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Cancer Drug Nexavar Tied to Pancreas Damage

Pancreas shrank by up to one-third in case studies following long-term use
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These concerns are not likely to cause cancer doctors to rethink their use of the highly effective drug, said Dr. Janice Dutcher, an oncologist at the St. Luke's Roosevelt Hospital Cancer Center, in New York City.

"When we are treating these cancers, we tend to put up with a lot of toxicity, and so do the patients," she said. "This letter doesn't change the risk/benefit rating."

The problem stems from the nature of these medications, which are called "targeted" therapies but often prove to be otherwise, Dutcher said.

"They don't just target the blood vessels of the tumor," she said. "They're going to affect other vascular beds, other small-volume blood vessels in other organs -- in this case, the pancreas." The medications also are known to create health risks for the thyroid, heart and kidneys.

By shining a spotlight on pancreatic damage, the doctors have provided a target for future efforts to control and prevent the diarrhea that is a common side effect of sorafenib and other similar medications, Dutcher said.

"Having a specific cause to investigate and remediate is useful," she said. "The diarrhea is difficult to manage. In some patients, having a specific condition they can take medicine for will perhaps make it more manageable."

Dutcher did note one unusual aspect of the patient cases cited -- the people appeared to have taken sorafenib for a much longer period than usual.

"Most people come off Nexavar in less than a year," she said. "We like to cycle them onto different medications."

Online pharmacies show prices ranging from $2,600 to more than $5,000 for a one-month supply of Nexavar.

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