StemCell Therapy

A new study aims to alert medical professionals to the potential of 3D printings future use in the field.

3D printing technology is going to transform medicine, whether it is patient-specific surgical models, custom-made prosthetics, personalized on-demand medicines, or even 3D printed human tissue, says Jason Chuen, Director of Vascular Surgery at Austin Health and a Clinical Fellow at the University of Melbourne.

Before inserting and expanding a pen-sized stent into someones aorta, the hose-like artery that carries our blood away from the heart, Chuen, a surgeon, likes to practice on the patient first. Not for real of course, but in plastic.

He has a 3D printer in his office and brightly colored plastic aortas line his window sill at the Austin Hospital in Melbourne. They are all modeled from real patients and printed out from CT scans, ultrasounds, and x-rays.

By using the model I can more easily assess that the stent is the right size and bends in exactly the right way when I deploy it, says Chuen.

At the moment 3D printing is at the cutting edge of medical research, but in the future the technology will be taken for granted by all of us in healthcare, he says.

At its core 3D printing is the use of computer guidance technology to create 3D objects from digital plans by applying layers of material, such as heated plastic, or powders in the case of metals and ceramics. It is being used to print out anything from toys and food, to warships producing on-demand spare parts and even drones. Medicine is just another frontier.

The new paper, coauthored by Chuen and Jasamine Coles-Black, from the Austin Hospital in Melbourne, appears in the Medical Journal of Australia.

Here are the top five areas in which 3D printing is set to change medicine, according to the Chuen and Coles-Black:

It sounds like something out of Frankenstein, but could we eventually 3D print human organs? Not exactly, says Chuen. But hes convinced that in the future we will be able to 3D print human tissue structures that can perform the basic functions of an organ, replacing the need for some transplants.

Scientists are already using 3D printing to build organoids that mimic organs at a tiny scale and can be used for research. They are built using stem cells that can be stimulated to grow into the functional unit of a particular organ, such as a liver or kidney. The challenge he says is to scale up organoids into a structure that could boost a failing organ inside a patient.

we are moving towards a world where if you can imagine it, you will be able to print it

Such bioprinting involves using a computer-guided pipette that takes up cell cultures suspended in nutrient rich solution and prints them out in layers suspended in a gel. Without the gel the cells would simply become a watery mess.

The problem, says Chuen, is that once inside the gel, cells can die in a matter of minutes. This isnt a problem for small structures like organoids that can be built quickly and then transferred back into a nutrient solution. But it is a problem when attempting to make something larger like an organ because the initial layers of cells will die before the organ is completed.

Unless there is some breakthrough that enables us to keep the cells alive while we print them, then I think printing a full human organ will remain impossible. But where there is potential is in working out how to reliably build organoids or components that we could then bind together to make them function like an organ, says Chuen.

People suffering from a range of ailments, such as the elderly, are often dependent on taking multiple pills throughout the day. But imagine if one pill could replace the ten pills your doctor has prescribed?

According to Chuen, 3D printing is on the way to making this possible, opening up a whole new world of customized medicines.

Rather than simply embedding a single drug in a pill that is designed to dissolve and release the drug at a set time, the precision of 3D printing means pills can be designed to house several drugs, all with different release times. A 3D printed polypill that contains three different drugs has already been developed for patients with diabetes and hypertension.

It maybe that in the future instead of a prescription your doctor will be giving you a digital file of printing instructions.

Studies of surgeons using 3D printed models to rehearse procedures have shown that operations can be completed faster and with less trauma for patients. The potential cost savings alone are considerable. As Chuenpoints out, running an operating theatre can cost AUD$2,000 an hour. That is over AUD$30 a minute.

Chuen and Coles-Black themselves have begun printing out copies of patient kidneys to help surgeons at the Austin in planning the removal of kidney tumors. Such hard plastic models can be made more realistic by printing them in more expensive flexible material such as thermoplastic polyurethane. The material cost of the hard plastic aortas in Chuens office is about AUD$15 (less than $12 in the United States), whereas if printed in soft plastic the cost can rise to AUD$50 (less than $40 USD).

The real cost in 3D printing biological models is not just materials or printers, but also the software used to translate the scans into files for the printer. The 3D segmentation software Chuen uses costs about AUD$20,000 a year (under $16,000 USD).

As soon as 3D printing began to take off people were quick to see the opportunity for creating amateur prosthetics for their petsfrom puppies to geese, and even tortoises. Unlike for humans, there was no mass-supply chain of prosthetics for pets. But mass-supplied prosthetics are likely to be a thing of the past as 3D printing is increasingly used to manufacture prosthetics that are exactly tailored to a patients needs.

For example, with hip replacements, surgeons have to cut and ream a patients bone to fit the prosthetic, but in the future, it will be normal to 3D print a prosthetic to fit a patient, says Chuen.

Just as 3D printing is allowing customized production of medicines and devices, the production itself is likely to become localized. The warehouses that are full of packaged medicines and prosthetics will in the future likely be replaced by digital files of designs that hospitals and pharmacies will be able to download and print on demand using stored raw materials, says Chuen.

Such distributed manufacturing, he says, could make medicines and devices more equitably available across the world so long as a local hospital for instance has the printing technology in place and access to raw materials.

However, Chuen warns distributed production will present new risks for ensuring the quality control of end products. It will need a fundamental shift in responsibility from the supplier to wherever the medicines or devices are manufactured. That represents a huge shift and we have to work out how it could work. But if we get the regulation right then it will transform access to medical products.

But for Chuen, the immediate overall challenge in medical 3D printing is ensuring that medical professionals themselves are up to speed with the technology because it is their clinical experience that will be needed to drive its successful application.

It is a revolutionary technology that will make medical care better and faster, and more personalized. But what we need is for more medical professionals to start exploring and experimenting with what this new technology can do, because many things that we thought of as impossible are now becoming possible.

I think we are moving towards a world where if you can imagine it, you will be able to print itso we need to start imagining, Chuen says.

Source: University of Melbourne

Original Study DOI: 10.5694/mja16.01073

Visit link:
5 ways 3D printing could totally change medicine - Futurity: Research News

The doctor straightened and pulled the stethoscope from her ears. I dont hear anything on the right side.

Sometimes silence is a good sign. When it comes to listening to my husband breathing, its not.

One quick X-ray later and we discover that his right lung had collapsed. There was also air putting pressure on his left lung.

The fix was easy. The doctor inserted a slender tube into his chest, sucking out the air. His lung reinflated in a matter of minutes.

I caught the doctor later and asked her why this had happened. When the pain started, hed been watching TV.

She shrugged and admitted that sometimes it was just something that happened to men who are tall and thin.

Of course, the answer to the question of How do we avoid this? was dont be tall and thin.

Not the most satisfying answer. Modern medicine at times can feel vague and frustrating.

But there is a new, growing segment that specializes in pinpointing the exact problem and the treatment that works best.

The companies in this sector stand to make enormous profits if you know where to look

No one likes going to the doctor. Its not just the expense or the waiting.

Its not knowing precisely whats wrong. And then getting a treatment that has maybe a 50% chance of working.

Precision medicine stands to completely revolutionize the health care industry.

Through closely examining our individual DNA and trillions of bytes of collected data, doctors can precisely identify what is wrong with a patient. Whats more, the doctor can tailor the patients treatment to their specific strain of an ailment.

Precision medicine aims to end the broad, one-size-fits-all medicine that weve suffered under for centuries.

And were just at the beginning of this revolution.

Global Market Insights released a report revealing that precision medicine was a $39 billion industry in 2015. By 2023, precision medicine should grow to $87.7 billion.

Credence Research expects precision medicine to swell to $98 billion by 2023, with a compounded annual growth rate of 12.3% from 2016 through 2023.

Cancer treatment has dominated precision medicine over the last several years, accounting for roughly 30% of the sector. It will continue to drive demand for personalized medicine.

In 2015, the global market for cancer treatment was $107 billion. Its expected to reach $161 billion by 2021.

As spending for cancer treatment expands, so will spending in precision medicine as it proves to be a more effective course for beating this disease.

In addition, new advancements in health care technology will push spending in precision medicine.

Precision medicine is largely divided into different technologies such as:

Companies are developing tools that will work through massive amounts of data. These tools locate commonalities between patients with similar ailments and their reaction to specific treatment options.

Pharmaceutical companies are focusing on treating patients with specific genetic markers for improved results.

In fact, precision medicine has the potential to touch nearly every facet of the health care industry.

With this explosive growth underway, its important to know which companies are poised to lead the charge forward within the precision medicine sector.

Thats why Paul Mampilly, editor of Profits Unlimited, has pulled together a special report identifying the next company that is set to skyrocket on the back of massive growth within precision medicine. If you would like to get a copy of this report, click here.

Weve already witnessed revolutions hit industries with the creation of the combustion engine.

And then again with the advent of the internet.

Precision medicine stands to change the entire medical industry. You dont want to miss your chance to take part.

Regards,

Jocelynn Smith

Sr. Managing Editor, Sovereign Investor Daily

P.S. Pauls new video report explains why precision medicine will be more important for your health than every drug, vaccination and medical device combined. To watch Pauls shocking video, click here.

More here:
The Entire Medical Industry Is About To Change - ValueWalk

The global research antibodies market (including reagents) is projected to reach USD 12.60 Billion by 2022 from USD 9.33 Billion in 2017, growing at a CAGR of 6.2% during the forecast period.

Factors such as the increasing R&D activities and expenditure in the life science industry, increasing funding for proteomics research and drug discovery, and growing collaboration between industries and academic institutes are the key drivers of the market.

The report analyzes the global research antibodies market (including reagents) by product, technology, application, end user, and region. Based on product, the market is segmented into reagents and antibodies. The reagents segment accounted for the major share of the research antibodies market (including reagents) in 2016. This can be attributed to the fact that a large number of reagents are used in various routine assays and techniques.

Furthermore, based on type, the reagents market has been further segmented into media & sera, stains & dyes, fixatives, buffers, probes, solvents, enzymes, and others (controls, stabilizers, and diluents). The media & sera segment is expected to dominate the market in 2016 due to its high usage in all types of assays, culture procedures, and techniques.

Market Dynamics

Key Market Drivers

Key Market Opportunities

Key Challenges

Key Topics Covered:

1 Introduction

2 Research Methodology

3 Executive Summary

4 Premium Insights

5 Market Overview

6 Research Antibodies Market, By Product

7 Research Antibodies Market, By Technology

8 Research Antibodies Market, By Application

9 Research Antibodies Market, By End User

10 Research Antibodies Market, By Region

11 Competitive Landscape

12 Company Profiles

For more information about this report visit https://www.researchandmarkets.com/research/xgmch2/research

Media Contact:

Research and Markets Laura Wood, Senior Manager press@researchandmarkets.com

For E.S.T Office Hours Call +1-917-300-0470 For U.S./CAN Toll Free Call +1-800-526-8630 For GMT Office Hours Call +353-1-416-8900

U.S. Fax: 646-607-1907 Fax (outside U.S.): +353-1-481-1716

View original content:http://www.prnewswire.com/news-releases/global-research-antibodies-market-2017-2022---increasing-demand-for-personalized-medicine-and-protein-therapeutics-300505197.html

SOURCE Research and Markets

http://www.researchandmarkets.com

Read this article:
Global Research Antibodies Market 2017-2022 - Increasing Demand for Personalized Medicine and Protein ... - PR Newswire (press release)

Vibrent Health's cloud-based precision medicine platform has gained authority to operate from the National Institutes of Health, a certification that it meets federal privacy and security standards and paving the way for the company's work on the landmark research cohort that will fuel the Precision Medicine Initiative

"This ATO certification marks a significant milestone for Vibrent in its journey to power the next generation of personalized medicine," said the company's CEO Praduman Jain, in a statement.

Vibrent's SaaS platform combines genomic information with data from electronic health records, medical devices, wearables and more.

[Also:NIH All of Us program gearing up for 'precision engagement,' Eric Dishman says]

It will be the technology around which the All of Us Research Program will be based as the precision medicine project works to enroll more than one million participants in its cohort to understand how genomics, lifestyle, behavioral, and environmental factors impact an individuals health.

In addition to NIH, Vibrent's technology is at use at Johns Hopkins, Stanford, the U.S. Veterans Administration, UnitedHealth Group and Medtronic.

For the ATO certification, the company worked with Coalfire, a third-party assessment organization, to develop security plans, policies, procedures, scanning, SSP, and pen testing, per FISMA risk management framework, to ensure the integrity of its platform, officials said. Coalfire confirmed that Vibrent Health has the necessary operational and technical controls in place to provide a secure environment for federal systems, bureaus, departments, and their supporting entities.

Twitter:@MikeMiliardHITNEmail the writer: mike.miliard@himssmedia.com

Like Healthcare IT News on Facebook and LinkedIn

Read more from the original source:
NIH gives nod to Vibrent Health for precision medicine work - Healthcare IT News

Technology could speed the process of precision medicine; Beaverton firm is at forefront.

Ganapati "Gans" Srinivasa is not a doctor, but he just might hold the key to saving millions of lives.

Srinivasa is famous for being the chief architect of the Xeon processor, a 400 MHz Pentium microprocessor from Intel for use in mid-range enterprise servers and workstations. The device is found in most modern technological devices.

Srinivasa is chief executive officer of Omics Data Automation, a resident company at the Oregon Technology Business Center and one of five winners of the 2017 Beaverton Challenge winners. The company is designing and selling software in the precision medicine area to aggregate data for cancer treatment centers and hospitals.

"We can talk about gadgets, but so what? This is the Holy Grail," Srinivasa said of his current project to assist medical professionals working with cancer patients who are faced with a mountain of data from a wide and confusing array of sources.

And he's not alone in that opinion.

"A patient with a newly diagnosed cancer may undergo many different types of tests, but the results of these tests exist in separate data silos," said Dr. Chris Corless, director of the Knight Diagnostic Laboratories, Oregon Health & Science University. A data silo is a separate database or set ofdatafiles that are not part of an organization's enterprise-widedataadministration.

"Omics will aggregate and analyze the very large quantity of data contained across all of these silos, which will result in faster diagnostics and more effective treatments," Corless said.

According to Srinivasa, there are currently about 16 million cancer survivors in the United States and, of those, about 600,000 are expected to die from some form of cancer, making it the second deadliest disease next to heart disease.

Precision medicine is a lot more than stethoscopes and X-ray machines."It's an eye-opener how dependent precision medicine is on computation,"? saidMichael Wrimm, Ph.D, a principal with Omics.

The treatment of cancer isn't justa "race with time," it's also an expensive effort, Srinivasa said. His goal is to provide this service in a price range of $100 to $500 per patient to compute and store information for 10 years.

Omics recently was awarded a grant from the National Science Foundation for $224,903 to develop technology that will help patients receive faster and more accurate diagnosis and treatment. This capability has the potential to help patients with cancer and other serious medical conditions. Omics also recently received a $500,000 contract with the University of California, Los Angeles Hospital.

The vision of Omics Data Automation in the Oregon Technology Business Center Incubator, is for effective precision medicine treatment each patient has be characterized, analyzed and targeted with a plan tailored to inhibit their cancer. Precision treatment is an informatics enterprise that aims to expedite and perfect the process so the most precise, tailored treatment plan can be generated in one day using all the information available.

Srinivasa said the specialized computation of treatment for cancer and what Omics is doing is a timesaver and a lifesaver. Omics has grown from about four principals at the beginning of the year to 11 contributors to the project now.

Wrimm said precision medicine seems exotic, but the company tries to make it accessible to all.

Omics develops infrastructure for aggregating multidimensional data to enable customers to build and scale up clinical practices while keeping the costs low, so lifesaving technology is available for everyone.

Omics is designing and selling software in the precision medicine area to aggregate data for cancer treatment centers and hospitals.

Wrimm and Srinivasa said they both left their "cushy Intel jobs" to make a difference in the world.

Omics looks for groups of population cohorts that have a similar set of variations.

Steve Morris, executive director of the Oregon Technology Business Center, said, "I think this project really has exciting potential this whole idea of personalized medicine takes you (the patient) into account right down to the genome. It's a great example of incubation. Gans (Srinivasa) is awesome in terms of technology and this has excellent potential to make a very big splash worldwide."

The broader impact/commercial potential of this small business innovation project is that patient medical information comes in many diverse forms including genomic sequences, medical images and clinical observations.

The integration of the various data sources across patient populations have shown to reveal patterns and similarities among patients, which inform treatment options. With advances in imaging and genomic sequencing technologies, the sheer volume of available information is growing exponentially, straining current computational approaches and creating an imminent need for scalable data integration, Srinivasa said.

The ability to overcome the data mountain opens the door to support precision medicine and provide enhanced services to medical institutions. With Omics innovations, patients can receive faster and more accurate diagnoses and treatments, clinicians can deliver verified treatment decisions through patient cohort comparison, hospitals have better standard of care and society overall will potentially be empowered by supporting global treatment options and well-informed pharmaceutical development, Srinivasa added.

The project develops a scalable aggregation, a technique for improving the interactive behavior of database systems, and analysis of factors and circumstances that cause a patient's symptoms to improve or worsen. The project blends all that information to help create personalized diagnosis and therapy for each patient.

But bringing all that information together in one place for the doctors to find is the trick.

The project aggregates features from genomics (the branch of molecular biology concerned with the structure, function, evolution and mapping of genomes), imaging and clinical characterization of patients. This enables identification of groups of patients based on both genotypes (the genetic constitution of an individual organism) and phenotypes (the set of observable characteristics of an individual resulting from the interaction of its genotype with the environment).

For more information, visit omicsautomation.com.

Continued here:
Computing cancer - Pamplin Media Group

Identifying the best care for a patient can be extremely challenging. To support the creation of multifactorial Decision Support Systems (DSSs), we propose an Umbrella Protocol, focusing on prostate cancer.

The PRODIGE project consisted of a workflow for standardizing data, and procedures, to create a consistent dataset useful to elaborate DSSs. Techniques from classical statistics and machine learning will be adopted. The general protocol accepted by our Ethical Committee can be downloaded from cancerdata.org .

A standardized knowledge sharing process has been implemented by using a semi-formal ontology for the representation of relevant clinical variables.

The development of DSSs, based on standardized knowledge, could be a tool to achieve a personalized decision-making.

Future oncology (London, England). 2017 Jul 31 [Epub ahead of print]

A R Alitto, R Gatta, Bgl Vanneste, M Vallati, E Meldolesi, A Damiani, V Lanzotti, G C Mattiucci, V Frascino, C Masciocchi, F Catucci, A Dekker, P Lambin, V Valentini, G Mantini

Radiation Oncology Area, Gemelli-ART, Catholic University of the Sacred Heart, Rome, Italy., Department of Radiation Oncology (MAASTRO), GROW - School for Oncology & Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands., School of Computing & Engineering, University of Huddersfield, Huddersfield, UK.

PubMed http://www.ncbi.nlm.nih.gov/pubmed/28758431

Read this article:
PRODIGE: PRediction models in prOstate cancer for personalized meDIcine challenGE. - UroToday

As a result, there are more than 1,000 immunotherapy trials underway, and the number keeps growing. Its hard to imagine we can support more than 1,000 studies, said Dr. Daniel Chen, a vice president at Genentech, a biotechnology company.

In a commentary in the journal Nature, he and Ira Mellman, also a vice president at the company, wrote that the proliferating trials have outstripped our progress in understanding the basic underlying science.

I think there is a lot of exuberant rush to market, said Dr. Peter Bach, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center. And we are squandering our most precious resource patients.

Take melanoma: There are more than 85,000 cases a year in the United States, according to Dr. Norman Sharpless, director of the Lineberger Comprehensive Cancer Center at the University of North Carolina, who was recently named director of the National Cancer Institute.

Most melanomas are cured by surgery, leaving about 10,000 patients who have had relapses and could be candidates for an experimental treatment. But nearly all will be treated by doctors outside of academic medical centers, who are not part of the clinical trials network and so do not offer patients experimental treatments.

Companies therefore must compete for the few patients with relapsed melanoma who are at centers offering clinical trials. Many end up struggling to find enough subjects to determine whether a treatment actually works and if so, for whom.

And these drugs often are not so different from one another.

Immunotherapy drugs that attack a protein known as PD-1 are approved for treatment of lung cancer, renal cell cancer, bladder cancer and Hodgkins disease, noted Dr. Richard Pazdur, director of the F.D.A.s Oncology Center of Excellence.

Yet many pharmaceutical companies want their own anti-PD-1. Companies are hoping to combine immunotherapy drugs with other cancer drugs for added effect, and many do not want to have to rely on a competitors anti-PD-1 drug along with their own secondary drugs.

So in new trials, additional anti-PD-1 drugs are being tested all over again against the same cancers a me-too business strategy taken to multibillion-dollar extremes.

How many PD-1 antibodies does Planet Earth need? wondered Dr. Roy Baynes, a senior vice president at Merck, which received approval for its first such drug in 2014.

Immunotherapy trials have proliferated so quickly that major medical centers are declining to furnish patients to them. The Yale Cancer Center participates in fewer than 10 percent of the immunotherapy trials it is asked to join.

The problem is that many of the trials are uninteresting from a scientific view, said Dr. Roy Herbst, the centers chief of medical oncology. The companies sponsoring these trials are not addressing new research questions, he said; they are trying to get proprietary drugs approved.

If the struggle to find patients for immunotherapy trials is challenging, finding patients for another new type of cancer treatment can be next to impossible.

These are drugs that attack mutations that tumors need to grow and thrive so-called targeted therapies. The idea is that tumors can be reliant on certain gene mutations. Block those mutations and the tumors will die.

The problem is that the mutations can be extraordinarily rare. Most patients who have cancers with the mutation in question have no idea; to find them, large groups of cancer patients must have their tumors genetically tested.

Thats expensive: Genetic sequencing costs about $5,000, and insurers rarely pay. Most cancer patients treated outside of academic centers do not have their tumors sequenced.

So what to do if youre a company with a drug that seems to be dramatically effective, but only in a few patients?

You may be forced to undertake a worldwide search for subjects that can last for years.

To test a two-drug combination against lung cancer, GlaxoSmithKline searched the United States, Japan, South Korea and Europe for 13 months just to find 59 patients whose tumors shared a rare mutation.

It took Pfizer three years to locate 50 lung cancer patients who carried a rare aberration called ROS1, found in just 1 percent of patients.

Clinical trials with patient searches like these are not for the faint of heart, said Dr. Mace Rothenberg, a senior vice president at Pfizer.

It helps that the F.D.A. has not insisted on large trials with control groups in instances of targeted therapies with few who qualify.

Instead the agency is looking for drugs with effects so powerful there is no question that they work studies in which patients went into remission, for example, when all evidence suggested they would die.

We used to have trials not long ago that had 700 patients per arm, Dr. Sharpless said, referring to the treatment groups in a study. Thats almost undoable now.

Today, trials can be eight patients.

To test a drug that attacks a tumor with a mutation found in just 1 percent of cancer patients, researchers at Memorial Sloan Kettering fanned out to the nonacademic medical centers where the majority of patients are treated, offering to pay for most of the cost of genetic testing, seeking patients at practices in the Lehigh Valley of Pennsylvania; Hartford, Conn.; and Miami.

That is how Bruce Fenstermacher, 67, a retired long-distance truck driver who lives in Allentown, Pa., discovered he had the rare mutation that the drugs manufacturer, Loxo Oncology, had been looking for.

He had been receiving immunotherapy for his melanoma, but it had stopped working and his cancer was spreading again. Discovering that mutation was like hitting the jackpot for Mr. Fenstermacher, said Dr. Suresh Nair, an oncologist with Lehigh Valley Health Network.

The experimental drug seems to be working for Mr. Fenstermacher. But since so few patients have tumors that might respond, oncologists wonder how they will find them.

Is it worth it? Is it even possible?

If, God forbid, I had a family member with cancer, I would insist on this type of testing, said Dr. David Hyman, chief of the Early Drug Development Service at Memorial Sloan Kettering Cancer Center. But I dont know what the rate has to be for society to say, We cant afford to miss these people.

And trials involving limited numbers of patients can be perilous. The smaller the study and the shorter its duration, the more likely that what looks like an effect in a trial might simply be a result of chance, Dr. Bach of Memorial Sloan Kettering said.

That leaves some of us evidence geeks wondering if it works, he said.

Some of the new cancer drugs have had such impressive results that their effectiveness was not in doubt, said Dr. Vinay Prasad, an oncologist at Oregon Health and Sciences University.

But, there also were drugs approved without control groups that did not provide such stunning benefits, and others that markedly slowed the growth of tumors but did not extend life.

In tiny studies, serious side effects can be missed, said Dr. Scott Ramsey, an oncologist at the Fred Hutchinson Cancer Research Center.

He worries about the expense of the new drugs, including out-of-pocket costs to patients. They may want the new cancer drugs reaching the market, he said, but you wonder if you are doing them any favors.

Read the original here:
A Cancer Conundrum: Too Many Drug Trials, Too Few Patients - New York Times

CHARLOTTESVILLE, Va., Aug. 10, 2017 /PRNewswire/ -- Biovista announced today that it is collaborating with HPE to advance Biovista's Project Prodigy Big Data AI healthcare platform applied in the personalized medicine vertical. Advances from the HPE-Biovista collaboration will be used initially within the context of Biovista's existing collaboration with Sarah Bush Lincoln Health Center (SBL), a hospital and health care organization that is home to more than 300,000 provider office visits per year.

HPE is joining the ongoing effort between Biovista and SBL and will work with Biovista to help advance the capabilities and productization of Project Prodigy as a Big Data AI engine in the personalized medicine vertical as a start.

Biovista develops advanced technologies that use Big Data and next generation analytics to address major needs in data-heavy verticals, with healthcare and personalized medicine as an initial focus. HPE and Biovista's new collaboration will leverage HPE computing and Biovista's Big Data AI engine, Project Prodigy, to identify and validate new therapeutic options for personalized medicine, starting with the community hospital setting.

"It's exciting to see Project Prodigy help advance the practice of healthcare," Aris Persidis, Ph.D. Biovista's president said. "The aim is to help doctors deliver more targeted care with fewer side effects in a way that integrates well with their workflow and is also cost effective. We are happy to be working with HPE within the context of our work at SBL to accelerate the advances of Project Prodigy in personalized medicine."

"Medicine as currently practiced in the United States is hardly sustainable financially," noted James Hildebrandt, MD, VP Medical Affairs at SBL . "We need to deliver better care with fewer side effects at a lower cost, or the system will fail. Efforts like the SBL-Biovista-HPE collaboration in personalized medicine that aim to combine IT efficiencies with sound medical practice promise to move us in the right direction."

"Project Prodigy offers unique prospects to apply AI Deep Learning techniques and Big Data analytics to personalized medicine," said Dr. Stephen Wheat, Director, HPC Vertical Solutions and Apollo Pursuits. "Combining HPE capabilities with Project Prodigy is a powerful and exciting path forward for us in personalized medicine, as well as in other verticals that have emerging AI Deep Learning workflows."

James Hildebrandt further noted, "We are very happy to work with Biovista to advance the practice of personalized medicine using the very best technologies available. SBL continually works to incorporate leading edge capabilities, including those at the forefront of big data healthcare analytics, such as Biovista's Project Prodigy, as we deliver high quality care close to home for our patients and communities. We see the Biovista-HPE link within the context of our SBL-Biovista collaboration as very positive for SBL and our patient community."

About Biovista: Biovista develops advanced technologies that use big data and next generation analytics to address major needs in biomedical R&D and clinical practice. Project Prodigy is a new category of inference generation and validation system. Biovista is using Project Prodigy to advance its own drug repositioning programs, as well as in programs with biopharmaceutical companies, regulators, and patient advocacy groups.

About SBL: Sarah Bush Lincoln provides a full range of acute care services to residents of East Central Illinois' Coles County and the surrounding eight counties. Primary care services are provided through 14 extended campus primary care locations and three walk-in clinics. Post Acute Care services extend to the surrounding 19 counties in East Central and Southern Illinois through active and consulting medical staffs that include approximately 175 providers representing 28 specialties delivered throughout the health center, including its 129 bed hospital, its cancer center, heart center and other centers of excellence.

Employing about 2,300 area residents, the health center promotes a culture of excellence through continuing personal and professional growth. SBL has received the Illinois Performance Excellence Gold Award for Achievement of Excellence in 2011, and is accredited by The Joint Commission, the nation's oldest and largest standards-setting and accrediting body in healthcare.

View original content:http://www.prnewswire.com/news-releases/biovista-expands-project-prodigy-collaborations-in-personalized-medicine-300502425.html

SOURCE Biovista

Read this article:
Biovista expands Project Prodigy collaborations in personalized medicine - Markets Insider

BUFFALO, N.Y. Personalized medicine, tracking of deadlyepidemics and new insights into drug side effects are just a few ofthe ways that biomedical informatics is helping enhance medicalresearch and clinical care. Big data science holds the promise ofrevolutionizing how health care data are used to provide bettercare for patients.

But as more and more health care data become available, theability to efficiently analyze and utilize these data is growingincreasingly problematic. At the same time, there arentenough people trained in the field of biomedical informatics.

Now, a new five-year $2.5 million grant to the Department ofBiomedical Informatics in the Jacobs School of Medicine andBiomedical Sciences at the University at Buffalo will train a newcadre of research leaders skilled in analyzing and interpretingthese data.

The funding, known as T15, from the National Library of Medicineof the National Institutes of Health, supports doctoral andpostdoctoral level training for research careers in biomedicalinformatics and data science. The training programs are designed tomeet the growing need for investigators trained in biomedicalcomputing, data science and related fields with applications inhealth care clinical informatics, translational bioinformatics andclinical research informatics.

Over the five years of the grant, the department will be able totrain as many as 15 doctoral and postdoctoral researchers inbiomedical informatics.

UBs program will focus on three major areas:

clinical informatics, including socio-technical and human-centereddesign, workflow analysis and cybersecurity.

translational bioinformatics, including database management,pharmacogenomics and predictive modeling.

clinical research informatics, including a big data sciencetraining program, statistical machine learning and data mining.

The NLM grant puts the department at the forefront ofthis rapidly changing field, said Peter Elkin, MD, professorand chair of the Department of Biomedical Informatics, and directorof the new training program. Elkin also is director of theinformatics core of UBs Clinical and Translational ScienceInstitute.

Biomedical informatics is the field that will provide theinfrastructure necessary to allow scientists to performtranslational and clinical genomic research moreefficiently, he explained. The National Library ofMedicine funding, together with our established fellowship programin clinical informatics, will allow our department to play a keyrole in developing tomorrows research leaders in biomedicalinformatics.

He added that trainees in the new program will benefit fromUBs existing Big Data-Scientist Training EnhancementProgram, funded by the U.S. Department of Veterans Affairs incollaboration with the National Cancer Institute of the NIH. The UBprogram was one of just six sites funded nationally in 2015.

Read this article:
Biomedical informatics gets a boost with $2.5 million grant - UB News Center

Every human on earth is unique our genes are different, we eat different things, we live in different places. As a result, medical treatments tend to work differently on different people. Depending on your genes, a drug might cure your sickness or it might cause a side effect that makes you sicker.

In the past, many of humanitys individual variations were invisible to us, but today, new technology offers us a way to peer into each persons genome, allowing doctors to personalize treatments for each patient. This approach, called precision medicine, has been a major focus of research and investment in the last few years.

But precision medicine only works if scientists have studied people who are similar to you. If your genes are rare or unusual compared to those researchers have examined in the past, you could end up getting the wrong treatment. Since the vast majority of genetics studies are done on people of European ancestry, members of other racial groups may lose out on the benefits of precision medicine entirely. Those same groups already often receive worse health care in the United States than people of European descent get, and personalized medical treatment could make the gap in care larger.

Precision medicine is based on the idea that genes can be linked to diseases. To study this, scientists assemble a group of people, some with a disease and some without, and identify their genetic differences. If particular differences are common among the people who have the disease and absent from the people without it, then scientists can infer that those genetic patterns might be involved in the disease.

But each person has their own catalogue of genetic characteristics. Some are common in people of certain ancestral backgrounds and rare in those from other backgrounds. If scientists exclusively study individuals of one ethnic group, they may not know how to refine their treatments for a person from a different group.

A 2009 analysis of the studies that can link a genetic variant to a disease or trait showed that fully 96 percent of participants were of European descent. In a 2016 commentary in the journal Nature, Alice Popejoy and Stephanie Fullerton, respectively a graduate student and a professor at the University of Washington, showed that these studies had grown more diverse and people of European ancestry now account for 81 percent of research subjects. Things are getting better, and its still pretty darn slow, Fullerton said in an interview. And of the progress that has been made, much of it is attributable not to an increase in diversity in U.S. research but to studies conducted in Asian countries, which involve local participants.

Disparities in biomedical research exacerbate an existing gap in U.S. health care. African-Americans and Latinos are less likely to have health insurance and more likely to suffer from chronic diseases. Even controlling for wealth differences between populations, African-Americans receive worse health care.

The science underlying precision medicine threatens to make these disparities worse because it could leave any genetic differences that primarily affect nonwhite groups unstudied. Some genetic differences are prevalent in one population and rare in another. A prominent example is a gene called APOL1. Differences in this gene are common in people whose ancestors are from sub-Saharan Africa but rare in those of other backgrounds. Some of these variations increase the risk of developing kidney disease more than sevenfold, but they also seem to confer protection against African sleeping sickness. Knowing a patients APOL1 genetic makeup might be useful for guiding kidney disease treatment, and APOL1 is likely one of many genes that must be studied within a nonwhite population.

Its possible to solve the problem of underrepresentation. The National Institutes of Health fund a number of large-scale genetic research projects in the United States, and scientists there consider this a major issue. We are aware of this situation, and work is being funded to rectify the situation, said Charles Rotimi, an investigator at NIH. He pointed to initiatives like Human Heredity and Health in Africa and the Population Architecture using Genomics and Epidemiology Consortium. These projects are developing more diverse study populations to address the underrepresentation of people of non-European ancestries, in some cases going to African countries to collect genetic data. In the United States, individual investigators can also apply for smaller-scale NIH grants to study particular diseases.

Even when scientists make a conscious effort to recruit a diverse study population, they can run into hurdles. For very good reason, minority populations can be more skeptical and concerned about being involved in biomedical research, said professor Danielle Dick of Virginia Commonwealth University, who studies how genetics contribute to a persons risk of substance abuse. The good reason Dick referred to is a long history of biomedical researchers mistreating people of color, including in the Tuskegee trials and through the forced sterilization of Puerto Ricans. Dicks team and others have tried to address issues of underrepresentation by visiting various hospitals to recruit Hispanic or African-American study participants, providing educational materials about genetics research, arranging to collect samples when patients may be off work, and taking other measures to encourage participation.

But the imbalance in samples is so severe, and the rush to develop precision medicine is so swift, that the problem may not be solved before treatments are developed, and as a result, those treatments will likely predominantly help people of European ancestry. The time horizon for a lot of therapies is typically in the 10- to 15-year range, Fullerton said. Could we solve it in that time frame? Possibly. But genetic differences may already be causing disparities in treatment results between groups. Some genetic variants that are common to certain racial or ethnic groups can affect a patients tolerance for drugs, for example, so knowing about a patients genetic code can guide a physicians prescription. Doctors are observing these phenomena in the clinic already, said Nishadi Rajapakse, an NIH administrator at the National Institute on Minority Health and Health Disparities.

Clinical differences in health care are only likely to become more severe as precision medicine advances. New drugs are already targeting certain genetic differences, although none that would function primarily in one ethnic group and not in others. In the long run, people of European ancestry could benefit from ever more specialized treatments while people of color are left behind.

More here:
Medicine Is Getting More Precise For White People - FiveThirtyEight

The secret to healing what ails you lies within your own DNA.(photo credit:DREAMSTIME)

Israeli genetic researchers have opened the door to new avenues of medical innovation with their research into the role that RNA plays in gene regulation.

Genomes, a complete set of genes, are divided into two categories: coding DNA and noncoding DNA (known as RNA). Dr. Ramon Birnbaum, co-founder of Ben-Gurion University of the Negevs Center for Evolutionary Genomics and Medicine (EGM), had long been fascinated with the latter. His pioneering research found that noncoding DNA, once labeled junk, plays an essential role in gene regulation.

His research focuses on understanding gene regulation during the brains development and specifically in early onset epilepsy. He explains why diagnosis and treatment can be difficult in infants: The symptoms can look the same, but the causes can be very different. Diving into the mechanisms that cause genes to express or not express will lead to more accurate diagnoses and avoid inefficient or even damaging medication."

Dr. Barak Rotblat, a member of the EGM Center, focuses on how genes affect cancer cells. He explains the potential for personalized medicine treating cancer patients. You can take a biopsy, see the specific tumor, know which genes are highly expressed, and which promote the cancers growth. You then create a cocktail to hit the tumor cells of the individual patient.

Meanwhile, Dr. Debbie Toiber, also of the EGM Center and Department of Life Sciences, is taking the RNA research in another direction. Her focus is on how mapping DNA can improve health and potentially increase lifespans.

DNA damage is one of the major causes of aging and age-related diseases, she explains. Most of the damage is repaired, but not everything. So as we age the DNA damage accumulates. With the accumulated damage, cells and neurons die, and organs become debilitated, causing the body to be more susceptible to disease and aging disorders.

Damage to the body is inevitable on some level by simply living, with the environment causing additional damage. While lifestyle plays a major role in the bodys ability to repair DNA damage on its own, genetic makeup contributes as well.

For example, if someone has an inherited gene mutation, it could limit his or her bodys ability to repair itself, leaving the individual prone to immune system damage, cancer, neurodegeneration, and premature aging. By looking into a persons genetic makeup, researchers are opening the door to personalized medicine, designed to uniquely address an individuals needs.

As Israeli researchers move forward with their studies, we come closer to gaining a deeper understanding of the human genome and providing the right personalized treatment for a myriad of medical conditions, from birth to old age and everything in between.

Making lives better in the Negev, in Israel and around the world, Ben-Gurion University of the Negev inter-disciplinary research and applied science teams are shaping the world of tomorrow with groundbreaking innovation. Sign up for eIMPACT newsletter to learn about the latest innovations as they happen.

Share on facebook

Read the original here:
Ben-Gurion University scholars uncover the secret to personalized medicine - The Jerusalem Post

The Report Global Therapeutic Drug Monitoring Market 2017-2021 provides information on pricing, market analysis, shares, forecast, and company profiles for key industry participants. - MarketResearchReports.biz

This press release was orginally distributed by SBWire

Albany, NY -- (SBWIRE) -- 08/01/2017 -- MarketResearchReports.biz has announced the availability of a new report in its repository, titled "Global Therapeutic Drug Monitoring Market 2017-2021." The report has been developed by a group of experienced market research analysts and aspires to armor its targeted audiences as a credible business tool. The report provides comprehensive assessment of all factors that may drive or obstruct the inflow of the demand for therapeutic drug monitoring, catches the recent trends, segments the market on the basis of product type, drug class, end-users, and region, and profiles some of the leading companies in order to showcase the competitive landscape.

As per the findings of the report, the global therapeutic drug monitoring market is gaining traction from a number of factors, such as increasing demand for personalized medicine, advances in drug pharmacogenetics, and the growing use of TDM in traditional anticancer therapies. On the other hand, the shortage of skilled technicians to perform the peculiar diagnostic tests and unavailability of financial provisions for clinical interpretations of TDM results are some of the challenges faced by the vendors operating in the global therapeutic drug monitoring market. Nevertheless, this market is expected to gain additional traction from a number of trends, such as increased focus on the development of novel therapeutic drug monitoring tools for new indications, advances in technologies, and the advent of POC tests.

Get Sample Copy Of This Report @ https://www.marketresearchreports.biz/sample/sample/1064785

Based on product, the global therapeutic drug monitoring market is segmented into equipment and consumables. As of now, consumables form the largest chunk of demand, which can be attributed to growing number of grants by the National Institutes of Health (NIH) for R&D activities. As an increasing number of vendors are focusing on the production of consumables for its high margin, the segment is expected to remain highly profitable throughout the forecast period. Based on end-users, the report classifies the global therapeutic drug monitoring market into hospitals and private laboratories, while on the basis of drug class, the market has been bifurcated into immunosuppressants, antiepileptics, antiarrhythmics, antibiotics, and others. Geographically, the report gauges the potential of therapeutic drug monitoring market in the regions of Americas, Asia Pacific (APAC), and Europe, The Middle East, and Africa.

View Press Release @ https://www.marketresearchreports.biz/pressrelease/5482/growing-demand-for-personalized-medicine-driving-therapeutic-drug-monitoring-market

The report finds the global therapeutic drug monitoring market to be fragmented in nature with the presence of several global and regional players, who are consistently competing on factors such as automated systems, aggressive pricing, diverse applications, and improved standardization. Some of the key players of the global therapeutic drug monitoring market, who have been profiled in the report, are Bio-Rad Laboratories, Beckman Coulter, Siemens Healthcare, F. Hoffmann-La Roche, Thermo Fisher Scientific, Exagen Diagnostics, bioMerieu, AESKU.Diagnostics, Adaptive Biotechnologies, Alere, Bio-Techne, DiaSorin, BUeHLMANN Laboratories, Euro Diagnostica, Quest Diagnostics, InSource Diagnostics, IDEXX Laboratories, Merck Millipore, Myriad Genetics, Miraca Life Sciences, Phadia, SEKISUI MEDICAL, Tecan, and SQI Diagnostics.

About MarketResearchReports.bizMarketResearchReports.biz is the most comprehensive collection of market research reports. MarketResearchReports.Biz services are specially designed to save time and money for our clients. We are a one stop solution for all your research needs, our main offerings are syndicated research reports, custom research, subscription access and consulting services. We serve all sizes and types of companies spanning across various industries.

ContactMr. NachiketState Tower90 Sate Street, Suite 700Albany, NY 12207Tel: +1-518-621-2074Website: http://www.marketresearchreports.biz/ E: sales@marketresearchreports.biz

For more information on this press release visit: http://www.sbwire.com/press-releases/therapeutic-drug-monitoring/healthcare/release-842012.htm

See the article here:
Growing Demand for Personalized Medicine Driving Therapeutic Drug Monitoring Market - Digital Journal

HAMBURG, Germany, August 2, 2017 /PRNewswire/ --

Indivumed is pleased to announce a collaboration with MedStar Health to individualize anti-cancer medical therapies through state-of-the-art biospecimen collection, preservation and analysis.

Indivumed, a Germany-based oncology research company has developed a unique global standard for tissue and clinical data collection, establishing the leading cancer database which provides a unique basis for developing precision medicine in cancer.

MedStar cares for thousands of cancer patients and survivors through the MedStar Health Cancer Network. In collaboration with the MedStar Health Research Institute, MedStar is increasing biospecimen collection started nearly a decade ago at Georgetown University's Lombardi Comprehensive Cancer Center. Over the term of the agreement, the cancer biobank will encompass MedStar's most active cancer programs throughout the system to partner with Indivumed's global annotated cancer biobank of human tumor tissue samples used to develop anti-tumor drugs and personalized medicine for cancer.

This international partnership will allow MedStar researchers to access highest quality biospecimens and associated clinical data contributed by consenting patients. In addition, MedStar cancer researchers will have access to samples contributed by more than 30,000 patients within Indivumed's global cancer database operating within Europe, Asia and the United States.

"Attaining individualized cancer diagnosis and treatment for every patient based on reliable clinical data and molecularly intact biospecimens is our goal," said Hartmut Juhl, M.D., founder and CEO of Indivumed, and a cancer researcher. "Our tool for achieving this goal is the establishment of a unique global cancer database using molecular information from tissues collected under stringent protocols. MedStar Health brings a special blend of clinical care, research and patient outreach within the largest hospital network in the Mid-Atlantic Region.Our long-standing partnership with Georgetown's Lombardi Cancer Center has made possible our expanded commitment to partner throughout the MedStar System. By building a biobank together, we can make a dramatic difference in phenotype-based precision medicine worldwide," Juhl went on to say.

"By participating in the Indivumed global network, we'll have access to a critical mass of biological samples and clinical data for use in unique research for our community," said Neil Weissman, MD, President of the MedStar Health Research Institute. "Indivumed is a world leader in tissue collection and preservation and will expand our ability to conduct metabolic, as well as gene-based, cancer research."

MedStar's Cancer Network has recently been granteda three-year accreditation with Commendationfrom the Commission on Cancer (CoC) of the American College of Surgeons (ACoS). In addition, the Georgetown University Lombardi Cancer Center holds the distinction of being a National Cancer Institute-designated Comprehensive Cancer Center, the only cancer center in the Washington area with such distinction. Louis M. Weiner, MD, director of Georgetown Lombardi and Director of MedStar's integrated cancer network stated firmly that, "the MedStar Cancer Network and Georgetown Lombardi are committed to delivering the highest standards of care and providing access to the most current cutting-edge research for our patients suffering from this horrendous disease." Weiner continued, "the Indivumed cancer biobank has been and will continue to be a critical asset to our physicians and researchers in their quest to defeat cancer."

Under an initial multi-year agreement, MedStar will collect lung, breast, colorectal, pancreatic and other cancer tissues at its most active cancer programs throughout the system for research and storage according to Indivumed's unique biobanking standard. Tissue collection at Georgetown Lombardi will continue pursuant to Georgetown University's existing agreement with Indivumed.

AboutIndivumed GmbH

INDIVUMED an ISO certified global oncology research company based in Hamburg, Germany, has established the world's leading Cancer Database and biobank, retaining unique patterns of biomolecules such as RNA, DNA, and proteins as they existed in the human body. This Cancer Database makes possible multi-omics capabilities that will allow for characterization of samples and data such as whole genome gene expression analysis, expression analysis of cancer relevant proteins, expression analysis of cancer relevant phosphoproteins and bioinformatic solutions for integrating molecular, biological and clinical information.

Indivumed's products and services allow for in-depth understanding of the underlying mechanisms of a patient's cancer, addressing important demands in translational research and molecular diagnostics to support implementation of personalized healthcare.

For more information, please visithttp://www.indivumed.com

About MedStar Health

MedStar Health is a not-for-profit health system dedicated to caring for people in Maryland and the Washington, D.C. region, while advancing the practice of medicine through education, innovation and research. MedStar's 30,000 associates, 6,000 affiliated physicians, 10 hospitals, ambulatory care and urgent care centers, and the MedStar Health Research Institute are recognized regionally and nationally for excellence in medical care. As the medical education and clinical partner of Georgetown University, MedStar trains more than 1,100 medical residents annually. MedStar Health's patient-first philosophy combines care, compassion and clinical excellence with an emphasis on customer service. For more information, visithttp://www.MedStarHealth.org.

Contact:Hartmut Juhl, MDFounder and Chief Executive OfficerIndivumed GmbHTel.: +49-40-413383-0rel="nofollow">press@indivumed.com

Link:
MedStar Health Collaborates With Indivumed to Advance Precision Oncology Research - Markets Insider

Margaretta Page, RN, MS, UCSF Neuro-Oncology Gordon Murray Caregiver Program, will discuss her experience in creating the first neuro-oncology caregiver program at UCSF and share some early caregiver survey data in a session entitled, "Improving Quality of Life for the Caregiver." Page's efforts to create the UCSF Neuro-Oncology Caregiver Program appear in a paper published in the June 2017 issue of Neuro-Oncology Practice.

"Neuro-oncology caregivers face unique challenges as they are caring for a loved one with a catastrophic, life-threatening diagnosis combined with progressive neurological decline that can produce great distress," Page said. "A tailored plan that includes information about the disease and disease transitions, the role of the caregiver, managing children in the home when a parent has a brain tumor, and the need for connection with others are among the high need areas."

Tobias Walbert, MD, PhD, MPH, Co-Director of the Hermelin Brain Tumor Center, Henry Ford Health System, is a board certified neurologist, neuro-oncologist and palliative care and hospice physician. His research focus includes helping patients and their families with symptom management, advance care planning, communication and end-of-life decision making.

Dr. Walbert, who believes that "cutting edge therapy needs to come together with a sense of family and a sense of hope," will share his approach to creating individualized supportive care plans for patients that begin with diagnosis and are evaluated and adapted to reflect evolving patient needs throughout the trajectory of the disease, in a breakout session entitled, "Supportive Care and Brain Tumors."

Break-out sessions are scheduled for Sat., Aug. 5. Additional topics include innovations in:

The ABTA National Patient & Family Conference, Redefining Survivorship Through Science, Technology and Clinical Innovation is being held at the Westin O'Hare in Rosemont, Ill., August 4-5. Advance registration is encouraged; walk-in registration will be based upon space availability.

To view the conference program and register, visit http://www.braintumorconference.org, or call 800-886-ABTA (2282) or email info@abta.org.

ABOUT THE AMERICAN BRAIN TUMOR ASSOCIATIONFounded in 1973, the American Brain Tumor Association was the first national patient advocacy organization committed to funding brain tumor research and providing education and information for people of all tumor types and all ages. For more information, visit http://www.abta.org or call 800-886-ABTA (2282).

CONTACT: Jennifer Keljik, jkeljik@abta.org, 773-577-8790

To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/personalized-medicine-extending-to-supportive-needs-of-brain-tumor-patientscaregivers-300484724.html

SOURCE American Brain Tumor Association

http://www.abta.org

Follow this link:
Personalized Medicine Extending to Supportive Needs of Brain Tumor Patients/Caregivers - PR Newswire (press release)

Back to Browse Journals Journal of Hepatocellular Carcinoma Volume 4

Danijel Galun,1,2 Tatjana Srdic-Rajic,3 Aleksandar Bogdanovic,1 Zlatibor Loncar,2,4 Marinko Zuvela1,2

1Hepato-Pancreato-Biliary Unit, University Clinic for Digestive Surgery, Clinical Center of Serbia, 2Medical School, University of Belgrade, 3Institute for Oncology and Radiology of Serbia/Unit for Experimental Oncology, 4Emergency Center, Clinical Center of Serbia, Belgrade, Serbia

Abstract: Hepatocellular carcinoma (HCC) is characterized by a growing number of new cases diagnosed each year that is nearly equal to the number of deaths from this cancer. In a majority of the cases, HCC is associated with the underlying chronic liver disease, and it is diagnosed in advanced stage of disease when curative treatment options are not applicable. Sorafenib is a treatment of choice for patients with performance status 1 or 2 and/or macrovascular invasion or extrahepatic spread, and regorafenib is the only systemic treatment found to provide survival benefit in HCC patients progressing on sorafenib treatment. Other drugs tested in different trials failed to demonstrate any benefit. Disappointing results of numerous trials testing the efficacy of various drugs indicate that HCC has low sensitivity to chemotherapy that is in great part caused by multidrug resistance. Immunotherapy for HCC is a new challenging treatment option and involves immune checkpoint inhibitors/antibody-based therapy and peptide-based vaccines. Another challenging approach is microRNA-based therapy that involves two strategies. The first aims to inhibit oncogenic miRNAs by using miRNA antagonists and the second strategy is miRNA replacement, which involves the reintroduction of a tumor-suppressor miRNA mimetic to restore a loss of function.

Keywords: hepatocellular carcinoma, drug resistance, multimodal treatment, chemotherapy

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License.By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

See the original post:
Targeted therapy and personalized medicine in hepatocellular ... - Dove Medical Press

OXNARD, California and TEL AVIV, Israel, July 11, 2017 /PRNewswire/ CURE Pharmaceutical (OTCQB: CURR), (CURE), a leading disruptive drug delivery technology and pharmaceutical cannabinoid molecule development company and Therapix Biosciences (NASDAQ: Ltd. (Nasdaq: TRPX), (Therapix), a specialty clinical-stage pharmaceutical company dedicated to the development of cannabinoid-based drugs headquartered in Israel, announced today that they signed a memorandum of understanding (MOU) to enter into a research collaboration with Israels largest and leading private medical services center, Assuta Medical Centers, Ltd., (Assuta). The Companies will collaborate to advance, research, develop and commercialize potential therapeutic products in the fields of personalized medicine and cannabinoids.

As CURE focuses on targeting unmet needs in traditional pharmaceutical markets that could be disrupted by cannabinoid-based options, we are continuously looking to help bring new therapeutic cannabinoid-based products to market and further efforts toward the creation of personalized medicine, said Robert Davidson, CEO of CURE Pharmaceutical. Our new collaboration with Therapix and Assuta, two leading companies in Israel, a Country that is at the forefront of cannabinoid-based research in the world, is the perfect place to start the development of these products.

CURE is the ideal partner for us to enter this promising and cutting-edge personalized cannabinoid-based therapeutics; this deal has all the signs of a fruitful venture.

As agreed to in the MOU, the Companies intend to formalize the pooling of professional, scientific, financial resources and expertise, in order to benefit from each of its respective advantages and capabilities to develop new therapeutic products in the fields of personalized medicine and cannabinoids. Specifically, CURE and Therapix will provide support and expertise in the development of pharmaceutical products, while Assuta will support the early research and development of potential projects through its research and facilities.

Assuta is happy to enter into the MOU with CURE and Therapix, and I am confident that the parties cooperation will be a successful one, with many other projects to follow. This new collaboration is yet another step Assuta is taking in the innovation world, and one of many steps to be taken by Assuta in the field of biopharma.

About CURE Pharmaceutical

Headquartered in Oxnard, California, CURE Pharmaceutical (OTC:CURE) is a fully integrated specialty pharmaceutical/bioscience company that leverages disruptive proprietary drug delivery technologies for a broad range of molecules serving the biopharmaceutical, veterinarian, medical foods and pharmaceutical cannabis markets. CURE develops its patented and proprietary delivery system (CureFilm), the most advanced oral thin film on the market today, from its industry leading full service cGMP manufacturing facility. The Companys mission is to deliver proven drugs in a fast and efficient manner and to improve quality of life.

For more information about CURE Pharmaceutical, please visit its website at http://www.curepharmaceutical.com.

About Therapix Biosciences Ltd.

Therapix Biosciences Ltd. (Nasdaq: TRPX) is a specialty clinical-stage pharmaceutical company focused on developing technologies and therapeutics based on cannabinoid pharmaceuticals. The Companys clinical pipeline assets follow a de-risked 505(b)(2) regulatory pathway benefitting from Therapixs unique proprietary formulations based on repurposing an FDA approved synthetic cannabinoid (dronabinol). Therapixs lead compound, THX-TS01, is currently in Phase 2 clinical trials for Tourettes Syndrome and the Company intends to initiate a Phase 1 clinical study of THX-ULD01 for the treatment of Mild Cognitive Impairment, for which no FDA-approved therapies currently exist.

Please visit our website for more information at http://www.therapixbio.com.

About Assuta Medical Centers

Assuta Medical Centers (https://www.assuta.co.il/en/) is the largest private hospital network in Israel operating 8 hospitals and medical centers from north to south. Owned by Maccabi Healthcare, the second largest HMO in Israel, Assuta accounts for about 15% of the surgeries in Israel and takes care of the health of more than 1 million patients yearly. Assuta holds JCI quality accreditation with excellence and its service standards are ranked as top tier by the ministry of health.

Original press release:http://www.prnewswire.com/news-releases/cure-pharmaceuticaltherapix-biosciences-signs-mou-with-israels-assuta-medical-center-to-develop-first-in-class-therapeutic-products-in-fields-of-personalized-medicinecannabinoids-300486025.html

The most reliable, fact-based information on Therapix Biosciences found only on its Investor Dashboard.

Before this cannabis stock news is here, it's published to subscribers on 420 Investor.

The NCV Newswire by New Cannabis Ventures aims to curate high quality content and information about leading cannabis companies to help our readers filter out the noise and to stay on top of the most important cannabis business news. The NCV Newswire is hand-curated by an editor and not automated in anyway. For questions contact us.

See original here:
CURE Pharmaceutical & Therapix Biosciences Signs MOU with Israel's Assuta Medical Center to Develop First-in ... - New Cannabis Ventures (blog)

Register Now for the Personalized Medicine Summit 2017

Sunday June 11th-Tuesday June 13th, 2017-The Summit will be held at the Life Sciences Institute, University of British Columbia, Vancouver, BC

The Personalized Medicine Initiative and partners are pleased to announce the 2nd Personalized Medicine Summit 2017, scheduled for June 11-13, 2017 at the University of British Columbia (UBC). This meeting follows on from the highly successful 1st Personalized Summit 2015 at UBC, which resulted in a consensus advisory document, the Roadmap for Bringing Personalized Medicine to British Columbians. The Summit will produce an updated Roadmap to assist government, the public and healthcare providers to implement personalized precision medicine to result in more efficient and effective healthcare.

The 2nd Summit will attract an internationally renowned faculty and will be of interest to clinicians, patient advocates, health care providers, academics and representatives from government and industry who are interested in the revolution in healthcare that is being enabled by personalized, molecularly-based medicine. We anticipate approximately 450 attendees.

The deliverable of the summit meeting will be an updated edition of our 2015 publication Roadmap for Bringing Personalized Medicine to British Columbians (see attached). This publication summarized the consensus arising from the Personalized Medicine Summit 2015 and made four major recommendations:

Contact:

the.summit@ubc.ca

Follow this link:
Personalized Medicine Summit Personalized Medicine ...

Study by study, researchers are pushing ever closer toward identifying the gene variants to blame for inflammatory bowel disease (IBD). The latest and most promising findings were published in the journal Nature.

There are two forms of IBD: ulcerative colitis, which affects only the colon and is more common in women; and Crohn's disease, which can affect any part of the gastrointestinal tract and is slightly more common in men. Today, IBD affects between 1 and 1.3 million Americans, yet we understand very little about why it happens or why some groups of people are more susceptible than others.

It's possible and even likely, scientists say, that the root of the illness could lie in our genes. Previous studies have linked IBD to hundreds of different genetic variants, but that's as specific as they could get.

To take a closer look, researchers at three institutions collaborated to build a massive, high-resolution genetic map. They collected the genomes of 67,852 different people18,967 with Crohn's disease, 14,628 with ulcerative colitis, and 34,257 healthy people for a control groupand combed through, looking for variants unique to the folks with IBD.

Like previous researchers, they found plenty. But the new map was so detailed that its creators could zoom in further and further down, checking how likely it was that any given variant could actually cause the disease. From hundreds, they narrowed it down to just 18 variants, and had at least 95 percent certainty that these were the ones responsible. Some of these gene variants were related to processing amino acids; some seemed to interfere with healthy molecule binding; and some were tied to the switching on and off of immune or gut cells.

"We need to be careful in deciding when we are sure we have the right variant," first author Hailiang Huang, of Massachusetts General Hospital and the Broad Institute, said in a statement. "This new technique helps us to pinpoint which genetic variants are implicated in IBD with greater confidence."

The authors say that isolating IBD-related gene variants will help develop new drugs, and could someday even aid in personalized medicine by helping doctors identify which existing drugs will be most effective for their patients.

See the article here:
We Just Got Two Steps Closer to Personalized Cancer Vaccines ... - Mental Floss

1~p R rICuBePaT%G3Ry& CXvtyG+Hn?^5Hb,Vt-i-`kG;5YJ0m[^ec9Ax,st-ipD|JYJrS|OxDjFDyNF,1_p%F:AlkRV|g[qFghhyIkMRul}{ K;>kXz'c8>nM|+X0#n#W'#F KL,zM'yOPT/X54VuU'Qob-Co1FQZ~tA&lzT9 nKLK*Jl)MK3'L'FUqm g9B+oszdyF"Ypjiw>5~[Cnbnoo6YMlf3)t8ld`Pzgua~y D#ng/@WP^Oxi];f+P/gU%CUNcad]OX l[,b:1XL'& >70vbG$yFWf1'w|/ ?00d?> 6=jD^)4s+ekf6Hg1b+6NY"BSNCDhb+&1y0 Y0|*ep! Q^0X}XhJ$Y4=}TD{1iDvJ.Ej)',fl%Y|rNs74}RL'"0ea)' &4w ArA.ckFPFP >w8HkdbO@-%3n!Hm>?hdm.,4(AjhIEh:!5[q2 UcU52}vX'8eY$!3[/"WQ@B7::&K9 }YyaVS3J12B5u3:c;zb)~u#j u,yr8JDp[nGu^[7OpQg4g't$U~1'GV|k>$YmZ;z3[-= h6DD%j`64z}}r6DLbI?R]y?Zd$OZQ#]>}6[~A]+g'kkOkh%}~z{}IsQ~4C|vLm0Bcl&a}*R ,Mq! MM;!):uX:@g^.?_7B_[0K *SB*%W-%/ADVQMV`lIqNZzimhc)'R5RI@_i},82}4(:{ FRDdHBW#:(^h(KmE K b6Zv]>$ gvb ]qEAZI}/$Y.eU86@P;$G*BRljVlw`s IWHH^'(_tVY,H 6r!V(GB 8z,#Bg11G#`4S'2$aUA$n8 ]BTK+f VU-%&9rubeKw!POWP}_f>n"!9wr]9S,3y2Gx,(Pb,OuLD[A'yn-KwAZdKz_U =, x4eZo^Z S%s_zr4%au.UDZM!>eHyce!*q.5_Q1't6@;#9u&+9na Y2b6_72]s:*w^c xGK: y&>gkN gb^8Qid2~$Wk8b.dR"4}Vk*Vu}~vvP9C!/=zR:,2k`EJ]"e7a;kHOdEhUX"VDm5U?fZv=@vk. p,otjBc5We?hbs M&j0rQbq n(z=;9k(+W!e{FW&v(/~5 d`Q_XZ_Ue7%1Q{U8a,B _ED4=%Bf7kv^eaA*SNd-;r1>:2r?;tSThL{KYUp'`nfsP_bcj`GEg_mrs>|# |sZ/FTWY.W)} earO9:(cE"L{3a=y3gV73]0eIL>YL0q$WY!XmxVrYq Em3ImYbjZ-QQ A ^"v RN~j4t>fW(B!pw [] B l~=/l#q,Nzm;[;K|ndldg R#Jr$=_Fp'Salq2zZt dpqOs|WqKn^y]p+#7o~=on1k|jGd un0!:6S:q*o2$tJn9`>ZMA"{~0Z%9yPCu)YAca i}9w}A,|*/Hu5!C!FzJZZl|a3a)?l__%j$/>u/%dbSRkI=*q Aak?]ZlJI6f=o],rs~^hP0X;(@)4B}1F`gWu#X=AdtGwNBrt_l,it]6:R8|igsrd3WVu*Kz9.m :kJuX_Hp9|.M) D]m?6 "3a(A(*+U+$%tE)*xK0]7r(]>YE;V7z Q]("u$YIv%A 2wP@d.k>@l~FS,kE-O;4@7;K:Gl9%&kWUk;+Uo"7-rUk YM+d,+D0IZKZo/=M;Az$ TmbzO*$YDkG75PI?N1]PNufE7-C*bd?JD*rujoes GlUYrNCO.e.5z%9E3&!a4WLA X"}iI|R=%, 6m@k3og-8F3GC#r5hhZ=X scf&7Y9%SL!]cD__3m#h+;CX(G^v!u(w~IKc4*jzz(UG[b")IAH{ 01PFV c2@I.{\`q!9$%)Y"gC]e*L~L3m p~+$1T1Fpcc{h&{4^I9nDdS6&`s-pp7IZtl&%&q;/O|1"hs?uis`Is2dD^%Oc ~|j p0S >~+}(~lY^`H:ha("ZdIeN ]#/fms@3DCv)dU7::1yi4 6"5wPRI/Wp]+ft n7pT_SjMca5{*?4jR3Aott`}nwDx2x=YE*y6S!N={ HN/ Sh=Fc@AipikQ cPn4j0PsiQ|oG 1c>"ZNP[Nt'[O6%c5Hq]B#V ,Y1&'Mm2.t$(6X@H2txw GNbPX4N[3{% ~"}VvWH?a=oA@U%dUUy#-DCpR6X-`Z:*=z3ECqCD?_ve'"#bf:`f^30]/GkCd ;v!9Wn%I+jt" %Xch|='NVLil[&ju_nn.9R[q/^]`M;zU]aq]XxN*sPS7huG-TAE]6w5q,(p8 FHl)+)l6;#pQLA6l3yhpk@YcOnBpZ4m}7p%i &O`TSnDz +G4D6KmeprZthsn,Q]4rFrZ}ByQf=[`X>_F*~U"1YR SI'&~H{u

UV/x1=9oe=%TF*Z>w$C % ut5XU`|zyy%>$1I7#?hAVbkJ(BwW u2Y+iJ-+KqBOqImK"-lGJHcSL=L(B 0fX2jr$*?)^*~O&jY(L7(D+o E(0l`0sl^6Xlx,E#nc 2b;|tlO9 j c5 *0LwDxcw_R}hpk|G%Pl9*jJia&]X6Jt lqr[DX?&4H1IMqk{cf-x2Cu/x|4p;;7t5k~`n,&aC'^M;6i66hm[YM;6Xl!M?Z3kYYMk)6mnn+sMds>jn3787747onnnswS Jqw7+rWaZIV}:D'66 -k025`;5 5pQgIT6%bF1x;VByM:wP-HN%bMr~fT~IK>7h22J{m1|"fYI8Y1.4 {Q:.iG+"h[o,][$S?8>I}"@]2@U(=hcoI2T mR&% Y/,u=H'a(Qo_N^:M=R)5i A=yrPT enQDF EBHZw"`eo9{q$5wl_w/pR$B_G1~O3Mg4Si|&kLl%9K3YOdL,X2dKJ+X2s[63a/I$> Y%>Gx%H q/HHFLQ%Kb}% ffTC EtPshqn!c/vaT6O`%MJoAH}d?XMGv9B)Zy*Daz*WJA<*kMb(pI+E;|!'5s/LeqU G~IgAninq3j7=cf32$cB:NxH+k}tx,!jO'3]~9bTa r6R!j@&h3 *]G 63~i8; +y9/0G1a|p1y&1Qc%7`ox3HVa`>AC`U!h"d1F5u+7a;8FZuC:PbBG$.VRK0jHFh.ylaM_2-jZ#8|xAi7h"v-8/~~`9.7oxs-T?~?~qwsxwKOWr1m6D1=t[Mgu"w7/_`cbk^]<=[wxoh6#|DT?{|[b8X<,`IHy|U$mcS5U_]~iDvp?F1wb9rr74YwTnOOk|b4iaq/Gje6.y{p<#x"~{x|NYn |}"^P++&ztP({xyb=~p#z48zKW9W FR]j%S-,5:r:.Lma=WUx tY|' $B2^h`5%z!m;ns,EQXh:Je%z5 {V DLRTHN6]3)8 ZrDmW=rsIS`yt37 DSl%fs^|uP42s0F8I Xrh5 b3y jTTRbf5)&ZykXh Z@S4.i@NZ]Ko)izsu>ue&@w%L4Mf&AUlf9Z5.EICj5ISZKV,0(JLt9i^w_ bQ/#'=^ZmqVT'l({G.8BOVJ5=_s{J/hzL &M,fP|0 MfIR4decA3dE"{WQp%E |R F"&z6InIYl`o6Lt/c+qW7wEUL{(vo=O4~Sq*(lv+F-@J(@XqU^832i/qwqMiZ>81n03PpLlbTv{22vz^ldi[8sf4pt<> LgWqXd_c B L]se>F[F+[EvI34p?]HJ-`a(}I={4H/4#V8~n2f"^M0Owwt)<-dK,U/K*`?=>8&+0*iaQ#~8jOy#DX29G_^W!iDX2"-wew,+;3zB7|> ^K&JOF(=~*R|,*JQ9'42MU_'),o3R(>r^G^8#&wk~M'Q@6,g5`D qzc> :1"*VZ?b[GnpQI(`` cGe _x.TWWgAJVHU,H)Np/RnbB7y{x-Y?t&G&@LA%. >^:Kof9?6y@/{-kQ)v-2E}Z*j80C"p$f!{[XeL_WHrAx8 @Z+{Hkvgan4lE Na}-~^R=@{ K$13V3/JDI,lyb3i HJ

,-Z(k!Re],/Hk!P-B 8_U_UUwU}j3iyg{a4F#Vw3GEZd+G/*Y4.V^TvikxHQ[dP)])*U-goAo5H.]4dEYukx`ZrtvZgV;w1pNLu7VT&ERBX)^cc(?elXp~6^:l[X E[.S[G#R,[RTqBxD))](a75;vd'!?6 :dGBF>g5_3f.;tv3 7_]wJ ]94!W" Z:ob[ 3AJX5#8>F:SfjJh0}92p6c96H0D:QN;(MI~m2WZ#ddQ _JS1HJ.sUP+SK;H4r7J, *-*$h>|0Igi@X^:3I2)A_x82]48S.vIj68 $iNr_ezH [$rdf'2-;B:)TM)&l21du{dV $K (dPu=V)q*ZH=-'\FF6=3^a`2Ig*TU+^^^^>_+}BP Ji'e: b4Su&}`;7Gu@t`[`oxeF#f,+L9e44i2Ad3LxI+nprlF>J7 SB//,F/)R*>2&pdV5DhT P=?r}@v;s {A)Q OQV!8GG{-WVxH+[6v8J#K20=rb_,, %^8o|qp`n3{~8}~:tP -;:bjM3U;NzVYyrv-sE|+D 3cn$/ZqXGp aHB>e3M!giYE94br:G=

+ h*qmj> eXPHU|),"&)ck~)O;N#ehU7OjSYW)1Z;*QJHV%^dj"Exv$,M}:fLiYPPnPv-1tt>8cH>Dd"1;|OTgk~V&aPJ~9Y|E dNqs)/[G>. ?#40y3_tfD&'y { z,2?0Wv7qQ#IxLFn*@=FRa9_Uw7_[1U_@m/ v,$FN [p;/7P=|6ln*N"GIziN+n^|1kE"TO`%Z"!V bZnC))|+=9gj_38 _3${RIa 3jH T)B;^VwWN@ytwVkD3jNWm6,jv`YZv#=1/Pl58 mrdPq0 g?do' fH}_`:vRr.0zdM ,3A,ibd o5^ybo'

wl9(e+Op[jzhR0zt+'p73voY5>/b)R)UJN>-e =oi}Rvd5GSYc?Yvp-x+gEBye4#=|mYZ"er0d*@poX XgJ? %psY7U/knc'43'tq3&Q]z+&RR4'Aq2a^7[&c%'R`CMZxl>Du`c^!^*ofq^}3oF?t^wbjXWl8H+U9m`Yp%4{j9c5,c/f Gsi _sDpR:asgok,jhz+UFX~Bh^qlU+$O;8866!;kdG;Qje6h~NrY%,JGd??Xa'tJ!52S>$Ou^bc`{|4)4TGa&T&IS|dlqGp&GCjt?}aC?S'6&mhddT#CNX4CO!$(F:lb~ZZh?#^6/l bp@w.1e9Z^ VR#DvFSaS.5%p:~j/L[VL@]v"sdz9rOK;p *)9Nz1NTXFKo=+|9Cq:ZVML7ju's WIe|pIKrv6z!/rRN!BPR+aW [{O_("~2C^ aq6iu{p3'wu^ooz d?s#F3pl[*m[gk3L:LeYbKSbzNtanCtBt-#:U]W^2hf+lD1EO%9} _)yGJCd$JV8BfD*HI #.zf5q-OK5R $=pmL,~B-[},QDL,633uT^Z^'u;G%?ABM"/+9pzB6jt7(*PP~ wq$95cS >l~4-M?-!{x2_[n[n;Kk-_+^>3C6lR!J`[!_nLgL qZD#[Y(`>*t,$CW`AjMC0jHxxQ XI*h,R,w{pS2h4pM2]yGf4orV:-:0 ^QbBJO&E1{J9f[]J9yt)apFs%qHlNXYeen.6/[2J?OAcxB5|>~Sj~[q^Z}g`Z?Qj^3fo 8FF.ah(?jTID&D.f #8eCzu7^||UV[jtrhl/f8-:Ep A qQm(CT]BJcKK0jD;I&,U{Bg)EQ+|evTqFwUgf/l0({F*x|22YbVfQHH}B-4 Jv n wy7Ke,Y'Ic!ZOgLmG d%p A!bYVCA bnYJR*.O.z~o+aFB].wr:tkR:zJw+)tv8%413r+z]YhAw:@C`pC2[vm6$Ha] .G_fvR 3m}%T_n8+S$:U%ns?O-OEs;s.syy_39KsRz,Ciqr:@ZV:FW;9NK?mh*Ug~A3oIVk5U5'vY l(n}Q>;wJP5>u4+]mik,PgSY3[ ^->'h{SCPv4uCl8f"g#Jw2TkE`0>.ME}-QoW+..E2G&H^sy)ZZ33r&7q_TG1l/rErHbWg.$Zp7}J}wbKK)m. 5*u4}beVu?Rvhgm+X*|&dvU?%OAl67 hZYvI%G%zj> hC?'"#JnD/@|:z:;SzT;cQ4%%7jWxHK QZ*rHarfRHoFyyCZD'Q1QyYc!9PG(RfE}pisi%$nAMb"1L*r`~;z6TkZ-H))ouN1SlSlwS

=J+f65}!G hb}~?k]68R+oKy1|x'6H4sc6)ytWKn%Ly4,{z31$FTE/"P).]puF}eF.{]#bS{tJ]KJW%P~0+CS_ip^^kj"z`L9{G!%F0cqD0h+;ql6ie-=xUac}% gU;Ze+Cvrm%I626B@hxL-:kAm?@c.`X+[oM1P6.|[AY^kj ,~P9y}%DZV$EX#SC%(CP HJI>{NR7{D;e9^vc,u4Tv6k[usZ#md$w'B'.c==2 RbFWhw*]V >y&J{=T-=8 P+OM3U?F,EmJIZ;{X lOcoXHnGjTgR5sO=YNr]'zKCJkyjba$mvJ#,1iToqw-3l9e`+"Mw{>j*YuiPVho ?PZrq:_i$lx-}U_}7wsZ{jBgMyKR2(w;mI5Z2Xe8US(tRS !a^Ex@XV{mM1iatp42#lXs!^o% NSZJUMrj'm^FSn hcs[,q(FE%H{Top$@JCF F?wamrhiO)PIMW_L-lYW0ZKY=Dv4qmLb@rp] >N-L33A:Iv0md^GcHRtcDj*TDER,-jadl*0Tntld[) pmKNQ_aqF9h*x7+ -$2OJa7Ok[vBH[x~pM6zY5cE e$^|^eEJk#A >Vks^s+-b fY ~JwCaPB7, Oh$u"Dmk]'b`[^, U}Q`>A.>q@0ERgr>XW&}ybEF)x'*[$q}.?Gh%oOc2`s:yAWoy)XSG~-N$B*Td:7R~B]A2vA"saloy6/)RA hwu_AiAy$A)2>PKE-" ROb1ANB4fMAWT `.L?@{x^P_Q b%F4z %K)z?9~3e7tGtLuD[h5=6aWQh5Y6!va emB$)wz ,6guU)3b1=utJuE4l?B5rp-fx8A='vbn&!jU`TtqII4#?#!qO~@|]My5NUE5r5Bs]b}a0db7#DnNutKHP#1TilX](Adv2XUX'`ZB.FD hJhc@cumV:rSr }]2A$*W[Z$9Z;i;G'fSUsQ6zZ*d"_c}e3lI{X][?R ^d#SWsQ@hrC`<+b%iJ|mnSXaZ?T:+8cKb%&b*.anapw_91:wWw(qF>95/Dd]2/9 l+ Mit@+"&u{=F^gdy>K .yf1@aZ o;|gc/r|i/[y;D+q:Z'{E+(rosX-#;;nt86xj'hMdPr/j?*-t %{i_tc*/EX>i#+]K1U}$?{)h`EU);g>8~];64TpedH=5GZ=D"p,^Pv;rrRQ !Y[H7DpGo4 YdcQ!b^3D%NZJ6-<`}w>&:Znb,*S!464[q 6X3!/|7c`$`Qm8Bj)eN9A) @ 4 f+~{5e,mzWfD 4jiezQu>R1NwC2^=`R"Eq<79S1NT6[2Hpz3i#K!N{GIYlW;!o88@*e]{PQ_-b/qG<-JPj'c//k/{G/~@eS1f7NdPNp`t*S4:M6V|F/TF*ymd{$<6/ki__0a^VvrP>bo `eL-BSS^(Q.)=}K0NS~[3[t}kF|zn?:Yujjj 6f6~sz@| B'gAuL|4 w*?,2q_0bK XcuB TI3%U,@} #[ ol)m.8YF>-qprCa/lDR' Oc@<{X}xthR'a]azhrlfuI*iEGw%u{ZfuTU*3u9-V6l"XQZ9*CnS5wy]P.+cfL;Ho^1VSV$M h@/ifMGYGe*k(v/&M,ft[ge4&vG)fm6oNZ5&'3Y&_g~d0,--EKCavxUAl;a&.*k=Zr&=~]qM/rM=y%{WI2%I/rz:t415J8Tt9.l b >Uh(+"|dy&v)d`PvzjqLLO/3KiF+l.S]YZ"mI1r0&," /zG,F[+L:Jo,~rkXb>&br"QBB37Deb]RjrS&ImXJ`7,pAZ):Ng% 8k[SnJEK_]LI/My5tp$c> 9B> V^tqm-U41x0y)J#H^(3 BBICDdBhnwfaeDk _KqjD;I)bVF4j;P5wJ+";8re>:KLgZrc0=]:66LA)SGpy$[/D^7]3 au6 MoE Fh;%-af@>0rjOO6g%.#qA(t,k hDi~"th@^=>Dx^C7d#0O> u|r09s>#}1ejRmx ,ee|/qJ}PY6!K{G^fX,NUKg*`Z.9ygh'GR#@^F:^+#1lF+/Etx6(E>2v-QuQif5Iect9 jMbX(wJTjV ?vW"EJ@CISC, kJ"U<=K5x( JJGR[_[d[za(45TRs;bU<:pI.zZ(fx opuN) K%)ib0}p^]K~~*e>^OO.v{ ?>m! B*zO j6j,7`[UF_fb[KRuXu3A~?8LtNufT3~"># iq}sfjIm#/yGj2D g+l;vF;/XhN{l-?jb~6WAc'bP]n(d a99GVDT;}aXPO:dsO% + i`~"64t5BF8yI?saK?@)cfl%#/{lcxm3)~9|3EzsZ6bX7NwV 5uC fY9Gq?FdvA2yxmcq"~!*;6S[WLYk]&U#wd1$m1-e6f;Dz Ki1DcJrca!RyYlqlW-([W_c2kG27T~O?dK( p#%Mg6|"'*:&P/E^/8|4T*.:~RPFmT0#S7>5P /3hCXZ7y +APtc-f5M`XEHA>Ir=FBIpkI7"`g#]C9-blGh+`Bx[q8K&:[bZP->**=hP!^C.6 :^'%vS^S,>G~#x J`W1#XBCLieMT G3r:P9`A Z}Y#):m9( ,!mSp)`R{-,dC5`jLAFA)0/32w9q"4:J&eAe#B9Yqi"9fj.: {5c[z}7FCt>d:V/Co_}K'JH9EAPMhZGKmNEN:.{"LQ[.Go%zM!fTw&#AvR i`JiNzhO("{Yrr*b0Nf8rDDGYsdY1kTz.aX&+HIw ^hiM:i9\c8YN&0`8m=K!(hVa }=JNT%CkTGB5c7;Dv3bp:8^" 0 %yu JutZ@Z75xA!p00!&9b$#7zZ#/t&K~ qXC8Rw9p*s:& &}W0zrwuZS1y pYkk}KRS QYr /NP7RQMB[sldVo 6"tz+A-0VsqlfcGI-k"5ISW~)Qu)~{EDG.qPhjk{RL?")Eu*[>[s3~Fexao0oD}8DG.knn~?l%{fZsDqVt,mK-iiP~T$P^V5}K=1HIrZLmc^iCv[i22Z v754$e-n I,VT3iutFj$1&qFfAU>@{K0x lgT-@JOT+%?u=T g`1sVCuxzUH !Qj2j;^0RiWaTZ?ZeNlE=d8gw'$zjkCF (bKcf(@tm%;[I6EqNjj~rp&d!*} te* ^j=X^RNz+idL5Y7N&qp

poeJ%HbS-g[S^[,& ^Q3POAI!9nJBO.Cb1e7.W1MrU_lxu2`vD'*,;a4zYC;afMR ]C%OUhEq.=Mkl."B),$f2@4 U&$u#3N6hY2s#Gau5HiLLQjPFA5a!A|3J&]2$/|R/j GUf go5$vMyz_-b.{K}u)'MWILv]dby ^vtyO.m VR9V0H=dF^rQ(;RxTU&ZK_p2$n5;1r%5R{)k;,?q'If#5?Hm,RK3STuCo p)c ^0H,C$7cP+e39JH5o{Ws8H4 =u(q g"sjPQvHMsEa >!:t(]Hm8PBu4x`3.uI1[cE|F3'm.>,x Wwu@qq[9GZp~Hv%^TqAnq9>Z!!,kT4`l-=y)^TT1E4(PY>]v)sA1.jQD.&f;$Qn>x:Zwx#&1L(i~~KXNn)oa n?"8m9!(%+qx5msQ->SS ,'aq6;V+o%C&7?|zLBTFwWu7Pzv0p,b4^9zZtH^D>uVS*;.[6.8?]dLc^3|B*:F=uW/z%[Nr;Yy1d=NK6=evy:S7q9v32r]IsU;o-R7Kw[Os$q'Owj~G{ "YWS||}?}~__:x_5/(TBKk,4%Y4#)N#,:Cd(l^pfQ=dVQC%DK.8Hs:wH ] xqorjv!J !T@$ide>'8{ 7nRkMFJ`qBV~g^lqI9imClpUejW~_+8dP*`C+ Z [rYq6DDIsb>DQ3TLnTmf1%,"qQF2]|;/ZG0Hq`*"^ )Pa[IYtTVz1E.TvW+;P6&$u-KQWnt1>s%2P@u-1FkXu 61A{V*@ZR+q 9(hKx@Wj u`kSax,/?B5h=jpj5![_~dJT>,dz!^ywnlkmRwk(GU uHB~.X~E}Ei,s ia"]yjZ^X.f)]ko8}];O/BfRF}!;|#s56~n>>RlFafCNqkZrt]eF>W{votrgQv:7l^~GY| B>bx/J&ASdzZ&r(u)( 2 4/SJGn642# lI$j ,Oo{p(Z{!]*^~@CmK08pS[~z{V4[f77L.MbJma'w^~_G7g|=A].F1./3??/RWSe& k#Hja nbP'5 OW*HxdJML#ZM2#&1:=A-^X$nBIx9)Z9OU1*sh>2DFRi*0!:G+o&}sh?K.DQp]-IMW h2 %U:{qC|f8_uK92oBOf-b6N!wp"&}4A@ZCz1O~qxB-.s4l}89h_Y-0FD@`8[09wI&p,,3.A1FC&opG$b5)|h^Q> }?.i7B_UA=G+&ks- eCH8HnE__,E}ze9[2mIZ$;#m-he7U{mvKigGvuoEJw]`Pm7/]+aF(l.^ TF$^dn;/L"]8j@b>V|TnQ2OS|0^c),>~U$2,^6kn9}$JfmroAklu, ?"IYr|5 gy2pA&5Nt 83,E{".N*@tfrM3_hon9(hTI_ Ks _~xsmTUo^5D1?@id)3,3c9lPJ8YA2? 'w*ziohXvjUcoQxg[ag7Zew^dDi6ulmSk~T ?}b}FWJ[*uq;v33>ob`

5:w" %+;gZaEVgU| 6.=Jv]'Ymj5SY)q&F*Y^X@~2q`u7`j^&Z!5y lK-LA( ]z.I=OLIqr$uRAY""q#2TDv#6EN[[iV=qgUfB(pJ1UIQ!||&@ =uROcW#?N)BfS-N=P7K)xcD[yZs7u++G|{|~t*QExW"GaEU-hSVX>ppI.7Ko-(lESm,PxbFg1_RTA[WFt}.]|~V+ky98[j=(J7^mGXS{}w@K;qkyYBV7{5?#z3^|+5W}Cf+'Mc"h9lgF7Z2eNn^%m69|( Xv4r:s5oo.Ni7f@8 *%#rHmAc[0]B&sT`E%gOf|pcT,$H?' lIGehNsn?WNj)1$s p#[Jb9s|v}N4_V?hQ|3B*mq{v !S @#UpQ)ZW|cMiCS 6yQj=UG|PI9mT!@Mhv)C|1X;.kO#T B_Fb]Cb3zG{MK[h7a5nS|]>IMc/R_^Q-I k {b]SZxwFV`S/v|1rzTH/67m^qC)tW0-NNy]H t'G *siJltI'Gp{#`yf;"9X~b:&q&e/$Y2yz_]HMs?}][NV^K' %nhC~c^Ri/$b%*2L [Ck@/uk:]9u-BSd@w,JuIk8}67Sf&Mg+ B'} @hsA]hkgx p)y-, ]*"xV4g |tGQ% ;L#:} _>>]Ri&aGt6[NL$E4XYafLh:J9Zpf!0Y(?X3Z2V?LYudt5d**&ya;"k"|zET@D 1r9+7^-w$C*{m&CWiU)J|1Bq$&BLd1L Z;boR1:tyA7+.9*Z"+4Uo,q.8k6#$>g]+/4&I"uEsaiSGI~-4:.&41Y$o$* Re=zPq@J+8gHJ]5VZA j^ HX.[b@oCVX[7%)hQuyF+~Bt9BN1%1}2dA4jk}^&7%OJ7@6:4~(yr6p3E!2@x~u(_CtRHe1C)K[$/M)l'A]='wl:B~oiT|cESRkK|*1glo+=a qp=y?hH VB'e-}>{&;T`(dmzTe^:tqh0$xYcmE;:>wj#ccpRzL' n1zARoZXSL`V "1Kbsa 3K4;.40T{6'xn9" VMyO/^X[:Zh!28qqW.W%&3$%f6Kg-@-J4k~^;Wg`'b=hzL;Z ("h:e2 it]_%+ 4T+W2bTFEOtrSr6Xn IOF"s8GN%`PhCpUl

ed @SvUt,K,#=[b>)[Np:~HfoTua6[e{e3ZaCxZn(965/XTw^JdJjw+&i-`y F 2LhM1)o=o4~=[rqwvj! H^jaQTnO)zCy&#I~Q[8HpD+{-rgqz($?0dBeTZJCt8ZY{Rvn>N4t g+Tgf_&>~^z{mC%g hw`_=^L_TOUXoK(6_Qk_0Ci^H^ZAU'F$$MoQ^d3#5a*P,O.+)?Oz|OqiE+_ wU/XOonhYxU5d0Sz.RZ{tM/3BmsQ\u'&.UQ]#)Lo5HseSa5F.n R6REx ]OvtEq!%N3t 7rFsG`D@vNyE _]N^ AT^Q5}qQ3Xl@#(dB"}4U9y|Zdk%Vy,[ >GI07{BdE'K]7=WaKZyg(]O{R~.LYgLqso&yGpdv$im0]@i.GpE?f8`-9/nXa~E sHkbSs%=Co7sbnD[O(fz5#+=hoo/!&JQhFs%.M8.DJMguUt5rY@D7jEgh8 3> 0+6_He@PxO2IuU36]aoCI`-RQi(;7P!/.zA~'qt*R!p n4$OUptdp@p=u SjU2+EjE{A^NWrp&d3dxFkNx.*N8,SU$NP"nHl;ZU!E!Bz3yco8^u~Cx Uj70Fo!t]&^d&

8'tjXxDfv%Z0er!S9 JWy4L9-wOQQ'QBAyn()ZlG t'aimFv_jIC sAJGsuu$+DWn^5,"alqjqEG:{m6J^B_"IhdM~$qzI yJuD]%zK>b9+5B-CW!GIfs#b>idTDiq*2m}^lunRlyY@+''P$|j|.r@MiKTtp/124CA?Ad0FT!Z2w7/A_,&u}RuNM 9k-3}qXM_F$$,/88"mc=hC{lnY2>je [&G"Em3vbR% p73-4Fb65d7Rq)DJ/k&_DwXZ(ht5/I>UZm"NJYR(@&,/YlMqx'I#cx5r=miXZ9pmKVM"0 lPVfv8MMUts)|P0yNP`??1[s`_8Z"f2H-iV?O1>~g!'?awe}1.:8f~X^4hG>Hh0^MgDGldbZ.XL9 .Ce^XP3+yD"&A>VdOez^g$ &?e@/rcJX*iPV|jH};:y ybMY VCB_ AG_`{EF$FmDmV,my@U|zSyZFa=RkvFnw77eJ*HFu Oqkm(B G]maO|^|rd5x(2 #>>Nqy#V }f&qoyv6=N$sT F9DU7DM(px!b4XZ7Dpv~/OA*Y9ZDr0HAq%{p`6%YoAfSbU]<_>x 5H%a9_C Kb1^x3m[P>7/vq-~GR-yH,BX!p*q,C[Ba:/( U8wLJ=)5:PH-'JBM*d]-lV~bOMn_,bUwpIE|3p]D[ozV=ylI&|d$N~#nU,Wo o .!~l LsBASG /pV$Ib5o_/7/qjK.Nt`b sTm>Z`in%9O5@{*}fvbkyjPrj17%J404>x[~XYa[1A9 07A!Kpc,FPm 0UKpuB=BSvA ]`xM`N(8uR&dn(M1b]8Ysn( %@W71 e/PVcI7 nrxU*] $2Ph}V};4p0UKY5lNu:&Uh1S9I pgvfBpSB=`Ppg]3qRC(0J-wwsIU3D$oRyhd,yGp2VQ"DCI}2^s/p_Sj_~>c`3#T9^=G.OmAXln&#MEx+'|ci9_BzpN>{v!Aw8?'`8A}Lfc|ZC)%06NRmF #(E[H27 @Rv,G:-i^=owbUXtOI`X2 (>NgpyS%sgcH&nyXSX94'Q4&.Y Cvxe.Xwrm 4+Ma-[hw0""_8 "2|~Yr.oqi..rr)!o!QbE`-c 'cCXExX x={(3)+`d@:pfo-GL;;yD,A'6ry (RAX@b u_?/AP22y3;`tVjV 6sGKvL:!JED?^r#Bi_ ( snua0}X4h1 }w nA=}1@"W/9K#T*&S9yzqr?Kzic?jD#Q0k3so9OC[+U}ELKc5v?Xl[n0&5 )`z.8 cx+FPx=1pp:Y~'9U?a6z#Q 7wj%,?3x:o G4>6^&hcfk}Pix5Sjc ~O1 endstream endobj 40 0 obj >stream HWMzC))r`0=H2i^fI6m,?eW="?A8g~6ayCu}6l-B+=[)&z8m5c;pv)kE-(;|(ycA.oa:pvQ;KR[w!nuh8f.p1JL&1m-A9c.UTo))HEm;|aDu >PyeMjV@jO7n+q'*M-[fP=zO-CK+Ej:.ZyO1OZbm#--mrz3>}Rru=p6nS-q^y{lK1Cf3Jsv9nW}y[6$"CM&f F3a_}K+a~yEWi#zGds]I3'?yZF%3.@V5Qo]#o`2P#oeNzO3[QdXoW]??mC>1iSp +lVLyO4&L2MDV|*Tb;M>k-z+ka?iwwIQ6' !PD5lZe(SoX Q'itb+ 'Ha;{Al4j 2Pgb6:6heDmCw%}?*RV 7ZXllPJjzp@I4CZ --Y0$0fS.ih${U8wR@BpS^dBu#:)hBFF:8 i,h$ S2?a9 ww*B%8- ZS?,g&@p%iM`sEl_>Ji qO}wLkryLi{k adYl[zkNdeB6N(yVJC|9OL]Th7,#.:> Np&h,IVdRDdSm1=dsyfn@6fABOaulU.dv3[(n_$g5+lf5k!5 |0ou&JlhRCjZP1@OL8N]cyEU)r^P_3tzZ-V/U{/dYw6lSs t5oCb Kd j1sFf$!w+.Sz5uGCyEy v#YW'~O~PNi5kGd3W.^/Z2fNZB I[ fd7_x-.-qhy1-M}$Ig)q;[at}SzDH}|IG n{z*-`3{zYiu_ v;)(kNRX|EZO9MJ|]xN;RSjZFU,uX(4h%Y3~UR=dfj]bSgn~*jTDy#HuOQg}U:yT8ChcTj/PS{): T/cGrR?7FX}|W??zL i8-:F'L Ngovt %lQ j%kpAT!s.39K{ 5*Ir$_tYnB2mlJ} B=keTuGgj]S)MZ8_.F`+{6*nxq$LA6kI*?W~AhklQvxRRw6J+A>:ohJh/0:{q.h(OPJ!eQU`^`G}|;>6 aA{JlH/ $!tWA1MM}ViI./3NW&9vmr{yZU7T(G60h!Mb-C#-z6N}o:myx3l9`,|C0.}5vNJM,}>Y5[|:Njlr }mrmSV]bETUbCwe}3[A 9p6R>YMuwLF+h-HEd~1nhUId-F7~}wA)Whmf{|CSuBkp*LE *pHaZvNu@i P4e'v}!{jusdn Ue*xw1q:jp[;>R{w|.DwBC31hOzjdLo 2XQ9|Iq_];#884NiI/4$f_{JUW;s,,o4%m>;"|yl=*8n9|ySOxg V}4o]}z>2d1`k9o6}6]{+>ifu[Tw6-U3ovz&ur)]H}2{I]x;6sGWaZ{'inB50PQ>DS NQ GSv[M?vcUM3~ |L=6 SgCmwUlqohw'yFjD=t7> bYyeRmt1)eDSw HbQYQVGu+TG|"&~+AdiE8s?q}_4p3l"VmmV93|m}?UA+KO;BX! y$'=~kFv5 IU`"PIwd$,F[4=-92@jKW87Sfn@q>)5NJ}e%hJH+HrGQ#h,=BC>H4Qgi8r :+8jL+^X4E"6aQN:IpDNU^XQ[8s-Uzuz dM H2uWC!]!"X)m%jMH8]xW=6S7t}J4?T%GD`u}pMAK}B=Gp4{* G*@Is]veC)]=#"NudAx!d`eNSN[8-9UxHAgy4S?'ozEBXi.7i@!LhnW>X"deG`bMN^v*O]Z@5h:N 6U`{]m}]y5 yMQxguw]}# 4974UT!a{$+P$/(uZ1e7 VhRL}Ul2& Eilj./D>zn{FtO_/ l 8Q7?!6pPIU*!G`Y)CFvLZKq9 oIVuEPp?|V l9C/(ao~MYV|nMQSNXga su t~2E1nB, hZC3K'pSSoKIgcW4.}+yY_;yrK2nG(5'8-jS6b#+tG;G8|J`jo)/@&/;2AW77W-]X.@Mpk+TCP9b_U Tc{jvkls1MG 8x,T q961oA+|3$&k$b)Y5h~'q{X *kS#)ITtgCwtCGAo2bGx~bJfxtSjX1!w5U8( [B5$s5wA*%%.}Voi4$IAWZ:d[f#U_pocn=b^=zXh;fJ8a `(:1y$&@;}2/1/~{1.,uand3n48?%.0b|GUuCdetfUDu#|'k0k[kFjB6 ,!/_E[ `>WcI!OX+``O:j+ eg`D8y1uuC~)q5U`wSL ac6@%S:d!edpI|"9$1ZG|f,sdf^_oCL5#*V[KI31!xT1u lXw+`~&AEkaro8&H*x/CDsU?BOr+q6MR'%Tym. lqT4`u;!o0aqjIb{z^&n'['~~pG6=hOli^X#VVCahjV"GFL7_%7E TA/J2

G^QjjZ/u40*Qa"UOl$!Y8v;.6!?!),= w6,G.^.MB?X@o4)(Qu}$k"uA#@x])H(YMrBRLL nCh5SN"_pEc6x0"&Vw.LI{]>WUY.f;tqh*gBfAQxm| F&G1Dkk?M]]=q-}VF{)YM:19% wBy9LcFZb33!8fRh U #/J`UwdLF+d lyiEMV~4DGw^WMv@t~/M0z]ry B!k_7eAgJN=T%gMhuTY(;G_H0=MSrwkP`X7_B5.%m7m3#u&b-7h&]Db'9>2kdidK~"*" ,QOQ `z/cb"f_i6aT@PF!Z5%E'9 Yx`(HgP0'uLAwA }k, lkEAI4~tyP)XB"HMAD,9 Hk5h8u#C>xyd?BxeKdxFl2B(/yIRYpnl;mpwJ,wmO5~wR"c~ & QJ(GA>r{M~a+m5re]KA/2TQh/X_S PhzJ+NW3;$OL IUi}SAji$Q$zJK7: luxT|ke:Y"l]j o(KOX>/ F`jKQzW|r3S:>t/vqu#-v>v?XFE 3n dW#(B^A n NgZp@4:K%W ;`U57E@mYz PY+%Ve~SF-7?*O1dH}l^ alPa374;?DG*aUF#Uvkk8o ;uMy:kxDd_\Hm f;}-M}P{>QnZ-BQ.{2;'Zw&R6.3vzz:AFWYNP |si5uw@s`$Ym`nuQP!Rx^5)bu*Ouu^jA:}L}&*)5yJ~lPe5/C^X)SSd7`&lx/=S*KQ-+C"'8=%>3 F%ITPDUr6jDGf]-6A)0%lbKn/& 3zN%jB*'}JX/sl-GcG?Gf~tc[:$k*{$Je)oG7d0;jr{ jh&>8/N&@m&rq[/qvxsRQxSCSZui#M17wtPn0;*aPQ"|BU dKCZ |~$x%+}52rn~5GS:eA1 JyRigG#_1QtHi;WI]zKk hf(%f-cHS`&P$th=]wLxCyyA}V18Fj5{;_zJ(Sh%[V{T`NJ+P( Yf~m+])WB7p_4A%]u#:%g.c2X$8twx|bO8Z8[n2Ui[5DR=+_1vP|A^H?`1p9}>GQETznxU`@'slY Ak^5TU~:kSP;/XZ7Pdvekue>g,~],Hp^e"Uk R7a9.*4k]cr>Q.a335yXJCq&B. SYSg)OqQ2vsE=^+T;SX-ea8s=(H.Xf@}zB':y1W%m6W.uv8_r7OKKEGDJmoM5O('1fI'yOtyb'Vfc~6a6'nTj=#Tj'{pwA"jp:O[tDYE?lX5Gc+?yGa"Vj`7sv9R*lJ[p.=JFJmH+JOK8. 2kWOUeGYn=aJ{i%oikzL:+jO)+g&B&"pKnM'>]rReo.&C-~Vcii*C4m&"yXBRiYxmP0/) gPQVMn1vbzdjT 7~p`S.1&uOs &y '2fLvF}0G[TBI$jBHL.mD^gR5=,qb0h P6d'oPS^B0vLLWe,z"B.urnClKa,=6k'Sd|+D|z'y(nd3o(~m))I`'= }^G^Wr~sA= vgmh^'0[I",r"NP`, $!*"Q"nB~S%X~p3):hPg}:1k=ml|dtlp 9`8`k*THRt26jY{,=#XOa B>l5pM`Up?+nw^d9t }.:'i)lQaMU_hSgFiU_4|)M9ptLg[?g&PG}2%U=b*$+1jRDH',`r3]_Eas! ag*Lqpe( By2mRA}'x9)Au#$um2O#(O)=2Vlaqsf8)3>mn8lLnUgW$bdj~0vDy/

#U#7:kM'G*fZ'#/nN%K#PM%W))n {HgIAJ3`j="7m!0e3szAc9i a[,Nm#P'v~|%1o9]9z6daXm3M o!` ep,h'7cCdhO9wfo]FXvJMvG2bQy5*M6^h@ )jnKRZno8 xuX*C&/j_7eCx5k^{0F=6M~I1#{:!Ug~&WP@4 l-PJ|,VyzDZ.)yYr&E"(@"&m:e mjL_ 7DfB|bO#$fe*{gJ*svLp ]tV;_q*4M4eKB3p,B_ x7eBN2m.JSy&q]7z bM|^u@L=ZFJ8u2;x,BHcdPI]

P;,l$R?^'X{g1Axc~3qu`;0it]3z6j%[NT5)Is }*-4kVl9$(@F#H%I 4^wd:-PLFCW=roQ4N.ys[={#s-6ekgWk|W/k/]g=Z);d9^z0nj5@RLIWnk^%JB%xoI>$LH nB_vg =&_7kDFl4Ib?~b f(T^ct l=*G)@|_Ihq,UQ$JN 15uvlChP P6p4LcmYL%4_AP1X!Ba*X0$0zAV2:"w C%5/bLX|E|%H"L>t#`w"6D*#8vLXZ5 E&3= 2P+0PMkRo HWP`xarY|`v: 6k_mA#%~]-Ce#"^{C1ApOj;kd;14VC q{mg6Zr#O,.nSst7-D`q]7%KO"huV} z`p KPMgaR1ppHLOC7|Buy'|4y7m^o!H>k"+F !m^cX71gqI4x0N LqH; I!# _ PoB)a;d3z!=l Vd&D=R({i^%:cLy:'N^$k~NpcO0X~m:OqPdFiQ +t(N='MF/>S[7n[#OkX[K]&O`Hn,~0|$+akl t+t?'-i*SwI|m e6],HVhtfxFGt_9%kMT7p"2dNj>&XmL4sqsF SX6y-ZZ{kX,= zAQipP}3yyZ*k6]>/5IE^4isM>;O57YW?9LMl7I,DdH/xV Ps#o@ gW&6>g-_zt9Qy5uScJNweMI1c&8hucp NtjW+x/{grx `iNd5~$8=dsk!)V$8 5U

vD[]4[vjF8a!N]!Q(.{ _U0xrXt"Uqa0^d)%JhkUF- CR2 uH:ZxS`'CZ]R['%xE~M|b;X#7;mo]$d4a=eFCa:z DM2 p{#lE *#t&3: LYIYGV3?58xV2}nh5 ]EcgoM)[o'Fpq>!nycO] f N,mQ-kylt.}6^8{AG{AoO4!ROK6{@ga(aa%]WKb)}+BC$U[Yn>/0HJtaA=$/(*+:NGa5oPz{%|hVqAK([L> oB n8?[x$;vhYL|~s:tsX}>WFyNSfucJ'}>t8km0Mx7~MV-y~X?q{:c3~O~6:je]`D`q@/`}efO8-w_@2[xnu|$KzPF "5VPa_tfK #vl d?;W%0L`q z9n v58ap}tZI M-ZG#{#h_D)DERih Z P|~zb5j]"oUHKz'04`dxc7TD2zA1XVeCrn/E|k6 >fXO q&Xy#yXpiX,bn`H{QOnu~{t*>GD+at}Uv|]g'~pgh>'{/Vptis87FZc{lS=~^~o^6JdU|kxFG :hr&'5MlD;}II2ZGsXmI]d!Aym!"X6pF4$E2Cm t#OE*@k=CI?=UyY:.[&tr%YC-.RPHu_)Ck7>V{|G^`Iq TcP|BcpZnK%a2[Sv/?BI$fI}Y;{zAzE/~}C*0Oly,W4d+!?^pKoU;)9mSJ>_022^"rR%!ZC^4nl73cQOO3*T,9=+yunf3?Sb$oqJ/t$7 [!+d.{s:k [n=,tcwrE~!/@ T{6mOEVP(f]

na3$AgO}u7Q' 7jRz,A4+6j'ZiAm&7 1,mLY4&^^mqx-b%2&"1Zpy6F9Z|BItj (Lo!E ^rEO.#YZN8"6t71ItV+z?KP.c1?}j>:MO&sGM1l"h2UlU'u}h%UqV['t3D! 6~] lB%8#a>.WNWkM[x.2&]8lFal,)VNR~K@?%,S=Xupef0)BoCb@:"E;h 6]O4{l`EntDcVx_2/D?b>v~bC11f .N|aC46AdGkEQg3m nh^''#38!)5 :v!Vrh3 hBxh61'2oF~^PS9ys(&fx|t>1oV8CL(w=/Pi!|J]U[vo5%K|~~A:[8NU3gs%b_1NbX C$Bs)O[jGFC!Q 'S*zp]N(d/.B 'kL= f CI`e^*lV5;I&z>u-S!>9MB`Zi9 #"8(B.+C/K mDsm=8a$*2iJ=e@_K,N9F%oWgVG|.P,z,,'@N'J2NRuQ 6=),D]fwvl#2HV 56c. QaYxM64~;u;:9NKmy6E7>oJ~AkXt3Apn]r }OI_ViO~M?(Y arxTt-OqltB^mj.***(amI!?`e{[V9~dkQ-?4FSQ.*_,/{PauUNSw_7'Oz$:*i9Z*7Z5}Y?Y"f5P N ]v Z1vNN` =sC0oN0)czZ6K"R-HrD9xsG"IUwN [4Vy*Yjw(N(8 Un}9#d/E/IrzR]@ZS(zC6j=JrFRh7SRpBN-BI[9p|CvQU7K"^_Hy-rc_BG$HExER3dQ":^dzs8qTYVC~+ G1`T}t>p8v>Us`j(e4kc= =1{Uq6&_ mNh:k-i7whx={Xu;V5gju{^jT$X[p?cB+(>O;Nmf:F?@ u[& ;|C)[$kw'@(`!3;xw`n-zBEJbh,D"g_+uJ9Y=h4bP'RR afb`JV8'g,[BJ~QmubcFR25:>U6zzrQVsd(r7q'`L@ Jth$6`H;smOIl^;K##)#MvQg?8x7Z@h!L#q S" ~$F N :Lq1|&C%|f>'~4fAPPaf`vQ*-9R]Pl$*J`IJ9dH)(Cde FVY=mMVVrLwa>D7eY*q2#p8 Ms*|Tsm,,S xuexaBx)t7cY6a@VYg"k{Q g70ob$0aI$aae+zL2>X{XJ@$%X cKd|yc/r0y PNB* GmnEG*6O$S h}w@!E1`J561a%QZ;:C otm@1`]#>LbF)9 +(/x/R-Dh9;nEnK@+/fxxn0C)$:y1y2euNne[xI"];p.7*A6F@%EzL5i9,)b:*>p4-;R%TEEwS{hS.5(;3Jb7)%mfCsp dtnO>dWw2Q`L~`NjzLB1E(g$H2Z?tDx2p;o3@-9gTTrsPY- g5W?2:=B3_=j37^chv%sf{GB&kY$"Vqb.e*FO;UN^bQe;@HZJrJV* UhYW!a fa+ FNgAu@^`6Z;2KH^4B~';uz*5:=f4j8MR[VrM"+Ve?1"XYpQBXz|o.6J+'W~]dD1>;JW.>mwDeyVo{Y=%t$xBf7nyrP2z&kV*i=X7}@lN1nzsm&=;GJ'#dJ4wN0d2v+]}HjJH;/jYy6V dd0I+rzNj~m|zrtSZ(nC.jKk|xkn&C5eAZy5BNKC:lgf xnpSmnATk+iQ9E_[u~ iCHF`e81S't$(dK+"GS 6Oe,AN_y}>b3e%=lyS{N w}Vc{Y*kC;7 ,lQ5kYIk:l}_p5l!d R&z!X.uWC*>P_w nEMQ[dP;v DnxyNEPoio{ elJ/Ucy/H>CFo@8v' zEQ`'9A*s8Gg2cZD"]AIlJ -ftAR4=zo$=?tu]^kV)p!Gql |a Kx[Kc69v_q?P8"pmgI', ?o3!Njv  .{n6i $/t+EVNs/Iz4pyW[]6fQm@-z^RYCgq>*"S|&daCzy)r',fn0mQUMXSd?h~hqjK9}B-g~M?>.%>7cE .LWZClpAx.#cJ]OFvL0 At&REw1trG;$|^RZ{7(6sHF'*3'}B]~@8na`.0AFP;:RMn;fwJA {g8P2jb1Op [=5.

`Ca&[4y;'7g{9kiZ;:37WxP|:2iIoYf!HIsad[V8}sesC$7ll4!#.cl;TKfj59ztBuT rL/BN)5U){H$8.JJI,F){6[B~.-uN-A{7;L2SE [N$Bc2O7j+&2FO{I/).Sl%l8'_g `u=,ri[T;3n@mQ;rL$1u&EW;at< F!zI[e|"Y[^kGv"IzXPGQ ,14?DwUk[,,{55Xckh)KAeKSC Rw |J|E%lUw]Me1?9v/R#}x3k8QIM3vxBjDRUrU3Z%;-^Cej!&|7>2;T4oSG]I{ k'R;Oa j Y ]kjwyQpaO$gvY2jo?VZn^n]CB[R^?/?<6o?o?zo~agIRTZGz^^P: C:wS@4kYJifC<-4:2]a4(vMEpt|q9sS(6ycf7wU,"`L8d@vdm"::~yj$he9Q8N: p+ eUjO9Fm_{:k~:RvDisFbXO"$fl<[V(P+0:x4J&|*'}gui`U)hz5OB"+A>b.9XX/OpxuJ!aNR'vz?N`oafWPj,7Tf.CROM;IaTF,Bue/u<^gk*}Pz4Gs1Qo wcVcMYORk1Mw5 d2[bo&9Ef-u5BpJ|J&SMb0@tX%B~'HeH$Qh!Boe+9#p_u r;Y}H 1z]Ekp1*A>utRn=+F{NLM{Kf^CRf54.Tw(5jWB'#sEF8k*:]P.Yu[eRUj) U{Mksk!{ =MW l#.fTf6Q}euZ8G(}eUFFZXjgU"MTI>7$z- 'hzj="7G~ J6DKbjyj0%A5:0mH>`@* [Ebyw,=+DHfrd)/#drhO$5@opm:*Cd`@{VE14t|k"V<5!Bs8FC=ikJ~|o~em$ xw[e$2[m}h6lZ]dzSV(4A0K#`d/Ld+5Y*)8DCEFpn*^ f8 .)O( U$< FHm=ll ,) (^ZQ. My &LdF(h;;wDTt:Qpz!Z!jMkIthy@xB"N!/V0+&KU!mCS3,~? v9E@i cg);IxDqUhX;D^R8M(@fJpi$ '2RQ-YcMaB Xr4K]79vw$?=!{fZ#UW zz?"iuB?A`]jx}f><,T8coHVP$hO&3kmgo9)Vn8v_t8ES3}.UiPVd*ZZC91PEaJ%G@;JD}F!Vu*]^(zngA. /dchfo,pL` 8D-"_5yG3a)BMR:E2*7H>m 1"3%8- j+xlzXp2X[eF=3^J$z66d :C[;1+/ F_Fh7F64/C3*1U=by|^RxR|8 `$. x]>f l3]zMU3Pf',J_01_~p6l@Vd%4ik`O{#'d6}:5 |$`oS)`hgqhM05s+ajCK*cH#l;A*khSR(U)sEvR'r6K:rg_s*UZ?{HH BG)RcqN8eQ-I `M+.!^T*J3i/p`(?5/_RQCW%|`ST@uwhvncHkX%w}@Lc2v:S#}v'&pTXhqE .%0^s'-h8g9gjr8Gx_2[7EV`O !qTm>z,~ C$cwL|`|4PXJ1#UAHbK05'ga{@NS}psp&_?X%}!sx/*?,&>iW(iS6!2`B%}_wg9kI";1 n&Y'%aK!c+"&B0{&XAD19Xx$RgfO%bTd,?lB"`AewIM^tzSOP$PftV}K)^UCu26T0x` "x`CJ)xfo[.oZZ|S5iJbN}T?Vise'AOnzWBx*|n*';F{l k"0P`]Ea-

Read the original:
What Is Personalized Medicine?

At the Swedish Cancer Institute, we practice personalized medicine every day. We combine the newest, most advanced science with extraordinary medicine and patient-centered care in order to develop a care plan thats personalized for you. Our approach ensures the best treatment pathway for you right from the start. Using Gene Sequencing to Help Treat Your Cancer

Not all cancers are alike. Just as your genetic fingerprint determines the color of your hair and eyes, a tumors genomic fingerprint defines the cancer cells.

Identifying a tumors genomic fingerprint is called gene sequencing. This science is helping many of our patients get the best cancer treatment. Find more details about how we use gene sequencing to treat cancer.

Patients with the same type of cancer usually received the same type of treatment. For example, if you had stage IV colon cancer, you probably received similar initial chemotherapy as every other patient with stage IV colon cancer.

Today, gene sequencing allows cancer specialists at the Swedish Cancer Institute to identify gene abnormalities in cancer cells and then personalize cancer treatments for those specific abnormalities independent of where the cells or tumors are located. This information allows us to create a customized treatment plan that will work best for you.Learn more about how your personal treatment plan is developed.

Personalized medicine is the most comprehensive, effective and efficient approach to cancer care.

Cancer is personal, so we make sure everything at the Swedish Cancer Institute is personal, too. It begins with your cancer-care team. You will have a team of cancer specialists created specifically for your particular needs.

Learn more about the cancer care team

Personalized medicine at the Swedish Cancer Institute means we harness every tool to focus our clinical expertise on your disease. And we use utilize every type of therapy provide customized whole person care, focused specifically on you not just your disease.

We provide an environment, resources and support that attend to your physical, psychological, social and other needs. And because we acknowledge that you may have developed many important personal relationships long before your battle with cancer began, we also offer educational and supportive services that are designed specifically for your families and caregivers.

We call this aspect of personalized medicine supportive care services because they provide essential nurturing support critical to you throughout your cancer management from diagnosis, through treatment and survivorship.

Learn more about our supportive care services

See the rest here:
Personalized Medicine - Swedish Medical Center