[MOL] Advances in Chemotherapy discussed at lung cancer summit.... [01669] Medicine On Line

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[MOL] Advances in Chemotherapy discussed at lung cancer summit....

Advances in Chemotherapy Discussed at Lung Cancer Summit   
By Andrew Bowser

TOKYO—Treatment with a new combination of the chemotherapy drugs irinotecan and cisplatin helped patients with a type of lung cancer live about 31 percent longer than did standard chemotherapy in a large Japanese trial.

In fact, the survival benefit was so significant that the trial, undertaken by the Japan Cooperative Oncology Group, was stopped early, according to T. Tamura, M.D., of the National Cancer Center Hospital here.

“Based on these results, irinotecan and cisplatin is a new standard treatment against [advanced] small-cell lung cancer in Japan,” Tamura said.

Small-cell lung cancer (SCLC), which is almost always caused by smoking, accounts for about 20 percent of all lung cancers. Lung cancer is the leading cause of cancer death among both men and women.

These trial results were among several important research updates presented here last week as leading experts in chemotherapy gathered for the 9th World Conference on Lung Cancer.

In the randomized Japanese study, patients with advanced SCLC who received the irinotecan/cisplatin combination lived longer and experienced less immune suppression (a common chemotherapy side effect) than their counterparts who were given standard therapy, etoposide plus cisplatin.

The planned sample size was 230 patients. But at an interim analysis after a total of 154 patients (average age 63) had been enrolled, the difference in average survival time was 411 days for the irinotecan/cisplatin group versus 282 days for etoposide/cisplatin patients.

Side effects, such as reduced levels of immune and blood-clotting cells, were fairly common, but they were consistently lower among the patients on the irinotecan/cisplatin combination.

Two major U.S. trials aimed at confirming these findings are planned.

David H. Johnson, M.D., director of hematology and oncology at the Vanderbilt-Ingram Cancer Center in Nashville, said the irinotecan/cisplatin findings were “quite exciting” and indicative of the explosion of research that has opened up new treatment options for patients with both small-cell and non-small-cell lung cancer.

“For those of us who have been in the lung cancer world as long as I have, it’s almost mind-boggling,” Johnson said. “For a decade or more, we worked with five drugs, none of which worked very well. Now we’ve really become almost like kids in a candy shop.”

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