Saturday, 05/14/05

Study is expected to change treatments

ORLANDO, Fla. — Patients with advanced lung cancer lived longer when treated with a combination of chemotherapy and a drug that cuts off the tumor's blood supply, according to a new study.

The study, which is expected to change the treatment regimen for the most common type of lung cancer, marks the first time a targeted agent has added to the survival of patients with lung cancer. The drug, Avastin, is approved to treat colon cancer.

''This study suggests that some advanced lung cancer patients have a 20%-to-25% chance of living one, two or maybe even three years longer,'' said Dr. Alan Sandler, a professor of medicine at Vanderbilt University Medical Center and the lead author of the study. ''The greater hope is that once it's used earlier in the stage of the disease, it could help cure it.''

Avastin also showed dramatic results in a trial involving patients with advanced breast cancer. Combined with chemotherapy, it doubled the chances of patients surviving without cancer progression, compared to chemotherapy alone.

The two studies are among a number showing targeted drugs — drugs that attacks tumors without harming healthy tissue — making inroads against the most lethal cancers. They were presented yesterday at the annual conference of the American Society of Clinical Oncology in Orlando, Fla.

A third study showed another new breast cancer drug, Femara, outperforming old industry-standard tamoxifen. Femara is the same type of drug as Arimidex, whose impressive performance in an international study prompted doctors five months ago to call for it to replace tamoxifen among postmenopausal women. Both drugs work by lowering the amount of estrogen the body produces.

But it was Avastin's lung-cancer showing that caused the greatest interest at the conference's first day. Patients with non-squamous, non-small cell lung cancer who received Avastin and chemotherapy lived an average of 12.5 months, compared with a median survival of 10.2 months for patients receiving chemotherapy alone.

The study also showed that 51.9% of combination-therapy patients were alive after one year of treatment, compared with 43.7% on chemotherapy alone. At two years, it was 22.1% of patients to 16.9%. The tumor response rate, meaning a significant reduction in size and a delay before the cancer progresses, was 27% for the combination-therapy group and 10% in the chemotherapy-alone group.

The most serious side effect was life-threatening or fatal bleeding, mainly from the lungs, which occurred in 1.7% of patients in the Avastin group and did not occur in the chemotherapy-alone group.

The trial did not include patients with brain metastases, who account for about 10% of lung cancer patients.

Lung cancer is the leading cause of cancer deaths in both men and women. The American Cancer Society estimates that more than 172,000 new cases of lung cancer will be diagnosed this year and the disease will claim more than 163,000 lives.

Also at the conference yesterday, researchers touted a new generation of experimental cancer drugs they say is poised to upstage current hot shots by attacking the multiple methods tumors use to grow and spread, instead of just one.

These drugs are like a repairman who brings an entire toolbox to a job instead of just a wrench or hammer.

Doctors reported that one of Pfizer's new multitasking drugs had shrunk tumors in 40% of people with advanced kidney cancer. Current treatments do that in only about 1 out of 10 cases.

Some patients have been on the experimental drug for more than a year — far longer than they'd been expected to live.

Nashville researchers play vital role at meeting