Hi there Crislyn
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As you likely know, Votrient is the brand name for the drug pazopanib. Goggling “pazopanib” may return better search results than just the brand name. I noticed the dilemma of choice between mainly sunitinib and pazopanib a few weeks back when trying to understand my new found Stage IV RCC.
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To help answer your question, a recent study found that 70% of patients preferred pazopanib while only 22% preferred sunitinib and 8% had no preference. The difference was due mainly to better quality of life and less fatigue reported for pazopanib.
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This interests me greatly because, like your hubby, I too want to work. One of many web links to that study summary is here (I will also copy the summary at foot of this post):
http://www.kidneycancercare.ca/Patient-Preferences-Revealed. " target="_blank" rel="nofollow">http://www.kidneycancercare.ca/Patient-Preferences-Revealed.
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Or, googling “pazopanib sunitinib” will turn up heaps on the subject. Incidentally, I found that subscribing keywords like “pazopanib” and “rcc” and blah, blah to Google Alerts is helpful to keep up with the latest news (because one gets a daily email list of latest articles on the chosen keywords subjects)..Actually, my daily Google Alerts “rcc” keyword returned your Forum post which led me here today..While you may have this, there’s much tech stuff here on pazopanib:
http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_ also found Renal and Urology News pretty helpful:
http://www.renalandurologynews.com/kidney-cancer/section/614
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You know, although I’m sorta a tough old guy, your plight brings a tear to my eye. Damn Stage IV RCC, regular home, kids, and hubby’s must-work circumstance with painful sternum bone cancer because the powers-that-be refused him a disability pension!!
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That sucks. Just what the heck is wrong with aUSA that allows such unbelievable torture? As an Aussie, I just don’t get the wretchedUSAhealth and social security system. A so-called Christian country! Who the hell are they kidding!!
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Here, a guy in your hubby’s position with wife and two kids would immediately receive, effectively no questions asked, about USD700pw complete with free drugs, free hospital and free doctors in our free-for-all health care system (which, for a guy who’s had an otherwise healthy life, I’ve now found is a surprisingly well run system).
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My advanced RCC ain’t half as bad as you hubby’s but if I wanted a good pension I could get it in a flash right now merely by asking my doctor to write a one sentence note to big brother stating that I am medically unfit for work (none of that ‘contributions’ nonsense here).
.Go after those miserable sods that knocked back the disability payments!
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My RCC with a rib met was found 8 weeks ago. About a 5” tumor in left kidney with about 2” of right rib bone chewed out that resulted in a broken rib from doing a couple of push-ups..Much debate followed about drugs or aggressive surgery. Today’s latest scan shows the met is still isolated to only the rib so the kidney will be whipped out (radical, with a wide margin) in early July to be followed by chopping out the rib.
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Meanwhile, I actually feel great (and, working harder than ever) and I would not believe what’s happening on the inside if I didn’t see the actual scans. So, I feel fortunate compared with your hubby’s chit.
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You know, I can really relate to what must be on your hubby’s mind given the family and kids. It sorta surprised me that I ain’t scared of death (as I soon learned that this thing is fatal). My only fear is my wife’s position when I go. Her end position, not me karking it from RCC, truly scares the heck out of me.
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She is effectively my only worry to the extent that the RCC has given me a new lease on life to throw everything into my business so she will be okay when I dip out in another year or two.
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I sense that your hubby feels the same way (but gees, how can he do his physical work). The pain ain’t in the RCC or in thoughts of passing away. For your hubby and me, the pain is in the question: what happens to my family?
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I shed a tear and say a little prayer for you and yours and I trust you will raise merry hell to whack those low-life disability payment “public servants”.
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http://www.kidneycancercare.ca/Patient-Preferences-Revealed. " target="_blank" rel="nofollow">http://www.kidneycancercare.ca/Patient-Preferences-Revealed.
PATIENT RCC DRUG PREFERENCES REVEALED
Source: John Schieszer
June 4, 2012
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CHICAGO—Patients with metastatic renal cell carcinoma (mRCC) prefer pazopanib over sunitinib because the former is associated with a better quality of life (QOL) and less fatigue, according to study findings presented at the American Society for Clinical Oncology 2012 annual meeting.
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In a double-blind, randomized crossover study, 168 mRCC patients were randomized to pazopanib for 10 weeks followed by a two-week break and then sunitinib for 10 weeks, or vice versa. In the primary analysis of 114 patients, 70% preferred pazopanib, 22% preferred sunitinib, and 8% had no preference.
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The differences were statistically significant. The most common reasons that patients gave for preferring pazopanib were better QOL and less fatigue. In addition, patients on pazopanib had fewer dose reductions than those taking sunitinib (13% vs. 20%) as well as fewer treatment interruptions (6% vs. 12%).
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“While we expected patients would prefer one drug over the other due to the known toxicity profiles, we didn't expect this great a preference,” said lead investigator Bernard J. Escudier, MD, of the Institut Gustave Roussy, Villejuif, France. Study findings provide “an important reminder that low-grade toxicities patients experience may not seem bad, but if you are experiencing the toxicity over a long time, it has an effect on your quality of life.”
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How patients feel when they take a drug over many months is not reflected in traditional adverse event reporting, he said. Patient-reported outcomes like these, however, are being added to traditional efficacy outcomes to better understand the clinical relevance of differences in toxicity between therapies. In this current environment, mRCC patients may take therapies for several years. QOL differences between two therapies may appear relatively modest to physicians, but can be perceived very differently by patients who may have to take therapies for many months or years.
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Physician preference was not as strong as patient preference: 60% preferred pazopanib, 21% preferred sunitinib, and 21% had no preference. The study was funded by GlaxoSmithKline, the maker of pazopanib, and involved several European, U.K., and U.S.cancer centers.
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“Drugs with relatively similar safety profile can be perceived very differently by patients, and the difference observed in this study is more than any expectation we had before embarking into this study,” Dr. Escudier told Renal & Urology News.
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“This difference will be important to explain to patients with kidney cancer when they could receive both drugs. Patient preference should become a major endpoint to consider in oncology, especially with development of chronic therapy and by consequence of chronic toxicities. The grading system used in oncology today is more accurate to describe acute toxicity that low-grade chronic toxicity. As an example, having fatigue or nausea three days a month is very different than having continuous fatigue or nausea, even if grade of toxicity is lower.”
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Urologist Robert G. Uzzo, MD, FACS, Chairman of the Department of Surgery at Fox Chase Cancer Center in Philadelphia, said the study findings are novel. As mRCC becomes more of a chronic condition instead of a terminal illness, patient preferences will become a bigger concern for physicians, Dr. Uzzo said.
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