Question about low-dose Chem0

[Elaine]

I just got home from the oncs, and I asked about low dose chemo. I knew I shouldn't have went alone but had no choice. Couldn't understand what he was saying, mostly because he again upset me a great deal (another story,)

Anyway, what is the status of low dose chemo as of right now. Has anyone been on what is called a low-dose regime(sp) and if so, have the side effects been less and has it been effective.

Thanks

Elaine

[Guest Jim]

Here is part of my wifes story I posted about a year ago.

On 04/05/01 Pam had a CEA done. It was 2.6 ( NORMAL!!!!!!! ) This surprised us and the doctor, then to top it off a few days earlier Pam had a follow up with her heart doctor and he had some blood work done and unknown to us he had a CA-125 blood tumor marker done and sent it to Pam's oncologist. It was 13.0 . Normal is 0 to 35 . This was a great day but we never heard the word we had been longing to hear ( remission ) still a great day anyway. We can wait. From here the oncologist started slowly bringing Pam down to a maintenance dose. Pam went 4 on 1 off, 4 on 1 off, 3 on 1 off, 2 on 1 off, and finally around 08/10/01 she was down to 1 treatment of 135 mg every other week from then on. I don't know what Pam's oncologist was thinking when he put Pam on a maintenance dose of every other week but I had read that low dose Chemo/Taxol for a extended period of time, 1 year or more, has had much better results with chemo resistant tumors, held remissions longer (if not forever), and had a lot less side effects. It is thought that when one goes from high dose to low dose chemo, the chemo goes from killing cancer cells to cutting off the blood supply to the tumor called angiogenesis inhibition, although it will still kill cancer cells the conventional way to some degree, new mets for instance. The link below explains this concept better and although taxol at 135 mg every other week for a extended period of time dosn't seem the same, to me it seems similar.

http://www.cancerprotocol.com/low_dose_ ... erapy.html

Below is a link to the full story. I belive that the maintenance dose for an extra 7 to 8 months and the things she took to to stop resistance made all the difference.

http://health.groups.yahoo.com/group/ca ... sage/20661

[gpawelski]

Angiogenesis & Low Dose Chemotherapy

Giving low doses of several drugs every day by mouth. There would be no needles and the side effects are expected to be mild. Unlike standard chemotherapy, which is given in high doses to kill as many cancer cells as possible, the lower-dose regimen is meant to attack the blood vessels that feed the tumor. Tumors create their own supply lines by secreting substances that stimulate the formation of new blood vessels and researchers suspect that frequent low doses of certain drugs may disrupt the growth of those new vessels, starving the tumor.

The treatment includes small daily doses of standard chemotherapy drugs and two other drugs that have been found to inhibit the formation of new blood vessels, called angiogenesis. One is Celebrex and the other is Thalidomide. It is offered only to people who have no other options, who have advanced tumors that standard treatment cannot cure or those for whom standard chemotherapy has quit working.

Women with advanced breast or ovarian cancer are being given smaller, more frequent doses of chemotherapy to reduce side effects. It is hoped that low-dose treatment may help other cancer patients, not just those who are considered terminal. It may work just as well or even better, maybe through this ability to cause an anti-angiogenesis effect.

This approach to treatment is based on something that can frequently occur in people, when a tumor becomes resistant to chemotherapy and high doses stop working. It is believed that angiogenesis plays a role. Angiogenesis is essential to the survival of many tumors. Many chemotherapy drugs, in addition to killing tumor cells, also fight angiogenesis. But, if these medicines stop angiogenesis, chemotherapy should work better than it does. Blood vessel cells are less likely than tumor cells to become resistant to chemotherapy, so if cancer cells become drug resistant, these medicines should still be able to shrink tumors by destroying their blood supply.

The reason chemotherapy was not stopping angiogenesis was that chemotherapy is usually given in big doses, with breaks of several weeks between doses to let the body recover. During the breaks, the tumor's blood vessels could grow back. By giving chemotherapy more often, at lower doses, it might prevent the regrowth of blood vessels and kill the tumor or at least slow its growth.

It is especially important to study low-dose therapies now because they are being used increasingly in clinics. Doses, timing and combinations all need to be worked out. Doctors need to find out whether the treatments can make patients live longer and whether tumors will eventually outsmart the drugs and find ways to survive even without angiogenesis.

For further information about clinical trials, refer to the National Cancer Institute's website: http://cancertrials.nci.nih.gov

[karen335]

Elaine,

Thanks for asking your question. Is this the treatment your onc wants to dod for you. I have heard low dose is better that high dose or every three weeks... Please keep us posted.

God Bless,

Karen

[Jerrye]

Elaine,

I had low dose chemo(Taxol/Carbo), once every week for 3 weeks at the same time I had radiation to my sternum, right femur and left hip. I did not have any side effects, my blook counts did not even dip.

In fact, I thought this chemo thing was a piece of cake - until I got my first full dose chemo 3-1/2 weeks ago. Even after the first full dose, I mostly had extreme fatique and constipation as a side effect (and of course my hair is falling out). Go for it, you will never know until you try.

Jerrye

[gpawelski]

The October 2005 issue of Ultrasound in Medicine and Biology reports that researchers at the University of Pennsylvania School of Medicine are studying the use of ultrasound to disrupt the vessels supplying blood and nutrition to tumors, much like cancer treatment utilizing anti-angiogenic therapies. After all, cutting-edge techniques can often provide superior results over tried-and-true methods that have been around for many years.

This approach is in keeping with the latest studies of cancer treatment utilizing antiangiogenic therapies, in which they look for ways to stop the growth of vessels supplying blood and nutrition to tumors, rather than develop methods to kill tumor cells themselves. In the future, treatments with ultrasound either alone or in combination with chemotherapeutic agents could be used to treat cancers.

Nobody believed Judah Folkman when, in the 1960s, he claimed that the growth of cancers could be stopped, even reversed, by blocking the tiny vessels that feed them blood. Over the years, however, he has survived peer rejection of his theory, and gone on to develop drugs that did what he predicted they would do. The angiogenesis-blocker boom is on.

[Lisa O]

This is fascinating. I have had tremendous luck with celebrex and Iressa. My Oncologist does believe that oral drugs may also be the next step due to growth rate of BAC.