Colon Cancer

[Guest guest]

In colon cancer drug study, more wasn't better

By STEPHANIE NANO, Associated Press Writer Nano, Associated Press

Writer – 20 mins ago

Play Video Cancer Video: Dodgers Go To Bat For Cancer Patients CBS 2 / KCAL 9

Los Angeles

Play Video Cancer Video: Doctors Remove Tumor From Haitian Boy's Arm WJZ 13

Baltimore

 

 

NEW YORK – Doctors thought that combining two newer drugs that more precisely

attack cancer would help people with advanced colon cancer. Instead, it made the

cancer worse and made the patients more miserable, a study found. The surprising

findings underscore the importance of doing rigorous studies before rushing to

mix these pricey, new-generation drugs, the Dutch researchers and other experts

said.

The doctors tried combining Erbitux and Avastin because lab tests and an earlier

small study had shown promising results.

" This will stand out as a warning, " said Dr. Cornelis Punt, the study's leader.

" You have to do the randomized studies to see what really happens. "

For the study, Eli Lilly & Co.'s Erbitux was added to standard treatment, which

includes Genentech Inc.'s Avastin. Since both are " targeted " drugs and attack

tumors in different ways, the thinking was that the combo would do a better job

of keeping the cancer from growing.

But the results show " more is not always better, " said Dr. Mayer, of

Dana-Farber Cancer Institute in Boston. He wrote an editorial published with the

study in Thursday's New England Journal of Medicine.

What makes the results even more compelling, Mayer said, is that another similar

study reached the same conclusion. That study, released in December, tested

another targeted drug that works the same way as Erbitux.

" This is the first time we've seen harm by combining targeted therapies and it

tells us we need to be cautious, " said Dr. Jordan Berlin, a gastrointestinal

cancer specialist at Vanderbilt-Ingram Cancer Center in Nashville, Tenn.

Berlin, who had no role in the research, stressed that the drugs do help

patients, just not when given together.

Colorectal cancer is the nation's second leading cancer killer. The disease was

expected to kill almost 50,000 Americans last year although death rates are

dropping because of screening and better treatment.

The research was done at hospitals throughout the Netherlands and led by Punt at

Radboud University Nijmegen Medical Center. The 755 study patients had colon

cancer that had spread. They all received Avastin, also known as bevacizumab,

and two chemotherapy drugs. Half of them also got Erbitux, also called

cetuximab. They were followed for nearly two years.

The group that got Erbitux saw their cancer get worse sooner, the researchers

found. On average, their cancer progressed after 9.4 months compared to 10.7

months for those who didn't get Erbitux. The Erbitux group also had lower

quality-of-life scores.

The overall survival in both groups was about the same.

Punt said they are now trying to figure out why the combo didn't work; it could

be an interaction between these two specific drugs, Erbitux and Avastin.

After the study began in 2006, it was shown that Erbitux didn't help colon

cancer patients who had a specific gene mutation. The Dutch researchers said

their study confirmed that — the worst results were in those with the mutation

who got Erbitux.

Vanderbilt's Berlin said the results also show doctors need to be careful when

using drugs " off-label. " Drugs are approved for specific uses but doctors can

prescribe them for other purposes. Medicare has recently expanded its coverage

for such use of some cancer drugs, which can cost thousands a month.

Off-label use " needs to be cautious and this proves it, " said Berlin.

The study was supported by a network of Dutch researchers which receives grants

from a cancer foundation and drug companies. The two targeted drugs were

provided by the companies that market them in Europe. Several of the researchers

have consulted for cancer drug companies, as has the editorial writer and

Berlin.