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96RE: Rituxan article from August 27, 1997

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  • TSClover@aol.com
    Oct 31, 1997
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      Hi 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 Malignancy

      Georges 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
      impossible.

      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
      effect potentiated.<

      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.

      Laurie H.
      Pleasanton, CA
      dx 6/97 low-grade NHL follicular-cleaved stage IV
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