Using two opposite strategies, scientists say they have made significant progress in taming two of the most intractable types of cancer.
One approach, highly focused on specific types of tumors, shrank them significantly in 57 percent of patients with a lung cancer marked by a specific genetic abnormality.
Even though the clinical trial was small (just 82 people, with no control group), the results were considered so striking for such sick patients that the study was yesterday at the main session of the annual meeting of the American Society of Clinical Oncology here.
“This is a phenomenal example of finding the right patient and the right drug very early on,” said Pasi Janne of the Dana-Farber Cancer Institute in Boston, who was involved in the trial.
The other strategy is a potentially universal treatment for all types of cancer that works by releasing a brake on the body’s immune system, letting the immune system attack the cancer more vigorously.
In a study of patients who had advanced melanoma, those who got an experimental drug lived a median of about 10 months, compared with 6.4 months for those in a control group. After two years, about 23 percent of those who got the drug were alive, compared with 14 percent in the control group.
Lung cancer and melanoma are among the hardest cancers to treat, so the studies are being viewed as significant advances, though far from cures.
Steven O’Day of the Angeles Clinic and Research Institute in Santa Monica, California, a lead investigator in the melanoma trial, called the result “historic,” and added, “This is the first randomized placebo-controlled trial ever to show a survival benefit in Stage 4 melanoma.”
Bristol-Myers Squibb, which sponsored the trial, is planning to apply for regulatory approval to sell the drug, ipilimumab.
The lung cancer drug, by contrast, blocks an aberrant protein called ALK that is found in only about 5 percent of non-small-cell lung tumors. But in patients whose tumors have this aberration, the drug seems to work wonders. Not only did the tumors shrink significantly in 57 percent of the 82 patients, they remained stable in 30 percent more.
Beverly Sotir, 71, of Belmont, Massachusetts, who has been taking the pills as part of the trial since July last year, said her tumors had shrunk without debilitating side effects.
“For someone who’s been on chemo before, this is like a miracle drug,” she said. “You feel yourself. You look yourself.”
Pfizer, which sponsored the study, has started a more definitive trial aimed at winning approval of the drug, crizotinib.
There are caveats. The effects of crizotinib can eventually wear off, though 72 percent of the patients in the trial were free of cancer progression for six months.
As for the melanoma drug, because it removes checks on the immune system, 10 percent to 15 percent of patients in the study suffered severe side effects.
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