Why don't cancer doctors prescribe Bexxar and Zevalin?

Your assumption that "there's more money for the oncologists in the treatment than the cure" is faulty. Oncologists have more business right now than they know what to do with. What is really difficult is getting insurance companies to pay for the treatments prescribed while not making both the patients and Drs repeatedly jump over hoops to qualify for and obtain cutting edge treatment options.

If these two drugs are not being prescribed enough then you have to look at the insurance companies that will not pay for very expensive new drugs until the (often HMO) patient has received and failed one or two older and cheaper drugs that treat the same disease and often happen to have lower cure rates. The same is true for many cancers. They do not do stem cell or bone marrow transplants on newly diagnosed lymphoma patients due to the high cost. A patient must fail one or several other treatment regimens before a BMT is considered.

You have your facts wrong and your anger is directed in the wrong direction. Remember that as things stand now one person in six will receive no treatment options at all unless they happen to be on Medicaid and very knowledgeable as to how to work the system. I won't even get into the many arguments that surround the uninsured and whether they ever get the opportunity to try these very expensive treatments vs receiving palliative "acceptable medical care" instead of curative medicine.

If a drug is approved by the FDA all you need to do is ask the doctor for a perscription. If the drug is still in Clinical Trials, you need to contact the company for compassionate use . . or the research investigator to be included in the trial or see if you can have the drug off trial.

FDA: Access to Unapproved Drugs

http://www.fda.gov/cder/cancer/access.htm

I am not sure exactly what you mean about oncologists . . my son has been offered many off trial drugs . . which we have investigated for his particular type of cancer. It's not even an issue. There is no cure for cancer and treatment is a constant juggling to try and fine the right combination that will work.

Are you dealing with non-Hodgkins disease? Because you can get these drugs if that is what you need. You do know that many patients are now pro-active and can guide their own treatment. An oncologist can guide you and make recommendations, but the patient makes the final decisions.

I think Michael Moore is a brilliant documentarian. I enjoy his work. There is much that needs to be fixed in the medical insurance industry and other areas of healthcare. But, until you have need of an oncologist and have seen them fight to keep your child alive . . have seen their compassion . . have consulted with them for their expertise and knowledge about treating tumors . . what do you really know.

Incidentally the two drugs are still undergoing clincial trials to establish efficacy (dosage and whether different combinations are better than single agent):

http://clinicaltrials.gov/ct/search;jsessionid=F49...

http://clinicaltrials.gov/ct/search;jsessionid=F49...

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RE:

Why don't cancer doctors prescribe Bexxar and Zevalin?

I just read an article about cancer drugs, proven successful as a one dose treatment of late-stage, non Hodgkins lymphona. The drugs are approved and cured them. Article states what my hubby and I have said for years. Basically, there's more money for the oncologists in the treatment than the...

I had the Zevalin back in February this year.

One "side effect" is lowered blood counts, if you haven't had alot of previous treatments the counts recover within 9 to 12 weeks.

Unfortunately for me, since march of 04 having had CHOPR, CMOPPR and BEAM (auto sct a yr ago) my counts 5 months later still remain in the toilet, my counts before this past Fridays transfusion were

WBC 1.7

RBC 2.4

Platelets 3000

I still have traces of the disease in my groin

I have spoken with a few people that have had the Zevalin both as a first line treatment (Clinical Trial) and after having Relapsed after having CHOPR and they recovered and achieved remission with NED.

Would I do it again? Probably as I am determined to kick this CRAP what ever it takes.

With my ALLO SCT approaching soon, the only thing that might play in my favor is lower dose on the chemo and possible avoidance of TBI as there isn't much left in my bone marrow to kill of right now.

Like all treatments what works for one doesn't always work for someone else, and Dr's take that into consideration on a case by case basis. They just aren't throwing at all people with NHL randomly thats not how the medical field works.

That is an excellent article, thank you for posting it.

I think your interpretertation is faulty though. The article clearly brings up three reasons for the perceived under use of Bexxar and Zevalin.

1. No proof that they are better than chemo/Rituxan. Clearly some people have responded to them, but not everyone, and there is no proof that using it as front line therapy would be better for the majority of patients.

2. Very complicated program of administration.

3. Cost.

So please don't demonize physicians who are using proven therapies.

I looked up Bexxar, it has a whopping 4 black box warnings.

* Hypersensitivity reactions (including anaphylaxis) have been reported. Patients should be screened for human antimouse antibodies (HAMA); may be at increased risk of allergic or serious hypersensitivity reactions. Hematologic toxicity was reported to be the most common adverse effect with 27% patients requiring supportive care.

* Severe or life-threatening cytopenias (NCI CTC grade 3 or 4) have been reported in a large number of patients; may be prolonged and severe. Secondary malignancies have been reported following use.

* Treatment involves radioactive isotopes; appropriate precautions in handling and administration must be followed. Patients must be instructed in measures to minimize exposure of others.

*Women of childbearing potential should be advised of potential fetal risk.

And you wonder why doctors are not prescribing it more often?

I get so tired of people that think there is a magic pill out there that cures disease without side effects and the doctors are just refusing to give it to them.

Tositumomab is a monoclonal antibody derived from immortalized mouse cells. It is a IgG2a anti-CD20 antibody and is covalently bound to 131I. 131I emits both beta and gamma radiation and decays with a half-life of 8 days.

Clinical trials have established the efficacy of tositumomab in patients with relapsed or chemotherapy/rituxan refractory follicular lymphoma.

It is manufactured by Corixa. It sells in the U.S. under the trade name Bexxar.

Ibritumomab tiuxetan, also sold under the trade name Zevalin®, is a monoclonal antibody radioimmunotherapy treatment for some forms of B cell non-Hodgkin's lymphoma, a myeloproliferative disorder of the lymphatic system. The drug uses the monoclonal mouse IgG1 antibody ibritumomab in conjunction with the chelator tiuxetan, to which a radioactive isotope (either yttrium-90 or indium-111) is added.

Consult your doctor.

Please see the web pages for more details on Tositumomab (generic name) Bexxar (brand name) and Ibritumomab tiuxetan (generic name) Zevalin (brand name).

I would guess that it is because of the very high risk of a SERIOUS allergic reaction to the drugs. It's a nasty one when it happens.

I haven't seen Michael Moore's movie yet, but he usually has some good things to say.

Bexxar has not proven itself the be a better medication than other available therapies.

Don't get angry with your oncologist, he/she may have a good reason for not prescribing this drug. Maybe if you talk them about it they can explain why they don't prescribe Bexxar for you.

Bexxar