Re: Use of Oxaliplatin for Cholangiocarcinoma?

"Steph" <steph@xxxxxxxxxxxxxxxxx> wrote in message
news:yttne.1538978$6l.772567@xxxxxxxxxxx
>
> "farrell77" <farrell77@xxxxxxxxxxxxxxxxxx> wrote in message
> news:Ifone.503$Wk4.11300@xxxxxxxxxxxxxxxxxx
> > Can anyone provide references or data that could help persuade an
> > insurance
> > company to pay for oxaliplatin to treat cholangiocarcinoma? Insurance
> > claims have been denied, apparently on grounds that this is not a
standard
> > treatment. Thanks.
> >
> > - Bob
> >
> >
>
> What do you expect oxaliplatin to achieve?

Options and time are running short, and it's been suggested by several
doctors
(as a treatment for my brother).

Here's one abstract I received from a doctor at a major cancer center:

A phase II study of Oxaliplatin (O) and Gemcitabine (G) first line
chemotherapy
in patients with advanced biliary tract cancers. Abstract No: 4132
Author(s): N.
Gebbia, F. Verderame, R. Di Leo, D. Santangelo, G. Cicero, M. Valerio, C.
Arcara, G. Badalamenti, F. Fulfaro, I. Carreca Abstract: Background: Biliary
tract cancers are uncommon tumors with a poor prognosis and most patients
(pts)
present with invasive and inoperable disease at diagnosis. Chemotherapy
represents a palliative treatment, but single or combination-drug schedules
have
demonstrated poor response rates with a median survival less than 6
months.Recently O and G have showed an interesting activity as single agents
in
this group of pts. Methods: We carried out a multicenter phase II study to
evaluate the efficacy and safety of combined O and G in locally advanced and
metastatic biliary tract carcinoma. The schedule of chemotherapy included O
100
mg/m2 on day 1 and G 1000 mg/m2 on days 1 and 8, every 21 days. Inclusion
Criteria were: histological diagnosis of biliary tract carcinoma, age <75,
Performance Status (PS)<=2, normal kidney and liver function, absence of
brain
symptomatic metastases, informed consent.Median patient age was 68 years
(range
59 -73). At present 24 pts ,15 males and 9 females, have been enrolled. Nine
pts
had carcinoma of the gallbladder, 7 cholangiocarcinoma and 8 extrahepatic
biliary system disease. Locally advanced 14 pts, metastatic 10 pts. Thirteen
pts
had a PS =0, 7 pts had a PS=1, 4 pts had a PS=2. Results: All the 24 pts
were
evaluable for response and toxicity. According RECIST criteria we observed 1
CR
and 11 PR for an overall response rate of 50 %. Five SD and 7 PD also
occurred.
The responders (PR+CR) demonstrated a TTP of 10 months (range 6-24) and an
overall survival of 14 months (range 6 - 28), while the overall survival for
all
the pts on study was 10 months (range 2-28). According WHO criteria, 6 pts
(25%)
suffered grade 2-3 neutropenia, and 3 pts (12.5%) grade 2 thrombocytopenia.
One
third of pts developed grade 1-2- peripheral neuropathy, only 2 pts (8%)
suffered grade 3 neuropathy . Nausea & vomiting G1-2 was present in 6 pts
(25%).Conclusions: From these preliminary data O and G combination seems to
be
effective with a favorable safety profile in first line chemotherapy of
advanced
biliary tract cancers.



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