96RE: Rituxan article from August 27, 1997
- Oct 31, 1997Hi all! Below is an excerpt of this article which appeared last week. I
appears to be a good article on a subject that affects us all, but could
anybody help me wade through this stuff. I get a vague sense of what its
saying, but I would like a better understanding:
>Monoclonas vs MalignancyGeorges Kohler and Cesar Milstein of the Laboratory of Molecular Biology,
Cambridge, England, won the 1975 Nobel Prize for creating cloned cellular
factories capable of producing virtually unlimited quantities of identical
antibodies. They developed a technique of fusing antibody-producing B cells
from a mouse to immortalized cancer cells called hybridomas. Each hybridoma
clone produces multiple copies of a single specific antibody. They are
called monoclonal antibodies to distinguish them from the polyclonal
antibodies that a normal immune response produces.
Before, the theory for treating malignancies was that a monoclonal antibody
could be constructed to identify the cancer-specific antigens and then bind
to the antigens on the patient's cancer cells. The immune system would then
eliminate the cancer cells.
Unfortunately, because the monoclonal antibodies were derived from mice, the
human body's immune system inactivated any therapeutic effect. Moreover,
once stimulated against mouse monoclonal antibodies, the body's anamnestic
response made more than a single treatment with any specific monoclonal
Using genetic engineering, techniques now have been developed to overcome
this problem, resulting in a chimeric monoclonal antibody that has mostly
human components. The human immune response is modified and the therapeutic
This is Laure speaking again. I have another question. IF stage III and IV
is incurable, and IF none of the treatments available improve long term
survival (and perhaps that second statement is not true? perhaps they still
don't know, particularly about rituxan and other antibody agents?), then WHAT
is the purpose of treatment? To alleviate symptoms? To improve quality of
life? and IF chemotherapy actually ends up diminishing quality of life or,
sometimes leads to death itself, then perhaps the 'to chemo or not to chemo'
debate is valid.
I am not making statements here, or trying to convince anyone else -- I am
wondering this stuff aloud. I'm on W&W right now, so I'm not facing this
decision. When that time comes, I will definitely listen to my doctor and do
what makes the most sense. Like I said, I'm just wondering.
In general, I like to go with the odds. I have an ongoing debate with my
in-laws because they don't like to wear their seat belts because they're
afraid they'll be trapped in a burning car. As an insurance agent, I am
acutely aware that the odds are MUCH greater that a seat belt will SAVE my
life. I wear my seat belt -- I want the odds on my side. I'll approach
these decisions the same way, but as somebody else on the list has said, the
statistics are difficult to find and even more difficult to understand.
dx 6/97 low-grade NHL follicular-cleaved stage IV
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