Once again the OCF News had an article that helps me understand my own battle with cancer. Today's story on the Evolution of Cancer explained in more detail what my RO, MO, and ENT had told me about my cancer coming back: your tumor had a high percentage of cells resistant to radiation and targeted chemo.
As the article explains
[quote]The authors point out that for most patients with advanced cancers � even when there is a well-known target and a highly specific drug � response to therapy is fleeting owing to the evolution and proliferation of a resistant population of cancer cells.

While targeted therapies have been among the most recent approaches to treating cancer, the authors suggest that the vast changes in the genetics of tumors via mutations reduce the effectiveness of targeted therapies and are a reason why targeted therapies cease to work.

�The emergence of resistance is predictable and inevitable as a fundamental property of carcinogenesis,� Gatenby said. �However, this fundamental fact is commonly ignored in the design of treatment strategies. The emergence of drug resistance is rarely, if ever, dealt with until it occurs.�[/quote]
Like the Washington Post says about subscribing to it :
[quote]If you don't get OCF News, you don't get it.
[/quote]
Thank you Brian & Sheldon for OCF News
Charm

I was especially interested in the Gardisil / Adverse effects story from Forbes - I read Science Daily ... um, daily but never would have picked uo the Forbes article. Great job, Brian and Sheldon!

While I read Forbes occasionally ( can't ditch my old business background), I have been communicating with Matt Herper for some time. He is the one science writer that comes to things in an unbiased, and very easy to understand manner. My favorite article of his had to do with Bill Gates and how his "outlier ideas" about the health problems in Africa, are completely changing our understanding of childhood deaths there, and what he is doing about it for not so much $ per life saved.

http://www.forbes.com/sites/matthewherper/2011/11/02/the-second-coming-of-bill-gates/

What a great article about Bill Gates and his ability to shift course in his thinking in order to solve problems! I wish more of our politicians had the same insight and ability.

[quote]�The emergence of resistance is predictable and inevitable as a fundamental property of carcinogenesis,� Gatenby said. �However, this fundamental fact is commonly ignored in the design of treatment strategies. The emergence of drug resistance is rarely, if ever, dealt with until it occurs.�[/quote]

I think our doctors DO recognise resistance as inevitable without aggressive therapy. For this reason chemotherapy is often a combination of 3 drugs that work in different ways. It is important to hit from multiple angles so the cancer is annihilated before it "learns" the escape route.

Karen

Excellent article, Brian. Thanks for posting it - I never would have known about it otherwise.

Trial design is much more straightforward if you are looking at one factor at a time - the addition (or not) of a single chemo agent, or the radiotherapy fractionation protocol. If you design a trial that has multiple factors, it's harder to tell definatively which tweek gave better results, or if it was the combination that did it. Science Daily had another article that explains a combination. It is way pre-clinical (unless you are a fruit fly) but very interesting and less depressing that the cancer and the Darwinian cancer evolution one:

http://www.sciencedaily.com/releases/2012/06/120615141716.htm

Maria

Here is another piece of the "evolution" puzzle from a news release from John Hopkins Kimmel Cancer Center when its "Kimmel wire" email news service sent me this excerpt yesterday:
[quote]Targeted cancer cell therapies using man-made proteins dramatically shrink many tumors in the first few months of treatment, but new research from Johns Hopkins scientists finds why the cells all too often become resistant, the treatment stops working, and the disease returns.
[/quote]
As you can see from the full news release, it is about colon cancer and there is no proof that it would apply to oral cancer- I want to make that clear - although I do believe it does raise a hypothesis worth exploring for oral cancer patients. Hopkins news release
As noted in this thread, right now using a combination of therapies looks promising.
charm

Resistance to drugs is a huge issue. There is a whole journal devoted to drug resistance -

http://www.drupjournal.com/home

It includes recent work on EFGR targeted resistance in HNSCC - I can only get at the abstracts on my login. I stumbled on the journal trying to find references to recent work by Posner and Bonner. Will try to post the best links for these this weekend.