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Targeted Treatment Takes Aim at Cancer

Experts Praise Cancer Treatment Advances at Meeting

From the WebMD Archives

June 10, 2004 (New Orleans) -- Cancer researchers from around the world are buzzing about studies on new cancer treatments that are expected to make future cancer report cards better than ever.

While there were no so-called "miracle" drugs at this year's American Society of Clinical Oncology meeting held this week, there were hundreds of studies reporting advances in survival in people with cancer. In addition, there were many reports about drugs that can slow the spread of cancer, a very important finding since people may now live long enough for a "miracle" drug to come along.

"To me what is most remarkable about the research reported this year is the advances made in both targeted therapy and tailored therapy," says ASCO president Margaret Tempero, MD, director of clinical sciences and deputy director, University of California at San Francisco Comprehensive Cancer Center. Tempero met reporters for breakfast during the final day of the cancer meeting.

Changing the Way Cancer Is Treated

She tells WebMD that while there were several important studies reported this week, she thought a handful were "real landmark" studies that will change the way certain cancers are treated.

A good example of a landmark study, she says, is one in which a new drug called Temodar was used with radiation therapy after surgery to extend survival in a brain cancer called glioblastoma multiforme. This cancer is one of the most aggressive and difficult to treat types of brain cancer -- for ER fans this is the tumor that killed Dr. Mark Green. After two years, 26% of the patients taking Temodar were alive compared with just 10% of patients who received only radiation therapy after surgery.

"That type of survival advantage is hugely meaningful to both patients and physicians," says Tempero.

In another study that is likely to change cancer treatment, giving the drug Taxol weekly rather than every three weeks was more effective for women with metastatic breast cancer.

Researcher Andrew Seidman, MD, of Memorial Sloan Kettering Cancer Center in New York, tells WebMD that the results should be reassuring for both women and their doctors because "this is what many oncologists have been doing in their offices. We're just confirming it." But that "confirmation" is likely to translate into a new standard of care for treatment of advanced breast cancer.

New Drugs Change the Picture

Two more studies provide useful new information about two of the latest "hot" drugs in cancer treatment -- Iressa and Tarceva. Both of these drugs are examples of the new targeted therapies that hone in on a specific genetic pathway to kill the cancer or slow its progress.

In one study researchers reported that Iressa works in people who have a rare, but growing, type of lung cancer called bronchioloalveolar carcinoma for short. This is an aggressive cancer that usually doesn't respond to treatment, says Howard J. West, MD, of the Swedish Cancer Institute in Seattle. But West says that Iressa does seem to work and it works especially well in women, who lived an average of 19 months, while men only survived for an average of eight months.

In another lung cancer study from Canada, Tarceva, an experimental drug not yet approved by the FDA, increased survival by an average of two months in patients with advanced non-small cell lung cancer who had not responded to other treatments. While two months may not seem like much, Frances A. Shepherd, MD, a researcher for the study, tells WebMD that "it is the first time anything has worked in these patients. So that is a huge finding." Shepherd is chair of cancer research at Princess Margaret Hospital in Toronto and a professor of medicine at the University of Toronto.

Practicing "First Do No Harm"

Tempero says another important advance that was evident at this year's cancer meeting is the emphasis on kinder, gentler approaches to cancer treatment. For instance, researchers are now routinely studying quality of life. Shepherd emphasized this angle in her study saying that Tarceva not only extended life but also "gave patients a better life" because it eased symptoms.

A good example of this hunt for less toxic cancer treatments is a study from French researchers who report that changing a single drug in a chemotherapy treatment given to women with advanced recurrent ovarian cancer can prevent hair loss and limit the amount of numbness in the hands and feet.

"When a woman hears that ovarian cancer has recurred, it can be among the worst moments in her life because she knows that there is very little that we can do for her," says Eric Pujade-Lauraine, MD, chief of the department of medical oncology at Hopital Hotel Dieu, Paris. "In 90% of cases, she will lose her hair, and it will happen rapidly. She will lose the ability to sew, to dress herself, to do normal work because the regimen can affect feeling in her fingers. It impairs her social life, especially at a time when she has limited social life remaining," he says.

By replacing Taxol with a drug called pegylated liposomal doxorubicin those side effects were almost completely eliminated without loosing any of the efficacies of the more toxic standard therapy, he says.


Finally, Tempero predicted that this steady pace of advances, which she says are aimed not at curing cancer but at turning it into a chronic disease like diabetes, will continue thanks in large part to a new nationwide database that is being established under the aegis of the National Cancer Institute.

Forty NCI-designated cancer centers are setting up the new information highway that will serve as a repository for research from each center. So, if a researcher wants to do a study about a specific form of cancer, for example, "he or she can just plug into the database and find out what center has the most information and access that data," says Tempero.

With that type of information sharing readily available, it is probable that the "good news" in cancer treatment will only get better.

WebMD Health News

Sources

SOURCES: ASCO 2004, New Orleans, June 5-8, 2004. Margaret Tempero, MD, ASCO president; and director, clinical sciences; and deputy director, University of California at San Francisco Comprehensive Cancer Center; and chief, medical oncology. Andrew Seidman, MD, Memorial Sloan Kettering Cancer Center, New York. Frances A. Shepherd, MD, chair, cancer research, Princess Margaret Hospital, Toronto; and professor of medicine, University of Toronto. Howard J. West, MD, of the Swedish Cancer Institute, Seattle. Abstract 7002, "A randomized placebo-controlled trial of erlotinib in patients with advanced non-small cell cancer following failure of 1st line or 2nd line chemotherapy. A National Cancer Institute of Canada Clinical Trials Group trial. Abstract 7014, Gefitinib (ZD1839) therapy for advanced bronchioloalveolar lung cancer: Southwest Oncology Group (SWOG) study S0126. Abstract 2, "Concomitant and adjuvant temozolomide and radiotherapy for newly diagnosed glioblastoma multiforme. Conclusive results of a randomized phase III trial by the EORTC Brain and RT Groups and NCIC Clinical Trials Group." Poster 5022 "Carboplatin (PA) and pegylated liposomal doxorubicin (CA; PACA regimen) in patients with advanced ovarian cancer in late (>6 months) relapse (AOCLR): Survival results of a GINECO phase II trial."Abstract 515, "CALGB 9840: Phase III study of weekly paclitaxel via 1-hour infusion versus standard 3h every third week in the treatment of metastatic breast cancer with trastuzumab for HER2 positive and randomized for T in HER2 normal MBC."
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