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#84768 11-25-2008 02:44 PM
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What does Erbitux do to help patients? They have stopped by chemo after 5 treatments and want to start Erbitux and need information. If anyone has that information I would appreciate it. Thanks, Angel


SCC left tonsil, tonsillectomy with additional tissue removed 06/10/08, a few teeth on top left side removed 09/05/08,recurrence before treatment started at BOT and tonsil area, 35 IMRT treatments began 10/15/08, and Cisplatin IV (began10/16/08) weekly for duration of radiation.
angels1313 #84771 11-25-2008 03:08 PM
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I got Erbitux during my treatment, Angel. My understanding of it is that its a 'targeted' therapy that goes after the DNA of the cancer cells and prevents them from dividing. No cell division equals no new cancer growth.


Stage IV SCC lt lateral tongue, surgery 5/19/08 (partial gloss/upper neck dissection left side/radial free flap reconstruction) IMRT w/weekly Cisplatin & Erbitux 6/30/08, PEG 1 6/12/08 - out 7/14 (in abdominal wall, not stomach), PEG 2 7/23/08 - out 11/20/08, Tx done 8/18/08
Second SCC tumor, Stage 1, rt mobile tongue, removed 10/18/2016, right neck dissection 12/9/2016
Third SCC tumor, diagnosed, 4/19/2108, rt submandibular mass, HPV-, IMRT w/ weekly Cisplatin, 5/9 - 6/25/2018, PEG 3 5/31/2018
angels1313 #84780 11-25-2008 04:37 PM
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I also had Erbitux which technically is not chemotherapy but monoclonal antibody therapy. It blocks the EGFR (growth) receptors throughout the body but since the Cancer cells are the hungriest and fastest growing, it hammers them the most. As noted in other posts, there is some evidence that Erbitux also greatly enhances the effect of radiation upon the cancer cells since usually the cancer cells can rebuild themselves faster than normal cells. It is also used when chemo doesn't work out so well. I am convinced it saved me. Less poison and more burning. Although it did take six months for my fingernails to start growing again.


65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin

Passed away 4-29-13
angels1313 #84781 11-25-2008 04:42 PM
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Oops almost forgot to add an amusing fact about Erbitux: It is a chimera -(remember your Illiad by Homer). It is based on a MOUSE gene that has been altered to affect humans. The official literature language is: "a chimera comprising human and mouse monoclonal antibodies against the epidermal growth factor receptor (EGFR)"
I am eating a lot more cheese nowadays wink


65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin

Passed away 4-29-13
Charm2017 #84787 11-25-2008 05:29 PM
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Not sure about mice, but the pet rats, errr, Long-Tailed Norwegian Hamsters, that I have had didn't particularly care for cheese -- However, if you have a new longing for peanut butter, then the effect is there!


Age 67 1/2
Ventral Tongue SCC T2N0M0G1 10/05
Anterior Tongue SCC T2N0M0G2 6/08
Base of Tongue SCC T2N0M0G2 12/08
Three partial glossectomy (10/05,11/05,6/08), PEG, 37 XRT 66.6 Gy 1/06
Neck dissection, trach, PEG & forearm free flap (6/08)
Total glossectomy, trach, PEG & thigh free flap (12/08)
On August 21, 2010 at 9:20 am, Pete went off to play with the ratties in the sky.
Pete D #84826 11-26-2008 07:16 AM
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I just saw a hour long show on rats. They are amazing creatures to say the least. Just one of the things I found amazing was one of the favorite baits for traps is INSULATION. That speaks volumes about their resolve.

We have to deal with rats in our restaurant during the cold months when they want to come inside and the last thing a restaurateur wants is to have a cute little rat peaking it's head out in front of a customer so naturally we leave them up to the experts. Now I refuse to let them use glue boards but then again we must get rid of them so they use these bait boxes where they go in and die out of sight. So the other morning I cut the light on in the kitchen to open up and sure enough I saw one scurry into a crack. I called the experts and they came out only to tell me that "someone" had removed all the boxes. I was like WHO in the world would do something like that? and then it dawned on me....my dear darling wife. So now we have to be very careful not to tip her off. I wish there was another way but they just won't listen to reason.


David

Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
angels1313 #84830 11-26-2008 07:32 AM
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Angel

Let me be clear that I was just adding some levity in my second post and the other posters appear to be joining in the fun. There is ZERO known risk or side effects of becoming mouse like. I will leave out any psychological assessments of Pete and David focusing on rats. Erbitux is the biggest breakthru in treating oral cancer of the century. I hope it works as well for you as it did for me.


65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin

Passed away 4-29-13
Charm2017 #84860 11-26-2008 04:50 PM
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Charm, What are the side effects of Erbitux? When you stated it is the biggest breakthrough in treating oral cancer reckon why they would use the cisplatin on me instead of the Erbitux to begin with?

Thank ya'll for your responses. Angel


SCC left tonsil, tonsillectomy with additional tissue removed 06/10/08, a few teeth on top left side removed 09/05/08,recurrence before treatment started at BOT and tonsil area, 35 IMRT treatments began 10/15/08, and Cisplatin IV (began10/16/08) weekly for duration of radiation.
angels1313 #84862 11-26-2008 04:56 PM
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The two drugs are completely different in their mechanism of action. Erbitux is usually not used as a mono therapy by itself. It is a monoclonal antibody, (read more about targeted therapies on the main site) and interrupts a particular function of the cell life cycle. (Reproduction) Cisplatin is a poison, it kills everything. So since cancer cells divide and replicate much faster than normal cells, wouldn't it be cool if you could interfere with that ability while you were killing the crap out of them so there were fewer that you had to kill, and perhaps less time that you had to spend doing so? If you put Erbitux and Cisplatin or another poison together, this is essentially what you have done.


Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.
Brian Hill #84867 11-26-2008 05:48 PM
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I had Erbitux with my Rads, but sure couldn't say what it did or didn't do to the cancer,Had the seed implnats too and I have no idea which of them did what. I do know my cancer is supposedly gone.


Since posting this. UPMC, Pittsburgh, Oct 2011 until Jan. I averaged about 2 to 3 surgeries a week there. w Can't have jaw made as bone is deteroriating steaily that is left in jaw. Mersa is to blame. Feeding tube . Had trach for 4mos. Got it out April.
--- Passed away 5/14/14, will be greatly missed by everyone here
angels1313 #84871 11-26-2008 06:19 PM
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Angel

Brian answered your last question, explaining in plain english the prevailing theory most doctors use: combine the Erbitux with the chemo to maximize the effect. And as usual he's right that Erbitux alone is not commonly used first. I did not like what I read about the side effects and possible risks of cisplatin nor putting such a powerful poison into my bloodstream. Each medical team is different and mine was willing to substitute the killing effect of the more narrowly focused radiation for the cisplatin (which is why I had the max rads of 72 gy). I liked the whole MAB idea. So I took a chance on just Erbitux alone -knowing that the current "gold" standard is both. It was a decision I made, not the doctors, just like not getting a peg. Not the usual but worked for me.

As to side effects, the most common is the acne like rash and increased radiation dermatitis. In other words, your skin can blister up real bad and real red. My reaction was way worse than any of the patients my team had seen. On the other hand, some believe that the worst the skin reaction to Erbitux, the more effectively it is working. there were little things like every fast growing cell took a hit too, such as fingernails and toenails. Heck for the first time, even my ear hair slowed down. (inside old fogey joke)
Last but not least, it let me joke about Martha Stewart saving me.


65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin

Passed away 4-29-13
EzJim #84895 11-26-2008 10:26 PM
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targeted and biological therapies from the main site. http://www.oralcancerfoundation.org/treatment/targeted_therapies.htm


Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.
Charm2017 #84897 11-26-2008 10:36 PM
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I am not sure if I would go as far as to call Erbitux the single most significant breakthrough in oral cancer therapy.
The MAB idea has been around for a long time, and while it is attractive to have a targeted drug it is not magic nor does it always work. Take Herceptin (another MAB used in breast cancer) it "only" works in 30-40 % of breast cancers. I am not sure what the percentage is in SCC but it would make sense to test if that particular cancer is responsive or not. This has at least in my case not been done.
As to side effects you have the common ones (you are inhibiting EGFR which normal cells also use). Erbitux is a large protein (about 1000x bigger than aspirin). Its composition has been partially been "humanized" to make it less immonogenic. But, because it is a foreign protein some people can have very serious reactions to it. In principle this is something that can be detected relatively easily, If the first time you are given the infusion this is done slowly and you are closely monitored. However that may not always happen even if you ask for it. (Hence the soap box and my warning)

Having said this, it is good to have another drug that one can use, particularly if the cancer is not platinum drug sensitive. I am not sure what the documented survival advantage is for Erbitux/IMRT vs cis/carboplatin/IMRT>>>> Brian??. Testing for markers could be beneficial here. Also, there is something attractive about the nonspecific nature of cisplatin especially if some cancer cells have started their migration...
I would have used Erbitux had this been possible, since it was not (I am one of the lucky 3%) it was cis- then carboplatin. In retrospect this was not a bad choice for the above reason. What appears to be important is to support IMRT with a drug regimen.

Markus

FYI:

www.erbitux.com
MPORTANT SAFETY INFORMATION
Severe allergic reactions due to Erbitux� (Cetuximab) therapy have occurred in 3% of 1373 patients receiving Erbitux during clinical studies.

Heart attack and/or sudden death occurred in 4 of 208 patients (2%) with head and neck cancer treated with radiation therapy and Erbitux as compared to none of 212 patients treated with radiation therapy alone

Last edited by Markus; 11-26-2008 11:04 PM.

Partial glossectomy (25%) anterior tongue. 4/6/07/. IMRT start @5/24/07 (3x) Erbitux start/end@ 5/24/07. IMRT wider field (30x) start 6/5/07. Weekly cisplatin (2x30mg/m2), then weekly carbo- (5x180mg/m2). End of Tx 19 July 07.
Markus #84913 11-27-2008 06:54 AM
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Markus
I should have given citations to my praise of Erbitux since that phrase was hardly original but widely quoted. There were just so many to choose from but let's use the gold standard, the OCF reader Oral Cancer News on Oct 15th:
"Merck Serono�s Erbitux� is one of the finalists for the prestigious International Prix Galien Award for excellence in pharmaceutical development and innovation due to its role in transforming the treatment of head and neck cancer.

Erbitux is the first and only targeted therapy approved for the treatment of squamous cell carcinoma of the head and neck (SCCHN) and works in a completely different way to conventional chemotherapies. Through its targeted mode of action, Erbitux blocks the epidermal growth factor receptor (EGFR), which is expressed in more than 90% of SCCHN tumors1 and is directly related to a poor prognosis for patients. The efficacy and tolerability of this novel drug have been shown in clinical trials2 - the latest of which, EXTREMEa, demonstrated the first significant advance in 30 years for the treatment of recurrent and/or metastatic SCCHN. "
My CCC is tracking me as part of their studies to get meaningful statistics for Erbitux /IMRT to go with their ongoing clinical study on platinum/IMRT vs Plat+Erb/IMRT. As noted above, the 90% figure for head & neck is a lot better than than the 40% for breast cancer MAB.

Angel
I should have mentioned a warning that if you have lived anywhere where there are a lot of "seed ticks" - such as Georgia or Tennessee - and you were bitten a lot hiking by seed ticks, then Erbitux is not for you as that is the number one cause of a bad reaction. Seems that the antibodies you develop from the tick bites mess up the MAB action. My CCC quizzed me about this and they won't use it on patients who came in from those southern states even though the conclusive studies are still being done, My experience was just with the old fashioned grown up ticks in the Northeast, so no problem.


65 yr Old Frack
Stage IV BOT T3N2M0 HPV 16+
2007:72GY IMRT(40) 8 ERBITUX No PEG
2008:CANCER BACK Salvage Surgery
25GY-CyberKnife(5) 3 Carboplatin
Apaghia /G button
2012: CANCER BACK -left tonsilar fossa
40GY-CyberKnife(5) 3 Carboplatin

Passed away 4-29-13
EzJim #84968 11-27-2008 09:50 PM
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You can google Erbitux and read the stated side effects [some of which are very scary] but the one my husband had the most problem with was the rash- all over his body with concurrant swelling in his fingers and toes. He had to stop the Erbitux on 2 occasions because of the rash and we never got the rash under control. In his case Erbitux was given as palliative tx after the chemo failed to stop the growth of the tumors. He was on it for 8 months +-. Amy


CGtoJohn:SCC Flr of Mouth.Dx 3\05. Surg.4\05.T3NOMO.IMRTx30. Recur Dx 1\06.Surg 2\06. Chemo: 4 Cycles of Carbo\Taxol:on Erbitux for 7 mo. Lost our battle 2-23-07- But not the will to fight this disease

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