Sutent, Tykerb May Curb Liver Cancer

Studies Show Drugs May Help Treat Advanced Liver Cancer

Medically Reviewed by Louise Chang, MD on April 16, 2008
From the WebMD Archives

April 16, 2008 (San Diego) -- Two anticancer drugs show promise for treating people with advanced liver cancer, one of the deadliest types of cancers.

One drug, Sutent, stopped tumor growth and spread in about half of people with advanced liver cancer.

In a second study, a once-a-day pill called Tykerb halted tumor growth in about one-third of patients.

People with advanced liver cancer have very few options, says Andrew X. Zhu, MD, PhD, director of liver cancer research at Massachusetts General Hospital Cancer Center in Boston.

Nexavar is the only medication that's been shown to extend their lives, he says. It was approved by the FDA in November after a large study showed people with advanced liver cancer given Nexavar lived about three months longer than those given a placebo: 10.7 months vs. 7.9 months.

Enter Sutent, which puts the brakes on the growth of tumor-feeding blood vessels and deprives tumor cells of blood and nutrients needed for growth.

It is part of a class of drugs called tyrosine kinase inhibitors. It's already approved to treat advanced kidney cancer and recalcitrant gastrointestinal stromal tumors (GIST).

Sutent Halts Tumor Growth

The study involved 34 patients with advanced liver cancer. They took one Sutent pill a day for four weeks. Then they took a drug holiday for two weeks and repeated the cycle.

The findings were presented here at the annual meeting of the American Association for Cancer research.

By 12 weeks after starting treatment, the tumor shrank in only one patient. But 17 patients had stable disease -- "that is, tumor growth had stopped and they were doing well clinically," Zhu says.

Patients lived an average of 10 months.

Importantly, molecular markers showed clear evidence that the drug was associated with antitumor activity, Zhu says.

The treatment was safe, he adds. Common side effects included elevated liver enzymes, low levels of certain blood cells, and fatigue.

Christopher Willett, MD, head of radiation oncology at Duke University in Durham, N.C., tells WebMD that the findings are "preliminary, but encouraging."

The fact that there was evidence of changes in molecular markers that signal better outcome is particularly noteworthy, Willett says.

Tykerb Also Shows Promise

The Tykerb study involved 25 patients with advanced liver cancer. Joseph Markowitz, MD, PhD, a researcher at the Ohio State University, led the study.

Tykerb is already used to treat advanced breast cancer. It zeroes in on two related proteins, HER2 and EGFR, that sit on the surface of liver cancer cells and play a critical role in the growth and spread of cancer.

In excess, both HER2 and EGFR are some of the really bad guys, instigating cancer spread. They have a direct effect on cancer cells, stimulating the cells to proliferate, migrate, and metastasize. Tykerb attaches to the proteins, thereby blocking their action and slowing or stopping the growth of tumor cells.

Patients took Tykerb by mouth once a day for 28-day cycles. Some patients received as few as one cycle and as many as 12 cycles.

The drug stopped cancer spread in about one-third of patients. In 8%, no cancer growth was observed for more than six months and, in one case, for over one year.

The next step, Markowitz tells WebMD, is to figure out why this subset of patients responded so well.

The most common side effects were diarrhea and nausea, which afflicted more than half of patients.

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American Association for Cancer Research annual meeting, San Diego, April 12-16, 2008.

Andrew X. Zhu, MD, PhD, director of liver cancer research, Massachusetts General Hospital Cancer Center, Boston.

Christopher Willett, MD, head of radiation oncology, Duke University, Durham, N.C.

Joseph Markowitz, MD, PhD, Ohio State University.

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