Rudy, Rick, Peter, Mike, other lurkers, buyers, shorts,..:
Thanks for all info and participation on CELG SI tread.
I am following CELG for more than three years, been in and out several time, but never was as excited about company as this days. And, thalidomide is only part of the game. Nonetheless, it is now *HOT*, and I will dedicate discussion to this drug.
Thalidomide is *THE FIRST AND THE ONLY TRUE ANTI-ANGIOGENESIS* drug on market today. From three micro-vasculature grow factors/hormones: VEGF , Angiopoetins and bFGF, thalidomide appears as potent down regulator of the bFGF signaling and strong indication that it down regulate VEGF mRNA. So, NONE should be surprised that thalidomide work well in many cancer types.
<<"In conclusion, T [thalidomide] has remarkable anti-tumor activity in advanced and high risk MM, justifying its incorporation into combination chemotherapy trials (D.T. PACE-Dex, T, cisplatin, 1 Adria, CTX, VP16) which has induced 3 true CR's [complete remissions] after
1 cycle among 5 currently evaluable patients." >>
I will beet that this is only first of many trials where thalidomide will be added to first-line combination chemotherapy. Three out of five complete and true response after first cycle you will find only in few (if at all???) chemo combination. Two other most be partial response?? Bear in mind that this abstract was written at 8-1-98, so additional 3 1/2 months for more clinical data (more patients) are available for analysis and probably presented at conference.
I must confess that I was very surprised with strong thalidomide results in GVHD and LVH (leukemia-versus-host) trial. Specially low relapse rate (~5%) and ~40% overall response. After BM transfusion, acute or chronic GVHD accrue in 65-70% where immunosupressive drugs or combination (CyA, prednisone, corticosteroids,..and their combination) does not have satisfactory results in 30-35%. Also, high doses of the immunosuppressant have negative effects: increased infectious condition, weakest white blood cells fighting capability,...all in all GVHD is not easy to control! Actually very hard.
So, thalidomide have DOUBLE effects: anti-leukemia (anti-angiogenesis) and anti-GVHD. This is very rare and in hematology fild the only example. Regardless that this results is only publish and will not be orally presented at ASH, cancer clinicians and specialist are aware of this development. Good news will spread around.
I initialy posted GVHD abstract to intrigue SI bio-freaks. I guess it worked. :)
And MM and GVHD is not all! :)
Currently, thalidomide is in trials for prostate, ovarian, NSCLC, brain (primary and secondary), colorectal, KS,....WHO KNOWS how many more trials are ongoing at cancer institution??? Some of then are sponsored by CELG or ENMD, some by NCI, some are physician sponsored trials. Add to that anti-inflammatory indications (Crohn's, RA, Parkinson's,...mouth ulceration,...AIDS, cancer and TB wasting)...
IS THERE ANY DRUG WHICH HAVE MORE INDICATION THAN THALIDOMIDE?
But, we should never forget on thalidomide terrible side effects if it is used uncontrolled. For the sake of the current and future pts, I wish that STEP program continue to work well and that thalidomide *black market* do not get out of control. WITH INCREASED DRUG POPULARITY DANGER THAT DRUG WILL BE MISUSE IS GROOVING.
Hope that our society and medical community will make adequate steps to help thalidomide distribution to ones who needs drug the most.
Cheers!
Miljenko
|
