EGFR Gene and Lung Cancer Drug Tarceva
Accurate and descriptive genetic testing is something we all dream of as a way to tailor treatments for our unique genetic make-up. The reality, however, is hardly as clear cut as we would like.
In 2004, a commercially available genetic test was developed to detect a mutation in the epidermal growth factor receptor (EGFR) gene as a way to predict a person’s response to lung cancer drug Tarceva. People responded better to treatment if their tumors had the mutation.
Unfortunately, knowing whether or not a person has the EGFR mutation doesn’t necessarily make it easier to determine the most effective combination of treatments. There are many factors that go into designing a patient’s cancer treatment. Relying too much on the results of one genetic test oversimplifies the process. What’s worse, health insurance coverage may soon come to depend on genetic tests.
Wayne Rosenkrans, director of scientific and medical strategy at AstraZeneca Pharmaceuticals, says he worries about the impact of oversimplifying the interpretation of genetic diagnostic tests. For example, Medicare Australia, a government organization that subsidizes health costs for Australians, requires evidence that a lung cancer patient has the EGFR mutation for them to subsidize the drug. “That’s an example of a health authority using diagnostics in an inappropriate way,” says Rosenkrans.
Genetic tests bring hope of better prevention, treatments, and cures for a myriad of diseases. But they also bring greater uncertainty.
Technology Review, January 10, 2006
Via Medgadget.
Technorati Tags: genetics, health, tarceva, lung+cancer, cancer, EGFR, genes
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POSTED IN: Genetic Testing, Genetics of Disease
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10 opinions for EGFR Gene and Lung Cancer Drug Tarceva
Snowy
Jan 25, 2006 at 3:05 am
I think AstraZeneca are being disingenuous, as chemotherapy in lung cancer is expensive and is very often a means of extending life by only 7 or 8 weeks, at a physical cost to the patient that is considerable. I think that governments are right to use a relatively cheap test to allow them to target treatment, health funds are not infinite, and lung cancer leads to death in 90-95% of cases within 5 years whatever treatment is used.
Cary
Jan 28, 2006 at 7:19 pm
Considering that some patients respond quite well to Tarceva in spite of the fact that they are negative for the EGFR gene mutation, I find it quite distressing that treatment is being withheld based on this test…
Unfrtunately, the earlier commentor, “snowy,” sounds as if he/she is suggesting that since a large percentage of lung cancer patients die within five years it’s OK to not treat them with everything that is available.
Guess what – those 5 to 10% who DO survive lung cancer do it via treatment.
Each and every day, week, month, or year of life is precious. To suggest otherwise is to not understand what it means to be alive.
Snowy
Jan 29, 2006 at 1:09 am
I think that my views are based on the fact that I don’t agree that quantity of life is more relevant than quality of life, something that seems to get forgotten by drug companies.
Also I feel very strongly that when one is deciding what to do with ressources some difficult decisions have to be made, and giving to one means witholding from another.
I am a nurse and I worked 10 years in pulmonary medecine, and watched people die from lung cancer, or, very occaissionally, survive.
Cary
Jan 30, 2006 at 12:59 pm
Hi Snowy, as caregiver and husband to a young woman who has been on so-called “hard” chemo for more than three years, I can guarantee you that both quality AND quantity of life are important to cancer patients and their families.
While I agree whole-heartedly that difficult decisions do indeed need to be made when it comes to treatment costs, doing so based on a flawed testing strategy is certainly not the answer.
Real Cancer, Real Lives #11
Jan 30, 2006 at 1:02 pm
[…] My turn again, ladies and gentlemen to host the Real Cancer Real Lives Carnival. This was set up by Cary Miller a caregiver for his wife Lori […]
Snowy
Feb 1, 2006 at 2:15 am
Hi, Cary, it has taken me a long time to reply, I’m not sure what to say, except that my heart goes out to you … and I was thoughtless in posting, forgetting that there are other people out there with very different experiences to mine.
Remission and survival are important and when it’s your own wife you do not want to feel that politics and cost are the factors influencing the choice of treatment…
(To excuse myself, I have nursed the dying from newborn to very elderly, and what really seemed to matter to me, was not the death itself, but that it should be dignified, peaceful and painfree…and sometimes I have felt certain treatments to be counterproductive.)
roberto dorres
Feb 2, 2006 at 10:56 am
I think your blog is too many ads lol. But honestly, i like your writing.
this blog related to health too
Joseph
Feb 21, 2007 at 4:35 pm
Snowy I found your words and your testimony as a care giver sad and it made me very sad for those you cared for. So much pity and such a lack of hope in your tone. My god - how sad.
Thank god hope is not just a word folks can trample on and is but a descriptive term for true human ingenuity and pure spirit. We live on in spite of sad perspectives like yours. We will never submit to your sad end or your view on “quality of death”. s
Substance Abuse Treatment
May 29, 2007 at 1:30 pm
I think every single step that we make towards is a good step. One day we will defeat cancer.
Drug Rehabilitator
Sep 20, 2007 at 2:46 pm
there’s a nice article at the washington post to follow up on this, further exploring genetics, cancer, and the complications that follows it.
http://www.washingtonpost.com/wp-dyn/content/article/2007/09/16/AR2007091600626.html
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