To: DMB who wrote (1621 ) 11/20/1998 5:48:00 AM From: Maurice Winn 1 Recommendation Read Replies (1) | Respond to of 1762
Thanks DMB, The allergic reaction and any other adverse reactions I suppose will be accumulated in the Rituxan clinical outcomes charts and there should by now be very good statistical information on short term effects if not long term. Even 'very sick in intensive care' doesn't sound too bad compared with 'dead from lack of Rituxan'. Especially if it was in fact the Herceptin. Allergic reactions go away - as long as you survive the acute reaction. I see how diagnostic creep could skew the results making later treatments look more effective. It's surprising that professionals in a field could be taken in by such an obvious trend. But I'm sure that can happen - there have been much bigger mistakes than that made! Imagine a lymphoma patient going through the normal mill - surgical tumour removal, CHOP, involved field radiation. Some of those people will still have distant mestatic disease - we know that because lots of them die. But some of them don't and are fully cured - but it isn't easy to tell which is which. So there are many who have just a few cancer cells left and if only those could have been dealt with too, more would have joined the fully cured crowd. So, suppose the patient has had the tumour removed, the CHOP, the involved field radiation and THEN you give them Rituxan and Oncolym. That won't be the same as adding Methoxetrate or some other poison to the CHOP brew. Adding the monoclonal antibodies AFTER the normal treatment is sequential treatment which will target cancer cells which would otherwise be left to breed, mutate and kill the patient. Since we know Rituxan and Oncolym do kill cancer cells and a lot of them at that, we know that there will be an improved cure rate. We are told that the half life for expressed antigens is pretty short, so the cancer cells will be vulnerable days after the end of normal treatment. So the extra cure rate should be quite substantial. Offsetting the extra cure rate are the hazards of treatment and the cost of the treatment. The hazards seem much less than 1% mortality, so not significant compared with the extra people who would be cured. The cost is up to the person involved to put a value on [or their agents be they state funded systems, medical insurers or whoever]. So, let's go! Maurice