Bladder cancer: 'Exciting' drug breakthrough.

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A drug which makes a wide range of cancers more vulnerable to the body's immune system is "exciting" and may mark a new era, say doctors.
It strips cancer cells of the "camouflage" they use to evade attack by the immune system.
In the most detailed study, published in Nature, some patients completely recovered from terminal bladder cancer.
Cancer Research UK said the field of immunotherapy was delivering "a lot of very exciting results".

The immune system is in delicate balance with some chemicals in the body encouraging a strong vigorous response, while others try to dampen it down.
Tumours can hijack this system to hide from the immune system.
One trick which tumours use is a protein called PD-L1 which is normally used to prevent autoimmune diseases.
Bladder
An international team of scientists has been trialling a drug to block PD-L1, produced by the company Roche, on 68 people with advanced bladder cancer.
All the patients had tried chemotherapy and had been given six-to-eight months to live.
More than half the patients, whose tumours were using PD-L1 to hide from the immune system, showed signs of recovery.
In two patients there were no signs of cancer after the treatment.
One in ten patients responded to the experimental therapy even if PD-L1 was not present in the tumour.
Dr Tom Powles, an oncologist at the Barts Cancer Institute at Queen Mary University of London and part of the research team, said "There have been no new drugs for bladder cancer for 30 years.
"The tumours have developed a camouflage layer, PD-L1, and by removing the camouflage the tumour becomes identifiable.
"A subgroup of patients seems to do exceptionally well."
Dr Powles is funded by the NHS and receives no money from Roche.
The drug has been given "breakthrough therapy" status in the US and could be used widely by patients there at the end of 2015, if a larger trial shows the same results.
Much larger randomised clinical trials would be needed in order for the experimental therapy to be used in Europe.
More cancers
Dr Roy Herbst, who led the research at the Yale Cancer Centre, told the BBC: "This is a new paradigm in cancer.
"Immunotherapy for cancer has opened up an entirely new modality for treatment of the disease alongside chemotherapy, radiotherapy and surgery.
"Now we have immunotherapy and it is here to stay and the challenge for clinicians is seeing how it fits alongside those others."
His study was focused on the environment around a tumour and immune cells there, in order to help predict which patients would respond to therapy.
A similar set of trials to boost the immune attack revealed at the American Society of Clinical Oncology conference in Chicago in June, showed similar therapies could improve survival in advanced skin cancer.
In a trial of 411 patients evaluating a drug, pembrolizumab - 69% of patients survived at least a year.
Those results were described as having the "potential to be a paradigm shift for cancer therapy".
A separate study of 175 patients, led by Yale University in the US, showed responses to the drug in patients with non-small cell lung cancer, melanoma, renal cell carcinoma and other cancers.
Prof Peter Johnson, the chief clinician at Cancer Research UK, said: "We're seeing a lot of very exciting results from these new treatments using the immune system.
"This study in bladder cancer is further proof of the power of this approach, and it's really good to find a new treatment for a type of cancer that we've been struggling to make progress with for many years."
bbc.

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Sandhurst's sheikhs: Why do so many Gulf royals receive military training in the UK? A parade outside the building at Sandhurst Continue reading the main story In today's Magazine The death list that names 5,000 victims Is this woman an apostate? Voices from a WW1 prison camp The Swiss selfie scandal Generations of foreign royals - particularly from the Middle East - have learned to be military leaders at the UK's Sandhurst officer training academy. But is that still a good idea, asks Matthew Teller. Since 1812, the Royal Military Academy Sandhurst, on the Surrey/Berkshire border, has been where the British Army trains its officers. It has a gruelling 44-week course testing the physical and intellectual skills of officer cadets and imbuing them with the values of the British Army. Alongside would-be British officers, Sandhurst has a tradition of drawing cadets from overseas. Many of the elite families of the Middle East have sent their sons and daughters. Perhaps the most notable was King Hussein of Jordan. Continue reading the main story Find out more Matthew Teller presents Sandhurst and the Sheikhs, a Whistledown production for BBC Radio 4, on Wednesday 27 August 2014 at 11:00 BST It will be available on iPlayer shortly after broadcast Four reigning Arab monarchs are graduates of Sandhurst and its affiliated colleges - King Abdullah of Jordan, King Hamad of Bahrain, Sheikh Tamim, Emir of Qatar, and Sultan Qaboos of Oman. Past monarchs include Sheikh Saad, Emir of Kuwait, and Sheikh Hamad, Emir of Qatar. Sandhurst's links have continued from the time when Britain was the major colonial power in the Gulf. "One thing the British were excellent at was consolidating their rule through spectacle," says Habiba Hamid, former foreign policy strategist to the rulers of Dubai and Abu Dhabi. "Pomp, ceremony, displays of military might, shock and awe - they all originate from the British military relationship." Sheikh Hamad Bin Isa Al Khalifa, King Abdullah, Sultan Qaboos Sandhurst alumni: King Hamad of Bahrain, King Abdullah of Jordan and Sultan Qaboos of Oman It's a place where future leaders get to know each other, says Michael Stephens, deputy director of the Royal United Services Institute, Qatar. And Sandhurst gives the UK influence in the Gulf. "The [UK] gets the kind of attention from Gulf policy elites that countries of our size, like France and others, don't get. It gives us the ability to punch above our weight. "You have people who've spent time in Britain, they have… connections to their mates, their teachers. Familiarity in politics is very beneficial in the Gulf context." "For British people who are drifting around the world, as I did as a soldier," says Brigadier Peter Sincock, former defence attache to Saudi Arabia, "you find people who were at Sandhurst and you have an immediate rapport. I think that's very helpful, for example, in the field of military sales." The Emir of Dubai Mohammad bin Rashid Al Maktoum with his son after his Passing Out Parade at Sandhurst in 2006 Sheikh Mohammad bin Rashid Al Maktoum, Emir of Dubai, with his son in uniform at Sandhurst in 2006 Her Majesty The Queen's Representative His Highness Sheikh Hamad bin Khalifa Al-Thani, The Emir of Qatar inspects soldiers during the 144th Sovereign's Parade held at The Royal Military Academy Sandhurst on April 8, 2004 in Camberley, England. Some 470 Officer cadets took part of which 219 were commissioned into the British Army Hamad bin Khalifa Al-Thani, the Emir of Qatar until 2013, inspects soldiers at Sandhurst in 2004 Emotion doesn't always deliver. In 2013, despite the personal intervention of David Cameron, the UAE decided against buying the UK's Typhoon fighter jets. But elsewhere fellow feeling is paying dividends. "The Gulf monarchies have become important sources of capital," says Jane Kinninmont, deputy head of the Middle East/North Africa programme at the foreign affairs think tank Chatham House. "So you see the tallest building in London being financed by the Qataris, you see UK infrastructure and oilfield development being financed by the UAE. There's a desire - it can even seem like a desperation - to keep them onside for trade reasons." British policy in the Gulf is primarily "mercantile", says Dr Kristian Coates Ulrichsen, of the Baker Institute in Houston, Texas. Concerns over human rights and reform are secondary. The Shard at dusk The Shard was funded by Qatari investors In 2012 Sandhurst accepted a £15m donation from the UAE for a new accommodation block, named the Zayed Building after that country's founding ruler. In March 2013, Sandhurst's Mons Hall - a sports centre - was reopened as the King Hamad Hall, following a £3m donation from the monarch of Bahrain, who was educated at one of Sandhurst's affiliated colleges. The renaming proved controversial, partly because of the perceived slight towards the 1,600 British casualties at the Battle of Mons in August 1914 - and partly because of how Hamad and his government have dealt with political protest in Bahrain over the last three years. A critic might note that the third term of Sandhurst's Officer Commissioning Course covers counter-insurgency techniques and ways to manage public disorder. Since tension between Bahrain's majority Shia population and minority Sunni ruling elite boiled over in 2011, more than 80 civilians have died at the hands of the security forces, according to opposition estimates, though the government disputes the figures. Thirteen police officers have also lost their lives in the clashes. "The king has always felt that Sandhurst was a great place," says Sincock, chairman of the Bahrain Society, which promotes friendship between the UK and Bahrain. "Something like 20 of his immediate family have been there as cadets. He didn't really understand why there was such an outcry." David Cameron and King Hamad David Cameron meeting King Hamad in 2012... A protester is held back by police ... while protesters nearby opposed the Bahrain ruler's human rights record Crispin Black, a Sandhurst graduate and former instructor, says the academy should not have taken the money. "Everywhere you look there's a memorial to something, a building or a plaque that serves as a touchstone that takes you right to the heart of British military history. Calling this hall 'King Hamad Hall' ain't gonna do that." Sandhurst gave a written response to the criticism. "All donations to Sandhurst are in compliance with the UK's domestic and international legal obligations and our values as a nation. Over the years donations like this have saved the UK taxpayer a considerable amount of money." But what happens when Sandhurst's friends become enemies? In 2001, then-prime minister Tony Blair visited Damascus, marking a warming of relations between the UK and Syria. Shortly after, in 2003, Sandhurst was training officers from the Syrian armed forces. Now, of course, Syria is an international pariah. Journalist Michael Cockerell has written about Libyan dictator Colonel Gaddafi's time at the Army School of Education in Beaconsfield in 1966: "Three years [later], Gaddafi followed a tradition of foreign officers trained by the British Army. He made use of his newfound knowledge to seize political power in his own country." Ahmed Ali Sandhurst-trained Ahmed Ali was a key player in the Egyptian military's removal of Islamist President Mohammed Morsi That tradition persists. In the 1990s Egyptian colonel Ahmed Ali attended Sandhurst. In 2013 he was one of the key figures in the Egyptian military's removal of Islamist President Mohammed Morsi, now rewarded by a post in President Sisi's inner circle of advisers. In the late 1990s there were moves by the British government under Tony Blair to end Sandhurst's training of overseas cadets. Major-General Arthur Denaro, Middle East adviser to the defence secretary and commandant at Sandhurst in the late 1990s, describes the idea as part of the "ethical foreign policy" advocated by the late Robin Cook, then-foreign secretary. Tony Blair and Robin Cook Tony Blair and Robin Cook at one point planned to end Sandhurst's training of overseas cadets The funeral of King Hussein in 1999 appears to have scuppered the plan. "Coming to that funeral were the heads of state of almost every country in the world - and our prime minister was there, Tony Blair," says Major-General Denaro. "He happened to see me talking to heads of state - the Sultan of Brunei, the Sultan of Oman, the Bahrainis, the Saudis - and he said 'How do you know all these guys?' The answer was because they went to Sandhurst." Today, Sandhurst has reportedly trained more officer cadets from the UAE than from any other country bar the UK. The May 2014 intake included 72 overseas cadets, around 40% of whom were from the Middle East. "In the future," says Maryam al-Khawaja, acting president of the Bahrain Centre for Human Rights, "people will look back at how much Britain messed up in the [Middle East] because they wanted to sell more Typhoon jets to Bahrain, rather than stand behind the values of human rights and democracy." "It's one thing saying we're inculcating benign values, but that's not happening," says Habiba Hamid. Sandhurst is "a relic of the colonial past. They're not [teaching] the civic values we ought to find in democratically elected leaders." line Who else went to Sandhurst? Princes William and Harry, Winston Churchill, Ian Fleming, Katie Hopkins, Antony Beevor, James Blunt, Josh Lewsey, Devon Harris (From left to right) Princes William and Harry Sir Winston Churchill Ian Fleming, creator of James Bond (but did not complete training) Katie Hopkins, reality TV star Antony Beevor, historian James Blunt, singer-songwriter Josh Lewsey, World Cup-winning England rugby player Devon Harris, member of Jamaica's first bobsleigh team line Sandhurst says that "building international relations through military exchanges and education is a key pillar of the UK's international engagement strategy". Sandhurst may be marvellous for the UK, a country where the army is subservient to government, but it is also delivering militarily-trained officers to Middle Eastern monarchies where, often, armies seem to exist to defend not the nation but the ruling family.

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Generations of foreign royals - particularly from the Middle East - have learned to be military leaders at the UK's Sandhurst officer training academy. But is that still a good idea, asks Matthew Teller. Since 1812, the Royal Military Academy Sandhurst, on the Surrey/Berkshire border, has been where the British Army trains its officers. It has a gruelling 44-week course testing the physical and intellectual skills of officer cadets and imbuing them with the values of the British Army. Alongside would-be British officers, Sandhurst has a tradition of drawing cadets from overseas. Many of the elite families of the Middle East have sent their sons and daughters. Perhaps the most notable was King Hussein of Jordan. Four reigning Arab monarchs are graduates of Sandhurst and its affiliated colleges - King Abdullah of Jordan, King Hamad of Bahrain, Sheikh Tamim, Emir of Qatar, and Sultan Qaboos of Oman. Past monarchs include Sheikh S
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