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Chemotherapy after surgery extends survival for patients with advanced endometrial cancer
December 06, 2005A new study has shown for the first time that giving two chemotherapy drugs to women with advanced endometrial cancer after surgery reduced the risk of recurrence by 29% and extended survival by 32% compared with women who received whole abdominal irradiation. The findings could improve the care for the 15% to 20% of patients with endometrial cancer who have advanced disease. The study will be published online December 5 in the Journal of Clinical Oncology (JCO).
Endometrial cancer is the most common gynecologic cancer in the United States - the American Cancer Society estimates that in 2005, 40,880 women will be diagnosed with the disease, and 7,310 will die.
"For the first time, adjuvant chemotherapy has been shown to extend survival in patients with advanced endometrial cancer," said the study's lead author, Marcus E. Randall, MD, Director of the Leo W. Jenkins Cancer Center at the Brody School of Medicine at East Carolina University in Greenville, North Carolina. "These findings were surprising, given that previous studies showed that single chemotherapy agents do not have a significant impact on the disease."
Researchers from the Gynecologic Oncology Group (GOG) compared the rate of recurrence and overall survival between 194 women with advanced endometrial cancer who received chemotherapy with the drugs doxorubicin and cisplatin over a period of five months and 202 women who received radiation therapy to the entire abdomen over a period of approximately 1.5 months. Patients were enrolled in the trial from 1992 until 2001. Researchers followed patients for a median of just over six years, and used a statistical model to estimate five-year recurrence and survival rates.
After five years, 50% of patients who received chemotherapy were estimated to be free of disease compared with 38% of those who received whole abdominal irradiation. Moreover, 55% of patients who received chemotherapy were estimated to be alive after five years, compared with 42% of patients in the radiation therapy group.
However, serious adverse side effects were more common in the chemotherapy group. The most common serious side effects included reduced blood cell counts and problems with the digestive and nervous systems, liver, and heart. Treatment-related deaths were also twice as common in the chemotherapy group (4%, vs. 2% of radiation patients).
Another GOG study is underway to see if the chemotherapy drugs carboplatin and paclitaxel will be as effective, but with fewer serious side effects. A less toxic regimen could help a greater number of patients with advanced disease, many of whom are elderly or have other illnesses that might prohibit the use of the aggressive chemotherapy regimen.
In addition, another GOG study evaluated the use of combination chemotherapy after "involved field" radiation therapy (radiation to less than the whole abodomen) to see if these patients might benefit more than those who receive either treatment alone. Results from this study are not yet available.
"This study represents a major advance in the treatment of advanced endometrial cancer," noted Gini F. Fleming, MD, Director of the Medical Oncology Gynecologic and Breast Cancer Programs at the University of Chicago, and author of an accompanying editorial. "Future trials need to address treatment of earlier-stage disease, optimization of chemotherapy regimen, integration of radiotherapy, and application of newer targeted agents."
American Society of Clinical Oncology
Researchers from the Gynecologic Oncology Group (GOG) compared the rate of recurrence and overall survival between 194 women with advanced endometrial cancer who received chemotherapy with the drugs doxorubicin and cisplatin over a period of five months and 202 women who received radiation therapy to the entire abdomen over a period of approximately 1.5 months. Patients were enrolled in the trial from 1992 until 2001. Researchers followed patients for a median of just over six years, and used a statistical model to estimate five-year recurrence and survival rates.
After five years, 50% of patients who received chemotherapy were estimated to be free of disease compared with 38% of those who received whole abdominal irradiation. Moreover, 55% of patients who received chemotherapy were estimated to be alive after five years, compared with 42% of patients in the radiation therapy group.
However, serious adverse side effects were more common in the chemotherapy group. The most common serious side effects included reduced blood cell counts and problems with the digestive and nervous systems, liver, and heart. Treatment-related deaths were also twice as common in the chemotherapy group (4%, vs. 2% of radiation patients).
Another GOG study is underway to see if the chemotherapy drugs carboplatin and paclitaxel will be as effective, but with fewer serious side effects. A less toxic regimen could help a greater number of patients with advanced disease, many of whom are elderly or have other illnesses that might prohibit the use of the aggressive chemotherapy regimen.
In addition, another GOG study evaluated the use of combination chemotherapy after "involved field" radiation therapy (radiation to less than the whole abodomen) to see if these patients might benefit more than those who receive either treatment alone. Results from this study are not yet available.
"This study represents a major advance in the treatment of advanced endometrial cancer," noted Gini F. Fleming, MD, Director of the Medical Oncology Gynecologic and Breast Cancer Programs at the University of Chicago, and author of an accompanying editorial. "Future trials need to address treatment of earlier-stage disease, optimization of chemotherapy regimen, integration of radiotherapy, and application of newer targeted agents."
American Society of Clinical Oncology
Chemotherapy Current Events and Chemotherapy News RSSNew cancer target for non-Hodgkin's lymphoma
Physician-scientists from Weill Cornell Medical College have discovered a molecular mechanism that may prove to be a powerful target for the treatment of non-Hodgkin's lymphoma, a type of cancer that affects lymphocytes, or white blood cells.
Fertility procedures need not delay breast cancer treatment for younger women
A new study published in the November issue of the Journal of the American College of Surgeons shows that breast cancer patients under 40 years old who undergo fertility preservation do not face a significant delay in the treatment of their disease when their care is coordinated in a timely fashion.
Drugs to treat anemia in cancer patients linked to thromboembolism
Medications frequently given to cancer patients to reduce their risk of anemia are associated with an increased risk of deep vein thrombosis or pulmonary embolism, according to new research led by Dawn Hershman, M.D, M.S., co-director of the breast cancer program at the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian Hospital/Columbia University Medical Center.
For young boys with cancer, testicular tissue banking may be option to preserve fertility
For parents of children with cancer, the hopeful news is that pediatric survival rates have steadily improved for decades. Among the bad news-treatments that enable survival often cause infertility.
FDA approved leukemia drugs shows promise in ovarian cancer cells
The drug Sprycel, approved for use by the U.S. Food and Drug Administration in patients with chronic myeloid leukemia, significantly inhibited the growth and invasiveness of ovarian cancer cells and also promoted their death, a study by researchers with UCLA's Jonsson Comprehensive Cancer Center found.
1930s drug slows tumor growth
Drugs sometimes have beneficial side effects. A glaucoma treatment causes luscious eyelashes. A blood pressure drug also aids those with a rare genetic disease.
First use of antibody and stem cell transplantation to successfully treat advanced leukemia
For the first time, researchers at Fred Hutchinson Cancer Research Center have reported the use of a radiolabeled antibody to deliver targeted doses of radiation, followed by a stem cell transplant, to successfully treat a group of leukemia and pre-leukemia patients for whom there previously had been no other curative treatment options.
New Synthetic Molecules Trigger Immune Response to HIV and Prostate Cancer
Researchers at Yale University have developed synthetic molecules capable of enhancing the body's immune response to HIV and HIV-infected cells, as well as to prostate cancer cells. Their findings, published online in the Journal of the American Chemical Society, could lead to novel therapeutic approaches for these diseases.
Chemo-radiation before prostate removal may prevent cancer recurrence
Researchers in the Oregon Health & Science University Knight Cancer Institute and the Portland Veterans Affairs Medical Center have found a combination of radiation therapy and chemotherapy given before prostate removal is safe and may have the potential to reduce cancer recurrence and improve patient survival.
PMH finding may help some tonsil cancer patients avoid chemotherapy
Clinical researchers at Princess Margaret Hospital (PMH) have confirmed that patients with oropharyngeal squamous cell cancer ("tonsil cancer") harbour a common type of human papilloma virus (HPV16), but also that such cancers are very sensitive to radiation.
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