Women with ovarian cancer may be able to stave off relapses for an extra half-year or so by taking a drug already approved to treat kidney cancer, researchers reported here on Saturday. But it will not be clear whether the drug prolongs women’s lives until the patients are followed longer. The study was one of many being presented at the annual meeting of the American Society of Clinical Oncology.
Another study shows that a drug may have some effect against a rare but notoriously hard to treat form of melanoma.
A third suggests that the spouses or long-term partners of people with mouth or throat cancers linked to human papillomavirus, or HPV, do not have an increased risk of infection from that virus and do not have to change their sexual behaviors.
Ovarian cancer is often successfully controlled initially by surgery and chemotherapy. But about 70 percent of women with advanced ovarian cancer experience a relapse, often in the first year. The study tested the strategy known as maintenance therapy. Instead of stopping treatment after a tumor is controlled and resuming it only when a cancer starts to worsen, a new drug is given immediately after the successful chemotherapy.
In this study, which involved 940 women with advanced cancer, the maintenance drug was pazopanib, sold as Votrient to treat kidney cancer and soft tissue sarcoma. The trial was sponsored by GlaxoSmithKline, which manufactures Votrient. For those who received the drug, the median time before the cancer worsened was 17.9 months, compared with 12.3 months for those given a placebo. “Many patients will experience longer disease-free and chemotherapy-free periods,” said the lead author, Dr. Andreas du Bois, a gynecologic oncologist at the Kliniken Essen-Mitte in Essen, Germany.
GlaxoSmithKline said it would apply for approval of the drug for ovarian cancer. The drug is taken orally and blocks the formation of blood vessels that feed tumors.
Maintenance therapy, however, is controversial because it exposes patients to drug side effects when their cancer is not in evidence. It is also not clear whether the therapy prolongs lives compared with giving that same drug after a relapse. “These questions do remain as to what is the right drug and what is the right time,” said Dr. Carol Aghajanian, chief of gynecologic medical oncology at the Memorial Sloan-Kettering Cancer Center, who was not involved in the study.
The drug Avastin, sold by Roche, also delays the return of ovarian cancer when used as an initial and maintenance treatment. But in studies, it has not prolonged lives significantly. Avastin is approved for the treatment of ovarian cancer in Europe but not in the United States.
Another study found that an experimental drug, selumetinib, may be the first to improve the outcome of patients with melanoma that arises in the eye rather than the skin, though the improvement was quite modest. So-called uveal melanoma is very rare, with about 2,000 new cases a year in the United States. “We had no options for this group of patients,” said Dr. Lynn M. Schuchter, a melanoma specialist at the University of Pennsylvania, who was not involved in the study. She said the new drug represented an advance. The drug blocks the activity of a protein called MEK, which often plays a role in spurring cell growth in this type of tumor.
The study involved 98 patients with metastatic uveal melanoma. The median time before the disease worsened was 15.9 weeks for selumetinib, compared with 7 weeks for the control group, which received temozolomide, or Temodar, a drug often used for skin melanoma. Those who received selumetinib lived a median of 10.8 months, compared with 9.4 months for temozolomide, a difference that was not statistically significant. Most patients getting temozolomide switched to selumetinib after their cancer progressed, which could have blunted the difference in survival between the groups.
The drug, which is not yet on the market, is being developed for various cancers by AstraZeneca under license from Array BioPharma. The HPV study involved 166 people with oropharyngeal cancer, a cancer of the mouth and throat, and 94 of their spouses or partners. While HPV is most known as the cause of cervical cancer, it has also been linked to oropharyngeal cancer, which is increasing in incidence and is often caused by having oral sex with someone with a genital infection.
The patients were predominantly men, and all but a handful of the spouses or partners were women. About 5 percent of the female partners had an oral infection with the virus, roughly the same rate as in the general population. Two of the six male partners had an oral infection, but not of the worst type of HPV. That is higher than the general rate for men, but the sample size was too small to draw firm conclusions. Many people get HPV infections but usually clear them.
“Couples who have been together for several years have likely already shared whatever infections they have, and no changes in their physical intimacy are needed,” Gypsyamber D’Souza, the lead study author, said in a statement. She is an associate professor of epidemiology at Johns Hopkins University
Published: June 1, 2013
The New York Times