Chemistry behind bombardier beetle’s extraordinary firepower

If you want to see one of the wonders of the natural world, just startle a bombardier beetle. But be careful: when the beetles are scared, they flood an internal chamber with a complex cocktail of aromatic chemicals, triggering a cascade of chemical reactions that detonates the fluid and sends it shooting out of the insect’s spray nozzle in a machine-gun-like pulse of toxic, scalding-hot vapor. The explosive, high-pressure burst of noxious chemicals doesn’t harm the beetle, but it stains and irritates human skin — and can kill smaller enemies outright.

The beetle’s extraordinary arsenal has been held up by some as a proof of God’s existence: how on earth, creationists argue, could such a complex, multistep defense mechanism evolve by chance? Now researchers at Stevens Institute of Technology in Hoboken, N.J. show how the bombardier beetle concocts its deadly explosives and in the process, learn how evolution gave rise to the beetle’s remarkable firepower.

“We explain for the first time how these incredible beetles biosynthesize chemicals to create fuel for their explosions,” said Athula Attygalle, a research professor of chemistry and lead author of the work, which appears today in the July 2020 issue of the Science of Nature. “It’s a fascinating story that nobody has been able to tell before.”

To trace the workings of the beetle’s internal chemistry set, Attygalle and colleagues at University of California, Berkeley used deuterium, a rare hydrogen isotope, to tag specially synthesized chemical blends. The team led by Kipling Will then either injected the deuterium-labeled chemicals into the beetles’ internal fluids, or mixed them with dog food and fed them to the beetles over a period of several days.

Attygalle’s team sedated the bugs by popping them in the freezer, then gently tugged at their legs, annoying the sleepy insects until they launched their defensive sprays onto carefully placed filter papers. The team also dissected some beetles, using human hairs to tie closed the tiny ducts linking their chemical reservoirs and reaction chambers, and sampling the raw chemicals used to generate explosions.

Using mass spectrometers, Attygalle checked the samples sent to Stevens for deuterium-labeled products, enabling him to figure out exactly which chemicals the beetles had incorporated into their bomb-making kits. “People have been speculating about this for at least 50 years, but at last we have a clear answer,” Attygalle said. “It turns out that the beetles’ biochemistry is even more intricate than we’d thought.”

Previously, researchers had assumed that two toxic, benzene-like chemicals called benzoquinones found in the beetles’ spray were metabolized from hydroquinone, a toxic chemical that in humans can cause cancer or genetic damage. The team at Stevens showed that in fact just one of the beetle’s benzoquinones derived from hydroquinone, with the other springing from a completely separate precursor: m-cresol, a toxin found in coal tar.

It’s fascinating that the beetles can safely metabolize such toxic chemicals, Attygalle said. In future studies, he hopes to follow the beetles’ chemical supply chain further upstream, to learn how the precursors are biosynthesized from naturally available substances.

The team’s findings also show that the beetles’ explosives rely on chemical pathways found in many other creepy-crawlies. Other animals such as millipedes also use benzoquinones to discourage predators, although they lack the bombardier’s ability to detonate their chemical defenses. Evolutionarily distant creatures such as spiders and millipedes use similar strategies, too, suggesting that multiple organisms have independently evolved ways to biosynthesize the chemicals.

That’s a reminder that the bombardier beetle, though remarkable, is part of a rich and completely natural evolutionary tapestry, Attygalle said. “By studying the similarities and differences between beetles’ chemistry, we can see more clearly how they and other species fit together into the evolutionary tree,” he explained. “Beetles are incredibly diverse, and they all have amazing chemical stories to tell.”

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Study evaluates stress level of rehabilitated sea turtles during transport

A new study co-authored by six scientists with the New England Aquarium has found that rehabilitated Kemp’s ridley and loggerhead sea turtles experience a substantial stress response when transported to release locations in the southern United States but that the turtles remained physically stable and ready for release.

Every year, dozens and even hundreds of “cold-stunned” turtles are treated at the Aquarium’s Quincy Animal Care Center for a variety of life-threatening medical conditions that result from weeks of hypothermia and the inability to feed during stranding season. Typically, the stranding season begins in early November and runs through early January when New England water temperatures quickly turn cold and the turtles get stuck on the north side of Cape Cod. The turtles are then rescued and rehabilitated for two to eight months. When the time comes to be released back into the wild, the turtles must enter the ocean at beaches with appropriate water temperatures, often requiring transportation to southeastern states by climate controlled SUV or van. These transports may take up to 24 hours, and can induce a stress response.

“As for humans, traveling many hours over long distances can be stressful for turtles. We wanted to characterize the degree of the stress response and document whether the turtles were still in good condition after such a long trip,” said Dr. Charles Innis, Director of Animal Health at the New England Aquarium.

Until now, the full impact of the transport process was unclear. In this new study, led by Dr. Kathleen Hunt of George Mason University and published in the journal Integrated Organismal Biology, all turtles had stranded in a cold-stunned state along the shore of Cape Cod Bay between October and December of 2011-2017 and were rehabilitated at the Aquarium’s Animal Care Center for six to eight months. During trips to release the turtles back into the wild, scientists studied the responses of Kemp’s ridley and loggerhead turtles before and after vehicle transport for under six hours, 12 hours, 18 hours, and 24 hours, gathering blood samples.

The researchers found that transport induced a physiological stress response for both sea turtle species. The duration of those transports significantly affected the stress responses, with both species showing more pronounced changes on longer journeys. Importantly, despite the findings, both turtle species in the study remained in good clinical condition based on evaluation of vital signs and blood data, even after 24-hour transport. Nonetheless, the researchers suggest that minimizing transport time, when possible, may help to ensure that rehabilitated turtles are released into the ocean under the best possible conditions.

“Results of this study will be used to ensure that sea turtle transports are conducted under controlled environments and at safe durations,” said Connie Merigo, Marine Animal Rescue Department Manager. “This study will be helpful to the global community of sea turtle rehabilitators, veterinarians, researchers and biologists.”

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Materials provided by New England Aquarium. Note: Content may be edited for style and length.

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Honeybee lives shortened after exposure to two widely used pesticides

The lives of honeybees are shortened — with evidence of physiological stress — when they are exposed to the suggested application rates of two commercially available and widely used pesticides, according to new Oregon State University research.

In a study published in the journal PLOS ONE, honeybee researchers in OSU’s College of Agricultural Sciences found detrimental effects in bees exposed to Transform and Sivanto, which are both registered for use in the United States and were developed to be more compatible with bee health.

The western honeybee is the major pollinator of fruit, nut, vegetable and seed crops that depend on bee pollination for high quality and yield.

Coupled with other stressors such as varroa mites, viruses and poor nutrition, effects from these pesticides can render honeybees incapable of performing their tasks smoothly. Beekeepers and some environmental groups have raised concerns in recent years about these insecticides and potential negative effects on bees.

According to the researchers, this is the first study to investigate “sub-lethal” effects of sulfoxaflor, the active ingredient in Transform, and flupyradifurone, the active ingredient in Sivanto. Sub-lethal effects mean that the bees don’t die immediately, but experience physiological stress resulting in shortened lifespan.

In the case of Transform, the bees’ lives were severely shortened. A majority of the honeybees exposed to Transform died within six hours of being exposed, confirming the severe toxicity of the pesticide to bees when exposed directly to field application rates recommended on the label, the researchers said.

Study lead author Priyadarshini Chakrabarti Basu, a postdoctoral research associate in the Honey Bee Lab in OSU’s College of Agricultural Sciences, emphasized that the researchers aren’t calling for Sivanto or Transform to be taken off the market.

“We are suggesting that more information be put on the labels of these products, and that more studies need to be conducted to understand sublethal effects of chronic exposure,” Basu said.

Sivanto and Transform are used on crops to kill aphids, leaf hoppers and whiteflies, among other pests. Many of these same crops attract bees for pollination. There are some restrictions on their use. For example, Transform can’t be applied to crops in bloom, for example.

Honeybees might be exposed indirectly through pesticide drift, said study co-author Ramesh Sagili, associate professor of apiculture and honeybee Extension specialist in OSU’s College of Agricultural Sciences.

“The average life span of a worker honeybee is five to six weeks in spring and summer, so if you are reducing its life span by five to 10 days, that’s a huge problem,” Sagili said. “Reduced longevity resulting from oxidative stress could negatively affect colony population and ultimately compromise colony fitness.”

For the study, the researchers conducted two contact exposure experiments: a six-hour study and a 10-day study in May 2019. The honeybees were obtained from six healthy colonies at the OSU apiaries. In each experiment, groups of 150 bees were placed in three cages. One group was exposed to Transform, a second to Sivanto and the third was a control group that wasn’t exposed to either pesticide.

Honeybee mortality, sugar syrup and water consumption, and physiological responses were assessed in bees exposed to Sivanto and Transform and compared to bees in a control group. Mortality in each cage was recorded every hour for the six-hour experiment and daily for the 10-day experiment.

While Sivanto was not directly lethal to honeybees following contact exposure, the 10-day survival results revealed that field-application rates of Sivanto reduced adult survival and caused increased oxidative stress and apoptosis in the honey bee tissues. This suggests that even though Sivanto is apparently less toxic than Transform, it might also reduce honeybee longevity and impart physiological stress, according to the study authors.

Co-authors on the study included graduate student Emily Carlson and faculty research assistant Hannah Lucas, who both conduct research in the Honey Bee Lab; and Andony Melathopoulos, assistant professor and pollinator health Extension specialist.

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Coronavirus: Dexamethasone proves first life-saving drug

Patients should be given the cheap drug without delay, after “fantastic” trial results, experts say.

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Fun Is a Personal Standard

Whatever you’re currently doing to earn money, is it fun for you?

Would you still enjoy your income-generating activities even if they paid half as much?

Still fun with less pay? Or does the fun depend on the money?

Earning money can be fun. Spending money can be fun too.

But what if earning money isn’t fun? Then to earn more, you have to push yourself to do even more work that isn’t fun. Your reward is very mixed then – more money perhaps but also less fun. That creates a drag that will likely cause your income – and your ambition – to stagnate.

A lot of the world’s offers for income generation aren’t particularly fun. In fact, many of them seriously suck. Do this boring-as-hell work for a paycheck. That’s a crappy ass offer. Who’d be desperate enough to say yes to that? Lots of people apparently since most people don’t like their jobs – don’t become one of them.

You don’t have to accept a crappy ass offer that isn’t fun. You can either keep looking till you find a fun and inspiring offer, or better yet, create your own offer.

Safe Isn’t Fun

To bring some fun into this picture, I think it helps to choose income generation strategies that challenge you to grow. If you make it too easy, you’ll be bored.

A fun game is at least semi-challenging. Challenge alone won’t make the experience fun, but it will surely help.

Many people look to their past hobbies and strengths for income ideas. That tends to be a relatively weak approach that can easily lead to boredom. What if instead you develop income ideas based around what you’d like to explore and experience? Why rehash the past that you’ve already explored when you could lean into something new and adventurous?

What new challenges fascinate you? What seems a bit out of reach?

When I created my current business in 2004, my background was in programming and game design, having already invest 10 years in that path professionally. I could have generated income from my programming skills, but I saw that it would be more fun to figure out how to earn income from writing and speaking instead. Those income streams would be more challenging, growth-oriented, rewarding, and fun.

The edginess of making money from communication skills made the process more fun. Getting paid for my first professional speech was more fun and rewarding than getting paid the same amount from leveraging my programming skills.

Programming was safer, and speaking was scarier. Safe isn’t fun. Scary is often fun. Would you rather safely sit in your car in the parking lot of an amusement park… or would you prefer to go on the rides?

Earning decent income isn’t that hard if you’re having fun and enjoying fresh growth experiences from your work. Then it’s largely a matter of finding and testing the right strategies. But it can be really hard to earn good income if you don’t enjoy and appreciate the work you’re doing.

The Standard of Fun

You can earn income doing what isn’t fun. Or you can earn it doing what is fun. If you want the second option, don’t be a person who tolerates the first option. You get the lowest standard you’re willing to tolerate.

Fun work is essential to me. In Conscious Growth Club yesterday, we did a two-hour group coaching call, and it was fun, not just for me but for many of the members too. We shared a lot of laughs and silliness along the way, which actually enhances the coaching experience and doesn’t detract from the value. Would you rather be on a fun coaching call or a boring one? Don’t you think that fun is more motivating and inspiring than boredom?

Does your work spark joy for you? Do you look forward to showing up? Do you get excited when Monday morning comes up again, and you get to sink your teeth into some juicy and interesting projects? If that’s not your reality, then why the heck are you still showing up? Are you doing it for the income that will be perpetually held back by your lack of motivation? That’s a lame investment of your time and energy. What’s the long-term payoff? Sadness and regret? Step off!

Work doesn’t have to be a dreadful slog. You can choose to make it edgier and more fun. You can bring more of your playful personality to the experience. If you get fired for that, I’d say that’s a great reason to be fired. If your workplace can’t handle your having fun while doing your work, fuck ’em! Leave those dreadfully dull people behind, and work with fun-loving people instead. They’re out there if you’re willing to look and if you’re willing to rise to that standard and not accept less.

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Health24.com | Fruit juice early in children’s lives could lead to a better diet later in life, a study shows

  • A 10-year study of children’s diets showed that moderate 100% fruit juice consumption among children between three and six years of age had a positive impact on their adolescent diet
  • They were 3.8 more times likely to meet dietary guidelines’ whole fruit intake requirement than those who drank less than half a cup of fruit juice a day
  • The study also did not find a link between weight gain and early juice consumption

Fruit juice has had a bad rap in child nutrition circles due to its potential link to childhood weight gain and high sugar content – even 100% fruit juice. 

A new report from Boston University, published in BMC Nutrition, on data from the 10-year Framingham Children’s Study, however, shows evidence that moderate intake of 100% fruit juice by preschool children could lead to healthier diets with proper whole fruit intake in their adolescence. 

The study, conduted by the US National Heart, Lung and Blood Institute with Boston University, aimed to find out if any eating and exercise behaviours in childhood had any correlation to cardiovascular disease. The study started in 1987 with 100 children, and officially ended in 2001, after the 10 years were extended. 

READ: The GAPS diet promises to health-ify your gut and brain

According to the data focusing on 100% fruit juice – mostly apple and orange juice – children between the ages of three and six who had more than one cup of fruit juice a day, consumed just under one cup per day more total fruit and half a cup per day more whole fruit during adolescence. 

However, the fruit intake of the children who consumed less than half a cup of fruit juice a day sharply declined as they got older. 

They also measured their Healthy Eating Index (HEI) as part of the Dietary Guidelines for Americans, and found that those with higher fruit juice consumption in preschool years scored on average six points higher on their HEI than those who consumed less. 

They also found no link between 100% fruit juice intake and weight gain.

Limitations of the Farmingham study

There are some limitations to take note of in this study. The 100-children study is a small sample size, and it wasn’t diverse.

All the children came from middle-class families of Caucasian descent. In terms of other factors, only gender was included in the final models. 

In terms of the weight gain analysis, they included more factors like age, maternal education, maternal BMI, physical activity and screen time. 

They also excluded tomato juice and part-juice beverages that weren’t 100% fruit.

ALSO READ: Even one high-fat meal may dull your mind

What other studies say

According to current guidelines, they advise no fruit juice for children under one year of age and recommend limiting intake from one to three years old to 118ml a day, and from four to six years to around half a cup. These guidelines came into effect after the conclusion of the study.

They also encourage the consumption of whole fruit over fruit juice as it lacks fibre, has a high caloric count and has been reported to cause tooth decay. 

According to an article in the Official Journal of the American Academy of Pediatrics, a meta-analysis of studies, however, found that one serving of fruit juice didn’t have a significant impact on weight in children between one and six years old, and no effect on older children. 

In this case, half a cup of fruit juice equals one fruit serving. While the analysis sees no strong evidence to ban fruit juice in nutrition programmes, it still advises caution regarding high fruit juice intakes. 

In South Africa, four out of five local experts told Parent24 that fruit juice should be the exception and not the rule and served in small quantities, and parents should rather opt for whole fruit. While fruit juice contain micronutrients and antioxidants, they add that its sugar and acidity remain bad for teeth. 

READ: 5 secret healing powers of pineapple

Image credit: Pixabay

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Health24.com | Not a myth – contraceptives can cause weight gain

  • Some women are correct in claiming that their birth control causes weight gain
  • The interaction of genes with the hormones in birth control may be the reason for this weight gain
  • The alternative is for women to use non-hormonal forms of birth control like copper intrauterine devices 

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Genetics may explain why some women gain weight when using a popular method of birth control, researchers say.

“For years, women have said that birth control causes them to gain weight but many doctors failed to take them seriously,” said lead study author Dr Aaron Lazorwitz. He’s assistant professor of obstetrics/gynaecology and family planning at the University of Colorado School of Medicine, in Aurora.

“Now we have looked at the genetics and found that the way genes interact with some hormones in birth control could help explain why some women gain more weight than others,” Lazorwitz added in a university news release.

The etonogestrel contraceptive implant is inserted under the skin. It contains etonogestrel, a kind of progestin that inhibits ovulation, and is considered among the most effective types of birth control.

Individual genetic variation

For the study, the researchers reviewed the medical records of 276 women who received the implant. They found these women had a median weight gain of about 7lb (3.17kg) over an average of 27 months of use. Nearly three-quarters of the women gained weight.

Further investigation led the researchers to conclude that genetic variants in oestrogen receptor 1 (ESR1) among some of the women were associated with significant weight gain.

On average, women with two copies of the ESR1 rs9340799 variant gained over 30 pounds more while using the contraceptive implant than other women in the study.

Previous research has found links between ESR1 genetic variants and the workings of other types of medications, the study authors noted.

While this study focused on the etonogestrel contraceptive implant, other birth control drugs could have similar interactions with genes that cause weight gain, the researchers said.

Non-hormonal birth control

“It is imperative to better understand how individual genetic variation may influence a woman’s risk of adverse weight gain” while using these medications, Lazorwitz said.

Currently, there is no way to identify who will gain weight when using such medications. Health care providers can provide counselling about potential weight gain or suggest non-hormonal forms of birth control such as copper intrauterine devices (IUDs), the study authors suggested.

“As our understanding of pharmacogenomics in women’s health expands, we can develop individualised counselling that may reduce the incidence of hormone-related adverse effects, improve patient satisfaction, and help prevent future health risks associated with weight gain,” Lazorwitz said.

The study was published recently in the journal Contraception.

Image credit: Getty

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Health24.com | Teens can donate blood, but may need iron supplements

  • Donating blood results in a loss of iron from the body
  • Teens experience rapid growth, menstruation and often poor eating habits, which means that many already have low iron levels.  
  • Teenagers who donate blood may, therefore, develop iron deficiency  

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Teens who donate blood are at significant risk for long-term iron deficiency, a new study warns.

The concern comes as 16- to 18-year-olds have emerged as one of the fastest-growing groups of blood donors nationwide. But this study of nearly 31 000 teens who gave blood more than once between 2016 and 2018 found that roughly one in 10 were already iron-deficient when they donated for the first time.

And a year later, one-third of the girls and about 15% of the boys still had low iron levels, according to the report published online on 5 June in the journal Pediatrics.

“Blood loss of any kind is a common cause of iron deficiency in the US,” said lead author Dr Ralph Vassallo. And “blood donation results in the loss of iron-containing red blood cells,” he added. Vassallo is chief medical and scientific officer at Vitalant in Scottsdale, Arizona, a non-profit that collects and distributes volunteer blood donations in 27 states.

Significant consequences

The researchers pointed out that the teen donations occur against a backdrop of rapid growth, the start of menstruation for girls and less-healthy eating habits. All affect iron levels.

Dr Alan Mast, chairman for blood research at the Versiti Blood Research Institute in Milwaukee, Wisconsin, wrote an editorial that accompanied the study findings.

Mast pointed out that menstruation contributes to iron loss among teen girls and women, but after several blood donations, males will also develop iron deficiency. Donors are not required to have their iron levels tested.

The consequences of iron deficiency can be significant. The kind sometimes seen in blood donors of any age can undermine exercise performance, lead to lower infant birth weights, and trigger cravings for non-food items such as ice, clay or starch, according to Vassallo.

So US blood centres recommend that all donors take low-dose (18 to 28mg) iron for 60 days after donating “to quickly replace just the amount of iron lost during donation”.

Vassallo said most teen donors could safely take low-dose iron indefinitely. Most fall short of the daily recommended 11mg for boys and 15mg for girls. Foods that are good sources of iron include fortified cereals, some beans, lean beef and liver, spinach, tofu and potatoes.

Helping iron levels replenish

About 79% of girls and 75% of boys in the new study were first-time blood donors, the study authors noted.

The vast majority (96% of girls and 74% of boys) gave whole blood (WB), meaning the full gamut of red cells, white cells, platelets and plasma. Such donations lead to loss of about 250mg of iron, according to study background notes.

A smaller number made “double red blood cell” (2RBC) donations, in which only red blood cells are collected. A 2RBC donation leads to loss of 425 mg of iron.

To help iron levels replenish, donors are required to wait 56 days between WB donations and 112 days between 2RBC blood draws.

But a year after their first WB donation, up to 40% of girls and 20% of boys had iron deficiency, the investigators found. This increased to about 50% of girls and 30% of boys who were red blood cell donors.

“This underscores the need for iron replacement in young donors,” Vassallo said, noting that other research suggests that “time-limited, over-the-counter supplements” could reverse the trends.

A critical part of healthcare

But Mast suggested that a greater emphasis on adult donations may be a better way to go.

“Teenagers are still growing and developing neurocognitive function, which are developmental processes that require iron,” he noted. “They also tend to have poor diets that may be low in iron.” And girls are also adjusting to the start of their periods.

“Thus, teenagers have lower levels of iron stored in their body than adults, need more iron each day than adults, and are more susceptible to iron deficiency following blood donation than adults,” Mast said.

And that, he added, is why he doesn’t let his teenage daughter donate.

“Blood transfusion is a critical part of healthcare in the United States, and an adequate blood supply is essential,” Mast said. But, he added, parents should learn about the iron-deficiency risk their children could face – and having done so, step up and donate themselves.

“It would be wonderful if this happened more often, and we could decrease our reliance on teenagers for contributing to the blood supply,” he said.

Image credit: Getty

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The lockdown challenges of a 12-year-old with autism

Marium Ahmad is worried about the prospect of going out again and wearing a face covering.

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Cancer: Drug with new approach on impeding DNA repair shows promise in first clinical trial

In its first randomized clinical trial, a drug that targets a protein needed by cancer cells to maintain their dogged growth and division has shown considerable promise in combination with chemotherapy in patients with a common form of ovarian cancer, investigators at Dana-Farber Cancer Institute report.

As detailed in a paper published online today by The Lancet Oncology, patients with high-grade serous ovarian cancer (HGSOC) who were treated with the drug, berzosertib, and chemotherapy lived substantially longer before their disease began to worsen than did those treated with chemotherapy alone. The findings may set the stage for testing berzosertib — an inhibitor of the ATR protein — in a range of other cancers, investigators say.

“Our results in his phase 2 trial suggest that ATR inhibition in combination with chemotherapy has the potential to offer significant benefit to patients with chemotherapy-resistant HGSOC and, potentially, other tumor types where ATR plays a key role,” says the study’s lead author, Panagiotis Konstantinopoulos, MD, PhD, director of translational research, Gynecologic Oncology, at Dana-Farber.

Berzosertib is designed to take advantage of one of the most glaring vulnerabilities of some cancer cells. Like a tractor run non-stop, a tumor cell, driven by a constant imperative to proliferate, is apt to need frequent repairs. In a tumor cell, that involves fixing broken strands of DNA.

HGSOC, like other types of cancer, relies heavily on the ATR protein in making those repairs. That reliance becomes even greater when these cancers are treated with chemotherapy, which disrupts cells’ ability to copy their DNA.

“The unbridled growth of cancer cells places enormous stress on the process of DNA replication,” Konstantinopoulos explains. “ATR helps them survive that stress: its job is to coordinate the halting of the cell cycle to check if the DNA is intact or needs repair. Drugs that inhibit ATR — that deprive tumor cells of such repair — have the potential to be particularly effective in some cancers.”

In the study, investigators at 11 cancer centers around the country enrolled 70 patients with HGSOC that was resistant to platinum-based chemotherapy. Half the participants were randomly assigned to receive the standard chemotherapy agent gemcitabine alone and half received gemcitabine in combination with berzosertib.

The estimated median progression-free survival of patients receiving gemcitabine alone — the period in which their disease was in retreat or stable — was 14.7 weeks. For those receiving gemcitabine and berzosertib, it was 22.9 weeks. Among patients with the most platinum resistant tumors (i.e. those who had progressed within 3 months from prior platinum-based chemotherapy), the difference was even greater: 9 weeks for gemcitabine versus 27.7 weeks for gemcitabine and berzosertib.

Side effects were similar in the two groups. Those receiving the combination therapy, however, had a higher rate of thrombocytopenia, or low blood platelet levels.

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Materials provided by Dana-Farber Cancer Institute. Note: Content may be edited for style and length.

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