Radiation Benefits Expand, Research Says; Post-Chemotherapy Treatment Found to Help in Lung Cancer

Jun 03, 02:03 PM

Current Headlines: By KAWANZA NEWSON

Chicago - Giving preventive radiation to the brains of lung cancer patients who've responded to chemotherapy significantly improves survival, and could prompt immediate changes in treatment of the disease, according to new research reported Saturday.

"This is a very important finding," said Deepak Khuntia, an assistant professor of human oncology at the University of Wisconsin Carbone Cancer Center.

Khuntia, who was not involved in the study, said doctors already give radiation to those patients who don't respond to chemotherapy to prevent spread of the disease to their brains, but the new findings mean that all patients will be given preventive radiation for treatment.

"It will change the standard of care almost immediately," said Roy S. Herbst, professor and chief of thoracic medical oncology at the University of Texas M.D. Anderson Cancer Center, who also was not involved in the study.

Lung cancer is the most common cause of cancer deaths in men and women. The American Cancer Society estimates that there will be more than 213,000 new cases nationwide and more than 160,000 deaths from the disease this year.

About 15% of all lung cancers are the small cell type, which is normally caused by smoking. This cancer often starts in the bronchi near the center of the chest, but then quickly multiplies and forms large tumors that can spread widely through the body. Thus, the main treatment for the disease is chemotherapy with or without radiation.

The study, presented at the American Society of Clinical Oncology meeting, looked at data from about 150 patients with advanced small- cell lung cancer whose tumors shrank during chemotherapy. Those patients were then randomly assigned to either receive brain radiation daily for one to two weeks or to be watched during that period.

A year later, more than 27% of patients who received brain radiation were still living, compared with only 13% of those who didn't get the treatment.

"Based on these results, PCI (prophylactic cranial irradiation) should routinely be given to all patients," said Ben Slotman, author of the study and professor and chairman of radiation oncology at the VU University Medical Center in Amsterdam.

At the meeting of more than 32,000 cancer specialists, doctors also unveiled research that may mean better treatment for patients with non-small-cell lung cancer, the most common form of the disease.

In that study, researchers from the University of Heidelberg in Germany gave the cancer drug Avastin in combination with two other standard chemotherapy drugs - cisplatin and gemcitabine - to about 350 patients with advanced non-small-cell lung cancer. Those patients on the new treatment regimen had about a 20% to 30% reduction in tumor growth compared with those taking the standard treatment alone, said Christian Manegold, professor of medicine at the German university.

"Non-small-cell lung cancer is difficult to treat," he said. "This provides hope for patients suffering from a deadly disease."

Avastin, approved by the Food and Drug Administration in 2004, is an angiogenesis inhibitor that works by preventing the formation of new blood vessels, including those that help keep cancer cells alive. The drug is already approved for treatment of metastatic colorectal cancer and for use with other chemotherapy drugs during treatment of non-small-cell lung cancer.

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