Panelists: Mark A. Socinski, MD, Florida Hospital Cancer Institute; Tracey L. Evans, MD, University of Pennsylvania; Alexander Drilon, MD, Memorial Sloan Kettering Cancer Center; Vali A. Papadimitrakopoulou, MD, The University of Texas MD Anderson Cancer Center; Jared Weiss, MD, UNC Lineberger Comprehensive Cancer Center
Thursday, February 23, 2017
Wednesday, February 6, 2013
RRM1 gene can produce a better survival of pancreatic adenocarcinoma
Moffitt Cancer Center researchers have identified a gene that can better predict survival of adenocarcinoma of the pancreas, the fourth leading cause of cancer death in the United States. Researcher Richard Kim, MD, deputy member of the Experimental Therapeutics Program, and colleagues from several other research institutes have conducted a study to define the role of the ribonucleotide reductase M1 (RRM1). The gene encoding the regulatory subunit of ribonucleotide reductase RRM1, the molecular target of gemcitabine, a commonly used chemotherapy in pancreatic cancer.
In the study, published in the January 1 issue of Cancer, the research team studied the therapeutic value prediction RRM1 expression of the chemotherapy drug gemcitabine. They found that patients with adenocarcinoma of the pancreas surgically removed, low RRM1 expression provided a benefit in overall survival with gemcitabine therapy. High expression of RRM1 predicted gemcitabine therapy beneficial not.
"We have already suggested that low expression of RRM1 could predict the success of treatment of gemcitabine," said Kim. "This study was conducted to determine whether RRM1 expression is correlated with better survival in patients treated with gemcitabine."
This retrospective study included 122 patients who had undergone surgery for pancreatic adenocarcinoma 1999-2007. In the subgroup of patients who received gemcitabine treatment, those with low expression of RRM1 longer overall survival and a tendency to progression-free survival. Patients with high expression RRMI who received gemcitabine had a significantly higher overall survival and progression-free survival.
"Our results indicate that the best survival rate after surgical resection, the level of RRM1 expression can be used to select patients treated with gemcitabine and which are not," said Kim.
The authors note that their results were consistent with similar studies on the role of RRM1 plays in chemotherapy for patients with metastatic non-small cell lung cancer, but their findings "should be interpreted with caution" because of their small sample sizes and successful treatment of non-gemcitabine therapy after surgery.
"A validation study must be carried out before the present results can be applied clinically," Kim added.
Source: Moffitt Cancer Center
In the study, published in the January 1 issue of Cancer, the research team studied the therapeutic value prediction RRM1 expression of the chemotherapy drug gemcitabine. They found that patients with adenocarcinoma of the pancreas surgically removed, low RRM1 expression provided a benefit in overall survival with gemcitabine therapy. High expression of RRM1 predicted gemcitabine therapy beneficial not.
"We have already suggested that low expression of RRM1 could predict the success of treatment of gemcitabine," said Kim. "This study was conducted to determine whether RRM1 expression is correlated with better survival in patients treated with gemcitabine."
This retrospective study included 122 patients who had undergone surgery for pancreatic adenocarcinoma 1999-2007. In the subgroup of patients who received gemcitabine treatment, those with low expression of RRM1 longer overall survival and a tendency to progression-free survival. Patients with high expression RRMI who received gemcitabine had a significantly higher overall survival and progression-free survival.
"Our results indicate that the best survival rate after surgical resection, the level of RRM1 expression can be used to select patients treated with gemcitabine and which are not," said Kim.
The authors note that their results were consistent with similar studies on the role of RRM1 plays in chemotherapy for patients with metastatic non-small cell lung cancer, but their findings "should be interpreted with caution" because of their small sample sizes and successful treatment of non-gemcitabine therapy after surgery.
"A validation study must be carried out before the present results can be applied clinically," Kim added.
Source: Moffitt Cancer Center
Friday, January 25, 2013
Man who lost nose to cancer may get new one grown on his arm Read more: http://www.nydailynews.com/news/world/man-lost-nose-cancer-new-article-1.1247336#ixzz2IeJvj8Zf
ADAM GAULT/GETTY IMAGES
Scientists will create two prototypes in case someone drops one.
A man who lost his nose to cancer plans on getting it back by having doctors grow another one on his arm.
British scientists are taking a shot at the groundbreaking procedure by using the man’s bone marrow cells to grow the new nose, which they will then implant under skin in the man’s arm, in a highly controlled laboratory.
Doctors will initially grow two noses “just in case someone drops one,” using molds taken of the patient’s original nose before it was surgically removed, according to Dr. Alex Seifalian of University College London.
For two weeks, two prototypes will be maintained in a bioreactor with the heat set to approximate human body temperature, which helps the cells to multiply.
Simultaneously, Seifalian explained, doctors will insert a small balloon under the skin of one of the patient’s arms and inflate it little by little over weeks to help the skin stretch.
Once the facial features take shape, surgeons will implant one of them in the skin on one of the 53-year-old man’s arms. The unusual process will allow the new nose to grow its own skin and develop a normal blood supply.
"We can make the nose, but we can't make the skin," Seifalian told the Belfast Telegraph.
The made-from-scratch sniffer will remain in the man’s arm for four to six weeks as it continues to develop. After this period, doctors will then sew the nose to the patients face, open the nostrils and implant cells that allow for the secretion of mucus.
The exciting regenerative procedure is unprecedented, according to Seifalian. Doctors at University College London did not respond to a request for comment.
Read more:
Thursday, January 24, 2013
adenocarcinoma prostate
Study Shows ID Errors in Prostate Biopsies
As many as 3.5% of prostate biopsy specimens were contaminated or inadvertently switched with that of another patient, according to a review of 13,000 samples from 54 laboratories.
The overall error rate was less than 1%, but rates among different types of labs ranged as high as 3.51%. No laboratory included in the study had an error-free performance record.
Institutional approval for the study required investigators to remove all identifying information from the specimens. Consequently, the impact of the laboratory errors could not be assessed, as reported online in the American Journal of Clinical Pathology.
"It is possible that in a subset of cases, the adenocarcinoma from the foreign patient that was the source of the extraneous tissue exhibited sufficiently similar characteristics of the target patient such that either patient's diagnosis would have resulted in the same course of therapy," John D. Pfeifer, MD, PhD, and Jingxia Liu, PhD, of Washington University in St. Louis, wrote of their findings.
"Regardless of the portion of cases in which patients may have, by chance, received the correct treatment despite the specimen identity error, the fact remains that ... a diagnosis was assigned to the wrong patient with no knowledge or even suspicion of the error that had occurred."
The study examined the frequency of occult "specimen provenance complications" (SPCs), errors that occur without any indication of a problem. SPCs arise when specimens are matched to the wrong patients (type 1 error) or when one patient's specimen is contaminated by tissue from one or more other patients (type 2 error).
SPCs have obvious implications for patient safety and medicolegal actions, the authors noted in their introduction. However, the frequency with which these errors occur has remained unclear.
To describe the rates of both types of SPCs, Pfeifer and Liu analyzed data for 13,000 prostate biopsy specimens obtained in routine clinical practice. The specimens were processed by a variety of surgical pathology and urology group practice laboratories.
Data for the study came from Strand Analytical Laboratories, an Indianapolis company that has developed a DNA-based test for occult SPCs. The test employs short tandem repeat (STR) analysis, originally developed by the FBI.
"STR analysis has been shown to be particularly useful in identifying occult specimen identity errors," the authors noted in their introduction.
The investigators grouped the 54 laboratories into five categories based on work flow, location, and management structure: physician-owned labs within a group-practice setting, independent reference labs, hospital labs, nonphysician owned labs located in facilities shared with group practices, and labs that have the technical histopathology and professional pathology in separate facilities, necessitating transport of specimen slides.
The error rate for all labs combined was low: 0.26% for type 1 errors and 0.67% for type 2 errors. However, the authors pointed out, each SPC involved at least two patients, "the target patient and the foreign patient (or patients) whose tissue was misidentified as originating from the target patient."
Reference laboratories had the highest rate of SPCs: 0.37% for type 1 and 3.14% for type 2, resulting in an overall error rate of 3.51%.
Only one clinical trial has attempted to document SPCs, according to the authors. The Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial took steps to measure the rate of SPCs after three cases of occult biopsy specimen misidentification occurred during the first 2 years.
The rate of type 1 errors was 0.4% during the first 2 years of the REDUCE trial and declined to 0.02% in the final 2 years, after investigators implemented changes in specimen-handling procedures. A type 1 error rate of 0.5% persisted throughout the trial for blood samples that served as reference specimens.
Based on their study, the authors suggested that prospective DNA testing to confirm the identity of prostate biopsies that show adenocarcinoma may be useful for preventing treatment errors stemming from misidentification.
Strand Analytical Laboratories, which developed a test for STR analysis, provided the data for the study.
The authors had no relevant disclosures.
Primary source: American Journal of Clinical Pathology
Source reference:
Pfeifer JD, Liu J "Rate of occult specimen provenance complications in routine clinical practice" Am J Clin Pathol2013; DOI: 10.1309/AJCP50WEZHWIFCIV.
Source reference:
Pfeifer JD, Liu J "Rate of occult specimen provenance complications in routine clinical practice" Am J Clin Pathol2013; DOI: 10.1309/AJCP50WEZHWIFCIV.
Wednesday, January 23, 2013
New cancer therapy program opens at Children’s Healthcare of Atlanta
Last week, Erin and Stephen Chance of Druid Hills returned to the place where their son Patrick died from neuroblastoma, a solid tumor of the sympathetic nervous system.
It was one of the hardest things they’ve ever done.
But for years before Patrick’s death last January, the Chances, who are both lawyers, had resolved to be in this fight for the long haul. From the moment they learned of his diagnosis, they began raising money to fund new treatments for neuroblastoma and in 2007 joined forces with CURE Childhood Cancer Inc. to make their efforts official.
And so here they were, back at the Aflac Cancer Center of Children’s Healthcare of Atlanta at Egleston, to talk about Patrick and the center’s new MIBG (metaiodobenzylguanidine) radiation therapy room named in his honor.
Before the therapy room was built, metro Atlanta families like the Chances had to seek MIBG treatment far from home. The new radiation therapy room at Children’s is one of only about eight in the nation, a scarcity caused by cost and a lack of clinical expertise.
“We’d experienced firsthand how hard it was to travel for treatment, to be separated from family, your emotional support and your hospital,” Erin Chance, 39, said. “So, we wanted to provide a place where families in the Southeast could come without traveling so far.”
MIBG treatment has a distinct advantage over traditional radiation.
“Many patients with cancer, when they receive radiation, lay on a table and a beam is focused on them. … A problem with that treatment is while it’s focused on the tumor itself, it hits other parts of the body. It works, but it has some collateral damage,” said Dr. Howard Katzenstein, director of the Innovative Therapy Program for cancer at Children’s Healthcare.
“This MIBG treatment allows the patient to be injected with the radioactive drug that targets the cancer cells directly. The radiation goes inside the tumor and the cells die. There’s a lot less surrounding damage,” Katzenstein said.
Talks to bring the treatment to the Aflac Cancer Center began six months ago when the CHOA Foundation requested a grant from the Chances.
“Stephen and I talked about it for about 30 seconds before we decided to fund the project,” Erin Chance said.
Because of their personal experience with the therapy, they also volunteered to help with the design. Instead of one room, they decided they needed two. One for the patients and one for the family.
When Patrick received MIBG treatment in Philadelphia, for instance, Erin Chance said he had to be isolated from them because he was literally radioactive. They were separated by lead shields, unable to safely touch or see him for days.
“If Patrick would fall asleep or was watching a movie, Stephen and I sat in the hallway to limit radiation exposure,” she said.
Stephen Chance, 44, said they decided to install televisions in each room along with three-way video and microphones, one for the nurses, and the others for the parent and child so that they can see each other on the monitors, talk to each other and actually play video games with one another.
“The parent is protected (from radiation) but has improved access to the child,” he said. “And the nurses can see the child on the monitor without exposure to radiation as well.”
The cost to build the connected rooms was more than $200,000.
Although the therapy room was built with neuroblastoma in mind, Katzenstein said it will also allow for similar treatment for thyroid cancer patients.
“If other drug treatments become available for other types of cancers, the room is built and we’re good to go,” he said.
Patrick Chance was 3 years old when he woke up one morning in 2006, unable to walk.
“From the moment he was diagnosed, it was obvious that there was a need for less toxic, more effective childhood cancer therapy,” Erin Chance said.
It was then that the couple began raising money to fund those new therapies and donating the proceeds to Children’s Healthcare of Atlanta.
In June 2007, they began collaborating with CURE Childhood Cancer, a nonprofit that funds research and provides support to patients and their families. The Chances formed Press On to CURE Childhood Cancer with another family to fund therapies for neuroblastoma and acute myeloid leukemia, two of the deadliest pediatric cancers in the country.
CURE provides them administrative support, a board of directors and a scientific advisory council.
“Their support enables us to do what we do best, which is fundraise,” Erin said.
Over the next five years, all the while caring for Patrick and his two sisters, they pressed on. Patrick died Jan. 9, 2012, his ninth birthday.
On Jan. 9, 2013, the Chances, Kristin Connor, executive director of CURE Childhood Cancer, and other dignitaries celebrated the grand opening of the new therapy room.
“In a lot of cultures, if you die on your birthday, it’s a sign you perfectly completed your mission on earth,” Erin Chance said. “For me, dedicating this room a year after he died was another completion of that circle. It was part of fulfilling what I believe was his mission on earth: touching people’s lives and changing the course of childhood cancer treatment.”
To date they have raised more than $1.5 million and have donated the money to leading childhood cancer hospitals across the country.
“We’re not done,” Stephen said. “We want to bring more resources to CHOA to help improve childhood cancer therapy. There are lots of January 9s yet to come.”
It was one of the hardest things they’ve ever done.
But for years before Patrick’s death last January, the Chances, who are both lawyers, had resolved to be in this fight for the long haul. From the moment they learned of his diagnosis, they began raising money to fund new treatments for neuroblastoma and in 2007 joined forces with CURE Childhood Cancer Inc. to make their efforts official.
And so here they were, back at the Aflac Cancer Center of Children’s Healthcare of Atlanta at Egleston, to talk about Patrick and the center’s new MIBG (metaiodobenzylguanidine) radiation therapy room named in his honor.
Before the therapy room was built, metro Atlanta families like the Chances had to seek MIBG treatment far from home. The new radiation therapy room at Children’s is one of only about eight in the nation, a scarcity caused by cost and a lack of clinical expertise.
“We’d experienced firsthand how hard it was to travel for treatment, to be separated from family, your emotional support and your hospital,” Erin Chance, 39, said. “So, we wanted to provide a place where families in the Southeast could come without traveling so far.”
MIBG treatment has a distinct advantage over traditional radiation.
“Many patients with cancer, when they receive radiation, lay on a table and a beam is focused on them. … A problem with that treatment is while it’s focused on the tumor itself, it hits other parts of the body. It works, but it has some collateral damage,” said Dr. Howard Katzenstein, director of the Innovative Therapy Program for cancer at Children’s Healthcare.
“This MIBG treatment allows the patient to be injected with the radioactive drug that targets the cancer cells directly. The radiation goes inside the tumor and the cells die. There’s a lot less surrounding damage,” Katzenstein said.
Talks to bring the treatment to the Aflac Cancer Center began six months ago when the CHOA Foundation requested a grant from the Chances.
“Stephen and I talked about it for about 30 seconds before we decided to fund the project,” Erin Chance said.
Because of their personal experience with the therapy, they also volunteered to help with the design. Instead of one room, they decided they needed two. One for the patients and one for the family.
When Patrick received MIBG treatment in Philadelphia, for instance, Erin Chance said he had to be isolated from them because he was literally radioactive. They were separated by lead shields, unable to safely touch or see him for days.
“If Patrick would fall asleep or was watching a movie, Stephen and I sat in the hallway to limit radiation exposure,” she said.
Stephen Chance, 44, said they decided to install televisions in each room along with three-way video and microphones, one for the nurses, and the others for the parent and child so that they can see each other on the monitors, talk to each other and actually play video games with one another.
“The parent is protected (from radiation) but has improved access to the child,” he said. “And the nurses can see the child on the monitor without exposure to radiation as well.”
The cost to build the connected rooms was more than $200,000.
Although the therapy room was built with neuroblastoma in mind, Katzenstein said it will also allow for similar treatment for thyroid cancer patients.
“If other drug treatments become available for other types of cancers, the room is built and we’re good to go,” he said.
Patrick Chance was 3 years old when he woke up one morning in 2006, unable to walk.
“From the moment he was diagnosed, it was obvious that there was a need for less toxic, more effective childhood cancer therapy,” Erin Chance said.
It was then that the couple began raising money to fund those new therapies and donating the proceeds to Children’s Healthcare of Atlanta.
In June 2007, they began collaborating with CURE Childhood Cancer, a nonprofit that funds research and provides support to patients and their families. The Chances formed Press On to CURE Childhood Cancer with another family to fund therapies for neuroblastoma and acute myeloid leukemia, two of the deadliest pediatric cancers in the country.
CURE provides them administrative support, a board of directors and a scientific advisory council.
“Their support enables us to do what we do best, which is fundraise,” Erin said.
Over the next five years, all the while caring for Patrick and his two sisters, they pressed on. Patrick died Jan. 9, 2012, his ninth birthday.
On Jan. 9, 2013, the Chances, Kristin Connor, executive director of CURE Childhood Cancer, and other dignitaries celebrated the grand opening of the new therapy room.
“In a lot of cultures, if you die on your birthday, it’s a sign you perfectly completed your mission on earth,” Erin Chance said. “For me, dedicating this room a year after he died was another completion of that circle. It was part of fulfilling what I believe was his mission on earth: touching people’s lives and changing the course of childhood cancer treatment.”
To date they have raised more than $1.5 million and have donated the money to leading childhood cancer hospitals across the country.
“We’re not done,” Stephen said. “We want to bring more resources to CHOA to help improve childhood cancer therapy. There are lots of January 9s yet to come.”
Drug Is Shown to Help Pancreatic Cancer Cases
Celgene’s drug Abraxane prolonged the lives of patients with advancedpancreatic cancer by almost two months in a clinical trial, researchers reported Tuesday, signifying an advance in treating a notoriously difficult disease but not as big a leap as some doctors and investors had hoped.
“It was not the breakthrough we were anticipating,” said Dr. Andrea Wang-Gillam, an assistant professor and pancreatic cancer specialist at Washington University in St. Louis, who was not involved in the trial.
Still, Dr. Wang-Gillam and others said any progress was welcome against metastatic pancreatic cancer, which has defied most treatments, with patients tending to live only about six months after diagnosis.
Pancreatic cancer is the fourth most common cause of cancer death, with 38,000 Americans expected to die this year, almost as many deaths as from breast cancer, according to the American Cancer Society. Yet there are only 45,000 new cases of pancreatic cancer a year compared with more than 230,000 new breast cancer cases.
“This is a disease that gave oncology a bad name,” said Dr. Robert Mayer, a professor at Harvard and the Dana-Farber Cancer Institute in Boston, who was not involved in the study. Now, he said, Abraxane, as well as another treatment combining four generic drugs, are showing some promise.
In Celgene’s trial, patients who received Abraxane plus gemcitabine, the standard drug for pancreatic cancer, lived a median of 8.5 months, compared with 6.7 months for those who received gemcitabine alone.
At the end of one year, 35 percent of those getting Abraxane were alive, compared with 22 percent of those getting only gemcitabine. After two years, the figures were 9 percent for those getting Abraxane and 4 percent for those who received gemcitabine.
The results of the study, which involved 861 patients, were released by Celgene and by the American Society of Clinincal Oncology in advance of a presentation of the data Friday at the Gastrointestinal Cancers Symposium in San Francisco.
The results were roughly in line with investors’ expectations, according to a recent survey by ISI Group.
Celgene’s stock closed at $99.31 on Tuesday and moved slightly lower in after-hours trading. The study results were released after the close of trading.
Abraxane is a novel form of the widely used cancer drug paclitaxel, also known by the brand name Taxol. In Abraxane, the paclitaxel is bound to albumin, a human protein in tiny particles. That is said to enhance delivery of the drug to tumors and reduce side effects.
Abraxane was approved to treat advanced breast cancer in 2005 and to treat non-small-cell lung cancer in October. Sales in the first nine months of 2012 were $320 million, a small percentage of Celgene’s revenues of $4.1 billion in that period, much of it from the multiple myeloma drug Revlimid.
Abraxane was developed by Abraxis BioScience, which Celgene acquired for $2.9 billion in 2010. Abraxis stockholders also received a security entitling them to additional cash payments if Abraxane won approval for pancreatic cancer. Celgene said Tuesday it would apply for such approval in the first half of this year.
A big impediment to future Abraxane sales in pancreatic cancer could be that its median survival was almost three months less than that of Folfirinox, a combination of four generic cancer drugs.
Results of a clinical trial published in 2011 showed that pancreatic cancer patients getting Folfirinox had a median survival of 11.1 months compared with 6.8 months for those getting gemcitabine.
Experts cautioned that it was difficult to draw conclusions since Abraxane and Folfirinox were not compared directly in the same trial. Nonetheless, doctors are going to make treatment decisions based on the separate results.
Abraxane, which Celgene says will cost $6,000 to $8,000 a month for a pancreatic cancer patients, is likely to be more expensive than Folfirinox. However, Folfirinox is hard to tolerate and requires the patient to wear an infusion pump.
“The simplicity of Abraxane plus gemcitabine may be attractive to physicians and patients,” said Dr. Neal J. Meropol, chief of hematology and oncology at University Hospitals and Case Western Reserve University in Cleveland. Abraxane does cause low white blood cell counts and nerve damage.
How much of an extension of life is meaningful to patients is a matter of some debate, especially with cancer drugs costing thousands of dollars a month.
In 2005 the Food and Drug Administration approved Tarceva, now sold by Roche and Astellas, to treat pancreatic cancer. In a clinical trial, those who got Tarceva plus gemcitabine had a median survival only 12 days longer than those who received a placebo plus gemcitabine.
This article has been revised to reflect the following correction:
Correction: January 22, 2013
An earlier version of this article misstated the specialty of Dr. Andrea Wang-Gillam, an assistant professor at Washington University in St. Louis. She is a specialist in pancreatic cancer, not prostate cancer.
“It was not the breakthrough we were anticipating,” said Dr. Andrea Wang-Gillam, an assistant professor and pancreatic cancer specialist at Washington University in St. Louis, who was not involved in the trial.
Still, Dr. Wang-Gillam and others said any progress was welcome against metastatic pancreatic cancer, which has defied most treatments, with patients tending to live only about six months after diagnosis.
Pancreatic cancer is the fourth most common cause of cancer death, with 38,000 Americans expected to die this year, almost as many deaths as from breast cancer, according to the American Cancer Society. Yet there are only 45,000 new cases of pancreatic cancer a year compared with more than 230,000 new breast cancer cases.
“This is a disease that gave oncology a bad name,” said Dr. Robert Mayer, a professor at Harvard and the Dana-Farber Cancer Institute in Boston, who was not involved in the study. Now, he said, Abraxane, as well as another treatment combining four generic drugs, are showing some promise.
In Celgene’s trial, patients who received Abraxane plus gemcitabine, the standard drug for pancreatic cancer, lived a median of 8.5 months, compared with 6.7 months for those who received gemcitabine alone.
At the end of one year, 35 percent of those getting Abraxane were alive, compared with 22 percent of those getting only gemcitabine. After two years, the figures were 9 percent for those getting Abraxane and 4 percent for those who received gemcitabine.
The results of the study, which involved 861 patients, were released by Celgene and by the American Society of Clinincal Oncology in advance of a presentation of the data Friday at the Gastrointestinal Cancers Symposium in San Francisco.
The results were roughly in line with investors’ expectations, according to a recent survey by ISI Group.
Celgene’s stock closed at $99.31 on Tuesday and moved slightly lower in after-hours trading. The study results were released after the close of trading.
Abraxane is a novel form of the widely used cancer drug paclitaxel, also known by the brand name Taxol. In Abraxane, the paclitaxel is bound to albumin, a human protein in tiny particles. That is said to enhance delivery of the drug to tumors and reduce side effects.
Abraxane was approved to treat advanced breast cancer in 2005 and to treat non-small-cell lung cancer in October. Sales in the first nine months of 2012 were $320 million, a small percentage of Celgene’s revenues of $4.1 billion in that period, much of it from the multiple myeloma drug Revlimid.
Abraxane was developed by Abraxis BioScience, which Celgene acquired for $2.9 billion in 2010. Abraxis stockholders also received a security entitling them to additional cash payments if Abraxane won approval for pancreatic cancer. Celgene said Tuesday it would apply for such approval in the first half of this year.
A big impediment to future Abraxane sales in pancreatic cancer could be that its median survival was almost three months less than that of Folfirinox, a combination of four generic cancer drugs.
Results of a clinical trial published in 2011 showed that pancreatic cancer patients getting Folfirinox had a median survival of 11.1 months compared with 6.8 months for those getting gemcitabine.
Experts cautioned that it was difficult to draw conclusions since Abraxane and Folfirinox were not compared directly in the same trial. Nonetheless, doctors are going to make treatment decisions based on the separate results.
Abraxane, which Celgene says will cost $6,000 to $8,000 a month for a pancreatic cancer patients, is likely to be more expensive than Folfirinox. However, Folfirinox is hard to tolerate and requires the patient to wear an infusion pump.
“The simplicity of Abraxane plus gemcitabine may be attractive to physicians and patients,” said Dr. Neal J. Meropol, chief of hematology and oncology at University Hospitals and Case Western Reserve University in Cleveland. Abraxane does cause low white blood cell counts and nerve damage.
How much of an extension of life is meaningful to patients is a matter of some debate, especially with cancer drugs costing thousands of dollars a month.
In 2005 the Food and Drug Administration approved Tarceva, now sold by Roche and Astellas, to treat pancreatic cancer. In a clinical trial, those who got Tarceva plus gemcitabine had a median survival only 12 days longer than those who received a placebo plus gemcitabine.
This article has been revised to reflect the following correction:
Correction: January 22, 2013
An earlier version of this article misstated the specialty of Dr. Andrea Wang-Gillam, an assistant professor at Washington University in St. Louis. She is a specialist in pancreatic cancer, not prostate cancer.
By ANDREW POLLACK
Published: January 22, 2013
Tuesday, January 22, 2013
Sam Callahan faced cancer and lived his life to the fullest
Sam Callahan was a fighter and those who knew the 17-year-old say they'll remember him as an inspiration.
Sam died peacefully in the bedroom of his Campbell home on Jan. 14 after a 3 1/2-year battle with Ewing's sarcoma. He is survived by his mother Suzy Callahan van Bronkhorst, father Kenn Callahan, brother Joseph Callahan, stepfather Derek van Bronkhorst and grandfather Don Callahan, a lifelong resident of Los Gatos.
"He fought so hard," his stepfather said. "He really put up a battle. He never complained, never asked, 'Why me?' He took it head-on.
"He had his goals and he achieved those goals. But words can't express the effect he had on other people in the way he lived his life while he was here."
Sam's family will host a celebration of his life at Bellarmine College Preparatory, 960 W. Hedding St. in San Jose, on Jan. 24 beginning at 11:15 a.m. Sam was a junior at Bellarmine Prep.
Sam's life--along with the lives of his family members--changed forever in September 2009 when he was rushed to the hospital with a 102-degree fever and a pain in his side. After a series of tests doctors learned that it was Ewing's sarcoma, a rare type of cancer that frequently strikes teenage boys.
Doctors said that Sam's chances of living past a year were slim, van Bronkhorst said. But that didn't seem to shake Sam's confidence that he would not just live that long, van Bronkhorst said, but beat the deadly disease.
He was treated at Stanford University for about nine months, and then began flying to the University of Texas' MD Anderson Cancer Center in Houston for weekly treatments and then eventually to Santa Monica, his stepfather said.
Whether it was chemotherapy or clinical trials, he never talked too much to his friends about his illness. In fact, van Bronkhorst said, the teenager went out of his way to "just be Sam."
Although he lived a relatively short life, he made an impact on others, including Major League Baseball player Darnell McDonald.
Sam, an outstanding baseball player in his own right before he was stricken with the disease, met McDonald while the teenager and his family visited AT&T Park in San Francisco for a Giants-Red Sox game in 2010. As McDonald was saying goodbye, a family friend handed him a blue "Sam's Team" wrist band and said if he wore it during the game he would hit a home run.
McDonald, not known as a home run hitter, did wear the band and hit a ball into the stands.
"I thought of it as I was rounding second base," McDonald told the Boston Globe at the time. "I remember that they said I was going to hit a homer. And then I did. It made me feel blessed."
Sam and McDonald were able to meet a couple of more times and had "an amazing relationship," van Bronkhorst said.
It wasn't just McDonald who was inspired by Sam, van Bronkhorst added. He seemed to have a similar effect on many he came to know. Part of it may have been that he seemed mature beyond his years, both before and after his diagnosis.
Sam was asked, and eventually accepted the invitation, to speak at his eighth-grade graduation from St. Lucy Parish School. What he told his young peers could have been said to college graduates.
"No matter what the odds are against you, the human will is the strongest force in the world," Sam said. "In each of us we possess a drive that can move mountains and achieve anything we focus on."
Sam focused on living. And that's just what he did.
Sam died peacefully in the bedroom of his Campbell home on Jan. 14 after a 3 1/2-year battle with Ewing's sarcoma. He is survived by his mother Suzy Callahan van Bronkhorst, father Kenn Callahan, brother Joseph Callahan, stepfather Derek van Bronkhorst and grandfather Don Callahan, a lifelong resident of Los Gatos.
"He fought so hard," his stepfather said. "He really put up a battle. He never complained, never asked, 'Why me?' He took it head-on.
"He had his goals and he achieved those goals. But words can't express the effect he had on other people in the way he lived his life while he was here."
Sam's family will host a celebration of his life at Bellarmine College Preparatory, 960 W. Hedding St. in San Jose, on Jan. 24 beginning at 11:15 a.m. Sam was a junior at Bellarmine Prep.
Sam's life--along with the lives of his family members--changed forever in September 2009 when he was rushed to the hospital with a 102-degree fever and a pain in his side. After a series of tests doctors learned that it was Ewing's sarcoma, a rare type of cancer that frequently strikes teenage boys.
Doctors said that Sam's chances of living past a year were slim, van Bronkhorst said. But that didn't seem to shake Sam's confidence that he would not just live that long, van Bronkhorst said, but beat the deadly disease.
He was treated at Stanford University for about nine months, and then began flying to the University of Texas' MD Anderson Cancer Center in Houston for weekly treatments and then eventually to Santa Monica, his stepfather said.
Whether it was chemotherapy or clinical trials, he never talked too much to his friends about his illness. In fact, van Bronkhorst said, the teenager went out of his way to "just be Sam."
Although he lived a relatively short life, he made an impact on others, including Major League Baseball player Darnell McDonald.
Sam, an outstanding baseball player in his own right before he was stricken with the disease, met McDonald while the teenager and his family visited AT&T Park in San Francisco for a Giants-Red Sox game in 2010. As McDonald was saying goodbye, a family friend handed him a blue "Sam's Team" wrist band and said if he wore it during the game he would hit a home run.
McDonald, not known as a home run hitter, did wear the band and hit a ball into the stands.
"I thought of it as I was rounding second base," McDonald told the Boston Globe at the time. "I remember that they said I was going to hit a homer. And then I did. It made me feel blessed."
Sam and McDonald were able to meet a couple of more times and had "an amazing relationship," van Bronkhorst said.
It wasn't just McDonald who was inspired by Sam, van Bronkhorst added. He seemed to have a similar effect on many he came to know. Part of it may have been that he seemed mature beyond his years, both before and after his diagnosis.
Sam was asked, and eventually accepted the invitation, to speak at his eighth-grade graduation from St. Lucy Parish School. What he told his young peers could have been said to college graduates.
"No matter what the odds are against you, the human will is the strongest force in the world," Sam said. "In each of us we possess a drive that can move mountains and achieve anything we focus on."
Sam focused on living. And that's just what he did.
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