Cancer Medicine Advances on Many Fronts

Women with breast cancer who have already taken tamoxifen for five years and who take additional hormone therapy in the form of an aromatase inhibitor or more tamoxifen may reduce even further the chances of the cancer coming back.Adding the osteoporosis drug zoledronic acid (Zometa) in premenopausal women with early-stage breast cancer also undergoing suppression of ovarian function and hormonal therapy with tamoxifen or an aromatase inhibitor reduced the risk of recurrence.Giving one year of pegylated interferon treatment to people with stage III melanoma who had already undergone surgery reduced the risk of recurrence by 18 percent; the four-year recurrence-free survival rate for those on interferon was 45.6 percent vs. 38.9 percent for those not taking the treatment. Overall survival was the same.

In the area of personalized medicine:

Patients with newly diagnosed advanced colorectal cancer who have the normal version of the KRAS gene benefited from Erbitux, according to a study released last year. Those with a mutation in the gene did not benefit, a finding which will help guide treatment.

In the area of risk factors:

Women who take birth control pills reduce their risk for ovarian cancer by 20 percent for every five years they are on the pill.Between 1973 and 2004, the incidence of head-and-neck cancers related to the HPV virus increased by 0.8 percent. The incidence of these cancers not associated with HPV stayed the same, then declined during the same period. The increase could be due to changes in sexual behavior, for example, an increase in oral sex.

In the area of access to care:

A significant shortage of oncologists in the United States (up to 4,000) is predicted by 2020, even as the number of cancer patients will continue to rise.Childhood cancer survivors are up to 10 times more likely than their healthy siblings to develop heart disease 30 years after their initial cancer, although researchers emphasized that the absolute rates were still low.

The report also included two recommendations: Increase funding for clinical cancer research and boost the number of participants in clinical trials, which hovers at around 5 percent of all adult cancer patients who could be participating in such trials.

"The good news is that we continue to make great progress in cancer," Schilsky said. "All of that is based upon the strength of our research programs in this country, which are now really beginning to suffer. We've had five years of essentially flat funding to the National Cancer Institute, which really translates into an approximate 15 percent decrease in the budget. At a time when we have more opportunity and are making more progress than ever, the government is essentially pulling the rug out from under us."

"There have been significant advances, [but] if you're a patient out there or have a loved one who has cancer, the results are still not satisfying," said Dr. Otis Webb Brawley, chief medical officer for the American Cancer Society. "We have made definite positive steps, but they are steps. We haven't arrived. The problem is there are no home runs, just a bunch of bunt singles."

More information

View the full report at the American Society of Clinical Oncology.

SOURCES: Richard L. Schilsky, M.D., president, American Society of Clincial Oncology, and professor, medicine, University of Chicago Medical Center; Jay Brooks, M.D., chairman, hematology/oncology, Ochsner Health System, Baton Rouge, La.; Otis Webb Brawley, M.D., chief medical officer, American Cancer Society, Atlanta; Clinical Cancer Advances 2008: Major Research Advances in Cancer Treatment, Prevention and Screening