Numme, a senior associate dean of STEM programsat SNHU. "Also, nonprofits sometimes have difficulties having enough technology staff, so they frequently welcome additional help."

Relevant experiential learning opportunitiesdont just help you become a more appealing candidate; they can also help you determine what areas of technology interest you most.

Try to familiarize yourself with the various niches in technology, Villone, who has a background in programming, networking, cyber security and more, said. You dont have to be good at everything. Maybe you like SQL (database queries). Then follow that thread. Maybe you like forensic cyber security. Follow that thread.

While teaching a kinesiology course at a community college, Goggin saw an opportunity to automate a fitness center. In collaboration with two computer science students, she wrote a computer program that did just that.

That hands-on experience helped her get started in tech.

Technology micro-credentials are plentiful. A certificate programor certification can help you zero in on a particular area of technology that interests you, and they typically take less time to completethan a degree.

The trifecta of a degree, certification and experience really moves applicants to the front of the line, Goggin said.

Villone recommends earning one or more basic certifications, such as:

A good way to tell what certifications make sense for you is to review job listings for a position you want. (If) you continue to see CompTIA on job listings, you know you may want to... start working on that certification so that way it'll make you more competitive, Humkar said.

Some colleges, such as SNHU, may offer discounts for specific certifications, allowing you to save some money while obtaining the industry credential.

Having technical skills, sometimes called hard skills, is central to working in tech. But how do you know which ones youll need?

Beyond knowing how to navigate computers, cell phones and various operating systems, Goggin believes you should understand security, programming, networks, analytics and machine learning if you want to break into the tech field.

CompTIA breaks some of the most in-demand tech skills into five categories:

College degree programs cover many of these subjects, allowing you to study and develop your skills. Then, should you land an interview, you can describe how you have gained and applied skills in a bit more depth especially if you earned an A in the class, Humkar said.

No matter what field you go into, exercising soft skills can be valuable especially with the advancement of machine learning.

Certain soft skills are particularly helpful for a tech career. Alhweiti, Goggin and Villone stressed the importance of these, in particular:

You can display your soft skills during job interviews. For instance, the question Why should I hire you? can be met with a combination of verbal communication skills, problem-solving skills and more.

This is not (an) I think, or I feel, but instead I have these skills supported by these examples that will meet your companys mission in these ways, Goggin said.

Villone also offered the ability to let go as an important skill. This can help you move on in your career and avoid burnout. Being able to say, I did the best I could for now, and Im going to put this down for a while, This is not easy, Villone said. But it is a skill. It is a powerful skill.

Your college may have a team of trained professionals to support you as you achieve your professional goals. SNHU, for example, has career advisorsyou can work with as soon as youre enrolled, and they will be there for you even after youve joined the universitys alumni community.

Humkar, who is also a Certified Professional Resume Writer (CPRW), said that advisors like herself are available to help you explore your goals, build your resume, establish an online professional presence and navigate salary negotiations. They can help you prepare for interviews, too, and share other advice that may help you as you seek to establish and grow your career.

Some schools also have a career team dedicated to helping students interested in completing internships for college credits.

As technology continues to change and advance, so will the careers that interact with it. If you want to establish and grow your career in technology, you must be willing to keep up with the advancements. Sometimes this means earning new certifications. It could mean navigating search engines when you need to learn more about a particular subject or troubleshoot an issue youre having.

Having the ability to learn on your own is essential to working in the tech field, according to Goggin. Being able to problem solve and learn are crucial regardless of what skills you know, she said. Whatever skills you know, they will change quickly, so you will need to remain up-to-date and keep learning.

Following publications such as TechRepublic, PCMag and vendor blogs can be another good way to stay up-to-date on the latest tech news and insights, according to Numme. You can also find podcasts and tech forums that will support your ongoing education.

Taking initiative in the workplace and going above and beyond can also help you leave a good impression on your internship supervisor or employer. If youve completed your assigned tasks or observed a pain point on your team, Humkar suggests volunteering to help. For example, you could say to your manager: I noticed that ... so-and-so is a little overwhelmed, and I'm done with my work. Can I help them? This really shows initiative and employers like this, Humkar said.

While youll probably learn a lot on the job, its helpful to have foundational experiences and skills you can showcase as a job candidate that youll continue to build on once you land a role.

Experience comes in many shapes and forms, though from class projects to pet projects.

When youre ready to start applying for jobs, here are five entry-level careers to consider:

According to Numme, those working in this role build important sensitivities to the user experience and get an overview of the technology services with an organization. "In addition, doing this work allows them to see if (they have) an interest or aptitude in an area of specialization," Numme said. "This exposure can lead to other jobs."

Becoming a technology professional can take time and tenacity. Believe in yourself, leverage resources, develop your skills and keep learning. Do not let anyone tell you that you cannot do something, Villone said.

Between the evolving nature of the field and the multiple pathways available, a tech career could be worth it if its an area that interests you. Jobs in this field generally pay well, too. Per BLS data, the median salary for computer or information technology occupations was $97,430 in 2021 more than double the median wage for all occupations.

Additionally, theres increasing flexibility in the field to accommodate work/life balance, in Alhweitis experience. Most tech companies allow for working from home and adjusting work hours as needed, she said. Also, its very rewarding to work in an environment full of talented and innovative individuals and makes you learn quickly.

With all the advancements in the field, who knows where a career in tech could take you? It brought Goggin abroad for a year, where she implemented technology solutions at universities in France.

It is not an easy career, but the work is well worth it and think of the impact you can have, Goggin said. You might save people from a breach, a bug in a medical device or a bug in a bank that might cause people to lose money that is exciting.

Numme agrees that, as a tech professional, you can make a real difference in the world. "There are so many ways that technology has and will continue to improve the lives of others," he said. "Working in technology is an opportunity to ... make a positive impact for our fellow humans."

A degree can change your life. Find the SNHU technology programthat can best help you meet your goals.

Rebecca LeBoeuf 18 22G is a writer at Southern New Hampshire University. Connect with her on LinkedIn.

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How to Get Into Tech | SNHU - Southern New Hampshire University

Woman who was told she had tonsillitis correctly diagnosed herself with leukaemia - using GOOGLE

Duration: 00:42 3 days ago

A woman who was told she had tonsillitis correctly diagnosed herself with leukaemia - using Google. Chloe-Leigh Todd, 22, started experiencing a sore throat and general illness. One month after starting to feel unwell Chloe had a telephone appointment with her GP and was told she had tonsillitis. After googling her symptoms - which included vomiting, night sweats, and weight loss - Chloe realised she was suffering from textbook leukaemia symptoms. Chloe managed to have a face-to-face appointment where she went for a blood test. Her results came back abnormal and she went straight to the hospital where she was told she had leukaemia. Now she has been cancer-free for three years and is no longer having treatment, although still suffers with some side effects. Chloe Todd, 22, a stay-at-home mum from Gateshead, Tyne and Wear said: "Everyone knows their own body and I just knew it was something serious. "The doctors were putting it down to other things but I was adamant they were wrong. "I googled my symptoms - night sweats, fatigue, bruising and so on - and leukemia came up as the first search result. "I checked and saw I had every symptom on the whole website - everyone had thought I was crazy when I said it but I knew I wasn't. "When the doctor confirmed it, I thought I was going to die. In June 2020 after being told she had tonsillitis, Chloe managed to get herself a face-to-face appointment with a doctor because she thought they were wrong. The mum of one had been suffering from a sore throat, night sweats, vomiting and weight loss since February and was getting concerned so searched online for answers. After having a blood test, Chloe was called by the doctors and told her results were abnormal and called into the hospital where she was told she had leukaemia and was "weeks away from death". The following day Chloe was sent to the Newcastle Freeman Hospital to start treatment. She said: "I had a bone marrow biopsy and told I was weeks away from death. "The cancer was everywhere in my blood. Doctors told me they didn't know if chemotherapy would help but they were willing to give it a try." Chloe endured six rounds of chemotherapy which eradicated most of the cancer, leaving her more optimistic. In September 2020, Chloe was put on the Anthony Nolan register in search for a bone marrow donor. Straight away the hospital found a 100% match in a 27-year-old boy, and she had the transplant in October 2020. This is done by transferring stem cells from one person to another, replacing damaged blood cells with healthy ones. After a successful operation, Chloe underwent another bone marrow biopsy to make sure her new cells had worked - later receiving the news she was cancer free. Leukaemia symptoms - skin looking pale or "washed out" - tiredness - breathlessness - losing weight without trying - frequent infections - having a high temperature, and feeling hot or shivery (fever) - night sweats - easily bruised skin

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Maine is a hotspot for vacations in the summertime, even for locals. Our state is so massive with so much to offer that Mainers become tourists in their own state, visiting nooks and crannies, towns and cities they've never been to before.

Whether you're a tourist or a local, there are times when I'm sure you wish you could bring your furry friend on vacation with you.

Not all pets are travel-friendly but if you have a four-legged friend who loves to hit the road, does well in new places, and wants to go on an adventure, it should be able to come with you on your trip.

Luckily, there are plenty of pet-friendly lodging accommodations in Maine and scattered all around the state, so no matter where you choose to go, you'll be able to find a spot for you and your dog. Some spots even allow cats!

Not only do many places in the state offer pet-friendly accommodations but they also offer generous pet packages to make your pet as comfortable as possible during its stay.

At these spots in Maine, your pet is a respected and well-taken care of guest, just like you and the rest of your family.

From gorgeous Inns in coastal towns to cabins by the lake, you and your pets can have the ultimate vacation in Maine. Want to go kayaking on the lake? Your dog can come with you. Heading out for a hike? Grab the leash.

The weather is warming up, flowers are blooming, and the sun is shining here in Maine. Now is the perfect time to travel around Vacationland with your pets. Here are some places you can stay with them:

Take the whole family for a trip around Maine, even the four-legged members.

To prepare yourself for a potential incident, always keep your vet's phone number handy, along with an after-hours clinic you can call in an emergency. The ASPCA Animal Poison Control Center also has a hotline you can call at (888) 426-4435 for advice.

Even with all of these resources, however, the best cure for food poisoning is preventing it in the first place. To give you an idea of what human foods can be dangerous, Stacker has put together a slideshow of 30 common foods to avoid. Take a look to see if there are any that surprise you.

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Bring the Whole Family: 11 Pet-Friendly Lodging Options in Maine - WJBQ

What is Multiple Myeloma?

Multiple Myeloma, cancer of plasma cells is the second most common blood cancer around the world. Plasma cells are a type of white blood cells, which produce antibodies that protect the body from infection. They are found in the bone marrow, which is the spongy tissue seen in some bones.

In multiple myeloma, the plasma cells clone and proliferate excessively, displacing healthy bone marrow cells that produce red blood cells, platelets, and other types of white blood cells (WBC). This sets off a chain reaction of illnesses and disorders that can harm multiple organs like bones, kidneys, and the bodys capacity to produce healthy red, white, and platelet blood cells. Multiple organ systems are affected, hence the name.

It mainly affects adults in the age group of 65-70 years. Multiple myeloma presents with different kinds of symptoms which can resemble a lot of other conditions. Initially one may not experience any symptoms. This cancer does not cause any lump or tumour.

Some may not experience any symptoms and the condition may be accidental when blood or urine tests show abnormally high protein. This type is called smouldering myeloma.

Rarely, cancer cells concentrate in a particular bone or soft tissue, rather than involving many organs. This is called solitary myeloma/plasmacytoma.

The are many symptoms one can experience:

Researchers are yet to identify the exact cause of multiple myeloma. However, certain risk factors have been identified.

Monoclonal Gammopathy of Undetermined Significance (MGUS) is closely related. Here there is an overabundance of immunoglobulins in the blood. Approximately 1 in 100 individuals with MGUS go on to develop multiple myeloma each year. MGUS has no symptoms, so regular blood tests have to be done.

Currently, multiple myeloma cannot be cured. However, treatment can frequently assist to control the condition for several years. New medications, autologous stem cell transplantation, and improved supportive care have greatly improvedsurvival rates.

For diagnosing and initiating early treatment a set of criteria and defining events are necessary. This involves getting various blood tests and imaging.

Blood tests include:

Managing multiple myeloma requires a multidisciplinary approach of physicians, haematologists, radiologists, physiotherapists, dietitians and psychologists. The staging of the disease and symptoms dictate the treatment.

The therapy includes:

In first-line and relapsed settings, there is a combination of drugs used:

You may feel tired and nauseous and may also experience diarrhoea, constipation, numbness of hands and feet, mood changes, increased hunger, and sleep disturbances. A more thorough knowledge about the side effects can be obtained from your healthcare professional.

Experiences with multiple myeloma will vary from person to person. Some people have years to live with few symptoms. Others see a rapid deterioration in their condition. Using blood tests like albumin and beta-2-microglobulin, DNA tests can predict survival rates. As you discover how to cope with multiple myeloma, connect with doctors and support groups for guidance.

Ans: Yes, Kindly adhere to the doctors advice. It is absolutely important to get regular blood tests and other investigations as advised.

Ans: Eat healthy, exercise, protect yourself from infection and look after yourself. Take rest as and when needed.

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Excerpt from:
Multiple Myeloma - What It Is, Causes and Treatment Options ... - Metropolis Healthcare

Douglas W. Sborov, MD, MS

Associate Professor, Division of Hematology and Hematologic Malignancies

Department of Internal Medicine

University of Utah School of Medicine

Director, Multiple Myeloma Program and Division of Hematology Biorepository

Huntsman Cancer Institute

Salt Lake City, UT

CASE SUMMARY

Targeted OncologyTM: Can you go over the National Comprehensive Cancer Network (NCCN) guidelines for relapsed/refractory multiple myeloma?

SBOROV: As hard as we try to make this easier for everybody in the community with the NCCN guidelines, I fear that we make it even more complicated. What weve done in the last year is [phrase it as] having patients who are bortezomib or carfilzomib [Kyprolis] refractory, or having patients who are lenalidomide refractory. The majority of our patients at this point are going on lenalidomide maintenance. The question is, is the patient progressing off lenalidomide or are they progressing offnothing, because a lot of times we are stopping lenalidomide maintenance. I am not seeing a whole lot of bortezomib maintenance in the community anymore, which I think is probably appropriate.1

[For patients who are bortezomib refractory], there is daratumumab [Darzalex]/lenalidomide/dexamethasone [DRd] based on the POLLUX trial [NCT02076009] for patients who are not lenalidomide refractory.2 Theres also daratumumab/ carfilzomib/dexamethasone [DKd] based on CANDOR [NCT03158688];3 carfilzomib/lenalidomide/dexamethasone [KRd] based on ASPIRE [NCT01080391];4 isatuximab [Sarclisa]/carfilzomib/dexamethasone [Isa-Kd] based on IKEMA [NCT03275285];5 and carfilzomib/pomalidomide [Pomalyst]/dexamethasone [KPd] based on phase 2 data.6

Then on the opposite side, [for patients who are lenalidomide refractory], we dont want to use lenalidomide, so we are just going to pick our favorite triplet. I think its worthwhile to highlight that there are no doublets [in the guidelines].1 Doublets are a thing of the past. We are using triplets across the board. Were not using Kd as a doublet in this population anymore either. We should be utilizing it in a triplet.

There are all sorts of data out there, so you could probably use some other regimens. I think that the [therapeutic] space at first relapse is becoming clearer. Then what happens is you have somebody who is progressing and they have had 2 prior lines of therapy.

So what do you do in that case, when you are not yet ready to go to a chimeric antigen receptor-T cell therapy, teclistamab [Tecvayli], or whatever else? What do you do in that space? I think thats the big question. We wanted to make sure when we were writing the NCCN guidelines that physicians had all sorts of options that they could choose from. Basically, you want a triplet and you want to identify drugs that the patient has not seen yet after that second progression. This space is changing a lot, and I think we are going to see big-time changes in the next 2 or 3 years.

Can you briefly describe the previous treatments received in the phase 3 trials for relapsed/refractory multiple myeloma?

We always say you are not supposed to make cross-trial comparisons and I think this highlights why we should not. We have allthese different randomized phase 3 trials, and we can think about all these [treatment options] in patients with 1 to 3 prior lines of therapy.

For example, in POLLUX, for patients who had at least 1 prior line of therapy, 20% were refractory to proteasome inhibitor [PI] and 2.5% were refractory to lenalidomide and PI.2 They were not heavily pretreated patients and ultimately were not lenalidomide refractory. So in somebody who is not lenalidomide refractory, what do you go to? You should be going to DRd. That should be your decision for treatment after first progression.

Then CANDOR included patients with 1 to 3 prior lines of therapy.3 Thirty percent of the patients were lenalidomide refractory and 30% were bortezomib refractory. They didnt report on how many patients were refractory to both.

Then IKEMA [patients] had 1 to 3 prior lines of therapy.5 A third were lenalidomide refractory, 30% were bortezomib refractory, and 20% were dual refractory.

Another important trial, APOLLO [NCT03180736], looked at daratumumab/pomalidomide/dexamethasone [DPd].7 Patients had 1 to 3 prior lines of therapy, but 80% of these patients were lenalidomide refractory. Almost 50% were PI refractory, and 40% were dual refractory.

So you cant compare allthese trials because you are not looking at apples to apples, but I think it is still important to look at this group of data and try to tease it out a little bit.

What are the options for patients with 1 prior line of therapy?

The CASTOR [NCT02136134] trial looked at daratumumab/bortezomib/dexamethasone [DVd]. Median progression-free survival [PFS] with DVd was 16.7 months in not heavily pretreated patients.8 The OPTIMISMM [NCT01734928] trial looked at pomalidomide/bortezomib/dexamethasone [PVd] vs Vd.9 The PFS was 11.2 months with PVd. DVd and PVd are not my favorite regimens. In patients who dont have aggressive relapse, you could maybe think about those regimens, but I think that we can do better.

For CANDOR, using DKd, median PFS was 28.6 months.3 [This was] a similar population to the IKEMA trial, which used Isa-Kd, and that median PFS was 41.7 months.5,10 This is something thats new for most of us. Most of us [were thinking we] didnt know that Isa-Kd was that good. One of the other regimens that we think about in patients who are lenalidomide refractory is DPd. In my opinion, DPd is still a very good regimen.

APOLLO, with more heavily pretreated patients, had a median PFS of 12.5 months in that population.7 But, when you look at the [POM] MM 014 trial [NCT01946477], which investigated DPd, [it] was a phase 2 trial.11 But these patients were much less heavily pretreated. For patients who were lenalidomide exposed but not refractory, their median PFS was 30.8 months.

For patients who were lenalidomide refractory, their median PFS was 2 years. So maybe not as good as a carfilzomib-based regimen, but when you are talking about that patient who doesnt want to come in twice a week for carfilzomib, or may not want infusion, they want to just go on an oral agent and subcutaneous daratumumab, DPd can be a good regimen to consider.

CASE UPDATE

What was the design and efficacy of the IKEMA trial investigating Isa-Kd?

IKEMA was a randomized phase 3 trial.5,10 The primary end point was PFS. Three hundred patients were included with 1 to 3 prior lines of therapy, no prior carfilzomib, and not refractory to prior anti-CD38 antibody. The Isa-Kd regimen was given at 10 mg/kg. Isatuximab was given in an infusion, weekly for the first cycle and then every other week thereafter. Carfilzomib was given at 20 mg/m2 on days 1 and 2, and then at 56 mg/m2 thereafter on days 8, 9, 15, and 16 in cycle 1, and then on days 1, 2, 8, 9, 15, and 16 in all subsequent cycles. Kd was given per the same dosing.

Patient characteristics were well matched overall. This did include older patients, at least 10% in both arms. Twenty-three percent to 25% of the patients had high-risk cytogenetic features; 42% in each arm had gains of 1q21. We dont tease out 3 vs 4 copies.

These are probably the most important data: the median PFS, based upon the FDA-mandated censoring rules, was 41.7 months with Isa-Kd vs 20.8 with Kd [HR, 0.59; 95% CI, 0.42-0.83].10 When you look at the original statistical design of the trial, the median PFS was about 3 years vs 19.2 months, respectively [HR, 0.58; 95% CI, 0.42-0.79].

But I think keying in on this 41.7 months is important, especially when we look at DKd, for which the median PFS was about 29 months.3 So if Im thinking about using carfilzomib in this setting, at least based on these data, Ive switched my practice to utilizing isatuximab, primarily because I am avoiding that problem of the infusion vs subcutaneous [administration]. In all the subgroup analyses, we saw that the triplet therapy was favored over the doublet, which is not surprising given everything we know.10 Id highlight that Isa-Kd was beneficial in patients with renal insufficiency as well as 1q21, which is why we picked it for this case.

For depth of response in patients treated with the triplet, 44% of patients had complete response or better, and 34% of the patients were MRD negative compared with 15% with Kd [OR, 2.09; 95% CI, 1.26-3.48]. Those patients, at first progression or after first progression, can still get deep responses, and a third of them are getting into MRD negativity.

Utilizing the triplet prolonged the time to next treatment, at 45 vs 25 months [HR, 0.55; 95% CI, 0.40-0.76]. Overall survival has not been reached with 44 months of follow-up. This is not surprising, but we will see these data mature.

How did patients do in terms of toxicity in IKEMA?

I think its important to bring up the concept of whats happening with the cardiac issues.10 Its important to note that the addition of isatuximab did not increase cardiac toxicity. Whats driving those cardiac events is the carfilzomib. In addition, we would expect that the addition of an anti-CD38 antibody is going to increase rates of cytopenias as well as diarrhea, hypertension, fatigue, pneumonia, and other infections. Infusion reactions with isatuximab, just like daratumumab when were using it intravenously, happened mostly at the first or second dose, and primarily at the first dose. Primarily, these are grade 1 and 2 events, with very few grade 3 or higher events. About 40% of the patients are getting infusion reactions. So it really speaks to the importance of utilizing prophylactic medications, like we are doing with daratumumab.

REFERENCES

1. NCCN Clinical Practice Guidelines in Oncology. Multiple myeloma, version 3.2023. Accessed March 10, 2022. https://bit.ly/2T0mDYS

2. Dimopoulos MA, Oriol A, Nahi H, et al; POLLUX Investigators. Daratumumab, lenalidomide, and dexamethasone for multiple myeloma. N Engl J Med. 2016;375(14):1319-1331. doi:10.1056/NEJMoa1607751

3. Dimopoulos M, Quach H, Mateos MV, et al. Carfilzomib, dexamethasone, and daratumumab versus carfilzomib and dexamethasone for patients with relapsed or refractory multiple myeloma (CANDOR): results from a randomised, multicentre, open-label, phase 3 study. Lancet. 2020;396(10245):186-197. doi:10.1016/S0140-6736(20)30734-0

4. Stewart AK, Rajkumar SV, Dimopoulous MA, et al; ASPIRE Investigators. Carfilzomib, lenalidomide, and dexamethasone for relapsed multiple myeloma. N Engl J Med. 2015;372(2):142-152. doi:10.1056/NEJMoa1411321

5. Moreau P, Dimopoulos MA, Mikhael J, et al; IKEMA study group. Isatuximab, carfilzomib, and dexamethasone in relapsed multiple myeloma (IKEMA): a multicentre, open-label, randomised phase 3 trial. Lancet. 2021;397(10292):2361- 2371. doi:10.1016/S0140-6736(21)00592-4

6. Sonneveld P, Zweegman S, Cavo M, et al. Carfilzomib, pomalidomide, and dexamethasone as second-line therapy for lenalidomide-refractory multiple myeloma. Hemasphere. 2022;6(10):e786. doi:10.1097/ hs9.0000000000000786

7. Dimopoulos MA, Terpos E, Boccadoro M, et al; APOLLO Trial Investigators. Daratumumab plus pomalidomide and dexamethasone versus pomalidomide and dexamethasone alone in previously treated multiple myeloma (APOLLO): an open-label, randomised, phase 3 trial. Lancet Oncol. 2021;22(6):801-812. doi:10.1016/S1470-2045(21)00128-5

8. Palumbo A, Chanan-Khan A, Weisel K, et al; CASTOR Investigators. Daratumumab, bortezomib, and dexamethasone for multiple myeloma. N Engl J Med. 2016;375(8):754-766. doi:10.1056/NEJMoa1606038

9. Richardson PG, Oriol A, Beksac M, et al; OPTIMISMM trial investigators. Pomalidomide, bortezomib, and dexamethasone for patients with relapsed or refractory multiple myeloma previously treated with lenalidomide (OPTIMISMM): a randomised, open-label, phase 3 trial. Lancet Oncol. 2019;20(6):781-794. doi:10.1016/S1470-2045(19)30152-4

10. Pektas O, Moreau P, Dimopoulos MA, et al. Updated progression-free survival (PFS) and depth of response in IKEMA, a randomized phase 3 trial of isatuximab, carfilzomib and dexamethasone (isa-KD) vs KD in relapsed multiple myeloma (MM). Hematol Transfus Cell Ther. 2022;44(suppl 1):S15. doi:10.1016/j.htct.2022.09.1211

11. Siegel DS, Schiller GJ, Samaras C, et al. Pomalidomide, dexamethasone, and daratumumab in relapsed refractory multiple myeloma after lenalidomide treatment. Leukemia. 2020;34(12):3286-3297. doi:10.1038/s41375-020-0813-1

See original here:
Sborov Looks at Combination Therapies in Relapsed/Refractory ... - Targeted Oncology

Published 04-05-23

Submitted by Illumina

Originally published on Illumina News Center

This month, Illumina celebrates a quarter century of innovation, research, and passion. As a genomics pioneer founded in San Diego in 1998, we have provenand continue to provehow unlocking the power of the genome can exponentially improve the human condition.

When the company began 25 years ago, it was revolutionary just to decode the genome. Since then, genomics has played a crucial role generating insights into infectious disease, cancer, reproductive health, genetic disease, and morewhile improving patient outcomes every step of the way. To date, scientists and researchers have generated more than one billion gigabases of data and sequenced nearly four million people, and potential uses for that data multiply every year. Around the world, our customers and partners are sequencing samples extracted from seaweed, sugarcane, soil, yams, river water, wastewater, gorillas, ancient Nordic bonesthe list goes on. Its not surprising that over 300,000 studies featured in peer-reviewed scientific publications have used Illumina technology. Today, our workforce is 10,000 strong, with more than 8800 patents in 34 locations worldwide. Were celebrating 25 years of growth by looking at 25 of the greatest impacts that Illumina technology has made to date.

1. We advanced sequencing chemistry to be faster, more accurate, and more stable. When we launched the Genome Analyzer in 2007, we introduced the world to Illumina sequencing by synthesis (SBS) chemistry. SBS forever changed how sequencing is done, as it delivers high accuracy and a high yield of error-free reads. In the years leading up to 2022, we created XLEAP-SBS chemistry, which is engineered for longer reads with up to 2 faster incorporation speed and 3 greater accuracy. And because we made this chemistry stable at ambient temperatures, it no longer needs to be packed with dry ice, making it more sustainable as well as accessible to markets that lack the infrastructure for dry ice shipping.

2. We made DNA sequencing more affordable and accessible. In the last 14 years, we helped take the cost of sequencing a human genome from $150,000 to $200, a drop of more than 99%. Getting to the $10,000 genome in 2010 was a major feat, thanks to the Illumina HiSeq 2000. HiSeq made whole-genome sequencing (WGS) possible for labs of all sizes and drove widespread adoption of exome sequencing and noninvasive prenatal testing (NIPT). In 2022, we launched our most powerful and most sustainable sequencers to date, the NovaSeq X Series. The NovaSeq X Plus can sequence more than 20,000 whole genomes per year and enables the $200 genome.

3. We're increasing the diversity of available genomic data to better reflect our world. In 2008, Illumina completed the first-ever sequencing of an African human genome, from an anonymous Yoruban man from Nigeria. From the very beginning we have prioritized diversity, and in the years since, our partnerships with Our Future Health in England, PRECISE in Singapore, All of Us in the US, and OurDNA in Australia have allowed researchers to better target mutations specific to certain populations and deliver on the promise of precision medicine for all. Most recently, we announced an agreement between Illumina, Nashville Biosciences, and Amgen to sequence 35,000 DNA samples from African American patients at Vanderbilt University Medical Center. This is the first announcement from the Alliance for Genomic Discovery, created by Illumina and Nashville Biosciences, to perform WGS on 250,000 de-identified patient samples and make them available to pharmaceutical companies looking to develop new, life-changing therapies.

4. WGS for newborns in intensive care is on its way to becoming a universal standard of care. In the last several years, a handful of institutions have made life-changing advances in diagnosing critically ill babies with lifesaving speed. In 2015, Dr. Stephen Kingsmore, then at Childrens Mercy Hospital in Kansas City and using a HiSeq 2500, set a Guinness World Record for fastest genetic diagnosis, in 26 hours (now at Rady Childrens, he has implemented rapid WGS as a frontline diagnostic). Beginning in 2017, a groundbreaking study went on to demonstrate the value of WGS across five US hospitals. Other programs and studies at institutions from Germany to the United Arab Emirates have begun implementing WGS in their neonatal intensive care units. And in October 2022, NHS England launched the worlds first national genetic testing service, promising to sequence severely ill newborns for diagnosis within days. (Read Baby Fitzs story here.)

5. Patients with rare genetic diseases are getting answersfaster. In high-income countries, genetic disease patients often remain undiagnosed for up to seven years or more, while in low- and middle-income regions, many families never learn the cause of their childs suffering. This diagnostic odyssey costs families time and money, and causes frustration and heartache. But WGS is one way to arrive at a diagnosis within weeks. For 10 years, the Illumina iHope program has facilitated pro bono genome testing for more than 1700 children with suspected rare genetic disease across 24 clinical sites in eight countries. Approximately 40% of them have received a diagnosis and up to 78% received a change in their care management as a result. Based on the success of this program, Illumina recently announced an expansion of iHope to China. Illumina has committed to dramatically expanding access to genome testing outside China through a partnership with Genetic Alliance to develop iHope Genetic Healtha program supported by a $120 million in-kind donation of sequencers, reagents, and software to enable dozens of laboratories to provide genome testing in low- and middle-income communities around the world. This effort will reach up to 50,000 patients a year in five years.

6. NIPT and carrier screening transformed reproductive health for expecting families around the world. The VeriSeq NIPT Solution, released in 2017, provides fetal chromosomal information through a simple maternal blood test, significantly expanding families ability to make informed health care decisions. In 2020, the American College of Obstetricians and Gynecologists amended its guidelines, recommending that all pregnant people, regardless of age or baseline risk, receive testing. Prospective parents can test before conception, and embryos produced through in vitro fertilization can be tested. Further, products such as the Illumina Global Diversity Array with Carrier Screening Content v2 (intended for research use only), can screen for as many as 600 different autosomal recessive disorders.

7. Our arrays ushered in a new era of large-scale genomics. They changed the research and applied market landscape in applications such as genetic disease testing, agrigenomics, population genomics, and epigenetic research. We began developing array technology in 1998 and launched our first product in 2001. Today it is a $400 million business and a core part of how we address cost-sensitive applications and geographies. Innovations such as the Infinium Global Diversity Array with Enhanced PGx and the upcoming EX workflow will enable service providers to process samples in a quicker, more cost-effective manner that ultimately benefits patients, while the expansion of our methylation array portfolio will enable new insights in population cohorts and has the potential to improve outcomes in oncology and genetic disease testing.

8. We helped accelerate the field of precision oncology with comprehensive genomic profiling. In 2018, we introduced a pan-cancer assay designed to identify known and emerging tumor biomarkers. TruSight Oncology 500 (TSO 500) uses both DNA and RNA from subject tumor samples to identify key somatic variants underlying tumor progression, such as small DNA variants, fusions, and splice variants. It can measure tumor mutational burden and microsatellite instability, features that are potentially important biomarkers for immunotherapies. In 2022, we debuted the TruSight Oncology Comprehensive (TSO Comp) in vitro diagnostic kit to help inform treatment for cancer patients in Europe. We also launched the first companion diagnostic for TSO Comp, enabling targeted therapy with Bayers Vitrakvi medicine for patients with NTRK fusion cancer. With Merck, we codeveloped a TSO 500 HRD research assay.

9. Liquid biopsy became possible. The ability to detect cell-free circulating tumor DNA from tumors is growing. Clinical researchers see it as a potential alternative to invasive tissue biopsies, and the breakthrough technology can also help with multi-cancer early detection (MCED). With the help of MCED, catching cancer before it spreads increases the overall cancer survival rate by 400%.

10. We enabled partners to develop the COVID-19 vaccine without a live virus.In a lab at the Shanghai Public Health Clinical Center (SPHCC), researchers used a MiniSeq to sequence the sample of a seafood market worker admitted to the Central Hospital of Wuhan on December 26, 2019. SPHCC was one of the first to publish the viral genomic sequence, and it was this sequence that made vaccine development possible in just 10 months, rather than decades. It was also a catalyst for mRNA technology advancements in oncology testing, HIV, malaria, Ebola, and more.

11. We responded quickly to the need for widespread sequencing of SARS-CoV-2. On June 9, 2020, we received the first FDA Emergency Use Authorization for a sequencing-based COVID-19 diagnostic test. The Illumina COVIDSeq Test helped pave the way for large-scale, next-generation sequencing (NGS) COVID-19 testing, just a few months into the pandemic. By summer 2021, most of the resulting test datawhich was being used to identify viral variants, which could help public health agencies manage the pandemicwas coming from large genomic centers. Countries with limited resources to invest in high-throughput sequencers had far fewer submissions to COVID surveillance networks. Illumina launched the COVIDSeq Assay, which allowed small labs to participate in surveillance. Rural regions like the Yucatn peninsula in Mexico, with its influx of tourists and immigrants, were finally able to detect the variants present in the local community.

12. We doubled the number of countries in which we could enable access to genomics. Over the course of the pandemic, it became clear that sending samples across regions and borders to testing labs was not fast or scalable enough to mitigate the spread of new variants. Our customers, particularly global nongovernmental organizations such as the World Health Organization, United Nations Development Programme, and Association of Public Health Laboratories as well as the Illumina Foundation were requesting to have our products available in nearly every corner of the inhabited world. In just over six months beginning in late 2021, a cross-functional, global team at Illumina set up our systems to enable commercial orders and shipments to 88 additional countries and territories across Africa, Asia, Latin America, and Eastern Europe. The feat provided on-the-ground access to genomics to 900 million more people.

13. The world got a crash course in genomics. As the coronavirus pandemic unfolded, terms like PCR and mRNA entered the mainstream lexicon. Public health officials became recognizable figures, and Illumina was at the ready to share our knowledge about the power of genomics to impact human health with government leaders, health care professionals, and society writ large. In February 2021, our CEO, Francis deSouza, penned an essay for The Economist, calling for a global Bio Force to track viruses; two months later, deSouza appeared on the cover of TIME magazine when Illumina was named one of the 100 Most Influential Companies.

14. Pathogen surveillance expanded around the globe. In April 2021, we committed $60 million in sequencing capabilities to a global pathogen genomics initiative, in partnership with public and private entities. It expanded on the Africa Pathogen Genomics Initiative (Africa PGI) announced the previous October, to build critical public health capabilities in areas of need and bring us closer to the vision of an early warning system for disease outbreaks. (In a matter of months, the number of sequencing labs in Africa grew from seven to 40.)

15. Were working to make adverse drug reactions a thing of the past. Were developing pharmacogenomics testing to prevent adverse drug reactions, the most common cause of hospital admissions worldwide and one of the leading causes of death. (Watch Mehris story here.)

16. Millions of pet owners were able to improve their animals health. Our customers brought to market DNA tests to detect canine cancer earlier, and identify a cats breed, traits, and health risks.

17. We are supporting researchers enabling a more sustainable, nutritious food supply.Every year since 2011, we have awarded one Illumina Agricultural Greater Good Initiative grant. The program spurs critically needed research that will increase the sustainability, productivity, and nutritional density of agriculturally important crop and livestock species. Grant recipients receive donations of Illumina products. Our most recent winners are studying yams in Nigeria, mung beans in multiple regions, honeybees in Germany, and, as announced this year, marine algae in Brazil.

18. Genomics began supporting wildlife conservation. Initiatives like our iConserve program have brought the global community together to accelerate environmental and wildlife conservation. Some of iConserves work consists of facilitating research in comparative genomics of various species, which provides structure to cataloging biodiversity in wild and captive populations. This ultimately supports decisions made regarding species conservation and management. In recent years, we have been able to support research into the genomes of the bottlenose dolphin, red ruffed lemur, western lowland gorilla, and African elephants.

19. We convened world and industry leaders to discuss and advance the power and promise of genomics. At the inaugural Illumina Genomics Forum in September 2022, former President Barack Obama, Bill Gates, Nobel laureate Frances Arnold, and other experts shared their insights on genomics and health care.

20. We advocated for reimbursement (and we still do). Since its inception in 2017, our market access team has been working with consortiums, governments, payers, and others to increase insurance coverage for genetic testing. In 2021, the world crossed a significant milestone, with over one billion people across 45 countries reimbursed for genomic tests, cancer therapy selection, genetic disease diagnosis, and noninvasive prenatal testing. The market access team continues to advocate for patient access through innovative collaborations and contracts.

21. Our customers and partners used NGS to help protect the environment. Canadas STREAM project sequences river water and sediment samples to advance watershed health monitoring, Checkerspot is using microalgae to create a sustainable alternative to petroleum, and LanzaTech is turning carbon emissions into valuable material commoditiesits facilities in China have produced over 50 million gallons of ethanol from industrial emissions, which is the equivalent of keeping over 200,000 tons of carbon from entering the atmosphere.

22. The volume of genomic data has explodedand so have the insights. Ever since we acquired Solexa in 2007, NGS data output has increased at a rate that outpaces Moores lawmore than doubling each year and creating immeasurable opportunities. Today, the amount of total genetic data generated around the world exceeds one billion gigabases. Weve made significant improvements to our platforms and product pipeline to provide highly accurate, comprehensive, efficient analysis of this data. We launched Illumina Connected Analytics to empower customers to manage, analyze, and explore large volumes of multi-omic data in a scalable and flexible environment guided by core principles of security and privacy. Illumina DRAGEN Original Read Archive technology performs data compression in the cloud, reducing customers carbon footprint by up to five times.

23. We made big science green science. Last year, Illumina ranked highest in our industry in the Dow Jones Sustainability Index. In July 2022, we were the first genomics company whose plan to meet net-zero targets was approved by the Science Based Targets initiative, which includes validation of our corporate greenhouse gas emissions reduction targets. In 2021, the company met 59% of its energy needs through renewable sources, and by 2030 it aims to use 100% renewable energy and 75% less packaging. By 2050, it aims to become a net-zero company.

24. The next generation of scientists stepped into the lab. We celebrate DNA Day each April, and our 2022 campaign reached more than 90,000 STEM learners, inspiring the next generation of scientists and discoverers. Illumina has reached over 1 million STEM learners since 2019, and we aim to reach 5 million by 2030.

25. We championed a diverse and global workforce. In 2022 alone we received more than a dozen awards and recognitions from companies like Forbes, Newsweek, Bloomberg, and Dow Jones. We also empower our employeesin commemoration of the 25th anniversary, we are providing twenty-five $25,000 grants in communities where we operate, and we have provided $25 to each employee to donate to a cause of their choice.

And in the next 25 yearsor even 25 weeksstarting with the debut of Illumina Complete Long Read sequencing technology, stay tuned for more breakthroughs in cardiovascular disease testing, drug target discovery using AI-based genome interpretation and analysis, and expanded testing capabilities for countries most impacted by tuberculosis. In the meantime, our customers are making strides in research for autism spectrum disorder, PTSD, diabetes, and more.

For a quarter-century, Illumina has been on the forefront of a global genomics movement. We celebrate this milestone with excitement and cant wait to see how many more patients are able to experience better outcomes through the power of genomics. Heres to another 25 years of making even greater impacts in the Genome Era.

Illumina is improving human health by unlocking the power of the genome. Our focus on innovation has established us as the global leader in DNA sequencing and array-based technologies, serving customers in the research, clinical, and applied markets. Our products are used for applications in the life sciences, oncology, reproductive health, agriculture, and other emerging segments.

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25 Greatest Impacts in 25 Years: Illumina and the Evolution - CSRwire.com

MELBOURNE, April 04, 2023 (GLOBE NEWSWIRE) -- Data Bridge Market Research completed a qualitative study titled "Autism Therapy Market" with 100+ market data tables, pie charts, graphs, and figures spread across Pages and an easy to grasp full analysis. A steadfast Autism Therapy market research report serves to be a very momentous component of business strategy. This report provides important information which assists to identify and analyze the needs of the market, the market size, and the competition with respect to Autism Therapy industry. When the market report is accompanied with precise tools and technology, it helps tackle a number of uncertain challenges for the business. This market research report is one of the key factors used in maintaining competitiveness over competitors. Autism Therapy market report supports the business to take better decisions for the successful future planning in terms of current and future trends in particular product or the industry.

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Download a PDF Sample of the Autism Therapy Market @https://www.databridgemarketresearch.com/request-a-sample/?dbmr=global-autism-therapy-market

Autism therapies are the type of therapies that are applied in autistic children or adults to improve or enhance their condition. Different therapies include speech-language therapy, behavior therapy, play-based therapy, occupational therapy, physical therapy, and nutritional therapy. This neurological disorder is related to several disabilities, such as challenges with the individual's behavior or lack of social skills. The diagnosis of autism can be made from a very early age, but the cause is still unknown.

The growing incidence of autism and pervasive developmental disorder (PDD) is essential to escalate market growth. Huge research studies performed by organizations to assess the safety and efficiency of drugs in patients with ASD are anticipated to boost market growth. The stimulants segment dominated the market with a huge revenue share due to the wide availability and ease of accessibility of drugs to patients.

Fundamental Aim of Autism Therapy Market Report

In the Autism Therapy market, every company has goals, but this report focus in on the most important ones, allowing you to gain insight into the competition, the future of the market, potential new products, and other useful information that can boost your sales significantly.

Some of the major players operating in the autism therapy market are:

Recent Development

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The investment made in the study would provide you access to information such as:

Opportunities:

The increasing demand for stimulants is boosting the growth of the market. Adderall, Focalin, Vyvanse, Dexedrine, and Ritalin are some stimulants approved by the U.S. FDA for treating patients who have autism. These drugs improve patient behavior by 80% when administered properly to patients. Therefore, growing efficiency related to the stimulants may attract a new target population and boost market growth.

A growing number of product launches associated with autism therapy boost market growth. For instance, the FDA granted fast-track designation to Curemark's CM-AT specified for ASD in 3-8 years old children in 2022. Furthermore, Indian researchers developed the 6BIO compound in 2021, which has shown the potential to enhance daily activities in the pre-clinical investigation of patients with an autism spectrum disorder. Thus, this factor boosts market growth.

Key Growth Drivers:

The increasing incidence of the autistic population is boosting the market's growth. For instance, France and Portugal have the lowest rates of autism in the world, with approximately 0.69% and 0.71%, respectively, as per the research published by Health Data Exchange. In 2021, the CDC stated that nearly 1 in 44 children in the U.S. is diagnosed with an autism spectrum disorder (ASD). Thus, this increasing prevalence demands high adoption of therapies, boosting the market growth.

Huge research studies performed by organizations to assess the safety and efficacy of drugs in patients with ASD are anticipated to drive the market. The positive outcomes of these studies lead to new growth opportunities for the market. For instance, Stalicla completed phase 1b trials of precision medicine candidate STP1 and witnessed positive results with symptom improvement in patients with ASD in 2022. Therefore, the effective completion of the trial and following product approvals are estimated to drive the market. Thus, this factor boosts market growth.

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Key Market Segments Covered in Autism Therapy Industry Research

Age Group

Type

Treatment Type

Drug

Distribution Channel

Autism Therapy Market Regional Analysis/Insights:

The countries covered in the autism therapy market report are U.S., Canada, and Mexico in North America, Germany, France, U.K., Netherlands, Switzerland, Belgium, Russia, Italy, Spain, Turkey, Rest of Europe in Europe, China, Japan, India, South Korea, Singapore, Malaysia, Australia, Thailand, Indonesia, Philippines, Rest of Asia-Pacific (APAC) in the Asia-Pacific (APAC), Saudi Arabia, U.A.E, South Africa, Egypt, Israel, Rest of Middle East and Africa (MEA) as a part of Middle East and Africa (MEA), Brazil, Argentina and Rest of South America as part of South America

North America dominates the autism therapy market due to increasing R&D activities and the launching several new products through mergers and strategic partnerships in this region. Also, the increasing awareness about the availability of numerous therapies to treat patients with autism spectrum disorders in this region

Asia-Pacific is expected to witness significant growth due to the wide presence of major market players and strategic initiatives undertaken by them to develop and commercialize several new products to treat patients.For instance, Teijin Pharma and Hamamatsu Medical University confirmed the safety, efficiency, and tolerability of oxytocin nasal spray for treating patients with an autism spectrum disorder in 2022

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Autism Therapy Market Anticipated to Garner Significant Growth of ... - GlobeNewswire

A century has elapsed since the first successful brain tumour surgery was performed by the "" FATHER OF NEUROSURGERY "" DR HARVEY CUSHING.

In the following 70 years progress was made in all basic aspects of diagnosis and management of brain tumours.

The introduction of CT SCAN in 1971 the brain tumours diagnosis became fast,accurate,specific and easier. The lengthy , laborious,risky and invasive investigative procedures became the things of past.

In INDIA about 40-50,000 people are diagnosed with brain tumours and successfully managed with very good results.

Even then the fear of brain tumour diagnosis and pessimism regarding the surgery outcome are prevalent even today.

The popular impression in general public is that brain tumours are VERY COMMON & all are UNIFORMLY CANCEROUS is without scientific basis.

In fact brain cancers incidence is 2-3% per one lakh population,amounting to LESS than 2% of all cancers in human body.

It is very important to note that only ONE THIRD (1/3)of are all brain tumours are cancerous while there about 125 varieties of such .

Equally important to state that chances of any person to develop a MALIGNANT TUMOUR in their life span is LESS Than 1% .

Presenting symptoms are::

Morning headaches mainly in forehead

Vomitings

Double vision

Epilepsy

Memory disturbances

Loss of vision , smell , hearing particularly ONE SIDE

weakness of one half of body

Swallowing difficulty

Walking disturbance

Unclear speech

Menstrual cycle irregularity

Drowsy or unconscious

INVESTIGATIONS ::

Ct scan brain: PLAIN & CONTRAST MRI BRAIN WITH CONTRAT PET SCAN BRAIN rarely

Causative factors of brain tumours::

For a long time it was said to be UNKNOWN

Now with improved research and surveillance few causes are mentioned like:

1 Stress

2. Exposure to radiation

3. Exposure to chemicals like PESTICIDES, OIL PRODUCTS, RUBBER , CHLORINATED INDUSTRIAL SOLVENTS

4. Genetic factors and family history

5. Life style choices like Wrong diet disrupted sleep Sedentary life style Alcohol SmokingObesity

6. Vitamin deficiency like Vitamin c, beta carotene , folate

Brain tumours can develop in all AGE GROUPS mainly CHILDREN & ADULTS

Brain tumours are mainly two Varieties

PRIMARY & SECONDARY

PRIMARY: Tumours developing in brain , brain coverings & cranial nerves.

SECONDARY: Also known as METASTATIC TUMOURS from other parts of body like THYROID ,LUNG, BREAST , KIDNEY & INTESTINES secondary tumours amount to 40% of total brain tumours.

Once brain tumours are confirmed the line of treatment is SURGERY.

Nowadays tumours of less than 2 CENTIMETRES size are managed with radiotherapy if there is no significant brain compression.

Advances in surgical techniques and surgical equipment like NEURONAVIGATION, ULTRASOUND SURGICAL ASPIRATOR , OPERATING MICROSCOPE, intraoperative MRI and CT Scan, cortical mapping and AWAKE PRECEDURES have made possible access to & total removal of tumours with presentation of vital brain functions.

Of the primary brain tumours there are TWO IMPORTANT DIVISIONS.

1. CANCEROUS or MALIGNANT

2. NONMALIGNANT of BENIGN

BENIGN tumour are mostly removed completely with total CURE to patients. Some residual tumours in a critical brain area are managed with latest radiation methods.

Cancerous tumours are excised to the maximum possible without compromising important brain functions followed by adjuvant latest modalities of treatment.

The most malignant primary brain tumour called as GLIOBLASTOMA MULTI FORME was associated with poor outcome and testing the nerves of affected patients as well as treating neurosurgeons.

In fact almost half of these patients are alive at 2 YEARS an impressive result considering previous survival was thought to be LESS THAN A YEAR!!!!

It is no exaggeration to state that few lucky patients with GLIOBLASTOMA are living for 5,10,20 years

This is possible with advances in several areas like :

MOLECULAR ONCOGENESIS with identification of deletions in chromosome segments 1P &2Q

ADVANCES in imaging like functional localisations,spectroscopy ,diffusion and perfusion measurements ,diffusion tensor imaging to visualise white fibre tracts

Effectiveness of CHEMOTHERAPY and delivery of drugs placing catheters and TARGETED THERAPY

Most recently STEM CELLS have been used to target brain tumours

MULTI DISCIPLINARY approach in addressing the diversity and complexity of brain tumours is the key for successful results

In the few important points to remember:

1. NOT ALL BRAIN TUMOURS ARE CANCEROUS

2. Whole skull is NOT OPENED during surgery

2.brain tumour surgery is reasonably SAFE

3. Most of the times patient is CONSCIOUS after surgery

4. Within 12 hours patients are given feeds

5. Mobilisation at the earliest

6. Early diagnosis and treatment is mandatory for good results

7.Present day RADIOTHERAPY techniques are SAFE DELIVERS HIGHER DOSES IN PRECISE LOCATION & LEAST DAMAGE TO THE SURROUNDING NORMAL BRAIN STRUCTURES

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Brain Tumours New Horizons, New Thoughts - The Hans India