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Husband of Dying Wife Fights for Experimental Drug

Posted on 3/31/14 at 11:13 am
Posted by RollTide4Ever
Nashville
Member since Nov 2006
18310 posts
Posted on 3/31/14 at 11:13 am
LINK /

quote:

Two years after they tied the knot, Keith Knapp and his high school sweetheart, Mikaela, 25, were faced with a devastating diagnosis: Mikaela had a rare form of kidney cancer that had metastasized to her bones and brain.

“Over the past six months, [Mikaela and I] have had to face really difficult obstacles and talk about some things we didn’t expect to have to talk about this early in our lives,” Knapp told FoxNews.com.

Now, after six months of failed treatments at the University of California, San Francisco, Knapp and his wife have launched a Change.org petition and media campaign to get Mikaela access to a not-yet-approved form of treatment that they believe could prolong her life.

The drug Mikeala needs – anti-PD-L1 immunotherapy – is an experimental form of cancer treatment currently being developed and tested in clinical trials by several drug companies including Bristol-Myers Squibb, Genentech and Merck. These therapies work by enabling the body’s immune system to recognize and fight tumors.

Though Mikaela has applied to be included in multiple clinical trials for this line of treatment, numerous factors have prevented her from being accepted.

“With her condition, it’s a rare subtype of kidney cancer,” Knapp said. “And then she has brain metastases and pneumonia issues, and then because of the brain [metastases], she has to take steroids to keep swelling down…those are all listed in exclusionary criteria [for clinical trials.]”

However, after consulting with oncologists at Stanford University Medical Center, Knapp was informed of the U.S. Food and Drug Administration’s Expanded Access program, also known as compassionate use. The program allows drug companies to grant patients not eligible for clinical trials access to investigational drugs on a case-by-case basis.

According to Knapp, an oncologist at Stanford has agreed to administer the immunotherapy treatment to Mikaela if a drug company will agree to supply them with the drug. In an effort to get Mikaela access to the drug, Knapp started a Change.org petition on March 15 that has gained nearly 200,000 signatures.

“The reason we’re so interested in the immunotherapies we’re targeting now— we know it doesn’t work in everybody, but in the people it does— the results are just incredibly durable,” Knapp said.

So far, the couple has reached out to Bristol-Myers Squibb, Genentech and Merck for compassionate use access to their immunotherapy treatments. Knapp said Bristol-Myers Squibb denied their request, while Genentech has said they do not have enough medication available to supply anyone outside the scope of their clinical trials.

“Merck is the most promising right now because we haven’t gotten a rejection from them yet,” Knapp said. “[On Monday], their executive director of communications e-mailed and asked for our oncologist’s info, so she could get in touch. We don’t know what this means but it’s good to know they are aware of our petition and we are just waiting to hear back.”

Representatives from Merck and Bristol-Myers Squibb did not respond to FoxNews.com's request for comment.

Genentech confirmed to FoxNews.com that they had been in touch with the Knapp family to discuss their compassionate use policy and clinical trials.

"At this time, we are unable to have a compassionate use program for anti-PDL1 because our current supply is limited to our ongoing clinical studies," a company representative told FoxNews.com in an e-mail. "We are still at an early stage of development, and our focus needs to be on clinical trials to help ensure we are moving toward getting anti-PDL1 FDA approved as soon as possible for people who need it. And at this time, we don’t have enough to provide to anyone outside of our studies. We will continue to evaluate the potential for compassionate use in the future."

Though Knapp said he understands why his wife can’t be included in standard clinical trials due to her rare type of cancer and advanced disease, he believes there could be knowledge gained by offering the drug to patients like Mikaela.

“There might be some value in testing on exceptions-to-the-rules [cases],” Knapp said. “But pharmaceutical companies, if the FDA doesn’t make them do that portion of the testing, they don’t want to expose the risk of it showing some new side effect or issue with their drug. [I’ve read] it costs about a billion dollars to get a drug through the FDA, so delays are very expensive.”

The couple remains hopeful that they might gain access to the immunotherapy treatment they are seeking.

“We would be so happy – even though there’ s a small chance of it working, even if it doesn’t work…just knowing that there’s nothing in the world better to treat her than this, it would leave us with a good taste in our mouth no matter what happens,” Knapp said.
Posted by Layabout
Baton Rouge
Member since Jul 2011
11082 posts
Posted on 3/31/14 at 12:10 pm to
4,3,2,1... Obamacare. Death panels.
Posted by Negative Nomad
Hell
Member since Oct 2011
3173 posts
Posted on 3/31/14 at 12:13 pm to
(no message)
This post was edited on 6/15/14 at 11:21 am
Posted by Scruffy
Kansas City
Member since Jul 2011
72129 posts
Posted on 3/31/14 at 12:17 pm to
quote:

As long as the patient signs a waiver relieving the labs, hopistals and workers of all responsibility and no ability to sue, let her have it. If you're willing to take something you have no idea how it may affect you then so be it. I'm sure she's on deaths door, can't see how much harm it could do.
It isn't a liability issue. It fricks up their clinical trials. If some unforeseen factor of her disease causes a side effect, it could screw everything up.

I feel for them, but 1 life isn't worth that risk.
This post was edited on 3/31/14 at 12:20 pm
Posted by BlackHelicopterPilot
Top secret lab
Member since Feb 2004
52833 posts
Posted on 3/31/14 at 12:20 pm to
quote:

It isn't a liability issue. It fricks up their clinical trials


This.

But, there should be an "exclude the data" clause for any of these situations.


I can see, however, an issue with:

1) Availability of the drug (see Genentech's response)

2) Even IF the "data" is excluded in the actual trial info, you just KNOW that if the person has an adverse reaction or simply dies, that it will become known and be a negative that the drug would have to overcome.


Sad. But, sometimes TIMING just sucks.
Posted by Scruffy
Kansas City
Member since Jul 2011
72129 posts
Posted on 3/31/14 at 12:24 pm to
quote:

But, there should be an "exclude the data" clause for any of these situations.
The problem is that you can't. That would be highly unethical.

Now the internet hardasses are gonna get into a frenzy over this because they do not understand.
Posted by GeeOH
Louisiana
Member since Dec 2013
13376 posts
Posted on 3/31/14 at 12:35 pm to
quote:

This.

But, there should be an "exclude the data" clause for any of these situations.


Would they want it excluded if it worked on her?
Posted by udtiger
Over your left shoulder
Member since Nov 2006
98860 posts
Posted on 3/31/14 at 12:42 pm to
She can take a pain pill
Posted by BlackHelicopterPilot
Top secret lab
Member since Feb 2004
52833 posts
Posted on 3/31/14 at 12:56 pm to
quote:

Would they want it excluded if it worked on her?



I don't care what they "want".

If the protocol is set and a person falls outside of that...any data should be excluded.

I know that is unlikely. I stated why in my first post.


But, as to your point..."good" or "bad" should not factor into the study on subjects that fall outside of the guidelines.



Posted by KosmoCramer
Member since Dec 2007
76526 posts
Posted on 3/31/14 at 1:06 pm to
quote:

Would they want it excluded if it worked on her?


It would be excluded from the trial but most likely championed on an anecdotal basis if it worked.
Posted by Y.A. Tittle
Member since Sep 2003
101468 posts
Posted on 3/31/14 at 1:09 pm to
quote:

quote:
But, there should be an "exclude the data" clause for any of these situations.
The problem is that you can't.


It makes complete sense to me, why you can't do this. I'm hoping you still think of me as an internet hardass, though.
Posted by Scruffy
Kansas City
Member since Jul 2011
72129 posts
Posted on 3/31/14 at 1:12 pm to
quote:

It would be excluded from the trial but most likely championed on an anecdotal basis if it worked.
Exactly. These situations cause nothing but problems, but people let their emotions get the best if them and they start hollering on the internet.

Like I said, I feel for the guy and his wife, but there are certain procedures to follow. It's the way the system currently is built.
Posted by Scruffy
Kansas City
Member since Jul 2011
72129 posts
Posted on 3/31/14 at 1:13 pm to
quote:

I'm hoping you still think of me as an internet hardass, though
Always and forever.
Posted by thetempleowl
dallas, tx
Member since Jul 2008
14833 posts
Posted on 3/31/14 at 1:17 pm to
I get tired of everyone asking for compassionate use of these drugs.

It opens all these drugs to all kinds of potential problems.

The exclusion criteria are included for many reasons, but the patient is getting steroids likely for the brain mets. And steroids to reduce the immune response, which is what they are trying to get to happen with this type of drug. Hence I can easily see why steroids would be an exclusion of a patient from this study.

I feel for the patient. But if I had a drug I was trying to get out there, I wouldn't allow it.
Posted by onmymedicalgrind
Nunya
Member since Dec 2012
10590 posts
Posted on 3/31/14 at 3:07 pm to
What exactly is the story here?
Posted by Qwerty
Member since Dec 2010
2114 posts
Posted on 3/31/14 at 3:26 pm to
It seems like this is a very sad situation being handled appropriately.
Posted by ruzil
Baton Rouge
Member since Feb 2012
16917 posts
Posted on 3/31/14 at 9:38 pm to
This is truly a heart wrenching story that I wish was not familiar to me. We went though a similar situation with my younger brother about 14 years ago. He had metastatic colon cancer.

I formally worked for Genentech as a rep, and my wife worked with Biogen/Idec at the time. With all our connections, there was absolutely no chance for him to even get compassionate use of an angiogenesis drug, that incidently, didn't pan out as hoped.

Many times, during clinical trials, companies have a difficult enough time getting enough drug for clinical trials, let alone to give away for compassionate use. Sad, but true, it's a rare situation to get an experimental drug during clinical trials. Best bet to get compassionate use is after all the trials have closed and the company is awaiting approval.

I wish them the best.
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