My girlfriend's mom may have metastatic colon cancer. There was a
large mass in her colon, and several on her liver, the largest of
which is 2cm.

What are the best treatment options, chemotherapy and otherwise?
I am aware that Erbitux has been approved. Perhaps you can recommend
some good combinations of different chemotherapy agents. I am also
interested in other methods that may augument chemotherapy.

---

Request for Question Clarification by livioflores-ga on 21 Feb 2004 21:30 PST

Considering that we are not oncologists, we are not in the position to
recommend you any therapy over other snd we csnnot decide what are the
best treatment option. As researchers we can offer you the results of
a research on therapies considered effective nowadays, that is
articles or studies on this topic.

To start I suggest you to take a look here:
"FDA - Erbitux (cetuximab) Information Page":
http://www.fda.gov/cder/drug/infopage/erbitux/default.htm

Follow the links: ·FDA Press Release, ·Label, ·Questions and Answers
on Erbitux at this page.


Please let us know if this kind of information is useful to you.

Regards.
livioflores-ga

---

Clarification of Question by born2rule-ga on 21 Feb 2004 23:00 PST

I am looking for websites like this 
http://www.bms.com/news/other/data/fg_other_news_3743.html
which says that a Erbitux and Irinotecan combination reduces or
stabilizes tumor growth in over 50 percent of patients.

So basically, I am asking for some assistance finding websites that
have statistics about the success rates for chemotherapy drug
combinations that look promising. Feel free to contact me again if you
have any more questions. If you happen to find any non drug therapies
that look promising, I would love to hear about them too.

---

Request for Question Clarification by livioflores-ga on 26 Feb 2004 19:41 PST

Hi!!

Is my comment well oriented or not? 
Need to know if I am walking the right way.

Regards.

Hi born2rule!!

According to your last comment I post the answer with info related to
drugs  for Colon Cancer treatment at clinical trial stage that may be
approved in a
year or two and also recently approved drugs.


At Cancer.gov I found, at "Newly Approved Cancer Treatments" the
following three drugs (you know at least two of them), for more
complete info related to full prescribing information, clinical trial
information, safety, dosing, drug-drug interactions and
contraindications of each drug, please follow the second link:

- Avastin® (Bevacizumab):
http://www.cancer.gov/clinicaltrials/developments/newly-approved-treatments/page5

http://www.fda.gov/cder/foi/label/2004/125085lbl.pdf


- Erbitux® (Cetuximab):
http://www.cancer.gov/clinicaltrials/developments/newly-approved-treatments/page7

http://www.fda.gov/cder/foi/label/2004/125084lbl.pdf


- Eloxatin? (oxaliplatin for injection):
http://www.cancer.gov/clinicaltrials/developments/newly-approved-treatments/page8

http://www.fda.gov/cder/foi/label/2004/021492s002lbl.pdf 

"Eloxatin Information" page:
http://www.fda.gov/cder/drug/infopage/eloxatin/default.htm
 
--------------------------------------------------------------

Regarding to drugs that may be approved in a year or two, you must
note that it takes 10-15 years on average for an experimental drug to
travel from the lab to U.S. patients. The drugs that are at the end
Phase III of the Clinical Trials have the possibility to be approved
in a year or two. Please see the following document for more
references about this:
"THE DRUG DISCOVERY, DEVELOPMENT AND APPROVAL PROCESS":
http://www.phrma.org/newmedicines/newmedsdb/phases.pdf 


The next step to find treatments that can be approved soon is to
search within Clinical Trials databases to find the ones at Phase III
stage.

Again at Cancer.gov you can access such database through the following
search form, just select Colon Cancer for the Type of Cancer box and
select only Treatment for Type of Trial:
http://www.cancer.gov/search/clinical_trials/

Here is the results page, sorted by Phase of Trial:
http://www.cancer.gov/search/clinical_trials/results_clinicaltrials.aspx?protocolsearchid=801192&batchSize=25&sort=Phase&page=1


Another available database is provided by ClinicalTrials.gov, you can
search within it via the following search form:
"Focused Search" page, just complete the Disease or Condition box with
the keyword Colon cancer and select Phase III and Phase IV for Study
Phase, then click on the Search button:
http://clinicaltrials.gov/ct/screen/AdvancedSearch

At the results page you can select, at the top of the list, the option
to include trials that are no longer recruiting patients.

The most used drugs at Phase III trials are Fluorouracil (5FU) and
Oxaliplatin (Eloxatin®), you have info about Eloxatin, so I give you
some links to get info related to Fluorouracil:
This drug was approved on 2/11/2000, it is an "old" drug, but it is
tested in new combinations with other drugs.

"Fluorouracil (5FU)" from cancerBACUP:
http://www.cancerbacup.org.uk/Treatments/Chemotherapy/Individualchemotherapydrugs/Fluorouracil


"Fluorouracil" information page at FDA.gov:
http://www.fda.gov/cder/foi/anda/2000/040333_fluorouracil_toc.htm

http://www.fda.gov/cder/foi/anda/2000/40333_Fluorouracil_Prntlbl.pdf

--------------------------------------------------------------------

At "Pharmaceutical Research and Manufacturers of America, PhRMA"
website you can find a database of "New Medicines in Development":
http://www.phrma.org/newmedicines/

Here are the results page for Colon cancer:
"Colon Cancer":
http://www.phrma.org/newmedicines/newmedsdb/drugs.cfm?indicationcode=Colon%20Cancer|70

As you can see here, Leukine (Phase IV) is the only medicine in a high
development status. This is drug approved for treatment of Leukemia,
but now is approved for help in treatment of Colon Cancer:
"Interim Study Results Indicate Leukine(R) Facilitates
Shortened-Schedule Colorectal Chemotherapy Regimen":
http://www.forrelease.com/D20030711/nyf005.P2.07102003162500.10753.html

More info:
"Leukine" from RxList.com:
http://www.rxlist.com/cgi/generic/sargramostim.htm

"Leukine - Product Label" page at FDA.gov (this info is related to
Leukemia treatment):
http://www.accessdata.fda.gov/scripts/cder/onctools/labels.cfm?GN=sargramostim

-------------------------------------------------------------

The following links will give you more info related to Colon Cancer
and/or Clinical Trials:

"Colon Cancer Alliance (CCA)":
It is a national patient advocacy organization dedicated to ending the
suffering caused by colorectal cancer. CCA is the official patient
support partner of Katie Couric's National Colorectal Cancer Research
Alliance (NCCRA).
http://www.ccalliance.org/index.html

At this site you will find:
"Treatment News":
http://www.ccalliance.org/news/treatment/treatment.html

"Patient Support - Find a Clinical Trial":
http://www.ccalliance.org/patient/clinical/find.html

"Clinical Trials Links":
http://www.ccalliance.org/news/trials/links.html
http://www.ccalliance.org/news/trials/links.html#finding

---------------------------------------------------------

"Cancer Care : Colon Cancer -Clinical Trials":

-What Is A Clinical Trial?
http://www.cancercare.org/ColonCancer/ColonCancerList.cfm?c=148

-Colon Cancer and Clinical Trials: How Do I Decide if a Clinical Trial
is Right for Me?
http://www.cancercare.org/EducationalPrograms/EducationalPrograms.cfm?ID=3448&c=381

------------------------------------------------------------

"Colon Cancer Treatment- Clinical Trials" at Robert H. Lurie
Comprehensive Cancer Center site:
http://www.lurie.northwestern.edu/treatment_colon_cancer_trials.cfm

-------------------------------------------------------------

"Clinical Trials: Colon Cancer" from CenterWatch, a publishing company
that focuses on the clinical trials industry:
http://www.centerwatch.com/patient/studies/cat31.html

--------------------------------------------------------------

Search strategy:
"clinical trials" colon cancer
leukine colon
Search for each drug at FDA site


I hope this helps you, but don't consider this answer ended until you
feel satisfied with it, so if you find it incomplete, have troubles
with links, need further assistance or need a clarification, please
use the clarification feature to let me know, I will be glad to
respond your requests.

Best regards.
livioflores-ga

---

Clarification of Answer by livioflores-ga on 04 Mar 2004 19:36 PST

Hi!!

I need to clarify that the answer was intended in the sense that you
have the tools that keep you updated about new treatments and new
drugs.

Regards.
livioflores-ga

Hi!!

I just find the following pages, but I am unsure about if they are
what you need, so I post them as a comment, if they fill your
requirements of a proper answer, let me know and I will post it in the
answer box:

"Metastatic Colorectal Cancer: Systemic Treatment in the New
Millennium" by Anelisa K. Coutinho, MD, Caio Max S. Rocha Lima, MD;
from Medscape (may be you must register to can see this page, it is
free):
http://www.medscape.com/viewarticle/456039_print 


"Mass General broadcasts innovative surgical treatment for colon
cancer and diverticulitis":
"Surgeons at Massachusetts General Hospital, the largest teaching
affiliate of Harvard Medical School, demonstrate to an Internet
audience a minimally invasive surgical procedure to treat colon cancer
and diverticulitis"
http://www.or-live.com/massgeneral/1161/


"M. D. Anderson Cancer Center - Trial Shows Pill is as Effective as
Standard Chemotherapy for Advanced Colorectal Cancer":
http://www.mdanderson.org/diseases/colorectal/display.cfm/?id=4FFF6D90-2F6E-11D5-811200508B603A14&method=displayfull

"M. D. Anderson Cancer Center - New Test Reveals Breakthrough in
Colorectal Cancer Detection":
http://www.mdanderson.org/diseases/colorectal/display.cfm/?id=9d0f5566-084f-48af-8e4e55ac78940794&method=displayfull&pn=033766c5-832a-11d4-aec800508bdcce3a


"COLORECTAL CANCER: NO LONGER AN UNSPEAKABLE SUBJECT ":
http://www.drugtopics.com/be_core/content/journals/d/data/2004/0126/dxcoverstory01b.html


See the following pages from Cancer.gov, the website of the National
Cancer Institute (NCI):
"Colon and Rectal Cancer: Treatment"   
 Information about treatment, including surgery, chemotherapy,
radiation therapy, immunotherapy, and vaccine therapy.
http://www.cancer.gov/cancerinfo/treatment/colon-and-rectal

"Colon and Rectal Cancer Trial Results"   
 Provides links to clinical trial results about colon and rectal cancers. 
http://www.nci.nih.gov/clinicaltrials/colorectal-cancer-updates


"Colon and Rectal Cancers"
A report written and updated by experienced medical writers and
reviewed and edited by the in-house editors and a board of physicians
who have faculty positions at Harvard Medical School and Massachusetts
General Hospital:
http://www.healthandage.com/html/well_connected/pdf/doc55.pdf


"Guidelines for Treatment of Colon Cancer":
http://www.nccn.org/physician_gls/PDF/colon.pdf


Note: for the pdf documents you will need the Acrobat Reader, if you
don't have it installed download it from here (8.6 Mb):
http://www.oldversion.com/downloadx/acrobat505.exe


I will wait for your response. If this satisfy you let me know and I
will post this in the answer box to claim the prize, if it is not what
are you looking for let me know also to continue the research.

Regards.
livioflores-ga

Some of the stuff that you linked to was in the right direction. They
lead me to read about Avastin.
Please post a bit more information about colorectal cancer drugs that
are currently in clinical trials. Avastin was just approved by the
FDA. I would like to know about other drugs that may be approved in a
year or two. You can post what you find to the answer box.