How does the drug abemaciclib treat breast cancer?
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The anti-cancer drug abemaciclib (also known as Vernezio) has this month been added to the Australian Pharmaceutical Benefits Scheme (PBS) to treat certain types of breast cancer.
This significantly reduces the cost of the drug. A patient can now expect to pay A$31.60 for a 28-day supply ($7.70 with a health care concession card). The price of abemaciclib without government subsidy is $4,250.
So what is abemaciclib, and how did we get to this point?
It stops cells dividing
Researchers at the pharmaceutical company Eli Lilly developed abemaciclib and published the first study on the drug (then known as LY2835219) in 2014.
Abemaciclib is a type of drug known as a “cyclin-dependent kinase inhibitor”. It’s taken as a pill twice a day.
To maintain our health, many of the cells in our bodies need to grow and divide to produce new cells. Cancers develop when cells grow and divide out of control. Therefore, stopping cells from dividing into new cells is one way that cancer can be fought.
When cells divide, they have to make a copy of their DNA to pass onto the new cell. “Cyclin-dependent kinases” (CDKs for short) are essential for this process. So, if you stop the CDKs, you stop the DNA copying, you stop cells dividing, and you fight the cancer.
However, there are different types of CDKs, and not all cancers need them all to grow. Abemaciclib specifically targets CDK4 and CDK6. Thankfully, a lot of cancers do need these CDKs, including some breast cancers.
But abemaciclib will only be effective against cancers that rely on CDK4 and CDK6 for continued growth. This specificity also means abemaciclib is fairly unique, so it can’t easily be replaced with a different drug.
Two other CDK4/6 inhibitors were developed around the same time as abemaciclib, and are called ribociclib and palbociclib. Both of these drugs are also on the PBS for specific types of breast cancer. As the drugs differ in their chemical structures, they have slight differences in the way they are taken up and processed by the body. The preferred drug given to a breast cancer patient will depend on their unique circumstances.
What are the side effects?
Research is still ongoing into the differences between each of these CDK4/6 inhibitors, but it is known that the side effects are largely similar, but can differ in severity.
The most common side effects of abemaciclib are fatigue, diarrhoea and neutropenia (reduced white blood cells). The gastrointestinal issues are generally more severe with abemaciclib.
If these side effects are too severe, abemaciclib treatment can be stopped.
What types of cancer has abemaciclib been approved for?
In 2017, the United States Food and Drug Administration (FDA) approved abemaciclib for the treatment of patients with metastatic HR+/HER2- (hormone receptor-positive and human epidermal growth factor receptor 2-negative) breast cancer who did not respond to standard endocrine therapy.
Australia’s Therapeutic Goods Administration (TGA) similarly approved abemaciclib in 2022 as an “adjuvant” therapy (after the initial surgery to remove the tumour) for patients with HR+/HER2- invasive early breast cancer which had spread to lymph nodes and was at high risk of returning.
As of May 1 2024, the PBS covers this use of abemaciclib in combination with endocrine therapy such as fulvestrant, which is also listed on the PBS. Endocrine therapy, also known as hormonal therapy, blocks hormone receptor positive (HR+) cancers from receiving the hormones they need to survive.
Could abemaciclib be used for other cancers in the future?
Abemaciclib is of great interest to scientists and medical practitioners, and testing is ongoing to assess the effectiveness of abemaciclib in treating a range of other cancers, including gastrointestinal cancers and blood cancers.
Abemaciclib may even be usable in brain cancers, as it has long been known to be capable of crossing the blood-brain barrier, a common stumbling block for potential anti-cancer drugs.
Time will tell whether the role of abemaciclib in health care will be expanded. But for now, its inclusion on the PBS is sure to bring some relief to breast cancer patients nationwide.
Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute and John (Eddie) La Marca, Senior Resarch Officer, Walter and Eliza Hall Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Goji Berries vs Blueberries – Which is Healthier?
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Our Verdict
When comparing goji berries to blueberries, we picked the goji berries.
Why?
As you might have guessed, both are very good options:
- Both have plenty of vitamins and minerals, and/but goji berries have more. How much more? It varies, but for example about 5x more vitamin C, about 25x more iron, about 30x more calcium, about 50x more vitamin A.
- Blueberries beat goji berries with some vitamins (B, E, K), but only in quite small amounts.
- Both are great sources of antioxidants, and/but goji berries have 2–4 times the antioxidants that blueberries do.
- Goji berries do have more sugar, but since they have about 4x more sugar and 5x more fiber, we’re still calling this a win for goji berries on the glycemic index front (and indeed, the GI of goji berries is lower).
In short: blueberries are great, but goji berries beat them in most metrics.
Want to read more?
Check out our previous main features, detailing some of the science, and also where to get them:
Enjoy!
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4 Critical Things Female Runners Should Know
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When it comes to keeping up performance in the face of menopause, Shona Hendricks has advice:
Don’t let menopause run you down
- Prioritize recovery! Overtraining without adequate recovery just leads to decreased performance in the long term, and remember, you may not recover as quickly as you used to. If you’re still achey from your previous run, give it another day, or at least make it a lighter run.
- Slow down in easy and long runs! This isn’t “taking the easy way out”; it will improve your overall performance, reducing muscle damage, allowing for quicker recovery and ultimately better fitness gains.
- Focus on nutrition! And that means carbs too. A lot of people fighting menopausal weight gain reduce their intake of food, but without sufficient energy availability, you will not be able to run well. In particular, carbohydrates are vital for energy. Consume them sensibly and with fiber and proteins and fats rather than alone, but do consume them.
- Incorporate strength training! Your run is not “leg day” by itself. Furthermore, do whole-body strength training, to prevent injuries and improve overall performance. A strong core is particularly important.
For more on each of these (and some bonus comments about mobility training for runners), enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
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What Can Moderate Drinking Mean For Healthy Longevity?
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Alcohol is, of course, unhealthy. Not even the famous “small glass of red” is recommended:
Can We Drink To Good Health? ← this was mostly about the purported heart health benefits, and the answer to the question is: no, we cannot, and as WHO has declared, “the only safe amount of alcohol is zero”)
See also: How Much Alcohol Does It Take To Increase Cancer Risk? ← the answer is “any” (although, the risk is dose-dependent, so if not abstaining completely, less is still better than more)
A lot of why people think that moderate drinking is healthy, that widespread popular belief stems from flawed associative studies that compared the following two categories of people:
- non-drinkers, including many former heavy drinkers who stopped because they realized the harm they were doing to themselves
- light drinkers, who have been able to continue drinking because of their otherwise good health
In other words, they looked at now-teetotal former alcoholics whose health was ruined by drinking and concluded “aha, non-drinkers have bad health; clearly some drinking is best”.
You can read more about this and how that flawed research was later disproven once the confounding variables were removed, here: Are You Making This Alcohol Mistake?
But that’s background history. Now here’s for…
The latest evidence that makes things clearer
Researchers (Dr. Sinead George et al.) wanted to know the lifetime risk of alcohol-attributable death and illness in the US based on average weekly alcohol consumption, using evidence from more than 7,200 pre-existing research papers as well as national survey, census, mortality, and morbidity data.
So, can there be any benefit from moderate drinking?
In few words: no overall protective health effect was found at low levels of alcohol consumption, and even what is commonly considered moderate drinking was associated with increased risks of premature death and chronic disease.
In numbers: estimated lifetime alcohol-attributable mortality risk exceeded 1 in 1,000 at more than 6.5 drinks per week for men and more than 7.0 drinks per week for women, rose above 1 in 100 at more than 8.5 drinks per week for everyone and reached 1 in 25 (4%) at 14 drinks per week for men.
As for disease risk:
- Chronic disease in general: alcohol consumption increased the risk of multiple conditions, including cancers of the esophagus, mouth, and breast, cardiovascular disease, liver disease, and alcohol-related injuries.
- Heart disease in particular: although low alcohol intake was associated with a lower risk of ischemic heart disease and stroke, these potential benefits were outweighed by increased risks of cancer and other alcohol-related diseases when all health outcomes were considered together.
If you’d like to read the paper in full, here it is: Moderate alcohol consumption linked to premature death and chronic illness
If you’d like to rethink drinking for yourself, then feel free to check out: Rethinking Drinking: How To Reduce Or Quit Alcohol
Worried you’ve already done too much harm?
It’s never too early to quit drinking, but it’s also never too late:
What Happens To Your Body When You Stop Drinking Alcohol ← for a detailed timeline which parts of your body recover when
Take care!
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Wouldn’t It Be Nice To Have Regenerative Superpowers?
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The Best-Laid Schemes of Mice and Medical Researchers…
This is Dr. Ellen Heber-Katz. She’s an internationally-renowned immunologist and regeneration biologist, but her perhaps greatest discovery was accidental.
Unlike in Robert Burns’ famous poem, this one has a happy ending!
But it did involve the best-laid schemes of mice and medical researchers, and how they did indeed “gang gagly“ (or in the English translation, “go awry”).
How it started…
Back in 1995, she was conducting autoimmune research, and doing a mouse study. Her post-doc assistant was assigned to punch holes in the ears of mice that had received an experimental treatment, to distinguish them from the control group.
However, when the mice were later checked, none of them had holes (nor even any indication there ever had been holes punched)—the experiment was ruined, though the post-doc swore she did her job correctly.
So, they had to start from scratch in the new year, but again, a second batch of mice repeated the trick. No holes, no wounds, no scarring, not disruption to their fur, no damage to the cartilage that had been punched through.
In a turn of events worthy of a superhero origin story, they discovered that their laboratory-made autoimmune disease had accidentally given the mice super-healing powers of regeneration.
In the animal kingdom, this is akin to a salamander growing a new tail, but it’s not something usually found in mammals.
Read: A New Murine Model for Mammalian Wound Repair and Regeneration
How it’s going…
Dr. Heber-Katz and colleagues took another 20 years of work to isolate hypoxia-inducible factor-1a (HIF-1a) as a critical molecule that, if blocked, would eliminate the regenerative response.
Further, a drug (which they went on to patent), 1,4-dihydrophenonthrolin-4-one-3-carboxylic acid (1,4-DPCA), chemically induced this regenerative power:
See: Drug-induced regeneration in adult mice
Another 5 years later, they found that this same drug can be used to stimulate the regrowth of bones, too:
And now…
The research is continuing. Here’s the latest, a little over a month ago:
Epithelial–mesenchymal transition: an organizing principle of mammalian regeneration
Regrowing nerves has also been added into the list of things the drug can do.
What about humans?
Superpowered mice are all very well and good, but when can we expect this in humans?
The next step is testing the drug in larger animals, which she hopes to do next year, followed eventually by studies in humans.
Read the latest:
Regrowing nerves and healing without scars? A scientist’s career-long quest comes closer to fruition
Very promising!
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Tastes from our past can spark memories, trigger pain or boost wellbeing. Here’s how to embrace food nostalgia
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Have you ever tried to bring back fond memories by eating or drinking something unique to that time and place?
It could be a Pina Colada that recalls an island holiday? Or a steaming bowl of pho just like the one you had in Vietnam? Perhaps eating a favourite dish reminds you of a lost loved one – like the sticky date pudding Nanna used to make?
If you have, you have tapped into food-evoked nostalgia.
As researchers, we are exploring how eating and drinking certain things from your past may be important for your mood and mental health.
Halfpoint/Shutterstock Bittersweet longing
First named in 1688 by Swiss medical student, Johannes Hoffer, nostalgia is that bittersweet, sentimental longing for the past. It is experienced universally across different cultures and lifespans from childhood into older age.
But nostalgia does not just involve positive or happy memories – we can also experience nostalgia for sad and unhappy moments in our lives.
In the short and long term, nostalgia can positively impact our health by improving mood and wellbeing, fostering social connection and increasing quality of life. It can also trigger feelings of loneliness or meaninglessness.
We can use nostalgia to turn around a negative mood or enhance our sense of self, meaning and positivity.
Research suggests nostalgia alters activity in the brain regions associated with reward processing – the same areas involved when we seek and receive things we like. This could explain the positive feelings it can bring.
Nostalgia can also increase feelings of loneliness and sadness, particularly if the memories highlight dissatisfaction, grieving, loss, or wistful feelings for the past. This is likely due to activation of brain areas such as the amygdala, responsible for processing emotions and the prefrontal cortex that helps us integrate feelings and memories and regulate emotion.
How to get back there
There are several ways we can trigger or tap into nostalgia.
Conversations with family and friends who have shared experiences, unique objects like photos, and smells can transport us back to old times or places. So can a favourite song or old TV show, reunions with former classmates, even social media posts and anniversaries.
What we eat and drink can trigger food-evoked nostalgia. For instance, when we think of something as “comfort food”, there are likely elements of nostalgia at play.
Foods you found comforting as a child can evoke memories of being cared for and nurtured by loved ones. The form of these foods and the stories we tell about them may have been handed down through generations.
Food-evoked nostalgia can be very powerful because it engages multiple senses: taste, smell, texture, sight and sound. The sense of smell is closely linked to the limbic system in the brain responsible for emotion and memory making food-related memories particularly vivid and emotionally charged.
But, food-evoked nostalgia can also give rise to negative memories, such as of being forced to eat a certain vegetable you disliked as a child, or a food eaten during a sad moment like a loved ones funeral. Understanding why these foods evoke negative memories could help us process and overcome some of our adult food aversions. Encountering these foods in a positive light may help us reframe the memory associated with them.
Just like mum used to make. Food might remind you of the special care you received as a child. Galina Kovalenko/Shutterstock What people told us about food and nostalgia
Recently we interviewed eight Australians and asked them about their experiences with food-evoked nostalgia and the influence on their mood. We wanted to find out whether they experienced food-evoked nostalgia and if so, what foods triggered pleasant and unpleasant memories and feelings for them.
They reported they could use foods that were linked to times in their past to manipulate and influence their mood. Common foods they described as particularly nostalgia triggering were homemade meals, foods from school camp, cultural and ethnic foods, childhood favourites, comfort foods, special treats and snacks they were allowed as children, and holiday or celebration foods. One participant commented:
I guess part of this nostalgia is maybe […] The healing qualities that food has in mental wellbeing. I think food heals for us.
Another explained
I feel really happy, and I guess fortunate to have these kinds of foods that I can turn to, and they have these memories, and I love the feeling of nostalgia and reminiscing and things that remind me of good times.
Yorkshire pudding? Don’t mind if I do. Rigsbyphoto/Shutterstock Understanding food-evoked nostalgia is valuable because it provides us with an insight into how our sensory experiences and emotions intertwine with our memories and identity. While we know a lot about how food triggers nostalgic memories, there is still much to learn about the specific brain areas involved and the differences in food-evoked nostalgia in different cultures.
In the future we may be able to use the science behind food-evoked nostalgia to help people experiencing dementia to tap into lost memories or in psychological therapy to help people reframe negative experiences.
So, if you are ever feeling a little down and want to improve your mood, consider turning to one of your favourite comfort foods that remind you of home, your loved ones or a holiday long ago. Transporting yourself back to those times could help turn things around.
Megan Lee, Senior Teaching Fellow, Psychology, Bond University; Doug Angus, Assistant Professor of Psychology, Bond University, and Kate Simpson, Sessional academic, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Not-So-Sweet Science Of Sugar Addiction
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One
LumpMechanism Of Addiction Or Two?
In Tuesday’s newsletter, we asked you to what extent, if any, you believe sugar is addictive; we got the above-depicted, below-described, set of responses:
- About 47% said “Sugar is chemically addictive, comparable to alcohol”
- About 34% said “Sugar is chemically addictive, comparable to cocaine”
- About 11% said “Sugar is not addictive; that’s just excuse-finding hyperbole”
- About 9% said “Sugar is a behavioral addiction, comparable to video gaming”
So what does the science say?
Sugar is not addictive; that’s just excuse-finding hyperbole: True or False?
False, by broad scientific consensus. As ever, the devil’s in the
detailsdefinitions, but while there is still discussion about how best to categorize the addiction, the scientific consensus as a whole is generally: sugar is addictive.That doesn’t mean scientists* are a hive mind, and so there will be some who disagree, but most papers these days are looking into the “hows” and “whys” and “whats” of sugar addiction, not the “whether”.
*who are also, let us remember, a diverse group including chemists, neurobiologists, psychologists, social psychologists, and others, often collaborating in multidisciplinary teams, each with their own focus of research.
Here’s what the Center of Alcohol and Substance Use Studies has to say, for example:
Sugar Addiction: More Serious Than You Think
Sugar is a chemical addiction, comparable to alcohol: True or False?
True, broadly, with caveats—for this one, the crux lies in “comparable to”, because the neurology of the addiction is similar, even if many aspects of it chemically are not.
In both cases, sugar triggers the release of dopamine while also (albeit for different chemical reasons) having a “downer” effect (sugar triggers the release of opioids as well as dopamine).
Notably, the sociology and psychology of alcohol and sugar addictions are also similar (both addictions are common throughout different socioeconomic strata as a coping mechanism seeking an escape from emotional pain).
See for example in the Journal of Psychoactive Drugs:
On the other hand, withdrawal symptoms from heavy long-term alcohol abuse can kill, while withdrawal symptoms from sugar are very much milder. So there’s also room to argue that they’re not comparable on those grounds.
Sugar is a chemical addiction, comparable to cocaine: True or False?
False, broadly. There are overlaps! For example, sugar drives impulsivity to seek more of the substance, and leads to changes in neurobiological brain function which alter emotional states and subsequent behaviours:
The impact of sugar consumption on stress driven, emotional and addictive behaviors
However!
Cocaine triggers a release of dopamine (as does sugar), but cocaine also acts directly on our brain’s ability to remove dopamine, serotonin, and norepinephrine:
The Neurobiology of Cocaine Addiction
…meaning that in terms of comparability, they (to use a metaphor now, not meaning this literally) both give you a warm feeling, but sugar does it by turning up the heating a bit whereas cocaine does it by locking the doors and burning down the house. That’s quite a difference!
Sugar is a behavioral addiction, comparable to video gaming: True or False?
True, with the caveat that this a “yes and” situation.
There are behavioral aspects of sugar addiction that can reasonably be compared to those of video gaming, e.g. compulsion loops, always the promise of more (without limiting factors such as overdosing), anxiety when the addictive element is not accessible for some reason, reduction of dopaminergic sensitivity leading to a craving for more, etc. Note that the last is mentioning a chemical but the mechanism itself is still behavioral, not chemical per se.
So, yes, it’s a behavioral addiction [and also arguably chemical in the manners we’ve described earlier in this article].
For science for this, we refer you back to:
The impact of sugar consumption on stress driven, emotional and addictive behaviors
Want more?
You might want to check out:
Beating Food Addictions: When It’s More Than “Just” Cravings
Take care!
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