Chinese Mandarin - Chemo and surgery may help colon cancer

WORLD / Health

Chemo and surgery may help colon cancer

(AP)
Updated: 2007-06-05 10:33

CHICAGO - Scientists reported promising gains Monday for treating
colorectal cancer that has spread to the liver, showing that chemotherapy
before and after surgery to remove liver tumors can help keep the disease
in check.

The study is the first to scientifically test an approach that many
doctors have tried for patients with advanced colon and rectal cancers.

"It justifies what some of us have already been doing" and shows that
aggressively treating patients with limited spread of colorectal cancer
is reasonable, said Dr. Jeffrey Meyerhardt, a cancer specialist at Dana
Farber Cancer Institute in Boston.

About 1 million people worldwide develop colorectal cancer each year,
including more than 150,000 in the United States, where it is the third
most common major cancer. In up to half of all patients, the disease
spreads after initial treatment to the liver. For many cancers, spread to
the liver means the disease has also spread elsewhere, is incurable and
surgery isn't an option.

But with colorectal cancer, sometimes the disease spreads only to the
liver, and surgery to remove these growths increasingly is being
attempted, said Dr. Neal Meropol, director of the gastrointestinal cancer
program at Fox Chase Cancer Center in Philadelphia. Even so, recurrence
is common, and only about 30 percent of patients who have this surgery
survive five years.

In the new study, 42 percent of patients who got chemotherapy before and
after the liver surgery had no recurrence after an average of three
years, versus 33 percent of patients who had surgery alone.

The good results mean the approach could become standard treatment for
these patients, said Dr. Bernard Nordlinger, the lead author and a cancer
specialist at Ambroise Pare Hospital in Paris.

Nordlinger presented the results in Chicago at the American Society of
Clinical Oncology's annual meeting.

A separate colorectal cancer study presented Monday showed the targeted
cancer drug Erbitux can modestly improve survival when added to standard
chemotherapy in patients whose disease has spread. Patients who got
Imclone Systems Inc.'s drug survived an average of 8.9 months without
disease progression versus eight months for those who got chemotherapy
alone.

"Although we would all love to have huge breakthroughs that would
revolutionize cancer treatment, those are few and far between," said
Northwestern University's Dr. Al Benson III. Instead, cancer treatment
advances typically come in smaller but important steps like the
colorectal cancer studies presented Monday, which over time lead to real
progress, Benson said.

The chemotherapy-plus-surgery study involved 151 patients who had both
treatments and 152 who had surgery alone. The chemotherapy used was a
commonly used combination of drugs called oxaliplatin leucovorin
fluorouracil.

Complications, including diarrhea and reduced amounts of disease-fighting
white blood cells, were more common in chemotherapy patients but were
still within an acceptable range, Nordlinger said.

A separate study presented Monday involved primary liver cancer - disease
that originates in the liver rather than spreads there. Researchers said
they have found the first drug that improves survival for liver cancer
patients - a breakthrough that likely will become standard treatment.

Those results occurred in patients with advanced liver cancer treated
with the drug sorafenib, or Nexavar, which is marketed by Bayer
Pharmaceuticals Corp. and Onyx Pharmaceuticals Inc. to treat advanced
kidney cancer.

The companies are expected to seek U.S. approval this summer for treating
liver cancer with the drug.

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