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MAY 30, 2005
Developments to Watch


Introduction

The mood was unusually upbeat at the annual conference of the American Society of Clinical Oncology (ASCO) in Orlando on May 13-17, which attracted about 30,000 scientists and doctors. Here are some of the studies that helped fuel the optimism.

By Catherine Arnst

TREATMENT
New Targets For Drugs

The first years of this century witnessed the emergence of targeted cancer therapies such as Genentech's Avastin. With minimal side effects, these treatments take aim at one cellular abnormality that drives tumor growth. Their benefits have been modest, however: Only a few help patients live longer. But what would happen if you knocked out several cancer-causing factors at once?

A new class of multitargeted drugs is designed to do just that. The drugs block several proteins responsible both for the tumor's growth and its blood supply. A prime example is AstraZeneca (AZN ) 5/16/05 @ 8:40 PM --]'s zd6474 for lung cancer -- a huge killer, and one with few good treatment options. In a 127-patient trial, tumors shrank in 26% of the subjects, and the drug kept patients alive without tumor growth for a median of 18.7 months, six months longer than chemotherapy alone.

The first drugs in this category to reach the market will probably be sorafenib, developed by Bayer Pharmaceuticals (BAY ) and Onyx Pharmaceuticals (ONYX ), and Pfizer's (PFE ) Sutent. The companies plan to seek marketing approval by yearend.

Both drugs were tested against kidney cancer. Sorafenib shrank tumors in only 2% of patients but doubled the length of time patients survived, without the disease progressing, to 24 weeks. In two smaller trials, the tumors of 40% of patients on Sutent shrank, but the drug had more side effects than sorafenib, and survival benefits weren't verified. Cancer specialists cautioned against comparing the two drugs based on very different studies. "I think there will be a place for both," says Dr. George Demitri of the Dana-Farber Cancer Institute.

By Catherine Arnst

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PREVENTION
An Aspirin A Day Keeps The Cancer Away?

Cancer is most deadly when it reemerges after initial surgery or chemotherapy. To prevent such recurrences, doctors are testing a number of follow-on treatments, often with well-known drugs. Simple aspirin, for example, may halve the risk of recurrence and death for colon cancer patients. For 2 1/2 years, a team led by Dr. Charles Fuchs of the Dana-Farber Cancer Institute followed 846 patients whose colon cancer had spread to the lymph nodes. The 75 patients who reported taking aspirin daily or every other day had a 55% lower risk of recurrence and a 48% lower risk of death, compared with nonusers. More research is needed to confirm the findings and determine just why aspirin prevents recurrences.

Another study found that the controversial drug Thalidomide, made by Celgene Corp., can greatly lower the risk of recurrence for patients with multiple myeloma, a deadly bone-marrow cancer. In a 668-patient randomized study, the drug prevented the disease from reemerging for 55% of patients over five years, compared with 40% for those who received standard treatment. Launched as a sleep aid, Thalidomide was taken off the market in the 1960s because it caused serious birth defects. But it may work against cancer because it blocks blood vessel formation around a tumor.

By Catherine Arnst

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SMOKING
A Vaccine For Quitters

Smoking causes some 30% of all cancers, which is why there was a lot of buzz at ASCO over incremental progress on an anti-smoking vaccine. Cytos Biotechnology in Zurich reported that 40% of the 341 smokers in a trial of its CYT002-NicQb vaccine stopped smoking for 8 to 24 weeks. However, 30% of the patients on placebo also quit.

The Cytos drug is an antibody that blocks nicotine from entering the brain -- and the researchers did find that 57% of those patients who had high levels of the antibody in their blood were able to give up smoking. That suggests that even if the current Cytos vaccine fails, antibodies can indeed help fight nicotine addiction. The company plans further studies.

By Catherine Arnst



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