Indian, Pakistani women diagnosed with more aggressive breast cancer at younger age

News Network
October 26, 2020

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Houston: Indian and Pakistani women are diagnosed with breast cancer, including more aggressive forms, at a younger age, according to a study that provides an insight into understanding the risk factors influencing the disease.

The study, published in the International Journal of Cancer, examined the characteristics of breast cancer among Indian and Pakistani-American and non-Hispanic white women in the US using data from the National Cancer Institute's Surveillance, Epidemiology and End Results Program.

Both, Indian and Pakistani women are diagnosed with more aggressive forms of the disease, at a younger age, according to the researchers.

The researchers, who are part of the Rutgers School of Public Health and Rutgers Cancer Institute of New Jersey, reviewed incidence data among Indian and Pakistani women between 1990 and 2014.

"Our results provide an insight into breast cancer in Indian and Pakistani women, suggesting several hypotheses to guide future scientific studies to better understand the risk factors influencing disease etiology and prognosis," said Jaya M Satagopan, lead author and director of the Center for South Asian Quantitative Health and Education at the Rutgers School of Public Health.

South Asians are the fastest-growing major ethnic group in the United States with breast cancer rates increasing within the population, but little is known about the disease in this socio-culturally unique population, according to the study.

The researchers also reviewed the disease characteristics, treatment and survival data between 2000 and 2016 for 4,900 Indian and Pakistani women and 482,250 non-Hispanic white women with breast cancer.

They found that the occurrence of breast cancer in Indian and Pakistani women was lower than in non-Hispanic white women, however, the number of Indian and Pakistani women diagnosed with breast cancer increased over the years.

Indian and Pakistani women with breast cancer were more likely to be diagnosed at a younger age and at more advanced stages of the disease. In addition, they received more subcutaneous or total mastectomies than non-Hispanic white women, it said.

While the researchers found that Indian and Pakistani women were less likely to die of breast cancer than their non-Hispanic white counterparts, their health was tracked for a shorter time.

Prior cancer research has shown that fewer Indian and Pakistani women participate in scientific studies and that several sociocultural factors may delay their seeking health care.

Research also has shown poor mammogram screening rates in Indian and Pakistani women, which is linked to a lack of family support, lack of transportation, modesty, fear, beliefs that cancer is divine punishment for past deeds, having lived in the United States for less than 10 years, low English proficiency and a lack of faith in the health system.

"Our study indicated that there are important differences in this population that justify further studies to better understand biological, sociocultural, and system level factors such as interactions with the health system, affecting breast cancer screening patterns, diagnosis, risk and survival among South Asian women, given the paucity of literature on this topic,” said the study's senior author Elisa V Bandera, co-leader of the Cancer Prevention and Control Research Program at Rutgers Cancer Institute of New Jersey and professor at Rutgers Robert Wood Johnson Medical School.

The study recommends identifying strategies to better engage Indian and Pakistani women in breast cancer studies and to improve interactions between health care providers and Indian and Pakistani women to identify sociocultural factors associated with screening decisions and health care use in this population.

"As the South Asian population in the United States — and especially in New Jersey — grows, it is imperative that we work to promote health equity in cancer prevention, screening, early diagnosis and treatment through community engagement and a team science approach," said Anita Kinney, director of the Center for Cancer Health Equity at Rutgers School of Public Health and Rutgers Cancer Institute of New Jersey and professor at the Rutgers School of Public Health, who is also one of the study's authors.

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Agencies
November 26,2020

Geneva, Nov 25: Approximately once every minute and 40 seconds, a child or young person under the age of 20 was infected with HIV last year, the UN Children's Fund (UNICEF) said on Wednesday.

Prevention efforts and treatment for children remain some of the lowest amongst key affected populations, and in 2019, a little less than half of children worldwide did not have access to life-saving treatment, UNICEF said in a new report.

Nearly 3,20,000 children and adolescents were newly infected with HIV and 1,10,000 children died of AIDS last year, the Xinhua news agency reported.

"Children are still getting infected at alarming rates, and they are still dying from AIDS. This was even before Covid-19 interrupted vital HIV treatment and prevention services putting countless more lives at risk," said UNICEF Executive Director Henrietta Fore.

According to UNICEF, the Covid-19 pandemic has worsened inequalities in access to life-saving HIV services for children, adolescents and pregnant mothers everywhere, and there are serious concerns that one-third of high HIV burden countries could face coronavirus-related disruptions.

"Even as the world struggles in the midst of an ongoing global pandemic, hundreds of thousands of children continue to suffer the ravages of the HIV epidemic," said Fore.

Data from the Joint UN Programme on HIV/AIDS (UNAIDS), cited in the report, showed the impact of control measures, supply chain disruptions, lack of personal protective equipment, and the redeployment of healthcare workers on HIV services.

Pediatric HIV treatment and viral load testing in children in some countries fell by 50 to 70 per cent, and new treatment initiation by 25 to 50 percent in April and May, coinciding with partial and full lockdowns to control the novel coronavirus.

Health facility deliveries and maternal treatment were also reported to have reduced by 20 to 60 per cent, maternal HIV testing and antiretroviral therapy (ART) initiation by 25 to 50 per cent, and infant testing services by approximately 10 percent.

Though the easing of control measures and the strategic targeting of children and pregnant mothers have successfully led to a rebound of services in recent months, challenges remain, and the world is still far from achieving the global 2020 pediatric HIV targets, said UNICEF.

Despite some progress in the decades-long fight against HIV and AIDS, deep regional disparities persist among all populations, especially for children.

While the Middle East and North Africa region recorded 81 percent pediatric ART coverage, only 46 per cent and 32 per cent were covered in Latin America and the Caribbean, West and Central Africa, respectively.

The South Asia region recorded 76 per cent coverage, Eastern and Southern Africa 58 per cent, and East Asia and the Pacific 50 per cent.

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November 19,2020

New Delhi, Nov 19: From helping in optimising the yield of therapeutics to training staff for setting up large-scale manufacturing sites, cutting-edge technologies such as artificial intelligence (AI) and virtual reality (VR) can be used to fast track COVID-19 vaccine development worldwide, experts say.

The search for a COVID-19 vaccine has expanded worldwide, with thousands of researchers collaborating at hundreds of laboratories to fight the virus that has infected 56 million people and claimed over 1.34 million lives so far.

Recently, a panel of experts noted at the Berlin Science Week, a ten-day science festival, that AI and other technologies like machine learning (ML) can make sense of the mountains of data from several experiments by discovering patterns that a human brain might fail to spot.

As vaccine candidates advance to the final phases of testing in humans, experts said AI would be vital for analysing clinical and immunological data rapidly.

Rene Faber, from the pharmaceutical company Sartorius headquartered in Germany, said there is a need to utilise these "handy innovations."

Citing the example of single-use technologies, Faber said these can help build manufacturing capacities for the vaccines quickly.

In single-use technologies, he said, everything in the manufacturing process is made out of plastic, and is used just once to help users avoid any cleaning.

"It helps customers to build manufacturing facilities much faster, saving a year or even more than a year to build the manufacturing process, Faber said during a session on current trends in vaccine research organised by the Falling Walls Foundation.

"And also it's something which is very flexible, meaning if you build such a facility, let us say in the US, you can copy-paste very quickly that manufacturing process either in Europe or in Asia as well," he noted.

Another technology of importance in COVID-19 vaccine research, Faber said, is automation.

When customers develop a manufacturing process, he said they have to run a large number of experiments to narrow in on the right process parameters.

According to Faber, manufacturers also need to understand how the production process can impact the quality of the vaccine, and find ways to optimise its yield.

"This is very important work which needs to be done and takes a lot of time, and there are very innovative tools which allow for very high throughput, and automation is a way to run such experiments," he said.

Digitisation, and tools such as AI are used for real-time data analysis to predict or change the process before something goes wrong, he added.

"And you may avoid loss of a vaccine badge which of course nobody wants to have in the situation today. So there are a number of innovations we have in our hands today that we can use to really speed up the development and also build up the manufacturing," Faber said.

Uwe Gottschalk, Chief Technology Officer at Lonza Pharma/Biotech, Switzerland said in the therapeutic space, especially vaccine development, new innovations and technology are coming to help.

" the pharma industry as a whole is quite slow and that is because we cannot cut corners and compromise the efficacy and safety of our products, and this has also been for too long used as an excuse not to innovate, and from gene to R&D the mantra was it takes one or two years to make clinical material from the DNA becoming available for a new drug, Gottschalk said.

With this being challenged in the vaccine industry, he said companies are now applying all the know-how from ML to AI for speeding up vaccine development.

Citing another example of novel technology coming to aid amidst the COVID-19 pandemic, Gottschalk said Lonza is currently setting up large-scale manufacturing sites for vaccine production even before any equipment is on-site.

"We can train our specialists with the help of virtual reality. So the specialists are being trained as we speak. Although they are sitting in a training centre or maybe at home," he said, adding this approach can help save months.

Faber said the production of most biological products is based on the behaviour of individual cells, and AI is used to model how these building blocks of life act as a manufacturing facility for proteins and other molecules, including vaccines.

"Tools like AI, mechanistic modelling, statistical tools, statistical data analysis, all in combination we believe will bring a lot of insights in the challenges we still have today," he added.

Highlighting the use of AI in vaccine development, Professor Carlos A. Guzman, head of the department Vaccinology and Applied Microbiology at the Helmholtz Centre for Infection Research, Germany said every individual human even within the same age group does not respond to vaccines in the same manner, adding that it is important to understand why there are good responders and bad responders to the therapeutic.

Guzman believes that if the mechanism behind this is understood, novel vaccines can be developed which can even work for groups of the population that generally have poor response to immunisation.

"This kind of technology of course can be implemented and is something we are getting from other fields," he added.

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Agencies
November 24,2020

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Geneva, Nov 24: "There is now real hope that vaccines, in combination with other tried and tested public health measures, will help to end the pandemic," said the World Health Organisation (WHO) Director-General Tedros Adhanom Ghebreyesus.

The WHO chief's remarks came after drugmaker AstraZeneca said on Monday that its COVID-19 vaccine, developed with Oxford University, was up to 90 percent effective, making it the third major drug company after Pfizer and Moderna to have reported late-stage data for a potential COVID-19 vaccine, Xinhua news agency reported on Tuesday.

"The significance of this scientific achievement cannot be overstated. No vaccines in history have been developed as rapidly as these. The scientific community has set a new standard for vaccine development," Tedros added.

He pointed out now the international community must set a new standard for access, as "the urgency with which vaccines have been developed must be matched by the same urgency to distribute them fairly."

Worried that the poorest and most vulnerable countries will be trampled in the stampede for vaccines, WHO established the Access to COVID-19 Tools Accelerator to support global efforts in developing vaccines, diagnostics and therapeutics, and has joined so far 187 countries in the COVAX facility to collaborate on the procurement and rollout of vaccines, ensuring affordable prices, volumes and timing for all countries.

According to the WHO chief, some US $4.3 billion is needed immediately to support the mass procurement and delivery of vaccines, tests and treatments, while additional US $23.8 billion will be needed next year.

"The International Monetary Fund estimates that if medical solutions can be made available faster and more widely, it could lead to a cumulative increase in global income of almost US $9 trillion by the end of 2025," he said.

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