Friday, October 23, 2009
Saturday, October 17, 2009
Interesting Stuff
This article was from www.about.com
Ipilimumab is the drug that Bobby is currently getting. The clinical trial that is mentioned in this article is not the one Bobby is enrolled in. There are many options out there, but it is very hard to get accepted. One person mentioned that, "in one of these trials only 90 patients on the entire planet would be accepted." In Bobby's trial, it was 70.
Top 5 Treatments for Melanoma
Treatment of advanced (stage III and IV) melanoma is in desperate need of some good news. Although the incidence of melanoma is increasing by a whopping 3 to 5% per year in the United States, current therapies don't significantly increase survival in most patients and no new first-line medicines have been approved in over 10 years.
Clinical trials are the best hope for a long-lasting reduction or elimination of metastatic melanoma (called a "durable response" or "complete response" by doctors). The US National Institutes of Health lists 27 late-stage (phase III) clinical trials currently recruiting patients with melanoma. Many of the trials are testing new combinations of existing drugs, new ways to administer them, or new surgical procedures, but some are investigating brand new drugs. The most promising are the following:
Ipilimumab (MDX-010, MDX-101, or BMS-734016) - Ipilimumab is an antibody that activates the body's immune system to fight melanoma by inhibiting the CTLA-412 molecule. Three previous phase II clinical trials have shown that treatment with ipilimumab results in a one-year survival rate of 47% to 51% for people with stage III or IV melanoma, which is almost double the average. (Bobby is stage IV) Made by Medarex and Bristol-Myers Squibb. The trial that Bobby is in has 2 parts. Half of the patients are getting 'ipi" made by Medarex and the other half are getting the same drug made by Bristol-Myers (BMS). Since they expect FDA approval of this drug, Medarex could not keep up with the production. Because BMS is larger, and has more $$$, they are running the trial to show that their "ipi" is equivalent to the Medarex drug.
Allovectin-7 - This novel gene therapy is injected directly into the tumors of patients with stage III or IV disease, which then alerts the body's own immune system to attack the tumor. Earlier trials of Allovectin alone showed that tumors in 4% to 9% of patients responded to the therapy. The new trial is comparing Allovectin-7 to the standard chemotherapy treatment, either dacarbazine or temzolomide.
Oblimersen (Genasense) - Genasense is a unique inhibitor of Bcl-2, a protein made by cancer cells that is thought to block chemotherapy-induced cell death (called "apoptosis"). So by reducing the amount of Bcl-2 in cancer cells, Genasense may enhance the effectiveness of current anticancer treatment. Previous studies demonstrated that Genasense combined with the chemotherapy drug dacarbazine tripled response rate and significantly increased overall survival compared to dacarbazine alone.
MVax - MVax is a melanoma vaccine prepared from the patient's own cancer cells. Several studies have shown that MVax followed by interleukin-210 can lead to a complete response in up to 13% of patients, double that of interleukin-2 alone. MVax is also effective in patients with stage III melanoma when given post-surgery: it doubled the 5-year survival rate compared to surgery alone.
OncoVEXGM-CSF - OncoVEXGM-CSF is a vaccine that works by spreading within tumors and causing the death of cancer cells while stimulating the immune system to destroy metastatic tumors. Previous results from 50 patients with inoperable stage IIIc/IV melanoma demonstrated that 28% of patients responded, including 12% with a complete response. The new trial is enrolling patients with previously treated but inoperable stage IIIb, IIIc or IV melanoma and is designed to compare OncoVEXGM-CSF to a naturally-occurring substance in the body called a "granulocyte monocyte colony stimulating factor" (GM-CSF), which increases white blood cells.
Why Participate in Clinical Trials
Those who take part in clinical trials get access to the latest treatments that are often not available anywhere else. These treatments may be better than the standard of care and may offer the only hope for those with advanced disease. Simply put, participation in clinical trials by patients is the only way research will advance toward an eventual cure for melanoma.
Source: ClinicalTrials.gov. US National Institutes of Health. 10 February 2009.
©2009 About.com, Inc., a part of The New York Times Company. All rights reserved.
Ipilimumab is the drug that Bobby is currently getting. The clinical trial that is mentioned in this article is not the one Bobby is enrolled in. There are many options out there, but it is very hard to get accepted. One person mentioned that, "in one of these trials only 90 patients on the entire planet would be accepted." In Bobby's trial, it was 70.
Top 5 Treatments for Melanoma
Treatment of advanced (stage III and IV) melanoma is in desperate need of some good news. Although the incidence of melanoma is increasing by a whopping 3 to 5% per year in the United States, current therapies don't significantly increase survival in most patients and no new first-line medicines have been approved in over 10 years.
Clinical trials are the best hope for a long-lasting reduction or elimination of metastatic melanoma (called a "durable response" or "complete response" by doctors). The US National Institutes of Health lists 27 late-stage (phase III) clinical trials currently recruiting patients with melanoma. Many of the trials are testing new combinations of existing drugs, new ways to administer them, or new surgical procedures, but some are investigating brand new drugs. The most promising are the following:
Ipilimumab (MDX-010, MDX-101, or BMS-734016) - Ipilimumab is an antibody that activates the body's immune system to fight melanoma by inhibiting the CTLA-412 molecule. Three previous phase II clinical trials have shown that treatment with ipilimumab results in a one-year survival rate of 47% to 51% for people with stage III or IV melanoma, which is almost double the average. (Bobby is stage IV) Made by Medarex and Bristol-Myers Squibb. The trial that Bobby is in has 2 parts. Half of the patients are getting 'ipi" made by Medarex and the other half are getting the same drug made by Bristol-Myers (BMS). Since they expect FDA approval of this drug, Medarex could not keep up with the production. Because BMS is larger, and has more $$$, they are running the trial to show that their "ipi" is equivalent to the Medarex drug.
Allovectin-7 - This novel gene therapy is injected directly into the tumors of patients with stage III or IV disease, which then alerts the body's own immune system to attack the tumor. Earlier trials of Allovectin alone showed that tumors in 4% to 9% of patients responded to the therapy. The new trial is comparing Allovectin-7 to the standard chemotherapy treatment, either dacarbazine or temzolomide.
Oblimersen (Genasense) - Genasense is a unique inhibitor of Bcl-2, a protein made by cancer cells that is thought to block chemotherapy-induced cell death (called "apoptosis"). So by reducing the amount of Bcl-2 in cancer cells, Genasense may enhance the effectiveness of current anticancer treatment. Previous studies demonstrated that Genasense combined with the chemotherapy drug dacarbazine tripled response rate and significantly increased overall survival compared to dacarbazine alone.
MVax - MVax is a melanoma vaccine prepared from the patient's own cancer cells. Several studies have shown that MVax followed by interleukin-210 can lead to a complete response in up to 13% of patients, double that of interleukin-2 alone. MVax is also effective in patients with stage III melanoma when given post-surgery: it doubled the 5-year survival rate compared to surgery alone.
OncoVEXGM-CSF - OncoVEXGM-CSF is a vaccine that works by spreading within tumors and causing the death of cancer cells while stimulating the immune system to destroy metastatic tumors. Previous results from 50 patients with inoperable stage IIIc/IV melanoma demonstrated that 28% of patients responded, including 12% with a complete response. The new trial is enrolling patients with previously treated but inoperable stage IIIb, IIIc or IV melanoma and is designed to compare OncoVEXGM-CSF to a naturally-occurring substance in the body called a "granulocyte monocyte colony stimulating factor" (GM-CSF), which increases white blood cells.
Why Participate in Clinical Trials
Those who take part in clinical trials get access to the latest treatments that are often not available anywhere else. These treatments may be better than the standard of care and may offer the only hope for those with advanced disease. Simply put, participation in clinical trials by patients is the only way research will advance toward an eventual cure for melanoma.
Source: ClinicalTrials.gov. US National Institutes of Health. 10 February 2009.
©2009 About.com, Inc., a part of The New York Times Company. All rights reserved.
Friday, October 9, 2009
Tuesday, October 6, 2009
Saturday, October 3, 2009
Today is Bobby's Birthday
I haven't posted in a while. We've been doing pretty well so there hasn't been much to post. I've been working more than usual (someone has to) so I haven't had spare time. Too much to do...for everyone!
Bobby was a little sad this morning. Birthdays should be celebrations...he has other things to think about. One always wonders if this will be the last...or one of just a few to celebrate. I know it is hard and he thinks about it often. We keep the spirits up and his mind on other things.
Bobby bought me a dozen roses and a big huge bag of Peanut M&Ms last night...my favorite. He has been working on many projects around the house. Physically, he feels good. They wouldn't expect any symptoms from the medicine until after the 2nd dose (which is Tuesday). Bobby & Jim went to Charlotte on Tuesday (this week). Bobby enjoyed the time with Jim (6 hours each way). It was great that Jim could go along with him. 2 weeks ago, Bobby and I went to Charlotte. We had to stay for 11 days. I left early to bring Dan home. Dan had gotten sick with the flu just before we had to leave. We decided it was best to take him along and he missed a week of school. We worked hard to keep his germs away from Bobby-and it worked. It was hard for Dan to be stuck in the camper with us although we tried to do little things along the way.
We hope everyone has been well. It is hard to keep up with everyone and what is going on with you and your lives. We think and talk about everyone...and who is doing what & where...and wondering how life is for our friends (and family).
Tonight, for Bobby's birthday, we are going out to dinner with Jim & his family, Bobby's parents, and Bobby & the kids & me. It will be nice to have a family meal. I will get a cake and I ordered some balloons. Things to embarrass the Birthday Boy! We'll keep you posted of anything new...and I'll try to keep up with everyone. Love to all!
Bobby was a little sad this morning. Birthdays should be celebrations...he has other things to think about. One always wonders if this will be the last...or one of just a few to celebrate. I know it is hard and he thinks about it often. We keep the spirits up and his mind on other things.
Bobby bought me a dozen roses and a big huge bag of Peanut M&Ms last night...my favorite. He has been working on many projects around the house. Physically, he feels good. They wouldn't expect any symptoms from the medicine until after the 2nd dose (which is Tuesday). Bobby & Jim went to Charlotte on Tuesday (this week). Bobby enjoyed the time with Jim (6 hours each way). It was great that Jim could go along with him. 2 weeks ago, Bobby and I went to Charlotte. We had to stay for 11 days. I left early to bring Dan home. Dan had gotten sick with the flu just before we had to leave. We decided it was best to take him along and he missed a week of school. We worked hard to keep his germs away from Bobby-and it worked. It was hard for Dan to be stuck in the camper with us although we tried to do little things along the way.
We hope everyone has been well. It is hard to keep up with everyone and what is going on with you and your lives. We think and talk about everyone...and who is doing what & where...and wondering how life is for our friends (and family).
Tonight, for Bobby's birthday, we are going out to dinner with Jim & his family, Bobby's parents, and Bobby & the kids & me. It will be nice to have a family meal. I will get a cake and I ordered some balloons. Things to embarrass the Birthday Boy! We'll keep you posted of anything new...and I'll try to keep up with everyone. Love to all!
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