Benefits of combined treatments against cancer

In cancer therapy, the best results are often achieved by combining treatments such as chemotherapy, radiotherapy and surgery. This multidisciplinary approach is the focus of special symposia at the meetings of the European Society for Medical Oncology (ESMO) and the European Society for Therapeutic Radiology (ESTRO) taking place in Sweden this month.

"We are at a crucial moment in our fight against cancer," said ESMO President Prof. Jose Baselga. "We have never before made so much progress in our fight to eradicate cancer as a cause of death, and multidisciplinary treatment is a key factor in this success."

New data presented at the 33rd ESMO Congress, 12-16 September 2008, Stockholm, Sweden also highlight the benefits of combined treatments:

Phase II trial of pazopanib before surgery in early lung cancer

Pazopanib, a new oral angiogenesis inhibitor, has demonstrated interesting activity in difficult to treat non-small-cell lung cancer, US researchers report. In a phase II trial, 30 out of 35 patients treated with preoperative pazopanib for a minimum of two weeks saw their tumor size shrink by up to 85%.

"This is a positive result that will be explored further," said Prof. Nasser Altorki from Weil Medical College of Cornell University in New York. "To my knowledge, no other results on the effect of angiogenesis inhibitors in early stage operable lung cancer have been published. The results presented here with pazopanib indicate a highly active drug in this setting and further development in lung cancer is underway to fully understand the value of this drug in this disease."

Chemotherapy, radiotherapy and cetuximab in head and neck cancer

Treating locally advanced head and neck cancers with an alternating regimen of chemotherapy and radiotherapy, plus cetuximab, has shown promise in a phase II trial, Italian researchers report.

Their trial in 45 patients combined chemotherapy with fluorouracil and carboplatin given on weeks 1, 4 and 7 of treatment, with radiotherapy administered daily on weeks 2-3, 5-6 and 8-10. Cetuximab was also added weekly. "Both complete response rate and long-term results compare favorably with the best reported in the literature," Dr. Marco Merlano from the S. Croce General Hospital in Cuneo reports. 30 patients experienced a skin toxicity that the authors attribute to an interaction between the treatments, and 2 patients died from toxicities, they report.

Zoledronic acid added to adjuvant endocrine therapy prevents breast cancer recurrences

One-third of breast cancer recurrences in pre-menopausal women can be prevented by adding zoldronic acid to treatment with endocrine therapy combined with anastrazole or tamoxifen.

These results, reported for the first time recently, show that "we can positively impact the fate of our cancer patients by influencing the microenvironment of micro-metastases by relatively simple means," says lead author Prof. Michael Gnant from the Medical University of Vienna.

The study results are included in the ESMO "Oncology Highlights" session in Stockholm. The findings will be expanded with new data from a multivariate analysis of the variables affecting disease-free and recurrence-free survival, Professor Gnant said.

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