Category: Featured News
Afatinib Better Than Gefitinib in Extending Survival for Lung Cancer Patients
In January 2015, Boehringer Ingelheim reported results from clinical trials that showed EGFR-expressed lung cancer patients treated with afatinib saw “significantly extended overall survival” over those treated with chemotherapy.” Now, in the latest study, comparing the benefits of afatinib over gefitinib, researchers report afatinib resulted in improved progression-free survival compared with gefitinib.
An international team of researchers, led by Keunchil Park, MD, of Sungkyunkwan University School of Medicine in Seoul, South Korea, reported that although the three anti-cancer drugs gefitinib, erlotinib, and afatinib, have shown “superior” results to platinum-based doublet chemotherapy, no study has done a comparison between the drugs, according to an April 29 article in Cancer Network.
In the LUX-Lung 7 clinical trial of 319 EGFR mutation-positive lung cancer patients, half of the patients were treated with afatinib and the other half received gefitinib. The researchers reported the afatinib patients realized better progression free survival at 24 months at 17.6% vs. 7.6% in the gefitinib patients. The time-to-treatment failure was also better with afatinib, at 13.7 months vs. 11.5 months with gefitinib, and objective tumor response for afatinib was 70% compared to 56% with gefitinib.
“The improved antitumor activity with afatinib noted in this trial might reflect its more potent and irreversible inhibition of EGFR signaling,” the authors wrote. “Our findings suggest that first-generation and second-generation EGFR targeted drugs might not be interchangeable.”
In July 2013, the U.S. Food and Drug Administration granted approval to afatinib, a tyrosine kinase inhibitor that blocks proteins that promote the development of cancerous cells, for patients with late stage non-small cell lung cancer whose tumors express specific types of epidermal growth factor receptor (EGFR) gene mutations. The FDA approved gefitinib, also a kinase inhibitor, for the initial treatment of metastatic EGFR-positive non–small-cell lung cancer in July 2015.
EGFR is a protein found on the surface of some cells to which epidermal growth factor binds, which causes the cells to divide and spread. It is found at abnormally high levels on the surface of many types of cancer cells. According to a 2009 article in Current Drug Targets, EGFR over-expression has been shown in more than 50% of pleural mesothelioma patients. The American Society of Clinical Oncology identified approximately 15% of patients with lung cancer in the U.S. expressing EGFR mutations.
Pleural mesothelioma is a rare, serious cancer affecting the lining of the lungs that occurs in individuals exposed to airborne asbestos fibers. Mesothelioma displays as a large mass of interlocked tumors that blend in with healthy tissue, by contrast, lung cancer is characterized by more distinct, individual tumors. However, the treatments for the two cancers are often similar. Any breakthrough or update in research for lung cancer patients equally benefits mesothelioma patients.
“We believe that these data provide additional evidence to help to inform decision making when choosing a first-line treatment for patients with EGFR mutation–positive NSCLC.”
For more information on the LUX-7 clinical trial see ClinicalTrials.gov.
https://clinicaltrials.gov/ct2/results?term=%22malignant+mesothelioma%22&recr=Open&pg=1
Results of the study were published in the April 12 edition of The Lancet Oncology.
http://secure.jbs.elsevierhealth.com/action/cookieAbsent
Sources:
- Cancer Network
http://www.cancernetwork.com/lung-cancer/afatinib-improves-pfs-vs-gefitinib-egfr-mutated-nsclc - FDA approved gefitinib
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm454678.htm
Celebrate Mesothelioma Survivors Every Day
June 5 was National Cancer Survivors Day, a day set aside to ” to honor cancer survivors and to show the world that life after a cancer diagnosis can be fruitful, rewarding, and even inspiring.”Although this day has come and gone, chances are high that mesothelioma patients are aware of their cancer every day of the year. It is important that you also set aside time throughout the year to reach out and support a mesothelioma survivor.
June 5 was a day for mesothelioma survivors and their families to join the nearly 14.5 million other Americans, and millions more around the world, who have survived cancer. The day was a day for CELEBRATION for those who have survived, an INSPIRATION for those recently diagnosed, a gathering of SUPPORT for families, and an OUTREACH to the community, according to the National Cancer Survivors Day Foundation who sponsors the day. We encourage all of the mesothelioma community to take the time out to celebrate with mesothelioma survivors and their families – each and every day of the year.
Mesothelioma is a terminal cancer caused by past exposure to asbestos, a known carcinogen. Although there is no cure for the cancer, advances in treatments are helping patients live longer, more productive lives than in the past. These mesothelioma survivors, defined by the National Cancer Survivor’s Day Foundation as anyone living with a history of cancer – from the moment of diagnosis through the remainder of life, show true grit and strength every day while continuing to fight this dreadful disease.
“When most people hear the word ‘cancer,’ they automatically think the worst,” says National Cancer Survivors Day Foundation spokesperson, Laura Shipp in a May 20 press release announcing the day. “But the truth is that more people are living longer and better quality lives after cancer than ever before. National Cancer Survivors Day® is an opportunity for these cancer survivors – and those who support them – to come together and celebrate this new reality in cancer survivorship.”
In a statement on survivors day, Douglas R. Lowy, MD, Acting Director, National Cancer Institute, and Robert T. Croyle, PhD, Director, NCI Division of Cancer Control and Population Sciences, recognized the challenges cancer survivors face every day and acknowledged the role the NCI plays in helping improve survivorship, saying in part:
“As part of the leadership team of the National Cancer Institute (NCI), we also commend the tireless efforts of the researchers who are working to find new and better ways to control and treat cancer more effectively and safely. This is a vitally important task. Although more and more cancer survivors will return to active and productive lives following their cancer diagnosis, for many of them, the long-term physical, psychological, and social effects of cancer and its treatments remain serious and challenging. Recognizing this, survivorship research remains a key component of NCI’s research portfolio.”
The American Cancer Society reports the average survival time for people with mesothelioma, is between 4 and 18 months. However, between five and ten percent of mesothelioma patients will live at least five years after diagnosis.
“Our Foundation hopes that NCSD serves as a call to action for further research, more resources, and increased public awareness to improve quality of life for cancer survivors,” said Shipp.
Sources:
- National Cancer Survivors Day
http://www.ncsd.org/about-us - National Cancer Institute
http://www.cancer.org/cancer/news/features/when-a-friend-has-cancer - National Cancer Survivors Day Foundation
http://www.ncsd.org/_blog/Front_Page_News/post/Press_Release-May2013/
Can a Protein Garbage Truck Clear Out Mesothelioma Cells?
Researchers are turning to cell garbage collectors, or the proteasome, in their latest attempt to fight cancer. Scientists have known for years that proteasomes clean out unneeded or damaged proteins, now, they are focusing on lassoing them to attack cancer cells.
Two biochemists, Craig Crews and Raymond Deshaies, began discussing this possibility in 1998 in a bar. Crews, the L.B. Cullman Professor of Molecular, Cellular, and Developmental Biology at Yale University, has spent his career tinkering, as he calls it, with proteasomes. After years of research, he is on the cusp of a breakthrough treatment that can gobble up the proteins that help cause cancer.
This approach can target diseases that are considered undruggable or resistant to most treatments, like mesothelioma, a rare, terminal cancer. Currently, there is no known cure for the asbestos-caused disease that invariably recurs after building up a resistance to chemotherapy or other anti-cancer drugs that should kill the cancers. Mesothelioma is diagnosed in nearly 3,000 Americans each year.
In a 2010 presentation entitled, “Contemporary Treatment of Malignant Pleural Mesothelioma,” Nicholas J. Vogelzang, MD, Chair and Medical Director, Developmental Therapeutics Committee, US Oncology Research, Comprehensive Cancer Centers of Nevada, noted that proteasome inhibitors were one of “many new agents worthy of study” in the fight against mesothelioma. Dr. Vogelzang is a renowned medical oncologist, cancer researcher and mesothelioma expert.
Crews and Deshaies, Professor of Biology and Executive Officer for Biology Division of Biology & Biological Engineering California Institute of Technology, and founder of the Proteome Exploration Laboratory at the Beckman Institute at Caltech, have built their careers around the proteasome and have spawned several pharmaceutical companies, including Arvinas, focused on harnessing the power of the proteasome.
After rounds of research, Crews and his team found that when the proteasome was “jammed” up, toxic levels of old proteins built up in the cancer cells before the proteosome could clear them out. Without the help in throwing away the discarded proteins, the cancer cells were overwhelmed and died. Crews determined that this could be recreated by an anti-cancer drug.
“You can imagine a small molecule, a drug, that works under this new paradigm, will truly be one that can seek and destroy rogue, disease-causing proteins,” said Crews in a May 18 article in Stat News.
Crews was recently awarded the National Cancer Institute’s Outstanding Investigator Award. Crews, one of 60 U.S. scientists to receive the award, which brings $4.2 million over seven years to support his lab’s research, says the money will make a big difference in his research and could lead to “a second chance” for drugs that were abandoned because “they couldn’t block the function of rogue proteins.”
“This award will help us change the current small-molecule drug paradigm that fails to target 75% of rogue proteins,” Crews said. “Instead, we propose to hijack the cells’ quality-control machinery so that this new class of drugs can bind to and destroy these disease-causing proteins.”
If everything continues on track, Crews hopes that Arvinas, working with Merck and Genentech, will be testing this approach to cleaning up cancer within a year.
For the full story, “A tinkerer takes on cancer by hijacking the tiny garbage trucks inside every cell,” see the May 18 article in Stat News.
Key Ingredient in Aspirin Could Lead to New Treatment for Mesothelioma
The cancer-fighting properties of aspirin have long been touted. In fact, a daily aspirin may help prevent cancer, according to the American Cancer Society. Now, another study offers more evidence of a positive association between aspirin’s key ingredient, salicylic acid, and its cancer-fighting properties.
In what is encouraging news for mesothelioma patients, researchers report that both aspirin and diflunisal can stop inflammation and cancer. The two nonsteroidal anti-inflammatory drugs (NSAIDs) have the key ingredient salicylic acid that researchers from Gladstone Institutes, of San Francisco, report is effective in inhibiting two proteins, p300 and CREB-binding protein (CBP), preventing cellular damage caused by inflammation. The proteins, according to the researchers, control the levels of proteins that cause inflammation or are involved in cell growth.
“Salicylic acid is one of the oldest drugs on the planet, dating back to the Egyptians and the Greeks, but we’re still discovering new things about it,” said senior author Eric Verdin, MD, associate director of the Gladstone Institute of Virology and Immunology. “Uncovering this pathway of inflammation that salicylic acid acts upon opens up a host of new clinical possibilities for these drugs.”
For people who have previously been exposed to asbestos and face a life-long risk of developing pleural mesothelioma, a cancer of the lining of the lungs, this finding brings hope that the potential for developing the disease could be minimized. Microscopic asbestos fibers when inhaled can lodge in the lungs and remain there causing inflammation that eventually leads to pleural mesothelioma. Many of the cancer treatments are ineffective against the disease, and many experts agree, that the best way to fight the cancer is through prevention.
In the study, the researchers determined that suppressing p300 with diflunisal “stopped cancer progression and shrunk the tumors in the mouse model of leukemia.” The team has also conducted a trial in human hematologic cancers and determined the salicylic acid to be safe. The next step for them is to collaborate in the development of novel epigenetic therapies to find more effective treatment for leukemia patients.
In a separate study in 2015, researchers from the University of Hawaii Cancer Research Center “reported aspirin administration to individuals at high risk of developing MM [malignant mesothelioma], such as those with a history of asbestos …may prevent or delay the growth of MM, possibly increasing life expectancy and also increasing opportunities for early MM detection.”
“The ability to repurpose drugs that are already FDA-approved to be part of novel therapies for cancer patients is incredibly exciting,” said co-author Stephen D. Nimer, MD, director of Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine.
Although evidence may support aspirin use for its anti-cancer properties, doctors stop short of recommending aspirin to prevent cancer. Before starting an aspirin regimen please consult with your doctor.
In the United States, approximately 2,500 to 3,000 people are diagnosed with mesothelioma each year. The disease is incurable, though there are standard treatments to manage the disease including chemotherapy, radiation and surgery.
The study can be found in the May 31 issue of eLife.
Mesothelioma Patients Should Not Have to Choose Between Hospice Care and Active Treatment
One of the most important things mesothelioma patients and their families cite when it comes to end-of-life care is the desire to be home and with their family. To many in the U.S., this means hospice care and, therefore, the end of active mesothelioma cancer treatment. Now, researchers point to a model adopted by the U.S. Veteran’s Administration where hospice and active cancer care are given concurrently.
Hospice is designed to improve the quality of a patient’s last days by offering comfort and dignity, and often allows the patients to remain in their own home surrounded by their loved ones. Today, once hospice is established in the U.S. active cancer care is ended and the patient receives palliative care that is intended to control pain and relieve mesothelioma symptoms.
According to Drs. Jeanie M. Youngwerth and D. Ross Camidge from the University of Colorado, the U.S. trails behind many other countries when it comes to providing quality medical care for patients with terminal conditions. But, straying from the norm, the VA does not limit “curative” therapies while a veteran is receiving hospice care.
“Consequently, in theory, the VA would permit life-prolonging measures, such as chemotherapy, to be administered while a patient simultaneously receives hospice services,” said the doctors.
For veterans, this is good news since this population makes up one-third of those who suffer from mesothelioma, a terminal cancer caused by past asbestos exposure. Approximately 3,000 Americans are diagnosed with mesothelioma each year. Asbestos was used as insulation in military buildings and ships. It was also used as an insulator around heat and cooling systems, in Navy vessels and in the gaskets placed inside airplane engines and large machinery.
For other mesothelioma patients, the option for concurrent care is still being assessed. The doctors point out that several clinical trials found “ early initiation of palliative/hospice care with active anti cancer therapy, so called “concurrent care,” improves quality and, potentially, quantity of life for patients with advanced cancer.” In addition, they note, that a 2010 study found that “patients with advanced lung cancer did better in terms of both quality and quantity of life when they received palliative care integrated with standard anticancer care as opposed to receiving anticancer care alone.”
Other government agencies hope to join the VA in their treatment model. Centers for Medicare & Medicaid Services, through the Medicare Care Choices Model, is piloting a program for Medicare beneficiaries to receive palliative care services from certain hospice providers while concurrently receiving anticancer therapies provided by their oncology providers, according to the doctors.
Other medical professionals agree with the need for concurrent care for critically ill patients. In a 2012 presentation at the annual meeting of the American Academy of Hospice and Palliative Medicine, Dr. Diane E. Meier, director of the Center to Advance Palliative Care and professor of geriatrics and internal medicine at Mount Sinai School of Medicine, stressed that now is the time to educate physicians as well as the general public that palliative care is “actually about relieving the pain, symptoms, and stress of serious illness in patients of any age and at any stage of disease, and that palliative care can be delivered alongside curative or life-prolonging therapies.”
Sources :
- University of Colorado
https://connection.asco.org/magazine/features/hospice-and-cancer-therapy-must-we-choose-only-one
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