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Cancer Group Lists Top Treatment Advances for 2005

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http://www.forbes.com/lifestyle/health/ ... 29474.html

By E.J. Mundell

HealthDay Reporter

FRIDAY, Dec. 2 (HealthDay News) -- 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.

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