Cancer Meeting Focuses on Existing Drugs

Many of the studies presented at this year's ASCO conference centered on finding better ways to use current cancer treatments

One of the biggest challenges in modern-day cancer treatment is properly matching one or more of the many new cancer drugs to the patients most likely to respond. Consequently, much of the news coming out of the massive American Society of Clinical Oncology (ASCO) meeting focused on better ways to use existing treatments. More than 30,000 oncologists, scientists, and investors who attended the conference in Chicago May 30-June 3 came to learn.

Underlying the thousands of studies presented at the meeting was concern about the soaring cost of cancer treatment, with new drugs routinely costing $30,000 and up. "How will we be able to afford these drugs?" asked Dr. Julie Gralow, associate professor of medicine at the University of Washington. One way, she suggested, is to narrow the use of them to only those patients most likely to respond. The following are some of the more notable studies presented at the meeting.

Erbitux: Jointly marketed by ImClone Systems (IMCL), Bristol-Myers Squibb (BMY) and Merck KGaA (MRCG.DE) of Germany, Erbitux was the subject of several highlighted studies, including a much anticipated report that found the drug prolonged survival in patients with advanced lung cancer by five weeks. That's a statistically significant result in such sick patients. "This represents moderate progress," said Dr. Roy Herbst of M.D. Anderson Cancer Center in Houston. Erbitux is currently approved for colon cancer and head and neck tumors. This study will likely lead to the drug being used for the 50% of lung cancer patients who cannot tolerate Genentech's (DNA) Avastin.

Doctors were also very interested in a study finding that colon cancer patients whose tumors have a mutated form of a gene called KRAS will not respond to Erbitux. The mutation, found by removing and examining a small piece of tumor tissue, is found in about 30% to 45% of colon tumors. "This is hugely significant for colon cancer patients because it allows you to screen out those patients who absolutely should not be treated with [Erbitux] because they will not benefit," says Dr. Neal Meropol of Fox Chase Cancer Center in Philadelphia. It will also significantly narrow the size of Erbitux's potential market.

Zometa: An osteoporosis drug made by Novartis (NVS), Zometa turned in some surprising results—a study found that it can significantly lower the risk of breast cancer recurrence in young women. The drug was designed to strengthen bone, but in a study of 1,803 patients, researchers found that 6% of those given Zometa, plus standard hormone therapy, had a recurrence of the cancer after five years, compared with 9% of those who received only hormone therapy. The researchers called for more study.

RAD001: Also known as everolimus, this Novartis drug is a version of Certican, already approved in some countries (though not the U.S.) to prevent organ rejection in transplant patients. It's being tested against a number of cancers, and at ASCO results were released of a trial against deadly kidney cancer that was successful enough to be halted early, so that the patients on placebo could switch to RAD001.

The drug targets mTOR, a protein that plays a central role in controlling the metabolism of tumor cells. In the 400-patient trial, presented by Dr. Robert Motzer of Memorial Sloan-Kettering Cancer Center, the cancer did not progress for six months in 26% of those receiving RAD001, compared with 2% of those in the placebo group. Motzer called the drug "a new and clearly useful tool" that moved kidney cancer one step closer to being treated as a chronic disease, a big change for a cancer that was a certain death sentence not many years ago.

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