Patients suffering from the most common type of lung cancer experienced a 20-percent improvement in overall survival in a national clinical trial of a drug that chokes off the blood vessels nourishing tumors, a multicenter study has found.
Dr. Joan Schiller, chief of hematology/oncology at UT Southwestern Medical Center, said: "This is great news for lung cancer patients -- they live longer, and the side effects from Avastin are unlike those of conventional chemotherapy. For example, Avastin does not cause hair loss, nausea, or vomiting."
Results of the Phase III trial involving 878 patients that was conducted by the Eastern Cooperative Oncology Group are reported in the Dec. 14 issue of the New England Journal of Medicine. The publication of the study comes two months after the Food and Drug Administration approved the drug bevacizumab, known under the trademark Avastin, as a first-line treatment for patients with inoperable, locally advanced, recurrent or metastatic non-squamous, non-small cell lung cancer. The FDA approval was based on the findings of the study.
The results of the trial showed that patients who received Avastin along with the conventional chemotherapy drugs paclitaxel and carboplatin had a 35-percent chance of responding to the treatment, compared to 15 percent for patients who received chemotherapy alone.
Dr. Schiller is chairwoman of the Lung Cancer Committee for the Eastern Cooperative Oncology Group, which designed and conducted the study.
"Twenty years ago, we thought no treatment could help patients with advanced lung cancer," said Dr. Schiller, deputy director of the Harold C. Simmons Comprehensive Cancer Center at UT Southwestern. "Ten years ago, we found that chemotherapy could improve survival of these patients. Now, we are finding out that this very unique drug called Avastin can also help improve survival even more. Avastin is the first of this very exciting family of drugs to be approved for lung cancer, and there are several other drugs of this type under development which may prove to work even better."
The drugs in the class that includes Avastin are called anti-angiogenic therapeutics because they target the numerous small blood vessels supplying tumors with oxygen and nutrients and ensuring their continued growth. Anti-angiogenic drugs target a protein that plays an important role in the formation of new blood vessels in tumors. These drugs are called targeted therapeutics and have far fewer side effects than chemotherapy drugs because they spare healthy tissues and zero in on the cancer cells they seek to destroy.
Dr. Schiller said the researchers found that Avastin, developed by San Francisco-based Genentech, works well in combination with chemotherapy for a number of reasons.
"The reason for this is that the blood vessels in tumors normally do not allow the chemotherapy drugs to diffuse into the tumors well," she said. "In addition to choking off the tumor blood supply, Avastin also makes the remaining blood vessels healthier and enables them to diffuse the chemo drugs into the tumor better."
Dr. Schiller, president of the National Lung Cancer Partnership, an advocacy group of researchers and patients focused on raising awareness and research funds to fight the most lethal form of cancer, has dedicated her career as a medical oncologist to finding a cure for lung cancer.
The groups of patients she recruited for the study in conjunction with several major medical centers were seen by Dr. Schiller during her previous employment as a medical professor and lung cancer director at the University of Wisconsin.
Other researchers participating in the study came from Vanderbilt University, Nashville; Dana-Farber Cancer Institute, Boston; University of Missouri Ellis Fischel Cancer Center, Columbia, Mo.; Johns Hopkins University, Baltimore; University Hospitals of Cleveland; and Mt. Sinai Hospital, Miami.
The research was funded in part by Public Health Service Grants and grants from the National Cancer Institute, National Institutes of Health and the U.S. Department of Health and Human Services.
According to the American Cancer Society, lung cancer will kill an estimated 162,460 people in the United States in 2006 -- 90,330 men and 72,130 women -- and a projected 174,470 new lung cancer cases will be diagnosed.
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