Doctors report the success of new drugs that better control certain types of cancer, reduce the risk of recurrence, and make treatment simpler and easier to bear.
Milder medications would help patients like Jenn Carroll, a 57-year-old human resources manager from New Hartford, Connecticut, who underwent traditional IV chemotherapy after lung cancer surgery in 2018.
“It was very strong. I call it the “blammo” method, “she said.
Carroll jumped at the chance to help test a new drug taken as a daily pill, AstraZeneca’s Tagrisso. Rather than the imprecise approach to cell destruction of chemo, Tagrisso targets a specific genetic mutation. Its side effects are manageable enough to be used for several years to help prevent recurrences, according to doctors.
One big drawback: this drug and other newer drugs are extremely expensive – $ 150,000 or more per year. The amount that patients end up paying depends on insurance, income, and other factors.
Here are highlights from this study and others from an American Society of Clinical Oncology conference that will be held online this weekend due to the coronavirus pandemic.
Lung cancer kills more than 1.7 million people worldwide each year. Dr. Roy Herbst of the Yale Cancer Center led a study on Tagrisso in 682 patients with the most common form of the disease. All had operable tumors with a mutation in a gene called EGFR which is found in 10% to 35% of cases, particularly in Asians and non-smokers.
About half had standard chemo after surgery and then took Tagrisso or placebo tablets. Independent observers discontinued the study last month when the benefits of the drug appeared clear.
After an average of two years, 89% of the patients on medication were alive without recurrence of cancer against 53% on placebo. Serious side effects were a little more common on Tagrisso – mainly diarrhea, fatigue, and inflamed skin around the nails or in the mouth.
Tagrisso is approved for the treatment of advanced lung cancer, and “the excitement is now moving sooner” before the disease spreads widely, said Herbst, who consulted with the manufacturer of the drug.
The drug costs about $ 15,000 a month.
Men with advanced prostate cancer are often treated with drugs to suppress the male hormones that can help the cancer grow. The drugs are given by injection every few months but take days or weeks to start working and may cause an initial flare-up of bone pain and urinary or other problems.
Researchers tested Myovant Sciences’ relugolix – a different type of hormone blocker and the first pill that is a daily pill – against injections of leuprolide every three months in 930 men treated for almost a year.
About 97% of the investigational drug maintained hormones suppressed during this period, compared to 89% for leuprolide. Four days after starting treatment, 56% of men on relugolix and none on leuprolide had their hormones suppressed.
A heart attack, stroke or other serious heart problem occurred in 3% of men on relugolix and in 6% of men on leuprolide. The difference was even greater among men who had previously had heart problems.
This could be important because heart disease is a common cause of death in men with prostate cancer, according to Dr. Celestia Higano at the University of Washington in Seattle. She had no role in the study and wrote in a comment published with the results in the New England Journal of Medicine.
Myovant is seeking Food and Drug Administration approval for the drug; no cost estimates have been released.
The Keykuda blockbuster from Merck & Co., which helps the immune system to detect and fight cancer, has proven to be better than standard chemo combinations as an initial treatment for people with advanced colon cancer and tumors with genetic abnormalities that cause a high number of mutations, which makes them difficult to treat.
The study involved 307 patients in France. Those who received Keytruda spent more than 16 months on average before their cancer got worse, compared to 8 months for those on chemotherapy. After one year, 55% on Keytruda were alive without worsening of the cancer against 37% on chemo. After two years, it was 48% against almost 19%.
About 22% of people receiving Keytruda had serious side effects compared to 66% on chemo.
About 5% of colon cancers are similar to those in this study, said Dr. Howard Burris, president of the oncology society and director of the Sarah Cannon Research Institute in Nashville.
“If you are one in 20, instead of taking this combination chemotherapy, you can take simpler immunotherapy once every two weeks” with better results and fewer side effects, he said. .
Keytruda costs around $ 12,500 per month.
Marilynn Marchione can be followed on Twitter: @MMarchioneAP
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