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Medical Forum / Diseases and Disorders / Cancer / March 2007

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Metastasized Kidney Cancer

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Alfred Kaufmann - 19 Nov 2006 16:51 GMT
It has been some time since I reported on my friend's metastasized
kidney cancer and her trial on Sutent.  Right now she has three weeks
left on the trial.  It has been four periods of 4 weeks on the drug
and then 2 week rest, then on again.  She seems to be doing much
better on the drug than when she is in the rest period.  Of course she
is taking other drugs, creams, etc., to combat the side affects of the
Sutent.  When they check the cancer at the end of the last rest period
they found that it had not shrunk.

I really wonder what will happen when this trial ends.  She thinks
that the Cancer Society will pay for the drug as long as she needs it
and that sounds wonderful and I hope it is true.  If not she has a
drug plan that covers 70% but that still leaves her with a huge
expense.

Ak
J - 19 Nov 2006 18:37 GMT
Hello Alfred,
Thank you fro the update (see insert)

> It has been some time since I reported on my friend's metastasized
> kidney cancer and her trial on Sutent.  Right now she has three weeks
[quoted text clipped - 3 lines]
> is taking other drugs, creams, etc., to combat the side affects of the
> Sutent.

That (description) seems to be similar to the father of the person posting
on sci.med.diseases.cancer except your friend had cancer in her shoulder
and lung before she bagan Sutent and his father had one kidney removed.
He's just recently reported that his father was given an injection in hip,
for pain, and I am awaiting his reply as to whether arthritis is suspected
and it was a steroid injection.
I think he lives a ways from his father, so has to wait for communications
or until he goes there to visit.
Nothing concrete to report in his lungs except he's spitting up clear
fluids, the cough's back.

>  When they check the cancer at the end of the last rest period
> they found that it had not shrunk.
>
> I really wonder what will happen when this trial ends.  She thinks
> that the Cancer Society will pay for the drug as long as she needs it
> and that sounds wonderful and I hope it is true.

I don't know what their criteria is. Perhaps it will be enough if she can
prove non progression (with scans of her lungs and shoulder and ??) ?
Some places in the US are still recruiting
http://www.clinicaltrials.gov/ct/show/NCT00130897?order=1

>  If not she has a
> drug plan that covers 70% but that still leaves her with a huge
> expense.

I worry about that for the other fellow. I think he's paying it all
himself for his father /buying online.
I imagine if the hip proves to be cancer, they might stop the medication.
Have to wait and see. Scans cost - I don't think they have insurance at
all, so there's no point in bankrupting himself having his father have too
frequent scans.

I suspect, but could be wrong, that there's so few kidney cancer patients
worldwide (comparatively speaking to other more common cancers) and so few
on Sutent, that the value of Sutent is hard to pin point from a few
studies.

Same for your friend (might quit it, hope she doesn't bankrupt herself),
if scans start showing progression.
Thanks for update. Thanks for helping your friend, Alfred.
J

The product is a tyrosine kinase inhibitor designed to deprive the tumor
cells of the blood and nutrients needed to grow. According to another
webpage.

I don't think I've posted these before for you.  She'll be at the 9-month
median in 4 months, right?
http://www.accessdata.fda.gov/scripts/cder/onctools/summary.cfm?ID=370
U.S. Food and Drug Administration • Center for Drug Evaluation and
Research
FDA Oncology Tools Approval Summary for sunitinib maleate for Accel.
Approv. (clinical benefit not established) for the treatment of advanced
renal cell carcinoma. Approval for advanced renal cell carcinoma is based
on partial response rates and duration of responses.
There are no randomized trials of SUTENT demonstrating clinical benefit
such as increased survival or improvement in disease-related symptoms in
renal cell carcinoma.

http://professional.cancerconsultants.com/news.aspx?id=36671
In phase I-II studies, Sutent demonstrated antitumor and antiangiogenic
activity in renal cell carcinoma (RCC), as well as other solid tumors.
[Phase I and II measure for efficacy and dosing - safety ]

In one phase II study, Sutent was administered to 63 patients with
measurable RCC, who had failed one prior cytokine therapy. Patients
received 6-week cycles of Sutent, consisting of 50 mg daily for 4 weeks,
followed by 2 weeks off treatment. The partial response (PR) rate was 40%
with 27% having disease stabilization for 3 or more weeks. The median time
to disease progression was 9 months. Of the patients who achieved PR, the
median duration of response was 16.4 months. Fifteen of the 25 patients
who responded have progressed, 2 discontinued and 8 remain on treatment
for up to 2 years. This and other studies provided the data for FDA
approval of Sutent for treatment of RCC.
Alfred Kaufmann - 20 Nov 2006 01:05 GMT
>I don't know what their criteria is. Perhaps it will be enough if she can
>prove non progression (with scans of her lungs and shoulder and ??) ?

I just found out that the tumour in her shoulder did shrink.  I
thought that would be a good thing but not if that disqualifies her
from the trial.  Her next Cat-Scan is in the middle of December.  One
thing about scans here, when the doctor orders it, they are paid for
by our medicare system.

>I don't think I've posted these before for you.  She'll be at the 9-month
>median in 4 months, right?

Sounds about right for the time when she started taking Sutent in
June.  Diagnosis of the cancer was at the end of April.

Thanks for the information, it is pretty bleak.  I don't see her as
often as I should but she tires very easily and her schedule is pretty
full with wellness therapies and visiting family.  She has maintained
a very optimistic outlook.

Take care,
Alfred
J - 06 Feb 2007 09:05 GMT
> It has been some time since I reported on my friend's metastasized
> kidney cancer and her trial on Sutent.  Right now she has three weeks
[quoted text clipped - 10 lines]
> drug plan that covers 70% but that still leaves her with a huge
> expense.

Hello Alfred.
We haven't hear from you since November.
How's it going, Please check in.
J
Alfred Kaufmann - 31 Mar 2007 01:41 GMT
>Hello Alfred.
>We haven't hear from you since November.
>How's it going, Please check in.
>J

Hello J,

Sorry I have not been reading the newsgroup for some time now.  Here
is the last report. :-(

She had planned to travel to see her family for a great Christmas but
that did not work out, she was too ill to travel.

I really had to withdraw from the situation for a  few reasons, mainly
because I felt I could not tell her the truth about how I felt what
she should be doing and because I was beginning to feel that her
family was not stepping up to the plate to help her.  She also had
this crazy notion that selling and moving to her family was like
giving up on "the beast" and becoming a burden on her children.

Early in January her place was put up for sale and she moved into a
basement room in her son's house.  She was in and out of the hospital
for her many pains, the last being a bad lung infection.  A couple of
weeks ago I read e-mail that she was at home agan and on full oxygen.
She was even talking about buying a bike.

She passed away this morning and I heard she was in a lot of pain.  I
really regret not telling her to sell and move after she was disgnosed
last April or May.  She could afford to stay in the best hospice and
would had had quality time with her children and grandchildren.

She was on Sutent until the end but I have no idea wether or not it
prolonged her life or even improved it.  She seemed to think it did.

I hope you are doing well,
Alfred
J - 31 Mar 2007 09:55 GMT
> Hello J,
>
[quoted text clipped - 27 lines]
> I hope you are doing well,
> Alfred

Hello Alfred,
Considering she was more advanced than the father of the chap, on the
other newsgroup, who passed away on the 19th, and was on the experimental
regimen (+ an anti-estrogen to boot - the last few months as a last ditch
try), I'd say neither's regimen did a darned thing for (either of) them..

It's frustating isn't it when they have false hope?  And so sad to hear
that she died in pain.

I'd say sorry for your loss, Alfred, but I think you lost her at
diagnosis.

Someone on TV says "would you rather be right or happy?"
Sometimes we have to choose the latter for our own good.
Each experience (theirs or ours), changes us and makes us wiser.

Thank you for coming to tell us and may your future be brighter.
I wish you good health and lots of happier times.
J
 
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