Abstract: Over the past century, various efforts have been made to induce the rejection of cancerous tissues by the stimulation of an immune reaction, using both non-specific and antigen-specific strategies. Non-specific approaches attempt to augment an immune response in and around the tumor by injecting immune stimulating substances, for example, bacterial extracts, cytokines or gene therapy agents. Antigen-specific approaches use either the tumor cells themselves as a source of antigens or incorporate identified tumor-associated antigens into vaccines. This review describes antigen-specific therapeutic cancer vaccines that are currently in development.
Abstract: MUC1 is a large, highly glycosylated protein expressed on the apical membrane of many epithelial cells. With other members of the mucin family it contributes to the protection and function of mucosal cells. The intracellular part of the protein may also participate in signal transduction pathway, through multiple interactions with intracellular proteins. Overexpression of MUC1 is frequently observed in the majority of epithelial cancers and even in some haematological malignancies. In tumor cells, MUC1 loses apical distribution and is hypoglycosylated. These cancer-associated changes render it antigenic and make it an attractive target for a specific cancer immunotherapy. Several MUC1-based therapeutic cancer vaccines are currently under clinical investigation.
Abstract: OBJECTIVE: Early abortions have been predominantly surgical for many years, but medical options with comparable efficacy and safety are now available. This study compares the costs of two medical options and two surgical options. METHODS: We used a clinical model to compare the costs in Ontario of four options for early abortion: medical abortion using either mifepristone or methotrexate, and surgical abortion by vacuum aspiration in either a hospital or a free-standing clinic. The cost analysis was conducted from the perspectives of society, the health care system, and the patient. RESULTS: From all perspectives, total costs were highest for hospital surgical abortion, followed by surgical abortion in a clinic. From the patient's perspective, total costs were higher for surgical abortion but direct costs (mainly for medications) were higher for medical abortion. The total cost of mifepristone and methotrexate abortion was equal if the price of mifepristone (200 mg) was $59.52. The model was robust but was sensitive to the price of mifepristone. CONCLUSION: Early medical abortion costs less than early surgical abortion from the societal and health care system perspectives but more than surgical abortion from the patient's perspective. Surgical abortion costs more in hospitals than in free-standing clinics from the societal and health care system perspectives, but the costs are the same in both settings from the patient's perspective. No method for early abortion can be identified as best, and patients should be free to choose the option they prefer.
