Yes. He had recurrence 11 months after original diagnosis. He lived another 12 months. All the things we tried likely extended his survival but did not keep the monster at bay.
I can't think of any reason they shouldn't be given together. Avastin acts on VEGF/angiogenesis while CRONaxal (oxaloacetate) is thought to expedite the removal of glutamate from around the tumor by depleting glutamate levels in the blood. Excess glutamate around the tumor is excitotoxic to neurons, and thus contributes to seizures, and facilitates tumor invasion by killing surrounding neurons.
The mechanisms of CRONaxal and Avastin aren't overlapping and I wouldn't expect them to be antagonistic, in theory.
Excess glutamate output by GBMs is attributed to the glutamate-cystine exchanger system XC. In one study, about 55%-60% of GBM samples had high expression of the catalytic subunit of system XC, and the remaining samples had very low to undetectable expression.
https://www.ncbi.nlm.nih.gov/pubmed/26019222
Given the proposed mechanism of action of CRONaxal, I'd expect it could be helpful for ~60% of the GBM population.
Note that sulfasalazine is a dirt cheap drug that inhibits the glutamate-cystine exchanger. It would be very interesting to compare the efficacy of say 1.5 grams daily of sulfasalazine versus 1.5 grams daily of CRONaxal, as you could get that amount of sulfasalazine for about $20 or $30 a month, even without a coupon (like I said its dirt cheap).
Thanks Stephen, Leia, Greg's neuro-onc was ok with it, but she also said, a couple of testimonials doesn't make a study, but we knew that. I would also be interested in knowing if sulfasalazine would work the same as CRONaxal. Any recommendations of which sulfasalazine product to try?
CRONaxal and sulfasalazine have different mechanisms, but the end result should be similar - CRONaxal is supposed to help remove glutamate from around the tumor, and sulfasalazine inhibits the transporter that releases glutamate from the tumor in the first place. However for sulfasalazine to act it would need to get into the tumor cells, but CRONAxal has an indirect mechanism and supposedly acts by depleting glutamate from the blood.
Sulfasalazine is an old prescription drug so you could either look for the brand name product Azulfidine, or generic sulfasalazine from the pharmacy. Both are very cheap.
BeneGene, made by the same company and containing the same ingredient (oxaloacetate) as Cronaxal, still appears to be on the market. http://www.benagene.com/buy_benagene
My husband took it. Hard to know if it had any effect. It certainly did not produce a significant response.
ReplyDeleteThanks Jo so he had a recurrence on it?
ReplyDeleteYes. He had recurrence 11 months after original diagnosis. He lived another 12 months. All the things we tried likely extended his survival but did not keep the monster at bay.
DeleteI'm thinking of purchasing it for my husband. It's expensive and wanted some feedback from this group.
ReplyDeleteDoes anyone know if taking Cronaxal in conjunction with Avastin is advisable?
ReplyDeleteI can't think of any reason they shouldn't be given together. Avastin acts on VEGF/angiogenesis while CRONaxal (oxaloacetate) is thought to expedite the removal of glutamate from around the tumor by depleting glutamate levels in the blood. Excess glutamate around the tumor is excitotoxic to neurons, and thus contributes to seizures, and facilitates tumor invasion by killing surrounding neurons.
DeleteThe mechanisms of CRONaxal and Avastin aren't overlapping and I wouldn't expect them to be antagonistic, in theory.
Excess glutamate output by GBMs is attributed to the glutamate-cystine exchanger system XC. In one study, about 55%-60% of GBM samples had high expression of the catalytic subunit of system XC, and the remaining samples had very low to undetectable expression.
https://www.ncbi.nlm.nih.gov/pubmed/26019222
Given the proposed mechanism of action of CRONaxal, I'd expect it could be helpful for ~60% of the GBM population.
Note that sulfasalazine is a dirt cheap drug that inhibits the glutamate-cystine exchanger. It would be very interesting to compare the efficacy of say 1.5 grams daily of sulfasalazine versus 1.5 grams daily of CRONaxal, as you could get that amount of sulfasalazine for about $20 or $30 a month, even without a coupon (like I said its dirt cheap).
DeleteThanks Stephen, Leia, Greg's neuro-onc was ok with it, but she also said, a couple of testimonials doesn't make a study, but we knew that. I would also be interested in knowing if sulfasalazine would work the same as CRONaxal. Any recommendations of which sulfasalazine product to try?
DeleteCRONaxal and sulfasalazine have different mechanisms, but the end result should be similar - CRONaxal is supposed to help remove glutamate from around the tumor, and sulfasalazine inhibits the transporter that releases glutamate from the tumor in the first place. However for sulfasalazine to act it would need to get into the tumor cells, but CRONAxal has an indirect mechanism and supposedly acts by depleting glutamate from the blood.
DeleteSulfasalazine is an old prescription drug so you could either look for the brand name product Azulfidine, or generic sulfasalazine from the pharmacy. Both are very cheap.
Note that the FDA published a warning letter today to Terra Biological and the Cronaxal website says that it is no longer available.
ReplyDeleteYes there is a warning letter (dated July 18 2017) on the FDA website.
Deletehttps://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2017/ucm598171.htm
BeneGene, made by the same company and containing the same ingredient (oxaloacetate) as Cronaxal, still appears to be on the market.
http://www.benagene.com/buy_benagene