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Flu Shot 101 – What You Need to Know

Flu season is here again, and besides a fever and runny nose, it can bring about the longtime controversy surrounding vaccines. In order to protect more human lives this year and to clarify some of the most common misconceptions surrounding the flu vaccine, the team at ConsumerSafety.org met with Dr. William Schaffner, an infectious disease specialist at Vanderbilt Medical University. Below are answers to some of the most common queries surrounding the flu vaccine.

How is the Flu Vaccine Created?

Contrary to popular belief, the flu vaccine you receive this year is not the same vaccine that you received last year. The flu, also known as influenza, is a respiratory virus that is able to mutate and evolve over time. According to Dr. Schaffner, the virus can “change sometimes from year to year, perhaps every 2-3 years.” Therefore, the vaccine needs to change and evolve as well to keep people protected every year.

Because parts of the world experience flu season at the opposite time that we do, there are actually two vaccines developed every year – one for the northern hemisphere and one for the southern hemisphere. Each vaccine is developed nine months prior to flu season in a collaborative effort between the World Health Organization (WHO), the FDA, and the CDC. Based on WHO’s year-round global surveillance and influenza sampling, expert committees can “make recommendations about the creation of the vaccine” for each half of the world.

Who Needs the Flu Vaccine?

Everyone is at risk for the flu, and therefore with a few exceptions, everyone is recommended to get vaccinated. According to the CDC, everyone six months or older should receive an annual flu shot. Contrary to popular belief, this recommendation includes pregnant women, seniors, and children. It’s also important to note that not only is it safe for pregnant women, but the mother’s vaccine will actually protect the infant for six months after its birth.

In milder cases of the flu, a person experiences cold-like symptoms. However in its most severe form, the flu can lead to complications like pneumonia and even death. According to Dr. Schaffner, those most at risk for more serious complications include “people who are age 65 and older, and people who have underlying illnesses – heart disease, lung disease, diabetes, and the like who are immunosuppressed.” By receiving the vaccine, not only are you protecting yourself from this harmful virus, but you are also protecting those around you who might have a harder time fighting the flu.

Besides infants under the age of 6 months old, people who have Guillain-Barré syndrome, a very rare illness should NOT get the vaccination. Dr. Schaffner says that “if you’ve had Guillain-Barré  syndrome within 6 weeks of getting flu vaccine previously, you probably should not get flu vaccine this time.”

When Should a Person Get the Flu Vaccine?

Dr. Schaffner recommends anytime between September and November, and went on to explain that “vaccine interest on the part of providers and patients stops around Thanksgiving.” However, though our interest may wane, the peak season for flu outbreaks is often in February. So if it hits December or January and you still have not gotten your flu shot, Dr. Schaffner urges you to head to your nearest flu clinic. “RUN! Do not walk. Run and get your flu shot, because you can still get protection before the flu hits most seriously.”

Can the Flu Vaccine Give Someone the Flu?

No. After a flu shot, you may experience a headache, sore arm, redness, or a bump near the inoculation site, but the vaccine cannot give you the virus. As Dr. Schaffner explains, “The flu vaccine is not the complete virus. It’s broken up pieces of the virus. It can’t reconstitute itself and give you the flu.” The flu shot is administered during a season with high rates of colds and other airborne infections. Oftentimes when people get sick after a flu shot, they mistake a common cold for the flu by simple coincidence.

Is the Flu Vaccine Always Effective?

No, the flu shot is not 100% effective. In an age of money-back guarantees, many critics wonder why they should bother with a flu shot when they might still contract the virus. Dr. Schaffner argues that, “the protection effectiveness is measured as protection against the disease completely. What that doesn’t tell you is that you often get partial protection.” So you get a flu shot, and you still get the flu. The flu shot is still doing its part by lessening the severity of the virus. When it comes to a virus that takes tens of thousands of lives per year due to complications of high fever and pneumonia, Dr. Schaffner welcomes your complaints saying, “It’s wonderful that you’re here to complain. You didn’t die!” A mild case of the flu is better than a deadly case of the flu.

With the flu killing 30,000 to 40,000 individuals in the United States, it is imperative that more people recognize the dangers of the virus and the benefits of the vaccine. While the vaccine is not 100% effective, doctors and scientists work diligently every year to save as many people as possible from this deadly disease. You can make a difference too! Make the step towards health for you and your family this flu season and schedule your flu vaccination today.

Caitlin Hoff
Health and Safety Investigator with ConsumerSafety.org

Copyright © 2017 CancerConnect. All Rights Reserved.


FDA Approves Aliqopa for Treatment of Adults with Relapsed Follicular Lymphoma

The U.S. Food and Drug Administration today granted accelerated approval to Aliqopa (copanlisib) for the treatment of adults with relapsed follicular lymphoma who have received at least two prior treatments known as systemic therapies.

“For patients with relapsed follicular lymphoma, the cancer often comes back even after multiple treatments,” said Richard Pazdur, M.D., director of the FDA’s Oncology Center of Excellence and acting director of the Office of Hematology and Oncology Products in the FDA’s Center for Drug Evaluation and Research. “Options are limited for these patients and today’s approval provides an additional choice for treatment, filling an unmet need for them.”

Follicular lymphoma is a slow-growing type of non-Hodgkin lymphoma, a cancer of the lymph system. The lymph system is part of the body’s immune system and is made up of lymph tissue, lymph nodes, the spleen, thymus, tonsils and bone marrow. The National Cancer Institute at the National Institute of Health estimates that approximately 72,240 people in the United States will be diagnosed with some form of non-Hodgkin lymphoma this year; approximately 20,140 patients with non-Hodgkin lymphoma will die from the disease in 2017.

Aliqopa is a kinase inhibitor that works by blocking several enzymes that promote cell growth. Today’s approval of Aliqopa was based on data from a single-arm trial that included 104 patients with follicular B-cell non-Hodgkin lymphoma who had relapsed disease following at least two prior treatments. The trial measured how many patients experienced complete or partial shrinkage of their tumors after treatment (overall response rate). In the trial, 59 percent of patients had a complete or partial response for a median 12.2 months.

Common side effects of Aliqopa include high blood sugar levels (hyperglycemia), diarrhea, decreased general strength and energy, high blood pressure (hypertension), low levels of certain white blood cells (leukopenia, neutropenia), nausea, lower respiratory tract infections, and low levels of blood platelets (thrombocytopenia).

Serious side effects include infections, high blood sugar levels (hyperglycemia), high blood pressure (hypertension), inflammation of the lung tissue (non-infectious pneumonitis), low levels of certain white blood cells (neutropenia), and severe skin reactions. Women who are pregnant or breastfeeding should not take Aliqopa because it may cause harm to a developing fetus or newborn baby.

Reference:  https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm576129.htm

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Imfinzi Improves Survival in Stage 3 Non Small Cell Lung Cancer

Immunotherapy could be the new standard of care in patients with non-small cell lung cancer (NSCLC).  The novel immunotherapy checkpoint inhibitors Keytruda® (pembrolizumab) and Opdivo (nivolumab) are already standard of care for advanced NSCLC.1   A recently published study has demonstrated that patients with earlier stage III, locally advanced NSCLC may benefit from anther checkpoint inhibitor Imfinzi (durvalumab) in this hard-to-treat population.2

Lung cancer remains the leading cause of cancer-related deaths worldwide. In the United States, NSCLC accounts for 75–80% of all lung cancers. Although progress has been made in recent years, the majority of patients with advanced stage lung cancer still die from their disease. New treatments are needed. Precision medicine continues to impact the lives of lung cancer patients with research into genomics and genetics leading to unprecedented progress in improving outcomes. Tailored treatments have emerged to match a person’s genetic make­up or a tumor’s genetic profile. As a result, patients with lung cancer now typically re­ceive molecular testing that guides their physicians in determining which therapies are more likely to boost the chances of survival while limiting the potential for adverse effects. Results from studies evaluating immunomodulatory approaches using anti-PD-1 and anti-PD-L1 antibodies have demonstrated promising results and are advancing the standard of care for lung cancer.

One third of patients with NSCLC present with stage III, locally advanced disease, which is often unable to be removed by surgery.  The current standard of care for these patients is platinum-based chemotherapy and concurrent radiotherapy.

Results from the recently published PACIFIC study, show that giving Imfinzi after chemoradiotherapy doubled the period of survival without cancer progression.  The study authors observed “PD-L1 inhibition after chemoradiation appears to be a new option for patients with locally advanced, unresectable stage III lung cancer. It will be important to see the impact on overall survival after a longer follow-up.”

Study Details

The clinical study involved 713 adult patients with stage III, locally advanced, unresectable NSCLC who had progressed after two or more cycles of platinum-based chemoradiotherapy.  Half these patients were treated with Imfinzi and compared.  Time to cancer progression was16.8 months compared to 5.5 months for those not treated with Imfinzi.  Benefits were seen across all subgroups, including both patients with PD-L1-positive tumors and those with tumors negative for the marker.

References:

  1. http://news.cancerconnect.com/keytruda-demonstrates-superior-survival-compared-chemotherapy-first-line-treatment-advanced-non-small-cell-lung-cancer/
  2. European Society for Medical Oncology (ESMO) 2017 Congress: Abstract LBA1_PR. Presented September 9, 2017.

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Targeting both BRAF and EGFR doubles progression-free survival in metastatic colorectal cancer

Recent successes in genetically targeted precision cancer medicines are improving outcomes in a number of cancers.  Ensuring patients undergo genomic sequencing to determine if they have treatable targets is increasingly important to ensure patients receive the most appropriate personalized care.

Precision cancer medicine utilizes molecular diagnostic testing, including DNA sequencing, to identify cancer-driving abnormalities in a cancer’s genome. Once a genetic abnormality is identified, a specific targeted therapy can be designed to attack a specific mutation or other cancer-related change in the DNA programming of the cancer cells. Precision cancer medicine uses targeted drugs and immunotherapies engineered to directly attack the cancer cells with specific abnormalities, leaving normal cells largely unharmed.

By testing an individual’s colon cancer for specific unique biomarkers doctors can offer the most personalized treatment approach utilizing precision medicines.

Many colorectal cancers express epidermal growth factor receptor (EGFR) which is a transmembrane protein with cytoplasmic kinase activity that transduces important growth factor signaling from the extracellular milieu to the cell, and EGFR can be targeted with specific medications including Erbitux (cetixumab).

Personalized Precision Medicine Treatment of Colon Cancer: What Every Patient Should Know

BRAF is one of several other colorectal cancer biomarker that can be targeted.  The BRAF gene is known to play a part in cell growth, and mutations in BRAF are common in several types of cancer.  Five to 10 percent of colorectal cancer patients carry a very specific BRAF mutation known as V600E. This mutation produces an abnormal version of the BRAF protein that stimulates cancer growth.  Patients with mutant BRAF genes generally have a poorer prognosis.

Zelboraf (vemurafenib) is a novel precision cancer medicine that only works in patients whose cancer has a V600E BRAF mutation. Recent clinical trial results suggest that the addition of Zelboraf to treatment with Erbitux and Camptosar (irinotecan) in patients with metastatic colorectal cancer that have a BRAF V600E mutation can improve outcomes.

In a clinical study designed to evaluate whether Zelboraf could improve the treatment of advanced colon cancer, 99 patients were treated with standard colorectal cancer chemotherapy using Camptosar plus Erbitux with or without the Zelboraf and directly compared.

The 49 patients who received Zelboraf in addition to Erbitux and Camptosar experienced a doubling of survival time without cancer progression. The disease control rate was 67% with the addition of Zelboraf versus 22% for the two-drug combination. Overall survival was a median of 5.9 months for the two-drug combination and 9.6 months with the addition of Zelboraf. The study implies that inhibiting BRAF along with EGFR in patients with advanced colon caner may be more potent than inhibiting either of these targets alone.

Reference: http://abstracts.asco.org/199/AbstView_199_194502.html

Copyright © 2017 CancerConnect. All Rights Reserved.


Immunotherapy Active Against Triple-Negative Breast Cancer

October is breast cancer awareness month and patients with triple-negative breast cancer (TNBC) should be aware that data from two clinical trials provide additional evidence that they may derive benefit from checkpoint inhibitor therapy.1-4

About Triple Negative Breast Cancer

Approximately 12% of breast cancers are triple-negative breast cancers, meaning that they are estrogen-receptor negative (ER-), progesterone-receptor negative (PR-), and human epidermal growth factor receptor 2-negative (HER2-). This means that TNBC is not stimulated to grow from exposure to the female hormones estrogen or progesterone, nor through an overactive HER2 pathway.

Unfortunately, many available and effective treatment options for the majority of breast cancers block the growth stimulating effects of ER, PR and/or HER2; therefore, TNBC has limited therapeutic options.  Novel treatment options for TNBC have lagged behind that of other types of breast cancers.

About Checkpoint Inhibitors

Checkpoint inhibitors are a novel precision cancer immunotherapy that helps to restore the body’s immune system in fighting cancer. They create their anti-cancer effects by blocking a specific protein used by cancer cells called PD-1 and PD-L1 to escape an attack by the immune system. Once PD-L1 is blocked, cells of the immune system are able to identify cancer cells as a threat, and initiate an attack to destroy the cancer.  There are several PD-1 and PD-L1 inhibitors already approved for use to treat multiple cancer types.

Recently at the American Society of Clinical Oncology meetings additional evidence on the role of Keytruda (pembrolizumab), a checkpoint inhibitor was presented. In the KEYNOTE-086 clinical trial patients with previously treated metastatic TNBC had prolonged and durable response rates.  Patients with previously untreated PD-L1 positive metastatic TNBC experienced an overall response rate of 23.1%.3

In a second clinical trial (I-SPY2) combining Keytruda with Taxol (paclitaxel) in newly diagnosed, high-risk TNBC patients, a pathologic complete response rate of 60% in the neoadjuvant setting was observed and, compared favorably with the 20% response rate observed with chemotherapy alone.1

Another checkpoint inhibitor Tecentriq (Atezolizumab) has also demonstrated early encouraging results. Among patients with metastatic TNBC; those who responded to Tecentriq lived significantly longer compared with those who did not respond, according to data from a small clinical study presented at the American Association of Cancer Research annual meeting.2

Taken together, these studies suggest that checkpoint inhibitors are active against TNBC.  Doctors will continue to evaluate how best to incorporate these novel precision cancer medicines into their overall treatment strategy.

References:

  1. http://www.ascopost.com/News/55733
  2. Schmid P, Cruz C, Braiteh FS, et al: Atezolizumab in metastatic TNBC: Long-term clinical outcomes and biomarker analysis. 2017 AACR Annual Meeting. Abstract 2986. Presented April 3, 2017.
  3. http://news.cancerconnect.com/keytrudahalaven-combo-may-effective-advanced-triple-negative-breast-cancer/
  4. http://news.cancerconnect.com/tecentriq-plus-abraxane-effective-combo-difficult-treat-breast-cancer/

Copyright © 2017 CancerConnect. All Rights Reserved.


LynparzaTM Slows Spread of Inherited Breast Cancer Caused By BRCA Mutations

LynparzaTM (olaparib), a new drug treatment for women with advanced ovarian cancer associated with defective BRCA genes also appears to slowe the progression of breast cancer caused in part by mutations in the BRCA gene.  BRCA is an inherited condition that causes up to 3% of all breast cancers. BRCA + breast cancer is particularly hard to treat, and there has been a trend in recent years that these women opt for double mastectomies in order to lower their cancer risk.

About BRCA Breast Cancer

Breast cancer is the most common type of cancer in women, with some 250,000 cases likely to be diagnosed in the U.S. this year, according to the American Cancer Society. About 3 percent of breast cancers are in people who inherited BRCA mutations. Mutations in the BRCA gene raise the risk of cancer because they make the body less likely to repair damage to its DNA, making the mutations that lead to cancer more likely.

About LynparzaTM

LynparzaTM is a poly ADP-ribose polymerase (PARP) inhibitor that blocks enzymes involved in repairing damaged DNA. It was initially approved for women with heavily pretreated ovarian cancer that is associated with defective BRCA genes.  By disrupting cancer cells’ ability to repair themselves PARP inhibitors slow uncontrolled growth and replication of cancer cells.

In the current clinical study of 302 women whose breast cancer had spread, Lynparza reduced the risk of cancer growing by 42% compared to treatment with chemotherapy.  Overall 60% of the patients who received Lynparza experienced a response compared to only 29% of those treated with chemotherapy. The time to cancer progression was delayed almost twice as long for Lynparza treated patients compared to those receiving chemotherapy.

Lynparza is the first drug that targets an inherited genetic change in breast cancer. Ongoing clinical trials will determine its optimal use for women with BRCA + breast caner. LynparzaTM is an example of how a greater understanding of the underlying mechanisms of disease can lead to targeted, more personalized treatment.

Reference:  Robson M., Im SA., Senkus E., et al, OlympiAD: Phase III trial of olaparib monotherapy versus chemotherapy for patients (pts) with HER2-negative metastatic breast cancer (mBC) and a germline BRCA mutation (gBRCAm), Presented at the American Society of Clinical Oncology Annual Meeting, Chicago; June 2-6, 2017. http://abstracts.asco.org/199/AbstView_199_186720.html. Last accessed June 2017.

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FDA approves new treatment for certain advanced or metastatic breast cancers

The U.S. Food and Drug Administration today approved Verzenio (abemaciclib) to treat adult patients who have hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer that has progressed after taking therapy that alters a patient’s hormones (endocrine therapy). Verzenio is approved to be given in combination with an endocrine therapy, called fulvestrant, after the cancer had grown on endocrine therapy. It is also approved to be given on its own, if patients were previously treated with endocrine therapy and chemotherapy after the cancer had spread (metastasized).

“Verzenio provides a new targeted treatment option for certain patients with breast cancer who are not responding to treatment, and unlike other drugs in the class, it can be given as a stand-alone treatment to patients who were previously treated with endocrine therapy and chemotherapy,” said Richard Pazdur, M.D., director of the FDA’s Oncology Center of Excellence and acting director of the Office of Hematology and Oncology Products in the FDA’s Center for Drug Evaluation and Research.

Verzenio works by blocking certain molecules (known as cyclin-dependent kinases 4 and 6), involved in promoting the growth of cancer cells. There are two other drugs in this class that are approved for certain patients with breast cancer, palbociclib approved in February 2015 and ribociclib approved in March 2017.

Breast cancer is the most common form of cancer in the United States. The National Cancer Institute at the National Institutes of Health estimates approximately 252,710 women will be diagnosed with breast cancer this year, and 40,610 will die of the disease. Approximately 72 percent of patients with breast cancer have tumors that are HR-positive and HER2-negative.

The safety and efficacy of Verzenio in combination with fulvestrant were studied in a randomized trial of 669 patients with HR-positive, HER2-negative breast cancer that had progressed after treatment with endocrine therapy and who had not received chemotherapy once the cancer had metastasized. The study measured the length of time tumors did not grow after treatment (progression-free survival). The median progression-free survival for patients taking Verzenio with fulvestrant was 16.4 months compared to 9.3 months for patients taking a placebo with fulvestrant.

The safety and efficacy of Verzenio as a stand-alone treatment were studied in a single-arm trial of 132 patients with HR-positive, HER2-negative breast cancer that had progressed after treatment with endocrine therapy and chemotherapy after the cancer metastasized. The study measured the percent of patients whose tumors completely or partially shrank after treatment (objective response rate). In the study, 19.7 percent of patients taking Verzenio experienced complete or partial shrinkage of their tumors for a median 8.6 months.

Reference:  https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm578071.htm

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FDA Approves Aliqopa for Relapsed Follicular Lymphoma

The U.S. Food and Drug Administration (FDA) granted accelerated approval to Aliqopa® (copanlisib), an intravenously administered pan-class I phosphatidylinositol 3-kinase (PI3K) inhibitor, for the treatment of adults with relapsed follicular lymphoma who have received at least two prior systemic therapies.

Follicular lymphoma is the most common indolent (slow-growing) form of non-Hodgkin’s lymphoma (NHL), which is a type of cancer originating in immune cells referred to as B-cells. Follicular lymphoma accounts for approximately one in five cases of NHL, and is considered incurable with standard treatment options. In the United States, it is estimated that more than 14,000 new cases of follicular lymphoma will be diagnosed in 2017.

Aliqopa inhibits several key cell-signaling pathways, including B-cell receptor (BCR) signaling, CXCR12 mediated chemotaxis of malignant B cells, and NFκB signaling in lymphoma cell lines leading to cancer cell death by apoptosis and inhibition of proliferation of primary malignant B cell lines.

The approval was based on data from the phase II, single-arm CHRONOS-1 trial, which enrolled 104 patients with follicular B-cell non-Hodgkin lymphoma who had relapsed after at least two prior treatments. Patients received Aliqopa 60 mg intravenously on days 1, 8, and 15 of a 28-day cycle.

Sixty-one patients responded to treatment, with 15 patients (14%) achieving a complete response, for an overall response rate of 59 percent, and a median duration of response of 12.2 months with some patients with sustained responses greater than 22 months.

The most frequently reported serious adverse events (AEs) were pneumonia (8%), pneumonitis (5%), and hyperglycemia (5%). The most common AEs (occurring in ≥20% of patients) were hyperglycemia, diarrhea, decreased general strength and energy, hypertension, leukopenia or neutropenia, nausea, lower respiratory tract infections, and thrombocytopenia.

Copanlisib was previously granted priority review and orphan-drug designation.

Sources: FDA press release, September 14, 2017; Bayer press release, September 14, 2017.

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New Standard of Care for Treatment of Resectable Gastric Cancer

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Opdivo Proves Superior to Yervoy for Adjuvant Treatment of Stage III-IV Melanoma

Adjuvant treatment with the immunotherapy drug Opdivo (nivolumab) is superior to Yervoy (ipilimumab) for the management of stage IIIb/c or stage IV melanoma following complete surgical resection. These important results were presented at the European Society for Medical Oncology and published simultaneously in the New England Journal of Medicine.

There remains an unmet need for additional treatment options for individuals with stage III and resected stage IV high-risk melanoma patients because the risk of disease recurrence after surgery is significant. The results from the current clinical trial support Opdivo as a treatment option for these patients with high-risk surgically resected melanoma.

Connect with Others to Discuss this and Other Melanoma Treatment Options

Adjuvant Therapy in Melanoma

Melanoma is separated into five staging categories (stages 0-4).  Stage 3 melanoma is a cancer that has spread to the regional lymph nodes but has not yet spread to distant lymph nodes or to other parts of the body (metastasized).  Current standard treatment of stage 3 melanoma is surgical resection of the primary tumor as well as the involved lymph nodes. Despite surgical removal of the cancer however, most patients experience disease recurrence and progress to metastatic disease. By five years, the majority of stage IIIb and IIIc patients (68% and 89%, respectively) experience disease recurrence. There remains an unmet need for adjuvant therapy administered following surgery to reduce the risk of the cancer spreading.

About Opdivo

Opdivo is a precision cancer medicine that belongs to a new class of medicines called PD-1 inhibitors that have generated great excitement for their ability to help the immune system recognize and attack cancer. PD-1 is a protein that inhibits certain types of immune responses. Drugs that block PD-1 may enhance the ability of the immune system to fight cancer. Opdivo works by blocking PD-1. PD-1 inhibitors are being investigated in more than 30 different cancers, and it is already approved for the treatment of melanoma and lung cancer and researchers continue to evaluate its effectiveness in different types of cancer.

CheckMate -238 is an ongoing clinical trial comparing Opdivo to Yervoy in patients who have undergone complete surgical resection of a Stage IIIb/c or Stage IV melanoma. Overall 906 have been enrolled in the clinical trial and treated with Opdivo or Yervoy.

At this planned interim analysis, Opdivo has demonstrated a significant improvement compared to Yervoy. At 18-month from treatment 66% of Opdivo treated patients survive without cancer progression compared to 54% of those treated with Yervo. The treatment benefit was consistent across key subgroups, including BRAF mutated and BRAF wildtype patients.

Keep current about treatment advances in melanoma.

Reference: Weber J, Mandala M, Del Vecchio M, et al. Adjuvant Nivolumab versus Ipilimumab in Resected Stage III or IV Melanoma. September 10, 2017DOI: 10.1056/NEJMoa1709030

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