Giving patients a lung cancer diagnosis is never easy.
The treatment options that are available can be arduous
and don't guarantee that the cancer won't recur elsewhere
in the body. But new research is offering hope and time
to those suffering from the disease by way of improved
treatments.
Results of a trial published in
the June 23 New England Journal of Medicine, which
involved 482 patients with non-small cell lung cancer
in Canada and the US, show that those treated with surgery
and chemotherapy lived on average 21 months longer than
those who had only surgery. Chemo and surgery prolonged
recurrence-free survival.
"This is the best news for lung
cancer patients in decades," says Dr Timothy Winton,
lead author and an associate professor and director
of the Division of Thoracic Surgery at the University
of Alberta Hospital in Edmonton. "GPs out there need
to realize that the benefits of this treatment are and
will continue shifting the standard of practice around
the world."
Broken down, results demonstrated
that 69% of patients who had surgery followed by chemotherapy
were still alive five years later, compared with 54%
who had only surgery, an increase of 15%.
IMPROVED
TREATMENTS
These encouraging results could be due in part to improvements
in chemotherapy drugs and the management of side effects;
two reasons that prompted the study authors to re-examine
the use of chemo for this specific type of lung cancer.
New agents like vinorelbine, gemcitabine, taxanes and
camptothecins when paired with a platinum derivative,
increase the response of treatment. And serotonin-receptor
antagonists have been shown to reduce the severity of
vomiting in those using cisplatin. In this current study,
patients were given a combination of two drugs, cisplatin
and vinorelbine, once a week for 16 weeks.
"The benefits demonstrated in this
study far exceed that seen in breast or colon cancer
when adjuvant therapy was adopted [in treating] these
diseases," explains Dr Winton. "Furthermore this was
achieved with a short four month treatment regimen that
was well tolerated and from which patients recovered
rapidly — this is not a particularly toxic therapy
and it works extremely well and is inexpensive to boot."
Traditionally, surgery without
chemotherapy was the recommended treatment for patients
with non-small cell lung cancer. But the cancer often
recurred, usually elsewhere in the body, and was typically
incurable.
NEJM Jun 23, 2005;352:2589-97
|
