Wednesday, December 24, 2008

The war against cancer gathered steam in 2008, as new drugs tackled the toughest cancers with some success, and advances were made in both disease prevention and risk factor identification.

A new report from the American Society of Clinical Oncology (ASCO) details 12 "major" advances and 19 "notable advances" across the gamut of cancer prevention, screening, treatment and survival in the past year.

"These specific advances . . . reflect a maturation, if you will, of the whole approach of personalized medicine to oncology care," said ASCO President Dr. Richard L. Schilsky, a professor of medicine at the University of Chicago Medical Center. "And some of the reports deal with targeted therapies being used in a broader array of diseases. We're beginning to see the utility of targeted therapies expand across many, many diseases, and we're increasingly able to identify those patients who are most likely to benefit from those targeted therapies."



The report was expected to be published online Dec. 22 in the Journal of Clinical Oncology.

One of the most impressive reports of the year serves as a backdrop to these advances, pointed out Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. That was a study showing the first reported decline in the number of U.S. men and women developing and dying from cancer.

Nevertheless, some 1.4 million people received the devastating diagnosis of cancer in 2008, and half a million people died from the disease.

Following are the 12 major advances of 2008 identified by ASCO, divided into six general areas and not ranked in order of importance.

In the area of hard-to-treat cancers:

Cetuximab (Erbitux), a monoclonal antibody, when added to chemotherapy, increased overall survival by as much as 21 percent in patients with non-small cell lung cancer which expressed the epidermal growth factor receptor (EGFR). Patients receiving Erbitux in a recent trial lived an average of 11.3 months vs. 10.1 months in those receiving a placebo. Lung cancer is the number-one cancer killer among men and women; only 5 percent of those diagnosed with this type of lung cancer survive five years. The new chemotherapy drug Gemcitabine (Gemzar) doubled disease-free survival from 6.9 months to 13.4 months in pancreatic cancer patients, and increased overall survival from 20.2 months to 22.8 months in patients with early-stage pancreatic cancer who had undergone surgery. Again, only 5 percent of people receiving this diagnosis live five years.

In the area of new drug approvals:

Bendamustine (Treanda) "eliminated" chronic lymphocytic leukemia (CLL) in one-third of patients compared with 2 percent who went with current standard therapy, and extended survival without a recurrence to 21.7 months from 9.3 months. The drug was approved in March of 2008 and is now indicated as first-line treatment for the disease.Bevacizumab (Avastin), another monoclonal antibody, was approved (in conjunction with the chemotherapy drug paclitaxel (Taxol) for women with previously untreated HER2-negative, metastatic breast cancer. A trial the year before had found the combination doubled disease-free survival compared with women receiving chemo alone. A second trial, this one from 2008, confirmed the findings.

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