Cancer Therapy Based On Anatomical Location May Soon Be Obsolete
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#1 Apr 23, 2006
What a cancer patient would like ideally, is to know whether they would benefit from adjuvant chemotherapy (Molecular profiling). If so, which active drugs have the highest probability of working (Cellular profiling) and are relatively non-toxic in a given patient (Pharmacologic profiliig).
By utilizing Molecular profiling oncologists can identify those patients unlikely to benefit from adjuvant chemotherapy from those that would. If the patient needs adjuvant chemotherapy, utilizing Cellular and Pharmacologic profiling, the oncologist can select drugs that have a higher probability of being effective for an individual patient rather than selecting drugs based on the average responses of many patients in large clinical trials.
It's not one versus the other. The best thing is to combine these different tests in ways which make the most sense. One month's worth of herceptin + avastin costs approximately $8000. That's without any docetaxel and blood cell growth factors and anti-emetics. If nothing else, we can't afford too much trial and error treatment.
There are patients who have progressive disease after first-line therapy, only to enjoy a dramatic benefit from second or even third line therapy, and these patients would have been much better served by receiving the most probable active treatment "the first time around."
There should be an expansion of reimbursement to promote even greater utilization and development of these laboratory-based mechanisms for improving the match between tumors and an ever-increasing number of partially effective and very expensive drug therapies.
These laboratory tests are a tool for the oncologist. The oncologist should take advantage of all the tools available to him/her to treat a patient. And since studies show that only 25-30% of patients do respond to chemotherapy that is available to them, there should be due consideration to looking at the advantage of these tests to the resistance that has been found to chemotherapy drugs.
We can't afford anymore 'trial-and-error' treatment.
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