Cancer Therapy Center

Abraxane does not help patients live longer than an older treatment (Taxol), though it does shrink tumors in more patients, according to clinical trials. And the old and new medicines have similar side effects. An independent review of Abraxane published in December in a cancer research journal concluded that the drug was “old wine in a new bottle.”

Still, Abraxis BioScience, has promoted Abraxane as a major advance in treating late-stage breast cancer:

“We have a breakthrough,” he said. “Look at the data.”

The NY Times article describes the general formula:

ABRAXANE is a reformulated version of paclitaxel, a chemical found in the Pacific yew tree that destroys cancer cells. But paclitaxel, which is given intravenously, is difficult to use. Because it does not dissolve in water, the drug must be mixed in Cremophor, a combination of castor oil and alcohol that can cause severe allergic reactions. To reduce that risk, patients who receive Cremophor first receive a steroid and an antihystamine.

Working with University of Illinoisresearchers in the 1990’s, Dr. Soon-Shiong found a way to give Taxol without Cremophor by coating paclitaxel in fragments of albumin, a protein found in human blood. He named the new treatment Abraxane.

Abraxane patients do not need antihistamines or steroids. The drug can also be given at slightly higher doses and injected more quickly than traditional paclitaxel, which requires a three hour-infusion.

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A Reuters article (available at The Scotsman) today made clear that there exists a disconnect between researchers and patients in Europe:

Only 22 percent of 547 cancer patients in nine European countries who took part in a survey knew about or had a say in deciding to take hormone therapy after undergoing surgery to remove their tumour.

Women over 60 years old were the least involved in their treatment decisions. Most of the breast cancer patients questioned in the poll said they were dissatisfied with their level of involvement.

“An older patient with a lower level of education and no access to the Internet has no involvement and little information, regardless if she is Italian, British, Spanish or Swiss,” Dr Alberto Costa, the director of the European School of Oncology (ESO) in Milan, Italy, said in an interview.

Each year, nearly 350,000 women in Europe are diagnosed with breast cancer, a large majority of those women being over 50. As with most cancer, treatment depends heavily on the stage of the disease at diagnosis.

Surgery is performed to remove the tumour, radiotherapy is given to kill remaining cancer cells in the breast, and chemotherapy destroys cells that may have spread from the tumour site.

Hormone therapy includes the drug tamoxifen which has been used for decades. It interferes with the activity of the hormone oestrogen that can fuel tumour growth.

Newer drugs known as aromatase inhibitors are prescribed for post-menopausal women with hormone sensitive tumours to cut their risk of recurrence by blocking the enzyme aromatase which is needed to produce oestrogen. The drugs are usually taken for five years.

Without access or knowledge about tamoxifen and aromatase inhibitors, it’s likely that some women are experiencing recurrences that could likely be avoided. 

UPI is among those who point to a new study conducted at Massachusetts General in Boston that found that RF was able to kill Ovarian cancer cells that had spread to the liver:

Six patients with advanced ovarian cancer underwent radiofrequency ablation to destroy metastatic disease in their liver, and the procedure successfully eliminated all tumor cells in five of the six patients after only one session.

Gervais said her team followed the patients for between eight months and 3.3 years, and four of the five did not develop recurrent disease in the area the procedure destroyed.

“The treatment of ovarian cancer requires multi-modality approaches, including surgery and chemotherapy,” said Gervais, “but our study indicates that a small number of patients may benefit from radiofrequency ablation instead of repeated surgery.”

Like many new treatments, RF requires additional types of treatments to be completely effective, but this is a promising development for women diagnosed with ovarian cancer.

The Food and Drug Administration cleared Vectibix as a treatment for advanced colon cancer, the agency announced Wednesday. Vectibix is the first of nearly a dozen drugs currently under development at Amgen, the world’s largest Biotechnology company.

Analysts predict that doctors will begin treating colon cancer, the third most common form of cancer in American men and women, with Vectibix (also known as panitumumab) quickly, with over $300M in sales expected in the first year.

Approximately 110,000 adults are expected to be diagnosed with colon cancer next year, and over 55,000 will likely die.

Cancer Research UK notes that new US research has dramatically changed the current state of understanding of skin cancer. While the traditionally accepted causes (skin cell damage caused by UV radiation) remains the primary cause, researchers have isolated a compound in plants and used that chemical to induce tanning in mice that minimizes UV damage.

Tanning, sunburn and skin cancer are all caused by UV damage to skin cells.

Tanning occurs when the sun’s UV radiation stimulates the most common skin cells, known as keratinocytes.

These then release a hormone known as MSH which tells nearby melanocytes to produce a pigment called melanin, causing tanning.

Using a naturally-occurring compound derived from a plant, known as forskohlin, the researchers were able to simulate the chain of interactions that occurs when MSH stimulates melanocytes.

This created an effect similar to that of a sun tan, without exposing the skin to the sun’s damaging UV rays.

While a tan inducing compound will not alone protect fair skin (providing the equivalent of SPF4 sunscreen), it may allow fair-skinned individuals to obtain a tan in safe conditions, allowing them to skip intentional exposure and obtain a more natural tan than other synthetic tanning methods.

The TimesOnline has an article pointing to a British study indicating that breast cancer is up 80% (36,939 in 2004), but deaths have fallen by a fifth:

The rise has been blamed on dietary changes, an ageing population and because women are having smaller familes and breast-feeding less.

Mark Matfield, scientific consultant for the Association for International Cancer Research, said: “It is hard to pin down exactly what has caused this rise.” Lifestyle factors, such as the increase in obesity and alcohol consumption, had a significant impact “but so has the introduction of the national screening programme in the late 1980s”.

Lesley Walker, of Cancer Research UK, notes that 4 of 5 new cases of breast cancer appear in women over 50, and that both longer lifespans and increasing bodyweight are contributing to an increased risk of breast cancer.

“Fortunately, more women than ever are surviving breast cancer, thanks to early detection of the disease through the national screening programme and substantial improvement in treatments.” 

MOST COMMON IN WOMEN

36,939 (31.9 per cent of total) cases were breast cancer in 2004

13,020 (11.2 per cent) were bowel cancer

12,337 (10.7 per cent) were lung cancer

MOST COMMON IN MEN

29,406 (25 per cent) cases were prostate cancer in 2004

18,071 (15.3 per cent) were lung cancer

15,817 (13.4 per cent) were bowel cancer

Results from the largest study of men with prostate cancer treated with high-dose, intensity modulated radiation therapy (IMRT) show that the majority of patients remain alive with no evidence of disease after an average follow-up period of eight years. The 561 prostate cancer patients treated with IMRT at Memorial Sloan-Kettering Cancer Center were classified into prognostic risk groups. After an average of eight years, 89 percent of the men in the favorable risk group were disease-free and none of the men in any group developed secondary cancers as a result of the radiation therapy. This report, published in the October 2006 issue of The Journal of Urology, is the first description of long-term outcomes for prostate cancer patients using IMRT.

“Our results suggest that IMRT should be the treatment of choice for delivering high-dose, external beam radiotherapy for patients with localized prostate cancer,” said Dr. Michael J. Zelefsky, Chief of the Brachytherapy Service at Memorial Sloan-Kettering. “We were able to show long-term safety and long-term efficacy in a very diverse group of prostate cancer patients that we followed - many for as long as ten years. Despite the fact that some patients had an aggressive form of their disease with high Gleason scores and PSA (prostate specific antigen) levels, the overwhelming majority of patients had good tumor control with neither recurrence of their original cancer nor development of second cancers, which one might have expected from the high doses of radiation,” he added. Pre-treatment diagnostic evaluations were performed for all of the patients to better define their clinically localized prostate cancer. They were classified into prognostic risk groups as defined by the National Comprehensive Cancer Network guidelines (www.nccn.org). These are based on clinical characteristics including age, T stage, Gleason score, PSA level, and pre-treatment with neoadjuvant androgen deprivation.

Between April 1996 and January 2000, 561 patients with a median age of 68 (ranging from 46 to 86 years old) were treated with IMRT, an improved form of three-dimensional conformal radiation therapy (3D-CRT), also used in radiotherapy. IMRT uses enhanced planning treatment software that more precisely targets the prostate, allowing the beam of radiation to deliver a high dose (81 Gy) to the tumor target while sparing the adjacent bladder and rectum from exposure to the higher amounts of radiation. Perhaps because of this, the eight-year results show urinary continence was maintained for all patients, and only 1.6 percent of the five hundred sixty-one patients experienced rectal bleeding. The high-dose radiotherapy was curative for the majority of the patients in all three prognostic risk groups, with 89 percent of the favorable, 78 percent of the intermediate, and 67 percent of the unfavorable group alive after an average period of eight years. Of those men who were potent prior to IMRT, erectile dysfunction developed in 49 percent.

“This study confirms that we can improve patients’ quality of life by reducing the side effects of radiotherapy while maintaining disease-free survival,” said Dr. Zelefsky. “However, there is still room for improvement. We are incorporating image-guided approaches that may continue the excellent tumor control but further limit the area we are irradiating and reduce side-effects.”

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The study’s co-authors are Heather Chan, Margie Hunt, Yoshiya Yamada, MD, Alison M. Shippy, and Howard Amols, PhD, of Memorial Sloan-Kettering.

Memorial Sloan-Kettering Cancer Center is the world’s oldest and largest institution devoted to prevention, patient care, research, and education in cancer. Our scientists and clinicians generate innovative approaches to better understand, diagnose, and treat cancer. Our specialists are leaders in biomedical research, and in translating the latest research to advance the standard of cancer care worldwide.

Contact: Joanne Nicholas
Memorial Sloan-Kettering Cancer Center
 

Cancer is a class of diseases characterized by uncontrolled growth (division) of cells and the subsequent ability of these cells to invade other tissues. This growth may be through direct physical invasion, or by metastasis, the implantation of cancer cells into distant cells through transportation provided by the bloodstream or lymphatic system. The risk of cancer generally increases with age, as DNA damage becomes more apparent. It remains one of the principal causes of death in developed countries.

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