Ahad, 5 Jun 2011

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The Star Online: World Updates


Yemen's Saleh comes out of surgery, future unclear

Posted: 05 Jun 2011 09:20 PM PDT

SANAA/RIYADH (Reuters) - Yemeni President Ali Abdullah Saleh was recovering from an operation in Saudi Arabia to remove shrapnel from his chest while a truce between his troops and a tribal federation appeared to be holding.

Protesters, interpreting Saleh's absence as a sign that his grip on power was weakening, celebrated on the streets of Sanaa where they have been staging anti-government demonstrations since January.

Anti-government protesters shout slogans while holding a defaced portrait of Yemen's President Ali Abdullah Saleh during a demonstration demanding his ouster in Sanaa June 4, 2011. (REUTERS/Ammar Awad)

"Who is next?," asked one banner held up by a protesters in a sea of red, white and black Yemeni flags, referring to the wave of uprisings in Arab world that has seen the leaders of Tunisia and Egypt toppled and inspired uprisings elsewhere.

Saleh was wounded on Friday when a rocket was fired into his presidential palace in Sanaa, killing seven others and injuring his closest advisers. He is being treated in a Riyadh hospital.

He left as acting president Abd-Rabbu Mansour Hadi, the vice president who is seen by many as having little power. Leaving Yemen at a time of such instability, even for medical care, could make it hard for Saleh to retain power.

Early on Monday, a truce between troops loyal to Saleh and the Ahmar group, leader of Yemen's Hashed tribal federation, appeared to be holding, offering some respite after two weeks of fighting in the capital in which more than 200 people have been killed.

Key in the coming days will be any news of Saleh's condition and any signals from Saudi Arabia on whether he will be able to return to Yemen -- or whether Riyadh will apply pressure on Saleh to step down.

Saleh, a political survivor who has ruled the impoverished country at the tip of the Arabian Peninsula for nearly 33 years, had so far managed to remain despite the defection of his top generals and ambassadors.

Saleh has exasperated his former U.S. and Saudi allies, who once saw him as a key partner in efforts to combat Yemen-based al Qaeda in the Arabian Peninsula, by repeatedly reneging on a Gulf-brokered deal for him to quit in return for immunity.

"The kingdom (Saudi Arabia) will convince Saleh to agree to the Gulf-brokered exit so that the situation can be resolved peacefully and without bloodshed," said Saudi analyst Abdulaziz Kasem.

Saleh's fall could also give renewed impetus to protest movements around the region.

"The departure of Saleh is a turning point not just for the Yemeni revolution but also is a huge push for the current changes in the Arab region and is the start of the real victory," said Zaki Bani Rusheid, a leading figure in Jordan's Muslim Brotherhood.

Egyptian political scientist Hassan Nafaa agreed: "The 'Arab Spring' will continue, Arab people are in a state of total rejection of their current ruling systems."

(Reporting by Andrew Hammond and Reed Stevenson)

Copyright © 2011 Reuters

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New melanoma drugs a big improvement in survival

Posted: 05 Jun 2011 12:39 PM PDT

CHICAGO (Reuters) - Two new drugs using very different scientific approaches can extend survival among patients with the deadliest form of skin cancer, offering the first new hope for real progress in many years.

Advanced melanoma patients taking an experimental pill, vemurafenib, developed by Roche and Daiichi Sankyo were 63 percent less likely to die than patients given chemotherapy, according to a new trial presented on Sunday at a meeting of the American Society of Clinical Oncology in Chicago.

Dr. Paul Chapman of Memorial Sloan-Kettering Cancer Center in New York and the study's lead investigator called the results an "unprecedented level of difference" for patients with advanced melanoma, who typically survive just eight months on current treatments.

In a separate study presented at ASCO, previously untreated people with advanced melanoma treated with Bristol-Myers Squibb's Yervoy, or ipilimumab, plus chemotherapy lived an average of two months longer than people who got chemotherapy alone.

Yervoy works by spurring the immune system to fight off the cancer. Vemurafenib is designed for use in patients with tumors that have a mutation in a gene known as BRAF that allows melanoma cells to grow. About half of all melanomas have the genetic aberration.

The Roche trial included 675 patients with previously untreated, inoperable late-stage metastatic melanoma with the BRAF mutation.

After a median three months of treatment, vemurafenib patients also had a 74 percent reduction in the risk of cancer progression compared to dacarbazine.

"This is a huge difference," said Dr. Antoni Ribas, an oncologist at the University of California, Los Angeles, who has studied vemurafenib. "Even if it diminishes over time, who cares?"

Nearly half of patients treated with the Roche drug had tumor shrinkage, compared with 5.5 percent with chemotherapy.

Side effects included skin rashes and joint pain. About 18 percent of patients developed a low-grade skin cancer.

Analysts, on average, have forecast annual vemurafenib sales of $452 million by 2015 and expect Yervoy annual sales of $1.26 billion, according to Thomson Pharma.

MORE HELP FOR MELANOMA PATIENTS

Roche expects U.S. and European regulators to decide on approval of its drug before the end of the year.

Bristol-Myers' Yervoy was approved in March for patients with inoperable or metastatic melanoma, based on a previous study which showed the drug given alone extended survival by four months in patients who had failed other treatments.

"What was interesting about this study was not only was it the second one to show a benefit," but that the improvement "took place even in the presence of dacarbazine chemotherapy," Dr. Jedd Wolchok of Memorial Sloan-Kettering Cancer Center in New York, who presented the study at the meeting, said in a telephone interview.

"We worried a lot that chemotherapy could be immunosuppressive," Wolchok said, noting that that might explain why the average survival benefit was two months instead of four.

"We don't know what dacarbazine did to the ipilimumab, but we do know even in the presence of dacarbazine, ipilimumab still produced a durable response and extended survival."

Doctors said taken together the new studies offer new options for patients.

"This is really unprecedented time to have two new approaches to treat advanced melanoma," said Dr. Lynn Schuchter of the University of Pennsylvania in Philadelphia, a melanoma expert who moderated a panel discussion of the drugs.

"Once you finally understand what is driving the disease we can develop therapies that are more effective," she said.

She and others expect vemurafenib to be approved this year. Meanwhile, doctors are already working out treatment strategies.

For patients who are stable with slow-growing tumors, Chapman said he would start them off on ipilimumab.

"That is a drug that can take a while to work, so if the person has time I would rather give him essentially two shots on goal rather than one."

For advanced patients who need a quick response, he would use vemurafenib first.

Schuchter said now the future is going to be to build upon this success and combine therapies.

"Cancer cells outwit us -- they are brilliant -- and figure out other pathways," she said.

Bristol-Myers and Roche announced earlier this week a collaboration to evaluate the combination of Yervoy and vemurafenib as a therapy for metastatic melanoma.

More than 70,000 people in the United States and 160,000 worldwide are diagnosed with melanoma each year, according to the American Cancer Society. The five-year survival rate for the aggressive cancer is just 15 percent.

(Editing by Bill Trott and Marguerita Choy)

Copyright © 2011 Reuters

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Syrian forces kill 35 in protest town - residents

Posted: 05 Jun 2011 12:39 PM PDT

AMMAN (Reuters) - Syrian forces have killed 31 civilians since Saturday during demonstrations in the northwestern town of Jisr al-Shughour demanding the removal of President Bashar al-Assad, residents said on Sunday.

The killings began when snipers deployed on the roof of the main post office fired volleys of bullets at a funeral for six protesters who were killed on Friday, when a large protest demanding democracy came under fire, they said.

Protesters chant slogans in support of Syrian President Bashar al-Assad as they carry his pictures outside al-Omari mosque, where another demonstration to express solidarity with Syria's anti-government protesters is taking place, in downtown Beirut June 3, 2011. (REUTERS/ Mohamed Azakir)

"In the last 24 hours at least 31 people have been shot dead, among them eight mourners at the funeral," said one of the residents, a history teacher who gave his name as Ahmad.

He said angry mourners torched part of post office after the shooting.

The official Syrian news agency said "armed terrorist groups" killed four policemen in the town, attacked public buildings and "spread terror in the heart of citizens who called on the authorities to intervene forcefully to protect them".

The Syrian Observatory for Human Rights said 31 civilians and four police were killed. Ammar Qurabi, head of the Syrian Human Rights Organisation, said security forces killed at least 20 civilians.

"The killings in Jisr al-Shughour are an act of revenge by the state for the Friday protests and another attempt to silence a Syrian town through the use of violence," Qurabi said.

(Reporting by Khaled Yacoub Oweis; Editing by Jon Hemming)

Copyright © 2011 Reuters

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