Topic: Targeted Therapies, Cetuximab
My mom has just started her GemCis treatments at Sloan Kettering. I've done quite a bit of research and am familiar with the prognosis of this treatment, but I am wondering about improving her chances with a targeted treatment. Below is a rundown on the most interesting things I've found.
I found this paper which gives a very good summary on the current state of affairs of targeted treatments and cholangiocarcinoma:
In particular interest are the studies on Cetuximab (Erbitux) with GemOx, particularly the Gruenberger 2010 study. They report a response rate of 63%, and more spectacularly a complete response rate of 10%. In comparison, the large scale GemCis ABC-02 trial has a complete response rate of 0.6%. I have a version of the full text in case anyone is interested (PM me).
However this contrasts strongly with the early results of an ongoing larger randomized Cetux/GemOx trial (Malka 2009, the BINGO trial) which at 4 months shows only an 11% response rate (3 out of 18 with a partial response). Maybe 4 months just not enough time for the cancer to respond? Would be great if someone had more info on this.
I brought up the Cetuximab with our oncologist, Dr. Abou-Alfa, but he did not think it was a good idea, though he did not go into why. I didn't press the issue on the spot, but I was wondering if anyone had some more information on this, first hand or otherwise.
Do you think it is worth getting a second medical opinion on more experimental treatments? Should we be pursuing trial enrollments?
Also early studies on the MEK inhibitors like Selumetinib look interesting. I know they mentioned research on this in the MD Anderson video in the treatments part of this website. Anyone have information on this?