When are drug costs and side effects too much?

Study shows new hope for some breast cancer patients through immunotherapy drugs

Breast cancer for a long time was in effect immune from immunotherapy. That apparently is no longer the case.

According to an Associated Press story by Marilynn Marchione this week, one of the new immunotherapy drugs "has shown promise against breast cancer in a large study that combined it with chemotherapy to treat an aggressive form of the disease."

For the first time.

There's a big caveat lurking in the researchers' labs, however: "The benefit for most women was small."

And that, according to Marchione's story, raised questions "about whether the treatment is worth its high cost and side effects."

Results of the new study — which tested a drug from Roche called Tecentriq — were discussed at a cancer conference in Munich and published by the New England Journal of Medicine.

The type of drugs in question, called checkpoint inhibitors, have previously been found helpful in treatments of many other cancers "by removing a chemical brake that keeps the immune system from killing tumor cells."

Their discovery, in fact, recently earned scientists a Nobel Prize.

Dr. Michael Hassett

Side effects of the chemo and Tecentriq, which costs $12,500 a month, included nausea and low blood cell counts, similar to other treatments.

The story quoted Dr. Michael Hassett of the Dana-Farber Cancer Institute in Boston, who didn't take part in the study, as saying "he felt 'cautious excitement' that immunotherapy may prove helpful for certain breast cancer patients."

Details about other research on and treatments for the disease can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

New drugs can lead to 'varied, bizarre' problems

Cancer-killing immunotherapies can cause major side effects in otherwise healthy organs

New immunotherapies can eliminate cancers but may also cause big problems with healthy body organs. 

According to a recent story by Laurie McKinley in The Washington Post, the perplexing side effects can range from inconsequential to severely dangerous, even life-threatening.

The article cites the case of a 55-year-old patient whose therapy "knocked back her cancer [but] also gave her 'almost every 'itis' you can get'… arthritis-like joint pain, lung inflammation called pneumonitis and liver inflammation that bordered on hepatitis."

The woman, McKinley's piece continues, warns "that highly touted immunotherapy treatments have downsides as well as benefits and to watch for complications, because 'not all doctors know all the side effects.'"

The upside is clear, however.

Checkpoint inhibitors, the new therapies, "offer a tantalizing chance for survival for patients with advanced melanoma and hard-to-treat cancers of the bladder, kidney and lung," the story says.

The downside? 

"The treatments, designed to unleash the immune system to attack malignancies, also can spur an assault on healthy organs, causing varied and bizarre side effects ranging from minor rashes and fevers to diabetes and deadly heart problems."

Dr. Drew Pardoll

Some of the symptoms, unfortunately, can fool doctors because they "can mimic those of the flu, infections or even food poisoning. That lack of awareness [by physicians] can be dangerous, given that quick intervention is the key to preventing serious damage."

The Post article quotes Dr. Drew Pardoll, director of the Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, as noting that immunotherapy "has a completely different side-effect profile than chemotherapy, and that has caught some physicians off guard."

Doctors, including emergency-room physicians, dermatologists and gastroenterologists, Pardoll insists, "need to go back to school" to earn about immunotherapy.

The side effects, McKinley writes, "occur in 15 to 70 percent of immunotherapy patients, depending on which drug is used and whether the medications are used individually or combined with one another or conventional cancer treatments."'

Are the cancer treatments worth using despite the side effects?

According to Kevan Herald, an immunologist and endocrinologist at Yale University, they absolutely are. "If it's a choice between staying alive and developing diabetes versus not, I'd always pick taking the drug and managing the diabetes."

Jeffrey Bluestone, an immunologist at the University of California, San Francisco, is also quoted in the Post piece. "The last thing you want to do is scare people away from lifesaving treatments," he maintains.

Questions about new treatments, drugs and research on life-threatening diseases are addressed in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.