Chemotalk Newsletter

Chemotalk Newsletter, Vol. 4:  September 1, 2008

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A good Tuesday to you all. As promised, I'm going to try to find interesting and important news stories that relate to chemo.

In the past month, there were two news stories I thought particularly worthy of attention. Both are easily overlooked or ignored: the assay piece was buried in the middle of a business page, not in the health section - but both stories are the stuff that can make life easier for chemo recipients, both present and past ...

On June 17, a company that specializes in chemotherapy therapeutic drug monitoring, announced that it has developed an assay - a test, in layman's language - that allows people with CORECTAL, STOMACH, BREAST and PANCREATIC CANCERS, to monitor their actual plasma levels for individual dosing.

"Until now, a simple, rapid, and cost-effective 5-FU measurement tool that can be easily integrated into day-to-day practice has not been readily available. As a result, colorectal cancer patients receive chemotherapy based on their height and weight, with no monitoring system in place to allow oncologists to correlate dose with clinical patient response on an ongoing basis," said Salvatore Salamone, Ph.D., CEO of Saladax Biomedical.

"Access to this simple blood test will arm oncologists with the ability to individualize 5-FU dosing to ensure patients receive the optimal benefit from their treatment."

If your chemo requires monitoring of this kind, you should pass this information on to your doctor. Maybe your doctor already knows about it, maybe he/she doesn't use it and has specific reasons for preferring not to. The important thing, for both doctor and patient, is to be as fully informed as possible. Doctors sometimes miss information, so it's up to us to fill in the blanks when we can.

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The second story had to do with SKIN-RELATED SIDE EFFECTS of chemo. A survey done by CancerCare revealed that while patients were seldom worried about this particular side effect before treatment, nearly 80 percent were concerned about the actual skin effects they experienced as a result of their treatment and how those side effects - namely, irritation, rash, discoloration, dryness, strange markings that weren't there before, and a host of other skin problems - affected their quality of life.

"Many people starting cancer treatment are unprepared for its (chemo's) effect on their skin," Diane Blum, MSW, Executive Director of CancerCare, said. "In fact, the survey revealed that concern about skin irritation and dryness increased more than that of any other side effect after people underwent treatment. "These survey findings show the need to better inform and educate people being treated for cancer about what to expect about possible skin problems, and to help them find the remedies that can help treat these uncomfortable symptoms."

This item refers to chemo in cancer treatment, but clearly it applies to anyone being treated with chemotherapy drugs, for any number of diseases or conditions.

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These additional news items also appeared over the last month:

Good news for CANCER patients on chemo, who are experiencing FATIGUE because they've developed anemia:

It appears the drug DARBEPOETIN ALFA, already used to reduce the need for transfusion associated with chemo-induced anemia, increases hemoglobin levels, according to 3 studies presented at the American Society of Clinical Oncology's 44th Annual Meeting. When they announce a finding at an event as important to oncology professionals as this one, it's considered major. So if you or somebody you know is having fatigue from chemo, tell them to ask their doctor about Darbepoetin Alfa.

And a drug called PROVIGIL is also a fatigue-fighter in the chemo arsenal.

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Reuters reported on June 9 that treatment with high doses of CYCLOPHOSPHAMIDE, a generic cancer drug, cut the level of disability in people with RELAPSING-REMITTING MS. The drug also reduced the number of MS-related brain lesions, and improved physical functioning.

The study was small, only 9 patients. But were "the worst of the worse", with 8 of them failing all other treatment (1 having no previous treatment). They were tracked for 2 years after getting the drug. Five of them had no signs of disease activity, and the other four showed dramatic improvement, said Dr. Douglas Kerr of Johns Hopkins University in Baltimore.

The nine patients were in the study were given large doses of cyclophosphamide intravenously for 4 consecutive days in a bid to "reboot" the immune system -- and then no more of it. That was all it took for them to recover physical functions that had been lost to the disease, Kerr said.

"Every other therapy that's out there and, as far as I'm aware, every other therapy that's on any drug company's drawing board, is designed to hold the disease at bay for as long as you take the drug," said Kerr, whose study was published in the journal Archives of Neurology. "This is one in which you give it once to hopefully reset the immune system back to a naive state so it's no longer attacking the brain and spinal cord. And so that, I think, makes it quite different and quite exciting," Kerr added.

Researchers aim to begin a large, multi-center clinical trial of the approach next year.

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In a June 5 story on TopCancerNews, it was reported that early BREAST CANCER patients treated with standard chemotherapy followed by paclitaxel had better disease-free survival compared with patients treated with standard therapy alone, according to the final results from a randomized phase III trial. I was diagnosed with late-stage metastatic breast cancer, given that protocol, and it worked for me.

Paclitaxel and other taxanes are among the most active agents in metastatic breast cancer. Researchers are now testing the drugs in patients with early, non-metastatic breast cancer.

In the current study, Miguel Martin, M.D., of the Spanish Breast Cancer Research Group and colleagues randomly assigned 1,246 women to treatment with fluorouracil, epirubicin, and cyclophosphamide (FEC) or FEC followed by weekly paclitaxel (FEC-P).

The estimated 5-year survival rate was 78.5 percent in the FEC-P arm and 72.1 percent in the FEC arm. There was a trend toward improved overall survival, but it did not reach statistical significance. "Because distant relapse-free survival is usually associated with overall survival, a statistically significant benefit in overall survival may become evident with a more protracted follow-up," the authors write.

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And if you have any thoughts of how this newsletter could be improved, please email me directly, at

Elaine Jesmer

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