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Brain Cancer Pills Extend Survival for More Patients
Patients stay home, take a pill instead of IV chemotherapy
Aug. 21,
2003 - A new brain cancer treatment shows promise at keeping more
patients alive longer than the best current standard treatments for
the disease. The treatment is a combination of two cancer-killing
drugs that can be taken orally as pills, making it easier on those
patients who have already undergone difficult surgery, radiation or
traditional, intravenous chemotherapy.
A doctor
at the James P. Wilmot Cancer Center developed preliminary findings
that were presented recently at the American Society of Clinical
Oncology annual meeting in Chicago, and now the study is continuing
for adults and will be expanded to include children nationwide.
"It's not
a miracle, but it's a piece of the struggle against brain cancer,"
says David N. Korones, M.D., principal investigator and associate
professor of Pediatrics, Oncology, and Neurology at the University of
Rochester Medical Center. "It's a new, somewhat innovative approach
that has merit and offers better tolerance than traditional
chemotherapy. It makes life much easier for these patients. Patients
can stay home and simply take a pill, instead of coming into the
hospital for several hours to be tethered to an IV."
Korones is
the first to investigate the effectiveness of temozolomide and
etoposide, given together for patients with recurrent malignant glioma,
the most common brain tumor in adults. Each of the drugs, which have
been approved by the Food and Drug Administration, has been used
separately with some success. But Korones noticed that laboratory data
showed synergies between the two medications, and he theorized they
may work better in tandem.
Among the
24 adult patients he has followed so far, 16 percent saw their tumors
shrink and 35 percent were stable with no disease progression after
six months, compared to 10-20 percent of patients who stabilize after
traditional chemotherapy. The results are encouraging, he says; the
median survival time for brain cancer that recurs is just six months.
The
medications have been reasonably well tolerated. With no need to come
into the hospital for IV therapy, patients can stay home and report
weekly for blood tests. In a pilot study of four children aged 10 or
older, using doses comparable to the adults, Korones also noted that
side effects were minimal, and the tumors shrunk dramatically.
Brain
cancer consists of a mass of cells that do not belong there. But for
cancer-fighting drugs to reach the mass, first they must be able to
pass through the blood-brain barrier, which is cleverly designed to
keep out toxins. Temozolomide and etoposide are effective at passing
through the barrier, Korones says.
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