Navigation Links
Adding a Cancer Drug May Make Matters Worse
Date:2/4/2009

Finding underscores need for studies in people, not just animals, expert stresses

WEDNESDAY, Feb. 4 (HealthDay News) -- In a rude reminder that medicine is not yet an exact science, a Dutch study has found that adding a fourth anti-cancer drug to a three-medication treatment actually makes things worse for people with advanced colorectal cancer.

"The lesson is that there may be negative interactions between those inhibitors that may be detrimental to those patients, even when animal studies show benefits," said Dr. Cornelis J.A. Punt, a professor of medical oncology at Radboud University Nijmegen Medical Center in the Netherlands and lead author of a report in the Feb. 5 issue of the New England Journal of Medicine.

That lesson applies to proposed new treatments of all forms of cancer, Punt said. "A lot of new drugs are being developed that work through all sorts of new pathways," he said. "You should carefully design your studies of them before you use them in general practice."

The study of 755 people whose colorectal cancers had spread to other parts of the body was done because not only animal studies but two smaller human trials had found benefits from adding the antibody cetuximab (Erbitux) to a standard three-drug regimen of bevacizumab (Avastin), oxaliplatin (Eloxatin) and capecitabine (Xeloda), Punt said.

Each drug works in a different way. Capecitabine and oxaliplatin kill cancer cells directly, whereas bevacizumab inhibits vascular endothelial growth factor, a natural molecule that promotes cell division. Cetuximab inhibits the activity of another molecule, epidermal growth factor.

Yet the average survival time for people in the trial who got the four-drug combination was 9.4 months, compared with 10.7 months for those given the three-medication regimen. Also, adverse drug reactions were more frequent in those given the four drugs.

The reason for the negative results is unclear, Punt said. "It could be aggression between the antibodies of which the nature is unknown," he said. The fact that fewer side effects were seen in the animal studies could offer a clue, Punt said: "If you see less toxicity in the experimental animals, somehow the biological effect is less."

The finding holds a lesson applicable to all new treatments for cancer and other diseases, such as AIDS and tuberculosis, according to Dr. Robert J. Mayer, a professor of medicine at Harvard Medical School and vice chairman for academic affairs at the Dana-Farber Cancer Institute, who wrote an editorial accompanying the study.

"The message is that the way you learn whether adding more drugs to the treatment you have is beneficial is by conducting a proper clinical study," Mayer said.

There is an established belief, he said, that adding new drugs that have different modes of action to therapy will be beneficial. "But these are new classes of molecules, molecularly targeted treatments," Mayer said. "There can be cross-talk between one element of a cell and another. Even though the side effects may not be overlapping, the notion that the overall effect always will be beneficial doesn't seem to be true."

Living cells are complex machines, Mayer said. "The simple notion is that, like driving a car, you can turn the key and start running seven or eight steps under the hood, and that the same thing happens in a cell," he said. "That doesn't fully appreciate all those steps that might be occurring."

It's just not possible to predict what will happen when a new agent is added to a cancer treatment, Mayer said. "We must do these large and admittedly very expensive clinical trials," he said. "These aren't trivial undertakings. But we certainly have the enthusiasm and encouragement that having these molecules can provide benefit."

More information

The U.S. Cancer Institute has more on colorectal cancer.



SOURCES: Cornelis J. A. Punt, M.D., Ph.D., professor, medical oncology, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands; Robert J. Mayer, professor, medicine, Harvard Medical School, Boston; Feb. 5, 2009, New England Journal of Medicine


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Study: Adding Vimpat significantly reduces partial-onset seizures in adults with epilepsy
2. HC Innovations Expands Management Team, Adding Vice President of Human Resources
3. Adding Eccentric Resistance Training Improves Muscle Strength Following ACL Surgery
4. Hill-Rom Announces Agreement with Encompass Therapeutic Support Systems Adding New Surface Choice for Use with Hill-Rom Frames
5. CaringBridge(R) Enhances Web Service by Adding Printable CaringBook Option
6. Adding Light Eases Behavioral Problems of Dementia
7. %DV: Adding Up a Balanced Diet
8. Adding epratuzumab to standard therapy
9. Adding ultrasound screening to mammography brings benefits, risks
10. Freeland, MI Woman Wins $50,000 for Losing Weight, Adding Muscle and Changing Her Life
11. Microsoft Dynamics CRM 4.0 Users now can include Telephony and Call Recording features by adding ConversationPRO(TM) from VoiceGate, a Division of IgeaCare Systems Inc.
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Adding a Cancer Drug May Make Matters Worse
(Date:2/5/2016)... (PRWEB) , ... February 05, 2016 , ... Today, the ... , announced that the much-anticipated feature with author Jahnavi Foster, specialist in healthy vegetarian ... TV Network. , Each week, on his weekly Whole-Food Warrior TV show, Frank Davis ...
(Date:2/5/2016)... ... February 05, 2016 , ... ... addition of micro-needling services in their Napa Valley office. The technique utilizes the ... Surgery Associates, Dr. Canales and Dr. Furnas, are part of only a select ...
(Date:2/5/2016)... Florida (PRWEB) , ... February 05, 2016 , ... ... non-profit organization devoted exclusively to funding innovative lymphoma research and serving the lymphoma ... – is poised to once again host, Swirl, A Wine Tasting Event at ...
(Date:2/5/2016)... ... 05, 2016 , ... Regular gym users know the routine: each January, they ... access the treadmills. It’s a predictable trend. After the excesses of November and December, ... shape by joining gyms, starting new walking or running routines, or signing up for ...
(Date:2/5/2016)... , ... February 05, 2016 , ... At its annual ... Patrick McDermott as Chairman of the National Board of Directors. Mr. McDermott succeeds former ... the Board,” stated Leslie A. Chambers , APDA President and CEO. “Pat has ...
Breaking Medicine News(10 mins):
(Date:2/5/2016)... , Feb. 5, 2016 Amgen (NASDAQ: AMGN ... Annual Global Healthcare Conference at 9:15 a.m. ET on Wednesday, ... . David W. Meline , executive vice president and ... Live audio of the presentation can be accessed from the ... A replay of the webcast will also be available on ...
(Date:2/5/2016)... , Feb. 5, 2016  Patients in Alabama ... focused ultrasound (HIFU) therapy no longer have to travel out ... its partnership with Urology Centers of Alabama to ... FDA-cleared procedure for qualifying patients. Alabama ... in the treatment of prostate cancer using many different modalities. ...
(Date:2/5/2016)... , February 5, 2016 ... Research report states that the global active pharmaceuticals ingredients ... is predicted to reach US$185.9 bn by 2020. It ... from 2014 to 2020. The title of the report ... Manufactured, by Geography, and by Therapeutic Area) - Global ...
Breaking Medicine Technology: