Inhaled insulin causes lung cancer

[TropicalBob]

A product designed to deliver insulin from inhalation into the lungs was discontinued today after a test group of users had a much higher-than-expected rate of lung cancer. Here's what the AP wrote this morning:

NEW YORK (Associated Press) - An already faltering pharmaceutical industry effort to develop inhaled insulin suffered another severe blow Wednesday after Pfizer Inc. said its now-discontinued Exubera could cause lung cancer.

Pfizer pulled the product from the market late last year after sales failed to gain ground, though some patients continue taking the drug. The company's former partner, San Carlos, Calif.-based Nektar Therapeutics, said it will end its inhaled insulin programs.

Pfizer said Exubera's label noted that patients who developed lung cancer had a history of cigarette smoking, and there were too few cases to determine whether the cancer is related to the insulin.

Exubera was developed by its two inventors over a 14-year period, at a cost of $1-billion, and the company was called Nektar. After Nektar was formed, Pfizer came aboard to market the product. But when the lung cancers and other lung problems started popping up, Pfizer pulled out of the deal in October 2007 with a loss of $2.8-billion.

Exubera is insulin in microscopic powder form. An inhaler that looks as ridiculous as the American Heatbar sprays the powder through the mouth, where it is sucked into the lungs. The tiny particles of powder move through the lungs' walls into the blood stream -- in about 10 seconds (much like nicotine).

Shortly after testing began, the drug is said to have caused coughing, dry mouth and chest discomfort in some of those testing it.

Then came a warning:

You should not take EXUBERA if you have an unstable or poorly controlled lung disease (such as unstable or poorly controlled asthma, chronic obstructive pulmonary disease) or if you smoke, start smoking, or quit smoking less than 6 months ago.

It now appears former smokers were particularly suspectible to further lung damage from inhaling the powder.

Maybe this has nothing to do with the propylene glycol in our delivered vapor. My concern is that no agency seems to have investigated inhaling PG over a long time period. Let's just hope we don't discover that the former smokers among us -- me included -- have lungs easily susceptible to further damage by innocuous or even seemingly helpful chemicals.

[dnakr]

Maybe this has nothing to do with the propylene glycol in our delivered vapor. My concern is that no agency seems to have investigated inhaling PG over a long time period. Let's just hope we don't discover that the former smokers among us -- me included -- have lungs easily susceptible to further damage by innocuous or even seemingly helpful chemicals.

Okay, this would suck. All of us trying to get healthier only to find out we are causing more damage...

[TropicalBob]

From my not-a-doctor point of view, here's my take:

The lungs view particulates as foreign matter to be destroyed. They mount an immune response to the irritant. Now, irritate an organ or area long enough and cancer seems to be a result. Smokers have already irritated their lungs for however many years they've smoked; they are indeed more vulnerable to irritation. Powder is a particulate, which doesn't belong in lungs.

Perhaps, if instead of spending $1-billion on atomizing insulin into powder they had put it in a solution of propylene glycol and let former smokers smoke it, the medicine might have worked without the lung cancer consequence.

I think that. But I don't like to use the word "think" when I really want to "know" that.

[SmokeyJoe]

Horrible story - kind of reminds me of the time they gave A-vitamin supplements to smokers and found a greater incidence of lung-cancer among them. Talk about unintended consequences.

[TropicalBob]

I'm still living with that one. I was health editor for The Tampa Tribune two decades ago and we were told beta carotene would help prevent lung cancer in smokers. I took huge quantities, so great that the creases in my palms were brilliant orange when I balled up my hand.

Now they say excessive beta carotene causes lung cancer in smokers.

For years, I took large quantities of various vitamins. C, E, selenium, beta carotene. Laid in the sun daily for D. Virtually all bad, we're now told. And -- oh yeh -- smoked 30 cigarettes a day at my desk at the newspaper.

Live and learn. Not always how you wanted to live or what you wanted to learn.

[jimldk]

There's a huge difference between Exubra and our devices...powder...Any powder form of inhaled product will lead to a foreign body response from our Respiratory tract immune system....look at coal workers/miners..sand /silicon workers...most famous asbestos....all fine particulate matter....but not our NDS...ours in water vapor form and fast dispersible and even the Brownian Particle effect in our vapor is so much stable and easily absorb into the air...

My patients so far has not shown any lung changes(multi Xrays have been taken )..in fact more shows improvement as the Hilar pictures shown in the xrays becomes clearer..so far so signs of worsening condition...I have done my xray too...I'm not worried at all....so far no increase in phlegm (small/tiny ball like mucus) in fact total absence of it....

Yes, we have issues to throat irritation( all responded to Cetrizine treatment)...I find it more link to the types of flavors then others(PPG)...will and still testing other alternative to PPG now....and don't forget the other pollution factor..... 8-)

[dnakr]

jimldk:

Thank you.
Okay, now I feel better. I was beginning to wonder if I was doing more damage to myself.

[FullSteam]

Hello all, I'm new to the forum as a registered user, but I followed your interesting discussions already in the past. Especially the new study in Malaysia and the tips & tricks from the doctor personally (thanks a lot for all your work, jimldk!) caught my interest. I'm also an e-smoker since Jan. 08, in the first weeks I also used regular cigarettes (but a lot less), now for nearly 4 weeks exclusive e-smoking without one real cigarette.

OK, but back on topic. I'm also a bit worried about the inhalation of PG, but it is actually used as a transport medium in medical inhalation devices.

I searched PubMed (I also have a little biomedical background, did my MSc. in Biomedical Engineering two years ago, but primarily I am a software engineer).

There's actually a recent study where they used PG as transport medium for a medical treatment (only on animals), but the outcome is interesting.

Here's the link to the abstract on PubMed (I do not have access to the full text, though, eventually jimldk can get it for his institute if they have access).

And in short here's the most interesting quote out of the abstract:
"There were no respiratory or systemic effects of high doses of propylene glycol relative to air controls."

[FullSteam]

Oh, one addition to the Exubera thing. The manufacturer has a video on the website where you can see a person actually using the device before a meal in a restaurant.

This device is really way too big, can't imagine this was actually used in public. Also you can see the "powder" effect after inserting and opening a new cartridge.

If e-cigs where that big, they would have no chance to be used :mrgreen:

But this Exubera story is over, as we know.

[jimldk]

Hello all, I'm new to the forum as a registered user, but I followed your interesting discussions already in the past. Especially the new study in Malaysia and the tips & tricks from the doctor personally (thanks a lot for all your work, jimldk!) caught my interest. I'm also an e-smoker since Jan. 08, in the first weeks I also used regular cigarettes (but a lot less), now for nearly 4 weeks exclusive e-smoking without one real cigarette.

OK, but back on topic. I'm also a bit worried about the inhalation of PG, but it is actually used as a transport medium in medical inhalation devices.

I searched PubMed (I also have a little biomedical background, did my MSc. in Biomedical Engineering two years ago, but primarily I am a software engineer).

There's actually a recent study where they used PG as transport medium for a medical treatment (only on animals), but the outcome is interesting.

Here's the link to the abstract on PubMed (I do not have access to the full text, though, eventually jimldk can get it for his institute if they have access).

And in short here's the most interesting quote out of the abstract:
"There were no respiratory or systemic effects of high doses of propylene glycol relative to air controls."

Thanks for the headsup bro...thank you for the support...this will even help us more..