Reunion videos make me cry!

First, we had Christian the Lion. It was a video that went viral on youtube a while ago. I actually watched the documentary on Animal Planet. I have it saved on my DVR. The two men that raised Christian bought him at Herrod's Department Store in London sometime in the 70's and released him into the wild in Africa after they realized that London wasn't a good place to keep a full grown lion. Someone posted the reunion video with Aerosmith's song, "Don't Want to Miss a Thing," but I've also seen it with Whitney Houston's "I Will Always Love You" playing in the background. To see that grown lion bound toward his former owners and lick and paw at them makes me cry every time I see it.

Then today, I was introduced to Kwibi. Kwibi is a gorilla that was released into the wild at age 5. Five years later, his former owner went back to Gabon, West Africa to reunite with his dear friend. This video chronicling the reunion made me smile. What struck me was not only the fact that Kwibi responded to a call from Damian as he drifted in a boat down the river, but that he introduced Damian to his new family!

The fact two different potentially dangerous animals were able to recognize their past owners is amazing to me. To me, it clearly shows the bonds that we make with the animals in our care. I think it also demonstrates how intelligent these animals are as well.

My Work

The following is an author's commentary that I wrote in September 2009 for the website, www.MDlinx.com. It's a website for physicians and patients that is dedicated to provide users with the most recent, innovative published research on a variety of topics. I was asked to provide a brief commentary on my paper that was published in Cancer Immunology, Immunotherapeutics.

Commentary for “Concurrent vaccination with two distinct vaccine platforms targeting the same tumor antigen generates phenotypically and functionally distinct T-cell populations” by A. L. Boehm, et al. 2010. Cancer Immunol Immunother 59:397-408.

Combination therapy is not a new concept for the treatment of cancer. For years, oncologists have combined chemotherapeutic drugs, radiation, and most recently small molecule inhibitors to achieve maximum therapeutic efficacy. The first FDA-approved therapeutic cancer vaccine will be approved at the end of this year, while several other therapeutic cancer vaccines are in the late stages of development. It is foreseeable that the combination therapy trend will continue and as is the case with currently FDA-approved anti-cancer therapies, therapeutic cancer vaccines will be combined to target a single tumor-associated antigen. Our study is the first to show that two vaccine platforms targeting the same antigen can be concurrently administered due to their induction of distinct T-cell populations. Furthermore, our data show that this combination of therapeutic vaccines results in significantly increased antitumor effects in vivo, setting the stage for future studies employing combination therapy for cancer with two vaccines targeting the same tumor-associated antigen.

I would like to note that since this paper was published, the first therapeutic vaccine for cancer, Provenge, has been approved by the FDA. My work demonstrates that two vaccines can be administered at the same time without deleterious effects on the immune system. Given that Provenge may quickly become the standard of care therapy for prostate cancer, in the future, it will be important for researchers to study the combined effects of provenge with other vaccines to improve survival. My work provides evidence that this may be possible through the development of a more diverse T-cell population to target the cancer cells.

A long wait...

Sometime this week, the first therapeutic vaccine for cancer is going to be approved by the FDA to treat prostate cancer. The vaccine, Sipuleucel-T, is being marketed by Dendreon as Provenge. The company has shown that the vaccine extends the lives of advanced prostate cancer patients by an average of 4.5 months. Some of the participants in the trial lived for an additional 2-3 years. The side effects observed in the clinical trials were limited to mild flu-like symptoms—a key advantage to Provenge over conventional therapies.

It is being reported that the vaccine will cost approximately $75,000 per patient. When I first read this, sadly, I wasn’t shocked. I had just read an article in the Washington Post by Sandra G. Boodman that told the story of three different cancer patients who had to decide between dying of their cancer or putting their families into debt to pay for their cancer medications. One patient’s insurance company refused to pay for an oral chemotherapeutic medication ($4000 per month) when the i.v. version was cheaper. The patient had surgery to implant a port into her chest for the i.v. When the port sprang a leak, she was rushed to the ER. She bitterly remarks that if the insurance company had paid for the pill version of the drug, it would have been less expensive than the surgery and ER visit, and she is probably correct. This article went on to talk about another man with a form of leukemia that filled a prescription for the drug Gleevec at his pharmacy. The total charge was $10,000 for a 30-day supply. In her article, Boodman uses these stories to frame her report on the greed of pharmaceutical companies and the lack of federal guidelines and legislature that addresses these very real financial issues that are literally forcing people to choose between dying or diving into deep financial ruin in order to live. Of course, the companies cite that the development of these drugs cost billions and years to gain FDA approval. They legitimately have a lot invested and do deserve to profit off of these drugs. I have hard time reconciling the needs of the patient and the rights of the companies. I know that it can take about 10 years and about $1 billion for a drug to be developed, tested, approved, and marketed. It is a significant investment on the part of the company, which includes not only the individuals on the business end, but also scientists and doctors who literally devote their entire careers. The companies like to site that they have programs to cover the costs for patients who can’t afford their treatment. While this is an outstanding service that they provide to their community, many patients will never know about this option or live long enough to maneuver their way through the paperwork.

While Gleevec and other drug therapies simply require the patient to take a pill, Provenge is unique. It is not a pill. Actually, it isn’t a drug at all. Patients undergo leukapheresis, a procedure in which blood is collected and the white blood cells are separated out. These white blood cells include antigen-presenting cells (APCs). APCs are immune cells responsible for the recognition, processing and presentation of foreign antigens to the T-cells. The APCs are sent to a Dendreon facility, where they are kept alive in culture and exposed to a recombinant fusion protein that contains prostatic acid phosphatase (PAP). PAP is an enzyme produced by the prostate and found at elevated levels in the blood of prostate cancer patients, much like prostate-specific antigen (PSA), because the cancer cells produce it and it sheds from the cell surface into the blood stream. Cancer cells have multiple mechanisms by which they can avoid detection by T-cells. The APCs process and present PAP on their surface. Two days after the initial blood draw, the patient returns to the hospital/doctor’s office and the APCs are infused back into their body through an i.v. They undergo this process three times over the course of a four-week period and then the treatment is complete. The PAP-presenting APCs interact with other types of immune cells in the body. Essentially, the APCs are “telling” your T-cells that the PAP protein is “bad” so that they target and kill any cells in the body that express this protein on their surface. The result is that your own immune system is manipulated and used to kill your cancer. It is unlike any other FDA-approved cancer therapy. Every man diagnosed with prostate cancer will undergo this treatment, just as chemotherapy and hormone therapy are the standard today. For these men, the key will be how they pay for it.

From this point on, labs will be writing clinical trials for prostate cancer that will combine their drug with Provenge, as it will eventually become the standard of care for metastatichormone-refractory prostate cancer. This will undoubtedly be a complex undertaking as the workings of the immune system are intricate and easily influenced. It is well established that some chemotherapy drugs are immunosuppressive. It is reasonable to question if other drugs will effect the immune system’s ability to respond to Provenge or some other therapeutic vaccine. This is a question that I ask everyday in my own studies. Clearly, this is a truly exciting development that will benefit patients. However, the FDA approval of the first therapeutic vaccine for prostate cancer is also a significant event for the field of cancer biology. It is going to create an unbreakable bridge between the fields of immunology and cancer biology and will hopefully encourage the development and approval of future innovative immunotherapeutic approaches to treat cancer, leading to treatment options for patients with fewer side effects and better outcomes.

Knitting Rut

I am a knitting machine. I have made countless numbers of socks, hats, mitts, and even some sweaters. Most of my knitting is given as gifts throughout the year, but especially at Christmas. I start a project and I become obsessed with finishing it. Because of this, I typically have only two or three projects going at one time, just to break up the monotony. I have found that knitting gave me something interesting to do when I am watching TV. Or I’ll pull it out when my mind is overloaded with all the things that are going on in my life—it feels good to have something else to focus on. But the past month, I have had no interest in knitting. I have three projects that are just sitting in their bags by my couch. I don’t know what is going on with me! It’s not that I don’t like the socks, shawl and tank. I love the yarn I’m using for each, so that isn’t contributing to this knitting block either. Maybe it’s the weather? All I do know is that this is a huge problem. I have several friends expecting babies this fall and I have to start on these projects soon. I have got to get my knitting mojo back!

There are so many things that I love about spring. Tulips! I have always loved tulips! When I was a kid, I would inspect the progress of the tulips in the front yard on a daily basis. When they were emerging from the ground, I would speculate on what colors we would get. I love all of the colors. I think a big vase full of multi-colored tulips is perfection. In college, I lived on the tiny campus of Washington and Jefferson College in Washington, PA. In 1998, when I began my freshman year, the campus was little more than a 6 square block area. I would walk to my 8am biology and chemistry classes and find the best tulips that week. Then under the cloak of darkness, I would take a study break around 10 or 11pm, grab a pair of scissors, and go cut down the tulips I had pre-screened earlier that day. I’m sure that the grounds people were wondering what was happening to all of their tulips. They would last a week or so, and in the meantime, I would keep an eye out for the next flowerbed that was in bloom. I have no regrets that I was a tulip-bandit. I think that having those flowers on my desk while I was studying was a comfort. It reminded me of a time when I didn’t place my self worth on a grade from a biology exam. And it made me smile.

I think that spring holds the potential for provoking a lot of smiles. It’s said that spring is a time of rebirth. After the cold dark winter, spring comes along and everything is made new again. Flowers bloom, trees are leafy green, and the birds are chirping first thing in the morning. The beautiful weather in D.C. is enough to make me smile. It’s been absolutely gorgeous the past few weeks. Other things that make me smile this time of year: squirrels (I just think they are cute), little kids in sunglasses, and local farmers’ markets. Also, Cadbury Eggs. Love love love Cadbury Eggs. I hope that everyone else can take a minute or two and find something to smile about. Happy spring!

Sweet Sweet Tequila

I’ve signed up for a couple of email alerts from different websites that recommend articles for me to read about cancer, immunology, etc. Today, I happened upon the article, “ Ingredient in Tequila Plant May Fight Osteoporosis and other Diseases,” published on the Science Daily Website. Immediately I thought that this is awesome news because now I have another excuse to drink margaritas—to fight off osteoporosis! I did a quick wikipedia search and got some more info on the magical agave plant, which is used to make tequila. Predominantly found in Mexico, Agave is apparently a popular ornamental plant and many parts of it are edible. The sap of the blue agave plant is fermented and distilled to make tequila. Studies have shown that fructans, found in agave, are responsible for the therapeutic benefits associated with the plant. As I continued reading the Science Daily article, studies suggesting fructans have therapeutic potential for the treatment of diabetes, obesity, and constipation were cited in addition to the recent findings concerning osteoporosis presented at the 239th National Meeting of the American Chemical Society. Furthermore, studies have indicated that fructans stimulate the immune system. I did find a few articles that support these key points, listed below. Then comes the bombshell, about three paragraphs in. “Fructans do not occur in tequila, however, because they change into alcohol when agave is used to make tequila.” Seriously? I knew it was too good to be true! Apparently a weekly happy hour featuring Patrone won’t save me from a hunchback.

Sources:

1. American Chemical Society (2010, March 23). Ingredient in tequila plant may fight osteoporosis and other diseases. ScienceDaily.

2. Lobo AR, Cocato ML, Jorgetti V, de Sá LR, Nakano EY, Colli C. Changes in bone mass, biomechanical properties, and microarchitecture of calcium- and iron-deficient rats fed diets supplemented with inulin-type fructans. Nutr Res. 2009 Dec;29(12):873-81.

3. Ryz NR, Meddings JB, Taylor CG. Long-chain inulin increases dendritic cells in the Peyer's patches and increases ex vivo cytokine secretion in the spleen and mesenteric lymph nodes of growing female rats, independent of zinc status. Br J Nutr. 2009 Jun;101(11):1653-63.

4. Urías-Silvas JE, Cani PD, Delmée E, Neyrinck A, López MG, Delzenne NM.Physiological effects of dietary fructans extracted from Agave tequilana Gto. and Dasylirion spp. Br J Nutr. 2008 Feb;99(2):254-61.

The 5 W's

Who? What? Where? When? Why? Sometime, many years ago, when I was in a reading class in elementary school, I remember that I was taught to always ask these questions when I read something. Read a paragraph out of the grade 2 reading workbook? Well then you have to answer these questions. I think it was a way to get us to begin to think critically about what we were reading, now that we actually knew how to read. And I thought the hard part was over! The 5 W's re-emerged when I was in charge of making my own invitations for my birthday party. I had a pile of construction paper, a glue stick and some glitter laid out on the table in front of me. I spent all of this time making sure that the Care bear on the front was drawn and glittered up properly. Then I was absolutely stumped about what to put in it. I remember my mom telling me, "Just use the 5 W's--list them out and you'll have all the info they need." In the 20 or so years since, I have used the 5 W's in many situations, including the ads for the Prom Fashion Show, the announcements at chapter meetings about the volunteer activities I planned, and again in grad school for the email fliers about the annual bar crawl. So many times, when I am at a loss at how to start something, I use the 5 W's and it has never failed me.

So that leads me to today. I am about 5 days away from turning the big 3-0. And it's occurred to me that there are a lot of things that I want to accomplish in this next decade of my life. I also want to reflect on some of the things I've accomplished in the past 30 years. So while I was laying in bed last night, it occurred to me that instead of keeping a classic journal--with pen and paper--I'd embrace technology and record my thoughts on a blog. Now anyone who knows me will be shocked at reading this. I was one of the last people I know to get an email address. I didn't really become computer savvy until grad school, when it became a necessity. Furthermore, I still refuse to acknowledge the existence, let alone the utility of Twitter. But I'm going to embrace technology here.

About 2 seconds after this blog idea took form, I almost immediately talked myself out of doing it. "Who the hell will read it? I'll be devastated if no one ever reads it! I don't have anything interesting to say." Well, I don't care if anyone ever reads this thing. It would be nice, but, oh well if it doesn't happen. I'll use this as my journal and journals are never read by anyone unless you are under the age of 16 and have a nosy sibling. Or you do something amazing that merits people actually being interested in what you had to say. Oh, and of course, I asked myself, "How do I even start?" So here it goes.

Who? Amanda L. Boehm. I am a science nerd. I have 2 cats. (You'll hear more about them soon enough.) I was born and raised in Pittsburgh, PA. My family and friends are the most important thing to me. That, in a few words, is who I am. But I'm so much more. And that will come in time.

What? A blog. A journal. A way to get all of my thoughts and impressions on the world down in black and white. I want to talk about me and what I do. Maybe talk about an interesting article on cancer that I read or a great recipe or maybe one of those wonderfully thought provoking philosophical questions that always annoy the hell out of me. An exercise in thinking and writing.

Where? Well, here on this blog.

When? Whenever I have something on my mind.

Why? Because it could be awesome in another 30 years to have something to show my kids or gran kids that records who I was before I became that crazy lady with the blue hair and an ornery attitude.

So if you are reading this, you have been officially invited to my blog. Hope you enjoy it!