by on 2.8 months and is only 20 to 30% effective?
Nexavar (sorafenit) belongs to a class of target chemo-drug called the Tyrosine Kinase inhibitors. Currently drugs belonging to this group family include Sprycel (dasatinib), Tarceva (erlotinib), Iressa (gefitinib), Gleevec (imatinib), Tykerb (lapatinib) and Sutent (sunitinib). With time, there will be more additions.
The first targeted Tyrosine Kinase inhibitor developed and released to the market is Gleevec, used for chronic leukemia. It was developed in the late 1990′s, and was approved by the FDA in May of 2001. TIME magazine hailed Gleevec as the magic bullet that the world has been waiting for. It turned out to be a great media hype!
For all these drugs above – the Target Therapies – patients need to know the following:
1. It is indeed hard to find the word cure – or any shade of cure if you like – being associated with any one of them. That is to say they don’t cure your cancer.
2. They are expensive, costing from approximately RM 8,000 to RM 20,000 for a month’s supply.
In spite of what people want you to believe or what the mass media says and the huge price tags, these drugs only prolong life by a few months. For some drugs, they only shrink tumour which is rather meaningless.
Patients coming to us after taking some of these expensive drugs had the impression that these drugs would cure their cancer. No, these are not magic bullets at all. The truth is they do not cure at all.
One reminder: By writing this, you may think that I am against patients taking any of these drugs. It is not for me to tell you what to do. Do what you think is right for you. If you have the money or you think these drugs can cure you … go ahead. My responsibility here is confined to providing you with free information as honestly as I can.
The following are facts about Nexavar gathered from the internet.
Use: Treat patients with unresectable hepatocellular carcinoma (HCC), and patients with advanced kidney carcinoma (mRCC),
Cost: RM 20,000 per month.
Effectiveness
For liver cancer
• With Nexavar – median survival = 10.7 months
• Placebo – median survival = 7.9 months
• Nexavar increased survival by 2.8 months
For kidney cancer
• With Nexavar – median survival = 167 days
• Placebo – median survival = 84 days
• Nexavar increased survival by 83 days
Warning and Precautions
• It decreased blood flow to the heart and / or cause heart attack
• Increased risk of bleeding may occur. Bleeding may be fatal.
• Hypertension usually occurred early in the course of treatment.
• Hand-foot skin reaction and rash. This causes redness, pain, swelling, or blisters on the palms of your hands or soles of your feet.
• Perforation of the bowel.
• Wound healing complications. Temporary interruption of Nexavar therapy is recommended in patients undergoing major surgical procedures.
• May cause fetal harm when administered to a pregnant woman.
Side effects
• weight loss, rash/desquamation, hand-foot skin reaction, anorexia, and abdominal pain, join pain, headache.
• chest pain, shortness of breath, feel lightheaded or faint, sweating a lot.
• rash, redness, itching or peeling of your skin.
• hair thinning or patchy hair loss.
• diarrhea (frequent or loose bowel movements)
• nausea or vomiting, mouth sores, weakness, loss of appetite
• numbness, tingling or pain in your hands and feet
Patient’s Experience
Patient 1
Chris: Oh, this is the new drug – Nexavar.
Sam: After talking a bit, I felt tired and breathless.
Wife: He felt breathless.
C: This is RM 20,000 for a month?
S: No, RM 10,000 for this box.
S: Actually I was supposed to take 2 tables, twice a day. But because of my liver surgery, I was asked to take only 1 table, twice a day.
C: So actually it is RM20,000 per month for others.
S: Actually, what is this drug for?
C: One patient came to me. He was given the option to take this drug. It would cost him RM 20,000 per month. I asked him what the name of the drug was. He could not remember. Oh, this must be the one then. And even if it cost RM20,000 per month, he was told by the doctor that it is only 20 to 30% effective. No, it does not cure at all.
S: I would like to return this drug to the doctor. Do you think he would accept it?
C: I don’t know. My mission here is not to cheat or mislead people. I am here to help people.
Sam took the drug, Nexavar for a day and a half (i.e., a total of 3 tablets). He suffered the following side effects:
1. He felt tired when walking or even talking.
2. His ear started to produce a humming sound throughout the day.
3. His sleep was disturbed.
Patient 2
C: Oh the doctor wanted you to take the drug that cost RM 20,000.00 per month.
Pang: I asked the doctor – how many people can afford to take such a drug? I cannot afford it.
C: It is okay, if it can cure you.
P: Exactly, the doctor told me it is only 20 to 30% effective. It is not about taking the medicine for just a month only. If I need to take for one month only, it is okay. I am ready to sell my old car to pay for the drug. My car may fetch RM10,000. In this case, it is not going to do me any good.
C: What does 20% really mean? Actually there is no cure!