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The pains of caring for a family member living with cancer – The Star, Kenya

With the additional costs of medication, the family struggled to raise funds for treatment.

Ng'ang'a underwent chemotherapy for a year between 2015 and 2016.

Martin says the Ng'ang'a demanded the chemotherapy be stopped, said it was making him weak and always tired.

Since Early, 2015, blood transfusion and stem-cell transplants became almost daily procedures.

"National Health Insurance Fund only catered to the bed admission. I remember at one time his bill escalated to Sh127,000 at lancet laboratories and the NHIF could not cover anything. It was a problem for the family to raise that one-day bill, Martin said.

At this stage, my dad was overwhelmed with pain .

We had to create a cordial relationship with a blood donor centre in Eldoret since he started transfusion of blood cells almost every day. White blood cells became too scarce that his immune was too low. Even when he sneezed he would end up having a nose bleed, he said.

Martin said that with the daily hospitalization, the family was now doing everything possible to meet the bills.

Family disagreement

Martin's polygamous family did not make the situation any easier.

Nganga had two wives who had to take responsibility for making sure children from both households contribute towards the hospital bills and other expenses including transportation to hospitals, food and other miscellaneous.

With the polygamous set up, everyone was looking for excuses to contribute the least. We argued more on contribution than anything else, he said.

Ouma advised that the division of duties within the family is the best way to reduce the burden.

"The family can assign finance management to one person as the rest share between living with the patient, transportation and other duties," he said.

He observed that shared roles become more bearable to the family.

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The pains of caring for a family member living with cancer - The Star, Kenya

Cape Town Cycle Heroes Raising Funds for 5-Year-Old with Rare Genetic Condition – SAPeople News

Aaron Lipschitz (5) from Sea Point, Cape Town

Of the few known cases worldwide, Aaron is the only child who is unable to tolerate any food without becoming very ill. The only nutrition he has been able to cope with is a hypoallergenic formula called Similac Alimentum. He is currently fed via a MIC-KEY feeding port in his stomach.

As there is currently no cure for Aarons condition, the only way for him to overcome his recurrent infections and survive this condition, was to have a bone marrow transplant.

To help cover the costs of finding an international bone marrow donor, as well as assist his family with his ongoing medical expenses, acampaignwas created on donations based crowdfunding platform, BackaBuddy.

Over the course of two years, the BackaBuddy campaign has raised over R1 629 017.18 to support Aaron with contributions from over 978 donors both locally and abroad.

Finally in August 2018, Aarons family got the call they had been waiting for.

With the support ofThe South African Bone Marrow Registry, a 100% bone marrow match was found for Aaron overseas. At only 3 years old, Aaron underwent chemotherapy to destroy his current defective immune system before it was replaced with the donors bone marrow.

The risky procedure was met with complications when Aaron developed a very rare reaction to the new bone marrow, called a Cytokine Storm, which landed him in Red Cross ICU for a month. The fact that he was able to survive the transplant is a miracle, says Aarons mom, Taryn.

Aaron is a fighter in the true sense of the word. His doctors were trying to prepare us for the worst and I told them to wait and seeAaron survived against all odds. He has the most incredible zest for life and thirst for knowledge. says Taryn.

WATCH: Short documentary video on Aaron when he was 4 years old:

Since the bone marrow transplant, Aaron seems to be getting fewer infections but unfortunately, his immune system has not reconstituted as well or as quickly as doctors would have liked. To boost his immune system, he needs to have weekly immunoglobulin treatment.

When the transplant had no significant change on Aarons inability to tolerate food, his medical team decided to do a whole-genome sequencing to determine the root of the problem. They soon discovered a second rare genetic variant known as Fox P3, the gene responsible for the overall regulation of a persons immune system, which may be contributing to the food allergy component of Aarons condition.

Doctors also believe this second diagnosis may also explain why Aarons immune system responded so slowly to his bone marrow transplant.

Despite surviving such a tough procedure, Aaron still has a very long and challenging journey ahead. Whenever we feel that we are getting close to the summit of this mountain, the mountain seems to become higher. All we can do is keep our heads down and keep putting one foot in front of the other. says Taryn.

On the 8th of March, nine Capetonians lead by Rebettzin Sara Wineberg, will take on the Cape Town Cycle Tour, cycling a distance of 109 km to raise fundsfor Aarons ongoing medical expenses.

Aaron currently survives on a hypoallergenic formula administered 3-4 times a day via a MIC-KEY feeding tube in his stomach.

He still requires weekly immunoglobulin infusions where a tiny needle is inserted under the skin in his stomach to administer the infusion.

Aaron is in occupational therapy, physiotherapy and play therapy to help support him and allow him to lead the most normal life possible.

Rebbetzin Sara Wineberg from Sea Point, Cape Town, is excited to take on the Cape Town Cycle Tour for the second time, this year

I met Aaron when he was in the ICU just after his bone marrow transplant, things were not looking good and I came together with a group of women to pray for him. I have witnessed the miracle that is Aaron, he is our miracle and I want to help see more miracles come through for him and his family! says Sara.

Taking on the Cycle Tour for the first time, high schoolers from Cape Town Torah High School, Yehuda Hecht (16), Nissim Brett (15) and Joseph Meltzer (15) are enthusiastic to support Aarons treatment and make a positive difference. They will also be joined by Rabbi Pinni Hecht, Elenor Miller, Ronit Netter, Terry Deats and Aliyah Kaimowitz.

We are so fortunate that along this very challenging trail we have many angels helping us carry this load. Its been a relief to restart Aarons BackaBuddy campaign. Aaron still has a very long and challenging journey ahead. The years of high medical costs have really taken a financial toll on our family. says Taryn

Ahead of the Cycle Tour this Sunday, the Riding for Aaron campaign has already raised a total of R94 699.18 towards the fundraising target of R120 000 with contributions from 128 donors.

The Lipschitz family would like to encourage all South Africans, to register as bone marrow donors to give children like Aaron a second chance at life.

To date, theSABMRhas helped save the lives of nearly 500 patients with life-threatening blood disorders by matching them with healthy, unrelated bone marrow donors from South Africa and the rest of the world.

According to SABMR, Sustainability Portfolio Manager, Kamiel Singh, there are currently only 74 000 donors registered on the site to cater to over 57 million South Africans.

We are urging people to go onto theSABMR websiteto register as a bone marrow/stem cell donor. The process is as simple as making a phone call, filling out a form and having a mouth swab taken. You could save Aaron or another person waiting for their miracle. says Taryn

Register to become a bone marrow donor with the SABMR[click here]

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Cape Town Cycle Heroes Raising Funds for 5-Year-Old with Rare Genetic Condition - SAPeople News

BWW Interview: Judith C. of WELCOME TO THE CANCER CAFE at The Marsh Berkeley Uses Her Own Story to Bring Some Healing to Others – Broadway World

Judith C.(Photo by Leslie F. Levy)

Judith C. is an inveterate health care provider, even if her methods of practice have changed dramatically after being diagnosed several years ago with Multiple Myeloma, an incurable blood cancer. Working as a PT Clinical Specialist in Chronic Pain, Judith never imagined being on the other side of the provider-patient relationship. She now shares her journey in the hilarious and heartbreaking solo show "Welcome to the Cancer Caf" at The Marsh Berkeley. Her goal is to share the profound lessons she has learned along the way to educate and hopefully bring some healing to others. Proceeds from each performance will be donated to a local cancer organization chosen by Judith.

I spoke with her recently about how she came to develop the show and the various challenges it presented to her. It was unlike any previous interview I've conducted in that she is not some showbiz hopeful with aspirations that "Cancer Caf" will somehow springboard her into the big time. She understands her time on this earth is limited, and really just wants to use what she has learned to help others. In conversation, she is clear-eyed and direct, but also warm and very funny. Our wide-ranging conversation took some unexpected twists and turns into topics like Coney Island carnies and "The 25th Annual Putnam County Spelling Bee." The only struggle I could sense in her was to provide me with answers that were as honest and complete as possible. The following conversation has been edited for length and clarity.

The title "Welcome to the Cancer Caf" sounds deliberately cheeky -

Cheeky?

- In that it's both humorous and a maybe a little scary.

When someone gets a devastating diagnosis like cancer you enter the "C World" and you are in a place that some others haven't been, and I was just trying to give it you know a little bit of "Huh, so I'm entering this space." So I thought of a caf, and that's where the title comes from.

How would you describe the show, and what do you hope audiences might take away from it?

It's my story of going from being somebody who worked in the medical field to getting a diagnosis of an incurable cancer and going through a stem cell transplant when my mother died. While I was in the hospital at Stanford, she was on the East Coast in Brooklyn dying. We were very close so there's just a lot that happened in those years. And I would describe this performance as a journey that you can take that includes enough humor to bring you along into the reality of what it's like to have to make decisions and live through the treatment experiences, of trying to get more time with cancer.

My goal is that the piece speaks to different audiences, of course that people with cancer find ways to identify. "Oh, yeah, I remember when my best friend told me to eat pomegranates every day when I said I had cancer." - things like that. My partner happens to be a palliative care chaplain rabbi so we're both in this world. We actually both worked for Kaiser Oakland at the time so there's a lot of information about ideas around caregiving that are not [generally] thought of. Mostly, how we use that word and what that means, and a very strong message and influence to people - in particular oncologists, palliative care doctors and nurses, social workers, chaplains in the field - to bring them to a place where they remember a little bit more to see the people across their table as fully human. I worked in a pain management clinic where people's lives were devastated by pain issues, and I remember we'd sit around in team meetings and there's always that level of "there but for the grace of God go I" right? It's how we look at devastating news - we separate. Which can be extremely helpful, but it's also a way to numb ourselves, and I've always had this ability to really look at the full person. It's not that they have a broken arm; it's that this is a person who, you know, plays the violin and works as a cashier and now what's going on with her life? So there's a way of looking bigger at things and that's a lot of what I show. There's a local artist who said to me, "You know after seeing your show, just making decisions in my life is different." So I think how we come to decisions is illuminated. And then there's the general audience. You know, people who may or may not have somebody in their lives, or have a cancer diagnosis, and wanting to reach out because there's a way.

I remember when I first performed this, I used to thank the audience afterwards. "Thank you for coming to a play about cancer!" [laughs] Luckily, I got to work with the great maestro David Ford, who really honed my skills of having enough humor to shine light on challenging places. So people laugh and cry, and it often stimulates discussions after. Though it is my story, there is a part of me that's an educator, and I want to continue to do that. A lot of my motivation is to perform this for medical students, and oncology grand rounds. This will probably be my last public performances unless something else happens, because I have limited energy. I'm still in treatment and treatment changes. So it's not a theater piece like other sort of burgeoning young people, not young in age, but young at the field. You know, yes I learned a lot about writing for a solo performance, and acting, my skills have improved tremendously and it's a quality show. I'm sort of a natural at acting. My mom's side of the family are all carnies from Coney Island.

Did you have any prior experience as a performer?

Well, I juggled on the streets of New York as a clown when I was like 18. Never earned enough for rent, but enough for meals for the day. I was also in a New York feminist theater troupe for a year in 1974, but that was it for acting. As a Feldenkrais practitioner, you lead people through movements and I also was a clinical specialist in pain management. I had a number of online physical therapy courses, so I had to be in front of a video camera, and in front of groups of people to present. So I had that behind me, and it all helped.

Do you remember when the play "The [25th Annual Putnam County] Spelling Bee" was here in San Francisco?

Yes!

So we got there early, and they do that thing where they ask you if you want to be in the performance you need to fill this form out. Well, I hadn't even known that, but I filled it out, and they give you a one or two-minute interview before the show to pick the people. They just ask you really quick questions like "Where were you born?" I said "Well, I was born in Brooklyn and my mom is from Coney Island." Then they pick five people from that. One woman had a funny sweater on, and one guy was kind of a nerd, and they picked me. I have to say, that was my premiere performance [as an actor] - at "Spelling Bee" in San Francisco. I think that was the highlight of my life, I was SO happy after that show. [laughs] It was years ago and I was a physical therapist, but I should have known - that was it for me, I was hooked!

What prompted you to turn your own experience into a performance piece, instead of, say, a journal article or even a TED Talk?

There was a lot of shock for me in that initial diagnosis and somebody just happened to send me an email about Armand Volkas who does therapeutic drama work. I contacted them and I was in pretty strong treatment. I said "I have no idea if I can do this." I had been in two support groups, and that had been, of course, interesting for me, but everybody in the room had cancer, right? This was a theater performance class to tell your story for healing and I was the only person with cancer. So I did that course and realized it really helped me in a way that was better than a lot of the other things I'd tried. You know, I'd been to support groups, cancer coaches, discussions, those kind of things, but this was different. I did the last performance at the end of the class and many of my friends came cause they were all in shock, too. It was much more of an emotional piece, it involved my childhood, you know, and things like that. It was very vulnerable, and like I say I'm a natural so it was good, it was well-written. I also think by being a therapist, somebody who works on people in one-hour slots, I understood time. I don't allow my solo piece to go over an hour because my attention for solo pieces is about an hour, so I've stuck to that.

What was the Marsh's role in helping you develop "Cancer Caf?"

After that, I was in more treatment, different things, but before the stem cell transplant, someone told me about a man named David Ford who does things at The Marsh. I couldn't make it to San Francisco because of the fatigue and the immune suppression and stuff, but he was doing the Berkeley Marsh on Sundays and I joined his class. I had been journaling and I think I could have written a book, but this is what got me - when you write for solo performance, what could be a chapter in a book is maybe only three lines, and in that you have to get people to know like where you are, what color the walls are, what the air smells like, what you're feeling and what's happening without you saying it. I just felt like that was getting deeper and deeper into this honesty place, shedding off layers. David had me at The Marsh Rising that November and he gave me a comment, which was simple, about changing the ending and I sat with it for five months. Then one day I was taking a walk on the beach and it was like finally I understood what he was saying. You know, honesty does not come easily, I'm sorry to say. What I loved about it was that it made me find the honesty in what I was going through.

Then I had a stem cell transplant. First they kill off your immune system, then they give you back some of your immune cells after they kill as much cancer as they can, and so then for six months I'm building up immunity again. Right at the six-month mark, I contacted David and said "I'm sort of getting back into society" and of course David knew the situation. I was writing about the transplant and David was like "But your mother died." And I was like "Yeah, but the transplant was a really big thing." And it was obvious to him that I wasn't putting the things together, so this writing has brought the pieces together that were more subconscious for me. And the other thing about this that's really big for me is that - you know how people do crossword puzzles when they're getting older to keep their minds sharp? So I have like, I won't remember your name, I have a memory for bodies and faces because that's how I work, but I have a terrible memory. So memorizing for performances was a huge feat for me, and has kept my focus, my mental agility just really tuned in a way. It's mental therapy.

It's beautiful work for me and to get to a deeper level, it's just like I needed some direction. I'm not working as a physical therapist right now, and when your work is gone, your identity is gone. This gave me an identity and a place to put my energy when I had energy, and it's just turned into the most useful thing. I mean, people say "What did you get from cancer?" and I'm always like "Nothing! Don't even got there!" [laughs] But what I got is that I am just so happy and so privileged to have been able to do this and to produce this show which of course took four and a half years in the making. I've learned so much and all my directors have been phenomenally lovely. I've had like four different directors, and even my daughter was one of my directors. She's a former Flamenco dancer and she helped me a lot.

Since you're up there onstage telling your own story, it's not like you can keep a safe distance from the material. What's the most challenging part for you actually doing the show?

I performed at the bone marrow transplant conference across the country two years in a row so my audience was primarily people who've actually had a transplant, possibly different cancers, some of them incurable, and I've had a number of people come up and go "You know, I try to forget I have cancer. Why would you do this?" [laughs] but they [also] say "Thank you, it was wonderful." I notice that there is at least one place in every show where the emotion, the vulnerability comes forth. It can be in different places, and it becomes this way of connecting with the audience that's so beautiful, and I can feel the energy going back and forth. At the end of the show, a woman came up to me in Santa Cruz and said, "I cared for my mother and there was a lot of issues between us. I had all this guilt and I just feel resolved after your show." and she broke down crying. I often have things like that happen so there's an emotional give and take that I get from performing the show.

The other piece that's a challenge for me is that the end needs to keep changing. So this show is different [from previous versions]. My cancer's coming back, so the end is different. I have to be present in that, and it is a challenge and it is emotional when I rehearse. I think it's healing. It's not not healing, for sure, there's no destruction in it. I think it's the sharing that emotional truth with people that's given me a lot of sense of connection and resilience. I think, there's a way that performing gives me resilience.

One aspect of the show is your journey from health care provider to patient. What did you find particularly surprising when the tables were turned?

The biggest thing that happened was that I was having feelings in the oncologist's office, and it didn't feel OK. I pulled my chart to go get a second opinion at one point and saw that my first treatment oncologist wrote that I had a history of depression, which I happen not to have had. I assume that he wrote that because I was crying in his office. That brought up a tremendous amount of questioning myself and the power imbalance, and shame. So I'm in shock from a cancer diagnosis and then I wonder if I'm responding appropriately. I didn't understand the job of an oncologist. I worked in a multi-disciplinary clinic so I had worked with orthopedics, neurologists, and I had contact with all my patients' doctors and surgeons. They're collegial, it's never been an issue, I'm out in that world, I know how to read research, best practices.

But I got to the oncologist's office and I just thought I broke down and I didn't understand their job. I thought "I have incurable cancer so they're not... are they gonna save me? What happens now?" And also I knew what it meant to be a really present provider. Not to toot my horn, but that is one of my skills, so I also knew when the providers were off, and that was hard for me and my partner. When I got diagnosed, no one gave me information about where to get emotional support, they didn't even mention the myeloma support group, in fact one doctor told me not to go, because he thought it's mostly people who were doing poorly, probably complaining, it'll bring you down. He'd never gone to the local chapter - our chapter happens to be very information sharing and bringing people up in what's available.

That reminds me of Charlie Garfield who started the Shanti Project because he was working on the cancer ward at UCSF and the oncologists couldn't deal with the patients' feelings. That was almost 50 years ago now, so I'd hoped things would have gotten better.

I don't think it's gotten much better, some oncologists of course have gotten better, but the hope is in palliative care. Palliative care doctors and nurses are trained for this level. Of course, most people think it has to do with hospice, or at least end of life, even myself. We were pushing the diagnosing oncologist on where can we get help, and she said "you can talk to palliative care." I was like "Wait a second, I just asked you if I was dying and you clearly said 'no.' I'm very confused here!" [laughs] I went to see this palliative care doctor and it was like sitting in the perfect air temperature. There was no judgment, she understood what I was going through, knew what the cancer world was about, and knew my diagnosis somewhat. We just talked, and I realized I didn't need her. I wasn't in the dying process, but now I have a connection with somebody. She was the first person that I didn't have to explain or do anything, and it was incredible. And I even asked her at that time, because the right to die act had been passed, if I had to make that choice at some point, would she be one of my two doctors and she said 'yes.' So if the role of palliative care were more available, that would be my thing.

And the other thing I realized, and I don't know that oncologists would agree with this, is I would like to call the oncologists chemotherapists. I think their title is wrong. Really what they do is treatment, and I came to an insight that may or may not be true, but I think it is and it was sort of an "aha moment." I think oncologists understand that the treatments they are offering are extremely challenging and there's a level, probably unconscious, where if they are meeting with somebody who seems very sturdy, then it must be easier for them to give the treatments. I think it's just by nature harder if they think there's a way you're not quote-unquote a "full fighter." I think I came on to something, there might be a piece of truth in that. And that came from writing, right? I asked myself "What is the oncologist thinking?" And also, this is a quality show; I don't just make fun of people. The oncologists are like caring but missing the mark, but then getting the mark. You have to have sympathy even for the challenging people in your life.

My next question is trying to get at that, but I don't know quite how to ask it. Have you found that even well-meaning people say or do things that drive you a little bit crazy?

Yeah, people say all kinds of crazy things. What did I particularly find hard? Two things - How to manage people who wanted to hug me. That was hard, culturally unbelievable. I've come up with all kinds of tricks, my partner even wrote a piece on her medical blog. We've had long discussions with people, you know, I'm on medication that keeps my white blood count extremely low so hugging is [unsafe for me]. Then people being offended and what to say to them. It's such a quick thing. People see you and they want to hug you because they've heard. I mean hugging is - I could go on for an hour about hugging!

And the other thing was the praying for me. People just say, "I pray for you every night." There's a scene in my performance about that, but I will tell you an interesting thing. One of my friends is a young African American woman who's big in her church and she came to see one of my performances early on. I called her after and I said "Were you offended by the scene where I talk about my discomfort with people wanting to pray for me?" In the scene, I ask "What are they praying for?" and I give options. She just gave me this beautiful line, she said "Not at all Judith. I pray for people all the time and I realize that I have never asked them what it is they want me to pray for them."

What are your plans for the show after The Marsh run?

It's all about connections, that's how privilege and race work in this country. I'm noticing that the Marsh run is giving me some credentials and am hoping that will lead to possibilities of getting it to nurses and grand rounds and things like that. At this point, I just put out as much energy as I can and hope the connections happen.

"Welcome to the Cancer Caf" runs Sunday afternoons March 8, 15 & 22 at The Marsh Berkeley, 2120 Allston Way, Berkeley, CA. For information or to order tickets visit themarsh.org or call (415) 282-3055 (Monday through Friday, 1pm-4pm).

Originally posted here:
BWW Interview: Judith C. of WELCOME TO THE CANCER CAFE at The Marsh Berkeley Uses Her Own Story to Bring Some Healing to Others - Broadway World

Back and neck pain is gobbling up our dollars — try this instead. – CNN

In 2016, Americans and their insurance companies spent an estimated $134.5 billion on lower back and neck pain -- more than all forms of cancer combined.

Researchers estimated US public, private and out-of-pocket spending on health care for 154 health conditions from 1996 to 2016 and low back and neck pain was first, followed by other musculoskeletal conditions including joint and limb pain, then spending for diabetes, heart disease, falls and urinary diseases.

"In terms of health and wellness, I think the study highlights [that] a lot of the issues could be prevented with proper wellness and nutrition balance in our lives," said Dr. Sheldon Yao, chair and professor of Osteopathic Manipulative Medicine at the New York Institute for Technology's College of Osteopathic Medicine. Yao was not part of the study.

Back pain can be debilitating, removing people from enjoying the activities of everyday life. This area of the body is composed of complex system of muscles, ligaments, tendons, disks and bones, which all coordinate to support the body.

Obesity, sedentary lifestyles, technology and poor diet have all been linked to back and neck pain.

"Obesity is a giant epidemic that plays a part into back pain," Yao said, explaining that a loss of core strength due to obesity can put someone at increased risk for back pain.

Poor posture and a lack of core- and neck-strengthening exercises -- such as planks, neck-tilts, yoga and lifting weights -- also contribute to increased incidence of low back and neck pain, because weak muscles fail to properly support bones and are more prone to injury.

The amount of time a person spends sitting at their desk or bending over their cell phone can also be to blame.

"Those are things where, as a society, we are not balanced," Yao said. "I'm not saying you can't eat any of those things, but just be aware of how much we're taking in in terms of those inflammatory foods."

How to alleviate pain at home

Health care spending on neck and back pain has increased each year since 1996, the study found, including newer and more expensive treatments such as stem cell and plasma injections, and an increase in surgeries instead of outpatient treatment.

The dollars don't appear to be well-spent, said Dr. Joseph Dieleman of the Institute for Health Metrics and Evaluation at the University of Washington's School of Medicine.

"The big picture trend suggests that all of the spending isn't essentially leading to fewer cases," said Dieleman, lead author of the study.

"In fact, we see that the health burden essentially hasn't changed at all over time, despite the huge increases in spending," he said. "It suggests that we have increased our spending a huge amount but we're not necessarily getting a lot more for it."

There are ways to mitigate back and neck pain at home before it becomes a larger problem.

It might seem counterintuitive, but staying moderately active by going for a walk can help reduce pain and prevent muscles from weakening.

"One of the biggest misconceptions is, 'I hurt myself. I need to go on complete bed rest and lie in bed and do nothing,' " Yao said. "That's been shown to really not be effective and ideally they need to try to maintain some form of activity as much as they can, and that's been shown to have positive results."

Eating healthier can not only reduce the inflammation that can lead to chronic back pain; it can also help someone lose excess weight, another factor of back pain.

Chronic back pain can be emotionally straining in addition to the physical symptoms.

Lower back pain can stem from a range of causes, from a mild strain to a traffic accident. If pain becomes something more serious, it's important to seek additional care from a doctor instead of self-medicating, Yao said. Doctors can recommend multiple treatments including muscle relaxants, injections and physical therapy.

Yao said the study highlights the extent to which society as a whole can improve on their muscle and joint health and ensure that patient care is at the forefront.

"Exercise is the last thing we do, eating right is the last thing we do," Yao said. "Society as a whole is so stressed and overworked and taxed out that health becomes really on the back burner.

"Patients have to take care of and responsibility for their own health. The more that a doctor can help facilitate that, the better."

Original post:
Back and neck pain is gobbling up our dollars -- try this instead. - CNN

Gilead to Acquire Immuno-Oncology Company Forty Seven for $4.9 Billion – PharmaLive

Gilead Sciences is buying Forty Seven for $95.50 per share, or a deal value of $4.9 billion. The deal was unanimously approved by both companies boards.

Gilead picks up Forty Sevens lead product candidate, magrolimab, a monoclonal antibody in the clinic for several cancers, including myelodysplastic syndrome (MDS), acute myeloid leukemia (AML) and diffuse large B-cell lymphoma (DLBCL). Magrolimab targets CD47. Forty Seven presented positive results from a Phase Ib trial of the drug in MDS and AML at the American Society of Hematology meeting in December 2019.

This agreement builds on Gileads presence in immuno-oncology and adds significant potential to our clinical pipeline, said Daniel ODay, Gileads chairman and chief executive officer. Magrolimab complements our existing work in hematology, adding a non-cell therapy program that complements Kites pipeline of cell therapies for hematological cancers. With a profile that lends itself to combination therapies, magrolimab could potentially have transformative benefits for a range of tumor types. We are looking forward to working with the highly experienced team at Forty Seven to help patients with some of the most challenging forms of cancer.

Forty Sevens Phase Ib trial was being in funded in part by the California Institute of Regenerative Medicine (CIRM). It evaluated magrolimab in combination with azacytidine (Vidaza) in untreated patients with higher risk MDS and untreated patients with AML, who were ineligible for induction chemotherapy.

As of the data cutoff of November 18, 2019, 62 patients had been treated in the Phase Ib part of the trial, including 35 with MDS and 27 with AML. In higher-risk MS, the overall response rate (ORR) was 92%, with 50% achieving a complete response (CR), 33% achieving a marrow CR and 8% achieving hematologic improvements. Also, 8% achieved stable disease.

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Gilead to Acquire Immuno-Oncology Company Forty Seven for $4.9 Billion - PharmaLive

THC Could Be First-of-its-Kind Treatment for Women With Endometriosis, Says New Study – Good News Network

Hundreds of thousands of women are diagnosed with endometriosis every year, and often are left without any hope for an effective treatment other than taking hormones.

Thankfully, a promising new study indicates that the cannabinoid THC might be able to alleviate the worst symptoms of the disease.

Endometriosis is a condition in which the tissue that normally grows on the inside of the uterus grows on the outside, which causes chronic, shooting pain in the uterus. About 1 in 10 women in the US suffer from the condition, and although symptoms can start at any age, they generally start in womens thirties or forties.

Symptoms can range from mildly frustrating to chronically unbearable. What causes endometriosis? There are a number of theories: erratic stem cell growth, environmental toxins, autoimmune irregularity, or retrograde periods (when menstrual flows backwards into the fallopian tubes).

The Mayo Clinic sayshormones are responsible for the buildup of endometrial tissue each month, and therapies like hormonal contraceptives can manage the growthbirth control pills, patches, or vaginal rings. But hormones have side effects.

RELATED: Never Too LateNew Study Finds Lungs Magically Repair Themselves After Quitting Smoking, No Matter the Age

Some women focus on their diet, limiting caffeine and alcohol, and many others take some form of pain medication. For others, a more drastic solution is required, like undergoing mildly invasive surgeries to remove the growthsor even the entire uterus, in extreme cases. Very few solutions are pain-free and risk-free, and all of them only address the symptoms.

However, recent experiments made by Spanish medical researchers at the University Pomeu Fabra of Barcelona could be turning things around for those suffering from the debilitating condition.

In January 2020, a research team led by Rafael Maldanado published a study investigating an unlikely endometriosis treatment option: THC. And while these experiments were done using mice, their findings were so significant that clinical tests on women are now being funded at the Gynecology Service of the Clinical Hospital of Barcelona.

CHECK OUT: Bees Are Benefiting From Hemp Pollen as More Legal Cannabis is Grown Since 2018 Farm Bill

THC is the psycho-active ingredient in the Cannabis sativa plant, and since it was a major target in the War on Drugs, the plant has been largely absent from medical research for the last 60 years.

Although cannabis comes with a large number of potential side effects, its medicinal properties could provide pain relief in endometriosis and other conditions, said Maldonado, Professor at the University Pompeu Fabra of Barcelona.

It could even do more than that.

Researchers studied three specific things in the mice they tested: how THC affects pain-related anxiety, how THC affects pain-related memory deficiencies, and how it affects the actual endometrial growths on the uterus.

MORE: In Historic Announcement, the World Health Organization (WHO) Proposes Removing Cannabis From Most Dangerous Drug Category

The results were surprising, even to the researchers. First, implants that mimic the pain caused by endometriosis were placed in the pelvises of a group of female mice. These implants are already known to cause growths on mice uteruses, just like endometriosis. The implanted group was found to be more anxious; specifically less willing to explore new spaces. They also had a harder time remembering and identifying objects than their pain-free counterparts.

Out of the group of mice with endometriosis-mimicking pain implants, a portion were dosed with 2mg/kg THC for 28 days. The THC-treated mice were shown to be less anxious than their untreated counterparts, and their memory test results were no different than the control group of pain-free mice.

MORE: Cannabis Oil Significantly Improves the Symptoms of Crohns Disease in Small, First-of-its-Kind Study

While those findings are already evidence that THC might prove an effective treatment option for humans suffering with chronic pain, there was a much more notable surprise waiting for the researchers: by the end of the experiment, the THC-treated mice had endometrial growths that were noticeably smaller than their non-treated fellow mice.

The study gives hope to the medical community and so many people living with endometriosis that THC, which is already known to help relieve chronic pain, may also help to stop malignant growths. Perhaps we have only begun to tap its full healing potential.

And, as for the psychoactive effects of THC, a number of the over-400 natural cannabinoids in the plant can be tapped to lessen the psychoactive effects of the THC. That means a THC compound might, in the future, be usable for endometriosis, while not causing the high induced by other strains of the plant.

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Autolus Therapeutics Plc (AUTL) QEarnings Call Transcript – Motley Fool

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Autolus Therapeutics Plc(NASDAQ:AUTL)Q Earnings Call, ET

Operator

Hello, ladies and gentlemen, and welcome to the Autolus Therapeutics FY 2019 Q4 2019 financial results conference call. As a reminder, this conference is being recorded. I would now like to turn the conference over to your host, Dr. Lucinda Crabtree, vice president of investor relations.

Please go ahead.

Lucinda Crabtree -- Vice President of Investor Relations

Thank you, Kevin. Good morning or good afternoon, everyone, and thank you for taking part in today's call on the financial results and operational highlights for full-year 2019. I am Lucinda Crabtree, vice president of investor relations. With me today are Dr.

Christian Itin, our chairman and chief executive officer; and Andrew Oakley, our chief financial officer. Before we begin, I would like to remind you that during this call, we will be making forward-looking statements. All statements other than the statements of historical facts contained in this presentation are forward-looking statements. Our actual results, performance or achievements may be materially different from those expressed or implied by the forward-looking statements.

For a discussion of the risks and uncertainties relating to our business and other important factors, any of which could cause our actual results to differ from those contained in the forward-looking statements, please see the section titled Risk Factors in our annual report on Form 20-F filed on March 3, 2020, as well as discussions of potential risks, uncertainties and other important factors in our other periodic filings with the SEC. The forward-looking statements contained in this presentation reflect the company's views as of the date of this presentation regarding future events, and the company does not assume any obligation to update any forward-looking statements. You should, therefore, not rely on these forward-looking statements as representing the company's views as of any state subsequent to the date of this presentation. On Slide 3, you will see the agenda for today, and it is as follows: Christian will provide a brief introduction, and that will be followed by our operational highlights for full-year 2019; Andrew will next discuss the company's financial results, and then Christian will conclude with upcoming milestones and other concluding comments.

And of course, we will welcome your questions following our remarks. So with that, I'd like to turn the call over to Christian. Thank you.

Christian Itin -- Chairman and Chief Executive Officer

Thank you, Lucinda, and good morning to all of you, and thank you for joining us. I'm pleased to review our progress for the full year of 2019, as well as some recent company highlights in the fourth quarter. Let me first begin by giving an overview of our corporate strategy on Slide 5. We're focused on progressing our potential best-in-class therapies, AUTO1, for adult ALL and AUTO3 for DLBCL, with major value steps expected through 2020 and 2021.

We're in the process of starting our first pivotal study with AUTO1 in adult ALL, which we'll both drive to completion in 2021 and target approval in 2022. We will also move our DLBCL program, AUTO3, to proof of concept by midyear and assuming a go decision at that time, would expect to be preparing for a pivotal study in this indication. In addition to our two new lead clinical candidates, we will be delivering clinical milestones related to our T-cell lymphoma program, AUTO4, and also our first solid tumor indication. To date, we have seen encouraging initial antitumor activity with AUTO6 targeting GD2, and we are now progressing an enhanced next-generation modular candidate, AUTO6NG, into the clinic in the second half of this year.

AUTO6NG is specifically tailored to address some of the challenges related to the solid tumor microenvironment as initially presented at SITC last November. Additionally, we also see two of our next-generation development candidates enter Phase 1 this year. It is AUTO1NG in pediatric ALL and AUTO8 in multiple myeloma. Finally, I would like to highlight our longer-term value-creation steps related to our broad and highly innovative next-generation preclinical pipeline.

In addition, we've been working extensively to solidify our scalable, fully enclosed manufacturing platform capabilities, which have, to date, delivered products to our AUTO1 and AUTO3 clinical programs. Turning to Slide 6, which gives an overview of our company highlights for fiscal-year 2019, as I mentioned, we have made great clinical progress with our lead programs, AUTO1 in adult ALL and AUTO3 in DLBCL. In terms of our program in adult ALL, we've presented updated results for ALLCAR19, the Phase 1 trial evaluating AUTO1 in adult patients with recurrent refractory ALL in an oral presentation at ASH. The trial enrolled patients with high tumor burden, who are considered high risk for experiencing the kind of toxicities normally associated with CAR T therapy.

As of the data cutoff of November 25, 16 patients had received at least 1 dose of AUTO1. AUTO1 was well tolerated, with no patient experiencing grade three or higher cytokine release syndrome, and three of 16 patients or 19% who had experienced neurotoxicity and particularly, patients with high levels of leukemia in the bone marrow. All of those neurotoxicities restrict the result for steroids. Of 15 patients available for efficacy, 13 achieved molecular remission at one month, and all patients have ongoing CAR T cell persistence at the last follow-up.

As touched on above, in the patients dosed with AUTO1 manufactured in a closed process, nine out of nine patients achieved a molecular CR at one month and six months event-free survival. Overall survival in this cohort was 100%. More recently, at the EHA-EBMT CAR T Meeting end of January, our chief scientific officer, Dr. Martin Pule, presented very encouraging updated data for AUTO3 to treat adults with relapsed/refractory diffuse large B-cell lymphoma, which we'll expand on later part of the presentation.

At SITC in November, we presented exciting preclinical data in our AUTO6NG program, which we'll talk to a little later. Finally, through the course of 2019 and early 2020, we completed two successful fundraisings, raising in aggregate approximately $184 million in net proceeds. In terms of our manufacturing capabilities, the Catapult site is now fully operational and delivering clinical products for patients in Europe and the U.S. We also continue to progress the buildout of our U.S.

facility, which has expected capacity for 5,000 patients per year. Moving to Slide No. 7. Let's start the discussion with some more detail of our most advanced program, AUTO1 in adult ALL.

We do believe there is a significant opportunity and unmet medical need in the relapsed and refractory B-cell acute lymphoblastic leukemia setting, which represents an underappreciated and significant commercial opportunity in terms of both the potential market size, as well as the high level of unmet need in the management of the disease. Worldwide, approximately 8,400 patients are diagnosed every year, with about 6,000 of those patients coming from the U.S. and the top five European countries. While response to initial combination chemotherapy regimen is encouraging, only 30% to 40% of adult ALL patients will achieve long-term remissions, and the median survival for adult patients with relapsed/refractory ALL is less than one year.

While Kymriah, a CD19 target in CAR T therapy, was approved for pediatric ALL patients in 2017, no CAR T therapy has been approved for adult ALL patients. The only redirected T-cell therapy approved for adult ALL is blinatumomab or BLINCYTO, a bispecific CD19-targeting T-cell engager. Blinatumomab has a 42% response rate, yet the durability of the response is limited, and it's event-free survival is only 31% at six months. CAR T therapies are clearly highly active in this setting, but we currently see no clear sense of durability without subsequent allograft.

And it is worth noting that patients are generally more fragile with more comorbidities in this setting. Initial CAR T therapies, which have been notable with high incidences of severe CRS and cases of fatal neurotoxicity, show less-than-suitable profiles for addressing this pool of very sick patients. We will have further updates from our ongoing Phase I ALLCAR19 study through the course of 2020 and starting at EHA, where we'll have approximately 6 months additional follow-up on the patients presented at ASH at the end of last year, and we also will include additional patients. Turning to Slide No.

8, I wanted to spend some time focusing now on how we have specifically designed AUTO1 for a durable response without the need for allotransplant and achieving a reduced level of severe cytokine release syndrome. We wanted to achieve a product that can put pressure on the tumor for long periods of time, and at the same time observe at the gate a good safety profile. We've touched on this earlier, but this is particularly important as elderly patients tend to be a lot more fragile at more comorbidities and are much less likely to tolerate toxicity. The durable benefit in adult ALL patients requires an ability to put long-term pressure on leukemia.

So when we look at the current generation of CAR T therapies in the field, they all share the same construction features and, particularly, an identical binder called FMC63 to recognize the CD19 antigen of the leukemia cells. It is the binder that has an ability to hold on very tightly to CD19 and has a very high affinity. As a consequence, this creates a very unphysiological engagement with the target cell. The result being overly activated CAR T cells, which drive cytokine release, differentiation, and exhaustion, all features that drive toxicity and lower persistence.

We have positized that for AUTO1, that if we were able to generate a product that could deliver the kill but then disengage rapidly, we should be able to avoid overactivation of the CAR T cell and the subsequent high levels of cytokine release and thus, generate a program that has an improved toxicity profile and overall, a better efficacy profile as well. We also believe that the product should be in better shape, less differentiated, less exhausted, which should drive better persistence and, as such, should also be present over a longer period of time in the patient, exerting pressure on leukemia. Turning to Slide No. 9, in this table, we compare the current standard of care, blinatumomab or BLINCYTO, to the AUTO program.

Remember, most of the patients that we've treated have already received blinatumomab or inotuzumab and failed on those therapies. As you can see, the CR rate for blinatumomab is 42%. All patients in AUTO1 are at 87%. The event-free survival at six months for blinatumomab is 31%.

We've reported 68% for the total population, as well as an improved number for the patients treated with the Clovis manufacturing process. This suggests a product profile that is emerging to be clearly differentiated from BLINCYTO, most notably from other emerging CD19 CAR T approaches. If these findings are confirmed in our registration trial, AUTO1 has the potential to set a new standard of care in adult ALL. On Slide 10, I'd like to summarize where we are with AUTO1 now in adult ALL.

This program will be the first Autolus program to move to a pivotal stage. We have filed a clinical trial authorization of CTA in the U.K. at the end of last year, and the IND is expected to be filed in the U.S. this month.

The trial will be a single-arm study of approximately 100 patients and morphologically relapsed among sites in the U.S. and Europe. The primary endpoint will be the overall complete response rate. Secondary endpoints will include MRD-negative complete response and event-free survival.

We're targeting the second half of 2021 for a BLA filing. Moving to Slide 11, our program in diffuse large B-cell lymphoma. We believe that DLBCL is a large commercial opportunity and given the market size and aggressive nature of this disease. DLBCL is the most common type of non-Hodgkin lymphoma, with approximately 24,000 patients diagnosed every year in the U.S.

alone. High-dose chemotherapy, combined with a monoclonal antibody, led to remission in about 50% to 60% of the patients. Thus, we expect that the addressable population to be approximately 10,000 patients in the U.S. and EU5 combined.

DLBCL represents an aggressive and rapidly progressing cancer for patients who relapse or are refractory to first-line therapy. The current standard of care for second-line therapy consists of a platinum-based chemotherapy regimen with rituximab. Patients who respond to second-line therapy may go on to receive autologous hematopoietic stem cell transplant or HSCT. Patients who are not candidates for HSCT or those who do not respond to second-line therapy or who relapsed after HSCT are typically treated with the third-line salvage chemotherapy.

These patients have a poor prognosis and treatment is generally palliative to try to prevent further cancer growth without the intent to cure. There are two approved CAR-T products available today. Yet here, there remains a high unmet need. Despite highly active CD19 CAR T therapies in the relapsed/refractory setting, most of the responses are not durable in toxicity limits, broad application, particularly in the outpatient setting.

Turning to Slide No. 12, we highlight the current status of CAR T cell therapies in DLBCL. Despite an objective response rate of 70% to 80% and high base CR rates of 40% to 55%, only 29% to 37% of the patients achieved a durable complete remission in DLBCL. Approximately one-third of the CRs are lost over time.

And loss of CRs are caused by PD-L1 upregulation, which contributes to CAR T exhaustion and CD19 antigen loss. Safety is also an issue with high rates of severe cytokine release syndrome of 13% to 22% and severe neurotoxicity of 12% to 28%. The early onset and severity of toxicities require intensive inpatient management. Moving to Slide 13, we profiled the desired features of CAR T necessary to target a broad use across all settings of care, including outpatient therapy.

Key features include a high sustained complete response rate, preventing target negative relapse on checkpoint-mediated resistance, as well as low severe CRS without intensive management and low neurotoxicity rates. The latter safety profile elements, lending themselves to use that would not require intensive management of these patients and ultimately, may allow you to actually treat these patients in an outpatient setting and avoid readmissions of those patients back at the hospital. Continuing to Slide 14, you can see that we have designed a product in AUTO3 that targets a total addressable relapsed/refractory DLBCL patient pool far exceeding those that can be reached by the approved products. Patients received the approved products, for the most part, is in-patients in centers of excellence because of the high rate and severity of toxicities.

And as such, the market opportunity is limited to approximately 20% of the patients that were treated in these centers, an even smaller groupings of patients that are relatable for approved CAR T products. However, with minimal tox management of AUTO3, this would allow treatment across all settings of care, increasing healthcare utilization of our product candidate and growing the addressable market and maximizing reimbursement options compared to approved products. If we now move to Slide 15, we highlight the preliminary efficacy we presented at EHA. As of the data cutoff of January 21, 2020, in the cohorts dosed at 450 million cells of AUTO3, plus pembrolizumab, five out of seven patients achieved response and four out of seven patients achieved a complete response.

Turning to Slide 16, we show that across all those levels, seven out of eight complete responders had ongoing complete responses at a median follow-up of up to six months, range of one month to 18 months. All seven out of seven complete responders treated with AUTO3 and pembrolizumab have ongoing complete responses as of January 21, 2020, at a median follow-up of three months, a range of one to 18 months. Looking at Slide 17, AUTO3 continues to demonstrate a safety profile, much like the desired profile we described earlier, which may allow use in the larger outpatient setting. No patients experienced grade three or higher cytokine release syndrome were reported with primary treatment.

And as of the data cutoff, no patient has experienced neurotoxicity of any grade in cohorts treated with AUTO3 and pembrolizumab. You will see this compares very favorably to other CAR T therapies, both approved and in development across the competitive landscape. Overall, as summarized in Slide 18, we are very pleased with the profile of AUTO3 to date, its successfully manufactured product for all patients from the cell and gene therapy Catapult at Stevenage, and the AUTO3 program is on track for a decision middle of this year to advance the program to Phase 2. On Slide 19 onwards, I would like to conclude with a brief discussion of three AUTO programs in our pipeline, because they have the potential to bring additional value inflection in 2020 and beyond.

Slide 19, we highlight our unique targeting approach in T-cell lymphoma. We've been able to decide for very small differences in the amino acid sequence of the T-cell receptor value chain constant domain, such that we identified two mutually exclusive receptors, which can be individual targeted by antibodies unique to the specific subtype. Unlike B-cell approaches, an individual cannot live without the T cells, and therefore, this approach allows us to salvage the subtype of T cells likely to represent an equal proportion in the body in order to restore a functional immune system. Moving to Slide 20, we recently revealed the clinical outcome of patient one, which despite having been treated at the lowest dose of 25 million CAR T cells, showed a complete metabolic response.

The patient subsequently had progression on day 71. Patient enrollment in our Phase 1 study with the more advanced product, AUTO4 targeting TRBC1, is ongoing with supply from the Catapult. As a result, we expect to present initial Phase 1 data by the end of 2020. We remain very excited about this program and the opportunity to progress another specifically tailored product utilizing our advanced modular approach to a disease setting where no other CAR T product option exists.

Finally, on Slide 21 through 23, we summarize some important points from our lead program in solid tumors. Focusing on Slide 21, solid tumors have remained a challenging area for the advancement of cellular therapies due to the complexity of the microenvironment and the ability to target disease-specific antigen. AUTO6, a GD2-targeted therapy has been encouraging, has shown encouraging preliminary data, demonstrating the initial antitumor activity, giving us confidence that this target is an interesting and relevant target to pursue. Turning to Slide 22, we draw your attention to our modular approach to enhance AUTO6NG for the solid tumor microenvironment.

We have empowered our next-generation product to tackle the key areas that have previously been shown to hamper responses in the solid tumor environment. AUTO6NG leverages the same GD2-targeting CAR T, but increase persistence and also improve the persistence, as well as help the cells survive in a checkpoint-rich and TGFBeta-rich environment. This product has been specifically designed to address the persistence, control tumor defenses. Turning to Slide 23, at SITC, we were excited to reveal data showing that the addition of these modules to the AUTO6NG product was shown to augment its functions by extending T-cell persistence and rendering modified T-cells resistant to both TGFBeta and PD-1, PD-L1-driven immune inhibition in vitro.

We've also revealed that the clinical outcome of patient 1 in our Phase I program, despite being treated at the lowest dose, demonstrated encouraging endpoints of activity. We believe AUTO6NG is positioned for additional value inflection as we commence the Phase 1 study second half of 2020. With that, I will turn over the call to Andrew for our third-quarter 2019 financial update. Andrew?

Andrew Oakley -- Chief Financial Officer

Thanks, Christian, and good morning or good afternoon to everyone. It's my pleasure to review our financial results for the full year, January through December of 2019, and we are on Slide 25. Net total operating expenses for the 12-month period ended December 31, 2019, were $146 million, and that was net of grant income of $2.9 million. That compares to net operating expenses of $74.1 million, also net of grant income of $1.5 million for the same period.

The increase in total net operating expenses was due in general to the increase in development activity to support the advancement of our product candidates, increased headcount primarily in our development and manufacturing functions, as well as the cost of being a public company. Research and development expenses increased to $105.4 million for the year ending December 31, 2019, from $48.3 million for the year ended December 31, 2018. Cash costs, which exclude depreciation, as well as share-based compensation, increased to $83.4 million from $41.5 million. The increase in research and development costs of $41.9 million consisted primarily of an increase in compensation-related costs of $20 million, primarily due to an increase in headcount to support the advancement of our product candidates in clinical development and investment in manufacturing facilities and equipment; an increase of $4.1 million in research and manufacturing consumables, in part due to the migration and expansion of our research and process development laboratories from Forest House to our new location in the MediaWorks facility; preparations in advance of any potential disruption to supply arrangements that may occur due to Brexit; as well as validation and training costs as part of the start-up at the Catapult facility; an increase of $10.2 million in facility costs, primarily related to increase the number of facilities, mainly at MediaWorks and at Catapult; an increase of $3.8 million in project expenses related to activities to prepare, activate and monitor clinical trial programs; and an increase in legal and professional fees that includes a decrease in milestone payments of $0.5 million consisting of a milestone payment to UCL Business plc of $2 million in 2018; and a milestone payable to Noile-Immune Biotech in the current year; as well as an increase in IT and general office expenses as well to round it out.

General and administrative expenses increased to $39.5 million for the year ended December 31, 2019, from $27.3 million for the year ended 31 December 2018. Cash costs in this area, which exclude depreciation, as well as share-based compensation, increased to $26.6 million from $21.4 million. The increase of $5.2 million consisted primarily of an increase in compensation-related costs of $2.6 million due to an overall increase in headcount; an increase of $1.9 million in commercial activities; and an increase in public company compliance costs of around $1 million; an increase of $0.7 million in facility costs, and this was offset by a decrease of $1 million in IT charges and other office expenses. Net loss attributable to ordinary shareholders was $123.8 million for the 12-month period, compared to $57.9 million for the same time frame in 2018.

The basic and diluted net loss per ordinary share for the 12 months ended 31 December 2019, totaled $2.88, compared to a basic and diluted net loss per ordinary share of $1.48 for the 12 months ending 31 December 2018. Cash and cash equivalents at the end of the period totaled $210.6 million, and that compares with $217.5 million at the end of December 2018. Adjusting for the recent follow-on offering in January, where we raised gross proceeds of $8 million, our cash at the end of January approximately stood at around $286 million. And we anticipate that that cash on hand provides us with the runway into 2022.

With that, I will now hand the call back to Christian to give you a brief outlook on expected milestones. Christian?

Christian Itin -- Chairman and Chief Executive Officer

Thanks, Andrew. Let me conclude this part of the management discussion with a review of the upcoming milestones and news flow through 2020. Let's move to Slide 27. The upcoming nine months will be an eventful period for us with multiple clinical milestones and opportunities for value creation.

Our chief operational focus will be commencing the registration trial for AUTO1 in adult ALL in the U.K. and U.S. We also expect to report data across multiple programs and to progress a number of our other clinical trial candidates, specifically updates on our ongoing clinical trials, initiation of Phase 1 study of AUTO1NG in pediatric ALL in the first half of this year; a go-no-go decision on Phase 2 initiation of AUTO3 in DLBCL middle of this year; initiation of a Phase 1 study for AUTO6NG toward neuroblastoma toward the end of this year; and initiation of the Phase 1 study of the next-generation program in multi myeloma called AUTO8 also toward the end of 2020; as well as working on some exploratory clinical trials toward allogeneic approaches as well. In conclusion, on Slide 28, I'd like to recap the major messages from today's call.

First, AUTO1 is our foundational program and the first Autolus program expected to move into a pivotal stage. Given the positive safety and efficacy profile today, we believe that AUTO1 has the potential to be a best-in-class CD19 CAR T in ALL. Secondly, our next priority is on AUTO3 in DLBCL, which, obviously, is expected and slated for clinical data middle of the year. We expect to report full Phase 1 data for AUTO3 in the middle of 2020 to reach a decision point for a Phase 2 trial initiation thereafter.

Looking ahead to the remainder of the year, we see opportunity for additional value steps for T-cell lymphoma, as well as the start for the AUTO6 next-generation program, targeting GD2-positive tumors. The company has a strong balance sheet with $286 million in cash, which will create a run rate into 2022. And finally, we're looking forward to seeing many of you at the upcoming AACR, ASCO and EHA meeting over the upcoming few months and are now happy to take questions. Operator, please open the line.

Thank you.

Operator

[Operator instructions] Our first question comes from Debjit Chattopadhyay with H.C. Wainwright.

Unknown speaker

Thanks for taking the question. So I have a question on the barriers -- oh, this is Aaron for Debjit, by the way. I have a question on the barriers to outpatient treatment with AUTO CAR-Ts in DLBCL. So we were looking at a study in which they treated patients with a median of only two prior lines with liso-cel in an outpatient setting, and they ended up hospitalizing 59% of the patients at the first time of CRS or neurotox.

So what do you think would be a reasonable level of hospitalization that could warrant expansion to the outpatient setting? And do you think that there could be more competition in certain subsets of patients in the outpatient setting for various auto CAR-Ts?

Christian Itin -- Chairman and Chief Executive Officer

So a very good question, Aaron. And it's obviously a very interesting kind of analysis when you look at the field, where you realized that approximately at this point, only about 20% of the patients sort of can be targeted with CAR T therapy in the current setting, which is really focused on the centers of excellence. And the reason for that is predominantly driven by the requirement for fairly intense management of these patients to deal with the adverse event profile that the current products have. And what we basically quoted that basically flux of patients back into the hospital that was considered initially to be treated in outpatient setting just indicates the need for a significant level of management of these patients, to begin with.

And that's a fundamental property of the product itself. And I think it's shared by all of the current products that have either been approved or are about to be approved. So what I think we were highlighting in our presentation is that the AUTO3 at this point has shown no high-grade cytokine release syndrome. And this did not require actual management of the patients.

So we didn't actually have to put steroid covering that we have been -- didn't have to put tocilizumab in these patients as a preventative measure and management measure. This is the data actually from unmanaged patients. What was probably more surprising and obviously a remarkable outcome is the fact that we have seen no neurotoxicity of any grade in the patients that we have treated in combo, in combination with pembro across a set of dose levels. And that is truly surprising because none of the programs redirecting T cells, targeting CD19 to date has shown this type of a feature.

All of them actually have neurotoxicity as a core type of adverse event that they do experience. The fact that we have seen none, without managing the patients, gives us a lot of confidence that we have a type of profile that should be well manageable also in an outpatient setting and also, importantly, in centers that are not the few centers of excellence in the country, but also much more broadly in the periphery, where, in fact, most of the DLBCL patients do get treated in the U.S. And I think that's going to be a core feature for the program. And to date, what we've seen as a profile certainly has not been reported by anyone else within the field.

Unknown speaker

Great.

Christian Itin -- Chairman and Chief Executive Officer

Thank you, Aaron.

Operator

Our next question comes from Chad Messer with Needham & Company.

Chad Messer -- Needham and Company -- Analyst

Great. Good day. Thanks for taking my questions. Maybe we'll just start by continuing a little bit the discussion we're just having on AUTO3 and safety, about a go/no decision coming up.

Is there an actual bar where you can describe? I mean, 0% would be awesome, but maybe not all that practical to hold on to.

Christian Itin -- Chairman and Chief Executive Officer

I think if you have a low level of neurotox, low-grade neurotox at a low level, I think that would be very well manageable. We also should remember that the patients treated with BLINCYTO actually are treated in an outpatient setting, and they've managed that way. And the neurotox rate obviously for BLINCYTO is not zero, but it is less intense than what we see with the CAR-Ts that are currently gone through approval or close to approval. And so there's clearly a bar here that is not a zero number, but definitely want to see a low level of neurotoxicity.

And you want to avoid the high-grade cytokine release syndrome, which really requires you to go back into the hospital.

Chad Messer -- Needham and Company -- Analyst

OK. And then just again, thinking on efficacy and safety bars. On the AUTO4 program, I mean, for T-cell lymphomas, we don't have a good standard of care to compare ourselves up against. So what do we need to see later this year for AUTO4 in order to get excited and optimistic about that one?

Christian Itin -- Chairman and Chief Executive Officer

I think what we would like to see is we see a good level of responses in those patients and evidence that we start to see also a reasonable level of persistence. So we get some durability of those responses. As you pointed out, this is a very devastating disease. There are very little options at this point.

And I think a program that gives you a reasonable level of remissions in these patients together with some durability of response will go a long way. And clearly, the bar for this indication is lower than what we're seeing in lymphoma and certainly much lower than what we're seeing in leukemia.

Chad Messer -- Needham and Company -- Analyst

All right. Great. Well, thanks. We're looking forward to all the data you guys are coming up this year.

Christian Itin -- Chairman and Chief Executive Officer

Excellent. Thanks for joining, Chad.

Operator

Our next question comes from Biren Amin with Jefferies.

Biren Amin -- Jefferies -- Analyst

Hi, guys. Thanks for taking my questions. Christian, on AUTO2, can you just give us a status update on the NG program there?

Christian Itin -- Chairman and Chief Executive Officer

With multiple myeloma, obviously, I went back and reengineered a new program, which is called AUTO8, and that program is slated to get back into the clinic second half of this year.

Biren Amin -- Jefferies -- Analyst

Got it. And then on AUTO4, thanks for the prior response. But if I look at some of the data with bendamustine, for example, in relapsed/refractory setting, I think there's some data out there that reports an OR of close to 30%; CR of about 20%, 25%; median DOR of about 3.3 months. Is that kind of like the bar that you would need to beat with AUTO4?

Christian Itin -- Chairman and Chief Executive Officer

I think you want to be above that. But you're right, that is currently what the bar looks like in that disease setting. That is sort of as kind of the best we can do for these patients at this point. So it's clearly one of the CR rate side, but it's clearly a very poor starting point.

Biren Amin -- Jefferies -- Analyst

OK. And then maybe just a question on AUTO3. How much data do we need to see later this year to move this program into pivotal? And, I guess, at what cell dose are you looking at? Greater than 150 million in cell dose? Or are you looking at the 450 million cell dose to make a determination on pivotal studies there?

Christian Itin -- Chairman and Chief Executive Officer

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Autolus Therapeutics Plc (AUTL) QEarnings Call Transcript - Motley Fool

CytoDyn Treats First Patient with Leronlimab in Phase 2 Trial for GvHD under Modified Trial Protocol – Yahoo Finance

VANCOUVER, Washington, March 04, 2020 (GLOBE NEWSWIRE) -- CytoDyn Inc. (CYDY), (CytoDyn or the Company"), a late-stage biotechnology company developing leronlimab (PRO 140), a CCR5 antagonist with the potential for multiple therapeutic indications, announced today the treatment of the first patient in its Phase 2 clinical trial for graft-versus-host disease (GvHD) under the modified trial protocol.

The modified protocol now includes reduced intensity conditioning (RIC) patients and an open-label design under which all enrollees receive leronlimab. The modified protocol also provides for a 50% increase in the dose of leronlimab to more closely mimic preclinical dosing. The next review of data by the independent data monitoring committee (iDMC) will occur following enrollment of 10 patients under the amended protocol after each patient has been dosed for 30 days.

Nader Pourhassan, Ph.D., president and chief executive officer of CytoDyn, added, GvHD is a life-threatening complication following bone marrow transplantation in patients with leukemia who have compromised immune systems due to treatment with aggressive cancer therapies. We selected GvHD as one of our immunology indications for leronlimab, as it targets and masks the CCR5 receptor on T cells. This receptor on T cells is an important mediator of inflammatory diseases including GvHD, especially in organ damage that is the most frequent cause of death in these patients. Dr. Pourhassan concluded that, Based upon the compelling results in our preclinical studies, we are optimistic about the opportunities for leronlimab to provide a therapy for transplant patients to mitigate GvHD.

The Companys preclinical study by Denis R. Burger, Ph.D., CytoDyns former Chief Science Officer, and Daniel Lindner, M.D., Ph.D. of the Department of Translational Hematology and Oncology Research, The Cleveland Clinic, was published online in the peer-reviewed journal Biology of Blood and Marrow Transplantation.

The Company previously reported that the U.S. Food and Drug Administration (FDA) granted orphan drug designation to leronlimab (PRO 140) for the prevention of GvHD. Orphan drug designation is granted to development-stage drugs that have shown promise in addressing serious medical needs for patients living with rare conditions. This designation provides CytoDyn with various incentives and benefits including seven years of U.S. market exclusivity for leronlimab (PRO 140) in GvHD, subject to FDA approval for use in this indication.

About Graft-versus-Host Disease (GvHD)Graft-versus-host disease is a risk when patients receive the transplant of bone marrow stem cells donated from another person. GvHD occurs when the donors immune cells attack the patients normal cells. GvHD can be acute or chronic. Its severity depends on the differences in tissue type between patient and donor. The older the patient, the more frequent and serious the reaction may be. Acute GvHD can occur soon after the transplanted cells begin to appear in the recipient and can range from mild, moderate or severe, and be life-threatening if its effects are not controlled. Certain approved drugs exist that can help prevent or lessen GvHD. However, GvHD does not always respond to these treatments, and it can still result in fatal outcomes. Furthermore, many deaths related to GvHD occur because of infections that develop in patients whose immune systems are suppressed by such drugs.

About Leronlimab (PRO 140)The U.S. Food and Drug Administration (FDA) has granted a Fast Track designation to CytoDyn for two potential indications of leronlimab for deadly diseases. The first as a combination therapy with HAART for HIV-infected patients and the second is for metastatic triple-negative breast cancer. Leronlimab is an investigational humanized IgG4 mAb that blocks CCR5, a cellular receptor that is important in HIV infection, tumor metastases, and other diseases including NASH. Leronlimab has successfully completed nine clinical trials in over 800 people, including meeting its primary endpoints in a pivotal Phase 3 trial (leronlimab in combination with standard antiretroviral therapies in HIV-infected treatment-experienced patients).

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In the setting of HIV/AIDS, leronlimab is a viral-entry inhibitor; it masks CCR5, thus protecting healthy T cells from viral infection by blocking the predominant HIV (R5) subtype from entering those cells. Leronlimab has been the subject of nine clinical trials, each of which demonstrated that leronlimab can significantly reduce or control HIV viral load in humans. The leronlimab antibody appears to be a powerful antiviral agent leading to potentially fewer side effects and less frequent dosing requirements compared with daily drug therapies currently in use.

In the setting of cancer, research has shown that CCR5 plays an important role in tumor invasion and metastasis. Increased CCR5 expression is an indicator of disease status in several cancers. Published studies have shown that blocking CCR5 can reduce tumor metastases in laboratory and animal models of aggressive breast and prostate cancer. Leronlimab reduced human breast cancer metastasis by more than 98% in a murine xenograft model. CytoDyn is therefore conducting aPhase 1b/2 human clinical trial in metastatic triple-negative breast cancer and was granted Fast Track designation in May 2019. Additional research is being conducted with leronlimab in the setting of cancer and NASH with plans to conduct additionalclinical studies when appropriate.

The CCR5 receptor appears to play a central role in modulating immune cell trafficking to sites of inflammation and may be important in the development of acute GvHD and other inflammatory conditions. Clinical studies by others further support the concept that blocking CCR5 using a chemical inhibitor can reduce the clinical impact of acute GvHD without significantly affecting the engraftment of transplanted bone marrow stem cells. CytoDyn is currently conducting a Phase 2 clinical study with leronlimab to further support the concept that the CCR5 receptor on engrafted cells is critical for the development of acute GvHD and that blocking this receptor from recognizing certain immune signaling molecules is a viable approach to mitigating acute GvHD. The FDA has granted orphan drug designation to leronlimab for the prevention of GvHD.

About CytoDynCytoDyn is a biotechnology company developing innovative treatments for multiple therapeutic indications based on leronlimab, a novel humanized monoclonal antibody targeting the CCR5 receptor. CCR5 appears to play a key role in the ability of HIV to enter and infect healthy T-cells. The CCR5 receptor also appears to be implicated in tumor metastasis and in immune-mediated illnesses, such as GvHD and NASH. CytoDyn has successfully completed a Phase 3 pivotal trial with leronlimab in combination with standard antiretroviral therapies in HIV-infected treatment-experienced patients. CytoDyn plans to seek FDA approval for leronlimab in combination therapy and plans to complete the filing of a Biologics License Application (BLA) in the first quarter of 2020 for that indication. CytoDyn is also conducting a Phase 3 investigative trial with leronlimab as a once-weekly monotherapy for HIV-infected patients and plans to initiate a registration-directed study of leronlimab monotherapy indication, which if successful, could support a label extension. Clinical results to date from multiple trials have shown that leronlimab can significantly reduce viral burden in people infected with HIV with no reported drug-related serious adverse events (SAEs). Moreover, results from a Phase 2b clinical trial demonstrated that leronlimab monotherapy can prevent viral escape in HIV-infected patients, with some patients on leronlimab monotherapy remaining virally suppressed for more than five years. CytoDyn is also conducting a Phase 2 trial to evaluate leronlimab for the prevention of GvHD and a Phase 1b/2 clinical trial with leronlimab in metastatic triple-negative breast cancer. More information is atwww.cytodyn.com.

Forward-Looking StatementsThis press releasecontains certain forward-looking statements that involve risks, uncertainties and assumptions that are difficult to predict. Words and expressions reflecting optimism, satisfaction or disappointment with current prospects, as well as words such as believes, hopes, intends, estimates, expects, projects, plans, anticipates and variations thereof, or the use of future tense, identify forward-looking statements, but their absence does not mean that a statement is not forward-looking. The Companys forward-looking statements are not guarantees of performance, and actual results could vary materially from those contained in or expressed by such statements due to risks and uncertainties including: (i)the sufficiency of the Companys cash position, (ii)the Companys ability to raise additional capital to fund its operations, (iii) the Companys ability to meet its debt obligations, if any, (iv)the Companys ability to enter into partnership or licensing arrangements with third parties, (v)the Companys ability to identify patients to enroll in its clinical trials in a timely fashion, (vi)the Companys ability to achieve approval of a marketable product, (vii)the design, implementation and conduct of the Companys clinical trials, (viii)the results of the Companys clinical trials, including the possibility of unfavorable clinical trial results, (ix)the market for, and marketability of, any product that is approved, (x)the existence or development of vaccines, drugs, or other treatments that are viewed by medical professionals or patients as superior to the Companys products, (xi)regulatory initiatives, compliance with governmental regulations and the regulatory approval process, (xii)general economic and business conditions, (xiii)changes in foreign, political, and social conditions, and (xiv)various other matters, many of which are beyond the Companys control. The Company urges investors to consider specifically the various risk factors identified in its most recent Form10-K, and any risk factors or cautionary statements included in any subsequent Form10-Q or Form8-K, filed with the Securities and Exchange Commission. Except as required by law, the Company does not undertake any responsibility to update any forward-looking statements to take into account events or circumstances that occur after the date of this press release.

CYTODYN CONTACTSInvestors: Dave Gentry, CEORedChip CompaniesOffice: 1.800.RED.CHIP (733.2447)Cell: 407.491.4498dave@redchip.com

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CytoDyn Treats First Patient with Leronlimab in Phase 2 Trial for GvHD under Modified Trial Protocol - Yahoo Finance

Molecular Signature of Young-Onset Parkinson’s Disease Is… : Neurology Today – LWW Journals

Article In Brief

A unique molecular structureevident in induced pluripotent stem cells taken from people with young-onset Parkinson's diseasesuggests that the defects may be present throughout patients' lives, and that they could therefore be used as diagnostic markers.

Induced pluripotent stem cells (iPSCs) taken from patients with young-onset Parkinson's disease (YOPD) and grown into dopamine-producing neurons displayed a molecular signature that was corrected in vitro, as well as in the mice striatum, by a drug already approved by the US Food and Drug Administration (FDA), a study published in the January 27 online edition of Nature Medicine found.

Although the patients had no known genetic mutations associated with PD, the neurons grown from their iPSCs nonetheless displayed abnormally high levels of soluble alpha-synucleina classic phenotype of the disease, but one never before seen in iPSCs from patients whose disease developed later in life. Surprisingly, for reasons not yet understood, the cells also had high levels of phosphorylated protein kinase C-alpha (PKC).

In addition, the cells also had another well-known hallmark of PD: abnormally low levels of lysosomal membrane proteins, such as LAMP1. Because lysosomes break down excess proteins like alpha-synuclein, their reduced levels in PD have long been regarded as a key pathogenic mechanism.

When the study team tested agents known to activate lysosomal function, they found that a drug previously approved by the FDA as an ointment for treating precancerous lesions, PEP005, corrected all the observed abnormalities in vitro: it reduced alpha-synuclein and PKC levels while increasing LAMP1 abundance. It also decreased alpha-synuclein production when delivered to the mouse striatum.

Unexpectedly, however, PEP005 did not work by activating lysosomal function; rather, it caused another key protein-clearing cellular structure, the proteasome, to break down alpha-synuclein more readily.

The findings suggest that the defects seen in the iPSCs are present throughout patients' lives, and that they could therefore be used as diagnostic markers. Moreover, the drug PEP005 should be considered a potentially promising therapeutic candidate for YOPD and perhaps even for the 90 percent of PD patients in whom the disease develops after the age of 50, according to the study's senior author, Clive Svendsen, PhD, director of the Cedars-Sinai Board of Governors Regenerative Medicine Institute and professor of biomedical sciences and medicine at Cedars-Sinai.

These findings suggest that one day we may be able to detect and take early action to prevent this disease in at-risk individuals, said study coauthor Michele Tagliati, MD, FAAN, director of the movement disorders program and professor of neurology at Cedars-Sinai Medical Center.

But the study still raises questions regarding the biological mechanisms, and certainly does not warrant off-label prescribing of PEP005 at this time, said Marco Baptista, PhD, vice president of research programs at the Michael J. Fox Foundation, who was not involved with the study.

Repurposing PEP005 is a long way away, Dr. Baptista said. This is not something that neurologists should be thinking about prescribing or recommending to their patients.

Accumulation of alpha-synuclein has been seen in iPSC-derived dopaminergic cultures taken from patients with known genetic defects, but such defects account for only about 10 percent of the PD population. In those without known mutations, on the other hand, no defects in iPSC-derived dopamine-producing neurons have been seen. Until now, however, such studies had been conducted only in patients who had developed PD after age 50.

My idea was why to look in young-onset patients, said Dr. Svendsen.

The idea paid off more richly than he expected. We were shocked to find a very, very prominent phenotype, a buildup of alpha-synuclein, in the neurons of these patients who are genetically normal, Dr. Svendsen said. None of the controls had a buildup of synuclein, and all but one of the early PD patients had a twofold increase in it.

The signature is so consistent, he said, that it offers a natural model that can be interrogated to further understand its workings.

Because high levels of PKC were also seen, Dr. Svendsen said, We picked a bunch of drugs known to reduce PKC. We found one, PEP005, which is actually extracted from the milkweed plant, and it completely reduced synuclein levels almost to normal in dopaminergic neurons. And it also increased dopamine levels in those cells, so we got two for one.

After observing the effects of PEP005 in vitro, We put it into the mouse brain and found it reduced synuclein in vivo, Dr. Svendsen said. But we had to infuse it right into the brain. We're now trying to work out how to get it across the blood-brain barrier more efficiently.

To determine how PEP005 lowers cellular levels of alpha-synuclein, his group tested whether it was activating the lysosome, but found to their surprise that it did not do this until after the synuclein had already been degraded.

Then we asked whether it could be the proteosome, which also breaks down proteins but normally doesn't break down synuclein, Dr. Svendsen said. But when we applied PEP005, it did activate the proteasome. So we think that might be the mechanism.

Because the drug is currently applied externally, Dr. Svendsen said, the next step will be to see if it crosses the blood-brain barrier when applied to the skin of mice, and whether that results in a lowering of synuclein levels in dopaminergic neurons.

Justin Ichida, PhD, the Richard N. Merkin assistant professor of stem cell biology and regenerative medicine at the USC Keck School of Medicine, said the findings are quite important in the field. The potential diagnostic tools they made could be important in clinical care. And identifying a drug that may very effectively reverse the disease in neurons is a very important discovery.

He wondered, however, whether the increase in alpha-synuclein is truly specific to Parkinson's neurons or if it would also be seen in iPSC neurons from patients with Alzheimer's disease or amyotrophic lateral sclerosis.

I wonder if alpha-synuclein accumulating is a sign of PD in a dish or is a consequence of neurodegeneration or impaired protein degradation in general, Dr. Ichida said. That's a key question if you want to use this molecular signature as a diagnostic tool.

He also questioned if proteins other than alpha-synuclein, such as tau, would also be seen to accumulate in the iPSCs of YOPD patients.

If one of the protein-clearance mechanisms in the cell is working poorly, you would imagine that other things would also accumulate, Dr. Ichida said.

In response, Dr. Svendsen said that while some proteins other than alpha-synuclein were reported in the paper at increased levels, We did not look at tau specifically, but are in the process of looking right now. It could be that synuclein and some other proteins are somehow altered to evade them from being degraded by the lysosome, or that there is a general lysosomal problem.

Patrik Brundin, MD, PhD, director of the Center for Neurodegenerative Science and Jay Van Andel Endowed Chair at Van Andel Research Institute in Grand Rapids, MI, called the paper very interesting and thought-provoking. If these findings hold up, they could shift our understanding of young-onset PD. They imply that there is a strong genetic component that has not been picked up in prior genetic studies.

Dr. Brundin said he would like to see the results replicated in another lab using different sets of reagents. It is so intriguing and rather unexpected that one wonders if the observations really apply, as the study states, to 95 percent of all YOPD.

He also questioned whether all the young-onset PD patients are similar. Clearly the iPSCs studied here are not monogenetic PD, so they must be very diverse genetically and still all have the same alpha-synuclein change.

Dr. Brundin also asked why the abnormalities seen in YOPD neurons have not previously been seen in older cases of PD. Is there a specific cutoff regarding age-of-onset when these purposed genetic differences apply? he asked.

Dr. Svendsen responded: We don't know why the YO have this phenotype or exactly what the cut off is. We have, however, looked at one adult-onset case that did not show this phenotype. Also, one of our YO cases did not show this phenotype. Thus some patients even with early onset may not have it. We are currently testing many more cases from older-onset patients.

Dr. Brundin also wanted to know whether non-dopaminergic neurons have the same deficits described in the study.

We don't know which neurons specifically have the protein deficit as we cannot do single-cell proteomics, Dr. Svendsen answered. It could be a little in all cells or a lot in a small set. Immunocytochemistry is not quantitative but showed that it is more likely a general increase in synuclein and not specific to dopaminergic neurons.

While the findings in iPSCs suggest that the abnormal levels of alpha-synuclein must be present at birth, Dr. Brundin said, I do not know how to reconcile the present findings with genetic data.

The absence of previously described mutations in the YOPD patients means only that more work must be done to uncover the genetic underpinnings, Dr. Svendsen said.

We're just at the tip of the iceberg with understanding the genome, he said. It's such a bizarrely complex beast. Perhaps there are a thousand different proteins interacting to stop the synuclein from being degraded. In 10 years, we probably will be clever enough to see it. We know it must be there. Now the genome guys will go after it.

Dr. Baptista from the Michael J. Fox Foundation said he agreed with the view that there must be genetic alterations underpinning the defects seen in the iPSCs.

Just because we call something non-genetic could simply reflect the current ignorance of the field, he said. I think the discoveries are simply difficult to make.

He added that he wished that the main comparator in the study was not healthy controls, and that there were more older-onset iPSCs to compare against YOPD patients' samples.

Dr. Svendsen said it could be that the iPSCs from older-onset patients might yet be found with additional study to display abnormalities similar to those seen in YOPD.

Right now we only see it in young onset, he said. We may need to leave the cultures longer to see in the older-onset patients. We are doing those experiments now.

Drs. Tagliati and Svendsen disclosed that an intellectual patent is pending for diagnostic and drug screening for molecular signatures of early-onset Parkinson's disease. Dr. Ikeda is a co-founder of AcuraStem Inc. Dr. Brundin has received commercial support as a consultant from Renovo Neural, Inc., Lundbeck A/S, AbbVie, Fujifilm-Cellular Dynamics International, Axial Biotherapeutics, and Living Cell Technologies. He has also received commercial support for research from Lundbeck A/S and Roche and has ownership interests in Acousort AB and Axial Biotherapeutics. Dr. Baptista had no disclosures.

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Molecular Signature of Young-Onset Parkinson's Disease Is... : Neurology Today - LWW Journals

How industry hopes to take on COVID-19 – Bioprocess Insider – BioProcess Insider

The biopharma space has stepped up its efforts to both prevent and treat the coronavirus (SARS-CoV-2) that is threatening to bring the world to its knees.

A month is a very long time when it comes to infectious diseases. The first cases and deaths from the novel coronavirus (COVID-19) led to a response to contain the virus, but the difficulties of containment and the nature of international travel means cases and deaths have become global.

The latest statistics place the number of cases at 95,483 and deaths at 3,286 across 84 countries, though by the time you are reading this the number is likely to have skyrocketed.

So as the world tilters on the edge of a pandemic, we take a look at how industry is responding. There is no specific treatment for the virus, nor a vaccine, but a proactive response is seeing the pharma industry throw everything in its arsenal at attempting to stymie this global threat.

First off, vaccines. As the World Health Organization (WHO) states it can take a number of years for a new vaccine to be developed, it has not stopped companies and academia stepping up their R&D efforts.

Both Sanofi and J&J have separately teamed up with the US Department of Health and Human Services (HHS) to expediate vaccine development.

Sanofi Pasteur aims to reverse engineer proteins isolated from the virus to produce DNA sequences, which will then be mass produced using Sanofi Pasteurs baculoviral expression system and formulated into a vaccine that elicits an immune response. Well that is the aim.

Johnson & Johnsons unit Janssen Pharmaceutical, meanwhile, is reviewing products in development for Middle East Respiratory Syndrome (MERS) or Severe Acute Respiratory Syndrome (SARS), to identify promising candidates for the novel coronavirus, and aims to upscale production and manufacturing capacities, leveraging its AdVac and PER.C6 technologies.

Another Big Vaccine company, GlaxoSmithKline, has teamed with Chinese biotech Clover Biopharmaceuticals to help develop a preclinical protein-based vaccine candidate. GSK will provide its pandemic adjuvant system for further evaluation of Clovers S-Trimer, a trimeric SARS-CoV-2 spike (S)-protein subunit vaccine candidate produced using a mammalian cell-culture based expression system.

Inovio Pharmaceuticals has also entered the race, and like GSK has teamed up with a Chinese company. Together with Beijing Advaccine Biotechnology and a grant of up to $9 million from the Coalition for Epidemic Preparedness Innovations (CEPI), Inovio hopes to bring its DNA vaccine candidate INO-4800 rapidly into clinical trials. VGXI a subsidiary of GeneOne Life Science has been selected to manufacture the DNA vaccine from its facilities in The Woodlands, Texas.

Thegenome sequence for 2019-nCoVwas published on January 10, 2020, a VGXI spokesperson recently toldBioprocess Insider. This DNA sequence information is used by Inovio and their collaborators at the Wistar Institute to design a synthetic DNA plasmid for manufacturing at VGXI. No viral particles or proteins are involved in the manufacturing process. When delivered as a vaccine, the DNA plasmid can elicit a protective immune response.

RNA vaccines are also being investigated. Moderna Therapeutics recently shipped the first batch of its investigational messenger RNA vaccine mRNA-1273 to the National Institute of Allergy and Infectious Diseases (NIAID) for use in a Phase I study. The vaccine is designed to train the immune system to recognize cells invaded by the coronavirus.

Moderna also received a grant from CEPI, as has CureVac, which is looking to use its mRNA vaccine platform to expedite a candidate into trials. CureVacs technology and mRNA platform are especially suitable to rapidly provide a response to a viral outbreak situation like this, said CureVac CTO Mariola Fotin-Mleczek. Currently, we are in the process of developing a vaccine that, after successful preclinical tests, could be tested rapidly in humans in a clinical study.

But industry could be pipped to the clinical trial post by academia, with Israels MIGAL Research Institute claiming to be sitting on a human vaccine against COVID-19 as a by-product of a vaccine it has developed against avian coronavirus Infectious Bronchitis Virus (IBV).

From research conducted at MIGAL, it has been found that the poultry coronavirus has high genetic similarity to the human COVID-19, and that it uses the same infection mechanism, a fact that increases the likelihood of achieving an effective human vaccine in a very short period of time, the Institute says.

According to MIGALs Biotechnology group leader Chen Katz, the vaccine is based on a new protein expression vector, which forms and secretes a chimeric soluble protein that delivers the viral antigen into mucosal tissues by self-activated endocytosis a cellular process in which substances are brought into a cell by surrounding the material with cell membrane, forming a vesicle containing the ingested material causing the body to form antibodies against the virus.

Other pharma companies are looking to treat coronavirus, rather than prevent.

Regeneron has teamed with the HHS to use its VelociSuite technologies to identify and validation and develop preclinical candidates and bring them to development, having followed a similar approach to advance its investigational Ebola treatment REGN-EB3.

The tech platform includes the VelocImmune mouse technology, a genetically modified strain in which genes encoding mouse immune system proteins have been replaced by their human equivalents.

The life-saving results seen with our investigational Ebola therapy last year underscore the potential impact of Regenerons rapid response platform for addressing emerging outbreaks, said George Yancopoulos, Regeneron CSO. Our unique suite of technologies expedites and improves the drug discovery and development process at every stage, positioning Regeneron to respond quickly and effectively to new pathogens.

Meanwhile this week, Takeda announced it is looking to a therapy to target COVID-19 based on polyclonal hyperimmune globulin (H-IG). The candidate, TAK-888, aims to concentrate pathogen-specific antibodies from plasma collected from recovered patients. Initially, due to a lack of current donors, the firm will produce the therapy in a segregated area within its manufacturing facility in Georgia.

The Japan-headquartered firm will also review its current pipeline for any other viable candidates to take on COVID-19.

Such an approach has aided Gilead Sciences efforts. The firm has begun two Phase III clinical studies of its antiviral candidate remdesivir, developed (though never approved) to treat Ebola virus. It has also shown promise against other infectious diseases including Marburg, MERS and SARS.

This is an experimental medicine that has only been used in a small number of patients with COVID-19 to date, so Gilead does not have an appropriately robust understanding of the effect of this drug to warrant broad use at this time, Gilead said.

With about 1,000 patients set to be tested with remdesivir, Gilead has turned to a stockpile manufactured in response to Ebola to address present coronavirus needs, and in anticipation of expanded use is manufacturing two formulations of remdesivir, in both liquid and freeze-dried forms, while upping capacity and production internally and externally.

According to San Marinos Bioscience Institute SpA, a regenerative medicine center and stem cell production facility, mesenchymal stem cells could potentially be treatment for the novel coronavirus by improving lung microenvironment, inhibiting immune system overactivation, promoting tissue repair, protecting lung alveoli epithelial cells, preventing pulmonary fibrosis, and improving lung function.

The company, citing the Chinese open repository for scientific researchers chinaXiv.org , says at least 14 trials are taking place in China using stem cells to treat coronavirus patients after positive animal testing showed stem cells might be able to repair the severe organ damage caused by the virus.

The firm even reports that a critically ill 65-year-old Chinese woman infected with SARS-CoV-2, whose conditions significantly improved after the infusion of mesenchymal stem cells.

If mesenchymal stem cells do prove to be the solution to the potential coronavirus crisis, Bioscience Institute alludes to the advantage that they are obtained from fat cells.

That means that everyone can utilize his/her cells, eliminating any contamination or rejection risk, said Giuseppe Mucci, CEO of Bioscience Institute.

But expanding them to the quantity needed for infusion, that corresponds to at least 1 million cells per kg of weight, takes 2 to 3 weeks. That is why it is useful to cryopreserve a personal reserve of mesenchymal stem cells, that would allow to access an early, more successful, treatment.

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How industry hopes to take on COVID-19 - Bioprocess Insider - BioProcess Insider