[chrisy]

Hi Joy,

Great questions, I think we all ask those questions all the time.

I'm no expert of course, but on the "causes pain at tumor site", that is a reported S/E in the Herceptin literature; there may be some resource somewhere that lists all the possible side effects and the drugs that cause them...but I'm not sure that would be good information to have!

In my personal experience, I had T/C/H and it worked on extensive liver mets then maintained NED on H alone, never with any pain. The only time I have had pain was after my first DM1 infusion, and it was a mother of a pain but short lived. And the DM1 worked. My personal belief was that the pain with DM1 indicated it was pissing off the cancer - and I'm sticking to it. But my experience with other agents was no pain, so I don't see a direct correlation.

I think there is limited (if any) actual study of these correlations for the most part. There are so many complexities - is that side effect just one more complexity that may or may not have significance?

Your other question is also really interesting - and I'll bet somebody is, at least indirectly, researching that area.

There is a lot of emerging knowledge and research into the mechanisms that cause drugs to work, or not, or develop resistance. There is also interesting data on how resistance can be reversed, how various pathways can be activated/deactivated/reactivated... So although I don't think the answer is known yet, as the understanding of the basic biology advances this may reveal how we can improve/change the response to a particular drug.

Still way too much remains unknown - but I'm grateful that people who actually have a chance of understanding it are also asking these questions!