Big Pharma Stomps on Cancer!
“Big Pharma expected to dominate key cancer meeting” screams the headline tonight.
Hey, I thought Big Pharma was our enemy - out to ruin us average Joes with their secret plans to vacuum up all the money in this country. What gives?
It appears that three new treatments against metastatic renal cell carcinoma, all developed by Big Pharma (as compared to teensy-weensy biotech bodegas) are getting publicity at the annual ASCO meeting, where the latest research results are presented urbi et orbi. The three are:
1. Sutent (sunitinib), an oral targeted therapy
2. Nexavar (sorafenib), another oral targeted therapy (Oops! According to the news in this link Wall Street has nixed Nexavar for announcing negligible survival benefits compared with that ancient bane of alchemists known as placebo. Oh well - that’s life in a capitalist economy!)
3. temsirolimus (no brand name yet), an intravenous targeted agent
I’m not certain what is more thrilling about these results (Hey, I’m an oncologist. We hyperventilate over stuff like this) - the fact that we now finally have some new weapons against kidney cancer, a tumor that has been totally resistant to all chemotherapy, or the fact that these new targeted treatments (as well as others) will now be tested in patients with other more common tumors such as lung, breast and colon cancer.
We live in exciting times, don’t we? What will they come up with next?
My friend with metastatic lung cancer is in a trial with this drug http://www.oncogenex.ca/products/ogx011.html She’s just on the first cycle of 18 and her first posttreatment scan isn’t for a couple of weeks. We are hoping of course.
Comment by promenea — June 6, 2006 @ 10:49 am
I’m not hyperventilating over these new treatments. I’m kind of dreading them. It’s not that I want to die, but I just don’t want to address the consequenses of them. Does that make sence?
Comment by emmy — June 7, 2006 @ 3:38 am
I wish they had come up with stuff like this sooner. But I am so very glad advances are being made!!! Someday.
Comment by wolfbaby — June 7, 2006 @ 6:27 am
After the ‘Isha Salaah (the compulsory Islamic nightfall prayer) on most Saturday evenings, a Sufi in group adhkaar at the Habibia Sufi Mosque in Rylands Estate, Cape Town, South Africa, recites (in Arabic) over a glass of water and gives to cancer patients to drink. I have seen people being cured in this manner. The grey-bearded, turbaned dhaakir does this free of charge.
Comment by Faiz — June 8, 2006 @ 12:46 pm
The TV and newspapers send the American public from outrage over the raping drug companies bankrupting grandma with their overpriced products, to admiration for their new drugs that will cure grandma’s cancer.
It gets very confusing to know what to believe. The truth must be in there somewhere.
Comment by John J. Coupal — June 12, 2006 @ 1:49 pm
According to Chemical & Engineering News, targeted “small-molecule” therapies ruled at the annual ASCO meeting of oncologists. The most exciting results shown came from studies of multitargeted tyrosine kinase inhibitors, small molecules that act on multiple receptors in the cancerous cells, like Tykerb and Sutent. The trend is away from the monoclonals to the small molecules, a trend which the new EGFRx ™ test may be able to hasten.
The EGFRx ™ assay will test molecularly-targeted anti-cancer drugs therapies Iressa, Tarceva, Sutent and possibly Nexavar, because of being small molecules. The monoclonal antibodies like Herceptin and Erbitux are “enormous” molecules. These very large molecules don’t have a convenient way of getting access to the large majority of cells. Plus, there is multicellular resistance, the drugs affecting only the cells on the outside may not kill these cells if they are in contact with cells on the inside, which are protected from the drug. The cells may pass small molecules back and forth.
However, drugs like Avastin (although a monoclonal antibody) can be tested with EGFRx ™ because the target of Avastin is not the cells themselves, but rather a hormone (VEGF) secreted by the tumor cells. The Avastin complexes with free VEGF and blocks its action. The EGFRx ™ test can discriminate between the activity of different targeted drugs and identify situations in which it is advantageous to combine the targeted drugs with other types of cancer drugs. All the more reason to “test the tumor first.”
Comment by Gregory D. Pawelski — June 19, 2006 @ 8:42 am
Sutent, One of the New ‘Targeted’ Drugs
The new “smart” drugs are a really exciting element of cancer medicine. One of the new molecularly-targeted cancer drugs is Sutent. It is a “multi-targeted kinase inhibitor.” A drug that inhibits several proteins involved in triggering replication in cancer cells. Basically, inhibits various kinases, a type of enzyme that transfers phosphate groups from high-energy donor molecules to specific target molecules.
Sutent (sunitinib) is an inhibitor of multiple protein kinases, platelet-derived growth factor (PDGFR), vascular endothelial growth factor receptors (VEGFR), stem cell factor receptor (KIT), FMS-like tyrosine kinase (Flt3), colony stimulating factor (CSF-1R), and the neurotrophic factor receptor (RET). Because these proteins are involved in both tumor proliferation and angiogenesis, Sutent has both anti-tumor as well as anti-angiogenic properties. In addition, because Sutent inhibits multiple kinases, it possesses activity against multiple types of tumors.
Sutent can be used as a second-line drug for tumors that are non-responsive to Gleevec. The proto-oncogene KIT, a tyrosine kinase that is inhibited by Gleevec, is overexpressed in a majority of GISTs. Some patients have suffered relapses due to acquired point mutations in KIT, which prevents Gleevec from binding to the protein. Similar mutations have been characterized in EGFR from Iressa-resistant lung cancer patients.
The largest group of kinases are Protein kinases, which act on and modify the activity of specific proteins. So people will try and get some sort of gene-based test to measure the expression-mutation of these kinases. But something more elemental is going on. Does the drug even enter the cell? Once entered, does it immediately get metabolized or pumped out, or does it accumulate?
Sutent is conveniently pigmented. Brilliant yellow. Easy to see which cells have taken it up. In photomicrographs (two magnifications), it is fairly easy to see that some clones of tumor cells don’t accumulate the drug. These cells won’t get killed by it. But you wouldn’t pick this up with an assay which only measured the kinases themselves. The new EGFRx ™ Assay measures the net effect of everthing which goes on (Whole Cell Profiling). Are the cells ultimately killed, or aren’t they?
Normal chemotherapy kills both cancer cells and healthy normal cells (mainly rapidly-dividing cells). Oncologists try to minimize damage to normal cells and to enhance the cell-killing effect on cancer cells. Too often, this delicate balance is not achieved.
Targeted therapy drugs interfere with specific molecules (receptors and enzymes inside and outside a cancer cell). By focusing on these molecular and cellular changes, targeted cancer drugs go after the “target” in these cells, rather than just all cells. Because of this, “targeted” drugs may be more effective than current treatments, and may be less harmful to normal cells.
Whole cell profiling can discriminate between the activity of different “targeted” drugs and identify situations in which it is advantageous to combine the “targeted” drugs with other types of cancer drugs. Because these new “smart” drugs will work for “some” but not “all” cancer patients who receive them, whole cell profiling can accurately identify patients who would benefit from treatment with molecularly-targeted anti-cancer therapies.
Not only is this an important predictive test that is available, but it is also a unique tool that can help to identify newer and better drugs, evaluate promising drug combinations, and serve as a “gold standard” correlative model with which to develop new DNA, RNA, and protein-based tests that better predict for drug activity.
This kind of technique exists, and might be very valuable, especially when active chemoagents are limited in a particular disease; it makes more sense than ever to test the tumor first. Afterall, cutting-edge techniques can often provide superior results over tried-and-true methods that have been around for many years.
The EGFRx ™ Assay is the only assay that involves direct “visualization” of the cancer cells at endpoint. This allows for accurate assessment of drug activity, discriminates tumor from non-tumor cells, and provides a permanent archival record, which improves quality, serves as control, and assesses dose response in vitro.
Comment by Gregory D. Pawelski — November 21, 2006 @ 9:31 am
Yes, we now finally have new weapons against kidney cancer. Thanks for the information - Prakash Arige
Comment by Health Value Travel — October 4, 2007 @ 12:24 pm