Metastatic Kidney Cancer

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Metastatic Kidney Cancer

by Bruce on Thu Jun 30, 2005 12:00 AM

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A message I recently sent to my friends. As you know, I continue to fight kidney cancer that was discovered when I had that motorcycle accident almost two years ago. I am a patient of Dr. Wolfram Samlowski at the Huntsman Cancer Clinic here in Salt Lake City. Over the past year, I have been on a clinical trial drug called Tarceva that is designed to interfere with the cancer cells signals to grow. Every other month I get scanned and the report has always been “no growth of the cancer”. My latest scan last week showed some growth in two areas (lungs). This means serious trouble for me. They want to put me on a radical treatment that will take me down for several months. And the treatment is not considered a high percentage of success. I feel fine right now and have till late August to decide if I will do this (interlukin) treatment. I am not sure yet what I will do. You are receiving this message because I consider you to be a special friend. We’ll talk later.

Metastatic Kidney Cancer

by Rccdoc on Fri Jul 01, 2005 12:00 AM

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Your options in the second-line setting are either to use traditional cytokines (IL-2 or IFN) or to consider particiapting in a clinical trial of one of the new oral drugs (sorafenib or sutent). There is a trial of sutent (SU011248) for patients who have failed avastin. This trial is open at only 8 centers in the US. For information about this trial, go to the Kidney Cancer Association website. Cytokines still have a role in this cancer and if you chose IL-2 or IFN that would also be a reasonable option. Both sutent and sorafenib will be available soon as compassionate use, so if the cytokine does not work then you could receive one of the newer drugs as a third treatment.

Metastatic Kidney Cancer

by Trishpm on Tue Jul 05, 2005 12:00 AM

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There is an email support list specific to kidney cancer. Join it at http://cancerguide.org/kofaq/. High Dose Interleukin is the only other treatment besides surgery that has been shown to put you into a long lasting (perhaps permanent remission). Sutent and sorafenib are still in trials but very promising. If you enter a clinical trial, be sure to find out if you will get the new treatment for sure, or will randomly get another treatment or worse yet, no treatment (good for research, but not good for patients). Some trials will exclude you if you have had another treatment, some require that you have had another treatment. There are many trials underway for metastatic kidney cancer.

Metastatic Kidney Cancer

by Rccdoc on Wed Jul 06, 2005 12:00 AM

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High-Dose Interleukin-2 is not what it is cracked up to be. First and foremost, although two recent studies from Jim Yang at the NCI and McDermott at Beth Israel (Cytokine Working Group) demonstrated a higher response rate 20-25%, there has never been a trial of high-dose interleukin 2 that has shown a survival advantage. You can confirm that by asking any physician member of the medical advisory board of the KCA. Although a very small percentage of patients may have a durable response. Low-dose IFN however has been shown in 4 clinical trials compared to placebo controls (megace or vinblastine) and in 2 clinical trials combined with cytoreductive nephrectomy to confer a survival advantage. At the end of the day, it is survival which is the gold standard. The patients with durable responses to high-dose IL-2 are a very select group with limited metastatic disease to the lung. Most patients unfortunately do not achieve benefit from this therapy. And, although safer than in the past, there is still a mortality rate from the therapy. Ongoing research into markers for response will help narrow down the patient population receiving high-dose IL-2 to those most likely to respond. For instance, patients who express carbonic anhydrase 9 in greater than 85% of the tumor have a greater than 60% liklihood of response. This test is not yet commercially available. A good center to go to would be UCLA, Robert Figlin, who tests all of his patients prior to HD IL-2 only treating those who overexpress. I use HD IL-2 for very select patients. Most of my patients, who travel from many states away, chose to enroll on a clinical trial. Wait and watch for complete responses to SUTENT. Remember there is only 5-7% of patients treated with high-dose IL-2 that have a complete response. Not a very high hurdle to overcome with one of the new drugs.

Thanks For Those Responses

by Bruce on Wed Jul 13, 2005 12:00 AM

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Much appreciate the replies to my original email about my cancer. My right kidney was removed two years ago and testing showed no lymphs were affected. there are several places where I have suspicious spots but recently two have grown a little in the lungs. I am hesitant to try interleukin not yet understanding the risks and side affects. It's success rate is so very small. The new drugs that have been mentioned may be a better direction. I have already tried Tarceva and we beleive it delayed growth for a year. I am no longer taking it. I trust my doctor but I know now that I need to get more knowledge and take control of my future. Thanks again. //bm

to Bruce m. re Metastatic Kidney Cancer

by Mystic04 on Fri Feb 03, 2006 12:00 AM

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Bruce, Would like to discuss more about our commonality with Dr. Wolf Samlowsk and metastatic renal cell cancer. A family member is a patient of his. Look forward to hearing from you.

Bruce Response

by Bruce on Sun Feb 05, 2006 12:00 AM

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sure. I will discuss this with you. //bm
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