THE RIGHT TO A TRIAL

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BlankTHE RIGHT TO A TRIAL

by JEROME GROOPMAN

Should dying patients have access to experimental drugs?

Issue of 2006-12-18

Posted 2006-12-11

In 2002, Kianna Karnes, a forty-one-year-old nurse and mother of four in

Brownsburg, Indiana, was given a diagnosis of kidney cancer. She had surgery to

remove the tumor, but a year later the cancer spread to her bones. Karnes’s

doctors treated her with interleukin-2, a protein that stimulates the immune

system and, in its synthetic form, was the only medication approved by the Food

and Drug Administration for use against kidney cancer. The drug causes high

fevers and the accumulation of fluid in the lungs, and it shrinks tumors in only

fifteen per cent of cases. “High-dose interleukin-2 damn near killed her,”

Karnes’s father, Rowe, recalled recently. “It’s a brutal treatment, but her

husband pushed her pretty hard, because he didn’t want to lose her.”

Karnes did not improve on interleukin-2, and Rowe began to look into

experimental therapies. Four years earlier, he, too, had received a diagnosis of

a life-threatening cancer, chronic myelogenous leukemia, for which there were

few effective treatments. He had found the Web site of a man from South Carolina

with leukemia, who had enrolled in a clinical trial of an experimental drug, now

called Gleevec, and had experienced a remarkable remission. Rowe learned about a

trial comparing Gleevec with interferon, then the standard therapy for his

illness, and asked his doctor to help him apply. He was the last patient to be

admitted. “Luckily, I got the good stuff,” he told me, referring to Gleevec. His

cancer has been in remission for five years.

Full story (very long)

http://www.newyorker.com/printables/fact/061218fa_fact