Información sobre riesgo, prevención, detección, síntomas, diagnosis, tratamiento y apoyo para el cáncer.
Información sobre el tratamiento del cáncer incluyendo quirúrgica, quimioterapia, radioterapia, estudios clínicos, terapia con protón, medicina complementaria avanzadas.
OncoLink se complace en ofrecer una amplia lista de lista completa de los agentes quimioterapéuticos más comúnmente usados??. Esta guía de referencia incluye información sobre la forma en que cada fármaco se administra, cómo funcionan, y los pacientes los efectos secundarios comunes pueden experimentar.
Maneras que los pacientes de cáncer y las personas que le cuidan puedan enfrentar el cáncer, los efectos secundarios, nutrición, cuestiones en general sobre el apoyo para el cáncer, duelo/decisiones sobre el termino de vida, y experiencias compartidas por sobrevivientes.
Profesionales de la salud / / / /
Reviewer: Christopher Dolinsky, MD
University of Pennsylvania School of Medicine
Ultima Vez Modificado: 2 de noviembre del 2005
Presenter: J. Randolph Hecht, MD
Presenter's Affiliation: UCLA GI Oncology Program, Los Angeles, California
Type of Session: Scientific
Materials and Methods
While the concept of using an inhibitor of all three VEGF receptors is certainly elegant, one must remember that CONFIRM-1 is essentially a negative trial. Centrally reviewed radiologic analysis for progression (the primary endpoint) did not produce a statistically significant difference between the experimental arm and placebo. The magnitude of the difference noted in median survival (7.7 months versus 7.6 months) is 3 days, and may be due to random chance. Although the investigator assessment of progression did favor the experimental arm, this was not a completely blinded analysis. Investigators may have had some idea which patients were receiving the experimental compound (based on side effect profiles), and this may have produced bias in their assessment of response and progression.
This agent does not appear to compare favorably with other agents used to inhibit the VEGF receptor pathways (such as bevacizumab) that have shown significant activity in colorectal cancer. While it is true that overall survival data and further analyses are required to fully characterize the efficacy of PTK787, these data do not predict success in the future using this compound for metastatic colorectal cancer.
An important question raised by this trial is, why doesn't it work? Multiple hypotheses exist, including: the agent is not sufficiently active, the drug was not dosed properly, or patients were not chosen properly. The drug has a fairly short half-life, and no one knows what sorts of trough levels are needed to sufficiently inhibit VEGF for tumor control. The fact that patients with high LDH responded to this compound is certainly interesting, and may speak to the biology of this agent. Perhaps in the future, this drug can be tested in only patients with elevated LDH. Finally, one can speculate that this agent may be effective in patients who have already failed bevacizumab. The PTK787 story is not over, and the study of this compound will continue to move oncology forward, both in terms of its specific use and more broadly in term of how biologic agents are developed and tested in the future.
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