Taxol?

[battleofbrooklyn]

Yay! My mom has enough strength back that the doctor agreed to more chemo. (How weird is it when you're HAPPY someone is going to inject you with poison?). She didn't tolerate the Topotecan she had as a second-line treatment, so he's starting her on Taxol. One hour, once a week. Anyone have experience with Taxol for small cell?

[gpawelski]

Taxol appears to increase the risk of lung inflammation (December 2001 Journal of the National Cancer Institute). It is sometimes used along with radiation treatments since it is thought the drug might enhance the radiation's effects. The combination may cause more problems than it solves, like radiation pneumonits. Radiatin pneumonitis is a lung inflammation that occurs from radiation. It may develop about eight weeks after completing a course of radiation. Taxol increases the chance of having this problem. Researchers have found out that this is more common in patients who receive Taxol. Taxol has not been shown to have any clear benefit.

True synergy is rather uncommon in most adult solid tumors. Most drug combinations in diseases such as lung cancer are merely additive, where the whole equals the sum of its parts, and not synergistic. In hematologic neoplasms (leukemia, lymphoma, multiple myeloma), true synergy is very common. In cases where drugs are only additive and not synergistic, nothing is learned by testing the drugs in combination over what is learned by testing them separately. So drugs in combination are only tested in cases where there is the realistic possiblity of seeing true synergy.

Such solid tumor drug combinations as Cyclophosphamide + Doxorubicin or Carboplatin + Taxol are virtually always only additive and not synergistic. Cisplatin plus Etoposide is virtually never synergistic in non-small cell lung cancer, but is synergistic 25% - 50% of the time in small cell lung cancer. Gemcitabine + Cisplatin is very often synergistic. Vinorelbine + Mitomycin c or Mitoxantrone is occasionally synergistic, as is Irinotecan + Cisplatin. The best combinations are those in which there is true synergy and in which the toxicities of the drugs in the combination are non-overlapping, so that full doses of each drug may be given safely.

[MilliBr1]

So happy to hear your mom is getting her strength back. Prayers the new treatment works.

[blaze100]

Hi B.of B.

You might want to make sure they watch your mom closely when they first start the taxol drip....less than 1cc of Taxol made me turn purple and stop breathing, but Benedryl got me back right away. Anyway, some people have a bad reaction. Hope it goes well for your mom. Love and Mercy, Barb

[jorja]

That is great news. Sorry but I have no experiences with Taxol. Praying that it works.

love,

jorja

[blaze100]

Hi B.of B.

You might want to make sure they watch your mom closely when they first start the taxol drip....less than 1cc of Taxol made me turn purple and stop breathing, but Benedryl got me back right away. Anyway, some people have a bad reaction. Hope it goes well for your mom. Love and Mercy, Barb

[Kaffie]

I had Taxol and did just fine on it.

I do have some joint pain in my hips

at night I have to turn over several

times every night.

During my treatment I had a little joint

pain but most of my symptoms were kept under

control with medications.

Kathy

[gail p-m]

Hi Battle of Brooklyn,

Was born there myself in the Flatbush area many years ago -- assuming it's Brooklyn, N.Y.

Glad your Mom is back up battling. It is strange how we can "rejoice" about sticking poisons in those we love. But I do know JUST what you mean.

My Dad did have Carbo and Taxol for NSCLC. After his 3rd treatment, we did notice some neuropathy in his feet and it was discontinued. Looking back on it, I think he had some evidence of this after his second treatment, but we didn't connect things then. So I would advise to watch out for this. My Dad describes the feeling as if he were walking on "pillows." He trips and has a strange sounding walk at times. It sounds more like he's stomping along than a gentle gait which you shouldn't really hear.

Good luck and prayers for your Mom.

gail p-m

[dadstimeon]

I had Taxol and had very good success with it, did it twice, but I have NSCLC not SCLC. No problems to speak of. Did seem to have more memory issues on that one. But overall did the trick and was worth it. Hope this helps. Good luck.

[Bill]

GDPawel >>There are over 100 chemotherapeutic agents and hundreds in the pipeline, all of which have approximately the same probability of working. The tumors of different patients have different responses to chemotherapy. It would be highly desirable to know what drugs are effective against your particular cancer cells before these toxic agents are systemically administered into your body. It requires individualized treatment based on testing individual properties of each patient's cancer.

/////////////////

IMO targeted therapy is the wave of the future. However, as we have already discovered, the therapeutic efficacy of targeted tx drugs are dependent on very specific patient ( responder ) critieria. Therefore, the testing that you speak of will eventually have to become mandatory. IMO, it's an economic reality as insurance companies will demand that tx be streamlined to best match patient criteria.

[gpawelski]

Bill

Back in December, the New York Tiimes ran an article on the efforts of scientists to put together the gaint puzzle of cancer genetics. What a cancer patient would like ideally, is to know whether they would benefit from chemotherapy. If so, which active drugs have the highest probability of working and then, those that are relatively non-toxic in a given patient. The technologies to do this are here. It's a question of, will we choose to use them?

The hallmark of cancer IS its heterogeneity. Not just many types of cancer, but many subtypes of cancer within a given type. The biologies are very different and the response to given drugs is very different. The heterogeneity of human cancer tells us that patients who have similar stages and grades of cancer and whose tumors have similar histologic features have a broad range of clinical outcomes. Cancer is not a single genetic disease, but rather hundreds of diseases consisting of various combinations of genetic alterations.

And of course, the hallmark of cancer treatment IS its heterogeneity. There are so many new drugs coming down the pike that there is simply no way to evaluate them in prospective, randomized clinical trials. All of these drugs tend to be partially effective, and even then, in only a minority of cases, and often for only a short duration of time. Tumor shrinkage should not be the criteria for approving cancer drugs. A patient responds to therapy when their tumor shrinks, but apparently this has nothing to do with survival. A tumor responds, shrinks a little, then quickly grows and spreads. The cancer comes back with a vengeance and the cancer patient is given a death sentence.

The “single most neglected area of cancer research” has been the acceptance of methods and technologies to be matchmakers between individual cancer with individual cancer treatment. The best chance for discovering the right formula is having all the drugs available to oncologists, and allow creativity and insight and the “Art of Medicine” enter into the process. A “standard” therapy would not be for everyone, but having a lot of tools (drugs) available and making use of various tests to match treatment to the patient.