Jatoo, Please read, Need your input

Jatoo:

I just talked with the nurse and was told that I may qualify for the clinical trial in Arizona with Avastin/Tarceva.  I may also possibly qualify for a clinical trial at MD Anderson with Topetecan/Iressa. Now the hard part.  I need to decide what to do.  I will have to fly out to Arizona every two weeks from Texas.  My insurance may not cover any of the procedures except the drugs.  MD Anderson is not but about 3 hours from me.  I would really like to know if you know anything about Topetecan/Tarceva Clinical trial.  YOur input always help.  I am really having a hard time deciding what to do.  
    My status for review is:

         Stage 3c
         Poorly differential Papillary
                 Serous
         Platinum refractory

Thanks for your time.  It is greatly appreciated.

plady

[plady]

Jatoo:  

One more question.  I asked my nurse about getting the Avastin here, as you said, off label.  She said they could give me the drug, but it wouldn't be covered by my insurance.  Did you say you got your insurance to cover yours.  How hard was that, and what did you have to do?

[Jatoo]

Dear Plady:

1. Its good you posted. I really wanted to know as to what was happening to you. I almost posted "To Plady".

2. My wife after Doxil (also given on clinical trial) was given Topotecan which is a standard drug and has almost the same success rate as Doxil. Adding Iressa or gefitinib an EGF-R inhibitor (epidermal growth factor receptor) expressed in 50-70% of epithelial ovarian cancers to Topotecan would increase the success rate of single Topotecan alone.

3. Iressa is similar to Tarceva. That makes the Avastin/Tarceva trial as effective or much better. In this latter trial you don't have the side effects of a chemo drug which weakens your bone marrow (My wife had Neupogen and platelets transfusions while on Topotecan). Although you don't have the side effect of Avastin which can be fatal (a risk factor of 6% for GI perforation based on recent estimate).

4. Right now I don't see any promising drug better than Avastin based on clinical trials results if one is platinum resistant. Even platinum sensitve patients can highly benefit from Avastin in combination. But Plady your tumor has not seen Topotecan yet.

5. My suggestion is to take the Topotecan/Iressa trial at MD Anderson which is much closer to you since it looks like you need treatment now. In the meantime insists on your Insurance covering Avastin by going up the ladder in your hospital or asking some more referral GynOncs in your area that were successful in having Avastin covered by their insurances. VFC who goes to MD Anderson had her insurance covered Avastin while at MD. We are in the Los Angeles area and our insurance covered Avastin without going in a trial.

6. If Topotecan does not work in the early stage, then you can always go to the Avastin trial. And with Avastin ones you get coverage you can always use it in many ways: Avastin alone, in combination with Carboplatin, Abraxane or Taxol, Gemzar, Topotecan, Cytoxan, Doxil etc. Don't forget that there are also hormonal drugs like Tamoxifen or Arimedex and Goserelin.

I hope this helps in your decision-making and I will pray for that.

All the best,

Jatoo

[plady]

Thank you so much for replying to me.  My husband and I are sitting here deciding what to do.  I am so grateful for your reply.  I have read it very quickly, and I am going into the other room to read it to him.  We have just about decided to be at MD Anderson Monday Morning, without an appointment and try to talk to the study nurse in person.  I am going to be aggressive with this so I can speed things up, instead of waiting for their phone call.  I will study your post and I can assure that it will help us in our decision.  Once again, thank you so much.  I will let you know what happens.