Zytiga is the Darling of the Day. Really!

Zytiga was in news today, but more so were its competitors, Provenge and MDV3100. The big news was early unblinding of Zytiga trial in metastatic prostate cancer patients due to significant improvement seen in progression-free survival (PFS) and other endpoints.

Whacking the Hedgehogs in Basal Cell Carcinoma with Vismodegib

If the year 2011 was the year for the 5% of skin cancers, this is the year for the 95% majority.  Last year saw approvals of two new melanoma cancer drugs, vemurafenib and  ipilimumab.  But, this year may be dubbed as the year when the other skin cancer called basal cell carcinoma finally gets a new Erivedge loaded Webley.

Skin cancer is the most common type of cancer in the western world—40% of all cancers are skin cancers with 80% of skin cancers being nonmelanoma, and primarily basal cell carcinoma.

One-Two Punch: Curbing HER-2 Positive Breast Cancer with Herceptin-Tykerb Combo

Using Tykerb (lapatinib; GlaxoSmithKline, U.K.) and Herceptin (trastuzumab; Genentech, South San Francisco, Calif.) anti-HER-2 drugs together doubles the odds of recovery compared to either drug alone in HER-2 positive early breast cancer patients, reports NeoALTTO trial investigators in the January 17th online publication at Lancet Oncology journal homepage.  This study provides a proof-of-concept that dual HER-2 block is better than using a single agent HER-2 blocker.

San Antonio Breast Cancer Symposium 2011: Clinical Trials Report

San Antonio Breast Cancer Symposium is one of the largest gatherings of breast cancer clinicians, scientists and those with a stake in breast cancer treatment. There are over 8,000

28% of Phase III Failures are in Oncology Trials

John Arrowsmith of Thomson Reuters, who described these numbers in a Nature Reviews Drug Discovery article, listed three major reasons for Phase III failures in oncology:

Taking the bite out of second cancer risk attributable to radiotherapy of primary first cancer

 Extract of my guest post at maiBlog, a radiology-focused blog.

"The increasing ranks of cancer survivors have brought new concerns into focus—second primary cancers now account for 18% of all cancer diagnosis and are the third most common cancer diagnosis in US. ... Radiotherapy, while a highly effective cancer treatment option, has long been considered to increase the risk of subsequent cancers, but convincing data had been lacking.  Now, an epidemiological study published by the National Cancer Institute in the April 2011 issue of Lancet Oncology journal shows that 92% of all second cancers are due to causes other than the radiation treatment of previous cancer. ..."

Click here to read full post at maiBlog.

(Find complete post at InternetArchive here.) ___________________________

Complete Post Below:

By Ajay K Malik, PhD

Over the last forty years, we have made great strides in the diagnosis and treatment of cancer. According to the Centre for Disease Control and Prevention (CDC), the number of cancer survivors have steadily increased from three million in 1971 to over eleven million today; one in twenty Americans is a cancer survivor. The increasing ranks of cancer survivors have brought new concerns into focus‚Äîsecond primary cancers now account for 18% of all cancer diagnosis and are the third most common cancer diagnosis in US. Similar data is also emerging from other countries. Second primary cancers (a.k.a. second cancers) are new cancers that arise after the first incidence of any cancer. Second cancer may be in the same, surrounding or distant organs, and differ from metastatic cancer which is a result of primary first cancer cells disseminating to a distant organs (see a definition here).

Genetics and lifestyle behaviors, for instance, smoking, alcohol or poor diet, are partly responsible for second cancer, the treatment modalities during first cancer may also have a role. Both chemotherapy and radiotherapy can increase predisposition of other cells to cancer. Radiotherapy, while a highly effective cancer treatment option, has long been considered to increase the risk of subsequent cancers, but convincing data had been lacking. Now, an epidemiological study published by the National Cancer Institute in the April 2011 issue of Lancet Oncology journal shows that 92% of all second cancers are due to causes other than the radiation treatment of previous cancer.

This study relied on a National Cancer Institute resource called US Surveillance, Epidemiology and End Results (SEER) cancer registries. Since 1973, SEER registries have been collecting and reporting data on patient demographics, cancer diagnosis, tumor morphology tumor stage at diagnosis, first-line treatment and follow-up status. There are fifteen SEER registries which cover 28% of the US population from Conn. to Calif. with a racial make-up reflecting the overall US population. The authors analyzed data (collected from nine registries) for 647,672 patients who were 20 years or older (adult) and had been followed for a mean of 12 years since the primary cancer diagnosis. Their analyses included all (i.e., fifteen) solid-cancer sites, and cancers which had appeared after 5 years of first cancer were counted as second cancers. In this analysis, patients who had survived five or more years, nine percent developed second tumors‚Äînot all had received radiotherapy.

Radiotherapy, as part of initial first cancer management included external beam, brachytherapy or a combination of both. There was a variation in the use of radiotherapy across various cancer types. In this cohort, 60-80% of testicular (seminomas), brain, anal and laryngeal cancers were treated with radiotherapy, whereas less than 30% of non-small-cell lung and eye & orbit cancers were managed with radiotherapy. Yet, for every cancer type analyzed, the risk of second cancer was significant (Relative Risk, RR>1); the highest risk was for testicular (34%) and cervical(17%) cancers. However, of all the second cancers, only 8% could be attributed to radiotherapy during first cancer management. This is a much smaller percent than expected, and is a very good news for the radiology community. It helps communicate long-term risk of radiotherapy with respect to the potential benefit of tumor control and patient survival. Furthermore, the overall risk also decreases with time and by 15 years after the first diagnosis, only five excess cancers were found per 1000 cancer survivors.

The strengths of this study were: systemic analysis of all first cancer sites in adults, large population and over three decades of follow-up population data. However, there are some limitations: pediatric populations were excluded, also excluded from the study were patients who survived <5 years, those with hematological cancers, non-seminoma testicular cancers and small-cell lung cancer. The radiotherapy tools and equipment are continuously evolving and new technologies are being adopted. Thus, another look at these statistics will be warranted in coming years. But, for now, radiotherapy must be considered safe and should help professionals address anxiety of patients choosing a radiotherapy option.

This study was led by Amy Berrington de Gonzalez of Radiation Epidemiology Branch of National Cancer Institute, Bethesda, and included researchers from MD Anderson Cancer Institute, Houston, Texas.

Read more about the author, cancer biologist and biotech writer,Ajay K. Malik, PhD

References

Cancer Survivors‚ÄîUnited States, 2007. Morbidity and Mortality Weekly Report (MMWR). March 11, 2011;60(9):269-272 | FreeFullText |

de Gonzalez AB, Curtis RE, Kry SF, et al. Proportion of second cancers attributable to radiotherapy treatment in adults: a cohort study in the US SEER cancer registries.Lancet Oncol. 2011 Apr;12(4):353-60. | PubMed | Scholar |

Tags: radiation therapy, radiotherapy, secondary cancer

CTing the risk of dying from lung cancer.

Is CT scan is to lung cancer what Pap smear is to cervical cancer?  Can routine CT-scan screening detect asymptomatic lung cancer and improve the odds of someone being a "lung cancer survivor."  The results of the NCI-sponsored National Lung Screen Trial (NLST) released recently, would like you to believe, yes, it is.