Dr. Lenz

I wanted to share with you an amazing story which began a few weeks ago.  A 28 year old woman with metastatic colon cancer with intra-abdominal spread came for a second opinion. She is well-educated and knows what she wants. She already had two opinions from the National Institutes of Health and the University of California at San Diego, and was open to hear what we would suggest.

I love patients who are informed (although it does not necessarily mean they have all the statistics and data correct). The discussion can move more quickly to create a plan, and there is no need to spend much time on the basics. But sometimes the problem with having a lot of information, especially from the internet and all the good friends you have, is prioritizing it. You have to decide what is the most important, what is validated, and what is a scam. Read the rest of this entry »

Dr. Lenz

The short answer is YES, but obviously this depends on many factors. We usually recommend that patients complete one or two cycles of chemotherapy to see if there are many side effects or not. If patients tolerate the first two cycles well, usually there is no accumulating side effect expected except for neurotoxicity with oxaliplatin down the road.

Personally I think going back to work is important, because it gives the patient some normality and forces him or her to think about something else than the cancer. However this may not apply for everyone, so discussions with your doctor and family are critical. It is important to plan how you will continue to work while you get cancer treatment. I see patients on Mondays and Thursdays, so patients who want to continue to work or may have to continue to work to keep their insurance, usually get treatments on Thursdays, giving them the weekend to recover. Patients who want to spend the weekend with the family choose Monday treatments, giving them time to recover for the weekend. Here are some tips which might help you to better manage your time and work: Read the rest of this entry »

Dr. Lenz

Because of the overwhelming response to my earlier post on PRI724, I wanted to clarify a little bit more about this trial and other trials available for patients with advanced colorectal cancer who have received all standard of care regimens including FOLFOX, FOLFIRI, Avastin and Erbitux (if they were wild-type KRAS).

Of course we will have PRI724. The reason we are so excited because it is the first in class to inhibit a pathway so essential for colon cancer stem cells.

The IND is filed at the FDA, which means we need to wait 30 days for the FDA to respond. If they have concerns, we need to answer them. When they agree, we will go ahead to get institutional review board (IRB) approval. We already have scientific approval from the Cancer Center Scientific Review. Once we have IRB approval we are ready to go.

In the first phase any solid tumor is eligible. However, phase I trials are heavily regulated, so patients need to meet eligibility criteria, which means almost normal function of renal, liver, blood etc. They have to be in reasonable shape (able to do their daily activities). We anticipate that this trial may open at the beginning of November. Read the rest of this entry »

Dr. Kahn and Dr. Lenz in Their Lab

I have shared with you in the past the efforts of Dr. Michael Kahn and myself to develop novel drugs which are completely different than the existing ones.

Even the smart drugs we have such as Avastin or Erbitux, which are monoclonal antibodies that attack important targets in cancer growth and progression, have disappointed,  particularly if you are not able to select the patients who benefit the most.

Why are they not more effective? Read the rest of this entry »

This has been an amazing year with unexpected findings.

We were all convinced that when we added Erbitux and Avastin to our chemotherapy, it would work in the adjuvant setting, which means with FOLFOX for 6 months after the successful removal of colon cancer.

But it did not work. Neither Avastin nor Erbitux showed any benefit. How is that possible? Read the rest of this entry »