Researchers Log Advances in Cancer Treatment
Oncology: Conference is told of promising data on
chemotherapy for lung patients and other study results, but breakthroughs
shown for the first time that chemotherapy can extend the lives of
patients with metastatic lung cancer, the leading cancer killer of both
men and women in the United States.
current primary therapy for lung cancer is surgery; only about 25% of
patients also receive chemotherapy, most of them during the early stages
of the disease. Once the cancer has metastasized, or spread, there has
been little that could be done for patients.
The promising results were just one of
several advances in cancer therapy reported last week at a New Orleans
meeting of the American Society for Clinical Oncology (http://www.asco.org). No major
breakthroughs were revealed, but progress was noted in a variety of areas.
"We are still trying to hit a home run,"
said Dr. Charles Balch, executive vice president of the society, "but
sometimes you hit a double that gets you across the plate. A lot of this
is incremental progress."
Gandara and his colleagues at the UC Davis Cancer Center have been
treating lung cancer patients with docetaxel, a close relative of the
well-known cancer drug Taxol. Docetaxel, trade named Taxotere, is derived
from needles of the European yew tree, while Taxol is obtained from the
* * * Gandara's group
treated 81 metastatic lung cancer patients, who had already undergone
surgery, with radiation and a combination of the drugs cisplatin and
etoposide, followed by docetaxel. He reported that 48% of the patients
survived for at least two years and that the median survival was 20
"This is a group of patients
whose expected survival for two years would be less than 10%," Gandara
said at a news conference. "Nothing in the literature parallels this kind
of survival in this group of patients."
In contrast to the UC Davis study, Dr.
Joan Schiller of the University of Wisconsin reported on clinical trials
with several combinations of cancer drugs that did not include docetaxel.
Her group found that treated lung cancer patients had a median survival of
eight months, compared with six months for untreated patients. Just over a
third of the treated patients survived for at least a year and 12% lived
The American Cancer Society
predicts that 164,000 Americans will be diagnosed with lung cancer this
year and 157,000 will die of it.
other research reported at the meeting:
* Controlling hot flashes: The hot
flashes suffered by women following therapy for breast cancer can be eased
by two common antidepressants, Prozac and Effexor, according to
researchers at the Mayo Clinic in Rochester, Minn.
Physicians hesitate to use estrogen to
treat the hot flashes because of the fear it might trigger a cancer
recurrence. The antidepressants might also be useful for controlling hot
flashes in post-menopausal women and men undergoing hormonal therapy for
prostate cancer, said Dr. Charles Loprinzi.
A report last week from Georgetown
University had reported similar success with the antidepressant Paxil. All
of the drugs were studied in dosages smaller than those used for treating
Loprinzi reported at the New
Orleans meeting on a study of 229 breast cancer survivors who were divided
into four groups. Three groups each received a different dose of Effexor,
while the fourth received a placebo. The best results were obtained in the
group receiving half the normal dose of Effexor. Those women reported 61%
fewer hot flashes than the control group.
A small number of the women reported
side effects that included nausea, dry mouth and decreased appetite.
Loprinzi did not report results from the Prozac study. Another group is
performing a similar study with the drug Zoloft.
* Therapy for stomach cancer:
Researchers from St. Vincent's Cancer Center in New York City have scored
the first improvement in therapy of stomach cancer in more than a decade.
An estimated 21,900 Americans will be diagnosed with stomach cancer this
year, and 13,500 people will die of it. The disease is commonly treated
only by surgical removal of the tumor, because chemotherapy has not
previously shown any benefit.
S. McDonald and his colleagues studied the use of radiation therapy along
with the drugs leukovorin and 5-fluorouracil after surgery. They enrolled
556 stomach cancer patients in the nine-year study. Half of the patients
received only surgery, while half received the new regimen.
McDonald reported at the New Orleans
meeting that, after three years of treatment, 49% of those receiving the
new regimen were disease-free, compared to only 32% of those receiving
surgery alone. Overall survival at three years was 52% for those receiving
the drugs, compared to 41% receiving surgery alone.
* Use of interferon-alpha: Incremental
progress was also achieved in treating kidney cancer, which strikes 31,000
Americans each year and kills 12,000. Chemotherapy and radiation therapy
do not work in treating metastatic kidney cancer, but clinicians have had
some success boosting patients' immune systems with a naturally occurring
protein called interferon-alpha.
Researchers had previously speculated
that the interferon-alpha treatment did not work well because the kidney
continues to spew out cancer cells, overwhelming the immune system. A
group headed by Dr. Robert C. Flanigan of Loyola University in Maywood,
Ill., decided to see if removing the kidney would improve treatment.
The group enrolled 246 patients with
metastatic kidney cancer. Half only received interferon-alpha, while the
rest had their kidneys removed before receiving the drug.
Flanigan reported at the meeting that
patients whose kidneys were removed survived for an average of 12 months,
compared to an average of eight months for those receiving only the drug.
Researchers are developing new immune agents that should increase survival
even more, Flanigan said.
as treatment: New findings in patients with multiple myeloma indicate that
thalidomide--long out of favor with doctors because of the severe birth
defects it produced when given to pregnant women--may be a valuable drug
in treating cancer. About 14,000 new cases of multiple myeloma are
diagnosed each year.
Dr. Bart Barlogie
of the University of Arkansas for Medical Sciences in Little Rock
administered thalidomide to 169 patients who had received a bone marrow
transplant but were not responding to treatment with other anti-cancer
drugs. After 18 months, the overall survival rate was 55% and disease-free
survival was 30%, he reported at the American Society for Clinical
The study did not have
a control group, Barlogie said, but "an educated guess" is that most
patients would have died within six months without thalidomide.
* * * Times wire services
contributed to this report. Thomas H. Maugh II can be reached at email@example.com.
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