8A Midweek Edition-February 7-8, 2024
The Times, Gainesville, Georgia I gainesvilletimes.com
LIFE
Cancer treatment advances, doctors push back against side effects
Nam Y. Huh Associated Press
Jill Feldman, 54, poses for a photo at her home in Deerfield, III., Friday, Jan. 19.
Lung cancer patient and advocate Jill Feldman takes pills at home that shrink
tumors by blocking a signal that tells cancer cells to grow.
BY CARLA K. JOHNSON
AP Medical Writer
For cancer patients, the harsh side effects
of powerful drugs have long been the trade
off for living longer. Now, patients and doc
tors are questioning whether all that suffering
is necessary.
They've ignited a movement to radically
change how new cancer drugs are tested,
with the U.S. Food and Drug Administration
urging drugmakers to do a better job at find
ing the lowest effective dose, even if it takes
more time.
Advances in treatment mean millions of
people are surviving for years with incur
able cancers. Jill Feldman, 54, of Deerfield,
Illinois, has lived 15 years with lung cancer,
thanks to that progress. Her parents both died
of lung cancer months after their diagnoses.
But her cancer drug causes joint pain,
fatigue and mouth sores that make eating and
drinking painful.
“If you drink something that's too hot,
you really bum your mouth. That's how my
mouth feels 24/7," Feldman said.
She has lowered the dose with her doctor's
blessing but she wants drugmakers to study
lower doses early in the research process.
“No one should have to endure avoidable
harmful effects of treatment," she said.
Unlike in other diseases, cancer drug
development has focused on finding what's
called the “maximum tolerated dose.”
To speed testing of chemotherapy drags,
researchers ramp up the dosage in a few
people in early studies to determine the
highest possible dose patients can toler
ate. That “more is better” philosophy works
for chemotherapy, but not necessarily for
newer cancer drugs — like the one Feldman
takes — which are more targeted and work
differently.
Chemotherapy is like a battering ram
where aggressive strikes are a good strategy.
But newer cancer drugs are more like hav
ing a front door key. They target a mutation
that drives cancer cell growth, for example,
or rev up the body's immune system to join
the fight.
“You might only need a low dose to turn
off that cancer driver,” said Dr. Lillian Siu,
who leads cancer drug development at the
Princess Margaret Cancer Center in Toronto.
“If you can get the same bang for your buck,
why go higher?”
Through a program called Project Opti-
mus, the FDA is pushing drugmakers to
include more patients in early dose-finding
trials to get better data on when lower doses
can work. A key motivation for the project
was “the growing calls from patients and
advocates that cancer drugs be more toler
able,” said FDA spokesperson Chanapa Tan-
tibanchachai in an email.
Many of the new cancer drags were devel
oped using the old strategy. That leads to
problems when patients skip doses or stop
taking the drugs because of side effects.
Some dose recommendations have been offi
cially lowered after the drags were approved.
Other dose-lowering happens one patient at
a time. Nearly half of patients in late-stage
trials of 28 targeted therapy drags needed to
have their doses lowered, according to one
study.
“We were pushing the dose as high as we
could go,” said Dr. Patricia LoRusso, who
leads drug discovery at Yale Cancer Center.
“You get side effects and then you have to
stop the drug to recover from the side effects
and the tumor can grow.”
There's also huge patient-to-patient varia
tion. The amount of a pill that reaches the
bloodstream can vary because of liver and
kidney function and other differences. But
that means lowering the dose for everyone
risks underdosing some patients, LoRusso
said.
Dr. Julie Gralow, chief medical officer
of the American Society of Clinical Oncol
ogy, is planning a 500-patient study to test
whether lower doses of two drags for breast
cancer that has spread.
The study will compare two strategies:
Starting treatment at the full dose then low
ering the dose for side effects versus starting
with a lower dose and increasing dosage if
the patient does well.
Much of the questioning of high doses has
come from metastatic breast cancer patients,
including the Patient Centered Dosing Initia
tive, which has done influential surveys of
patients and cancer doctors.
“We will be on treatment for the rest of our
lives,” said Lesley Kailani Glenn, 58, of Cen
tral Point, Oregon. “We want to try to live the
best that we can, knowing that treatment is
never-ever going to stop.”
During the 11 years she's lived with the
disease, she has summited Mount Whitney
in California, hiked the Cinque Terra in Italy
and started a nonprofit.
When Glenn learned how cancer drug
research favors high doses, she started work
ing with her doctor. She has taken drugs at
lower doses and even lower when she can't
live with the side effects. Diarrhea is her deal-
breaker: She wants to be able to walk her dog
or shop for groceries without worrying about
a bathroom emergency.
“The last thing we want to do is have our
quality of life stolen from us,” Glenn said.
Through Project Optimus, the FDA is
encouraging drug developers to conduct
more head-to-head dosing comparisons. That
could slow down the process, said Dr. Alice
Shaw, who leads early cancer drug develop
ment at Novartis.
“That will require more patients and
then, as you can imagine, also will require
more time to identify, enroll and treat those
patients,” said Shaw said. Adding six months
to a year to the process, Shaw said, needs to
be balanced against the urgent need for new
cancer drugs.
But getting the dose right early will in the
long ran lead to more effective drugs, said
Dr. Timothy Yap, a drug developer at MD
Anderson Cancer Center in Houston. “If the
patients are not taking the drug, then it's not
going to work.”
EVENTS
Georgia Art League Winter Exhibit.
10 a.m. to 5 p.m. Mondays through
Saturdays through Feb. 26. Quinlan
Visual Arts Center, 514 Green St. NE,
Gainesville. 470-272-3010, mela-
nievaughanl33@gmail.com. Free.
Author Talk: Bobby Nash. 1 to 3 p.m.
Feb. 7. Hall County Library System,
Gainesville Branch, 127 Main St. NW,
Gainesville. 770-532-3311 ext. 4011,
jcline@hallcountylibrary.org. Free.
Flomeschool Workshop: The Art of
Papermaking. 10 a.m. to noon Feb. 7.
Atlanta Botanical Garden Gainesville,
1911 Sweetbay Drive, Gainesville. $10.
Caffeine and Octane Lanier Race
way. 8 a.m. to 5 p.m. Feb. 9. Caffeine
and Octane's Lanier Raceway, 5301
Winder Highway, Braselton.
Elachee Story Time. 10:30to 11:30
a. m. Feb. 9. The Storybook Market,
224 Main St. SW, Gainesville. 770-535-
1976. Free.
Valentine’s Weekend Sunset Cruises.
5:30 to 7:30 p.m. Feb. 9-14. Lanier
Boat Charter, 6800 Lights Ferry Road,
Flowery Branch. 678-882-8062, cpt-
thomasstepnowski@gmail.com. $225.
Cat Cafe. 1 to3 p.m. Feb. 12. Hall
County Library system, Gainesville
Branch, 127 Main St. NW, Gainesville.
770-532-3311 ext. 4011, jcline@hall-
countylibrary.org. Free.
Galentine’s Charcuterie Workshop.
5:30 to 7:30 p.m. Feb. 12. Hall County
Library System, Gainesville Branch,
127 Main St. NW, Gainesville. 770-532-
3311 ext. 4011, jcline@hallcountyli-
brary.org. Free.
Valentine Flower Fundraiser. 9 a. m. to
4 p.m. Feb. 12-14. The Marketplace,
1 First St., Gainesville. 470-703-0187,
themarketplacel717@gmail.com.
$20.
Local History and Genealogy Re
sources in the County Next Door.
10:30 a.m. to noon Feb. 13. Gainesville
Branch Library, 127 Main St. NW,
Gainesvi lie. 770-532-3311 ext. 4011.
Free.
Special Needs Social Hour. 11a.m.
to noon Feb. 14. Hall County Library
System, Gainesville Branch, 127 Main
St. NW, Gainesville. 770-532-3311
ext. 4011, jcline@hal Icou ntyl i bra ry.
org. Free.
The Crown MountainTrio. 7:30 p.m.
Feb. 16. Gainesville Performing Arts
Center, 3040 Landrum Education
Drive, Oakwood. 706-864-1423, mu-
sic@ung.edu. Free.
The Crucible. 7:30 to 10 p.m. Feb. 16-
17. Brenau University’s Hosch Theatre,
429 Academy St. NE, Gainesville. 678-
717-3624, boxoffice@gainesvillethe-
atrealliance.org. $16 - $24.
Lori Williams Quintet 2024 Evenings of
Intimate Jazz. 8tol0p.m. Feb. 16. The
Arts Council Smithgall Arts Center, 331
Spring St. SW, Gainesville. 770-534-
2787, info@theartscouncil.net. $40.
Nicole Zuraitis Quarter. 8 to 10 p.m.
Feb. 16-17. The Arts Council Smith-
gall Arts Center, 331 Spring St. SW,
Gainesville. 770-534-2787, info@
theartscouncil.net. $40.
Roman Street Quarter 2024 Evenings
of lntimateJazz.8to 10 p.m. Feb. 16.
The Arts Council Smithgall Arts Center,
331 Spring St. SW, Gainesville. 770-
534-2787, info@theartscouncil.net.
$40.
Art as Therapy: Paint Pour. 11 a.m. to
12:30 p.m. Feb. 17. Quinlan Visual Arts
Center, 514Green St. NE, Gainesville.
770-536-2575, info@QVAC.org. $40.
Georgia Audubon Birding Hike. 8 to 10
a.m. Feb. 17. Chicopee Lake, Gaines
ville. 770-535-1976. $10.
ONGOING
Alzheimer’s Caregivers Support
Group. 5:30-6:30 p. m. first Tuesdays
of the month. Grace Episcopal Church,
422 Brenau Ave. NE, Gainesville. 727-
409-6608, charlenebestdewitt@gmail.
com. Free.
Card workshop. 10a.m.to 1 p.m.first
Saturdays of the month. Hall County
Library System, Gainesville branch,
127 Main St. NW, Gainesville. 770-532-
3311 ext. 4011, gkoecher@hallcoun-
tylibrary.org.
Discovery Saturdays. 10a.m.to3
p.m. second Saturdays of the month.
Elachee Nature Science Center, 2125
Elachee Drive, Gainesville. 770-535-
1976. $3-$5.
Ekphrasisforthe Masses. Noon to 1
p.m. second Tuesdays of the month.
Quinlan Visual Arts Center, 514 Green
St. NE, Gainesville. 770-536-2575,
info@qvac.org. Free.
GainesvilleLacers. 10a.rn.tol p.m.
third Saturdays of the month. Hall
County Library System, Gainesville
branch, 127 Main St. NW, Gainesville.
770-532-3311, gkoecher@hallcoun-
tylibrary.org.
Gentle Yoga. 11:30 a.m. to 12:30
p.m.second, third and fourth Wednes
days. Blackshear Place Branch Library,
2927 Atlanta Highway, Gainesville.
770-337-1572, dl9345@bellsouth.
net. Free.
Georgia Cross Stitchers. 10a.m.to
4:30 p.m. second Saturdays of the
month. Hall County Library System,
Gainesville Branch, 127 Main St. NW,
Gainesville. 770-532-3311 ext. 4011;
gkoecher@hallcountylibrary.org. Free.
Gold Rush Quilting Guild. 10 a.m. to
noon first Wednesdays of the month.
Friendship Baptist Church, 3513
Westmoreland Road, Cleveland, ale-
nekempton@gmail.com.
Hip Hop Class Wednesdays. 4-5 p.m.
(3rd to 5th Graders) through May 15.
Gainesville Ballet Company, 971 River
side Drive, Gainesville. 770-866-5353,
info@gbcdance.com. $88.
Homeschool Day. 10 a.m. to 12 p.m.
third Thursdays of the month. Elachee
Nature Science Center, 2125 Elachee
Drive, Gainesville. 770-535-1976. $15.
Ice Skating at Sugar Hill. Through Feb.
17. The Ice Rink at Sugar Hill, 5039 W.
Broad St., Sugar Hill.
Music Bingo. 7 to 9 p.m. every Thurs
day. NoFo Brew Co. Gainesville, 434
High St. SW, Gainesville, topher@nofo-
brew.co. Free.
Northeast Georgia Writers. 1-3 p.m.
first Wednesdays of the month. Gaines
ville Downtown Library, 127 Main St.
NW, Gainesville. talltaleswriter@gmail.
com. Free.
Tea with Jane Austen: A Reading
Group.3-4p.m.fourth Fridaysofthe
month through November. Hall County
Library System, Gainesville Branch,
127 Main St. NW, Gainesville. 770-532-
3311 ext.4011,gkoecher@hallcoun-
tylibrary.org. Free.
Trivia Night. 7-9 p.m. Tuesdays. NoFo
Brew Co Gainesville, 434 High St. SW,
Gainesville, topher@nofobrew.co. Free.
Turning Leaves BookClub. 11:30
a.m. to 1 p.m.first Wednesdays of the
month. Linwood Nature Preserve Ecol
ogy Center, 415 Linwood Drive, Gaines
ville. karin.hicks@uga.edu.
War Stories Book Club. 4-5 p. m. sec
ond Fridays ofthe month. Murrayville
Branch Library, 4796 Thompson
Bridge Road, Gainesville. 770-532-
3311 ext. 171. Free.
FROM 7A
Valentine’s
MayurGala Unsplash
This Valentine’s Day, couples can set sail into love onboard
the Valentine’s Weekend Couples Sunset Cruise, hosted
Feb. 9-14 by Lanier Boat & Charter.
Stubing. For more information
and to buy tickets, visit Lanier
Boat & Charter's website.
Tea at the Northeast
Georgia History Center
Want to combine romance
with a little education? Then
enjoy tea for two while learn
ing about the history of Val
entine's Day at the Northeast
Georgia History Center in
Gainesville on Saturday,
Feb. 10. You'll be treated to a
curated selection of fine teas,
an assortment of sweet and
savory treats, and a presenta
tion on the origins and evolu
tion of Valentine's Day. Cost
is $35, $45 for non-mem
bers, and pre-registration is
required.
Valentine’s Wine Dinner at
Sweet Acre Farms Winery
Another Valentine's Day
option in nearby Alto is at
Sweet Acre Farms Winery is
the Valentine's Wine Dinner,
a four-course meal with four
wine pairings for $190 per
couple. Live entertainment
will be supplied by Rail Town
Music.
Dahlonegawith
your darling
If you want to get out of
town for Valentine's Day, try
Dahlonega. The Inn at Black
berry Hill offers a Romance
Package with mood-setting
accommodations, including a
bed adorned upon arrival with
romantic rose petals. Mean
while, Dahlonega Resort and
Vineyard will be offering a
Lovers' Dinner on Valentine's
Day, Feb. 14, with a special
chef-crafted three-course
meal for $85 per person; a
few rooms are still available to
book, starting at $135 a night.
And White Oaks Bistro, nor
mally open only for special
events, will be offering a spe
cial Valentine's Dinner for the
public on Friday, Feb. 16, per
fect for those who can't spare
time in the middle of the week.
Galentine’s Charcuterie
Workshop
Finally, for those without a
Valentine but still in the mood
to do something with their gal
pals, the Hall County Library
System's main branch in
Gainesville is staging a Gals'
Night Out Charcuterie Work
shop on Monday, Feb. 12.
For only $20, you get to put
together a Galentine-themed
charcuterie board, a fancy
name for a board of meats and
cheeses, perfect for snack
ing while binge-watching
your favorite TV shows with
friends.
Vitor Monthay Unsplash
Another wonderful love to celebrate on Valentine’s is the platonic love in
our lives. So, grab all your gal pals and check out the Gal’s Night Out
Charcuterie Workshop being held at the Hall County Libary System’s main
branch in Gainesville on Monday, Feb. 12.
