07 June 2010

Advances Reported Against 2 Cancers

Boston Globe

Using two opposite strategies, scientists say they have made significant progress in taming two of the most intractable types of cancer.

One approach, highly focused on specific types of tumors, shrank them significantly in 57 percent of patients with a lung cancer marked by a specific genetic abnormality.

Even though the clinical trial was small (just 82 people, with no control group), the results were considered so striking for such sick patients that the study will be featured today at the American Society of Clinical Oncology conference.

“This is a phenomenal example of finding the right patient and the right drug very early on,’’ said Dr. Pasi A. Janne of Dana-Farber Cancer Institute in Boston, who was involved in the trial.

The other strategy is a potentially universal treatment for all types of cancer that works by releasing a brake on the body’s immune system, letting the immune system attack the cancer more vigorously.

In a study of patients who had advanced melanoma, those who got an experimental drug lived a median of about 10 months, compared with 6.4 months for those in a control group.

Bristol-Myers Squibb, which sponsored the trial, is planning to apply for regulatory approval to sell the drug, ipilimumab.

The lung cancer drug, by contrast, blocks an aberrant protein called ALK that is found in only about 5 percent of non-small-cell lung tumors. But in patients whose tumors have this aberration, the drug seems to work wonders. Not only did the tumors shrink in 57 percent of the 82 patients, they remained stable in 30 percent more.

Pfizer, which sponsored the study, has started a more definitive trial aimed at winning approval of the drug, crizotinib.

There are caveats. The effects of crizotinib can eventually wear off, though 72 percent of the patients in the trial were free of cancer progression for six months.

As for the melanoma drug, because it removes checks on the immune system, 10 percent to 15 percent of patients who took it in the study suffered severe side effects that had to be treated with immune-damping steroids. Seven patients out of 540 who got ipilimumab died from these immune effects, according to a report of the study published online yesterday by The New England Journal of Medicine.

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