Am I the only one thinking that..

fullofbeans · 02-13-2013, 10:47 AM

We have so many anti her2 (inc tdm1 ect) inhibitors and others available but

not enough trial mixing these in various ways (inc. sequentially) to create a lethal cocktails to cancer cells..

How to force them to work together and faster?

Lani · 02-13-2013, 11:47 AM

As with most things, the problem is money. Each of the targeted agents is exorbitantly priced (and many come from different competing companies)

Best bet is for combo of different drugs from one company, eg. Roche's pertuzumab, herceptin--would be nice if could combine with off-patent drugs developed for something else. That might speed things up and avoid price constraints.

The other problem is the number of permutations and combinations and the number of patients needed to treat and the amount of time to generate data.

That is why we are moving toward so many neoadjuvant studies. Would be nice if they added pre-, during and post- bone marrows AND ctc testing to try to move things along eg, if bone marrow did not clear with treatment, would know another treatment would be necessary rather than waiting for years for the metastases to develop and cheating the patient of a possible
cure/ meaningful increased DFS, PFS, prevention of brain mets/improved QOL

Mandamoo · 02-13-2013, 03:11 PM

Yes very frustrating and reliant on Drs trying to think outside the square and drug companies that are willing to support and fund outside of clinical trials.
Where are the interlukin and neflinavir trials? There seems to be evidence theses ore existing drugs may have action in her2disease but no studies (that I am aware of) - drugs already have approval and too expensive to make applications for extended use in other conditions.
FOB I am so frustrated with population based studies. We are individuals and the drug companies need numbers to make it worthwhile but unique combinations may be what works best.
All about money I the end...

Lani · 02-13-2013, 06:43 PM

the hard part is that the agencies are saddled with proving safety

That means proving the safety of each and everyone of the permutations and combinations at all the different doses and frequencies.

Makes it hard to do individualized medicine

Efficacy is one thing. Safety unfortunately is another.

IrvineFriend · 02-13-2013, 09:04 PM

It's very, very expensive to run a drug trial, and combinations create the need for a very large trial with more inclusion/exclusion criteria making recruitment harder.

The reality is, drug companies also have to show a profit to their stockholders, just like any corporation that is trading on the stock market. Even large drug companies take a major hit when when they don't meet their end points, especially during a phase III trial. Before starting a large trial, you have to be pretty sure you're going to hit it out of the park and get approval. If drug companies

Doctors and FDA are contrained by the box (laws and regulations and not just the bottom $$ line). On the flip side, if patients were hurt by "creativity", you bet there would be a long list of lawsuits in line and a special 60 minutes episode about drug companies pushing products that haven't been proven safe and effective and FDA being under more government scrutiny.

Joanne S · 02-13-2013, 10:34 PM

I hate hearing about the costs, profits..... our gov't sends billions to other countries. We need a cure! Why is always about the money?

At one point wasn't there talk about a national data base to track all cancer patients, diagnosis, treatments, etc? Anyone know about this?

fullofbeans · 02-19-2013, 01:44 PM

Irvine nothing is safe there are many people dying of the side effect of chemo everyday. We all know here that we have to accept collateral damages in order to LIVE. Trials could be run as phase 1.

All of us end up not fitting any criteria because we have had too many lines of chemo and targetted drugs.

The real problem is the unwillingness of pharmas to work together (yes because of profit), yes I agree with you all about that.

Every researchers agrees onthe need to block various pathways so. My question is still: How can we force them to work together on creative blocking and personalised(ish) trials. Like they did for HIV research, how did they do it???