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【medical-news】招募生命尽头的肿瘤患者, 为了寻求
分四部分，每位战友认领一部分。每部分两分。
推荐: 这是纽约时报新刊登的一篇很精彩的文章,描述一位肿瘤医生为搞清为什么有的药对某些病人不起作用,所做的大胆尝试和额外努力.也许他的工作不一定会被人理解,甚至遭到临终病人及家属的断然拒绝,但这不失为一种很有价值的探索性工作,他所收集的穿刺样本,也许对人类征服某些恶性肿瘤有很大帮助. 文章很长,分四段, 希望大家能认领翻译,版主给与加二分鼓励.
第一部分
Target Cancer
Enlisting the Dying for Clues to Save Others
招募生命尽头的肿瘤患者, 为了寻求救治他人的神奇方法
By AMY HARMON
Published: December 26, 2010
LinkedinDiggMixxMySpaceYahoo! BuzzPermalink. LOS ANGELES — They had told him on his last visit: the experimental drug that had so miraculously melted his tumors was no longer working. His legs were swollen, the melanoma erupting in angry black lumps. The patient, a computer consultant in his 40s, had little time left.
Articles in this series have chronicled the trial of an experimental melanoma drug through the eyes of doctors and patients.
TRYING TO UNLOCK THE SECRETS A tumor from a patient is placed in a vial.
And now the man’s doctor, Roger Lo of the cancer center at the University of California, Los Angeles, was calling to ask whether they could harvest a slice of one of his resurgent tumors for research he would almost certainly not be alive to benefit from. He would need to fly to Los Angeles from Northern California at his own expense, subject himself to an injection of anesthetic and the slight risk of infection, and spend yet another afternoon in the hospital.
“I was hoping,” Dr. Lo said that day last spring, “you would come in for a biopsy.”
The hope lies in a new breed of cancer drugs that work by blocking the particular genetic defect driving an individual tumor’s out-of-control growth — in the case of Dr. Lo’s patient, a single overactive protein. If researchers can pinpoint which new genetic alteration is driving the cancer when it evades the blockade — as it nearly always does — similarly tailored drugs may be able to hold it off for longer. The crucial evidence resides in the tumor cells of patients who, like Dr. Lo’s, have relapsed.
But the need to ask those who know their time is short to undergo another invasive procedure in the name of science is just one obstacle to what many oncologists see as the best chance to give future cancer patients a more permanent reprieve.
A regulatory process that can take years to approve a drug for sale means that instead of thousands of patients to draw on, only the few hundred who receive the drug through clinical trials are available for such research. Ethical review boards frown on any procedure that exposes patients to unnecessary risk, like the rupturing of a blood vessel or puncturing of a lung. Some hard-won tumor samples prove unsuitable for research.
Then there is the question of who will pay for the biopsies, which cost as much as $5,000 and typically cannot be billed to insurance. Dr. Lo, for one, covered the costs when there was no other means to pay.
As drugs tailored to the genetics of particular tumors make their way through early clinical trials, similar quests to improve on them are being undertaken by researchers in the various forms of a disease that kills more than a half-million Americans and millions more people worldwide every year.
Dr. Lo’s quest to understand how melanoma forges its resistance to the drug PLX4032, made by Roche, illustrates the Herculean effort required to take even a baby step toward a cure for cancer. Finding a single clue that could lead to the testing of one new drug that might help a small fraction of patients took two long years.
But it also shows how such progress emerges, from a complex mix of academic ambition, collaboration and competition among scientists, and, especially, the willing participation of dying patients.
When the man Dr. Lo had called arrived in his office a week later, tumors covered his legs from the bottom of his feet to his groin. Some of them were infected, their odor so overwhelming that the doctor put on a mask before administering an anesthetic and cutting into his left thigh.
A Researcher’s Trials
Dr. Roger Lo, 38, was an unlikely player in the scramble to improve on the Roche drug, which had been given to only a handful of patients when its successes began to grab the field’s attention in late 2008.
An assistant professor in dermatology, he had started his own laboratory only a few months earlier and had been advised by senior colleagues to avoid high-risk projects until he secured a steady source of financial support.
But like others in the field, he was galvanized by watching melanoma patients respond to the Roche drug, the first to reliably slow a disease that typically kills within a year of diagnosis, and rarely responds to chemotherapy.
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作者:admin@医学,生命科学 2010-12-29 00:02
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