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Introduction


The latest advances against cancer were presented Sept. 21-25 at the European Cancer Conference in Copenhagen, where updates were presented on clinical trials and basic research. Here are several of the noteworthy findings. The overall U.S. cancer death rate has barely budged in the past two decades, but there is a shining exception: prostate cancer. After slowly rising during the 1970s and '80s, prostate cancer deaths fell by one-third in the '90s for men age 50 to 74.

A new analysis of existing clinical-trial data attributes part of the improving outlook to early detection and prompt surgery, but mostly credits follow-up hormone therapy. "Hormonal treatment as a whole works ridiculously well," said Sir Richard Peto, professor of medical statistics at Oxford University.

Prostate cancer is usually treated with surgery or radiation, but a few cancer cells may remain and cause an often-fatal recurrence. Since the mid-'80s, oncologists have increasingly followed up with either surgical removal of the testes, or with newer anti-hormone drugs. Peto said that 74% of men who received hormone therapy were still alive 10 years later, compared with 62% of those who did not. Promising early results were presented at the conference for a novel cancer vaccine that makes use of so-called heat shock proteins. These proteins help repair damage to the cell caused by stress -- an unwanted survival mechanism in cancer cells.

Antigenics' (AGEN) Oncophage vaccine is created from heat shock proteins taken from a cancer victim's own tumor. When injected, the vaccine is meant to prompt the immune system to attack cancer cells containing those same proteins. In a Phase 1 trial, the vaccine was given shortly after surgery to 10 patients with pancreatic cancer. This is a particularly deadly disease, with an average survival time following surgery of 14.5 months. Dr. Robert G. Maki of Memorial Sloan-Kettering Cancer Center in New York reported that two of the 10 patients were alive and disease-free after more than two years, and one was still alive and disease-free after five years. He cautioned that larger studies are needed to learn if it would be possible to treat all pancreatic patients with the vaccine. Studies of a new generation of targeted therapies dominated the 2003 European Cancer Conference. These drugs home in on a particular cancer-enabling mechanism found in a variety of different tumors. Thus Erbitux, developed by ImClone Systems (IMCL) has primarily been tested against colon cancer, but a European study indicates it may also be effective against lung cancer.

A team led by Dr. Rafael Rosell of Hospital Germans Trias i Pujol in Barcelona tested 85 lung cancer patients, all with tumors that expressed high levels of a growth-inducing protein blocked by Erbitux. Over 15 weeks, 43 of the patients received chemotherapy, while 42 were given chemo plus a weekly injection of Erbitux. Rosell reported that the disease was reduced or stabilized in 58.4% of the patients receiving Erbitux, compared with 29.7% of those on chemo alone. "This combination therapy looks very promising" as an initial treatment, he said. -- In the first study to show such a link, researchers found that women whose children develop cancerous tumors by the age of 5 have double the risk of developing breast cancer in the first 10 years after the birth. A research team led by Dr. Dong Pang at Britain's Royal Manchester Children's Hospital said such mothers are at even higher risk if the child is a boy. The link only showed up for children with solid tumors, not those with blood diseases such as leukemia. Pang said abnormal hormone levels in the mother during pregnancy and a disruption of tumor suppressor genes could be the cause.

-- In a study of 41 breast cancer patients treated with radiotherapy, Danish researchers have identified specific variations in four genes that correlate with different types of radiation damage. Dr. Nicolaj Andreassen of Aarhus University Hospital said the discovery could help predict how patients' cancers might respond to the treatments.


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