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Maintence Program to keep SCLC in remission


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HI all,

Eenzymic/hormone maintence programs.. I've been hearing a lot about these programs for SCLC to keep it in remission and need to start researching them. John or Anyone know anything about it? There are probably posts somewhere on it but I'm not sure where??? Any help would be greatly appreciated... or anyone who has information on these programs.

Thank you!


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That sounds interesting...I hope someone else knows the answer.

The only thing I am aware of is something called "chemoprevention" but I am not sure if this has been developed yet or not. I read about in an article on SCLC which was published about 5 years ago and it was still under investigation.


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Not sure if this could be something to look into ... BUT

Telomerase is an enzyme and found in 98% of sclc tumors. Telomerase allows a cell to become immortal, thus cancer results.

There is a trial at the NCI though it does not seem to be a telomerase inhibitor. it is a vaccine based on telomerase

http://www.clinicaltrials.gov/ct/show/N ... 40?order=1

Figure 4. Clinical trial design for telomerase inhibitors. (a) Aproposed phase III clinical trial design of telomerase inhibitors asmaintenance therapy in small cell lung cancer (SCLC) afterdebulking chemotherapy. hTERC expression is up-regulated in98% of cases of SCLC [2]. SCLC is extremely sensitive to first-line chemotherapy, but with a relatively short duration ofremission on completion of chemotherapy, with poor responsesto second-line chemotherapy regimens as a result of acquired orintrinsic drug resistance. SCLC is therefore an ideal model formaintenance studies with telomerase inhibitors. (B) A proposedphase III clinical trial design of telomerase inhibitors incombination with cytotoxic chemotherapy in advanced breastcancer, for example, in comparison with chemotherapy alone,with progression-free survival and overall survival (if there is norecognized salvage therapy) as the main endpoints410W. N. Keith et al.Copyright # 2001 John Wiley & Sons, Ltd.J Pathol 2001; 195: 404?14.


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patient population in whom new agents are evaluated.Demonstration of efficacy in `minimal disease state'patient groups requires a phase III-type design withrelatively long follow-up, compared with conventionalphase II studies. In order to justify proceeding to phaseIII studies with trial designs as outlined in Figures 4aand 4b, it will be necessary to demonstrate safety of theagent, to assess pharmacokinetics, and to have somemeasure of desired biological activity, such as inhibi-tion of telomerase activity and shortening of telomerelength within tumour biopsy tissues (Table 1). It isoften not possible to gain pre- and post-therapybiopsies and so it is important either to study a patientgroup where tumour tissue is readily available, or toconsider other surrogate tissue in which telomeraseactivity can be assessed.The challenges presented in the evaluation oftelomerase therapies will therefore require an inte-grated laboratory and clinical approach, with arational clinical trial design incorporating biologicalendpoints. With careful consideration of both tumourbiology and the appropriate clinical scenarios, theintroduction of telomerase-based therapeutics into theclinic is awaited with great anticipation.AcknowledgementsThe Cancer Research Campaign (UK), the Scottish HospitalEndowments Research Trust (SHERT), the European Commis-sion and Glasgow University support research in the authors' lab.References1. Shay JW, Wright WE. Hayflick, his limit, and cellular ageing.Nature Rev Mol Cell Biol 2000; 1: 72?6.2. Reddel RR. 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