This is a VERY worthwhile project. With most chemos, treatment is planned for a specific period of time, and even if the side effects are quite bothersome, we can put up with a lot when there’s light at the end of the proverbial tunnel. But with drugs like Tarceva, the period of treatment is open ended — we hope it will be for a long time, but if a person is miserable with no end in sight, the question can become “is it worth it?” What a shame when that happens. Aloha,

Ned

recce101

Hi Dr. West, I have been using Tarceva since March 19. I developed bad acne at about day eight. The protocol I am on has discontinuous use of Tarceva (take 200 mg/day days 2 through 16 of 21 day cycle). The rash is very mild now but maybe builing again. I hope to find it manageable because symptomatically it appears to be helping with my bone mets in my left leg.
Another issue I have read about and I am struggling with is drowsiness. I sit and read or watch TV and keep dropping off. I really hope this will improve as it affects my QOL.

CancerStar

Dr. West,

I came across these two articles below and would like to know your thoughts on these. Thanks.

Melissa

http://www.sciencedaily.com/releases/2008/06/080628155300.htm

http://www.guardian.co.uk/science/2008/jun/19/cancer.science

melissa

Melissa,

I think people should be very wary of any headline that uses the words “cancer”, “cure”, and “mice” together is very far from being a breakthrough. People need to understand that newspapers and internet sites are incentivized to generate interest, and that is often at the expense of accuracy. There’s a reason that so many mild snowfalls are hyped as a potential blizzard that will shut down the city, and it’s the same reason every baby step in cancer research is hyped as a breakthrough. It’s likely to be many years before current mouse research gets a good testing in human patients, and there are probably 10 to 100 times as many touted breakthroughs in mouse models of cancer as real valuable additions in cancer patients. Maybe this will turn out to be a real improvement, but we can’t determine that anytime soon.

Second, I’d say that immune-based therapies are getting tested, and I’ve written about a few of them here. But melanoma is probably the most immune-responsive cancers we know, and there is a well documented rate of spontaneous remission in patients with melanoma and kidney cancers, presumably from the body’s ability to modulate the cancer by the immune system. There are regular miracles with these cancers because of that (one of my good friends has a father with kidney cancer who had several brain metastases that were removed about 7 or 8 years ago and hasn’t had any treatment or progression of disease since then –this almost never happens in lung cancer). Lung cancer is not a very immune-sensitive cancer, so I’d suspect it’s not going to be an easy path to pursue.

I don’t mean to be dismissive — we have many new treatments in the past 5-10 years, and I strongly suspect that we’ll have several more approved in the next few years. These will have all been in early mouse and human studies in the preceding years. But there are just many more promising leads than actual breakthroughs, so I think it’s helpful to focus on the things that have passed a few hurdles and are still looking promising — such as the agents that appear encouraging in phase II human trials — before getting too excited, only to be disappointed in all of the hyped stories that never pan out.

-Dr. West

Dr. West