Cancer Treatment News: Making cancer treatment less onerous for patients

/ July 29th, 2011/ Posted in Cancer News / No Comments »

Making cancer treatment less onerous for patients

Questions about costs, timing and how to find the right treatment protocol can weigh heavily on patients, especially those who must travel great distances to meet with specialists or get a second opinion.

It doesn’t have to be that way, said Steve Bonner, chief executive of Cancer Treatment Centers of America (CTCA), a for-profit cancer-treatment network with hospitals in the Chicago, Tulsa, Philadelphia and Phoenix metro areas.

CTCA is launching a fixed-price product that offers a comprehensive diagnostic evaluation and treatment plan for four of the biggest cancer types that’s guaranteed to be delivered within three to five business days. Patients who still need additional testing after five days can complete the process at no additional cost.

“For the first time in oncology, we believe, you know what the services are you’re going to get, you know what the prices are going to be and you know how long it will take,” Bonner said.
More transparent pricing

The flat-price charges range from $10,000 for prostate cancer on the low end to $14,500 for lung cancer. A comprehensive work-up and treatment plan for breast cancer runs $12,200 while colorectal cancer costs $11,400 for employer health plans, health insurers or patients who pay out of pocket. At the end of the five-day process, patients are free to take the written treatment plan to a competing cancer treatment facility if they wish.

“In health care today, it’s rare that you know what the price is before you make a buying decision,” Bonner said. “This is our first step in that direction.”

Cancer Treatment Centers of America’s effort to make pricing more transparent comes at a pivotal time in U.S. medicine. The health-reform law that President Obama signed in March of 2010 and rolls out over the next few years calls for a variety of methods to raise health-care quality while holding down costs. It includes initiatives aimed at making health-care providers more accountable and health-information technology more widely used. It’s also reshaping financial incentives so doctors and hospitals that achieve the best health outcomes can share in the savings they generate.

Astronomical finding may help treat cancer patients

Astronomers studying stars and black holes have discovered that heavy metals emit low-energy electrons when exposed to X-rays at specific energies – a finding they say could lead to safer and more effective cancer treatments in the future.

The finding raises the possibility that implants made of gold or platinum can allow doctors to destroy tumours with low-energy electrons, while exposing healthy tissue to far less radiation than is possible on Friday, the researchers said.

“As astronomers, we apply basic physics and chemistry to understand what’s happening in stars. We’re very excited to apply the same knowledge to potentially treat cancer,” study author Sultana Nahar of Ohio State University was quoted as saying by LiveScience.

Computer simulations by the researchers suggested that hitting a single gold or platinum atom with a small dose of X-rays at a narrow range of frequencies produces a flood of more than 20 low-energy electrons.

These ejected electrons can kill cancer, shredding their DNA. So doctors can embed many heavy-metal nanoparticles inside and around tumours, then hit them with a tailored shot of radiation, the researchers said

The resulting electron shower can obliterate a tumour and the process would greatly reduce a patient’s radiation exposure compared to most current radiation treatment methods.

For their research, presented at the International Symposium on Molecular Spectroscopy held recently in Columbus, the scientists built a prototype device that showed that specific X-ray frequencies can free low-energy electrons from heavy-metal nanoparticles.

While the machine needs to be developed further, it’s providing a proof of principle for the potential cancer treatment technique, the astronomers said. “This could lead to a combination of radiation therapy with chemotherapy using platinum as the active agent.”

The researchers came up with the new potential cancer treatment after studying the space. Specifically, they were trying to understand what different stars are made of, based on how radiation flows through them and emanates from them.

The team constructed complex computer models to simulate these processes. The models clued them into how heavy metals such as iron behave when they absorb different types of radiation.

Iron plays the dominant role in controlling radiation flow through stars. But it is also observed in some black hole environments, which produce some types of X-rays that can be detected from Earth, the researchers said.

They said, “That’s when we realised that the implications went way beyond atomic astrophysics. X-rays are used all the time in radiation treatments and imaging, and so are heavy metals – just not in this way.

“If we could target heavy metal nanoparticles to certain sites in the body, X-ray imaging and therapy could be more powerful, reduce radiation exposure and be much more precise.”

2 Biotechs, 1 Promising Cancer Drug

It’s not often you find two companies with market caps below $350 million partnered on a drug, but such is the case for perifosine, where tiny Aeterna Zentaris (NAS: AEZS) licensed the cancer drug to only slightly larger Keryx Biopharmaceuticals (NAS: KERX) .

Yesterday, the duo announced that they had completed enrollment in a phase 3 clinical trial testing perifosine in patients with advanced colorectal cancer.

X-PECTing success
I’m a sucker for a good clinical-trial acronym, and they really don’t get much better than “X-PECT” (Xeloda + Perifosine Evaluation in Colorectal cancer Treatment), especially since the companies have a good reason to expect positive results.

As the name implies, the trial is testing perifosine in combination with Roche’s Xeloda in patients who have failed other colorectal-cancer treatments — including Sanofi’s (NYS: SNY) Eloxatin, Amgen’s (NAS: AMGN) Vectibix, and/or Erbitux from Bristol-Myers Squibb (NYS: BMY) and Eli Lilly (NYS: LLY) .

In a phase 2 trial, Xeloda plus perifosine improved median overall survival over Xeloda alone by 6.8 months. This was a small trial of only 35 patients, but it’s still fairly impressive since that’s a 62% improvement on Xeloda alone. Phase 3 data is typically not as impressive as phase 2 results, but there seems to be some leeway for less impressive results to still show a statistically significant effect.

The trial was run under a Special Protocol Assessment, or SPA, with the Food and Drug Administration. Essentially, an SPA means the FDA has agreed that the trial is sufficient for approval. If the trial meets its primary endpoint and nothing new crops up, the FDA should approve the drug.

With a primary endpoint of overall survival — the gold standard in oncology — it seems like a bit of overkill to have an SPA, but there’s really no downside to having one. Just don’t expect the presence of an SPA to increase the chance of a clinical trial success.

When can we expect results?
The companies will probably give us a timeframe in the coming months for their estimate of when the trial will be completed, but we can do some back-of-the-envelope calculations to get close.

The results will be revealed after 360 patients in the study die. It took less than 16 months to enroll the 430 or so patients in the trial. If you assume the patients enrolled steadily, the 360th patient was enrolled about three months ago; the enrollment probably accelerated as we went through the trial, but this is a rough estimate. The median survival of patients in the phase 2 trial was 10.9 months and 17.9 months, depending on whether the patients received perifosine and Xeloda or just Xeloda. Let’s call it an average of a 14-month survival, which would happen approximately 11 months from now. Add in a month or two to crunch the numbers, and we should have the data this time next year.

Which one?
Both companies have drugs in development beyond perifosine, but if you’re betting on the cancer drug as the near-term catalyst, I think Keryx is probably the more appropriate choice. The royalty structure wasn’t disclosed in the licensing deal, but assuming the royalties are in the 10% or less range, Keryx will retain a majority of the financial benefit from perifosine in the U.S. market.

While I’ve focused on perifosine’s potential in colorectal cancer, I’d be remiss if I didn’t point out that it’s also being tested as a treatment for a blood cancer called multiple myeloma. The success in colorectal cancer is important, but it would really take a failure of perifosine in both indications for it to be a complete flop.

Learn to thrive once cancer treatment is complete

University of Colorado Cancer Center is looking for cancer survivors to take part in a clinical trial of a program aimed at helping them manage their condition more effectively. The program, called “Cancer: Thriving and Surviving,” is adapted from a successful effort helping people manage other chronic conditions like diabetes.

With more than 12 million cancer survivors nationwide, researchers would like to know if programs that have proven effective in helping people manage fatigue, frustration, pain and stress might also work for managing similar issues associated with cancer.

“A cancer survivor’s journey does not end after treatment. And therapies and surgeries can have long lasting physical and emotional impact. If proven effective, ‘Cancer: Thriving and Surviving’ can help improve the quality of life for cancer survivors worldwide”, said Betsy Risendal, PhD, assistant research professor in the Colorado School of Public Heath and the trial’s principal investigator.

Cancer survivors can suffer numerous long-term complications including depression, difficulty concentrating and neuropathy.

The program, the first of its kind in the country, has been adapted especially for cancer survivors. Covered topics include communication with health care providers and family members regarding a cancer diagnosis, how to improve and maintain health and problem solving. The instructors, many of whom are themselves cancer survivors, are specially trained to lead the sessions.

The class will meet weekly for about two hours and for seven weeks. Cancer survivors and their caregivers are welcome to participate. Three metro area classes begin in August, and they may be offered in northern and southern Colorado and rural communities later this year.

There are some eligibility requirements for the study, which is being conducted by CU Cancer Center and funded by the Centers for Disease Control. To find out if you are eligible to enroll, you may call the community research partner, the Consortium for Older Adult Wellness at 303-956-8908 or toll free at 888-900-2629. Two classes begin next month on the Anschutz Medical Campus in Aurora: Aug 3 from 6:00 p.m. – 8:30 p.m. and Aug. 4 from 9:30 a.m. to 11:00 a.m.

Learn to thrive once cancer treatment is complete

The University of Colorado Cancer Center is Colorado’s only National Cancer Institute-designated comprehensive cancer center. Headquartered on the University of Colorado Denver Anschutz Medical Campus, the center is a consortium of three state universities (Colorado State University, University of Colorado at Boulder and University of Colorado Denver) and six institutions (The Children’s Hospital, Denver Health, Denver VA Medical Center, Kaiser Permanente Colorado, National Jewish Health and University of Colorado Hospital).

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