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Researchers Log Advances in Cancer Treatment

Oncology: Conference is told of promising data on chemotherapy for lung patients and other study results, but breakthroughs remain elusive.


Researchers have shown for the first time that chemotherapy can extend the lives of patients with metastatic lung cancer, the leading cancer killer of both men and women in the United States.

The current primary therapy for lung cancer is surgery; only about 25% of patients also receive chemotherapy, most of them during the early stages of the disease. Once the cancer has metastasized, or spread, there has been little that could be done for patients.

The promising results were just one of several advances in cancer therapy reported last week at a New Orleans meeting of the American Society for Clinical Oncology ( No major breakthroughs were revealed, but progress was noted in a variety of areas.

"We are still trying to hit a home run," said Dr. Charles Balch, executive vice president of the society, "but sometimes you hit a double that gets you across the plate. A lot of this is incremental progress."

Dr. David Gandara and his colleagues at the UC Davis Cancer Center have been treating lung cancer patients with docetaxel, a close relative of the well-known cancer drug Taxol. Docetaxel, trade named Taxotere, is derived from needles of the European yew tree, while Taxol is obtained from the Pacific yew.


Gandara's group treated 81 metastatic lung cancer patients, who had already undergone surgery, with radiation and a combination of the drugs cisplatin and etoposide, followed by docetaxel. He reported that 48% of the patients survived for at least two years and that the median survival was 20 months.

"This is a group of patients whose expected survival for two years would be less than 10%," Gandara said at a news conference. "Nothing in the literature parallels this kind of survival in this group of patients."

In contrast to the UC Davis study, Dr. Joan Schiller of the University of Wisconsin reported on clinical trials with several combinations of cancer drugs that did not include docetaxel. Her group found that treated lung cancer patients had a median survival of eight months, compared with six months for untreated patients. Just over a third of the treated patients survived for at least a year and 12% lived two years.

The American Cancer Society predicts that 164,000 Americans will be diagnosed with lung cancer this year and 157,000 will die of it.

In other research reported at the meeting:

* Controlling hot flashes: The hot flashes suffered by women following therapy for breast cancer can be eased by two common antidepressants, Prozac and Effexor, according to researchers at the Mayo Clinic in Rochester, Minn.

Physicians hesitate to use estrogen to treat the hot flashes because of the fear it might trigger a cancer recurrence. The antidepressants might also be useful for controlling hot flashes in post-menopausal women and men undergoing hormonal therapy for prostate cancer, said Dr. Charles Loprinzi.

A report last week from Georgetown University had reported similar success with the antidepressant Paxil. All of the drugs were studied in dosages smaller than those used for treating depression.

Loprinzi reported at the New Orleans meeting on a study of 229 breast cancer survivors who were divided into four groups. Three groups each received a different dose of Effexor, while the fourth received a placebo. The best results were obtained in the group receiving half the normal dose of Effexor. Those women reported 61% fewer hot flashes than the control group.

A small number of the women reported side effects that included nausea, dry mouth and decreased appetite. Loprinzi did not report results from the Prozac study. Another group is performing a similar study with the drug Zoloft.

* Therapy for stomach cancer: Researchers from St. Vincent's Cancer Center in New York City have scored the first improvement in therapy of stomach cancer in more than a decade. An estimated 21,900 Americans will be diagnosed with stomach cancer this year, and 13,500 people will die of it. The disease is commonly treated only by surgical removal of the tumor, because chemotherapy has not previously shown any benefit.

Dr. John S. McDonald and his colleagues studied the use of radiation therapy along with the drugs leukovorin and 5-fluorouracil after surgery. They enrolled 556 stomach cancer patients in the nine-year study. Half of the patients received only surgery, while half received the new regimen.

McDonald reported at the New Orleans meeting that, after three years of treatment, 49% of those receiving the new regimen were disease-free, compared to only 32% of those receiving surgery alone. Overall survival at three years was 52% for those receiving the drugs, compared to 41% receiving surgery alone.

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