All- Below is the research completed by Erin Peterson, the Galen researcher. As I posted previously, the articles written recently refer to only a couple of actual studies/reports that offer real info. As far as I can tell, a survivor can read the info below and talk to their onc about the FISH test and gene testing to indicate a survivor's chances of responding to bortezomib (velcade)- Terry, didn't you refer to a study that indicated that curcumin and velcade act synergistically and therefore work "better" together? David
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The following articles pertain to the topic of
individualizing treatment through genetic testing
in order to find out what therapies may work best
in a multiple myeloma patient.
(1)
This article purports that a chromosome test
called "FISH" has been found to be better than
conventional methods when identifying chromosomal
genetic abnormalities that are associated with
plasma cell malignancies. The medical community
is hopeful that this improved chromosomal
analysis could assist physicians in making a
better assessment of a patient's prognosis and
their likelihood to respond to a given treatment.
 Doctors explained that the FISH test could be an
important method for detecting "common genetic
abnormalities typically seen in patients with
multiple myeloma."
(2)
This article pertains to a 2006 finding
concerning the use of the drug Bortezomib for the
treatment of multiple myeloma. Prior to the
finding, Bortezomib was found to work in
approximately one-third of patients who use it,
but doctors were not been able to predict which
patients would benefit. The finding allowed
doctors to identify a group that will likely
respond because of nine mutations which seem to
be present in at least 25 percent of newly
diagnosed patients. The medical community is
hopeful that through this finding and similar
other findings, drug designers may be able to
fashion new therapies that are more specific to
patients genetic alterations.
(3)
Researchers have identified a small subset of
genes whose activity could assist in the
prediction of high-risk multiple myeloma patients
and potentially guide those patients course of
therapy. Researchers were able to make this
finding through a study which categorized the
differences in gene expression patterns.
Specifically, "the activity of as few as 17 genes
could mean the difference between high or low
risk for a poor prognosis." Â
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Dr. Robert Nagourney of Rational Therapeutics, Inc. conducts individualized lab tests to find which chemotherapy treatment will destroy a patient's cancer cells most effectively, instead of using chemotherapy by trial and error. For more information, see:
http://www.rationaltherapeutics.com/patients/aboutus.aspx
This is a testimonial taken from the link posted yesterday by Cathy-
"Dr. Robert Nagourney of Rational Therapeutics, Inc. conducts individualized lab tests to find which chemotherapy treatment will destroy a patient's cancer cells most effectively, instead of using chemotherapy by trial and error. For more information, see:"
[external link]
The cancer discussed is non-hodgkins lymphoma not mm but there are several terms mentioned that are similar to mm treatments-
"Terry Gallant
(Non-Hodgkin's Lymphoma)
I was diagnosed with indolent non-Hodgkin's lymphoma in August of 1999. My disease was minimal, and I was advised against any chemotherapy unless it became problematic. I was referred to Dr. Nagourney repeatedly by several patients and medical doctors, and I learned about the chemosensitivity assay. But, there was no reason to do an assay before treatment was needed.
Over the next several years, I searched many cancer facilities and oncologists trying to determine where I wanted to be if and when I might need treatment. Many doctors I didn't like, and very few were at all satisfying. I took one non-toxic clinical trial at Stanford University where I was given an idiopathic vaccine upfront without chemo preconditioning. Unfortunately, my cancer appeared to only progress. It quickly developed to bulky disease and symptomatic with pain. Delaying further treatment was no longer an option.
September 2002, I went to Dr. Nagourney. By then, I had seen twenty separate oncologists in my battle with cancer. There was no doubt in my mind that Dr. Nagourney was the one I wanted to treat me. He did an assay on my malignant tissue. The chemosensitivity assay is just a test, a tool to be used by a skilled oncologist in selecting protocols for his patient. Dr. Nagourney offered to treat me any way I liked -- toxic chemo toward a fast remission or slower less toxic therapies. He said whichever I chose; he knew he could succeed at getting me into a long-term remission.
I already knew that less toxic treatment meant a better chance of longer life. I asked for the least toxic protocol. Dr. Nagourney advised full dose Rituxan, a monoclonal antibody specifically designed for lymphoma, combined with partial doses of Fludarabine and Cytoxan. Within three cycles, I went from bulky disease to full remission. But, three more cycles were advised to maintain that remission.
My platelet count was too low after round four. Dr. Nagourney told me another choice was needed. I could continue the same protocol at a much lower dosage. I could quite the chemo and hope the remission would hold. Or, I could change the protocol. The choice was very easy because I asked what he recommended. Dr. Nagourney said, if I finished round five and six with CHOP in a lower than normal dose, I could have just as good a treatment as planned in the beginning. That's what I did.
February 19, 2003, was my last chemo. My remission is dramatic, and my former strength is returning to near normal. Most of Dr. Nagourney’s time is devoted to his lab work on the chemo sensitivity assays. He only sees private patients two afternoons a week and rarely accepts new patients. But, he’ll do a chemosensitivity assay for anyone.
I guess I just don't understand the reluctance of others not to use this great tool. It's here and available to us. Dr. Nagourney saves and extends lives with his work. It's my hope to extend my life with lymphoma until the day we all hope for, the day of the cancer cure."
In 2000, when I was diagnosed, (perhaps I didn't make contact until 2001) I contacted Dr. Nagourney's clinic. At that time, they told me they had not had any luck treating mm and it would not be worthwhile for me. I do not remember the exact words they used in saying this. My sister had suggested Dr. N because she knew of someone who was treated very successfully at the clinic. As I remember, generally, one was treated by a local oncologist with the recommendation of Dr. Nagourney. Â
Glenda- I'm just trying to be clear with your response/experience as I had hoped to add Dr. Nagorney to the "newly dx info packet."
"At that time, they told me they had not had any luck treating mm and it would not be worthwhile for me."
Perhaps something about a blood cancer that made Dr. Nagorney's chemosensitivity testing not work? Thanks for your experience. DavidÂ
Glenda, David, and List,
 In 2003 I was told that Dr. Nagourney did work with MM patients, so perhaps he started doing it after you called, Glenda. To clarify what they do today, I spoke with Sherry from Rational Therapeutics (562.989.6455, Ext. 103.) Sherry told me that RTI does work with MM patients, among others. To conduct tests, RTI needs a bone marrow aspirate which a patient gets from his/her local oncologist. This aspirate is Fed Exed overnight to RTI, where cells are subjected to several chemotherapeutic agents for one week, at which time results become apparent. Dr. Nagourney's method has resulted in a double- or triple- response rate for most patients. The cost is $3500, payable at the time of service, although RTI will file a claim with the patient's insurance company. Not all insurance companies cover this cost.
Cathy, David, and all,
Cathy, Glenda and all-
Thanks for the feedback.
Dr. Nagourney working with mm survivors is an important issue. I will try to research this more if only to confirm Cathy's comments. I know that I said that I would research gene testing and mm (not much there) but this is an important enough issue that I will try to confirm it. Thanks. David
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