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:6/23/2017)... ... 2017 , ... Studies show evidence that carotenoids and antioxidants derived either from ... these patients. , But how often do ophthalmologists and optometrists in Sweden recommend the ... of or with early symptoms of AMD? A study published recently in ...
(Date:6/23/2017)... ... 2017 , ... Everybody has their own personal preference when it comes to ... some people don't like it at all. FindaTopDoc took a look at what makes ... can give readers a taste of their deepest, darkest fantasies and has the ability ...
(Date:6/23/2017)... ... June 23, 2017 , ... Georgia State University will ... 20. , The two-day conference is focused on advancing scientific knowledge about the ... lives and eliminating racial breast cancer-related disparities. The conference theme is “Illuminating Actionable ...
(Date:6/23/2017)... ... June 23, 2017 , ... Ross Insurance ... With the Federal Emergency Management Agency’s (FEMA) recent update of flood zones, more ... 2012, the Biggert-Waters Act was enacted to reflect the actual risk in flood ...
(Date:6/23/2017)... ... June 23, 2017 , ... ... planning services to communities in the greater Chicago metropolitan area, is embarking on ... to underprivileged youth in Chicago. , Founded in 1897, Hephzibah Children’s Association is ...
Breaking Medicine News(10 mins):
(Date:6/8/2017)... 2017  Less than a month ago, amateur hackers ... companies, including hospital networks, in over 150 countries. ... the largest online extortion attempts ever recorded. With the ... is imperative that providers understand where the risks lie, ... — and many other very real cyber threats.  ...
(Date:6/7/2017)... 7, 2017  Novavax, Inc., (Nasdaq: NVAX ) ... 2 trials of its RSV F protein recombinant nanoparticle vaccine ... have been published in the journal Vaccine ... in prior scientific conferences). The Company previously announced top ... is developing the RSV F Vaccine with the goal of ...
(Date:6/3/2017)... INDIANAPOLIS , June 3, 2017  Eli ... today announced that results from the Phase 3 ... kinase (CDK)4 & 6 inhibitor, in combination with ... treatment with fulvestrant alone in women with hormone-receptor-positive ... advanced breast cancer who have relapsed or progressed ...
Breaking Medicine Technology: