Lies, damned lies, and statistics - Part II
When I was diagnosed in 2000, there was only one FDA-approved treatment for kidney cancer, high dose interleukin-2. In action, the patient's immune system is destroyed and rebuilt, on the theory that one's body will then be able to recognize and destroy cancer cells. It's a very toxic treatment, it requires hospitalization, and it's not terribly successful: about 20% of patients who receive it show any benefit, and only 5-7% are placed in remission, though that remission is generally long-term (decades). Nevertheless, as the only approved option, it was routinely prescribed in hopes that the patient might be "one of the lucky ones."
A second immunotherapy, interferon-alpha, has also been used to treat renal cell carcinoma. One of my doctors has referred to it as "a drug looking for a symptom" - that is, in his opinion, it's widely used for anything with T-cell involvement, but has not yet provided a "knockout blow" to anything. It is FDA-approved for use against hepatitis C.
In December 2005, the Bayer drug Nexavar was approved for use in kidney cancer, followed in January 2006 by the Pfizer drug Sutent. Both are biologics, and they are antiangiogenic. Tumors require enormous blood supplies and essentially create a vascular system for themselves through a process called angiogenesis. Antiangiogenic drugs fight this ability; tumors starved of blood supply die. (Antiangiogenic theory was developed by Dr. Judah Folkman. May his shadow never diminish.)
These and other developing drugs are known as targeted therapies. They work on the molecular level and target specific actions by the cancer cells. It's still too early to tell what these will lead to, but the results from clinical trials to date are overwhelmingly positive with recorded high levels of response rate or stable disease state. There will be more testing as time goes on - drugs in combination with each other, drugs in succession, drugs as first-line vs. second-line therapy options, etc.
I feel very lucky to have had multiple options open to me for treatment. I've tried them all and my options are probably still open should my Nexavar treatment course be unsuccessful.
A second immunotherapy, interferon-alpha, has also been used to treat renal cell carcinoma. One of my doctors has referred to it as "a drug looking for a symptom" - that is, in his opinion, it's widely used for anything with T-cell involvement, but has not yet provided a "knockout blow" to anything. It is FDA-approved for use against hepatitis C.
In December 2005, the Bayer drug Nexavar was approved for use in kidney cancer, followed in January 2006 by the Pfizer drug Sutent. Both are biologics, and they are antiangiogenic. Tumors require enormous blood supplies and essentially create a vascular system for themselves through a process called angiogenesis. Antiangiogenic drugs fight this ability; tumors starved of blood supply die. (Antiangiogenic theory was developed by Dr. Judah Folkman. May his shadow never diminish.)
These and other developing drugs are known as targeted therapies. They work on the molecular level and target specific actions by the cancer cells. It's still too early to tell what these will lead to, but the results from clinical trials to date are overwhelmingly positive with recorded high levels of response rate or stable disease state. There will be more testing as time goes on - drugs in combination with each other, drugs in succession, drugs as first-line vs. second-line therapy options, etc.
I feel very lucky to have had multiple options open to me for treatment. I've tried them all and my options are probably still open should my Nexavar treatment course be unsuccessful.
Labels: patient information
posted by rcclive at
6:43 AM
1 Comments:
Your blog is so educational. I am glad you are telling all of this so I can understand it a bit at a time.
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Swanknitter, at 2:30 AM
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