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Old 01-15-2008, 11:00 AM   #1
Lani
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Join Date: Mar 2006
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Supreme Court refuses to allow terminal patients right to use experimental drugs

http://www.medscape.com/viewarticle/568806
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Old 01-16-2008, 01:27 AM   #2
hutchibk
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I couldn't open Lani's link, so I found this explanation of what happened on Monday. Actually, the Supreme Court declined to hear the appeal of a 2006 Appeals Court decision...
  • Supreme Court Declines To Hear Case on Access to Experimental Medications for Terminally Ill Patients
    [Jan 15, 2008]
The U.S. Supreme Court on Monday without comment declined to hear an appeal in a lawsuit against FDA that sought expanded access to experimental medications for terminally ill patients, the <cite>New York Times</cite> reports (Greenhouse, <cite>New York Times</cite>, 1/15).

The lawsuit, filed in 2003 by the Abigail Alliance for Better Access to Developmental Drugs and the Washington Legal Foundation, asked FDA to provide a special initial approval of experimental medications that appear effective and allow their sale and distribution to terminally ill patients who have no other approved treatment options. FDA argued that programs currently exist to provide experimental medications to terminally ill patients and that increased access to such treatments would lead to unacceptable risk.

In May 2006, a three-judge panel of the U.S. Court of Appeals for the District of Columbia Circuit ruled that terminally ill patients should have access to experimental medications that have not reached Phase II clinical trials. According to the 2-1 decision, which reversed the dismissal of the lawsuit by a lower court, "barring a terminally ill patient from the use of a potentially lifesaving treatment impinges on this right of self-preservation." However, the full court in November 2006 reversed the decision (<cite>Kaiser Daily Health Policy Report</cite>, 8/8/07).
Arguments
In their appeal to the Supreme Court, plaintiffs' attorneys wrote that the "right of a terminally ill patient ... to take some risks ... in an effort to save her life is implicit in the concept of ordered liberty under any reasonable standard" (<cite>New York Times</cite>, 1/15).

In a brief filed with the court on behalf of FDA, Solicitor General Paul Clement (R) wrote that, although "patients who are suffering from serious diseases have an understandable interest" in experimental medications, "allowing patients to obtain and use unproven drugs carries a host of risks and potential detriments for the public health." According to Clement, FDA has found that "preliminary expectations of safety and efficacy" for experimental medications "often prove to be unfounded," and "drugs that initially appear promising are frequently found ineffective" or "dangerous" (Barnes, <cite>Washington Post</cite>, 1/15).
Reaction
FDA was "pleased" with the decision by the Supreme Court to decline to hear the appeal, according to agency spokesperson Julie Zawisza. She added, "We are committed to making effective therapies available to patients in need, and we also will continue to offer access to unproven therapies through our special access programs." The pharmaceutical industry, which has argued that expanded access to experimental medications would remove incentives for patients to participate in clinical trials, also praised the decision.

Frank Burroughs, co-founder of the Abigail Alliance, called the decision a "tragedy" (Rockoff, Baltimore <cite>Sun</cite>, 1/15). Steve Walker, also a co-founder of the Abigail Alliance, said, "We have now had all three branches of government abandon our constituents, which now number in the thousands" (<cite>Washington Post</cite>, 1/15). He added that the Abigail Alliance might seek congressional action to expand access to experimental medications for terminally ill patients (Edney, <cite>CongressDaily</cite>, 1/15).
Editorial
"Although we are sad for the outcome, we think the U.S. Supreme Court got it right Monday," according to a <cite>Contra Costa Times</cite> editorial. The editorial states that, although "we are sympathetic to the alliance's cause and believe that the FDA should go out of its way to help" terminally ill patients, "we do not believe there is a constitutional right" to access to experimental medications.

"We also agree with the appellate court's assertion that Congress could change the law to broaden such access," the editorial states, adding, "In fact, we think that Congress should do exactly that, and we encourage the Abigail Alliance to lobby Congress hard to make such a change." The editorial concludes, "It would be a far better solution than having the courts grant a nonexistent right" (<cite>Contra Costa Times</cite>, 1/15).
__________________
Brenda

NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)

Nov'03~ dX stage 2B
Dec'03~
Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~
Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~
micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~
micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg

Apr'07~
MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~
Started Tykerb/Xeloda, no WBR for now
June'07~
MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~
MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~
PET/CT & MRI show NED
Apr'08~
scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~
MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~
dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~
Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~
new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~
new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~
25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.

"I would rather be anecdotally alive than statistically dead."

Last edited by hutchibk; 01-16-2008 at 01:29 AM..
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