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The Truth About Cancer
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Chapter 6: How Complicated It Is [6:11]

Developing a successful drug takes many years. Several have helped Jennifer, who manages her cancer as a chronic condition.

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Transcript: Chapter 6 - How Complicated It Is

MANFRED HARREN: Now the conference is starting...

VALERIE GLANGINE: You can still hear us?

CARL CHALBECK: Yes, we can hear you.

VALERIE GLANGINE: Excellent.

GEORGE DEMETRI: Morning, Malte. How are you?

MALTE PETERS: Not too bad.

GEORGE DEMETRI: Hey, Carlos.

CARLOS GARCIA-ENCHEVERRIA: Hi.

MALTE PETERS: So, George, ah, good morning first of all, and thank you very much for agreeing to this, ah, video conference. I think we have, ah, some nice data to share with you about our, ah, first clinical trial of our pi3 kinase inhibitor, BEZ-235. And...

GEORGE DEMETRI: There is an incredible amount of buzz right now around something called pi3 kinase. It's a switch that's locked in the on position, that leads to cells growing and dividing abnormally. This is very common in a number of different kinds of cancers: breast cancer, lung cancer, the list goes on and on and on.

MALTE PETERS: So we have 3 breast cancer patients, uh, 8 colorectal patients, now, 2 pancreatic cancer patients, 2 prostate cancer patients, and various others. And as...

GEORGE DEMETRI: Many companies are trying to develop pi3 kinase inhibitors, and buzz is important for our patients and our scientists. But now we have to prove it. Now comes the hard work.

GEORGE DEMETRI: One thing that people don't understand if they haven't done this a lot is just how complicated this is. We're so used to thinking about taking an aspirin, and the aspirin gets into your system and nobody thinks twice about it.

GEORGE DEMETRI: In the drug discovery and development process, this process can take from 10 to 20 years, on average. What we're really trying to do with smarter drugs is to really decrease that process time. I totally feel the urgency here. Um, I have very close friends right now who are fighting cancer. There, there is nothing more than trying to fight this disease with every tool we've got that is on my mind 24-7.

*

GERALD GARLITZ: You just lay back down.

JENNIFER RILEY: Good.

GERALD GARLITZ: And just lift your legs up - that's fine. They just will need to come to about there.

JENNIFER RILEY: I was diagnosed in March of 2000 with breast cancer. I was 29 when I was first diagnosed.

ERIN PIKE: Okay, Jennifer, right now, take in a deep breath... and hold it.

JENNIFER RILEY: And I started with traditional chemotherapy.

ERIN PIKE: Breathe. Breathe normal.

JENNIFER RILEY: Tried to shrink the cancer and it did shrink some. And then from there, they did surgery, followed by radiation.

GERALD GARLITZ: Ready?

JENNIFER RILEY: I'm ready. Thanks.

JENNIFER RILEY: Two and a half years later I had a dry cough. I was seeing my oncologist, I think, about every six months, and mentioned the dry cough and he, ah, sent me for a scan. And that's when they discovered it was in my lungs.

GERALD GARLITZ: This way.

JENNIFER RILEY: Okay.

GERALD GARLITZ: That's fine.

JENNIFER RILEY: When I found out about the metastasis, it was shocking. And then to ask, "What does this mean as far as the staging goes?" And when he said, "You're at stage 4," and then I said, "How many stages are there?" And he said, "Stage 4, that, that's the last stage." So that was really devastating, to say the least; to find out that you can never hear what you want to hear, which is that you're cured.

LAURIE CHIANBALERO: 232354. And your date of birth?

JENNIFER RILEY: 12/10/70

JENNIFER RILEY: But, the hope is, with my type of cancer that can't be cured, to treat it like a chronic condition such as diabetes, and I feel that's exactly how I'm living with it right now.

LAURIE CHIANBALERO: It'll be a half hour. At the end of that we'll do another set of vital signs, and then 30 minutes after that, I'll do a little quick butterfly stick...hopefully your hand's not hurting you too much.

JENNIFER RILEY: Nope. It's fine.

JENNIFER RILEY: I've been on 10 to 12 different things. Some traditional chemotherapy drugs and even targeted chemotherapy drugs, which is what I've been on for the last couple of trials.

ALEX BALLETTO: 'Kay, mom.

JENNIFER RILEY: And they all worked for a certain amount of time.

DAVID BALLETTO: Here's to Jen. Love you, baby. Let's do it...and here's to this chemo bag.

JENNIFER RILEY: But each time I can tell when the drug is losing its effect because my cough starts to increase.

IAN KROP: So this is a woman with metastatic breast cancer who has been on a trial now for a number of months. Her previous disease has, has mainly been pulmonary.

PAMELA DIPRIO: Oh, that looks like it could be just a little bit bigger. 1.8 by 1.1 , now 2.0 by 1.5, that's in the right upper lobe. There's a larger lesion in the left upper lobe, it measures 4.0 by 3.1, previously 3.3 by 2.5.

IAN KROP: We were a little concerned about the CT scan showing a slight degree of, of progression, things getting a little worse, and I think that gave us some warning that we should at least think about potential other options. We had mentioned a little bit about this, uh, target called pi3 kinase, which is a, a protein that has a lot going for it, as far as a good way to treat your type of cancer. But it's, again, it's a Phase I study. We don't have much data at all, uh, in how--to give us a sense of how well it would work, um, in your kind of cancer. I think it's going to be, you know, your personal preference ...

JENNIFER RILEY: I'm going to be starting a, uh, traditional form of chemotherapy until clinical trial that hopefully will be opening up soon, and it's a pi3 kinase inhibitor drug.

IAN KROP: Alright?

JENNIFER RILEY: Thank you.

IAN KROP: Oh, you're welcome. Thanks for coming.

JENNIFER RILEY: Alright.

JENNIFER RILEY: As long as there's a drug I can try that's...that's working, and there's a lot of clinical trials out there, I'm okay with trying something that...that gives me another year, and another year, and another year.

*

GEORGE DEMETRI: I, I think one of the real challenges as a clinical investigator is how not to let the enthusiasm, uh, in a sense, hurt the field, because virtually every kind of cancer cell can be shut down with a pi3 kinase inhibitor, and, and just like you're saying, you have good data in colon cancer, breast cancer cell lines, in pancreas cancer, brain tumors; eh, it sorta starts to sound like snake oil at some point.

GEORGE DEMETRI: I think one of the challenges in cancer medicine is that sometimes it's hard, when you're caught up with things, to know what's a real breakthrough, and what may be an illusion. The success rate for putting a drug into a human and then having an FDA approved drug some time later is no better than 1 out of 10. So 1 out of 10, 9 drugs fail for every 10, that goes into clinical testing in people, so not a great track record.

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