Gene Therapy Again Showing Promise

(p. B2) Biotechnology startup Spark Therapeutics Inc. said its experimental gene therapy improved vision among patients with hereditary vision impairment in a clinical trial, without the serious safety problems that have dogged the emerging field of gene therapy in the past.
. . .
Spark said it plans to seek U.S. Food and Drug Administration approval to market its treatment next year, which could make it the first gene therapy to reach the U.S. market if regulators approve it for sale. . . .
Gene therapy involves the injection of genetic material into a person’s cells to treat or prevent a disease. The research stalled after some study participants died or developed cancer after receiving gene therapies in the late 1990s and 2000s.
But gene therapy is gaining ground again. In 2012, the European Commission approved the Western world’s first gene therapy, UniQure NV’s Glybera, for the treatment of patients with a rare enzyme deficiency. The therapy hasn’t been approved for sale in the U.S.

For the full story, see:
PETER LOFTUS. “Eye Gene Therapy Shows Promise.” The Wall Street Journal (Tues., Oct. 6, 2015): B2.
(Note: ellipses added.)
(Note: the online version of the article has the date Oct. 5, 2015, and has the title “Gene Therapy for Visually Impaired Shows Promise.” Where there were minor differences between the print and online versions, the passages quoted above follow the online version.)

“Good News for the Grumpy”: Happiness Does Not Lengthen Life

(p. A6) A study published on Wednesday [Dec. 9, 2015] in The Lancet, following one million middle-aged women in Britain for 10 years, finds that the widely held view that happiness enhances health and longevity is unfounded.
“Happiness and related measures of well-being do not appear to have any direct effect on mortality,” the researchers concluded.
“Good news for the grumpy” is one way to interpret the findings, said Sir Richard Peto, an author of the study and a professor of medical statistics and epidemiology at the University of Oxford.
He and his fellow researchers decided to look into the subject because, he said, there is a widespread belief that stress and unhappiness cause disease.
Such beliefs can fuel a tendency to blame the sick for bringing ailments on themselves by being negative, and to warn the well to cheer up or else.
“Believing things that aren’t true isn’t a good idea,” Professor Peto said in an interview. “There are enough scare stories about health.”
The new study says earlier research confused cause and effect, suggesting that unhappiness made people ill when it is actually the other way around.
. . .
Professor Peto said particularly important data came from 500,000 women who reported on their baseline surveys that they were in good health, with no history of heart disease, cancer, stroke or emphysema.
A “substantial minority” of these healthy women said they were stressed or unhappy, he said, but over the next decade they were no more likely to die than were the women who were generally happy.

For the full story, see:
DENISE GRADY. “Happiness Doesn’t Bring Good Health, Study Finds.” The New York Times (Thurs., DEC. 10, 2015): A6.
(Note: bracketed date added.)
(Note: the online version of the story has the date DEC. 9, 2015, and has the title “Happiness Doesn’t Bring Good Health, Study Finds.”)

The research summarized in the passages quoted above, appeared in:

Liu, Bette, Sarah Floud, Kirstin Pirie, Jane Green, Richard Peto, and Valerie Beral. “Does Happiness Itself Directly Affect Mortality? The Prospective UK Million Women Study.” The Lancet (Dec. 9, 2015) DOI: http://dx.doi.org/10.1016/S0140-6736(15)01087-9.

Frustrating Failure to Cure Cancer

PiersonEmmaAndGrandfather2016-01-20.jpg“Emma Pierson as a child playing chess with her grandfather, whose cancer she is trying to fight.” Source of caption: print version of the NYT article quoted and cited below. Source of photo: online version of the NYT article quoted and cited below.

(p. D4) . . . in the four years since I learned I carried a BRCA mutation, I have watched my attempts to do something about it repeatedly miss the mark. I joined a laboratory to do cancer research, but the paper we wrote had little to do with cancer; I joined a company that offered the cheapest BRCA tests on the market, and its service was shut down a month after I arrived. I am 24 years old; at 25, I will have to choose between aggressive screening and prophylactic mastectomy. I had hoped to use my brain to protect my body, but I am running out of time.

If life’s complexities confound a 20-year-old’s desperate idealism, cancer’s do as well. The more I learn, the more I worry that we may never find a singular cure for cancer: that each cancer’s unique biological filigree necessitates a brutal and byzantine combination of treatments.
I also worry that the end goal is so far away that we sometimes lose sight of its importance, and view biological research as a competitive game rather than a means of saving lives. I feared being the worst student in my first cancer class, even though a roomful of researchers better than I am is exactly what I should want. Since then, I’ve seen many indications of the competitiveness in cancer research — a teacher who made us promise not to steal other students’ final projects, scientists who snipe at one another or falsify work — that make me think I am not the only one who sometimes forgets what is at stake.
. . .
I am not going to cure cancer, not even the BRCA cancers. And I am going to watch the people I love die from diseases I cannot understand or prevent. I would be lying if I told you I have made my peace with that. It gives me hope only to fight, as my grandfather did, for futures unseen: to strive, to seek, to find and not to yield.

For the full commentary, see:
EMMA PIERSON. “Leaving No Move Untried.” The New York Times (Tues., Dec.. 1, 2015): D4.
(Note: ellipses added.)
(Note: the online version of the commentary has the date NOV. 30, 2015, and has the title “Seeking a Cancer-Free World.” The last words in Pierson’s commentary quote the final line of Alfred Lord Tennyson’s great poem “Ulysses.”)

Recording a Pain of “5” and Then Leaving Without Relieving

If health care was provided by free market companies whose success depended on voluntarily attracting customers, instead of by bureaucratic, hyper-regulated, CYA incentivized, and competition-insulated bureaucracies, would the surreal experience reported below be as common as it is?

(p. 11) A FRIEND was recently hospitalized after a bicycle accident. At one point a nursing student, together with a more senior nurse, rolled a computer on wheels into the room and asked my friend to rate her pain on a scale of 1 to 10.

She mumbled, “4 to 5.” The student put 5 into the computer — and then they left, without further inquiring about, or relieving, my friend’s pain.
This is not an anecdote about nurses not doing their jobs; it’s an illustration of what our jobs have become in the age of electronic health records. Computer documentation in health care is notoriously inefficient and unwieldy, but an even more serious problem is that it has morphed into more than an account of our work; it has replaced the work itself.
Our charting, rather than our care, is increasingly what we are evaluated on. When my hospital switched to bar code scanning for medication administration, not only were the nurses on my floor rated as “red,” “yellow” or “green” based on the percentage of meds we scanned, but those ratings were prominently and openly displayed on printouts left at the nurses’ station.
. . .
We need to streamline our records so that they serve just one master: the patient. We should focus on the most important information in guaranteeing accuracy of diagnosis, efficacy of treatment, continuity of care and patient safety. Otherwise the content of our care will be increasingly warped by the demands of our e-record systems — and patients like my poor friend will lie in hospital beds in pain, uncomforted by the knowledge that the electronic record of that pain is satisfyingly and exactingly complete.

For the full commentary, see:
THERESA BROWN. “Patients vs. Paperwork.” The New York Times, SundayReview Section (Sun., DEC. 20, 2015): 11.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date DEC. 19, 2015, and has the title “When Hospital Paperwork Crowds Out Hospital Care.”)

Cooking Over Indoor Wood Fires Kills Millions

(p. A13) Indoor air pollution, caused mainly by cooking over wood fires indoors, is the world’s biggest cause of environmental death. It kills an estimated four million people every year, as noted by the nonprofit science news website, SciDev.Net. Getting fossil-fueled electricity and gas to them is the cheapest and quickest way to save their lives. To argue that the increasingly small risk of dangerous climate change many decades hence is something they should be more worried about is positively obscene.

For the full commentary, see:
MATT RIDLEY. “The Green Scare Problem; Raising constant alarms–about fracking, pesticides, GMO food–in the name of safety is a dangerous game.” The Wall Street Journal (Fri., Aug. 13, 2015): A13.
(Note: the online version of the commentary has the date Aug. 13, 2015.)

Regulations Slow Eradication of Cancer

(p. D3) . . . the triumph of chemotherapy for Hodgkin’s and then for many other tumors opened an interlocking series of dilemmas. In the clinic and the hospital, the new protocols demanded that doctors muster the courage to make their patients very sick in order to make them well. But how sick was too sick? The risks and benefits of the powerful treatments now needed careful, deliberate assessment at every stage of the disease.
Similar questions dogged those who developed, evaluated and regulated the drugs. How poisonous could these agents safely be? How assiduously should desperate patients be saved by their government from pharmaceutical risk?
Dr. DeVita stands firmly among those affirming cancer patients’ right to aggressive treatment. One particular exchange summarizes his philosophy: “Do your patients speak to you after you do this to them?” one skeptic asked him early on. “The answer is yes,” he replied, “and for a lot longer.”
The regulatory caution of the Food and Drug Administration has been a thorn in his side for decades: “I’d like to be able to say that as cancer drugs have become increasingly more complex and sophisticated, the F.D.A. has as well. But it has not.” In fact, he writes, “the rate-limiting step in eradicating cancer today is not the science but the regulatory environment we work in.”

For the full review, see:
ABIGAIL ZUGER, M.D. “An Unbowed Warrior.” The New York Times (Tues., Dec.. 1, 2015): D3.
(Note: ellipsis added.)
(Note: the online version of the review has the date NOV. 30, 2015, and has the title “Review: Science and Politics Collide in ‘The Death of Cancer’.”)

The book under review, is:
DeVita, Vincent T., and Elizabeth DeVita-Raeburn. The Death of Cancer: After Fifty Years on the Front Lines of Medicine, a Pioneering Oncologist Reveals Why the War on Cancer Is Winnable–and How We Can Get There. New York: Sarah Crichton Books, 2015.

Anti-GMO Chipotle No Longer Wears Health Halo

(p. A13) . . . if you need an anecdote for how the year unfolded for the anti-GMO movement, look no further than Chipotle. Last spring the fast food company announced with great fanfare that it would take GMO ingredients off its menu. It was all downhill after that. As was quickly pointed out, Chipotle wasn’t being fully truthful, since its soft drinks and cheese contain genetically modified ingredients, and its meat comes from animals fed genetically modified grains. A lawsuit filed in California, which is pending, accused Chipotle of false advertising and deceptive marketing.
Then cases of food-borne illnesses hit Chipotle locations across the country. Supporters of traditional agriculture, who have felt maligned by the burrito company, started keeping a tally of the number of people sickened by Chipotle’s food (ongoing, but more than 300) versus the number sickened by GMOs (zero). As the year winds to a close, the company that once wore the restaurant industry’s health halo is apologizing, preparing for lawsuits, recentralizing its vegetable preparation and cutting locally sourced ingredients.

For the full commentary, see:
JULIE KELLY. “The March of Genetic Food Progress; ‘Farmaceuticals’ and other GM products are slowly being approved, despite political scare campaigns.” The Wall Street Journal (Weds., Dec. 30, 2015): A13.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date Dec. 29, 2015.)

Parents Set Up For-Profit Companies for Quicker Cures

(p. B1) Karen Aiach was working as a management consultant when she learned that her first daughter, Ornella, had Sanfilippo syndrome, a rare disease in which a missing enzyme causes toxic substances to build up in the body.

Ornella was 6 months old, and the prognosis was grim: She would develop mentally and physically to between ages 2 and 4, plateau and then lose whatever she had learned. She would become extremely hyperactive and develop sleeping disorders. Most likely she would not live past 15.
Within two years of the diagnosis, Ms. Aiach, who lives in a Paris suburb, had quit her consulting job to learn everything she could about the disease. She hired a neurobiologist to guide her in the world of medical research. And when she learned that few treatments were in the works, she founded a company called Lysogene to focus on genetic therapy.
Instead of raising money and awareness by setting up a nonprofit foundation, a more typical route, she opted to start a for-profit company to seek treatments, if not a cure. Far from common, what Ms. Aiach and other parents like her are trying is to leverage their wealth, contacts and the hope of sophisticated investors to jump-start research into rare diseases.
. . .
(p. B4) . . . with some rare diseases, where minimal research has been done, a little effort goes a long way.
Nicole Boice, who founded Global Genes, one of the leading rare-disease patient advocacy organizations, said even small investments can have meaningful impacts.
“You can start moving the needle with $3,500,” she said. “That leads you to the next $25,000, and then to innovation grants and funding at $100,000. That starts the interest from biotech.”
Gradually, parents like Matt Wilsey, a technology entrepreneur, have made headway. First, his family spent the better part of four years trying to figure out what afflicted his daughter, Grace, now 6. Even after her genome was sequenced, the first diagnosis turned out to be wrong. Grace, it finally was determined, was the second person in the world known to have a deficiency in the gene known as NGLY1.
“We went around the country,” Mr. Wilsey said. “We were just trying to find one doctor who had seen another patient with these symptoms.” After years of efforts, several dozen children have been found to have the same deficiency.
“Our goal is to find a cure,” said Mr. Wilsey, who lives in the San Francisco area.
“A lot of people in science dismiss that because cures are rare. But when I say cures, they’re not going to be astronauts. They’re going to be leading some sort of independent life. They’re going to be able to eat without choking. They’re going to be able to take a bath without drowning. They’re going to be able to communicate, whether with some assistive device or not.”
These parents also had a successful model to follow. In 1998, John Crowley left his job at Bristol-Myers Squibb to start a biotechnology company to search for a treatment for Pompe disease, a neuromuscular disorder that two of his children had. Within four years, the company, Novazyme Pharmaceuticals, had devised a treatment that he credits with saving their lives. His story was immortalized in the 2010 film “Extraordinary Measures,” starring Harrison Ford. And his company was bought by the pharmaceutical giant Genzyme for $137.5 million in 2001.

For the full story, see:
PAUL SULLIVAN. “Wealth Matters; Parents of Children With Rare Diseases Find Hope in For-Profit Companies.” The New York Times (Sat., DEC. 26, 2015): B1 & B4.
(Note: ellipsis added.)
(Note: the online version of the story has the date DEC. 25, 2015, and has the title “Wealth Matters; Building a Company to Treat a Rare Disease.”)

Consumers Vote “No” on Costly Organic Smoothies “Made of Swiss Chard, Cashew Milk and Himalayan Salt”

(p. D1) As recently as last month, one could hardly throw a lentil in New York City without hitting an Organic Avenue storefront, with its orange banner, stick-figure logo and promise of better living through $9 cayenne-infused lemonade.
Kat Schamens, a yoga teacher and fitness-apparel designer, liked it that way. “I would always think, ‘I can’t wait to go in and get my chickpea soup,’ ” she said.
In mid-October, Ms. Schamens learned that Organic Avenue’s 10 stores had been shuttered and that the company had filed for bankruptcy. “I kind of freaked out,” she said. “I was distraught. I lost my yoga for a minute.”
. . .
(p. D7) The loyalty of devotees like Ms. Schamens and Ms. Kerin notwithstanding, there is an admitted emperor’s new clothes quality to paying $25 for a lunch of vegetable shavings and a smoothie made of Swiss chard, cashew milk and Himalayan salt.
“You can’t get people to crave this food,” the former investor said. “You can’t build a long-term business off what Gwyneth Paltrow likes.”
Some researchers began to publish studies questioning the necessity and safety of juice cleanses. And the fashion world started to feel pushback from nutritionists and eating-disorder activists against its support of juicing in early 2013, after the Council of Fashion Designers of America announced a 50 percent discount for models on Organic Avenue juices during New York Fashion Week.

For the full story, see:
KATHERINE ROSMAN. “How Organic Avenue Lost All Its Juice.” The New York Times (Sun., NOV. 5, 2015): D1 & D7.
(Note: ellipsis added.)
(Note: the online version of the story has the date NOV. 4, 2015.)

FDA Forces Child to Go to London to Get Drug to Fight His Cancer

(p. A15) How far would you go to get a drug that could save your child’s life? Across an ocean? That is exactly what the federal government is forcing some American families with dying children to do.
In 2012, when Diego Morris was 11 years old, he was diagnosed with a deadly cancer in his leg called osteosarcoma. Doctors at St. Jude Children’s Research Hospital in Memphis, Tenn., removed the tumor, but the prognosis was poor. There was a significant risk that even extensive chemotherapy after surgery would not prevent the cancer from returning.
Fortunately, a team of doctors at MD Anderson Cancer Center in Houston and Memorial Sloan Kettering Cancer Center in New York City had developed a revolutionary new drug, mifamurtide (MTP), that can prevent osteosarcoma from coming back. A study by Dr. Eugenie Kleinerman of MD Anderson and Dr. Paul Meyers of Sloan Kettering showed the drug resulted in a 30% reduction in the osteosarcoma mortality rate at eight years after diagnosis.
The drug was approved in 2009 by the European Medicines Agency and is currently the standard of care in Europe, Israel and many other countries. In 2012 it received the prestigious Prix Galien Award, the gold medal for pharmaceutical research and development in the United Kingdom.
MPT was exactly what Diego needed. But there was one problem: The drug was not available in America because the Food and Drug Administration had rejected it, demanding additional studies. That meant that Diego had to travel from Phoenix to London to get the drug he needed to save his life–a drug that was available in almost every industrialized nation and should have been available in the U.S.

For the full commentary, see:

DARCY OLSEN. “Winning the Right to Save Your Own Life; As the FDA dawdles, 24 states pass ‘right-to-try’ laws giving terminally ill patients access to drugs.” The Wall Street Journal (Fri., Nov. 27, 2015): A15.

(Note: the online version of the commentary has the date Nov. 26, 2015.)

Olsen’s commentary is related to her book:
Olsen, Darcy. The Right to Try: How the Federal Government Prevents Americans from Getting the Lifesaving Treatments They Need. New York: HarperCollins Publishers, 2015.

Cuomo Bans the Fracking that Could Revive New York’s Southern Tier

(p. A25) CONKLIN, N.Y. — The main grocery store here was replaced by a Family Dollar store, already faded. The historic front of the town hall, a castle no less, is crumbling, and donations are being solicited. The funds earmarked to strip off the lead paint from the castle’s exterior went instead to clear mold from the basement.
This town of roughly 5,500 residents looks alarmingly like dozens of other towns and cities in New York’s Southern Tier, a vast part of the state that runs parallel to Pennsylvania. Years ago, the region was a manufacturing powerhouse, a place where firms like General Electric and Westinghouse thrived. But over time companies have downsized, or left altogether, lured abroad or to states with lower taxes and fewer regulations.
. . .
In western New York, . . . , Gov. Andrew M. Cuomo, a Democrat, pledged $1 billion in 2012 to support economic development. Since then, he has poured hundreds of millions of dollars into numerous Buffalo-area projects.
The Southern Tier has proved to be a harder fix. It is predominantly rural and lacks a significant population core that typically attracts the private sector.
The region is resource rich, but landowners are angry the government will not let them capitalize on it. Some had pinned their hopes of an economic revival on the prospect of the state’s authorizing hydraulic fracturing, known as fracking; many of them can recite the payment formula gas companies were proposing: $500 a month per acre.
But the Cuomo administration, citing health risks, decided last year to ban the practice, leaving some farmers contemplating logging the timber on their land, a move that could destroy swaths of pristine forest.

For the full story, see:
SUSANNE CRAIG. “Former Hub of Manufacturing Ponders Next Act.” The New York Times (Weds., SEPT. 30, 2015): A20-A21.
(Note: ellipses added.)
(Note: the online version of the story has the date SEPT. 29, 2015, and has the title “New York’s Southern Tier, Once a Home for Big Business, Is Struggling.”)