Immune-Boost Treatment Might Help Some With Advanced Colon Cancer (HealthDay)
WEDNESDAY, April 6 (HealthDay News) — By giving more intensivechemotherapy along with drugs designed to boost the body’s own immunesystem, researchers were able to roughly double survival time for patientswith advanced, metastatic colorectal cancer compared to patients receivingstandard chemotherapy alone.
In fact, the trial, results of which are being presented at the annualmeeting of the American Association for Cancer Research in Orlando, wasstopped early because of the promising findings.
“With this study, we have produced for the first time strongproof-of-concept that chemo-immunotherapy may be active and moreefficacious than standard [chemotherapy] in metastatic colon cancerpatients,” said study lead author Dr. Pierpaolo Correale, an oncologistwith Siena University School of Medicine in Siena, Italy.
The standard of care right now for patients with colorectal cancerthat’s spread to other regions is to use one of two dual-drug combinationsof chemotherapy alone, or use them alongside a newly developed monoclonalantibody treatment such as Avastin (bevacizumab) or Erbitux (cetuximab).These approaches can boost overall survival to about 20 to 22 months.
For this study, the research team randomized 130 patients to receiveeither chemotherapy alone (with a regimen known as FOLFOX) or to receiveFOLFOX plus drugs to ramp up the immune system (this regimen is known asGOLFIG).
The chemo/immune boost approach involves first giving patientsgemcitabine plus standard FOLFOX chemotherapy (oxaliplatin, levofolinicacid and 5-FU/GOLF) that targets and kills the cancer cells in a number ofways — all the while sending off signals alerting the immune system tothe cancer.
This is then followed up with the administration of signaling moleculescalled cytokines that spur key immune cells into action. Anotherimmune-boosting cancer drug, called aldesleukine, is also given to helpboost the population of immune cells targeted against tumor cells.
At the time of data collection, the patients treated with thisapproach have survived an average 16.5 months without a relapse, comparedwith just 7.5 months in the chemo-only group.
But the study began in 2005, before the advent of drugs like Avastin orErbitux, meaning that investigators do not yet know if GOLFIG wouldoutperform regimens that include those medications. This needs to belooked at, said Correale.
On the other hand, many patients do not see a benefit from biologicalagents such as Erbitux or Avastin because they have the wrong geneticprofile, noted one outside expert.
“Essentially, we have a very problematic subset of patients withmetastatic colorectal cancer which are limited to two lines ofchemotherapy and [perhaps] one biological agent,” said Dr. IgorAstsaturov, assistant professor of medical oncology at the Fox ChaseCancer Center in Philadelphia.
“For those patients, which are about one-third of the overall patientpopulation, this [new finding] will be particularly welcome news,”Astsaturov said, while adding the caution that the results are stillpreliminary.
However, clinical use of the protocol may be delayed further by thefact that “there is no direct commercial interest of pharmaceuticalcompanies,” noted Correale, who is nevertheless planning larger trials.
The costs associated with GOLFIG, he added, are “four-to-five timeslower than that produced by the current use of Avastin or Erbitux withapparently similar therapeutic results.”
Because this study was presented at a medical meeting, the findingsshould be viewed as preliminary until they are published in apeer-reviewed journal.
More information
There’s more on colorectal cancer at the U.S. National Cancer Institute.
Immune-Boost Treatment Might Help Some With Advanced Colon Cancer (HealthDay)
Tags: Fox ChaseCancer Center, correale, professor of medical oncology, Siena University School of Medicine, Immune-Boost Treatment Might Help Some With Advanced Colon Cancer, cancer research, siena university
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