Cancer
Group Lists Top Advances for 2005
Science's
slow but relentless advance against cancer continued in 2005 with breakthroughs in the
treatment of breast, lung, stomach and other killer malignancies.
That
was the conclusion of the first-ever annual report on clinical cancer research by the
American Society of Clinical Oncology (ASCO), which was released Friday.
"The
take-home message is that we are making steady progress in the management of a wide
variety of cancers," ASCO President Dr. Sandra J. Horning told HealthDay at a news
briefing in New York City.
"Many
of the advances that we described in the report are currently being applied to newly
diagnosed cancer patients," Horning said. Others aren't immediately available,
"but look extremely promising," she added. The ASCO report focuses on
treatments, not basic science, and was drawn up by a group of 21 experts who reviewed
data from studies published in major journals between November 2004 and October 2005.
Their
list of the most important breakthroughs includes:
Herceptin
(trastuzumab) combats breast cancer. Up to 30 percent of breast cancer patients have
malignancies that overproduce the HER-2 protein, and these cancers have been notoriously
resistant to therapy. However, a recent study found Herceptin slashed cancer recurrence
in this high-risk group by half. "Many in the breast cancer community feel this is
one of the most important breast cancer advances in decades," Horning said.
Chemotherapy
boosts survival after lung-cancer surgery. A major study found that "adjuvant"
(post-surgery) chemotherapy greatly reduced the risk of tumor recurrence in patients
with early-stage non-small cell lung cancers. Experts have debated the usefulness of
adjuvant chemotherapy against these tumors for years, and "these findings resolve
the debate," Horning said.
Avastin
(bevacizumab) fights advanced lung and colon cancers. This "angiogenesis
inhibitor" drug, which cuts off the tumor's blood supply, proved effective in a
recent trial in extending survival for patients with tough-to-treat advanced colon and
non-small cell lung cancers. "This is the first study to show that a targeted
therapy added to [standard] chemotherapy could improve survival" for these
patients, Horning said.
Chemotherapy
before surgery boosts stomach cancer survival. Updated results from a major British
trial showed that a combination of chemotherapy drugs given before surgery significantly
increased five-year survival for patients with stomach cancer. "These findings are
changing the way gastric cancer is treated in the United States," said Dr. Roy S.
Herbst, ASCO's chairman of cancer communications.
Two
new cervical cancer vaccines adding protection. While Pap smears have nearly eliminated
cervical cancer in the developed world, the disease still kills thousands of women each
year in poorer countries. However, two new vaccines appear to protect women against
infection with the human papilloma virus (HPV), which is thought to trigger most
cervical cancers.
Other
notable advances included the success of the drug oxaliplatin in fighting colon cancer
recurrence; the use of Rituxan and Bexxar combination therapy against B-cell lymphomas;
Revlimid's success in treating killer bone marrow disorders called myelodysplastic
syndromes (MDS); the use of temozolomide in boosting brain tumor survival; and the
success of the drug Erbitux against head and neck cancers, the researchers said.
Many
of these drugs fall into the category of "targeted" therapies, in which
treatments are tailored to fight specific cancer types and used in patients with
specific genetic or immunological profiles.
"This
is what we call the 'individualization' of cancer therapy," Horning said.
"We're moving toward tailoring treatment for patients, based on a knowledge of
their individual tumor and also their genetic predisposition to [drug] toxicity."
But
even though research continues to bear fruit every year, some of these drugs come with a
high price tag. In fact, a study released earlier this week found that one year's supply
of Herceptin could cost $40,000 per patient.
"It's
true that the newer, targeted therapies are expensive," Horning said. "That's
why it's extremely important for us to learn more about how best to use them, to better
understand which patients will clearly benefit. For instance, one of the trials included
in this report compared [the effectiveness of] one year vs. two years of Herceptin use.
It's by addressing these types of questions scientifically that we can get answers on
how best to use these drugs."
Expensive
and imperfect as many of these therapies might be, real progress is being made against a
wide range of malignancies, Horning added.
"This
progress has been the result of an investment in research and the dedication of patients
and researchers who've participated in clinical trials -- they've brought about these
advances," she said.