john
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Posts posted by john
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try this link for current clinical trials ... I think phase II
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MAC-321 is a new chemo based on a taxane (like taxol). There is an new clinical trial for this (multiple locations).
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the lymph node might not mean anything ... though it seems as if it is rare
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Kathy,
That is great. I read that you really love your current doctor. That is probably one of the most important things.
Hopefully the Iressa will keep everything stable.
Even with the lymph node it does seem like he is responding well - no pleural effusion, etc. I read that most doctors don't do a biopsy of the lymph node - what are you doctors thoughts on that?
Take care
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I've read that Iressa has a 15% chance of working. So if chemo has stopped working, this may be one of the few things available. It seemed like the chemo for Tim was working before. Why switch to Iressa at this point?
Have you tried getting a 2nd opinion at somewhere like Dana-Farber. Is this an option?
The lymph node under the arm may be due to an infection. Usually axillary lymph nodes are not mentioned too much with lung cancer. Mediastinal and supraclavicular lymph nodes are mentioned.
The one article where I saw about axillary lymph nodes was associated with SCLC. If axillary lymph nodes are enlarged then it upstaged to extensive vs. limited.
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Here is the exact trial .... not sure if he could be taken as refractory small cell.
A Phase II, Open-Label, Multicenter Study to Evaluate the Efficacy of 90Y-SMT 487 Administered Intravenously to Patients with Refractory Small Cell Lung or Advanced Metastatic Breast Cancer Expressing Somatostatin Receptors as Determined by OctreScan® Scintigraphy [CSMT487 A-Industry Study] (PI - Thomas O'Dorisio), Contact Pam Zehr or Linda Larson
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Carleen,
Here is a clinical trial that you may want to look into. It is for SCLC,
but is based on somatostatin. Not sure if this is any better than something else, but may be worth researching. Have you asked the onc about Gleevac and checking if Keith has the c-kit gene?
http://www.uihealthcare.com/depts/cance ... rials.html
Take care,
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The RESAN vaccine doesn't have much scientific basis. There are clinical trails of vaccines throughout the US though and your husband would have to match the protocol. Take care
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I dont know the anwer, but search for the Lance Armstrong foundation web site. He had to have his sperm saved and now he and his wife have three children. He has a foundation that provides information and may provide information to your questions.
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May decrease the effectiveness of Camptosar/Irinotecan/CPT-11 ...
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Yes, bob made a good point. You have to feel comfortable with the Dr and feel like he is willing to work with you not "At" you. And unfortunately, you'll get different opinions from different doctors. DaveG seems to have a good relationship with his Dr. This is probably ideal, where the dr will work in a collaborative manner.
Best of luck with finding your answers.
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There are clinical trials going on in the US.
http://www.clinicaltrials.gov/ct/search ... ung+cancer
They're only offered in texas
Texas
Burzynski Research Institute, Houston, Texas, 77055-6330, United States; Recruiting
Stanislaw R. Burzynski, MD, PhD 713-335-5697
Don't know much about it. I believe it got some bad press, but Burzynski managed to get it to a clinical trial (phase II), so there might be something there.
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FOR IMMEDIATE RELEASE:
June 9, 2003
HER2 RECEPTOR MAY BE IMPORTANT TARGET FOR BRONCHIOALVEOLAR CARCINOMA THERAPY
(CHICAGO) — A new study suggests the combination of two new “smart drugs” may be effective in treating bronchioalveolar carcinoma (BAC), a type of non-small cell lung cancer generally considered resistant to chemotherapy. Researchers from UC Davis Cancer Center reported the finding last week at the American Society for Clinical Oncology annual meeting.
“This is an important breakthrough,” said Paul Gumerlock, associate professor of hematology & oncology at UC Davis Cancer Center and an author of the study. “It suggests a combination of drugs that block EGFR expression with drugs that block HER2 expression may have potent activity against a previously untreatable form of lung cancer.”
Iressa and Tarceva are examples of EGFR blockers; Herceptin was the first HER2 blocker to reach the market. All three drugs are examples of a new generation of so-called “smart” chemotherapy agents that specifically target cancer cells.
About 3 percent of all lung cancer patients have pure BAC tumors, and about 20 percent of all non-small cell lung cancers possess some BAC features. Unlike most lung cancers, BAC occurs more frequently in women than in men, and more frequently in nonsmokers than in smokers. It appears to be increasing in incidence. Patients with BAC generally live longer than those with more common non-small cell lung cancers, but BAC tumors are usually too diffuse for surgery and unresponsive to existing chemotherapeutic agents.
Preliminary research from other centers and anecdotal reports from around the country have suggested a role for the EGFR blockers Iressa and Tarceva in BAC. The UC Davis study provides new evidence that combining an EGFR blocker with a HER2 blocker may be more effective than an EGFR blocker alone.
In the study, UC Davis investigators examined tissue specimens collected from BAC patients enrolled in a previous clinical trial of the drug paclitaxel. The specimen bank represents one of the largest collections of BAC tissue in the country. Wilbur Franklin, professor of pathology at the University of Colorado in Denver, participated in the study.
The investigators found that although EGFR and HER2 expression varied among the tumors, BAC proliferation correlated with HER2 but not EGFR expression.
“This suggests that perhaps it’s the combination of EGFR and HER2 that may explain the unusual biology of BAC,” Gumerlock said.
Scientists at UC Davis Cancer Center, who participated in the design of the first clinical trial of Iressa in BAC patients, now hope to launch a clinical trial of HER2- and EGFR-blocker combination therapy in the treatment of BAC.
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· Health/Science
· Lung Cancer
International
· Italy
Roman nose sniffs out lung cancer
Source: Agence France Presse (AFP), 2003-05-07
Intro: University of Rome scientists have pioneered an electronic nose that, they say, may one day give an early warning to people with lung cancer.
The experimental device works in the same way as hi-tech hygiene "sniffers" that are already in use the food industry, which analyze air on the production line for the tell-tale chemicals released by rotting ingredients, New Scientist says.
In the case of lung cancer, the e-nose responds to a signature cocktail of alkanes and derivatives of benzene exhaled by someone with the disease, the British weekly reports in next Saturday's issue.
The eight-sensor nose proved to be 100-percent accurate in a test at a Rome hospital in which it analyzed a breath sample from 35 people with a large lung tumour and 25 others who were healthy.
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Current clinical trials are in progress for Gliadel wafer for brain mets
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It could be his hemocrit is low from the chemo. Is he receiving EPO (procrit)? As ginnyd said hopefully it isnt brain mets. Hypercalcimia (sp?) from bone mets can cause dizziness.
It probably (and hopefully) is the chemo though.
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The study that DaveG posted awhile ago seems to indicate that adjunctive chemo may be usefull for early stage lung cancer.
Here is a clinical trial that you may want to investigate.
http://www.clinicaltrials.gov/ct/show/N ... 99?order=3
What is the grade of the tumor? If it is a high-grade (aggressive) tumor then it may be better to treat it aggressively.
Also there are other prognostic indicators, such as vascular invasion in the tumor. You could try to find out from the Dr or Path about the different prognostic indicators for your husbands tumor. Based on that
it may help what course to take.
K-ras and P53 mutations are associated with poor prognosis. There are some vaccines that target these mutations, though.
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maybe something to ask the Dr about ...
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It really sucks. Green tea is supposed to help with cancer, but it contains a lot of vitamin K which can cause blood clots.
Dietary Sources of vitimin K
Foods that contain a significant amount of vitamin K include beef liver, green tea, turnip greens, broccoli, kale, spinach, cabbage, asparagus, and dark green lettuce. Chlorophyll, which is water soluble, is the substance in plants that gives them their green color and provides vitamin K.
Freezing foods may destroy vitamin K, but heating does not affect it.
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I didnt know this... But I was helping my dad clean the house. Found meds for my mom ... HRT!
I think that most doctors are not recommending hormone replacement therapy anymore. Black cohash may help.
In anycase, one of the oncs was talking to my mom and said, "it is strange, seeing so many non-smoking women getting lung cancer"
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Study Finds Estrogen May Fuel Lung Cancer Growth
Long known to be instrumental in fueling the growth of breast cancer, estrogen may spur the same process in lung cancer, according to the findings of a University of Pittsburgh study presented at the annual meeting of the American Association for Cancer Research in San Francisco. The results are the first to directly demonstrate increased growth of non–small-cell lung cancer in the presence of estrogen.
More Estrogen Receptors on Lung Cancer Cells
“In our studies, we found greater numbers of estrogen receptors on lung cancer cells than on normal lung cells, strongly suggesting a role for this hormone in enhancing tumor growth,” said Jill Siegfried, PhD, principal investigator on the study and vice chairman of the department of pharmacology at the University of Pittsburgh. “These results are important in understanding how lung cancer affects women.”
Annually, lung cancer kills about 60,000 women in the United States. Non–small-cell lung cancer accounts for 80% of lung cancer cases. Some population studies have suggested that women develop the disease at an earlier age and with less tobacco exposure than do men, prompting scientists to search for biological reasons for these discrepancies. Investigations by Dr. Siegfried and others have indicated that there are fundamental differences in lung cancer between women and men, both in regard to the type of tumors that develop and the molecular mechanisms underlying the disease.
“Women have a naturally higher circulating estrogen level than men, and this difference may contribute to their increased susceptibility to lung cancer,” said Dr. Siegfried. “As in breast cancer, blocking the effects of estrogen could prove an important therapeutic strategy to halt disease progression or prevent recurrence. In addition, blocking estrogen receptors could prove beneficial in preventing lung cancer in women at high risk, much like blocking estrogen’s effect has been shown to prevent breast cancer in women at increased risk for that disease.”
Two Common Estrogen Receptors Examined
The study looked at two common estrogen receptors (ER-alpha and ER-beta) on lung cancer cell lines, cultured normal lung cells, and normal and tumor tissues from lung cancer patients. The researchers found that normal lung tissue rarely showed detectable levels of ER-alpha, whereas lung tumor cells had significantly higher levels of this receptor. ER-beta was found in both normal and tumor cells.
Treating cultured lung cancer cells with estrogen resulted in increased cell division, and estrogen given to animals with human lung cancers resulted in increased tumor growth. Antiestrogens inhibit this effect. Together, these results suggest that estrogen plays a role in lung cancer development.
Previous research conducted by Dr. Siegfried demonstrated that a gene for the protein gastrin-releasing peptide receptor is also more active in lung tissues in women than in men. This finding provides another possible biological reason for the observed differences in lung cancer between the sexes.
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©
MRI future for early detection?
in CLINICAL TRIALS
Posted
EARLY DETECTION
A perfect picture
Kristine Novak
Despite the fact that magnetic resonance imaging (MRI) is a useful non-invasive means of identifying lymph nodes that contain large metastatic tumours, it cannot detect metastases at very early stages. Ralph Weissleder and colleagues have addressed this issue by using magnetic nanoparticles in conjuction with high-resolution MRI to find small, otherwise undetectable lymph-node metastases in patients with Prostate cancer.
Lymphotropic superparamagnetic nanoparticles have a superparamagnetic iron oxide core that can be detected by MRI, surrounded by a dense packing of dextrans that allow maintenance of the nanoparticles in the circulation. Weissleder and colleagues used MRI to show that, after injection, the particles circulate and accumulate in the lymph nodes. In normal lymph nodes, this signal eventually decreases as the particles are taken up by macrophages. In lymph nodes that contain metastases, however, there is either a limited decrease in signal intensity, or discrete focal defects within the node, due to replacement of nodal architecture by the tumour.
But how sensitive and accurate is this method of tumour detection? The authors analysed 334 lymph nodes taken from 80 patients with prostate cancer. As confirmed by surgical or biopsy analysis, standard MRI was only able to detect metastases in 45% of patients. MRI analysis of nanoparticle distribution, however, correctly identified all (100%) patients with nodal metastases. The technique also correctly identified 96% of patients that were metastasis-free.
Many of the metastases detected were less than 2 mm in diameter. This non-invasive technique is therefore a useful screening approach to identify patients that would not otherwise have been candidates for lymph-node surgery.
References and links
ORIGINAL RESEARCH PAPER
Harisinghani, M. G. et al. Noninvasive detection of clinically occult lymph-node metastases in prostate cancer. N. Engl. J. Med. 348, 2491-2499 (2003) | Article | PubMed |
FURTHER READING
Weissleder, R. Scaling down imaging: molecular mapping of cancer in mice. Nature Rev. Cancer 2, 11-18 (2002) | Article | PubMed | ChemPort |
WEB SITE
Centre for Molecular Imaging Research, Massachusetts General Hospital