To what extent is the combined use of ipilimumab and nivolumab in cancer treatment viable?'
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| SUTENT 12.5mg, 25mg, 37.5mg and 50mg Hard Capsules - Summary of Product Characteristics (SPC) - (eMC), 2015). If the results of this combined therapy are more promising than existing treatments, which in the case of ongoing trials look optimistic (The Guardian, 2015), then a similar risk of adverse reactions is a small compromise that patients and professionals alike may be willing to make.
The high price of this treatment has caused many to question its economic viability, especially during this economic climate, where there is already strain on the NHS in the UK. Its high price reflects the results of the therapy, but also comfortably profits the pharmaceutical companies (The Guardian, 2014). However, all cancer treatment will come at a cost. It raises an important but difficult ethical question – how much is a human life worth? In reality it is impossible to fund numerous treatments for every disease; the most cost-effective treatments must be funded, without compromising the health of the population. The most difficult part is finding out which treatments these are, ongoing clinical trials will help provide evidence for making these important decisions. In my opinion, if the combined therapy of ipilimumab and nivolumab can significantly improve patients’ health on a variety of different cancers, it would be a viable option. If not however, efforts may be better off invested in developing a more cost-effective alternative. After all my research that I’ve carried out in respect to the combined therapy of ipilimumab and nivolumab, I believe that it is an extremely promising and exciting example of immunotherapy, hence it’s high price tag. The fact that it is such a current topic, with new resources being published constantly, means that it is hard to make an absolute, well-informed decision about it viability. More evidence needs to be produced to back up the use of this treatment before it can be deemed as completely viable, however, this combined therapy has certainly had an enthusiastic introduction into the medical industry. Reference List American Cancer Society (2014) [online] Available at: http://www.cancer.org/cancer/cancerbasics/thehistoryofcancer/the-history-of-cancer-what-is-cancer [Accessed: 9 August 2015]. 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A., Chesney, J., Pavlick, A. C., Robert, C., Grossmann, K., McDermott, D., Linette, G. P., Meyer, N., Giguere, J. K., Agarwala, S. S., Shaheen, M., Ernstoff, M. S., Minor, D., Salama, A. K., Taylor, M., Ott, P. A., Rollin, L. M., Horak, C., Gagnier, P., Wolchok, J. D. and Hodi, F. S. (2015) ‘Nivolumab and Ipilimumab versus Ipilimumab in Untreated Melanoma’, New England Journal of Medicine, 372(21), pp. 2006–2017. doi: 10.1056/nejmoa1414428. Reichert, J. and Valge-Archer, V. (2007) ‘Development trends for monoclonal antibody cancer therapeutics.’, Nature reviews. Drug discovery., 5(6). Royal Marsden (2014) Chemotherapy side effects. [online] Available at: http://www.royalmarsden.nhs.uk/cancer-information/treatment/chemotherapy/pages/side-effects.aspx [Accessed: 29 August 2015]. SUTENT 12.5mg, 25mg, 37.5mg and 50mg Hard Capsules - Summary of Product Characteristics (SPC) - (eMC) (2015) [online] Available at: http://www.medicines.org.uk/emc/medicine/18531#UNDESIRABLE_EFFECTS [Accessed: 1 September 2015]. The Guardian (2014) Big pharma’s ransom for new drugs. [online] Available at: http://www.theguardian.com/business/2014/apr/28/big-pharma-ransom-new-drugs [Accessed: 22 June 2015]. The Guardian (2014) Breast cancer drug turned down for NHS use due to high cost. [online] Available at: http://www.theguardian.com/society/2014/apr/23/breast-cancer-drug-turned-down-nhs-use-high-cost [Accessed: 22 August 2015]. The Guardian (2014) The real reason drugs cost so much – and why big pharma is so rich. [online] Available at: http://www.theguardian.com/commentisfree/2014/apr/23/reason-drugs-cost-so-much-big-pharmaceuticals-rich [Accessed: 22 June 2015]. The Guardian (2015) Cancer breakthroughs trigger big pharma interest in drugs and deals. [online] Available at: http://www.theguardian.com/business/2015/jun/01/cancer-breakthroughs-trigger-big-pharma-interest-drugs-deals [Accessed: 22 June 2015]. The Guardian (2015) Cancer trial of drug combination yields ‘spectacular’ results. [online] Available at: http://www.theguardian.com/society/2015/jun/01/paradigm-shift-hailed-in-treatment-of-lung-cancer [Accessed: 22 June 2015]. The Guardian (2015) Immunotherapy: the big new hope for cancer treatment. [online] Available at: http://www.theguardian.com/science/2015/jun/01/immunotherapy-the-big-new-hope-for-cancer-treatment [Accessed: 19 September 2015]. The Telegraph (2009) Sutent for kidney cancer approved on NHS but other drugs turned down. [online] Available at: http://www.telegraph.co.uk/news/health/news/6087834/Sutent-for-kidney-cancer-approved-on-NHS-but-other-drugs-turned-down.html [Accessed: 28 August 2015]. The Telegraph (2011) What’s the cost of beating NHS waiting lists? [online] Available at: http://www.telegraph.co.uk/finance/personalfinance/insurance/privatemedical/8438496/Whats-the-cost-of-beating-NHS-waiting-lists.html [Accessed: 28 August 2015]. Vidarsson, G., Dekkers, G. and Rispens, T. (2014) ‘IgG Subclasses and Allotypes: From Structure to Effector Functions’, Frontiers in Immunology, . doi: 10.3389/fimmu.2014.00520. Wall Street Journal (2015) High Prices for Drugs Attacked at Meeting. [online] Available at: http://www.wsj.com/articles/high-prices-for-drugs-attacked-at-meeting-1433119411 [Accessed: 22 June 2015]. Wikipedia (2015) ‘CTLA-4’, in Wikipedia. [online] Available at: https://en.wikipedia.org/wiki/CTLA-4 [Accessed: 10 August 2015]. Wikipedia (2015) Ligand (biochemistry). [online] Available at: https://en.wikipedia.org/wiki/Ligand_(biochemistry) [Accessed: 15 August 2015]. Wolchok, J. D. and Saenger, Y. (2008) ‘The Mechanism of Anti-CTLA-4 Activity and the Negative Regulation of T-Cell Activation’, The Oncologist, 13(Supplement 4), pp. 2–9. doi: 10.1634/theoncologist.13-s4-2. YERVOY 5 mg/ml concentrate for solution for infusion (2015) [online] Available at: http://www.medicines.org.uk/emc/medicine/24779 [Accessed: 10 August 2015]. Yervoy (ipilimumab) FDA Approval History (2011) [online] Available at: http://www.drugs.com/history/yervoy.html [Accessed: 6 August 2015]. 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