It all started typically enough a couple of weeks ago, with a request to review and comment on a study presented at the recent cancer meetings involving a new radiation therapy technique for the treatment of early stage breast cancer.
My comments-which were broadcast on a widely watched network evening news program-were reasonably straightforward: the study was interesting, but the treatment wasn’t ready for widespread use until more information and longer follow-up was available.
Shortly afterwards, I got a phone call from someone representing the company concerned about my statements and offering further information about the study. Now, I find myself trying to figure out how to sort through the research results and match what I have learned to what I think is the premature promotion of a potentially valuable new technique in the treatment of breast cancer for some women.
The interest in this new treatment is easy to understand. Women with early stage breast cancer can be successfully treated by removing the cancer from the breast (what we call a “lumpectomy”), then treating the remaining breast tissue with radiation therapy to the entire breast over a period of several weeks.
Usually the … Continue reading →
Sometimes you think you are making progress in treating cancer. Then someone points out that the progress isn’t so certain after all. Most of the media hypes the study which demonstrated improvement in treatment of advanced ovarian cancer with a targeted therapy drug and ignore the concerns. What appeared to be a very positive study in an abstract may not have been so positive after all.
Patients, families and their physicians are now under the impression that a new advance has been made in this deadly disease, when that may not be the case. The positive press releases and news conferences were not balanced. Most of the media ignored the expert who raised legitimate concerns and cautions. But that information was only available to those who waited for the study to be presented and were in the audience at the time.
Hopes have been falsely raised, when some caution is needed and appropriate.
The sad reality of ovarian cancer is that it is usually diagnosed at a late stage after the disease has already progressed. Although the outlook for women with this cancer remains grim, it is considerably better than it was in the past, in no … Continue reading →
Every year after the annual meeting of the American Society of Clinical Oncology I try to provide a sense of where I think we are in clinical cancer research and treatment, and what I think the major messages and themes are from the meeting.
Perhaps some of the excitement and expectations have to be tempered a bit in light of disappointing clinical trials and the increasing realization that cancer remains a wily foe, but I remain an optimist.
Take a look at this year’s report in a guest blog I just wrote for CNBC.… Continue reading →
A paper presented at yesterday’s plenary session at the annual meeting of the American Society of Clinical Oncology in Chicago underscores both the hopes and limitations of advances in cancer treatment linked to targeted therapies.
The drug used in the study is code named “PF-1066” was indeed very effective in a common form of lung cancer. The problem—if you choose to call it a problem—is that only a very small number of patients with advanced lung cancer will benefit from the drug.
First, the basics of the study:
The researchers had identified a genetic change called ALK which they called a “powerful oncogenic driver” in yesterday’s presentation. The drug (which is named crizotinib) was a powerful inhibitor of ALK and in experimental studies had led to remarkable tumor regressions.
In the clinical trial, the investigators treated patients who had previously failed treatments for their lung cancers. Most of the patients were non-smokers, and most had a form of lung cancer called adenocarcinoma. All of the patients tested positive for ALK.
The results were in a word remarkable: almost all of the patients treated in the study had a response of some type, including stable … Continue reading →
I come to the annual meeting of the American Society of Clinical Oncology to hear about the new research and treatments in cancer. But it is frequently the unexpected observations that get me thinking about some of the bizarre impacts of the rules and regulations governing medical practice that have been put into place by our state and federal legislators to deal with otherwise serious matters.
Last year, I wrote about the prohibition on drug companies from giving anything of value—even a pen or a pad—to a doctor. The year before that it was “the little rooms” on the convention floor where drug company representatives could honestly answer questions from the doctors from around the world, but not from doctors who practice in the United States.
This year tops them all and shows how far we have come in protecting the public and preventing drug companies from unduly influencing the doctors attending ASCO by putting restrictions on which doctors could get a free cup of coffee.
At one drug company booth where they were offering a small cup of espresso to meeting attendees there were signs posted which said that doctors from Minnesota and Vermont were forbidden … Continue reading →
One of the most disappointing realities of my professional cancer experience has been the difficulty in making real, sustained progress in the treatment of advanced melanoma, a skin cancer which has been increasing in frequency over the past number of years.
Despite long-held hopes that some form of chemotherapy or tumor vaccine would lead to successful treatment, we haven’t made real progress in helping melanoma patients once their disease spreads.
A paper released today by the New England Journal of Medicine and presented at the annual meeting of the American Society of Clinical Oncology (currently underway in Chicago) suggests that perhaps for the very first time we have a drug which substantively improves the outlook for patients who have advanced melanoma.
Survival for patients with melanoma that has spread through the body is dismal, and is estimated to be less than one year. As noted by the authors of the current study, “No therapy has been shown in a phase 3, randomized, controlled trial to improve overall survival in patients with metastatic melanoma.”
We have always had high hopes that we would find successful treatment for melanoma based on “fixing” how the body’s own defense mechanisms could be … Continue reading →