Chemotherapy Drugs

Hi,

After optimal debulking surgery, complete hysterectomy, my wife was treated with standard drug comb of carboplatnum/taxol, 6 cycles. Her CA125 went way way down by the second treatment. Last infusion was Feb. of 2003. But it was only about 7 months later when a recurrence was confirmed, through a biopsy/surgery on the lymph node under her arm. She was put on arimidex, which is no longer effective. Now it's back to chemotherapy, her doctor said. My questions: Could my wife repeat the carbo/taxol regimen before going on to doxil ? She knows she will lose her hair again, and have worse side effects, but she doesn't care, as long as there is a chance her cancer will again respond before taking doxil. She would also like to confirm she can always move on to doxil when necessary. Our doctor has explained you sometimes don't want to use your best weapons right away. Assuming the original regimen would shrink the tumor, why not repeat ? But what criteria is used to determine whether her cancer is now resistant to the carboplatnum ? If so, could she be treated with taxol alone, and that might be effective ? Or maybe be treated with taxetere or taxene, which I think are different than taxol ????? Info and feedback please. Thank you very, very much.

AMS

AMS

[gpawelski]

One approach to individualizing patient therapy is chemosensitivity testing. Chemosensitivity assay is a laboratory test that determines how effective specific chemotherapy agents are against an individual patient's cancer cells. Often, results are obtained before the patient begins treatment. This kind of testing can assist in individualizing cancer therapy by providing information about the likely response of an individual patient's tumor to proposed therapy. Chemosensitivity testing may have utility at the time of initial therapy, and in instances of severe drug hypersensitivity, failed therapy, recurrent disease, and metastatic disease, by providing assistance in selecting optimal chemotherapy regimens.

All available chemosensitivity assays are able to report drug "resistance" information. Resistance implies that when a patient's cancer cells are exposed to a particular chemotherapy agent in the laboratory, the cancer cells will continue to live and grow. Some chemosensitivity assays also are able to report drug "sensitivity" information. Sensitivity implies that when a patient's cancer cells are treated with a particular chemotherapy agent in the laboratory, that agent will kill the cancer cells or inhibit their proliferation.

The goal of all chemosensitivity tests is to determine the response of a patient's cancer cells to proposed chemotherapy agents. Knowing which chemotherapy agents the patient's cancer cells are resistant to is important. Then, these options can be eliminated, thereby avoiding the toxicity of ineffective agents. In addition, some chemosensitivity assays predict tumor cell sensitivity, or which agent would be most effective. Choosing the most effective agent can help patients to avoid the physical, emotional, and financial costs of failed therapy and experience an increased quality of life.

Fresh samples of the patient's tumor from surgery or a biopsy are grown in test tubes and tested with various drugs. Drugs that are most effective in killing the cultured cells are recommended for treatment. Chemosensitivity testing does have predictive value, especially in predicting what "won't" work. Patients who have been through several chemotherapy regimens and are running out of options might want to consider chemosensitivity testing. It might help you find the best option or save you from fruitless additional treatment. Today, chemosensitivity testing has progressed to the point where it is 85% - 90% effective.

[odaat]

On 8/10/04 I had surgery for ovarian cancer, was optimally debulked. I am stage 3, c.

I am in the GOG 182 Trial, Arm II: Carbo/Taxol/Gemcidibine for 8 sessions plus Gemcidibine 8th day after triplet dosing.

After initial triplet dosing I received results of the Resistance Assay done after surgery. The tested tumors are non resistant to Carbo/Taxol/Topotecan and totally resistant to Gemcidibine and Doxil.

It seems somewhat obvious to change drugs now to the the non resistant triplet but am receiving confliciting info as to the reliability of the Assay.

Any info on this would be appreciated.

ODAAT