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Immunotherapy Combinations in Renal Cell Carcinoma - OncLive

Immune checkpoint inhibitors have shown clinical activity in patients with advanced renal cell carcinoma (RCC). The distinct mechanism of action of these therapies represents the potential for combination strategies, suggests Thomas Hutson, DO, PharmD. In early studies assessing the combination of VEGF inhibitors with anti–PD-1 or –PD-L1 antibodies, adverse events (AE) were a challenge, particularly hepatotoxicity, although promising activity was also observed, Hutson notes. 

The AE profile with immune checkpoint inhibition is different than experienced with therapies against VEGF and mTOR, Hutson notes. Immune checkpoint inhibition causes the activation of T-cells against normal host cells along with tumor cells. This activation can cause flu-like symptoms, along with damage to the skin, gastrointestinal tract, adrenal glands, and pituitary gland.

As a single-agent, the PD-1 inhibitor nivolumab demonstrated activity in patients with metastatic clear-cell RCC. At a 2.0 mg/kg dose, the treatment showed a progression-free survival of 4 months, an objective response rate of 22%, and a median overall survival (OS) of 25.5 months in patients with previously treated mRCC. Interestingly, since these therapies are immune-based, histology should not significantly impact efficacy, suggesting that there should be activity in both clear cell and non-clear cell histologies, Hutson notes.
 
Top-line findings from the pivotal phase III CheckMate-025 study revealed that second-line nivolumab improved OS compared with everolimus for patients with metastatic RCC, although full data were not yet released. Results from this study are eagerly anticipated, particularly since profound and prolonged responses have been observed in a subset of patients, Eric Jonasch, MD comments. There are very limited data in untreated patients, which is the setting that is ideal for immunotherapy, notes David F. McDermott, MD.
 

In untreated patients with RCC, a number of trials are assessing combination strategies. In the phase III CheckMate-214 trial, nivolumab is being explored in combination with the CTLA-4 inhibitor ipilimumab in comparison with sunitinib (NCT02231749). Another phase III study is exploring the anti–PD-L1 therapy atezolizumab (MPDL3280A) combined with bevacizumab (NCT02420821) in comparison with sunitinib (NCT02420821).  As these therapies move into the frontline setting, it is important to understand responses, as patients appear to respond differently to an immune checkpoint inhibitor than has been seen with other therapies, says Hutson. In some situations, the tumor may grow momentarily before shrinkage is observed, in a phenomenon known as pseudoprogression, explains Hutson. While tumors do ultimately regress, it can be challenging for clinicians to distinguish pseudoprogression from true progression, adds David F. McDermott, MD, who emphasizes the importance of maintaining therapy and not discontinuing treatment too soon. 

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Dialysis patient hits out at ambulance delays, and asks 'why am I left waiting ... - Stoke Sentinel
Comments (1)

FED-UP Gwen Cooper are calling for improvements to the area's non-emergency ambulance service – after repeatedly waiting hours for a lift home.

The mother-of-one has been visiting the Royal Stoke University Hospital three times a week for dialysis since being diagnosed with kidney failure two years ago.

She is one of several patients picked up from home in the morning and taken to the hospital for treatment by private firm NSL.

But after spending four hours in a hospital bed, Gwen and other patients can be left waiting up to a further five hours before being returned home.

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"It's terrible," said the 67-year-old, of Lymebrook Way, Milehouse . "You can finish the treatment at 3.45pm or 4pm and then you could still be waiting to go home at 9pm. The worst I've had was around 8pm, but once when it snowed we were still waiting at 4am. They were talking about putting us up in beds.

"When you have been in treatment for four hours you just want to go home.

"It is almost like having a day out at the hospital, which shouldn't be the case. If I wasn't in my wheelchair I'd walk home because it would be quicker."

Each ambulance picks up around six patients in a morning and takes them to the hospital together. But each patient is later taken home individually.

Gwen added: "I don't know why they can't take a few patients at a time."

Husband Frank, aged 68, said: "I never know what time she will come home.

"I get worried when she doesn't come home and I often ring to check how she is getting on. I'm told she won't be too long and then hours later she is still in the waiting room."

Health campaigner Ian Syme was on the panel which appointed NSL and called for the operator to be fined if patients are waiting too long.

Mr Syme said: "The contract states that once a patient is ready to go home, they have a strict timeframe to pick them up. As NSL is apparently failing in that I would expect them to be fined. If patients are left hanging around for hours the hospital has a duty to keep them hydrated and comfortable and, if needs be, charge NSL for doing so."

NSL today apologised for any poor service. Spokesman Afrika Morris said: "We deeply regret any instances where patients have not received a satisfactory service and sincerely apologise for any instances where the transport we have provided has not been of the highest possible standards. Patients are at the heart of everything we do."

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Food Encapsulation Market Worth $39.5 Billion by 2020 - SYS-CON Media (press release)
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TORONTO, ONTARIO -- (Marketwired) -- 07/23/15 -- Arch Biopartners Inc (Arch) or (the Company)(TSX VENTURE:ACH) (OTCBB:FOIFF) announced today that Arch scientists have published details of their new technology and its potential applications in the area of dialysis.

Arch scientists Daniel Muruve, Randall Irvin and Elisabeth Davis have successfully applied proprietary Arch peptides to the surface of polysulfone to make it more compatible with the human blood. Polysulfone is a common polymer used in the manufacturing of dialysis membranes.

The exposure of blood to polysulfone during dialysis triggers leukocyte activation and protein absorption that contribute to blood clotting and inflammation. The Arch team has developed a single step, post manufacturing method for modifying the surface of polysulfone and other materials used for dialysis. The resulting, new biomaterial reduces the surface absorption of proteins and leukocyte activation and has potential benefit for patients undergoing dialysis or those using other bio-incompatible medical devices.

Details of these findings are reported in the ASAIO Journal. The publication, titled "Peptide-mediated PEGylation of polysulfone reduces protein absorption and leukocyte activation" by Davis, Platnich, Irvin and Muruve can be found at http://www.ncbi.nlm.nih.gov/pubmed/26181712 until it is assigned to a specific issue of the journal.

Arch plans to advance the technology further by developing a clinical prototype and producing efficacy data in-vivo, and eventually with patients in dialysis clinics.

"The data produced by our scientists shows the potential to solve a major complication for patients in dialysis treatment, and validates our BORG Peptide platform in medical devices. It adds to our growing pipeline, which includes MetaMx and ABP569" said Andrew Bishop, a director of Arch.

Dialysis and End-Stage Kidney Disease

CIO, CTO & Developer Resources

Patients with end-stage kidney disease require life sustaining dialysis treatments. Patients on dialysis experience significant complications not only from their disease but also related to the dialysis procedure itself. Hemodialysis involves the filtering of patient's blood to remove toxins and electrolytes that accumulate as a result of kidney failure. Specialized pumps and tubing in hemodialysis machines remove blood from the patient, deliver it to semipermeable dialysis membranes where the filtering occurs and then return it to the patient. Dialysis membranes are commonly manufactured using polysulfone. The contact of patient blood to these artificial surfaces, including the polysulfone dialysis membranes activates the clotting system as well as the immune system. As a result, patients with end-stage kidney diseases suffer from chronic inflammation and require regular blood thinners that increase the risk of bleeding complications.

About Arch Biopartners

Arch Biopartners is a portfolio based biotechnology company established to develop new products and technology for unmet medical needs. The Company's portfolio includes MetaMx, which targets brain tumor initiating cells; ABP569, a new treatment for respiratory Pseudomonas aeruginosa infections; and, Metablok, a treatment for sepsis and cancer metastasis.

For more information on the Company, please consult the other public documents filed on SEDAR at www.sedar.com .

The Company has 53,189,679 common shares outstanding.

Forward-Looking Statements

All statements, other than statements of historical fact, in this news release are forward looking statements that involve various risks and uncertainties, including, without limitation, statements regarding the future plans and objectives of the Company. There can be no assurance that such statements will prove to be accurate. Actual results and future events could differ materially from those anticipated in such statements. These and all subsequent written and oral forward-looking statements are based on the estimates and opinions of management on the dates they are made and are expressly qualified in their entirety by this notice. The Company assumes no obligation to update forward-looking statements should circumstances or management's estimates or opinions change.

Neither TSX Venture Exchange nor its Regulation Services Provider (as that term is defined in the policies of the TSX Venture Exchange) accepts responsibility for the adequacy or accuracy of this release.

Contacts:
Andrew Bishop
Arch Biopartners Inc.
(647) 428 7031
[email protected]

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Remote Patient Monitoring Tools May Improve Dialysis Care - mHealthIntelligence.com

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Remote Patient Monitoring Tools May Improve Dialysis Care - mHealthIntelligence - mHealthIntelligence.com

We respect your privacy. By submitting your registration information to mHealthIntelligence you agree to receive email communications from Xtelligent Media. Please read our Privacy Policy which contains important disclosures about how we collect and use your registration and other information. You can view our Terms of Service or you may contact us at .(JavaScript must be enabled to view this email address)

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