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Oncology Conference Briefing
2008 - American Society of Clinical Oncology - 44th Annual Meeting
By American Society of Clinical Oncology
Jun 3, 2008 - 10:07:13 AM

The American Society of Clinical Oncology - 44th Annual Meeting was held in Chicago, May 30 - June 3, 2008. The following is a briefing of some of the articles presented at the conference.

Anti-Bone-Loss Drug (Zoledronic Acid) Reduces Recurrence Risk in Early Breast Cancer Patients

Researchers report that zoledronic acid (Zometa), a drug used to treat bone metastases and recently approved to treat osteoporosis, also lowers the risk of breast cancer recurrence in premenopausal patients with early-stage disease who have undergone surgery and are receiving ovarian suppression and hormone therapy. All women in this multicenter phase III trial had cancer that was estrogen-receptor- or progesterone-receptor-positive.
Preclinical research suggested the drug might also have an anticancer effect.

The study, multicenter phase III trial ( ABCSG-12), enrolled 1,803 patients who were undergoing drug-induced ovarian suppression (using goserelin), who previously had surgery to remove the primary tumor and whose cancer had spread to ten or fewer lymph nodes. The study had four arms: treatment with the hormone therapies tamoxifen or anastrozole, with or without zoledronic acid. Tamoxifen is given as a standard adjuvant treatment after surgery in both pre- and post-menopausal women who have hormone-responsive tumors. Anastrozole also is approved for hormone-responsive tumors, but only in post-menopausal women, a condition that ovarian suppression with goserelin simulates.

At 60 months follow up the risk of recurrence was reduced by 35% when compared to hormone therapy alone. There was also a nonsignificant trend for better overall survival in patients that received zoledronic acid. The treatment was well tolerated in all four groups and there were no unexpected side effects.

Source:
M. Gnant et al. Adjuvant ovarian suppression combined with tamoxifen or anastrozole, alone or in combination with zoledronic acid, in premenopausal women with hormone-responsive, stage I and II breast cancer: First efficacy results from ABCSG-12. ASCO 2008 - Abstract # LBA4.

Bevacizumab Slows Cancer Growth in Patients Newly Diagnosed with Advanced Breast Cancer

A large, international trial ( AVADO trial) has shown that adding the targeted therapy bevacizumab (Avastin) to the chemotherapy drug docetaxel (Taxotere) slows disease progression in patients without prior chemotherapy for locally advanced or metastatic breast cancer. Bevacizumab targets the blood vessels that feed tumors and is known as an antiangiogenic drug.

Previous studies have shown that adding bevacizumab to paclitaxel (Taxol, a taxane chemotherapy agent similar to docetaxel) for patients with metastatic breast cancer doubles progression-free survival. This is the first phase III trial to evaluate bevacizumab in combination with docetaxel, a drug that is used much more commonly in Europe, Asia, and Australia, while paclitaxel is used more often in the United States.

In February, the U.S. Food and Drug Administration approved bevacizumab in combination with paclitaxel for the treatment of newly diagnosed metastatic breast cancer; the drug was previously approved to treat colorectal cancer.

In the current study, 736 patients were randomized among three arms: placebo plus docetaxel, a higher dose of bevacizumab ( 15 mg/kg) plus docetaxel, and a lower dose of bevacizumab ( 7.5 mg/kg) plus docetaxel. The higher dose was the standard that was established in earlier breast cancer
studies; the lower dose was the standard used to treat colorectal cancer.

After a median follow-up of 11 months, investigators found that patients in the low-dose group were 21 percent less likely to have their disease progress, compared with those who received docetaxel alone. Patients in the high-dose group were 28 percent less likely to have their disease progress compared with those who received docetaxel only. The percentage of patients who had their tumors shrink was 44.4 percent in the placebo plus docetaxel group ( response rate 55.2 percent in the low-dose bevacizumab group, and 63.1 percent in the high-dose group. Because of the number of patients in the trial, it was not possible to statistically compare the two doses with each other.

Patients in the two bevacizumab groups had a slightly higher rate of severe side effects: 74.8 percent in the low-dose group and 74.1 percent in the high-dose group, compared with 67.0 percent in the docetaxel alone group. The most common side effect attributed to bevacizumab was high blood pressure, which was treatable with medication. Severe bowel perforation, a toxicity seen in some other bevacizumab trials, occurred in few patients: two patients in the placebo arm, and one patient in each of the experimental arms.

Source:
D. Miles, et al. Randomized, double-blind, placebo-controlled, phase III study of bevacizumab with docetaxel or docetaxel with placebo as first-line therapy for patients with locally recurrent or metastatic breast cancer (mBC): AVADO. ASCO 2008 -
Abstract # LBA1011^.

Vaginal Brachytherapy Just as Effective as External Beam Radiation for endometrial cancer

Vaginal brachytherapy is as effective as external beam radiation therapy at preventing the recurrence of endometrial cancer, and causes fewer side effects.

Gemcitabine Improves Survival in Patients with Early-Stage Pancreatic Cancer

Gemcitabine (Gemzar) significantly increases survival for patients who have undergone surgery for early-stage pancreatic cancer – the first time chemotherapy has been shown to benefit these patients. Historically, there have been very few effective treatments for pancreatic cancer.

Everolimus Delays Progression in Patients with Metastatic Kidney Cancer

The experimental targeted therapy everolimus (RAD001, Cetican) improves progression free survival for patients whose advanced kidney cancer has progressed after other treatments – a finding which could lead to increased use of the drug earlier in the course treatment.


Plenary Study Links KRAS Status to Effectiveness of Cetuximab in Colon Cancer Patients

Researchers reported that patients with newly diagnosed metastatic colorectal cancer are most likely to benefit from the monoclonal antibody cetuximab (Erbitux) when their tumors contain the normal form of the gene KRAS, compared to patients who have tumors that contain a mutated form of the gene.

Cetuximab with Chemotherapy Improves Survival in Patients with Advanced Non-Small Cell Lung Cancer

A study finding that the targeted therapy cetuximab (Erbitux) combined with platinum-based chemotherapy is effective as a first-line treatment for patients with advanced non-small cell lung cancer.

Single Dose of Chemotherapy as Effective as Weeks of Radiation Therapy for Testicular Cancer

A study showing that a single dose of carboplatin chemotherapy is as effective and less toxic than radiation therapy in preventing recurrence after surgery for early-stage testicular cancer. Testicular cancer is the most common form of cancer in younger men, with 8,000 cases annually.

OHSU Cancer Institute finds that drug stimulated immune system in prostate cancer
In a multi-site study, Oregon Health & Science University Cancer Institute researchers have found that a drug called Ipilimumab, also known as MDX-010, works to stimulate the body's own immune system to fight prostate cancer. The drug was found to be effective in study participants with a serious type of prostate cancer -- one where the tumor has spread and was resistant to hormonal treatment and, in some cases, also to chemotherapy.

Metformin increases pathologic complete response rates in breast cancer patients with diabetes
Metformin, the common first-line drug for type 2 diabetes, may be effective in increasing pathologic complete response rates in diabetic women with early stage breast cancer who took the drug during chemotherapy prior to having surgery, paving the way for further research of the drug as a potential cancer therapy, according to researchers at the University of Texas M. D. Anderson Cancer Center.

New treatment combination safe for pancreatic cancer patients
Treating pancreatic cancer with a combination of chemotherapy, biotherapy and radiotherapy prior to surgery is safe and may be beneficial for patients, according to a University of Pittsburgh Cancer Institute study presented at the 44th annual meeting of the American Society of Clinical Oncology. In a preliminary study, physicians from the University of Pittsburgh Medical Center Cancer Centers examined the safety of combining gemcitabine with bevacizumab and radiotherapy in patients with operable pancreatic cancer.

Vaccine may double survival in patients with deadly brain tumors
A vaccine aimed at inducing immunity to the most common and deadly type of brain tumor may stave off recurrence and more than double survival in patients, according to a new study led by researchers in Duke's Preston Robert Tisch 

New treatment combination proves safe, effective for head and neck cancer patients
The addition of cetuximab to chemotherapy may benefit patients with locally advanced head and neck cancer, according to a University of Pittsburgh Cancer Institute phase II study. The results of the study will be presented at the 44th annual meeting of the American Society of Clinical Oncology in Chicago as an oral presentation. This is the first time cetuximab has been used in combination with docetaxel and cisplatin as induction therapy.

New combination therapy safe, promising for melanoma patients
Researchers in the melanoma and skin cancer program at the University of Pittsburgh Cancer Institute combined two biotherapies, high-dose interferon alfa-2b and tremelimumab, and found the combination may be beneficial for patients with inoperable melanoma. The study has since moved into the second stage, where it will enroll 21 additional patients.

Acupuncture reduces pain and dysfunction in head and neck cancer patients after neck dissection
New data from a randomized, controlled trial found that acupuncture provided significant reductions in pain, dysfunction, and dry mouth in head and neck cancer patients after neck dissection. 

Survivors of childhood Hodgkin's lymphoma at higher risk of future health problems
Adults who survived childhood Hodgkin's Lymphoma should be especially vigilant about cancer and cardiovascular screenings, according to researchers from Wake Forest University Baptist Medical Center and colleagues.

Eribulin mesylate demonstrated anti-tumor activity in patients with advanced breast cancer
The investigational chemotherapeutic agent eribulin mesylate (E7389) demonstrated activity in a heavily pretreated population of women with locally advanced or metastatic breast cancer, according to results of a multi-center Phase II clinical trial. The study also suggests that eribulin mesylate has a manageable tolerability profile, with a low incidence of Grade 3 (severe) and no Grade 4 (disabling or life-threatening) neuropathy.

Other news

A study examined whether elderly patients were more likely to experience hematological side effects from chemotherapy if they took anti-cancer drugs that inhibited cytochrome p450 or interfered with protein binding. (Vew Summary)

Researchers evaluated whether a test measuring messenger RNA levels of the erythropoietin receptors in the tumors of patients with head and neck cancer predicted whether they experience tumor progression after taking the anemia drug erythropoietin. (View Summary)

Investigators developed a RNA blood test that may help detect lung cancer early in smokers. (View Summary)

A study evaluating whether celecoxib (Celebrex, a COX-2 inhibitor) is a potential chemopreventive agent for lung cancer in current and former smokers. (View Summary)

A study assessing whether PET/CT is superior to standard CT for staging disease in patients with lung cancer. Accurate cancer staging is critical to determining whether patients will benefit from surgery. (View Summary)



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