CONTACTS 

SUBJECTS
Kaiser Answer Questions UCSF Letter 061229 Qualify Millie for Clinic

2503 -
2503 -    ..
2504 - Summary/Objective
2505 -
250501 - Follow up ref SDS 56 0000. ref SDS 55 0000.
250502 -
250503 - Primary care physician at Kaiser submits answers to questions from
250504 - Doctor Rugo on qualiifying Millie for clinical drug trial at UCSF with
250505 - Cetuximab Carboplatin. ref SDS 0 PN5X  Kaiser seems to propose holding
250506 - treament with Gemzar in order to qualify for drug trials, and does not
250507 - cite authority. ref SDS 0 OU5K  UCSF discusses qualifying Millie for
250508 - the cetuximab trial. ref SDS 0 PN5X  Research indicates severe side
250509 - effects, ref SDS 0 5G6O; another source says side effects are mild,
250510 - ref SDS 0 PO5M, and another source says patients are monitored for an
250511 - hour after treatment for severe reaction. ref SDS 0 PO6O  Doctor Rugo
250512 - at UCSF further mentions an Avastin trial for Millie, which seems to
250513 - conflict with patient history suffering pulmonary embolism with a
250514 - previous Avastin trial. ref SDS 0 JP5V  Kaiser presents CA 15-3 and
250515 - equivocal report on PET/CT test for measurable disease; does not
250516 - report progression of disease from left to right breast. ref SDS 0
250517 - PO3V  Costs of trial are covered by Millie's insurance with Kaiser.
250518 - ref SDS 0 3X6K  Since Millie seems to be presented with only 2
250519 - choices, contacted MD Anderson for additional IBC treatments.
250520 - ref SDS 0 MN4L  Research found another treatment with Lapatinib
250521 - (Tykerb), also, proposed by Doctor Benz. ref SDS 0 4X6G
250522 -
250523 -
250524 -
250525 -
250527 -  ..
2506 -
2507 -
2508 - Progress
2509 -
250901 - UCSF 2 Drug Trial Proposals Kaiser Collaborating to Help Millie
250902 - Drug Trials Kaiser Collaborating UCSF Consider Proposals Help Millie
250903 -
250904 - Follow up ref SDS 56 086H, ref SDS 55 086H.
250905 -
250906 - Background on Kaiser collaborating with UCSF on drug trials for Millie
250907 - is reported on 061228. ref SDS 56 086H
250909 -  ..
250910 - Millie received ref DRT 1 0001 dated 061229 from the primary care
250911 - physician saying...
250912 -
250913 -    1.  This is the message from Dr Rugo.  My responses are in
250914 -        brackets.  I woul hold Gemzar for now because it may otherwise
250915 -        disqualify you for one of these studies:, ref DRT 1 0001
250917 -  ..
250918 - Currently, on 061208 the doctor scheduled Millie to begin treatment on
250919 - 070105 with Navelbine. ref SDS 49 PF3O  There has been no discussion
250920 - to schedule Millie for treatment with Gemzar, although it appears to
250921 - be the only other drug Kaiser has available to help Millie after
250922 - Navelbine. ref SDS 49 P09H
250923 -
250924 -            [On 070105 the doctor clarified the letter today was a
250925 -            mistake; he intended to say that treatment with both
250926 -            Navelbine and Gemzar should be deferred so that Millie has
250927 -            a better chance of qualifying for treatment in clinical
250928 -            studies of new, more effective chemotherapy agents.
250929 -            ref SDS 59 PF3O
250931 -  ..
250932 - Doctor Benz recommended treatment with Gemzar and Taxotere in a 2nd
250933 - opinion letter received on 041117. ref SDS 15 OU5V and also
250934 - ref SDS 15 OU6S  More recently, on 060929 Doctor Benz 2nd opinion was
250935 - received from Kaiser for a consultation at UCSF on 060821, and the
250936 - Doctor recommended treatment with Gemzar and capecitabine.  There is
250937 - no evident record of UCSF indicating Gemzar disqualifies treatment on
250938 - drug trials.
250939 -
250941 -  ..
250942 - Cetuximab Carboplatin Trial Proposed by UCSF Rather than Navelbine
250943 -
250944 -
250945 - Letter from primary care physician continues...
250946 -
250947 -    2.  I think she has had three lines of therapy and therefore would
250948 -        still qualify for the cetuximab trial, could you confirm if
250949 -        this is true?
250950 -
250951 -        (This is true)........ ref DRT 1 EH5N
250953 -  ..
250954 - Millie's patient history shows following chemotherapy....
250955 -
250956 -        1.  AC
250957 -        2.  Taxotere
250958 -        3.  Taxol bevacizumab (Avastin)
250959 -        4.  AC
250960 -        5.  Taxotere capecitabine (Xeloda)
250962 -  ..
250963 - This seems to make "4 lines" of treatment, however, the scope for
250964 - "lines of treatment" may require clarification.
250965 -
250966 -              [On 070201 the study only counts treatments that were
250967 -              used until ineffective; Avastin was stopped because
250968 -              Millie developed PE, and so was not counted against her
250969 -              qualifying for the study. ref SDS 69 1N6N
250971 -               ..
250972 -              [On 070116 Consent documents show there are 100 patients
250973 -              on the study nation-wide, and 20 patients on study at
250974 -              UCSF. ref SDS 61 1H3O
250976 -               ..
250977 -              [On 070201 there are 6 patients on the study at UCSF.
250978 -              ref SDS 69 G68L
250980 -  ..
250981 - Cetuximab plus carboplatin trial was presented in the Benz 2nd opinion
250982 - received from UCSF on 060929.  UCSF further cited a phase 1 trial of
250983 - Abraxane in combination with lapatinib. ref SDS 40 UI9K
250985 -  ..
250986 - Side Effects are reported on the Internet...
250987 -
250988 -            Cancerbackup.org
250989 -
250990 -              http://www.cancerbackup.org.uk/Treatments/Biologicaltherapies/Monoclonalantibodies/Cetuximab
250991 -
250992 -            The side effects of cetuximab are generally mild and some
250993 -            of these can be reduced with medicines.  Cetuximab is given
250994 -            with the chemotherapy drug irinotecan, so many of the side
250995 -            effects you might have will be caused by the irinotecan.
250996 -            Cetuximab does not increase the side effects of irinotecan.
250997 -            ref OF 2 656M
250999 -  ..
251000 - Another source says about side effects...
251001 -
251002 -            Drugs.com
251003 -
251004 -              http://www.drugs.com/MTM/cetuximab.html
251005 -
251006 -            After you receive this medicine, your doctor will need to
251007 -            watch you for about an hour. This is to make sure you do
251008 -            not have any serious side effects from the medicine.
251010 -  ..
251011 - Another source lists....
251012 -
251013 -           Medline Plus
251014 -
251015 -              http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500511.html
251016 -
251017 -            Blemishes on the skin, pimples;  bloating or swelling of
251018 -            face, arms, hands, lower legs, or feet;  chills;  cough or
251019 -            hoarseness;  deep cracks, grooves or lines in skin;
251020 -            difficult or labored breathing;  dizziness;  facial
251021 -            swelling;  fever;  headache;  lower back or side pain;
251022 -            nausea;  painful or difficult urination;  pale skin; rapid
251023 -            weight gain;  severe dry skin;  shortness of breath ;  skin
251024 -            rash;  tightness in chest;  tingling of hands or feet;
251025 -            troubled breathing with exertion;  unusual bleeding or
251026 -            bruising;  unusual tiredness or weakness;  unusual weight
251027 -            gain or loss;  vomiting ;  weakness;  wheezing
251029 -  ..
251030 - Research on the Internet shows report by MD Anderson Cancer Center
251031 -
251032 -            http://www.bcrfcure.org/rese_meet_mendelsohn.html
251034 -  ..
251035 - MD Anderson reports poor results for cetuximab. ref OF 1 UK5H  The
251036 - Cancer Center performed a governent funded research project that seems
251037 - to have yielded improvement treating breast cancer. ref OF 1 VL8K
251039 -  ..
251040 - John Mendelsohn, MD and president of MD Anderson Cancer Center,
251041 - biography is also presented. ref OF 1 LP8J
251043 -  ..
251044 - Possibly, current clincial study at UCSF considered for Millie is
251045 - testing effectiveness of MD Anderson's research project.
251047 -             ..
251048 -            [...below, report on trial with Lapatnib targeted to treat
251049 -            IBC. ref SDS 0 4X6G
251051 -  ..
251052 - Letter from primary care physician continues...
251053 -
251054 -    3.  Is she doing well performance status wise, and is stable on
251055 -        anticoagulation?
251056 -
251057 -        (Yes.)......... ref DRT 1 V16G
251059 -         ..
251060 -    4.  Did the new PE occur on full anticoagulation or not?
251061 -
251062 -        (She was off wafarin because a year had past, she was off
251063 -        Avastin, and her disease was relatively inactive for a while
251064 -        after her mastectomy.), ref DRT 1 G16J
251066 -  ..
251067 - Kaiser's report is unclear; reflects the record on 051007 when the
251068 - doctor ended treatment with Coumadin for pulmonary emboli. ref SDS 26
251069 - RZ4I
251071 -  ..
251072 - Saying disease was relatively inactive after mastectomy aligns with
251073 - the record on IBC rash based on continuing examinations and
251074 - diagnostics.  There is no record of examination and diagnostics for
251075 - pulmonary embolism after mastectomy surgery on 051021.
251076 -
251077 -            [On 070110 most recent INR shows Millie within target range
251078 -            2.3. ref SDS 60 5O6P
251080 -  ..
251081 - Letter from primary care physician continues...
251082 -
251083 -    5.  I assume she has ER/PR/HER2
251084 -
251085 -        (Yes)......... ref DRT 1 007O
251086 -
251087 -           [On 070116 consent document for cetuximab and carboplatin
251088 -           clinical study shows drug trial is targeted for "triple
251089 -           negative" patients, which means ER PR HER2 negative.
251090 -           ref SDS 61 0Q7I
251092 -  ..
251093 - Avastin Abraxane Phase I Trial Considered for Millie
251094 -
251095 -
251096 - Letter from primary care physician continues...
251097 -
251098 -        - disease, we also have a phase one trial of avastin and
251099 -        abraxane that she would qualify for as well, and she could do
251100 -        that if the cetuximab/carboplatin combination was not
251101 -        effective.
251103 -  ..
251104 - Not sure why there would be consideration of bevacizumab (Avastin),
251105 - since she has pulmonary emboli recurrence, and on 041104 initial
251106 - diagnosis was attributed to the Avastin trial. ref SDS 14 RZ4I
251107 -
251108 -            [On 070130 Doctor Rugo explains that Millie can be treated
251109 -            on another trial with bevacizumab (Avastin) because the
251110 -            original diagnosis for pulmonary embolism may be due to
251111 -            genetic dispostion rather than Avastin. ref SDS 68 LE3S
251112 -
251114 -  ..
251115 - CA 15-3 Measurable Disease
251116 - Measurable Disease CA 15-3
251117 -
251118 -
251119 - Letter from primary care physician respond to UCSF continues...
251120 -
251121 -    6.  I assume also that her disease is emeasurable
251122 -
251123 -        (only elevated CA 15-3 and equivocal findings on PET),
251125 -             ..
251126 -            [On 070102 PET/CT report for test on 061227 reports mild
251127 -            FDG activity beneath left chest wall. ref SDS 58 9X4S
251128 -
251129 - "emeasurable" not sure if this is a technical term, or misspelling?
251131 -  ..
251132 - Kaiser's letter to UCSF on 061228 stated "Her only measurable disease
251133 - are the lesions on her chest wall." ref SDS 56 D76P
251135 -  ..
251136 - IBC rash spreading on the left chest since 060623, ref SDS 31 025H,
251137 - and and now to the right breast measures progression of disease
251138 - observed by doctor during examination on 061208, ref SDS 49 025H, and
251139 - cited in the letter to Kaiser on 061228. ref SDS 56 T66Y  Kaiser's
251140 - failure to report advancing disease to UCSF is not clear, since this
251141 - is a requirement for patent to qualify for treatment in the UCSF
251142 - clinical study drug trial, reported by Doctor Benz in a letter to
251143 - Kaiser dated 060821, and received from Kaiser in a meeting on 060929.
251144 - ref SDS 40 UI9K
251145 -
251146 -            [On 070101 letter from UCSF requests patient history of
251147 -            measurable disease. ref SDS 57 E23S
251149 -             ..
251150 -            [On 070101 background identifying measurable disease for
251151 -            IBC, including that IBC does not appear in image tests.
251152 -            ref SDS 57 4Q6K
251154 -             ..
251155 -            [On 070130 Doctor used a tape measure to estimate IBC
251156 -            disease area, and plans to create a photographic record of
251157 -            measurable disease. ref SDS 68 M95L
251158 -
251160 -  ..
251161 - Payment by Kaiser for Any Costs Not covered by Trial
251162 -
251163 -
251164 - Letter from primary care physician respond to UCSF continues...
251165 -
251166 -    7.  ...and that she could go on a trial that woudl be supported by
251167 -        Kaiser or some other insurer? ref DRT 1 TQ7H
251169 -         ..
251170 -        (Yes, for any costs not covered by the trial), ref DRT 1 TR7M
251172 -         ..
251173 -        Our trials are funded, but do not cover standard of care.
251174 -        ref DRT 1 QS8F
251175 -
251176 -            [On 070105 Kaiser changed treatment from Navelbine to
251177 -            prescribe cetuximab and carboplatin on referral to UCSF.
251178 -            ref SDS 59 PK7L
251180 -             ..
251181 -            [On 070119 Millie travels to San Francisco for meeting with
251182 -            Doctor Rugo, and get 1st treatment.  Jackie reports that
251183 -            Millie's primary care physician at Kaiser submitted
251184 -            authorization for referral to UCSF; but, treatment was
251185 -            deferred because there was not enough time to resolve
251186 -            policy conflict between Kaiser business units to submit the
251187 -            doctor's referral authorization for UCSF to get paid for
251188 -            Standard of Care. ref SDS 63 AS9L
251190 -             ..
251191 -            [On 070122 primary care physician reports resolving
251192 -            authorization policy confusion so that Millie can get
251193 -            prescribed treatment. ref SDS 64 LX8B
251195 -             ..
251196 -            [On 070123 UCSF reports authorization not received from
251197 -            Kaiser, treatment deferred. ref SDS 65 4Q54
251199 -             ..
251200 -            [On 070123 Millie notifies primary care physician treatment
251201 -            to prevent cancer from cascading out of control delayed
251202 -            again; ref SDS 65 J94L, Kaiser reports doctor on vacation
251203 -            did not received notification of continuing problem.
251204 -            ref SDS 65 LP4L
251206 -             ..
251207 -            [On 070124 Millie requests Kaiser Advice Nurse expedite
251208 -            authorization for prescribed treatment at UCSF. ref SDS 66
251209 -            YF8U
251211 -             ..
251212 -            [On 070124 Millie leaves town to give Kaiser and UCSF time
251213 -            to solve authorization problem. ref SDS 66 KX9H
251215 -             ..
251216 -            [On 070124 Kaiser Advice Nurse expedites authorization for
251217 -            referral to UCSF. ref SDS 66 UE4O
251219 -             ..
251220 -            [On 070124 Kaiser reports payment authorization problem
251221 -            solved. ref SDS 66 WR3J
251223 -             ..
251224 -            [On 070125 UCSF schedules Millie for treatment on 070131.
251225 -            ref SDS 67 YF8U
251227 -             ..
251228 -            [On 070610 Kaiser reports right channels are now open for
251229 -            effective communication to collaborate with UCSF on
251230 -            Millie's care. ref SDS 70 OG7F
251232 -             ..
251233 -            [On 070823 Millie receives nearly 100 documents from Kaiser
251234 -            and UCSF showing failure of communication past 8 months;
251235 -            invoices erroneous, incomplete, conflicting, Kaiser failure
251236 -            to perform requirements, UCSF claims entitlement to payment
251237 -            from Millie, ref SDS 71 X16N, which conflicts with
251238 -            agreement today, per above. ref SDS 0 3X6K
251240 -             ..
251241 -            [On 070823 spot checking UCSF invoices indicates possible
251242 -            duplicate billing to Medicare and the customer for costs
251243 -            paid by the clincial trial. ref SDS 71 Y53J
251245 -             ..
251246 -            [On 070830 UCSF accounting department confirms nobody knows
251247 -            the basis of charges calculated by Kaiser, ref SDS 72 WU5N,
251248 -            for UCSF Billings to Millie for coinsurance of 56% of
251249 -            Medicare payments. ref SDS 72 WP5I
251251 -             ..
251252 -            [On 070906 UCSF Clinical Trial Director confirms Kaiser
251253 -            made referral for Millie's treatment, ref SDS 73 UK5M, and
251254 -            the patient was not notified of extra charges for
251255 -            coinsurance, because nobody knew anything about this issue
251256 -            when treatment was started on 070202. ref SDS 73 I49K
251258 -             ..
251259 -            [On 070917 research indicates that Medicare entitlement for
251260 -            patients to self-refer participation in clinical trials,
251261 -            does not prevent Kaiser from prescribing treatment in
251262 -            clinical trial for the best course of care. ref SDS 74 4P5F
251264 -             ..
251265 -            [On 070925 Kaiser primary care physician assigns staff to
251266 -            solve problems caused by failing to develop referral
251267 -            coordination plan for Millie's treatment at UCSF.
251268 -            ref SDS 75 G54J
251270 -             ..
251271 -            [On 071006 Paula in Kaiser's MCRC unit asks why the doctor
251272 -            prescribed treatment with cetuximab and carboplatin at
251273 -            UCSF. ref SDS 76 Q969
251275 -             ..
251276 -            [On 071030 Paula confirmed that the doctor intended to make
251277 -            a referral for Millie's treatment in a clinical trial at
251278 -            UCSF; she could not find what happened to the referral that
251279 -            resulted in Kaiser denying payments for lack of
251280 -            authorization. ref SDS 77 FN3H
251282 -             ..
251283 -            [On 071031 Millie receives notice dated 071026 UCSF plans
251284 -            referral to collection agency for payment of $202.65 on
251285 -            Kaiser referral account 12493370, ref SDS 78 KK4I, revised
251286 -            070830, ref SDS 72 4P8K, and revised again on 070917,
251287 -            ref SDS 74 MK4H; no indication of UCSF collection efforts
251288 -            against Kaiser; separate notice dated 071027 and also
251289 -            received 071031 UCSF says Millie's treatment for cancer
251290 -            ordered by Kaiser will be terminated if UCSF does not
251291 -            receive payment of $202.65. ref SDS 78 KM8J
251293 -             ..
251294 -            [On 071128 Kaiser Appeals Committee approved payment for
251295 -            Millie's care on referral to UCSF. ref SDS 79 JZ5R
251297 -  ..
251298 - Letter from primary care physician respond to UCSF continues...
251299 -
251300 -    8.  (Should we arrange for her to see you or Dr. Benz again??),
251301 -        ref DRT 1 1C8I
251302 -
251303 -            [On 070101 Doctor Rugo arranging for Millie to meet at UCSF
251304 -            probably with Doctor Rugo. ref SDS 57 E23P
251306 -             ..
251307 -            [On 070116 Jackie called to begin scheduling meeting with
251308 -            Doctor Rugo at UCSF. ref SDS 61 NK8F
251310 -             ..
251311 -            [On 070118 UCSF schedules Millie to meet with Doctor Rugo
251312 -            on 070119, and to get treament after the meeting.
251313 -            ref SDS 62 1B5F
251315 -             ..
251316 -            [On 070119 Millie travels to San Francisco for meeting with
251317 -            Doctor Rugo, and get 1st treatment.  Jackie reports that
251318 -            Millie's primary care physician at Kaiser signed
251319 -            authorization for referral to UCSF; but, treatment deferred
251320 -            a week pending Kaiser submitting authorization for UCSF to
251321 -            get paid for Standard of Care. ref SDS 63 AS9L
251323 -             ..
251324 -            [On 070130 Millie meets with Doctor Rugo to plan starting
251325 -            treatment for IBC on cetuximab clinical study. ref SDS 68
251326 -            0001
251327 -
251328 -
251329 -
251330 -
251331 -
251332 -
251333 -
2514 -

SUBJECTS
MD Anderson Cancer Center Request Treatments for IBC Submit Patient

2703 -
2704 - 0146
270501 -  ..
270502 - Lapatinib Paclitaxel Phase 2 Trial MD Anderson
270503 - MD Anderson Cancer Center Request for Treatments
270504 -
270505 - Research on cetuximab/carboplatin discussed by UCSF today, per above,
270506 - ref SDS 0 PN5X, found information on MD Anderson Cancer Center
270507 - presenting clincial trials for IBC...
270508 -
270509 -              http://www.mdanderson.org/publications/cancerpro/display.cfm?id=11b5dd17-e1e7-4d93-9034d3fbe0a22229&method=displayfull#clintrial
270511 -  ..
270512 - This location describes a phase 2 study....
270513 -
270514 -           Lapatinib in Combination with Paclitaxel
270516 -  ..
270517 - Millie likely does not qualify because the study targets patients with
270518 - newly diagnosed IBC.
270519 -
270520 -            [...below, Lapatinib described as targeted to treat IBC.
270521 -            ref SDS 0 4X6G
270523 -  ..
270524 - Submitted a letter asking about additional treatments.
270525 -
270526 -    1.  Subject: IBC Chemotherapy Treatments and Trials
270527 -        Date: Sun, 31 Dec 2006 01:42:53 -0800
270531 -         ..
270532 -    2.  Hi,
270534 -         ..
270535 -    3.  I found your address researching a proposal by my doctor at
270536 -        Kaiser to consider treatment with cetuximab in a clinical trial
270537 -        at UCSF sponsored by Doctor Rugo and Doctor Benz.
270538 -
270539 -           http://www.mdanderson.org/publications/cancerpro/display.cfm?id=11b5dd17-e1e7-4d93-9034d3fbe0a22229&method=displayfull#clintrial
270541 -         ..
270542 -    4.  I am on my 3rd relapse of secondary IBC, originally diagnosed
270543 -        with biopsy on 040419.  I was treated with Taxol and
270544 -        bevacizumab (Avastin) for 7 cycles, but was taken off that
270545 -        treatment due to pulmonary embolism.
270547 -         ..
270548 -    5.  All of my image tests for the past 5 years have not found
270549 -        distant metastasis.  Most recent test on 061227 was clear;
270550 -        however, the rash on my chest is getting worse, and recently
270551 -        spread from my left chest, to slightly on the right breast.
270553 -         ..
270554 -    6.  Last year Taxotere and capecitabine reduced the rash on my
270555 -        breast to the point where Kaiser performed a mastectomy.
270556 -        Biopsy found no residual disease.  I was cancer free for about
270557 -        5 or 6 months, then the rash began to reappear on 060623.  I
270558 -        was treated again with Taxotere and capecitabine, only this
270559 -        time with less success, so Kaiser and UCSF are proposing
270560 -        consideration of a clinical trial with cetuximab.
270562 -         ..
270563 -    7.  The only alternative being offered is Navelbine.
270565 -         ..
270566 -    8.  Does MD Anderson have other treatment options to help me?
270568 -         ..
270569 -    9.  Patient history from 2002 until mastectomy surgery on 051021 is
270570 -        reported in the record on 050812...
270571 -
270572 -           http://www.welchco.com/sd/08/00101/02/05/08/12/102500.HTM#6L4M
270574 -         ..
270575 -   10.  Patient history following surgery during 2005 and to the
270576 -        present is listed on 060722...
270577 -
270578 -           http://www.welchco.com/sd/08/00101/02/06/07/22/225050.HTM#XQ7H
270580 -         ..
270581 -   11.  These histories have links to details including image test and
270582 -        biopsy reports, and meetings with the doctor.
270584 -         ..
270585 -   12.  Case studies from my long struggle with cancer are listed on
270586 -        061018.
270587 -
270588 -           http://www.welchco.com/sd/08/00101/02/06/10/18/100342.HTM#N55F
270590 -         ..
270591 -   13.  Thanks for considering my case.
270592 -
270593 -
270594 -
270595 -
270596 -
2706 -

SUBJECTS
Treatments IBC Lapatinib Tykerb MD Anderson Cancer Center Lapatinib

2903 -
290401 -  ..
290402 - Treatments targeted for IBC reported on the Internet....
290403 -
290404 - On 060929 2nd opinion from UCSF, Doctor Benz said Millie would qualify
290405 - for phase 1 trial of Abraxane in combination with lapatinib.
290406 - ref SDS 40 UI9K
290407 -
290408 -     [...above MD Anderson has a phase II trial involving Lapatinib,
290409 -     but is targeted for patients newly diagnosed with IBC. ref SDS 0
290410 -     I35L
290412 -  ..
290413 - Following very recent research describes lapatnib targeted to treat
290414 - IBC.
290416 -         ..
290417 -        Lapatinib (Tykerb)
290418 -
290419 -              http://info.cancerresearchuk.org/news/newsarchive/2006/december/18012263
290420 -
290421 -        Trial suggests role for lapatinib in 'inflammatory' breast
290422 -        cancer
290424 -         ..
290425 -        MONDAY 18 DECEMBER 2006
290427 -         ..
290428 -        Results of a preliminary trial suggest that lapatinib (Tykerb)
290429 -        could be used to treat the rare 'inflammatory' breast cancer
290430 -        (IBC), researchers have said.
290432 -         ..
290433 -        IBC accounts for just one to two per cent of all breast
290434 -        cancers but is often only diagnosed after the disease has
290435 -        begun to spread.
290437 -         ..
290438 -        The second-stage trials enrolled 49 recently diagnosed IBC
290439 -        patients, around a quarter of whose cancers had begun to
290440 -        spread.
290442 -         ..
290443 -        The women received a two-week course of lapatinib, followed by
290444 -        a combination of lapatinib and chemotherapy and eventual
290445 -        surgery.
290447 -         ..
290448 -        Of the 35 patients who advanced to surgery, 30, or 86 per
290449 -        cent, saw their tumours reduced in size by at least 50 per
290450 -        cent.
290452 -         ..
290453 -        Three of the first 21 patients who underwent surgery were
290454 -        cancer-free by the time that they were operated on.
290456 -         ..
290457 -        Between 25 and 30 per cent of the patients responded to
290458 -        lapatinib during the first two weeks of the trials, said
290459 -        researchers. Side effects were minor and manageable.
290460 -
290461 -        "For IBC patients, these results should be very encouraging
290462 -        because there's now more of a dedicated research effort for a
290463 -        type of breast cancer that has long been ignored and
290464 -        misunderstood," said researcher Dr Massimo Christofanilli of
290465 -        the University of Texas.
290466 -
290467 -        "With lapatinib, we finally have a drug on which to build
290468 -        effective therapy - we just have to refine the most effective
290469 -        way to use it."
290471 -         ..
290472 -        The findings were presented at the San Antonio Breast Cancer
290473 -        Symposium.
290474 -
290475 -
290476 -
290477 -
290478 -
290479 -
290480 -
290481 -
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2905 -