Fighting Cancer With Fire

Anaplastic oligodendroglioma brain tumor best treated with radiation Matulane CeeNU and Oncovin

(RxWiki News) For the most aggressive cancers, using aggressive treatments turn the fighting of the disease into an all or nothing event. Despite possible side effects.

For a few more months, many patients are willing to accept those risks.

A follow-up study from the Netherlands six years after the original was published has drawn some different conclusions, with the same scientists recommending aggressive treatment of a type of brain cancer known as anaplastic oligodendroglioma.

"Ask your oncologist about aggressive combination therapy."

First author of the study, Martin J. van den Bent, MD, of Erasmus University Medical Center, and Daniel den Hoed Cancer Center in the Netherlands presented his findings during the annual meeting of the American Society for Clinical Oncology. Study authors contributing to the research included scientists from cancer centers across Europe.

The optimal treatment now recommended is to follow radiation therapy with a triple course of chemotherapy that includes Matulane (procarbazine), CeeNU (lomustine) and Oncovin (vincristine).

Researchers also found that this blend of treatments had the greatest effectiveness in patients who have a cancer with a certain genetic alteration, a deletion of entire sections of two specific chromosomes.

Deletion of the p arm of chromosome 1 and the q arm of chromosome 19 -- as is sometimes observed in this particularly aggressive form of brain cancer -- is another wrinkle in the changing nature of cancer treatment into increasingly segregated types, even in the same kinds of cancers.

Dr. van den Bent neatly summarized his conclusions, saying, “Now we have identified a subgroup of patients who benefit from adjuvant chemotherapy following [radiation therapy].”

The study design had 368 patients who were enrolled, with half treated with radiation alone, and half treated with radiation, followed by a course of triple chemotherapy.

Although overall survival was statistically significant in an increase for patients in the radiation chemotherapy group, the most dramatic results were in patients who had tumors involving the chromosome deletions.

Early findings from another study on the same cancer, presented at the same conference by J. Gregory Cairncross, MD, of the University of Calgary in Canada, also supported the addition of triple chemotherapy to radiation treatment.

Also present at the conference was Mark R. Gilbert, MD, from The University of Texas' MD Anderson Cancer Center. Dr. Gilbert states the conclusions from the two studies are “practice changing,” noting the recommendations of the study authors had changed since they began to collect data in 2006.

Dr. Gilbert emphasized the importance of data collection by those in the front lines of cancer treatment, saying that you never know what will later prove to be the key to finding new treatments or therapies for a given cancer.

“The importance of collecting tumor samples in clinical studies cannot be overemphasized. When these studies were undertaken, the molecular marker that predicted treatment benefit had not yet been discovered. Collecting and archiving tumor samples allows for reassessing clinical outcomes when new markers are discovered,” Dr. Gilbert concluded.

Researchers disclosed financial relationships with MSD, GlaxoSmithKline and Roche.

Research presented at conferences is considered preliminary until published in a peer-reviewed journal.

Review Date: 
June 15, 2012