AIDS TREATMENT NEWS Issue #213, December 23, 1994
John S. James
The treatment is a monoclonal antibody targeted against a receptor called HER/2-neu. Several patients have had very good results with the antibody when all other treatments have failed. However, the treatment only works for tumors which express the receptor excessively -- and finding out which patients could benefit requires a special test. According to Genentech, this test is available to physicians from Roche Biomedical Laboratories and others, independently of Genentech; according to breast-cancer activists, patients must be tested through Genentech in order to qualify for the company's trials and have a chance to receive the drug.
The protest concerned Genentech's lack of a compassionate use policy, and also lack of access to the test (to tell if a patient is likely to benefit from the drug). According to breast-cancer activists, a 40-year-old physician died after waiting so long for the test that it was too late to use the drug; according to Genentech, this is inaccurate, but given patient confidentiality, neither Genentech nor her physician can discuss it. Also, activists had been frustrated by difficulties in arranging appropriate meetings with the company.
We asked Genentech if it wanted to reply to a draft of this article, and received the following statement: "Genentech empathizes with these patients and has been in discussion with them regarding this issue. No final decision has been made at this time regarding compassionate use. However, Genentech's policy is to try to do the most good for the most patients as quickly as possible. This means timely and effective progress with clinical trials leading to approval. The HER-2 antibody is scheduled to begin in phase III trials in the first half of 1995."
Breast Cancer Action, based in San Francisco, has led the fight for access to the treatment. But its board decided not to sponsor this demonstration, which included plans for civil disobedience. Instead the demonstration was sponsored by the Breast Cancer Working Group of ACT UP/Golden Gate. As it turned out, there were no arrests; in fact, the activists praised corporate security as being well informed, low key, and inconspicuous.
The protest got good coverage on public radio, but otherwise received little media attention, because of another story in the news. At the same time as the demonstration, a mentally ill man walked into a bank in San Francisco with two fake grenades, and was shot and killed by police. Reporters left the Genentech protest to cover the bank violence, which immediately filled the newspapers and pushed other news aside. But Genentech learned that the issue will not go away; clearly its luck in avoiding feared publicity may not hold next time.
The HER/2-neu antibody, incidentally, has no role in AIDS treatment. The fact that many AIDS activists would fight for access to a drug which they cannot use personally reflects the close working relationship between AIDS and breast-cancer activists in San Francisco -- and points the way to the coalition work which will be increasingly important in the future.
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