A note from Pat on a current topic here..
[b] Individual Dosing ? Could It Improve Our Survival?[/b]
by Pat Killingsworth
While I was in Chicago for the American Society of Clinical Oncology (ASCO) meeting this past weekend, I noticed a renewed emphasis by clinicians and researchers to aggressively move forward with individual, targeted cancer therapies. Attempts to use patient-specific antibodies as a way to deliver innovative anti-cancer therapies grabbed the headlines. But there is a far simpler way to use patient-specific information. Tailoring dosing to each individual can get the optimum results with minimal side effects, using anti-cancer drugs and therapies that are already available.
[b]This is especially true for multiple myeloma patients.[/b]
Just imagine a world where your oncologist didn?t need to guess how much Revlimid (lenalidomide), Velcade (bortezomib), or dexamethasone (Decadron) you would need to take in order to achieve maximum results. Or better yet, that based on your body?s ability to absorb, distribute, or eliminate specific medicines, he or she would know up-front which novel therapy agent, or agents, would work best for you. No more trial and error. No more unnecessary rashes, peripheral neuropathy, or other unwanted side effects from taking too much of a certain drug, or from using a drug that was never going to work anyway.
As you may already know, clinical trials are currently designed to help determine the maximum tolerable dose for a given drug. Patients most often are started on these maximum doses, even though the vast majority of patients don?t need to take so much in order to achieve positive results.
The current standard of care in oncology is it is better to ?err on the high side? when dosing patients.
This may minimize the risk of not hitting the cancer hard enough to be effective, but it can also lead to lots of unnecessary side effects.
This philosophy can be counter-productive in another way as well: More serious side effects often mean a physician is forced to delay or discontinue treatment. It can?t get much more counter-productive than that!
Lots of excuses are made for why individual dosing isn?t commonly used now.
[b]These include:[/b]
The doctor doesn?t have enough time to spend with each patient.
It takes too long?and is too expensive?to get a few blood samples back for each treatment agent before starting therapy.
There isn?t enough individual dosing research available to make this a reality.
In the meantime, thousands of multiple myeloma patients are forced to suffer unnecessary side effects every year?including you and me!
Moving swiftly in the direction of individualized dosing may not cure multiple myeloma. But it could very well extend patient lives by helping our doctors know which novel therapy agents will work best for us, while also allowing us to stay on the appropriate medication longer.
In some cases, getting the process started could be as easy as taking periodic blood tests to measure the amount of a given drug in a patient?s blood.
Computer software is available to predict the optimum amount and times to administer a drug based on the patient?s blood tests. Then, if there isn?t enough of the drug present at the appropriate time, the dose could be increased. Too much, and the dose could be decreased.
That doesn?t sound so hard, does it?
Feel good and keep smiling! Pat
DaiCro 13 years, 5 months ago.