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Measuring Medicine: How new technologies
could help doctors predict patient outcomes
Newswise — As potential cancer therapies proliferate,
researchers and clinicians are striving to
measure their effectiveness and to more
accurately predict which patients will
receive the most benefit.
At the American Association for Cancer Research 2008 Annual
Meeting, April 12-16, 2008, researchers
present data on a new role for MRI in brain
cancer, how doctors can more effectively
measure response to commonly used cancer
drugs, and a unique method for predicting
the risk of breast cancer spread.
A phase II study of the efficacy and tolerability of
lapatinib in patients with advanced
hepatocellular carcinomas: Abstract LB306
Results of a phase II trial suggest that lapatinib, currently
approved for breast cancer treatment, shows
promise for stabilizing disease in patients
with liver cancer.
“Lapatinib is well-tolerated and may have some activity in
hepatocellular carcinoma (HCC),” said Joseph
Markowitz, M.D., Ph.D., a researcher at The
Ohio State University, who works with Tanios
Bekaii-Saab, MD, the principal investigator
on the study. “More work is needed to
understand the underlying molecular
mechanisms of this cancer.”
HCC rates are rising in the United States, which correlates
with the increase in hepatitis C-related
liver disease, a known risk factor for HCC,
Markowitz says. “There is also a link to an
increased incidence of what we call ‘fatty
liver’ as a result of the increasing rates
of obesity and diabetes mellitus in the U.S.
population.”
Lapatinib blocks the activity of the tyrosine kinase of both
epidermal growth factor (EGFR) and HER2/neu,
Markowitz says. “A dual inhibitor such as
lapatinib should be effective in patients
who express one or both receptors. Given the
lack of curative or even modestly effective
treatment options for patients with advanced
hepatocellular carcinomas, new therapies are
desperately needed,” he said.
Markowitz, Bekaii-Saab and colleagues assessed the efficacy
of lapatinib as an HCC treatment in a phase
II trial with 26 participants.
Patients took a 1,500 mg oral lapatinib dose daily throughout
a 28-day cycle. The median number of cycles
during the trial was two with some patients
receiving as few as one cycle and some
receiving as many as 12 cycles. The
researchers performed radiological
assessments every eight weeks.
In this study, where 20 percent of all patients had previous
treatment before receiving lapatinib, there
were no objective responses. However, 31
percent of all patients receiving lapatinib
had stable disease; 8 percent had stable
disease lasting longer than six months.
The most common toxicities were diarrhea (69 percent) and
nausea (54 percent).Three patients had more
severe toxicities including diarrhea, rash
and acute renal failure. Researchers found
no evidence of cardiac dysfunction. Side
effects were considered tolerable.
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