Wiley InterScience :: Journal :: Article PDF

Wiley InterScience :: Journal :: Article PDF

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Prostate cancer responds to Revlimid

Just a brief note about a patient with hormone resistant prostate cancer who was started on Revlimid (lenalidomide) 10 mg daily. He developed a severe rash and fluid retention and the dose was stopped to be restarted after symptoms abated. The drug was decreased to 10 mg every other day. The rash subsided and the PSA decreased for a period of many months. This patient represents one of three Revlimid treated patients who has had a PSA reponse to the drug (the other two have failed). I suspect that similar to Thalidomide, Revlimid is active in this disease. If a patient can get the drug ($250.00 per daily 10 mg capsule) it may be worth a try. Though Celgene (CELG) stock is down in recent trading I suspect that it will recover and go up in the future. The drug is also active in chronic lymphocytic leukemia (new finding), multiple myeloma and of course some myelodysplastic syndromes (5q deletion and others) to name a few indications.
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Blue Cross obstructs patient access to newest cancer drugs!

Amgen Corporation developed a new biological drug called VectiBix and demonstrated by clinical trial that the drug was capable of extending the life of colon cancer patients. That won them FDA approval for the use of VectiBix in cancer patients that were resistant to the usual chemotherapy drugs, 5-FU, LV , Oxaliplatin, and Irinotecan. Blue Cross of Southern California arbitrarily enacted a rule restricting patient access to the drug if a patient received a similar drug called Erbitux. They are assuming that patients with prior exposure to Erbitux would be resistant to an entirely different drug targeting the “same” tumor cell receptor. The assumption is scientifically absurd and Blue Cross knows it. However their rule of financial convenience has been effective in denying my and probably other cancer patient’s access to VectiBix and to the potential extension of life. I inquired with Amgen if they were prepared to fight this ruling based on assumption and not on clinical tria...
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Intermittent androgen deprivation therapy...duration of tumor control.

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I frequently see patients with prostate cancer that want to know how long they will respond if they choose to be treated with intermittent androgen deprivation therapy (IADT). This involves the injection of a drug such as Lupron or Zoladex (LHRH agonist) usually on a 1-3 month basis plus or minus the ingestion of pills such as Celebrex, Flutamide, Nilutamide (anti-androgens) and Proscar or Avodart (inhibitors of activation of testosterone). A study by A. De La Taille et al. from France attempts to answer the question. From 1989 through 2001 these researchers studied 146 patients who had never receive hormone therapy before. They were treated in an intermittent fashion with LHRH agonist (Lupron, Zoladex) + non-steroidal anti-androgen (Flutamide, Casodex) = 28, LHRH alone = 42, non steroidal anti-androgen alone (i.e. Casodex, Flutamide) = 86. Disease Extent: Localized + locally advanced + metastatic prostate cancer = 72. Prostate-specific antigen (PSA) recurrence after radical pro...
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