Tuesday, October 7, 2003

Cancer drug offers hope



By Tim Bonfield
The Cincinnati Enquirer

Women with advanced cases of breast cancer live better for a while - and a few months longer - by taking a chemotherapy drug called Taxotere compared with those who take a similar drug called Taxol.

Patients say a little more time, a little more hope, is better than the alternative.

"When you read the figures, it doesn't sound that impressive," said breast cancer patient Joan Hock, a 64-year-old resident of Green Township.

"But to someone with cancer, anything that offers a hope your life can be extended is worth looking into."

This latest research about breast cancer care was presented Sept. 23 in Copenhagen, Denmark, at a European cancer conference. While far from a cure, the findings offer another sign of progress against the second-most-common cause of cancer deaths among women.

"This isn't a home run. But it is a significant step," said Dr. Elyse Lower, a breast cancer expert with the University of Cincinnati.

"Three months might not sound like much, but this is only the third study to show any survival advantage in such advanced cases for one form of chemotherapy over another. A lot of physicians thought there would be no significant difference."

Those most likely to benefit from the news in Greater Cincinnati would be the few hundred women a year who have already had surgery, radiation therapy and some forms of chemotherapy, yet their tumors have spread to distant parts of their body. In such cases, women often die within a year.

The study involved 449 women, including 20 in Greater Cincinnati, at about 30 medical centers nationwide. Women were enrolled between eight and three years ago and took the drug by IV once every three weeks.

Among the findings:

• About 36 percent of women who tried Taxotere experienced a benefit, such as a significant reduction in tumor size, compared with a 22 percent response rate for Taxol.

• On average, women who took Taxotere lived 15.4 months compared with 12.7 months for Taxol.

• During that time, women who took Taxotere typically enjoyed 5.7 months of relatively healthy life before the cancer flared up enough to require further medical care. The time until the cancer "progressed" lasted 3.6 months for those who took Taxol.

However, some women who took Taxotere also suffered significant side effects. About 15 percent suffered a decline in white blood cell counts, compared with 2 percent among women taking Taxol. In most cases, other medications were able to compensate for the declines.

Both drugs have been used for several years in breast cancer care. Taxotere (docetaxel) is made by Aventis, which paid for the study. Taxol (paclitaxel) is made by Bristol-Myers Squibb Co.

Taxol originally was developed from the bark of the Pacific yew tree and Taxotere from yew tree needles.

Both drugs are made synthetically now.

In Cincinnati, all but one of the patients who enrolled in the study have died.

The one surviving patient - who declined a request for an interview - has lived years beyond expectations, Lower said.

Breast cancer advocates say the new study amounts to modest good news.

"Having a longer period with good quality of life is significant, because even if you only have a couple of months left, you want those to be good months," said Ann Hernick, president of the Breast Cancer Alliance of Greater Cincinnati and a breast cancer survivor.

Some women who took Taxotere even returned to work, including a schoolteacher from Indiana who traveled to Cincinnati for the treatment.

But in the bigger picture, a three-month gain in survival time isn't impressive enough to excite many people with breast cancer.

"I want to see them adding years of life," Hernick said.

Thanks to earlier detection and treatment, some say, many women with breast cancer will never develop metastatic disease, in which tumors spread throughout their bodies. So they may never get sick enough to need Taxotere.

However, even before the research findings were published, some doctors had been introducing Taxotere to patients with less-advanced cases.

Recently, more Greater Cincinnati women with "locally advanced" breast cancer cases - in which tumors have grown larger but haven't spread to other parts of the body - have been getting Taxotere in combination with Adriamycin(doxorubicin), Lower said.

Hock is one of those patients taking Taxotere, even though her cancer isn't far advanced. Hock was diagnosed with breast cancer in 2000. She had a lumpectomy and "radiation seed" therapy, but it didn't get all the cancer cells.

In mid-June, Hock started a six-month chemotherapy treatment that requires weekly trips to Oncology Hematology Care office in Corryville.

Eventually, Lower predicts that Taxotere may be used in combination with new-generation chemotherapy agents that are genetically engineered to attack specific kinds of breast cancer tumors.

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E-mail tbonfield@enquirer.com




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