Hi all,
we are facing with a seriuos doubt and we are looking for a
suggestion.
The situation is this:
- my father has a NSCLC stadium 3b and has undergone with chemioterapy
and radiotherapy
- a new experimentation called GCAV has started in Dallas with enough
good results for a part of the patiens treated
- my father lives in italy and should go and stay in dallas for at
least 2 months
The question is quite obvious: is this experimentation worthof a try?
Of course the tentative is not free both for money and stress for the
patient.
May you give some suggestion please?
Regards,
Daniele
J - 25 Mar 2004 11:41 GMT
> Hi all,
> we are facing with a seriuos doubt and we are looking for a
[quoted text clipped - 17 lines]
>
> Daniele
Hello Daniele,
I'm very sorry to hear about your father.
Did you know that this process involves surgery?
So the tumour has to be accessible (by whatever approach that they use)
and there be enough tumour tissue to have a chance to produce the vaccine.
And then there has to be "measurable disease" left in his lung(s), after
the surgery.
Then there's a 30% chance that preparation of the tumor cells for the
vaccine will not be successful.
Then the persons in the trials are randomized into two groups, one
receives the vaccine only, the other group receives the vaccine and
Cytoxan.
That chemo is explained here
<http://www.cancerbacup.org.uk/Treatments/Chemotherapy/Individualchemotherapydrug
s/Cyclophosphamide>
http://www.cellgenesys.com/opentrials-lung-cancer.shtml
Eligibility
Non small-cell lung cancer, stage IIIB/IV
No prior treatment with gene therapy
Accessible and adequate tumor source for vaccine production with
measurable disease to evaluate following tumor procurement
Treatment
Tumors from planned surgical resection will be processed and made into the
treatment vaccine. Prior to treatment, patients will be randomized at a
ratio of 1:1 into one of two treatment groups, Cohort A and Cohort B.
Patients in Cohort A will be treated with GVAX® lung cancer vaccine only
and patients in Cohort B will be treated with GVAX® lung cancer vaccine
plus a single dose of cyclophosphamide administered one day prior to the
first, third, and fifth vaccine treatment. Patients will receive
intradermal (beneath the skin) vaccine injections every two weeks for up
to eight weeks, for a total of up to five vaccine treatments. The duration
of this study, including follow up, is approximately two years.
In order to assist you and your physician with determining whether this
trial is appropriate for you, select major eligibility criteria are listed
above. To receive additional information on participating in our clinical
trials, please refer to the enrollment information listed below.
http://www.crsti.org/news0202.html
This study tests a vaccine for the treatment of non-small cell lung cancer
(NSCLC)and is open to patients who have advanced or recurrent NSCLC. The
Lung Bystander GVAX® Vaccine consists of two parts: 1) a patient's tumor
cells and 2) K562 Bystander GVAX® cells. In this study, a patient's own
tumor will be used to try to make a cancer vaccine. Patients undergo a
surgical procedure to obtain tumor tissue specifically for vaccine
preparation. Their tumor cells are immediately preserved and stored for
rapid processing into single cells and irradiated so they can no longer
grow. In this form, they can be injected into the body, but they will not
cause new cancer because they cannot grow. There is a 30% chance that
preparation of the tumor cells for the vaccine will not be successful. If
it is not successful, patients will not receive the vaccine. If the
process is successful, patients will be asked to begin vaccine treatment
approximately 4 weeks following the surgical tumor procurement.[]
I will reply more in a bit.
J
J - 25 Mar 2004 12:01 GMT
> Hi all,
> we are facing with a seriuos doubt and we are looking for asuggestion.
[quoted text clipped - 16 lines]
>
> Daniele
Hello Danielle,
Is your father healthy enough for surgery?
I do not know what type of surgery that they do.
They mention "resection" and these are the types and descriptions that I
know of.
Have a look at both and the descriptions and the risks and known problems.
http://www.hopkinsmedicine.org/jhtop/Surgery/Surgical_Approaches/surgical_approa
ches.html
http://www.umm.edu/thoracic/lung_surgery.html
The main risks of lung surgery for cancer are: prolonged air leak (see
below), pneumonia or infection, bleeding, need for a blood transfusion,
stroke, heart attack and death. Preoperative chemotherapy and /or
radiation therapy can increase the chance of these risks.[]
So I would think that first you would have to send them the X-rays, or CT
scans (etc) of your father's chest, then find out if your father is a good
surgical candidate from their perspective and which surgical approach they
would plan for him and if there would be "measurable tumour" left for
their trial. You would also have to find out what type of anesthetic they
think they would be using.
http://www.cnn.com/2004/HEALTH/conditions/02/19/lung.cancer.vaccine.ap/
Forty-three lung cancer patients -- 10 in the early stage and 33 in the
advanced stage -- were injected with the vaccine every two weeks for three
months. Researchers followed them for three years.
The cancer disappeared in three of the advanced-stage patients. Two of
those patients previously had chemotherapy, which failed. In the rest of
the advanced-stage patients, the disease remained stable and did not
spread for almost five months to more than two years.
For patients in the early stage, the vaccine did not make much difference
against the cancer. "
So we don't know which of the above received just the vaccine and which
received the vaccine plus the chemo.
There's a lot to think about before embarking on such a trip and a trial
and lots of questions to ask of the people running the trial. Would you
or someone family be going with him?
If he survives the surgery, then he could possibly end up on the Cytoxan
(which is probably available in your country).
Then there'd be the side effects of that chemo, so he'd lose how many
months to the surgery and the trial, as opposed to gaining maybe 5 months
to two years. (is the claim).
Talk to us some more about your father and how he is doing now. Also if
you contact them, let us know what you are able to find out about the
surgery etc and your decision.
Keep in touch
J
Daniele - 25 Mar 2004 18:07 GMT
In the schema I read the patient should have a superficial tumor such
as a supraclavicular lymph node and my father is expected to have.
However the question rises again: (FIRST) supraclavicular lymph node
are only suspected to be mets but no tissue analysis had been done to
confirm that.
A SECOND question is: how can we know how many bad cells are in the
tissue?
He is a little bit weak after undergoing to chemiotherapy.
The THIRD point is: if we have to sustain all expenses, efforts and so
on we'd like to be sure that my father will be assign to more
promising experimentation type, ie that with chemiotherapy associated.
You know, it's difficult to decide because at the moment GVAX seems
the only real alternative for hoping in a survival.
Is this perseverance or it's probably worth of a trial?
Thanks for help.
Daniele
.........
> There's a lot to think about before embarking on such a trip and a trial
> and lots of questions to ask of the people running the trial. Would you
[quoted text clipped - 11 lines]
> Keep in touch
> J
J - 25 Mar 2004 19:09 GMT
> In the schema I read the patient should have a superficial tumor such
> as a supraclavicular lymph node and my father is expected to have.
[quoted text clipped - 11 lines]
> the only real alternative for hoping in a survival.
> Is this perseverance or it's probably worth of a trial?
Hello Daniele,
Have you tried asking your father's oncologist what would be best for your Dad?
If you have, what did the oncologist say?
J
Steph - 25 Mar 2004 16:50 GMT
> Hi all,
> we are facing with a seriuos doubt and we are looking for a
[quoted text clipped - 17 lines]
>
> Daniele
Daniele,
the likelihood of this therapy curing your father or extending his life is
very slim.
J - 26 Mar 2004 01:03 GMT
> "Daniele" <danielexyz@hotmail.com> wrote in message
> > Hi all,
[quoted text clipped - 21 lines]
> the likelihood of this therapy curing your father or extending his life is
> very slim.
Steph is a radiation oncologist. He knows.
J