Anti-Angiogenetic Drug Given by Wearable Pump

[Guest guest]

As has been pointed out a number of times, even

blood-related cancers such as CLL seem to involve the

growth of new blood vessels (neovascularization).

Results using endostatin have, so far, been mixed.

Perhaps this new procedure will enhance the efficacy

of anti-angiogeneic drugs

Saturday, October 27, 2001 Back The Halifax Herald

Limited

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New drugs could hinder cancer's progress - MD

Fatal forms could be as manageable as diabetes

Stuparyk / The Canadian Press

Dr. Judah Folkman, a leading cancer researcher at

Harvard Medical

School, takes part in Gairdner Foundation conference

at the

University of Toronto on Thursday. Dr. Folkman says

cancer could

become a manageable chronic disease in the next

decade.

By The Canadian Press

Toronto - Cancer could become a manageable chronic

disease in the

next decade, says a world-renowned cancer researcher.

While a cure for cancer is still a distant hope,

once-fatal forms of

the disease, like pancreatic cancer, may no longer be

a death

sentence, Dr. Judah Folkman says.

Cancer could be controlled like diabetes or heart

disease with the

help of new drugs that let people live longer without

the

debilitating side-effects of some current treatments,

Folkman said in

an interview.

" Always the goal is a cure, but I never use the word

because it's far

away right now, " said Folkman, visiting Toronto at the

behest of the

Gairdner Foundation to give a public lecture.

" It's step by step by step. The next step is to lower

the drug

resistancy and toxicity. That's not just pie in the

sky because we

actually have patients who had bad cancer, but who now

have no side-

effects and no drug resistance. "

Folkman, 68, is a professor of pediatric surgery at

Harvard

University in Boston and is frequently mentioned as a

candidate for

the Nobel Prize in medicine.

He says he learned from his rabbi father the

importance of giving

hope to sick and dying patients, and teaches his

medical students a

fundamental lesson: never destroy hope.

Much of the future hope for cancer and other patients

stems from

Folkman's breakthrough discovery nearly 40 years ago

of a new field

of science called angiogensis.

The theory of angiogensis is that small tumours

control their own

growth by triggering the extension of feeder blood

vessels from

existing arteries.

The feeder vessels then nourish and swell the original

tumour while

serving as conduits to spread cancer cells throughout

the body. If

this new blood supply can be controlled, so can the

cancer.

Scientific support for angiogensis wasn't forthcoming

until the early

1980s, when the first angiogenic inhibitor, a molecule

that appeared

to stop the growth of new blood vessels, was

discovered in Folkman's

lab.

Today, there are 24 different angiogenic inhibitors in

clinical

trials at 110 U.S. medical centres involving cancer

patients.

Seventy-one terminal cancer patients in Boston,

Houston and Wisconsin

are involved in phase 1 clinical trials for

endostatin, the most

powerful angiogenic inhibitor found to date. It was

discovered by

Folkman, and licensed to the drug company Entremed.

The trials involve patients with cancers of the

breast, colon,

prostate, pancreas and brain.

" The ticket to admission is you've failed every other

treatment and

you're dying. These patients are desperate and very

sick, " said

Folkman.

In 15 patients who received higher doses of

endostatin, the cancer

stopped growing and became stable, while tumours

actually regressed

in two cases. In two more patients, some tumours

regressed, while

others stabilized.

The most striking thing is that virtually none of the

patients

experienced side-effects, such as nausea, vomiting,

hair loss, weight

loss and diarrhea, which are common with other cancer

treatments.

Moreover, endostatin does not appear to generate drug

resistance over

time, as chemotherapy does.

Doses of endostatin are delivered intravenously 24

hours a day

through a pump the size of a cellphone that is carried

in the

patient's pocket. Patients would likely be on the drug

for the rest

of their lives.

More than 1,000 patients are on the waiting list for

endostatin

clinical trials.

Now the fear is that the drug will run out before

research is

complete. Entremed is making endostatin in limited

quantities until

it receives U.S. Federal Drug Administration approval,

which is

several years away.

" No company will invest hundreds of millions of

dollars to make a

drug until it's approved, " says Folkman. " But

everybody is clamouring

for this drug. People who are on it are afraid it will

run out and

people on the waiting list are afraid they won't make

it until the

drug is approved. "

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