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Iressa as Good as Chemotherapy for Lung Cancer
(HealthDay)
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FRIDAY, Nov. 21 (HealthDay News) -- The cancer-fighting pill
Iressa works as well as chemotherapy as a second-line treatment for lung
cancer, researchers report.
Although neither therapy prolongs survival beyond eight months, Iressa
(gefitinib) causes fewer serious side effects and may be a better choice
for patients who did not do well on their first round of chemotherapy.
"A pill, with less side effects, taken once a day, has similar activity
to traditional chemotherapy given by vein every three weeks," said lead
researcher Dr. Edward Kim, an assistant professor at the M. D. Anderson
Cancer Center in Houston.
This finding should reassure doctors that they are not compromising
effective therapy by using a pill, Kim said.
Iressa is not available in the United States, but a similar drug,
Tarceva, is.
Iressa was first developed by AstraZeneca, but it failed to meet
expectations. The National Cancer Institute ended clinical trials of the
drug in 2005 because it failed to prolong the lives of lung cancer
patients.
The latest finding has meaning for these patients, however, Kim said.
"You can be treated for lung cancer. There are different therapies
available, and they have different side-effect profiles," he said.
"Chemotherapy will never be eliminated, but we are getting more options
for targeted therapy; and people can live as normal a life as they can
bearing the weight of lung cancer."
The report was published in the Nov. 22 issue of The Lancet.
In a head-to-head comparison, Kim's team randomly assigned 1,466 lung
cancer patients who had undergone previous chemotherapy to daily doses of
Iressa or the chemotherapy drug docetaxel once every three weeks.
The researchers found that survival in both groups of patients was
about the same. Median survival for those taking Iressa was 7.6 months
compared with eight months for patients receiving docetaxel. For patients
with an EFGR gene mutation, average survival was 8.4 months for those on
Iressa and 7.5 months for those receiving docetaxel.
However, there were significant differences in the side effects
experienced by the treatment groups. For patients taking Iressa, the most
common side effects were rash or acne. Among patients receiving docetaxel,
the most common side effects were a blood disorder called neutropenia,
personality disorders, and hair loss.
Dr. Michael Cullen, from the University Hospital Birmingham in the
United Kingdom and author of an accompanying journal comment, noted that
Iressa works differently than chemotherapy by targeting a receptor that is
present in some patient's cancer cells.
"There are now two options that one can select from for patients in
order to offer treatment that helps a bit following failure of first-line
chemotherapy," Cullen said. "Survival overall is very poor, and, in fact,
it's almost certainly the case that only a small minority of patients
respond to either of the two treatments."
In addition, which patients would benefit most from Iressa isn't known,
Cullen said. "In the study, tests didn't indicate that we are able to
select treatment based on different characteristics of the patient."
Because survival time is short, Cullen thinks that doctors may want to
decide which treatment to use based on how well a patient tolerated
chemotherapy before.
"If they didn't tolerate chemotherapy very well, maybe the oncologist
would opt for the oral therapy, whereas if they responded well to
chemotherapy, the best choice might be to go with the chemotherapy,"
Cullen said.
More information
For more on lung cancer, visit the U.S.
National Cancer Institute.
Taken from here
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