Topotecan and brain mets

[john]

http://theoncologist.alphamedpress.org/ ... oncologist

[mhutch1366]

That is a very encouraging report. Thanks, John.

XOXOX

MaryAnn

[john]

I would think that it is for SCLC, since topetecan is used for SCLC. I guess it is unfortunately like any treatment, that it is not 100%.

The full article does talk about the potential use for nsclc and brain mets.

The article said 33%-63%, but maybe further research will find out why those 33%-63% respond and hopefully find a way to make it more effective for the others.

Since Topetecan is a 2nd line chemo, maybe it needs to be used earlier and possibly as a combination. The article said it worked better with chemosensitive tumors. Once someone has had a 1st line of chemo, sometimes the tumor becomes resistant

The article also talks about using it with Temozolomide

Although the data supporting the use of topotecan in the treatment of brain metastases come mostly from phase II studies and anecdotal reports, the compelling nature of the results warrants additional studies. In particular, phase III studies of topotecan with stereotactic radiosurgery or whole brain cranial irradiation versus stereotactic radiosurgery or whole brain radiation alone in patients with brain metastases would be a logical first step to define the effect of topotecan on progression-free survival and quality of life in patients with brain metastases

[kimblanchard]

John

I have been busy all this week getting my first 5 day round of Topotecan to scotch SCLC metastases. Five weeks after the much vaunted PET scan gave me a clean lack of metabolic activity, I got a CT scan because I felt substernal pain. My oncologist called me in after his vacation to tell me there were small 1cm nodules on my adrenal glands and that he wanted X-ray guided needle biopsy proof of their malignancy. I then informed him that thaumaturgic axial tomograpy neglected to find a 4 cm axillary lump found with a low tech finger. He said he would get a surgeon to biopsy it. When I learned that I would need general anaesthetic with intubation, I walked out on the surgeon. The oncologist said, no lymph node surgery, no chemotherapy, so I was forced to under go the procedure and delay the chemotherapy for three weeks while dragging around a canteen sized drain bottle sewn to my skin. Of course it was SCLC. All this time I have been feeling slightly confused and have trouble with my handwriting.

The paper that you posted looks like a bit of good luck for me, though I have only read the abstract. They could not save the last King of England, Richard Boon nor James Varney of Ernest Goes to Heaven, but it would be nice to keep ones brain going longer than other parts.

Dan