First Quarter 2008 - Issues in Hematology - ION Solutions

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drug update(PDGF-ß), FLT-3, RET, and C-KIT, which have beenshown to be important proangiogenic factors for tumorgrowth and metastasis. 5,12ConclusionNexavar is an oral multiple kinase inhibitor that preventstumor growth by blocking tumor cell proliferation andangiogenesis, two critical processes in the developmentof HCC. In the placebo-controlled Phase III SHARPtrial, therapy with Nexavar resulted in a significant 44%survival improvement in HCC patients, and is thus theonly agent that has demonstrated a survival benefit inthis malignancy. Therapy with Nexavar also resulted ina doubling of the time to cancer progression. Based onits efficacy and predictable side-effect profile, Nexavarmay be considered a standard of care for patients withunresectable HCC. Further trials are assessing theoptimal use of Nexavar in patients with HCC and othertumor types.Patient Support Programs to Begin andMaintain Nexavar TherapyPrescriptions for Nexavar tablets are not filled throughretail pharmacies but rather through specialty pharmacyproviders that are experienced with oncology products.To help patients begin and maintain Nexavar therapy,two support programs are available.oncologistics volume 7, issue 1 - spring 2008 5
oncologistics drug updateREACH ® (Resources for Expert Assistanceand Care Helpline)The REACH program provides reimbursement informationas well as support for clinical questions. By calling1.87.REACH.4.IT (1.877.322.4448) Monday through Fridayfrom 9:00 a.m. to 8:00 p.m. (Eastern), a REACH programcounselor can provide reimbursement support and patientservices, including processing insurance information, findingfinancial assistance, and matching patient needs withspecialty pharmacies.NexConnect This program provides patients with further support bymaking additional information available to complement theirNexavar treatment, as follows:> Access to a nurse-counselor who can provideinformation about Nexavar therapy>Patient education materials that clearly explainthe importance of adherence and effective tipsfor incorporating Nexavar treatment intopatients’ lives zRalph Boccia, M.D., F. A. C. P., is president andmedical director of The Centers for Cancer andBlood Disorders in Bethesda, MD. He also servesas chair of the ION Medical Advisory Panel.References:1. Jemal A, Siegel R, Ward E, et al: Cancer Statistics 2007.CA Cancer J Clin 57:43-66, 20072. Llovet JM: Updated treatment approach to hepatocellularcarcinoma. J Gastroenterol 40:225-235, 20053. Llovet J, Ricci S, Mazzaferro V, et al: Sorafenib improvessurvival in advanced hepatocellular carcinoma (HCC):results of a phase III randomized placebo-controlled trial(SHARP trial). 2007 ASCO Annual Meeting Proceedings.J Clin Oncol 25:18S, 2007 (abstr LBA1)4. NCCN Version 2.2008, 10/31/07. NationalComprehensive Cancer Network, Inc. Available at:www.nccn.org. Accessed on January 3, 20085. Wilhelm SM, Carter C, Tang L, et al: BAY 43-9006 exhibitsbroad spectrum oral antitumor activity and targets theRAF/MEK/ERK pathway and receptor tyrosine kinasesinvolved in tumor progression and angiogenesis. CancerRes 64:7099-7109, 20046. Liu L, Cao Y, Chen C, et al: Sorafenib blocks the RAF/MEK/ERK pathway inhibits tumor angiogenesis, andinduces tumor cell apoptosis in hepatocellular carcinomamodel PLC/PRF/5. Cancer Res 66:11851-11858, 20067. Ito Y, Sasaki Y, Horimoto M, et al: Activation of mitogenactivatedprotein kinases/extracellular signal-regulatedkinases in human hepatocellular carcinoma. Hepatology27:951-958, 19988. Hwang YH, Choi JY, Kim S, et al: Over-expressionof c-raf-1 proto-oncogene in liver cirrhosis andhepatocellular carcinoma. Hepatol Res 29:113-121, 20049. Calvisi DF, Ladu S, Gorden A, et al: Ubiquitousactivation of Ras and Jak/Stat pathways in human HCC.Gastroenterology 130:1117-1128, 200610. Villanueva A, Newell P, Chiang DY, et al: Genomics andsignaling pathways in hepatocellular carcinoma. SeminLiver Dis 27:55-76, 200711. Semela D, Dufour JF: Angiogenesis and hepatocellularcarcinoma. J Hepatol 41:864-880, 200412. Carlomagno F, Anaganti S, Guida T, et al. BAY 43-9006inhibition of oncogenic RET mutants. J Natl Cancer Inst98(5):326-334, 200613. Abou-Alfa G, Johnson P, Knox J, et al. Preliminaryresults from a phase II, randomized, double-blind studyof sorafenib plus doxorubicin versus placebo plusdoxorubicin in patients with advanced hepatocellularcarcinoma. Proceedings of the 2007 meeting of theEuropean CanCer Organization. European Journal ofCancer Supplements 5:259, 2007 (abstr 3500)oncologistics 6
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First Quarter 2008 - Issues in Hematology - ION Solutions

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