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Biotech / Medical : Ligand (LGND) Breakout! -- Ignore unavailable to you. Want to Upgrade?

To: Andrew H who wrote (14134)	2/3/1998 4:43:00 PM
From: Henry Niman	Read Replies (1) \| Respond to of 32384

There is more than just animal data for Targretin or Panretin treatment of breast cancer. Robinson has indicated that the initial Targretin data for advanced breast cancer looked good and they were moving for aggressively for that indication. Moreover combination treatments have begun using Panretin (and possibly Tagretin) with Tamoxifen (at least 2 separate studies sponsored by the government). In addition, LLY was impressed enough to include a Targretin/Evista program for cancer, which I assume will target breast cancer. I haven't heard results from the combination studies, but SA promised quite of bit of clinical data at the April 8 conference as well as ASCO in May (and more data at the International AIDS conference in June, which will not be related to breast cancer).

To: Andrew H who wrote (14134)	2/4/1998 8:31:00 AM
From: Henry Niman	Read Replies (1) \| Respond to of 32384

Here's some interesting info on neurotoxicity associated with high dose chemotherapy treatment of breast cancer: Efficacy, Toxicity Of High-Dose Chemo In Breast Cancer Requires Further Study WESTPORT, Feb 04 (Reuters) - Use of high-dose chemotherapy with autologous stem-cell rescue as a standard therapy for breast cancer is on the rise, but selection of this protocol may be premature, according to two reports out today in the February 4th issue of the Journal of the National Cancer Institute. In the first report, Dr. JoAnne Zujewski and colleagues at the National Cancer Institute in Bethesda, Maryland, show that the available clinical data are insufficient to support high-dose chemotherapy with stem-cell rescue as a treatment for breast cancer. The NCI team reviewed the literature on trials that were conducted between January 1966, and May, 1997. They found more than 600 English-language papers on the topic, including a number of preclinical, Phase I/II, Phase II, and pilot studies, but there was only one randomized Phase III trial comparing high-dose chemotherapy with stem-cell rescue with more conventional chemotherapy. The results of the latter trial were promising, and demonstrated a significantly increased survival rate for women treated with the high-dose regimen compared with those given conventional chemotherapy. But Dr. Zujewski and her associates write that the randomized trial was small and pointed out that the survival rate for women treated with conventional chemotherapy was lower in this study than would be expected. Overall, Dr. Zujewski and her team report that the data are "inconclusive," but that the results from ongoing, large, randomized trials should clarify the role of high-dose chemotherapy with autologous stem-cell rescue in the treatment of breast cancer. In a telephone interview with Reuters Health, Dr. Zujewski urged physicians and the public to "...have a trust in the clinical trials process and to enroll in clinical trials...[because] only through these trials will we be able to provide women with the answers that they really need to make decisions." Once all the cards are on the table, this therapy "...is likely to make a contribution to breast cancer treatment," the team writes in the paper. Elsewhere in the journal, researchers in The Netherlands warn that neurologic toxicity may be a limiting factor in use of high-dose chemotherapy in breast cancer. In response to complaints of persistent cognitive defects in breast cancer patients following chemotherapy, Dr. Frits S.A.M. van Dam of The Netherlands Cancer Institute in Amsterdam and a multicenter team examined cognitive functioning before and after treatment in a group of breast cancer patients who received high-dose chemotherapy plus tamoxifen, standard-dose chemotherapy plus tamoxifen or no chemotherapy. The Dutch team found that "...the patients treated with high-dose chemotherapy had an 8.2-times higher risk of cognitive impairment than the control patients who were not treated with systemic therapy and a 3.5-times elevated risk in comparison with the patients who were treated with standard-dose chemotherapy." "On the basis of [these] findings, which are indicative of neurotoxicity caused by systemic chemotherapy in adult patients," Dr. van Dam and colleagues "...believe that central neurotoxicity might become a dose-limiting factor in high-dose chemotherapy regimens." They point out that these effects should be further explored before high-dose regimens are introduced into routine clinical practice. Elsewhere in the journal, Dr. Patricia A Ganz of the University of California at Los Angeles agrees with Dr. van Dam's final conclusion, pointing out that researchers should "...push for systematic research on the late effects of cancer treatment." She adds that, though survival may be the number one priority for breast cancer patients in choosing a course of treatment, "...they are also concerned about the quality of their survival." J Natl Cancer Inst 1998;90:182-183,200-218. -Westport Newsroom 203 319 2700