Hello, blucken-ga!
Thank you for easing up on the parameters for an answer to your
question. This is an enormous subject which could potentially involve
weeks of research to even begin to do it justice. In fact, answering
your questions as they pertain to just one type of cancer would be an
extensive research project!
I have tried to cover most of the bases, here, but with so many types
of cancer, the numerous methods of treatment and the long list of
medications, alone - this is a monumental task that can really only be
touched upon in this format.
****************
TYPES OF CANCER
****************
FROM "Cancer Overview."
http://www.hanabiosciences.com/pipeline-cb.html
"There are more than 100 different varieties of cancer which can be
divided into six major categories. Carcinomas, the most common type of
cancer, originate in tissues that cover a surface or line a cavity of
the body. Sarcomas begin in tissue that connects, supports or
surrounds other tissues and organs. Lymphomas are cancers of the lymph
system, the circulatory system that bathes and cleanses the body's
cells. Leukemias involve blood-forming tissues and blood cells. As
their name indicates, brain tumors are cancers that begin in the
brain, and skin cancers, including dangerous melanomas, originate in
the skin. Cancers are considered metastatic if they spread via the
blood or lymphatic system to other parts of the body to form secondary
tumors."
List of all cancers from the National Cancer Institute
http://www.cancer.gov/cancertopics/alphalist/a-d
***********
TREATMENTS
***********
This is a very extensive topic in itself, and only a very general
overview can be provided here for certain major types of cancer.
Because cancer is a progressive disease, treatment options vary with
each stage. I have provided a general description of the various
treatments below, and followed with the major types of cancer with a
brief treatment description with links to the National Cancer
Institute website so you can investigate further. Again - this is such
an extensive topic that just one type of cancer and all your attendant
questions would involve a great deal of research!
General overview
==================
From "Cancer Overview." http://www.hanabiosciences.com/pipeline-cb.html
"Major treatments for cancer include
* surgery,
* radiotherapy
* chemotherapy
* drugs - There are many different drugs that are used to treat cancer,
including cytotoxics or antineoplastics, hormones, and biologics.
* experimental treatments - There are also many experimental treatments under
investigation including radiation sensitizers, vaccines, gene therapy and
immunotoxins.
Cytotoxics - or anticancer drugs, destroy cancer cells by stopping
them from multiplying. Healthy cells can also be harmed, especially
those that divide quickly. Harm to healthy cells is what causes side
effects. These cells usually repair themselves after chemotherapy.
Chemotherapy - can be used for different purposes which include
curing cancer (when the patient remains free of evidence of cancer
cells), controlling cancer (by preventing the cancer from spreading),
and relieving symptoms of cancer (such as pain, helping patients live
more comfortably).
Radiotherapy - also called radiation therapy, is the treatment of
cancer and other diseases with ionizing radiation. Ionizing radiation
deposits energy that injures or destroys cells in the area being
treated (the "target tissue") by damaging their genetic material,
making it impossible for these cells to continue to grow. Although
radiation damages both cancer cells and normal cells, the latter are
able to repair themselves and regain proper function. Radiotherapy may
be used to treat localized solid tumors, such as cancers of the skin,
tongue, larynx, brain, breast, or uterine cervix. It can also be used
to treat leukemia and lymphoma (cancers of the blood-forming cells and
lymphatic system, respectively).
Targeted cancer therapies - use drugs that block the growth and
spread of cancer. They interfere with specific molecular targets
involved in carcinogenesis (the process by which normal cells become
cancer cells) and tumor growth. By focusing on molecular and cellular
changes that are specific to cancer, targeted cancer therapies may be
more effective than current treatments and less harmful to normal
cells.
=
Also see individual links under "Cancer Treatment Information."
http://www.oncolink.upenn.edu/treatment/index.cfm
MAJOR TYPES OF CANCER AND TREATMENT RECOMMENDATIONS
====================================================
Bladder Cancer
==============
There are different types of treatment for patients with bladder cancer.
Four types of standard treatment are used:
Surgery
Radiation therapy
Chemotherapy
Biologic therapy
New types of treatment are being tested in clinical trials. These
include the following:
Chemoprevention
Photodynamic therapy
http://www.cancer.gov/cancertopics/pdq/treatment/bladder/Patient/page4
Treatment by stage
http://www.cancer.gov/cancertopics/pdq/treatment/bladder/Patient/page5
From the Urology Channel
http://www.urologychannel.com/bladdercancer/treatment.shtml
"Drugs commonly used to treat bladder cancer include valrubicin
(Valstar), thiotepa (Thioplex), mitomycin, and doxorubicin (Rubex).
Side effects can be severe and include the following:
Abdominal pain
Anemia
Bladder irritation
Blurred vision
Excessive bleeding or bruising
Fatigue
Headache
Infection
Loss of appetite
Nausea and vomiting
Weakness
"A new combination approach, called bladder-sparing surgery, utilizes
drug therapy and radiation therapy prior to surgery to shrink the
tumor and possibly completely eliminate the cancer. This experimental
technique may soon offer patients an effective alternative to removing
the bladder and an improved quality of life."
From Johns Hopkins
http://www.hopkinskimmelcancercenter.org/cancertypes/bladder-cancer.cfm?cancerid=20
Breast Cancer
================
Stage I, II, IIIA, and Operable IIIC Breast Cancer
http://www.cancer.gov/cancertopics/pdq/treatment/breast/HealthProfessional/page7
Stage IIIB, Inoperable IIIC, IV, Recurrent, and Metastatic Breast Cancer
http://www.cancer.gov/cancertopics/pdq/treatment/breast/HealthProfessional/page8
See "Profiles of Breast Cancer Drugs."
http://imaginis.com/breasthealth/bc_drugs.asp
Colon Cancer
=============
Three types of standard treatment are used. These include the following:
Surgery
Chemotherapy
Radiation therapy
Other types of treatment are being tested in clinical trials. These
include the following:
Biologic therapy
http://www.cancer.gov/cancertopics/pdq/treatment/colon/Patient/page4
"Irinotecan, oxaloplatin, and 5-fluorouracil are the 3 most commonly
used drugs, given either individually or in combination. There are
oral chemotherapy drugs which are similar to 5-fluroruracil, the most
commonly used being capecitabine (Xeloda). Oxaliplatin, a newer
chemotherapy drug, was approved by the FDA in 2002 and is also active
against colon cancer. It is often used in combination with
5-fluorouracil, and studies are being done that combine it with other
chemotherapy drugs."
From Medline:
http://www.nlm.nih.gov/medlineplus/ency/article/000262.htm
Rectal Cancer
==============
There are different types of treatment for patients with rectal cancer.
Three types of standard treatment are used:
Surgery
Radiation therapy
Chemotherapy
New types of treatment are being tested in clinical trials. These
include the following:
Biologic therapy
http://www.cancer.gov/cancertopics/pdq/treatment/rectal/Patient/page4
Endometrial Cancer
====================
There are different types of treatment for patients with endometrial cancer.
Four types of standard treatment are used:
Surgery
Chemotherapy
Radiation therapy
Hormone therapy
http://www.cancer.gov/cancertopics/pdq/treatment/endometrial/Patient/page4
"Chemotherapy is the use of anti-cancer drugs that go throughout the
entire body. Chemotherapy is not as important as surgery and radiation
for treating endometrial cancer. It is usually only used in
endometrial cancers that are very advanced or recur after definitive
treatment with surgery and radiation. There are many different
chemotherapy drugs, and they are often given in combinations. Patients
will usually have to go to a clinic to get the chemotherapy because
many of the drugs have to be given through a vein. Different
chemotherapy regimens are used for different purposes.
* Some of the drugs used in endometrial cancer chemotherapy include:
Cisplatin, Carboplatin, Doxorubicin, and Paclitaxel.
From Oncolink
http://www.oncolink.org/types/article.cfm?c=6&s=18&ss=137&id=8227
Kidney Cancer
==============
There are different types of treatment for patients with renal cell cancer.
Four types of standard treatment are used:
Surgery
Radiation therapy
Chemotherapy
Biologic therapy
New types of treatment are being tested in clinical trials. These
include the following:
Stem cell transplant
http://www.cancer.gov/cancertopics/pdq/treatment/renalcell/Patient/page4
"The Food and Drug Administration has approved a new treatment for an
advanced form of kidney cancer, the agency announced Tuesday. In
trials, kidney cancer patients treated with Nexavar, also known as
sorafenib toylate, went longer without their cancer progressing than
those taking a placebo. The drug was developed by Bayer and Onyx
Pharmaceuticals.
From "FDA approves kidney cancer treatment." CNN. December 20, 2005
http://www.cnn.com/2005/HEALTH/conditions/12/20/kidney.cancer.ap/
Leukemia
=========
Adult:
There are different types of treatment for patients with adult ALL.
The treatment of adult ALL usually has 2 phases.
Three types of standard treatment are used:
Chemotherapy
Radiation therapy
Chemotherapy with stem cell transplant
Other types of treatment are being tested in clinical trials. These
include the following:
Biologic therapy
http://www.cancer.gov/cancertopics/pdq/treatment/adultALL/Patient/page4
Chilhood:
There are different types of treatment for childhood acute
lymphoblastic leukemia (ALL).
Children with ALL should have their treatment planned by a team of
doctors with expertise in treating childhood leukemia.
The treatment of childhood ALL usually has 3 phases.
Three types of standard treatment are used:
Chemotherapy
Radiation therapy
Chemotherapy with stem cell transplant
Other types of treatment are being tested in clinical trials.
http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4
Adult Myeloid:
There are different types of treatment for patients with adult acute
myeloid leukemia.
The treatment of adult AML usually has 2 phases.
Four types of standard treatment are used:
Chemotherapy
Radiation therapy
Stem cell transplantation
Other drug therapy
Other types of treatment are being tested in clinical trials. These
include the following:
Biologic therapy
http://www.cancer.gov/cancertopics/pdq/treatment/adultAML/Patient/page2
Lung Cancer
===========
There are different types of treatment for patients with small cell lung cancer.
Three types of standard treatment are used:
Surgery
Chemotherapy
Radiation therapy
Other types of treatment are being tested in clinical trials.
http://www.cancer.gov/cancertopics/pdq/treatment/small-cell-lung/Patient/page4
Melanoma
========
There are different types of treatment for patients with melanoma.
Four types of standard treatment are used:
Surgery
Chemotherapy
Radiation therapy
Biologic therapy
Other types of treatment are being tested in clinical trials. These
include the following:
Chemoimmunotherapy
http://www.cancer.gov/cancertopics/pdq/treatment/melanoma/Patient/page4
"The following are some of the agents used to treat melanoma. They may
be used alone or in combination under specific situations.
Methylating agents, which impair the ability of cancer cells to
divide, include dacarbazine (DTIC), temozolomide (TMZ), and
procarbazine. To date, dacarbazine is the only drug approved for
melanoma. Temozolomide, an oral drug, may be comparable and improve
quality of life. Because it can cross the blood-brain barrier (unlike
dacarbazine), temozolomide is showing promise in preventing metastasis
to the brain. It may also have some benefits in treating cancers that
have already spread to the brain.
Nitrosoureas, which include carmustine (BCNU) and lomustine (CCNU) are often used.
Guanine analogues, such as O6-benzylguanine (BG), are being
investigated in combinations with the standard chemotherapies to
reduce disease resistance to the nitrosoureas and methylating agents.
Taxanes, such as docetaxel (Taxotere), are showing some low-level
activity against melanoma, and experts are recommending trials using
docetaxel in combination with other drugs.
(See side effects)
From "HOW IS MELANOMA TREATED?"
http://www.umm.edu/patiented/articles/how_melanoma_treated_000032_8.htm
Adult Non-Hodgkin's Lymphoma
=============================
There are different types of treatment for patients with non-Hodgkin?s lymphoma.
Three types of standard treatment are used:
Radiation therapy
Chemotherapy
Watchful waiting
New types of treatment are being tested in clinical trials. These
include the following:
Biologic therapy
High-dose chemotherapy with stem cell transplant
http://www.cancer.gov/cancertopics/pdq/treatment/adult-non-hodgkins/Patient/page4
Pancreatic Cancer
=================
There are different types of treatment for patients with pancreatic cancer.
Three types of standard treatment are used:
Surgery
Radiation therapy
Chemotherapy
Other types of treatment are being tested in clinical trials. These
include the following:
Biologic therapy
http://www.cancer.gov/cancertopics/pdq/treatment/pancreatic/Patient/page4
"For years, the drug fluorouracil (5-FU) was the only chemotherapy
option for people with pancreatic cancer. But fluorouracil wasn't
always effective. Now doctors are having more success with a newer
drug, gemcitabine. The drug is normally used alone but may be used in
combination with other drugs as part of a clinical trial. Doctors are
also testing a number of other new medications."
From Pancreatic Cancer. Mayo Clinic
http://www.mayoclinic.com/health/pancreatic-cancer/DS00357/DSECTION=8
See "Pancreatic Cancer: A Difficult Disease to Treat."
http://www.uspharmacist.com/oldformat.asp?url=newlook/files/feat/acf2fc4.htm
Prostate Cancer
================
Four types of standard treatment are used:
Watchful waiting
Surgery
Radiation therapy
Hormone therapy
New types of treatment are being tested in clinical trials. These
include the following:
Cryosurgery
Chemotherapy
Biologic therapy
High-intensity focused ultrasound
http://www.cancer.gov/cancertopics/pdq/treatment/prostate/Patient/page4
Read "Drug shows promise for preventing prostate growths." USA Today. 5/14/2005
http://www.usatoday.com/news/health/2005-05-14-breast-cancer-drug_x.htm
"The drug is toremifene, sold as Acapodene for treating advanced breast cancer."
From Medline
http://www.nlm.nih.gov/medlineplus/ency/article/000380.htm#Treatment
"Synthetic drugs like Lupron or Zoladex that mimic the function of
LHRH (luteinizing hormone releasing hormone) are being used
increasingly to treat advanced prostate cancer."
"Other medications used for hormonal therapy include androgen-blocking
agents (such as flutamide) which prevent testosterone from attaching
to prostate cells. Possible side effects include erectile dysfunction,
loss of sexual desire, liver problems, diarrhea, and enlarged
breasts."
"Chemotherapy is often used to treat prostate cancers that are
resistant to hormonal treatments. An oncology specialist will usually
recommend a single drug or a combination of drugs aimed at destroying
the cancer cells. Medications that may be used to treat prostate
cancer include:
Mitoxantrone
Prednisone
Paclitaxel
Docetaxel
Estramustine
adriamycin
Skin Cancer (Non-Melanoma)
==========================
Four types of standard treatment are used:
Surgery
Radiation therapy
Chemotherapy
Photodynamic therapy
Other types of treatment are being tested in clinical trials. These
include the following:
Biologic therapy
http://www.cancer.gov/cancertopics/pdq/treatment/skin/Patient/page3
"Surgery is the most common treatment for newly discovered nonmelanoma
skin cancers. It is aimed at eliminating the tumor from the site of
occurrence and, if successful, can bring about cure in over 95% of
cases."
From Fox Chase Cancer Center.
http://www.fccc.edu/clinical/skin/non-melanoma
Thyroid Cancer
==============
There are treatments for all patients with thyroid cancer. Four types
of treatment are used:
Surgery (taking out the cancer).
Radiation therapy (using high-dose x-rays or other high-energy rays to
kill cancer cells).
Hormone therapy (using hormones to stop cancer cells from growing) .
Chemotherapy (using drugs to kill cancer cells).
http://www.cancer.gov/cancertopics/pdq/treatment/thyroid/Patient/page3
"Surgery is the main treatment for most types of thyroid cancer, but
other therapies may vary, depending on the type of thyroid cancer you
have."
See Thyroid Cancer. CNN Health.
http://www.cnn.com/HEALTH/library/DS/00492.html
"Last year, a team of scientists at Johns Hopkins University School of
Medicine discovered a genetic mutation that is present in most
papillary thyroid cancers, the most common sort. Earlier this year,
the same team showed that the mutation is found in about half of
anaplastic carcinomas, as well.
The gene, called BRAF, acts as an on/off switch for cell growth. In
tumors with the mutation, this switch gets stuck in the "on" position
"A group of doctors around the country are testing an experimental
drug, known only as BAY 43-9006, that may be able to turn off that
switch. "If this becomes effective in anaplastic, it would be like a
dream come true," Shah says. "You could have a simple pill to fight
against this huge monster."
See "Taking on thyroid cancer," by Liz Szabo, USA TODAY. November 2004
http://www.usatoday.com/news/health/2004-11-08-thyroid-usat_x.htm?POE=click-refer
********************************************************************
CANCER DRUGS / DRUG MANUFACTURERS / DRUG LISTS INCLUDING SIDE EFFECTS
********************************************************************
The National Cancer Institute maintains a database of over 500 agents
used in the treatment of patients with cancer or cancer-related
conditions!
http://www.cancer.gov/drugdictionary/
=
The BCCA Cancer Drug Manual will allow you to look up hundreds of
drugs used in the treatment of cancer alphabetically. Each on contains
a description, usage and side effects.
http://www.bccancer.bc.ca/HPI/DrugDatabase/DrugIndexPt/default.htm
=
The American Cancer Society's "Guide to Cancer Drugs" also provides a
drug database which allows an alphabetical search with drug name,
usage, side effects, etc.
http://www.cancer.org/docroot/CDG/cdg_0.asp?pagKey=A
=
A selection of drugs used in Chemotherapy can be found on the
Lymphomation.org website:
See Treatments or Chemotherapy > Chemo agents, Alphabetical Index and
click on each link for the description and side effects:
http://www.lymphomation.org/chemo-index.htm
Drug Manufacturers
===================
The U.S. Food and Drug Administration - Center for Drug Evaluation and
Research, has a listing of approved oncology drugs that can be sorted
by manufacturer or by drug name. Last Updated: 10/29/2003
Please see the listing at http://www.fda.gov/cder/cancer/druglistframe.htm
Manufacturers on the list are Abbott Labs, Adria Laboratories, Amgen,
Inc., Anthra-Medeva, Asta Medica, AstraZenica, Aventis Pharmaceutical,
Baker Norton Pharmaceuticals, Bayer, Bedford Labs, Berlex
Laboratories, Boehringer Ingelheim Pharma KG, Bristol-Meyers Squibb,
Byran, Cell Therapeutic, Chiron Corp., corixa Corporation, Eli Lilly,
Enzon, Genetech, Genetics Institute, GlaxoSmithKline, Guilford
Pharmaceuticals, Inc, Hoffman-La Roche, ICN Peurto Rico, IDEC
Pharmaceuticals Corp., Immunex Corporation, IPR, Janssen Research
Foundation, Lederle Laboratories, Ligand Pharmaceuticals, Merck,
Millennium and ILEX Partners, LP, Nexstar, Inc., Novartis, Organon
Teknika Corp., Orion Corp., Orphan Medical, Inc., Parke-Davis
Pharmaceutical Co., Pharmacia & Upjohn Company, QLT Phototherapeutics,
Inc., R.W. Johnson Pharmaceutical Research Institute, Roberts Labs,
Roche, Sanofi-Synthelabo, Inc., Schering Corp., Searle, Seguus
Pharmaceuticals, Inc., Seguus Pharmaceuticals, Inc., Seragen, Inc.,
Sigma Tau Pharms, Skye Pharmaceuticals, Supergen, SYNTEX, Therakos, US
Bioscience and Wyeth Ayerst.
===
From "New Drug Approval Updates 2005." Moseby's Drug Consult
http://www.mosbysdrugconsult.com/DrugConsult/newapp2005.html#NewKidneyCancerDrugApproved
** "New kidney cancer drug approved in US." Moseby's Drug Consult."
December 22, 2005 - "Nexavar will be distributed and marketed by
Bayer Pharmaceuticals Corporation of Westhaven, Conn."
** "New leukemia and lymphoma treatment approved in accelerated FDA
channels." November 1, 2005 -
"Arranon will be distributed and marketed by GlaxoSmithKline of
Research Triangle Park, North Carolina."
** "First in new class of drugs approved to treat metastatic breast
cancer. January 11, 2005 - "American Pharmaceutical Partners, Inc,
and American Bioscience, Inc, announced on January 7, 2005, that the
U.S. Food and Drug Administration (FDA) has approved Abraxane for
injectable suspension (paclitaxel protein-bound particles for
injectable suspension) (albumin-bound). Abraxane is indicated for the
treatment of breast cancer after failure of combination chemotherapy
for metastatic disease or relapse within 6 months of adjuvant
chemotherapy."
**************************
COSTS OF CANCER TREATMENT
**************************
It is next to impossible to outline costs associated with cancer
treatment, as there are so many types of cancer, different treatments
according to stage of the disease, and a huge array of cancer
medications in use. I was unable to find a database of average costs
for individual cancer medications.
* If you must have numbers for market research, you might be
interested in ordering the
"Pharmacology Redbook." http://www.ramex.com/title.asp?id=1144
=
The difficulty in estimating individual drug costs is highlighted in
the following abstract:
From "Economic analysis of pharmaceutical drugs for breast cancer
treatment." 2002 APHA.
http://apha.confex.com/apha/130am/techprogram/paper_46650.htm
"Antiestrogen drugs, mainly Tamoxifen (brand name, Nolvadex),
accounted for 72% of all prescribed breast cancer drugs. The average
cost per prescription was significantly affected by drug ingredient
cost, patient?s age, number of days of drug therapy covered by a
prescription, class of drug, nature of pharmacy, some plan types, and
certain regions. The elasticities of drug cost with respect to
ingredient cost, the patient?s age, and days of drugs supplied were
0.82, 0.09, and 0.06, respectively. Controlling for other variables
including days supplied, brand name drugs on average cost $2 more per
prescription than generic drugs; chemotherapy cost $5 more than
antiestrogen drugs; drugs generally available in commercial pharmacies
cost $3 more in healthcare pharmacies compared to chain pharmacies;
and prescriptions under basic insurance coverage were $0.60 more
expensive while those made under preferred provider organization were
$1 less costly than those prescribed under comprehensive plan. Also,
compared to North Central region, prescription drugs were $0.88
cheaper on average in the Northeast."
Conclusions: The average drug cost per prescription depends
significantly on ingredient cost, patient?s age, class of drug, nature
of pharmacy, some types of benefit plans, and certain regions."
==
I have provided a variety of articles which just begin to touch on
this aspect of your question.
From Oncolink. http://www.oncolink.org/experts/article.cfm?c=4&s=33&ss=113&id=1090
"It is difficult to provide cost estimates for the treatment of cancer
without having a more definitive idea of where and how a patient will
be treated. The charge structure for medical services varies fairly
significantly across the country. Even on a regional basis, you will
find sizeable differences from hospital to hospital. A patient's
treatment regimen may include one or all of the three modalities used
to fight cancer, i.e. surgery, chemotherapy and radiation therapy. The
regimen could potentially include just one or any combination of the
three services. Therefore the total charge for a patient's treatment
will vary significantly, depending upon the method(s) by which the
patient is treated."
==
From Cancer.org http://www.cancer.org/docroot/MIT/content/MIT_3_2X_Costs_of_Cancer.asp
"The financial costs of cancer are great both for the individual and
for society as a whole. In the year 2004, the National Institutes of
Health estimated overall annual costs for cancer as follows:
Total Cost: $189.8 billion
Direct Medical Costs: $69.4 billion (total of all health expenditures)
Indirect Morbidity Costs: $16.9 billion (cost of lost productivity due to illness)
Indirect Mortality Costs: $103.5 billion (cost of lost productivity
due to premature death)
==
From "Price becoming factor in cancer treatments." AMY DOCKSER MARCUS,
The Wall Street Journal. September 7, 2004
http://www.sfgate.com/cgi-bin/article.cgi?f=/news/archive/2004/09/07/financial1018EDT0045.DTL&type=health
Some estimated costs of pricey cancer drugs:
* Iressa, for non-small-cell lung cancer: About $1,800 a month.
* Gleevec, for chronic myelogous leukemia and gastrointestinal stromal tumors:
More than $500 a month.
* Erbitux, for advanced colorectal cancer: $18,000 to $30,000 for 7-week
course.
* Thalomid for multiple myeloma and other cancers: About $10,000 for an
average five-month treatment.
==
From "New cancer drugs cost a lot for modest benefits." Associated
Press. March 29, 2005. http://www.msnbc.msn.com/id/7328565/
"In the two weeks since Genentech?s expensive new drug Avastin was
found to help the sickest lung cancer patients live a few months
longer than expected, investors have pumped nearly $17 billion into
the company. But at a cost of $4,400 a month, Avastin is proving that
what?s good for patients, the company and its investors is also
heavily stressing the ailing U.S. health care system, raising
uncomfortable questions about the cost of end-of-life care."
==
From "Price of cancer drugs called 'mind-boggling',By Liz Szabo, USA
TODAY. 7/21/2004. http://www.usatoday.com/news/health/2004-07-21-cancer-usat_x.htm
"With older chemotherapy regimens, patients with advanced disease
lived an average of one year, at a cost of $63 for an initial
eight-week treatment. A newer drug regimen has extended survival to 21
months, but at a cost of $12,000, the editorial says...Drugs such as
Erbitux and Avastin, approved in February, may allow patients to live
even longer. Adding Avastin to standard chemotherapy, however, raises
the price to $21,000; Erbitux combinations bring the total to $31,000,
according to the article, written by Deborah Schrag of Memorial
Sloan-Kettering Cancer Center in New York."
==
From "STATE SUIT TARGETS ILLEGAL PRICING SCHEME FOR CANCER DRUGS."
Office of New York State Attorney General. Feb 13, 2003
http://www.oag.state.ny.us/press/2003/feb/feb13a_03.html
See Chart "THE SPREAD AND SAVINGS ON A SAMPLE OF PHARMACIA'S, GSK's &
AVENTIS' DRUGS."
==
Targeted Therapies Market:
Read "Targeted cancer therapies: Another step forward."
News-Medical.Net. 22-Dec-2005. http://www.news-medical.net/?id=15100
"The existing targeted therapies market was worth $5.1 billion across
the seven major pharmaceutical markets** in 2004. Datamonitor
forecasts this market to reach $13.7 billion in value by 2014,
achieving a compound annual growth rate (CAGR) of 13.7%. Furthermore,
the introduction of current late-phase pipeline products will increase
the targeted therapies market's total value to a figure of $19.2
billion by 2014, says Datamonitor oncology analyst Fleur Pijpers.
'Growth of the current targeted therapies market will be driven mainly
by five key products: Genentech/Roche's Rituxan (rituximab), Herceptin
(trastuzumab), Avastin (bevacizumab), Tarceva (erlotinib) and
Novartis's Glivec (imatinib).'
********************************************
TREATMENT COMBINATIONS OR "CANCER COCKTAILS"
********************************************
See "New Drug Regimen Helps Hodgkin's Disease - High doses of seven
drugs work best, study finds," By Adam Marcus. HealthDay Reporter.
2003
http://www.healthscout.com/template.asp?page=newsdetail&ap=1&id=513654
"The new regimen, high doses of seven drugs known by the initials
BEACOPP, had a five-year survival rate of 91 percent, several points
better than the next most effective alternative.....The regimen does
have a few drawbacks: It's hard to tolerate and administer; it's
costly; and, more significantly, it has a propensity to cause other
blood cancers.
==
See "Cocktail combats leukaemia." Tuesday, October 22, 2002
http://www.health24.com/news/Cancer/1-898,19310.asp
"A new cancer-killing "cocktail" shows promise in laboratory studies
as an effective way to attack acute myeloid leukaemia (AML), a cancer
of the blood. A team led by Dr Edward Ball, director of the Blood and
Marrow Transplantation Programme at the University of California-San
Diego School of Medicine, report the findings in the October issue of
Biology of Blood and Marrow Transplantation.
The researchers took blood samples from 12 patients, either diagnosed
or just relapsed with AML.They separated out the white cells, which
included AML cells and T-lymphocytes, the family of cells that mount
an immune response to infected or cancerous cells.To the mix, they
added growth factors and interleukin-4 - which helps activate the
immune system - to turn the lymphocytes into stronger fighters.
The work is at the laboratory stage, Ball cautions, and he must prove
the cancer cocktail works in animals and in humans before it can
become available. The long-term hope, of course, is to have the cancer
"cocktail" be a cure.
=
Dated article - "Drugs cocktail beats breast cancer." 1999
http://news.bbc.co.uk/1/hi/health/372726.stm
The treatment involves adding the drug paclitaxel, also known as
Taxol, to two other commonly used chemotherapy drugs. The company
which manufactures Taxol, which is also used as a treatment for
ovarian cancer, advanced breast cancer, and a certain type of lung
cancer, is now applying for the drug to be licenced for early breast
cancer treatment in Europe
=
"Study results show dramatic drop in breast cancer death rate when
chemotherapy "cocktail" added to standard treatment." National Cancer
Institue of Canada. 16 May 2001
http://www.ncic.cancer.ca/ncic/internet/mediareleaselist/0,,84658243_85783616_88058951_langId-en.html
"Adding a chemotherapy "cocktail" to tamoxifen dramatically boosts
survival rates for women with a common form of breast cancer,
researchers announced today. Results of a ground-breaking
international study presented at this year's meeting of ASCO (American
Society of Clinical Oncologists) showed women taking triple drug
therapy known as CAF plus tamoxifen had a 24 per cent lower death rate
than those taking only tamoxifen.
"All patients received tamoxifen, the gold standard of treatment, for
five years. One group also received six months of chemotherapy with
CAF while taking tamoxifen, while another received six months of CAF
chemotherapy before being treated with tamoxifen. So far, study
results don't yet conclusively show whether it's better to take CAF
and tamoxifen at the same time, or one after the other, but
researchers expect to resolve this question soon."
==
From "Trial Drugs Offer Hope for Brain Cancer - Cocktail could target
specific proteins in tumors," By Steven Reinberg. HealthDay Reporter.
Nov. 2003
http://www.hon.ch/News/HSN/516143.html
"In his presentation, Rich discussed three approaches to treatments.
"One is a drug called ZD6474 which is directed at vascular endothelial
growth factor......SB431542, another new compound, was tested in human
malignant glioma cell lines. The drug successfully blocked the
receptor protein called transforming growth factor-beta
(TGF-beta)......Another drug combination, AEE788 and RAD001, blocked
the growth of glioblastomas...."
"These developments will enable us to develop a cocktail approach to
treating each patient," Rich says. "We can tailor for each patient the
particular needs the patient has, based on the type of tumor."
"Rich sees future treatment of brain cancers, and other cancers, as
using a combination of these drugs, customized for each patient, plus
chemotherapy and radiation. Rich believes that eventually drug therapy
alone may prove effective, eliminating the serious side effects
associated with chemotherapy and radiation."
==
From "Cancer Superdrugs, Costly Side Effects." Business Week Online.
JUNE 21, 2004.
http://www.businessweek.com/magazine/content/04_25/b3888043_mz011.htm
"Standard chemotherapy costs a few hundred dollars a month, but
Avastin, a drug taken intravenously, lists for $4,400 per month.
Tarceva, a pill likely to be approved by the Food & Drug
Administration later this year, is expected to cost close to $2,000 a
month."
"New drugs have enabled doctors to almost double the median length of
survival for advanced colon cancer over the past five years, to 22
months. During that time, notes Dr. Leonard Saltz of Memorial
Sloan-Kettering Cancer Center in New York, the wholesale cost of the
drugs used to treat a single colon cancer patient has shot up from
$500 in 1999 to $250,000 today. Insurers have been willing to pay so
far because drugs are still cheaper than surgery. And until now,
patients haven't lived long enough to become a huge cost burden. But
as survival rates creep up, price will become a much bigger issue.
"There is not enough money in the till to treat everyone," Saltz
warns.
"Erbitux, for example, which costs $12,000 per month, got a lot of
attention at the ASCO meeting for a clinical trial which found that
the drug can extend the median survival for patients with head and
neck cancer to 54 months from 28. ImClone CEO Daniel S. Lynch says
that as a drug is approved for more types of cancer "we'll have to
make an assessment of the pricing."
"Most therapies have notoriously low response rates: AstraZeneca PLC's
(AZN ) Iressa, which goes for $1,700 a month, works on just 10% of
lung cancer patients."
**************************
TRANSDERMAL DRUG DELIVERY
**************************
Transdermal drug delivery in relation to cancer is in it's infancy. I
found a few articles which might be of interest.
The following article mentions the experimental use of a transdermal
patch to deliver Tamoxifen, which is used as a breast cancer drug.
From "Tamoxifen in topical liposomes: development, characterization
and in-vitro evaluation."
Amit Bhatia and Rajiv Kumar. J Pharm Pharmaceut Sci 7(2):252-259, 2004
http://www.ualberta.ca/~csps/JPPS7(2)/P.Katare/tamoxifen.htm
"Tamoxifen (TAM), an estrogen receptor antagonist is known to be a
drug of choice for hormone sensitive breast cancer (1). It has
recently been documented to have potential in the treatment of
dermatological disorders like psoriasis (2-7). TAM is generally
administered through oral and parenteral route. Despite being quite
effective on oral administration, TAM exhibits certain side effects
like distaste for food, abdominal cramps, nausea and vomiting.
However, its other infrequent side effects include endometrial
carcinoma, ocular problems, thromboembolic disorders and acquired drug
resistance on long-term therapy (8-10). The problems associated with
oral administration of TAM, along with difficulty in parenteral
administration owing to its limited (0.5mg/ml) aqueous solubility, led
the researchers to explore other alternative routes of administration.
* Enhanced transdermal delivery of TAM, employing different
penetration enhancers has been reported (11-12). Topical
administration of TAM has recently been found to be effective in the
treatment of excessive dermal scarring (5). In another study on
topical application of TAM employing different melanoma models,
percutaneous administration of TAM yielded higher local tissue
concentrations with minimal systemic absorption (13). Similarly, Soe
et al. (1997) evaluated the therapeutic advantage with percutaneous
application of TAM for the treatment of tumors (14). Significantly
high local (subcutaneous and skin) concentration of the drug has been
achieved, with lesser drug distribution to other organs. The authors
suggested the potential role of topical application, to enhance the
therapeutic effect of TAM in the treatment of cancer. Besides TAM,
percutaneous application of 4-hydroxy tamoxifen, an active metabolite
of TAM, has also been found to exhibit anticancer activity (15-17).
However, despite such studies for the topical applications of TAM and
its potential in deep-seated dermatological disorders, no topical
dosage form of TAM has so far been developed. The present scenario is
full of opportunities in this regard, as there has been a substantial
progress in the design and development of topical carriers. Amongst
the many, phospholipid-based vesicles, i.e., liposomes have been shown
to possess a significant potential."
Read further..
=
Transdermal delivery of pain medication to cancer patients:
See "Transdermal fentanyl. A review of its pharmacological properties
and therapeutic efficacy in pain control," by Jeal W, Benfield P.
Drugs 1997 Jan; 53(1):109-38. http://www.heroin.org/fentanyl/
See "Drug patches catch on." The Royal Society of Chemistry.
http://www.chemsoc.org/chembytes/ezine/1997/patches.htm
"Alza developed the first transdermal patch system for an opioid
(narcotic) analgesic, called Durogesic, which Janssen Pharmaceutica
introduced to the market in 1991. The reservoir system delivers
fentanyl, which is used to manage chronic cancer pain. Fentanyl
permeates the skin at a sufficient rate to produce pharmacological
activity, and has a low potential for skin irritation. Reports have
said that Durogesic can provide relief to cancer patients equivalent
to that achieved with morphine, and that it may reduce side-effects
such as nausea."
See "Skin Patch Promised Land - UK's novel patch to ease AIDS, cancer
pain," by Alicia P. Gregory.
http://www.research.uky.edu/odyssey/spring04/skinpatch.html
"Stinchcomb formulated a plan: create a first-of-its-kind prescription
patch, a safe and legal method to deliver marijuana-like chemicals to
ease nausea and stimulate appetite in people with AIDS and cancer."
==
You might be interested in the following market report, which has a
section on transdermal drug delivery:
See "Drug Delivery in Cancer - Technologies, Markets and Companies."
Jain PharmaBiotech, Jan 2006, Pages: 460
http://www.researchandmarkets.com/reportinfo.asp?report_id=39080&t=t&cat_id=16
==
A discussion of transdermal delivery can be found in the following article:
"Controlled Release Technology and Drug Delivery." UKICRS
http://www.ukicrs.org/cr_tech_and_drug_delivery.htm
There is also mention of an implantable device to deliver medication
for prostate cancer, but that is a bit different than a transdermal
patch.
"Another example is the six-month implant of biodegradable
microspheres of the peptide, leuprolide, for treatment of prostate
cancer."
==
An interesting overview about the state of transdermal drug delivery,
in general, can be found in the two articles below:
"Global Overview of the Active Transdermal Drug Delivery Market," by
Guy Furness. http://www.drugdeliverytech.com/cgi-bin/articles.cgi?idArticle=226
"4 Myths About Transdermal Drug Delivery," By: Ryan D. Gordon, PhD,
and Tim A. Peterson, MS.
http://www.drugdeliverytech.com/cgi-bin/articles.cgi?idArticle=143
==
I hope this information begins to paint a general picture to help you
in your research. I believe that to truly answer many of these
question in more depth, you would be best served by dividing them up
in relation to particular cancers and treatments. If I can be of
further assistance in the future, please don't hesitate to ask!
Sincerely,
umiat
Search Strategy
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