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I wanted to post a talk from ASCO that I call the "kitchen sink" trial (Phase I only,
so far)
I call it that because they gave patients everything but the kitchen sink, ignoring the costs.
THE REAL TITLE (abstract 2512) was
A Phase I study of bevacizumab in combination with sunitinib, sorafenib, and erlotinib plus cetuximqab,and trastuzumab plus lapatinib.
It is a misleading title as there were four arms and no one got all the agents
As I recall patients had all sorts of cancers and had had multiple multiple prior treatments for it.
There were 4 arms--
1. Avastin + herceptin + lapatinib
2. avastin+sunitinib (had to be stopped because as they raised the dosage patients got hemolytic anemia)
3.avastin+sorafinib-- more toxicity than arms 1 and 4, but doable
4. avastom+erlotinib+cetuximab(13% got grade 3 side effects but 25% of patients with nonsmall cell lung cancer developed stable disease)
If I got it right, 3 of 58 patients in arm one got diarrhea, some got mild high blood pressure
When they reviewed only those patients who had her2+ breast cancer(16 patients)
9 had stable disease for over 4 months
1 had a complete response
4 had partial responses
So overall, 56% had stable disease for four or more months OR BETTER
The author(s) said they will be doing further studies centered on her2+ breast cancer
Remember these studies were done on Stage IV patients that had had so many many other previous treatments including herceptin and lapatinib before
These studies are obviously very expensive so we are glad when their results are so positive that it gives them ammunition to continue them farther
Interestingly, the authors said 70% of their patients with pancreatic cancer were her2+ so they are looking into giving herceptin to those with pancreatic cancer (I believe they are already doing this with some patients with gastric cancers)
More to come!
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