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| By
Andrew Bowser |
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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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