Christine

http://www.eurekalert.org/pub_releases/ ... 101707.php A new study finds that survival for elderly patients with lung cancer has changed little despite large increases in healthcare expenditures for lung cancer treatment. The study by Harvard University, National Cancer Institute, and National Bureau of Economic Research researchers, published in the December 1, 2007 issue of CANCER, a peer-reviewed journal of the American Cancer Society, finds that average life-expectancy rose by less than one month between 1983 and 1997, while costs rose by over $20,000 per patient. Lung cancer remains the top cause of cancer death in the United States, with an estimated 160,390 deaths expected to occur in 2007. The U.S. spends more than five billion dollars a year on detection, determining the disease severity, and treatment of lung cancer. This is a significant increase over the last few decades, mirroring similar increases in general healthcare spending over the same period. The one-year survival rate for lung cancer has increased slightly, from 37 percent in 1975-1979 to 42 percent in 2002, largely due to improvements in surgical techniques and combined therapies. However the five-year survival rate for all stages of lung cancer combined has remained relatively stable, and is currently only about 16 percent. Dr. Rebecca Woodward and her colleagues linked and analyzed non-small cell lung cancer survival data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database and Medicare Parts A and B reimbursement data from the Continuous Medicare History Sample File (CMHSF) database. Their objective was to examine changes in treatment costs and outcomes for localized, regional and metastatic lung cancer from the early 1980s to the mid-1990s. Cost-effectiveness, as measured by the cost of an additional year of life gained, was poor, with a high average cost of $403,142. While early stage cancer treatment was more cost-effective by conventional standards than treatments for advanced disease, the gains still were limited. When analyzed by disease severity, the cost per additional year gained for local and regional disease was $143,614 and 145,861, respectively. For metastatic cancer, the cost per additional year gained was $1,190,322. Dr. Woodward and her co-authors conclude, “The additional money spent on lung cancer treatment in the mid-1990s compared to in the early 1980s did not result in a favorable economic rate of return by conventional benchmarks.”

ZURICH, Oct 22 (Reuters) - Swiss drugmaker Roche said on Monday its lung cancer drug Tarceva received regulatory approval in Japan. "Roche, Chugai and OSI Pharmaceuticals, Inc. announced today that Tarceva (erlotinib) has been approved in Japan for the treatment of patients with nonresectable, recurrent and advanced non-small cell lung cancer (NSCLC) which is aggravated following chemotherapy," Roche said. Reporting by Sven Egenter Email: sven-markus.egenter@reuters.com

Grand Forks Herald By Valerie Kummer, Published Sunday, October 21, 2007 ST. PAUL - Lung cancer is one of the major lung diseases the American Lung Association battles. It is estimated that this year alone, 213,380 people will be diagnosed with lung cancer. While we search for a cure to this terrible disease, it is essential that we continue to improve treatment. Unfortunately, CMS (Centers for Medicare and Medicaid Services) recently established a new policy that undermines the quality of treatment for seniors with cancer. This National Coverage Decision (NCD) applies to erythropoiesis-stimulating agents (ESAs). For those who are unfamiliar with cancer, ESAs help the body make red blood cells, which are frequently compromised during chemotherapy. When red blood cell levels drop to dangerous levels, patients experience anemia and are either treated with ESAs or given a blood transfusion. In the eyes of patients battling cancer, ESAs have dramatically improved their quality of life. In establishing this policy, CMS ignored FDA recommendations as well as the oncology community and patient advocates who repeatedly warned that such a policy will be bad for seniors with cancer. The American Society of Clinical Oncology, the American Association of Cancer Research, U.S. Oncology and numerous other clinical experts and patient advocates have taken an immediate and vocal stand in defense of ESAs as a vital treatment option that should be left to the discretion of a patient's doctor. As many as 15 percent of cancer patients with hemoglobin levels above the level specified by CMS as “appropriate” for treatment will be denied ESAs as a result of the NCD. Their risk for a transfusion will jump by as much as 50 percent. Additionally, 70 to 80 percent of patients experience fluctuating hemoglobin levels when they are first introduced to ESAs. Under the NCD, these patients will have four weeks to get their hemoglobin levels below the mandated 10 g/dL before they are denied further ESA treatment. At that point, doctors will have to choose whether to comply with CMS' arbitrary mandates or deliver essential care to their patients. What will it take to convince CMS that the ESA issue runs deeper than their jurisdiction? Clearly FDA guidelines are no longer enough. Until CMS brings certified specialists and patient advocates on staff to help establish a national policy, Congress must step in to protect patients and ensure that doctors can provide the best care possible to all patients, including seniors. Congress has heard that call and is working right now to overturn the NCD. Please urge Rep. Earl Pomeroy (D-N.D.) and Sens. Kent Conrad and Byron Dorgan (D-N.D.) to support this effort. It is time once again to allow the experts who have conducted clinical trials and treated patients with ESAs first-hand to make a decision that works for - not against - seniors fighting the battle of their lives against cancer.

I am so sorry Laurie. You have my deepest sympathy.

Thanks Connie. I corrected the problem and the link is now working. Apparently the period at the end of the sentence was the problem.

Jon Echternacht, Hudson Star-Observer Published Friday, October 19, 2007 Although smoking leads the list of contributors to lung cancer, second place belongs to a natural element ahead of second-hand smoke. Radon, an odorless, tasteless, invisible and naturally occurring gas, has become the second leading cause of lung cancer, according to the U.S. Environmental Protection Agency. The radioactive gas gets into the air and, when taken into the lungs, causes disease, the EPA said. The EPA estimated about 21,000 lung cancer deaths were caused by radon in a 2003 assessment of risks. The U.S. surgeon general lists radon as the second leading cause of lung cancer — behind smoking — in the country today. The number represented more deaths than those caused by drunken driving, according to statistics from the Centers for Disease Control. Radon is found all over the country. It enters the home through the indoor air, water supply and soil. Radon entering through the soil is usually a much larger risk than through water, said the EPA. Radon is a radioactive gas that comes from the natural breakdown (radioactive decay) of uranium. Most soils contain varying amounts of uranium. It is usually found in igneous rock and soil, but in some cases, well water may also be a source of radon We wanted to know more so engaged in an e-mail conversation with Ian Williams, a geophysicist and geology professor at UW-River Falls. Professor Williams claimed not to be an expert on radon, but as a rock scientist we were sure he knew a heck of a lot more than the average Joe about the subject. “Radon gas is colorless, tasteless, odorless and actually inert, but very soluble and radioactive. It emits alpha particles, which is what causes the cell damage that leads to cancer,” he replied. Lung cancer often has a 10-25-year gestation period. Professor Williams said that we absorb radon from groundwater, construction materials and directly via our basements if we live on rocks that contain significant amounts of uranium, particularly basement rocks (i.e. metamorphic and igneous rocks). “In the Twin Cities area we live directly on platform sedimentary rocks such as dolostones, sandstones and thin shales — it’s the shales that may contain minerals that could contribute to radon,” he said. The professor said Taylors Falls to the north sits on a bed of basalt which probably contributes more radon. Living on granite such as in North Central Wisconsin, is probably even a worse scenario for radon. The EPA estimates 8 million homes in the country may have hazardous radon levels. And the element could contribute to about one-seventh of the total lung cancer deaths each year. The American Cancer Society estimated the number of deaths from smoking at 160,000 a year in 2004. The EPA urges that all homes be tested for radon regardless of geographic location. For more information on radon risks and testing, consult www.epa.gov/radon

Karen, I am so very sorry for your loss. Wishing you peace.

Happy Birthday Rich! Hope YOUR day was special.

Science Daily — Scientists have identified the transcription factor DMP1 as a pivotal tumor suppressor for both human and mouse lung cancers, especially in carcinomas that exhibit intact Arf-p53 pathways. The research, published in Cancer Cell, may lead to development of new drug therapies for lung cancer. Lung cancer is the leading cause of cancer deaths in the world, responsible for 1.3 million deaths each year. Non-small-cell lung cancers (NSCLCs) are the most common type of lung cancer, and scientists have identified distinct patterns of genetic alterations that are associated with this malignancy. Mutations that activate the oncogene K-ras or interfere with the tumor suppressors p53 and Arf are common in human NSCLCs. The mouse model K-rasLA had previously been developed based on this knowledge and is an excellent system for studying human NSCLC. Dmp1 is a unique tumor suppressor that activates Arf expression and thus induces p53-dependent cell cycle arrest. Mice lacking the gene for Dmp1 commonly develop lung tumors, and Dmp1 has been identified as a regulator of the Arf-p53 pathway in vitro. "In striking contrast to the accumulating information on mouse Dmp1, very little is known about the involvement of human DMP1 (hDMP1) in cancer," says lead author Dr. Kazushi Inoue of Wake Forest University. Dr. Inoue and colleagues conducted a study designed to investigate the collaborative effects of Dmp1 deletion and K-ras activation in the genesis and progression of lung cancer. Tumorigenesis was significantly accelerated in K-rasLA mice that were lacking one or both copies of Dmp1. The researchers demonstrated that Dmp1 also showed haploid insufficiency, meaning that cancer developed even when one copy of the gene was present, in samples from lung cancer patients with non-small-cell lung cancers. Further, in K-rasLA mice, lung carcinomas were associated with either p53 mutations or deletion of Dmp1 to inactivate the Arf-p53 pathway. Consistent with this finding, human lung carcinomas exhibited loss of hDMP1 in a mostly exclusive fashion with loss of Arf-p53 activation. Importantly, Dmp1 overexpression inhibited growth of human lung cancer cells with K-ras mutation and wild-type Arf and p53. These findings suggest that DMP1 plays a critical role in the development of lung cancer. "We have demonstrated that the hDMP1 gene is hemizygously deleted in a significant percentage of mouse and human non-small-cell lung carcinomas, especially those which retained the intact Arf-p53 pathway," explains Dr. Inoue. "Since hDMP1 loss-of-heterozygosity lung cancer cells retain one allele of the hDMP1 locus, this gene might be a promising target for future drug development." The researchers include Ali Mallakin, Takayuki Sugiyama, Pankaj Taneja, Lauren A. Matise, Donna P. Frazier, Mayur Choudhary, Gregory A. Hawkins, Ralph B. D'Agostino, Jr., Mark C. Willingham, and Kazushi Inoue of Wake Forest University Health Sciences in Winston-Salem. Reference: Mallakin et al.: "Mutually Exclusive Inactivation of DMP1 and ARF/p53 in Lung Cancer." Publishing in Cancer Cell 12, 381--394, October 2007. DOI 10.1016/j.ccr.2007.08.034 This work was supported by NIH/NCI 5R01CA106314 (K.I.). Note: This story has been adapted from material provided by Cell Press.

10/17/2007 10:05:43 AM Pharmion Corp. (PHRM) announced that it has begun an international pivotal Phase 3 clinical trial evaluating amrubicin, the company's third-generation synthetic anthracycline, in the treatment of second-line small cell lung cancer or SCLC. The randomized, controlled, multi-center study will compare amrubicin to topotecan, the only approved chemotherapy for second-line treatment of SCLC in the US and EU. Enrollment in the study of 480 patients is underway. Approximately 30,000 patients in the US and 32,000 patients in the EU will be diagnosed with SCLC this year.

Wed Oct 17, 2007 11:15am EDT Oct 17 (Reuters) - Poniard Pharmaceuticals Inc (PARD.O: Quote, Profile, Research) said the European Commission granted its drug, picoplatin, orphan drug status for the treatment of small cell lung cancer. This designation is given to drugs which may be used for conditions that affect no more than five in 10,000 persons in the European Union, the biopharmaceutical company said in a statement. Poniard said Wednesday's status for the drug, which already has orphan drug status in the United States for the same condition, is based on the recommendation from a committee of the health regulator European Medicines Agency (EMEA). (Reporting by Varsha Tickoo in Bangalore)

Tina, I am so sorry for your loss. You have been through so much. Wishing you peace.

Welcome to the site. I'm sorry you have to be here at all. Knowledge is power, and you'll find a lot of information here, as well as support and kind words when you need them.

Bobby, I'm happy to hear your sister is home. It's so much easier to rest and regain strength at home. My mother was on BCBS-IL (cobra) and had hospice care. Her doctor said that to qualify she needed to have a life expectancy of less than 6 months. However, he also said that many patients live past that 6 month period and generally aren't "kicked" out of hospice. My mother was allowed to continue Tarceva,and we were told that she could stop hospice care at any time to pursue additional treatment. My father continued to pay the cobra premium and she was never in danger of losing her insurance. I will say that bringing in hospice was the best thing we could have done and we're sorry we didn't do it sooner. Sending prayers your way.

Welcome Pipfitz. Some people "battle", while others do not. To each their own. No judgements here... just support.

A shrinking tumor is always good news... no matter how you slice it (a little CT scan humor there).

Nick, You are truly a special soul. Your mother is very proud of you, of this I am sure.

GSK Receives Approval for HYCAMTIN® (topotecan) Capsules for the Treatment of Relapsed Small Cell Lung Cancer First FDA Approved Oral Therapy Will Allow Patients to be Treated for This Aggressive Cancer at Home October 15, 2007: 08:45 AM EST PHILADELPHIA, Oct. 15 /PRNewswire-USNewswire/ -- GlaxoSmithKline announced today approval by the U.S. Food and Drug Administration (FDA) for oral HYCAMTIN® (topotecan) capsules for the treatment of relapsed small cell lung cancer (SCLC). Specifically, HYCAMTIN capsules are indicated for patients who had a complete or partial response to first-line chemotherapy and who are at least 45 days from the end of that treatment. HYCAMTIN capsules are the only oral single-agent chemotherapy approved for the treatment of SCLC after failure of first-line therapy. The product will be available in 2008. "The approval of HYCAMTIN capsules is particularly important for patients with relapsed small cell lung cancer as they now have an effective treatment option that has been shown to provide a survival benefit and can be conveniently taken at home," said Debasish Roychowdhury, M.D., Vice President, Global Clinical Development, Oncology Medicine Development Center, GSK. "Additionally, this milestone underscores GSK Oncology's commitment to helping improve cancer patients' quality of life." This approval was based on positive results from a Phase III study comparing HYCAMTIN capsules plus best supportive care (BSC) to BSC alone in patients with relapsed SCLC, in addition to Phase II and Phase III supporting studies. Best supportive care refers to treatments intended to control, prevent and relieve disease complications to improve comfort and quality of life for the patient, but are not intended to have any anti-tumor effects. In the pivotal Phase III clinical trial, HYCAMTIN capsules added to BSC were associated with prolonged survival in patients with relapsed SCLC. This was the first randomized study ever to demonstrate that patients with relapsed SCLC live longer when they are treated with BSC and chemotherapy compared to BSC alone. Study results were published in the December 1, 2006 issue of the Journal of Clinical Oncology.(1) "In clinical trials, HYCAMTIN capsules have shown the potential to benefit patients with SCLC, many of whom are prone to relapse," said John Eckardt, M.D., Director of Clinical Research for the Center for Cancer Care and Research, St. Louis, MO. "The approval of HYCAMTIN capsules opens up new possibilities for patients battling this disease and provides a convenient alternative to IV therapy." HYCAMTIN Capsules Clinical Trial Results(1,2) In the Phase III multicenter trial, 141 patients with relapsed SCLC not considered as candidates for standard IV therapy were randomized to receive BSC alone (n = 70) or HYCAMTIN capsules (2.3 mg/m2/day, days 1 through 5, every 21 days) plus BSC (HYCAMTIN capsules; n = 71). The primary objective was to compare overall survival between the two treatment arms. Patients who received HYCAMTIN capsules plus BSC showed a statistically significant improvement in overall survival compared with the patients who received BSC alone (Log-rank p = 0.0104). Median survival with HYCAMTIN capsules plus BSC was 25.9 weeks (95% CI, 18.3 to 31.6) and was 13.9 weeks (95% CI, 11.1 to 18.6) with BSC alone. The hazard ratio was 0.64 (95% C.I: 0.45, 0.90), indicating a 36% reduction in the risk of death for patients who received HYCAMTIN capsules plus BSC compared with the patients who received BSC alone.(1) The most common Grade 3 or 4 hematologic adverse reactions with HYCAMTIN capsules were neutropenia (61%), anemia (25%) and thrombocytopenia (37%). The most common (>10%) non-hematologic adverse reactions (all grades) were nausea (27%), diarrhea (14%), vomiting (19%), fatigue (11%) and alopecia (10%).(2) About Small Cell Lung Cancer (SCLC)(3) SCLC is caused by an uncontrolled growth of cells beginning on the surface of the lung's breathing tubes (called bronchi) and tends to spread widely through the body. This is important because it means that surgery is rarely used as a treatment option. Chemotherapy is the most common treatment for SCLC. Although SCLC is often responsive to first-line treatments, patients may relapse. SCLC is most common in current or past smokers, but can also be caused by environmental risk factors such as exposure to radon and air pollution. About 15% of patients with lung cancer have SCLC, a fast-growing form of the disease. About HYCAMTIN® Capsules HYCAMTIN capsules belong to a class of drugs known as topoisomerase I (topo-I) inhibitors. Topo-I is a naturally produced protein essential for cell division in both normal and cancer cells. Interaction between topo-I and HYCAMTIN capsules results in permanent damage to the cell's genetic material and the death of dividing cells. Registration dossiers for HYCAMTIN capsules have been submitted in Europe, Canada and other markets around the world. Important Safety Information HYCAMTIN capsules can suppress the body's ability to produce disease fighting white blood cells, a condition known as neutropenia. In addition, the amount of clotting cells can decrease (thrombocytopenia). Generally, HYCAMTIN capsules have a mild to moderate non-hematologic toxicity profile. Other common side effects include nausea, vomiting, diarrhea and hair loss (alopecia).

Silicon Valley / San Jose Business Journal Telik Inc. said Monday a partial hold on clinical trials for its cancer drug was lifted by the U.S. Food and Drug Administration. The Palo Alto-based biopharm (NASDAQ:TELK) said it was asked in June to temporarily halt trials for Telcyta, designed to treat ovarian and lung cancer. The company said the FDA had some safety concerns over the drug. Telik said that after a complete review of data, regulators permitted clinical development to resume on Telcyta.

Congrats! That is fantastic news. I am so happy for you.

I am so sorry for the loss of your mother. Christine

Debi, The news of Tony's passing saddens me. Please accept my sincere condolences. Prayers for you and your family. Christine

Christine, I am so very sorry for the loss of your father. Christine

Even though lung cancer can take two decades to develop, when it is detected it is already at such an advanced stage that the chances of successful treatment are very small. An immune system protein may offer the early warning system experts have been looking for. You can read about this study in the journal Thorax. Lung cancer kills approximately 900,000 people each year. No effective warning system exists which can detect lung cancer during its early stages - when it is treatable. Sadly, the long-term outlook for current lung cancer patients have not changed much during the last three decades. In this study scientists analyzed plasma samples from 50 healthy volunteers and 104 people with lung cancer. They were testing for autoantibodies - immune system proteins that are directed at the body's own tissues in response to certain chemical signals in the body. In particular, they were looking for a panel of seven autoantibodies - they are all linked to solid tumors which are found in lung cancer, ovarian cancer, breast cancer and prostate cancer. These seven autoantibodies are triggered when cancerous changes are happening. They found that 80% of patients with confirmed lung cancer had very high levels of at least one of the seven autoantibodies. These autoantibodies had been found in eight of the nine patients whose cancer had not infiltrated the lymph nodes - when the disease has not yet spread elsewhere and the chance of a cure is much greater. Out of all the healthy volunteers, only one had more than one of these autoantibodies in the blood. According to previous research, these autoantibodies can be detected five years before the clinical symptoms of lung cancer start to show - in other words, five years before lung cancer is detected. A previous study had also shown that these autoantibodies can be picked up in patients before their breast cancer is detected. As the lungs are sensitive to radiation it is not ideal to use x-rays for detecting lung cancer. A blood test, however, has no side effects and is much cheaper than imaging. And the panel can be altered to include more or different autoantibodies for lung and other cancers. The researchers say the test could be used for higher risk groups, such as smokers and second-hand smokers. If someone gets a positive result, he/she could be referred for more detailed scans, such as a CT (computed tomography) or MRI (magnetic resonance imaging). "Autoantibodies in lung cancer: possibilities for early detection and subsequent care" Thorax 2007; doi: 10.1136/thx.2007.083592 http://thorax.bmj.com Written by: Christan Nordqvist Copyright: Medical News Today

Video URL: http://www.13wham.com/mediacenter/local ... wokr13.com 13WHAM.com (Liz Bonis) A recent discovery could lead to a big breakthrough in treating lung cancer. As part of a national trial, lab researchers say they've found a pathway that could someday help with targeted treatment in chemotherapy. Recent studies show that a combination of surgery and chemotherapy may be more effective for some lung cancer patients than treating with either therapy alone. The problem is chemo treatment can be trial and error; researchers don't know who will benefit from taking these drugs or which drugs might work best in certain patients. Researcher Dr. Michael Reed said, “It would be ideal to be able to know ahead of time, before treatment which combinations of medications have the highest likelihood of success.” Reed’s team recently published a study in the journal Cancer Research which details a remarkable discovery. They found that turning off a certain tumor suppressor or pathway that controls the growth of cells, alters the response of lung cancer cells to chemotherapy. “Right now we are studying the response to specific individual agents. In the real world, we treat with combination therapy. Our next step is to start using a combination of agents to be able to better predict in a more realistic setting response to therapy,” Reed said. That means, eventually, doctors could target chemo based on a patient’s specific type of tumor. This study was funded from a grant from the National Institutes of Health. Final results are not expected for at least a couple more years.