clear cell carcinoma of the kidney – which drug should I pick out

My father is 75 years old, he`s still in good condition. First the anaemia was revealed. After the complex survey, it turned out – clear cell carcinoma of the kidney. One tumor in each kidney. The mets are in lungs, in the adrenal gland and in the hip bone.

I wonder what drug would you advise to start with? We can participate in the trial: bewacyzumab + interferon alfa versus bewacyzumab + temsyrolimus (Avastin + Interferon Alfa versus Avastin + Torisel). The trial, as you certainly know, is free. I can also start with – Sutent (or Nexavar). The doctors say, it finally depends on us – whether we choose the trail of Sutent/Nexavar. 

I live in Poland. My health insurance will cover ONLY the FIRST DRUG. 

For example, if I start with the trail, and it won`t get results, I will have to pay for any of the second drug. Unfortunately I can`t afford the Sutent / Nexavar / Torisel / Avastin – due to the price…

I also can start with the Sutent/Nexavar etc. for free and than - if it won`t get results - I can start the trail. 

What would advise me to choose – any of drugs listed below? Perhaps something else?
(it`s terribly difficult question for us….)

Nexavar is my choice of chemo.It lets you take it by pill twice a day.It doesnt like fried foods or really sweet stuff like cake and candy or soda.I stay on a low fat diet and diet cola's and tea with splenda.Eat lot's of vegetables it like those, otherwise you'll spend all day going to the bathroom.Use baby wipes instead of toilet paper as you can get quite irritated in that area,and for rawness in the area use preperation h cooling gel.I got a sore head from nexavar at first and ice packs on the head worked also you might get some pain killer for this if you get the side effect of the head,(feels like pins and needles)God bless you in this fight.

I agree, Sutent or Nexavar I think would be a good first choice given your fathers age. They are taken in pill form verses something like an infusion for Avastin.

His heart should be in good shape and something like a MUGA scan should be done first before placing on Sutent.

Good luck and God Bless

Krys

When choosing to go with an approved drug vs a trial, you should consider several issues, and the choice can be hard.  Cost is one; drugs for trials are usually provided free.  Trials are just that--they are with drugs that are as yet unproven (or they wouldn't be trials) but have shown some promise.  The higher the phase of the trial, the more previous tests the drug has had.  Some trials exclude or require specific previous treatment, so it may or may not be available to your father after he has had a orevious treatment.  See http://cancerguide.org/trials_home.html for a more extensive discussion of participating in clinical trials.  The newer oral drugs such as Sutent or Nexavar have not yet been proven to produce long lasting remission, such as can infrequently happen with high dose interleukin II.  

You can correspoond with many people who have had to make choices about clinical trials if you join KIDNEY-ONC, a free email support list.  See http://cancerguide.org/kofaq/ .

All four of my grandparents came from Poland to the United States.  There are some that feel that people of Eastern European descent have higher rates of kidney cancer.  We have had three cases in my family, all clear cell. 

 

The previous post is correct in that IL-2 can produce a durable response, albeit, with very low odds. I believe in the range of 5-20% success from what I read.

I took high dose IL-2 last year at 44 and I was in great shape. Very difficult and strenuous treatment. It did not work for me (although I was able to tolerate 18 courses).

If your dad at his age (75) is in excellent shape and he likes the odds, great, IL-2 worth a try but with caution.

You mentioned you can get Sutent/Nexavar for free, then are able to do the trial if they don't work? Your insurance may operate differently in Poland verses the States.

Since the trial drugs Avastin, Torisel, interferon are a different class of drugs compared to Sutent or Nexavar, he still might be able to do the trial. Check with the study doctor what the exclusions for the trial are.

Also, Pfiser (it may hold true for Nexavar as well), has a program that helps low income individuals obtain Sutent. This may apply to your dad if his insurance company will not pay for it. At his age, there is a good chance he would qualify. Google it in Polish to get into the website, maybe your Oncologist will have a contact number in Poland. I have the number somewhere, but it is in the States. Let me know if you would like it. You can private e-mail me if you wish.

Good luck and God Bless both of you.

Krys 

 

Go for the Nexivar, I underwent IL-2 treatment approx a year ago, Very,very, hard treatment and if I had it all over to do again, I would have started with Nexivar. Im currently taking it with great results, the smaller mets are srinking and the large has not grown since Feb-09 and currently no other spreding.

 Nexivar is avalable thru the nexivar reach program at little or no cost, depending on insurance, I have none and it's delivered to my home once a month.

 

God bless and I pray all works out for you.