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Old 06-13-2007, 08:40 PM   #14
Hopeful
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Join Date: Aug 2006
Posts: 3,380
Here is a link to an opinion piece in the latest New England Journal of Medicine on weighing the dangers of these drugs:

http://content.nejm.org/cgi/content/...2445?query=TOC

Of particular interest for this thread:

" The mechanism underlying the enhanced growth of tumors with<sup> </sup>higher doses of ESAs remains uncertain. There is good evidence<sup> </sup>that hypoxic tumors resist chemotherapy and radiotherapy. The<sup> </sup>biology of tumor hypoxia, with enhanced cell signaling through<sup> </sup>the Akt–mammalian target of rapamycin (mTOR) axis and<sup> </sup>subsequent up-regulation of hypoxia-inducible factor 1, is what<sup> </sup>inspired the clinical trials in which ESA treatment was combined<sup> </sup>with radiotherapy, cytotoxic chemotherapy, or both in an attempt<sup> </sup>to overcome hypoxia-induced resistance. But another possibility<sup> </sup>is that certain tumor cells have erythropoietin receptors that<sup> </sup>stimulate cell growth when they are bound by erythropoietin<sup> </sup>or an erythropoietin-like ligand. Squamous-cell lung cancer,<sup> </sup>squamous-cell tumors of the head and neck, and breast adenocarcinomas<sup> </sup>seem to express erythropoietin receptors, but such receptors'<sup> </sup>role, if any, in tumor growth is unclear. Henke et al. showed<sup> </sup>that erythropoietin receptors were expressed by two thirds of<sup> </sup>tumors in their study and that expression of such receptors<sup> </sup>in erythropoietin-treated patients was associated with shorter<sup> </sup>survival.<sup>5</sup> Conversely, in vitro studies have shown that stimulating<sup> </sup>erythropoietin receptors in cell lines from head and neck cancer<sup> </sup>and breast cancer causes the death of cells, though the questionable<sup> </sup>quality of the reagents used to detect erythropoietin receptors<sup> </sup>must be considered in interpreting these data."

Hopeful
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