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Biotech / Medical : IDPH--Positive preliminary results for pivotal trial of ID -- Ignore unavailable to you. Want to Upgrade?


To: Maurice Winn who wrote (1443)1/20/1998 8:23:00 PM
From: I. Luttichuys  Respond to of 1762
 
Hello Maurice,
I am an IDPH shareholder from way back. Lately, I haven't posted much. Things often seem busier for me than I would like... at least as it touches "investments".
I use quotes because, I'm sure the thread will agree, the human side to some issues come to mean so much more than the rest of it. We end up holding the stock because we believe deeply in the personal meaning of what it represents.
Your post serves to remind us all that this is such a case and, our hearts go out to you, and especially, to your son.
You have said that your son has a diffuse large-cell intermediate grade NHL with a 1A staging. With aggressive chemotherapy, 60-80% experience complete remission and, 50% remain free of NHL for a sufficient number of years that they come to be considered cured. These figures are specific to the exact diagnosis which your son now carries.
IDEC's approval is for low-grade follicular NHL, as you know.
It has been tested and (I would think) will continue to be tested for the other lymphomas which, as a group, would include your son's.
My hope for you and your son is that, you might keep very close watch for an opportunity to participate in such trials and that you might establish contact (if you have not already) with a physician who is knowledgable with respect to the work being done in this area by IDEC specifically.
I mentioned those numbers before because, they show that you both have time to do this. Rituxan is not out of reach for you. Maybe today, but you have time... maybe quite a bit more that you seem currently to imagine. A great deal will happen at IDEC and with these therapies in coming months and years. It will be difficult but, I firmly believe that the odds are on your side.
Watch this company, and for that matter, Coulter, very carefully and continue with the therapy your son must now endure. I know it is terribly difficult but, it has a very decent chance at repeated remissions if not outright cure. In the meantime, an expanded study for new indications or even the realization of additional approvals for new indications for Rituxan are possible.
As another poster said... please keep us informed.
I know some IDEC and Genentech people... and quite a few oncologists.
Perhaps as time passes, and an opportunity arises, we will hear about it.
BENNETT



To: Maurice Winn who wrote (1443)1/21/1998 9:49:00 AM
From: Scott  Read Replies (2) | Respond to of 1762
 
Maurice, have you considered a second opinion from another doctor? As a parent, I can only imagine the anguish you are going through. Bennett's post was encouraging, and I sincerely hope that your son is one of those who goes into complete remission. On the other hand, you have a great deal of knowledge about his condition and treatment options, and it does not sound as though you are completely comfortable that the doctor made the right call on use of Rituxan for your son. This is the situation that second opinions are for, and this should not cause any problem in your relationship with your son's doctor. In fact, I am surprised that he did not suggest this to you when he disagreed with you on whether Rituxan is appropriate for your son. I certainly do not know that it is. But if you are not yet comfortable with the choice not to use it, you need to get your son to see another oncologist within the critical week. That my sound impossible, but they (and most other types of docs) are used to being consulted on short time frames for exactly this kind of situation, and they will accomodate you. How do you find one? I do not know if you will be able to get an answer this way, but you might: Call Idec's customer service and keep asking to be transferred to the person who interfaces with physicians. Once you get someone knowledgeable, ask them to provide you with the names of physicians in your area who are experienced with Rituxan use. Idec has this information; they keep track of the physicians who prescribe their drug. The number of oncologists is surprisingly small, and Idec knows every one. Make it clear that you know that if they give you names, you do NOT regard that as a recommendation or an endorsement (you may well need to make that clear before they'll give you any names.)
If that fails, and if you are politely assertive enough it should succeed, call up the nearest big-name academic (university-affiliated) medical center. Get the oncology group's receptionist, and tell her you need one of the oncologists to call you back TODAY. She'll first tell you it can't be done if you are not currently a patient, bu politely persist, and you will be talking to someone today. Tell him/her you need a second opinion on a therapy problem this week. You can make it happen. your comfort level, and that of your son, with his treatment plan is critical.
Good luck, and please keep me posted. By the way, what area of the country are you in?



To: Maurice Winn who wrote (1443)1/23/1998 9:58:00 PM
From: Gregory Rasp  Read Replies (1) | Respond to of 1762
 
Maurice. Sorry to bud in on your conversation. I am a radiation oncologist in the US and noticed the statement about neutrophil levels. Rituxan is not in our armory yet here. Can you elaborate? I would not think normal neutrophil levels would affect the drug.

As for improving cure rates and relative dangers of untested therapies, we often run into this problem. When a disease has a small chance at cure (1-20% or so) there is little to lose in trying something about which only a little is known. On the other hand in diseases with high cure rates (70+% - I realize that anything less than 100% is low when you or a loved one is the patient), the risks are dramatically higher. We often radiate patients with Stage I or II intermediate and high grade NHL after they enter CR (complete response) to CHOP. We know that this improves cure rates 5-10% in some situations (bulky initial disease mainly). Nevertheless, we are still torn about doing so as we KNOW we will subject 100% of the patients to the toxicity of the treatment to help only 5-10%. It is a tough call to make.

Yours

Greg Rasp