Herceptin

[beryllium]

Thank goodness Ann Marie Rogers, fighting for her chance to survive cancer with herceptin, has won her case.

I dread to think what the stress of this case has caused for her health.

Why oh why do we have to fight for our treatments these days? some will not have the strength, and they will save the local pcts thousands.....

Wonder if those that dont fight will get a thank you letter?

rant over.....

[LazyGun]

I dont think it is quite as clear cut as people seem to think beryllium.

The perception widely held by many who have read the story seems to be that we have here a case of a plucky underdog, fighting a mean and malevolent state, who are withholding a new wondertreatment purely because of its cost. This is not a view I subscribe to.

From a recent "TImes" article about this case;
"The costly new treatment is still at the experimental stage, and the drug has neither been licensed by the European Medicines Agency for use to treat early stage breast cancer patients, nor adopted as an accepted treatment by the National Institute for Clinical Excellence (Nice). It costs �30,000 a year per patient"

NICE HAVE endorsed the use of Herceptin for particular types of breast cancer (particularly those that have the HER2 marker), where there are clear benefits. They will be producing a report in July 2006 about the benefits of Herceptin in cases of early stage breast cancer.. I would agree entirely with and support her fight if she was an early stage breast cancer sufferer with diagnosed HER2 markers,since she is likely to see the same benefit as those in later stages.

It is also clearly wrong that we do still have a "postcode lottery", and extremely unclear definitions by varying PCTs as to what constitutes "extreme circumstances". All PCTs of course have a legal obligation to offer Herceptin if the patient falls into the clincally mandated category, which is late stage breast cancer with HER2 markers.

I also think the drug companies need closer scrutiny... there marketing campaigns are sometimes steering very close to the unethical.
http://www.guardian.co.uk/g2/story/0,,1741697, 00.html

[alfiebrady]

Second that thought (2nd para.), LazyGun.

I also think that Ann Marie Rogers might be fighting her condition by fighting this case, if you see what I mean.

[jgs]

I believe Herceptin is routinely prescribed to women in Scotland which seems unfair to me. Are their lives worth more?

[beryllium]

Thank you LazyGun and Ann Marie Rogers is, I truly hope now, on her way to a cancer free life. Strange how drug companies do work though, if they're not trying to kill students, people are fighting in the courts, to become guinea pigs to prove the drug does work..... I know some drug companies are unethical, but..... some are working hard to get us the treatments that we need and that costs money.... and people willing to try them..

I too am on an 'unlicenced drug' for pain, and again, even though it's on a named patient basis, my GP had a hard time with the Home Office....

My other drugs cost around 12000, a year, but i'm due to stop because of side effects.... the cost of my drugs has not come down, will Herceptin?

[LazyGun]

Herceptin is routinely prescribed in England and Wales, jgs, for the clinically mandated criteria. (late stage breast cancer with HER2 markers)

I would be very surprised if Herceptin was routinely prescribed for any and all forms of early stage breast cancer in Scotland, not least because it has a high cardiotoxicity. Do you have any links as to the prescribing habits in Scotland, jgs?

[jno]

I read somewhere that if you treat 20 patients with Herceptin, you'll save the life of one of them. If that was all, it'd still be worth doing. But there's only so much money in the pot, and Herceptin's expensive. If you give one person an expensive drug, others miss out on cheaper drugs. Tough decisions have to be made. I'm not sure that judges are the right people to make them. I'm not sure the right one was made in this case. I sympathise with Ms Rogers - but also with the people whose (for instance) operations have to be put off further, but who don't get their names in the papers.

[beryllium]

LazyGun? out of interest on the cardiotoxicity front? if herceptin is rumoured to give up to 20 yrs? longer life expectancy, how is anyone gonna know, if the patients heart gives out in 5 yrs? how long before cardio problems? will it affect all?

[jgs]

Hi Lazygun,

I happened upon this yesterday which prompted my response on here. Thought it was worth a mention after the postcode lottery comment.

http://news.scotsman.com/scotland.cfm?id=247862006

Ta.

[LazyGun]

Thanks for the link jgs.... interesting article.

beryllium, this might be of interest.
MedWatch reports that Genentech and the FDA have released updated cardiotoxicity information relating to the use of Herceptin (trastuzumab), obtained from the National Surgical Adjuvant Breast and Bowel Project (NSABP) study (B-31).

Preliminary analysis of safety data from this study and the North Central Cancer Treatment Group (NCCTG) study (N9831) revealed a statistically significant increase in the 3-year cumulative incidence of New York Heart Association Class III and IV congestive heart failure and cardiac death observed in patients who received the Herceptin-containing regimen (4.1%) compared with control (0.8%). Final analysis of the cardiac safety data collected in both studies is ongoing. Please see the link for the company press release (American).

Just to clarify... based upon what I have read, I would fully endorse the use of herceptin where there is a proven clinical benefit. It is already clear, and NICE have already authorised the routine use of herceptin for advanced breast cancer treatment where there are HER2 markers... it is easy to infer that early stage sufferers with HER2 would also benefit. The point is that not every sufferer from breast cancer has the appropriate type of cancer suitable for treatment by this drug... and media reports do not make that particularly clear. I also think that peoples perceptions of the effectiveness of this drug are a little off... without the use of herceptin in HER2 breast cancers, there is a 18% chance of relapse and recurrence of the cancer.... in those receiving the drug there is only a 9% chance. Now, that is a massive reduction, but it still means that it will not always work.

[beryllium]

Thank you LazyGun, so, it's a lose-lose or a win-win or a win-lose, i must admit, i said to my doc yestarday, that i'm gonna take whatever takes me out first, and she just smiled and she knew what i was saying..... she's a lovely doc!!!

I am interested in cardiotoxicity, and i did read your link on it. Early days? these women are prepared to do anything and take those risks, some will lose and some will win, but without them, we'll never know and neither will Roche. I did feel for Lisa Jardine, and very interesting, is the fact that drug companies now have to state who they're paying....

It is a very hard business, but,.... i take roche vitamins hehe......

I would love to know what you do LazyGun, I am facinated by people in medical etc.... hope you don't mind me asking....

[LazyGun]

I dont mind you asking beryllium. I now run my own company, but for many years I worked as a Medical Laboratory Scientist, and specialised in Haematology and Blood Transfusion. I still retain a love of the NHS and a fascination with all things medical though.

[beryllium]

oooh, lovely!!! Blood.... and Morg_Monster with all her lovely info.....

You see, you were there in the medical sector, working on cures? or 'what is it?' stuff... i get better with the technical language!!! and on the good side, ethical....

By the way, i do cringe at the word NICE, but i dont know the politics involved, and why Canada gets a yes always before us!!! why is it good for other countries first? and i'm talking about Sativex, a british company with government permission, or is it always about a brand new investigation into said drug with no acceptance of other countries medical investigations....

from confused....

[LazyGun]

Cant give you a definitive answer on that beryllium.

The different international regulatory bodies can have different acceptance criteria, which will mean that some drugs/products are accepted in some countries and not others. That is changing though, and there is a lot of effort going into standardising such acceptance criteria.

NICE is not quite the same thing.... NICE is apolitical and comments on the relative clinical effectiveness of a drug or therapy in comparison with other therapies available, and then recommends what is in its opinion the best method/drug for a particular disease/symptom etc.

It can only comment on a drug once said drug has been licenced by the MHRA for a specific therapy.

[beryllium]

glad to hear that they're working on a central body, that surely is going to save money.... i just think it's odd when the drugs,hehe, are 'home grown' literally in my one!!! and then we dont get first go at it.....

so NICE can only comment once the drug is licenced, and comparisons must take years, up to 5? more? less? unless of course it's the only drug available after all the others have failed, after many years of use, because the body gets used to them and once you're on maximum dose and cant go any further, you need something new.

I know what i'm going to do.... live in Holland!!!

Thank You for your time, because it's important to have some inside info.

off to put me head back in the sand now...

B. xx