What’s interesting in cancer research right now? What do we most need to know about? This is the latest post in a series in which we review several of the most notable cancer research stories that have come out over the previous two to three months.
These are a few of the recent stories that seem to have the greatest potential impact, at least from my perspective, and that I know I’ll want to follow as they develop further.
Topics covered this time include HER2-positive breast cancer, immune system therapies and overcoming treatment resistance.
Breast Cancer Treatment
Last fall, the FDA, for the first time, approved the use of an anti-cancer drug for patient treatment prior to surgery. The drug was pertuzumab (Perjeta) and it was approved for pre-surgery treatment for patients with HER2-positive breast cancer. Perjeta had been approved in 2012 for treatment of patients with advanced breast cancer.
Recently, results were reported for a clinical trial which sought to find out whether adding Perjeta to a standard treatment regimen leads to improved outcomes for patients. In the CLEOPATRA trial, patients with HER2-positive metastatic breast cancer received either Perjeta, along with trastuzumab (Herceptin) and chemotherapy, or they received the Herceptin/chemotherapy combination and a placebo.
Final reported results of the trial showed that the treatment combination that included Perjeta increased overall survival for patients by almost sixteen months, considered a very long, if not unprecedented, extension of time for a drug that is given for metastatic cancer.
How effective pertuzumab might be in treating early stage breast cancer is not yet known. The AFFINITY trial is a stage III, randomized, controlled trial that will answer that question–initial results are expected in 2016.
Immune System Therapies
Much of the news in cancer research these days is about experimental approaches that would help the body’s own immune system fight cancer.
In the Early Summer edition of Top Research Stories, I wrote about early-stage clinical trial results for a type of immune system therapy that works by blocking the function of a protein called PD-1 (programmed death-1). The PD-1 protein prevents a patient’s white blood cells from effectively fighting his or her cancer.
While immune system therapies such as PD-1 inhibitors only work for some patients, when they do work they can have strikingly long-lasting benefits.
In September, another drug, pembrolizumab (Keytruda) became the first PD-1 inhibitor to receive approval from the FDA for the treatment of advanced melanoma. Referring to the new class of cancer drugs that includes Keytruda and other immune system therapies that are in various stages of development, Dr. Louis M. Weiner, director of the Georgetown Lombardi Comprehensive Cancer Center and a spokesman for the American Association for Cancer Research, told the New York Times:
This is really opening up a whole new avenue of effective therapies previously not available. It allows us to see a time when we can treat many dreaded cancers without resorting to cytotoxic chemotherapy.
Keytruda was in the news again in early November, when it received approval from the FDA for the treatment of non-small cell lung cancer. Cure Today reports that Keytruda is being studied across more than 30 types of cancer in more than two dozen clinical trials.
While new drugs like Perjeta and Keytruda may offer more effective treatment options for certain patients, the prices that are charged for newer cancer drugs like these are extremely high. Perjeta, for example, costs about $5,900 a month or $71,000 for a year of treatment (and if combined with Herceptin, which is also very expensive, the cost is even higher) and Keytruda is priced at about $12,500 a month or $150,000 for a year of treatment. I wrote about the growing problem of the high cost of cancer drugs to patients in a recent post.
Overcoming Treatment Resistance
Often drugs that are targeted to specific tumor characteristics or mutations may seem to work well for a patient at first, but eventually lose their effectiveness as the cancer develops new mutations that allow it to become resistant to the targeted therapy and begin growing again.
In a recent study published in Science, researchers developed a new way to identify treatment combinations that may work well in patients whose cancer has become resistant to a particular targeted therapy. The researchers grew samples of tumor cells from individual patients in culture dishes in the lab. They then tested an array of different combinations of existing drugs on the cell cultures to identify drug combinations that would stop the cancer cells from growing.
The scientists reported that using this method they were able to identify multiple drug combinations that were effective, at least on the cell cultures. Some of the combinations that seemed to work would not have been identified by simply doing genetic analysis of the tumor cells.
The journal Nature reports that the researchers are now working to reduce the time needed to culture a patient’s tumor cells in the lab. Refinements are clearly needed, and the technique is a ways away from being ready to be tested in patients, but it does seem to have potential.
That’s it for this time. If there was another recent cancer research story or article that caught your attention or if you have thoughts on any of what I’ve included, I’d love to hear from you!
Why Do New Cancer Drugs Cost So Much?
Top Cancer Research Stories: Late Summer 2014
Top Cancer Research Stories: Early Summer 2014
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