Second-line CML Drug Evokes Faster Response, Fewer Side Effects
In a multinational Phase III study, MD Anderson researchers found that treating chronic myeloid leukemia (CML) patients with dasatanib as a first therapy rather than the existing front-line drug, imatinib, or Gleevec®, provided quicker, better responses.
Hagop M. Kantarjian, M.D., professor and chair of MD Anderson’s Department of Leukemia and corresponding author on the study, published in the New England Journal of Medicine, presented the findings at the 46th Annual Meeting of the American Society of Clinical Oncology (ASCO) in June.
While imatinib is the approved initial therapy for CML and has increased the five-year survival rate from 50 percent to 90 percent, says Kantarjian, 30-40 percent of CML patients taking imatinib do not achieve confirmed cytogenic complete response, or the absence of the defective chromosome that causes the disease, within a year. Moreover, patients taking dasatanib had fewer side effects such as nausea, vomiting, muscle inflammation, rash and fluid retention.
“We’ve learned in cancer therapy that it’s important to use your big guns up front,” says Kantarjian. “Achieving complete cytogenetic response within a year of starting treatment is associated with more favorable long-term survival. Using this second-generation drug first will likely improve outcomes for patients with chronic myeloid leukemia.”
The study was supported by Bristol-Myers Squibb, makers of dasatinib.
CA-125 Blood Test Shows Promise in Detecting Ovarian Cancer
CA-125, the protein long recognized for predicting ovarian cancer recurrence, shows promise in screening for early-stage disease.
In conjunction with the ASCO annual meeting in June, Karen H. Lu, M.D., a professor in MD Anderson’s Department of Gynecologic Oncology, presented the findings of a prospective, single-arm study of more than 3,000 women enrolled from seven sites across the country. MD Anderson is the lead site of the ongoing study, and Lu is principal investigator.
If a larger study shows survival benefit, the simple blood test to detect CA-125 could be used to screen for ovarian cancer in post-menopausal women at average risk for the disease, which when caught early is “not just treatable but curable,” says Lu.
Robert C. Bast, M.D., vice president for translational research at MD Anderson and co-investigator on the ASCO study, discovered CA-125 and its predictive value of ovarian cancer recurrence in the 1980s.
“With these findings, I’m cautiously optimistic that in the not too distant future we may be able to offer a screening method that can detect ovarian cancer in its earliest, curable stages and make a difference in the lives of women with this now-devastating disease,” says Lu.
The National Cancer Institute supported the study, a research project of MD Anderson’s ovarian cancer Specialized Programs of Research Excellence (SPORE). Golfers Against Cancer, The Jane P. and Wiley L. Mossy Jr. Foundation, the Tracy Jo Wilson Ovarian Cancer Foundation and the Norton Fund also provided funds for the project.
Selenium Shows No Benefit in Preventing Lung Cancer
An international Phase III clinical trial sponsored by the National Cancer Institute has found selenium, a supplement taken daily by millions in hopes of protection against cancer and other diseases, to be of no benefit in reducing a patient’s risk of developing lung cancer, either a recurrence or second primary malignancy. Daniel D. Karp, M.D., a professor in MD Anderson’s Department of Thoracic/Head and Neck Medical Oncology, presented results of the decade-long study, initiated by the Eastern Cooperative Oncology Group, at ASCO’s annual meeting in June.
“Our results demonstrate that selenium is not an effective chemoprevention agent in an unselected group of lung cancer patients, and it’s not something we can recommend to our patients to prevent a second cancer from developing or recurring,” says Karp, the study’s principal investigator.
Heated Chemotherapy: New Option for Rare Abdominal Cancer
A study at MD Anderson published in the Journal of Pediatric Surgery has found that adapting an adult surgical procedure called hyperthermic intraperitoneal chemotherapy (HIPEC) or “heated chemotherapy” can increase the survival of children with rare and aggressive tumors in the abdomen. Andrea Hayes-Jordan, M.D., an assistant professor and pediatric surgical oncologist at the MD Anderson Children’s Cancer Hospital, is the first and only surgeon in the country to perform the adult procedure on children.
Before using HIPEC, Hayes-Jordan spends 10 to 12 hours removing, or debulking, the hundreds of tumors in a patient’s abdominal cavity. Then she runs the chemotherapy, heated at 40 to 41 degrees Celsius (104 to 106 degrees Fahrenheit), throughout the cavity while the patient lies on a cooling blanket to keep body temperatures at a safe level. The chemotherapy helps to kill microscopic tumor cells left behind after the debulking surgery. Within one to two months, patients are often fully recovered from surgery and back to regular activities.
“We really are encouraged that this is going to help many children with abdominal tumors,” says Hayes-Jordan, first author of the paper. “We’re sharing this technology with other centers. In the years to follow, we hope to try different chemotherapies with the procedure to better the outcomes and decrease any toxicities.”