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Experimental Chemotherapy Regimen shows
promise in treating advanced Lung Cancer
Newswise — A combination of chemotherapy
agents that have been tested in other tumor
types appears to be a promising alternative
to standard treatment for advanced non-small
cell lung cancer, according to a report in
the August 15 issue of Clinical Cancer
Research, a journal of the American
Association for Cancer Research.
In a phase II multicenter study of 56
patients with an advanced form of this
common lung cancer, endpoints including
response rate, progression-free survival,
and overall survival from use of S-1 and
irinotecan were similar to, or better than,
those reported from standard treatment with
platinum-based chemotherapy regimens.
Because the study had only a single arm –
meaning all patients received the
experimental therapy – the researchers
cannot say if this regimen offers more
benefit than standard treatment.
But they did report that side effects
resulting from the experimental therapy
appeared to be much less severe than those
typically seen with standard treatment.
“There continues to be reluctance on the
part of both patients and treating
physicians to accept the toxicity of
platinum-based therapy, given the associated
small gain in survival, so active therapies
with improved toxicity profiles are clearly
needed,” said the study’s lead investigator,
Isamu Okamoto, M.D., Ph.D., associate
professor in the Department of Medical
Oncology at the Kinki University School of
Medicine in Osaka, Japan.
Okamoto says that a direct comparison
between this experimental regimen and
platinum-based “doublet” chemotherapy should
be conducted to confirm what appears to be a
survival benefit among patients who used S-1
and irinotecan.
S-1 (also known as TS-1) is approved for use
in Japan and Korea, where it has shown
substantial benefit in treating gastric
cancer, but is still in clinical trials in
other countries, including the U.S. and
Europe.
The multifaceted agent, which is available
in capsule form, has three different
mechanisms of action.
One part breaks down into active
fluorouracil (5-FU) once it is in the body.
5-FU is a chemotherapy drug often used to
treat colorectal and other cancers.
Another part of S-1 keeps 5-FU production at
a steady level and a third part is designed
to counteract 5-FU's toxic effects, such as
nausea and vomiting.
Irinotecan, an intravenous drug originally
developed and tested in Japan and approved
for use in the U.S. in 1994, is most often
used to treat colon cancer.
It is currently being used in Japan to treat
lung cancer, but is not commonly used in
this way in other countries, says Okamoto.
The combination of these two agents appears
to offer a synergistic effect, he says. When
S-1 was tested as first-line chemotherapy
for advanced lung cancer, the response rate
was 22 percent with a median survival time
of 10.2 months.
In this study, patients who had not received
any treatment for their advanced lung cancer
were enrolled at 14 centers in Japan and
received a median of five cycles of
treatment.
The response rate for the combination
therapy was 28 percent, median
progression-free survival was 4.9 months and
median overall survival was 15 months.
Okamoto says these findings compare
favorably with previous studies of
platinum-based doublets, which demonstrated
response rates of 17 to 33 percent, a median
time to progression or progression-free
survival of three to five months, and a
median overall survival time of seven to 14
months.
“This is a promising alternative, but needs
further testing in randomized trials,” he
said.
The mission of the American Association for
Cancer Research is to prevent and cure
cancer.
Founded in 1907, AACR is the world’s oldest
and largest professional organization
dedicated to advancing cancer research.
The membership includes more than 28,000
basic, translational and clinical
researchers; health care professionals; and
cancer survivors and advocates in the United
States and 80 other countries.
AACR marshals the full spectrum of expertise
from the cancer community to accelerate
progress in the prevention, diagnosis and
treatment of cancer through high-quality
scientific and educational programs.
It funds innovative, meritorious research
grants. The AACR Annual Meeting attracts
more than 17,000 participants who share the
latest discoveries and developments in the
field.
Special conferences throughout the year
present novel data across a wide variety of
topics in cancer research, treatment and
patient care.
AACR publishes five major peer-reviewed
journals: Cancer Research; Clinical Cancer
Research; Molecular Cancer Therapeutics;
Molecular Cancer Research; and Cancer
Epidemiology, Biomarkers & Prevention.
Its most recent publication and its sixth
major journal, Cancer Prevention Research,
is dedicated exclusively to cancer
prevention, from preclinical research to
clinical trials.
The AACR also publishes CR, a magazine for
cancer survivors and their families, patient
advocates, physicians and scientists.
CR provides a forum for sharing essential,
evidence-based information and perspectives
on progress in cancer research, survivorship
and advocacy.
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