Pill found to help combat liver cancer
Patients in study survived longer by taking drug
CHICAGO -- For the first time, doctors say they have found a pill that improves survival in liver cancer, a notoriously hard-to-treat disease diagnosed in more than half a million people globally each year.
The results in a multinational study of 602 patients with advanced liver cancer are impressive and probably will change the way patients are treated, cancer specialists and the study authors say.
Patients got either two tablets daily of a drug called sorafenib or dummy pills in the study, which started in March 2005. Some patients are still alive, although on average sorafenib patients survived 10.7 months versus almost 8 months for those on dummy pills. That's a difference of 44 percent, or about three months.
The results were prepared for release today at the American Society of Clinical Oncology's annual meeting in Chicago.
This type of survival advantage has been found with liver cancer "and is a major breakthrough in the management of the disease," said Dr. Josep Llovet, the lead author.
"That may not sound like a lot of time," but for liver cancer, "this is actually a quite impressive gain," said Dr. Nancy Davidson of Johns Hopkins' Bloomberg School of Public Health. "It is the first effective systemic treatment for liver cancer, which is such a huge problem internationally."
Sorafenib attacks cancer with a targeted double-barreled approach. It zeros in on malignant cells and cuts off the blood supply feeding the tumor. It is believed to work on tumors within the liver and those that have spread elsewhere.
In the study, tumors didn't shrink or disappear but in many cases they also didn't grow.
"You are not curing the disease but you are delaying the progression of the disease significantly and strikingly," said Llovet, of Mount Sinai School of Medicine in New York and Hospital Clinic of Barcelona.
The study was halted early, in February, because of the good results, and patients on dummy pills were switched to sorafenib.
"This is a very good step forward in this disease," said Dr. Emily Chan of Vanderbilt-Ingram Cancer Center in Nashville.
The drug, sold under the brand name Nexavar, is approved in the United States and dozens of other countries to treat advanced kidney cancer. It is marketed by Bayer Pharmaceuticals Corp. and Onyx Pharmaceuticals Inc., which funded the liver cancer study. Llovet has done consulting for the sponsors.
The companies hope to receive approval for liver cancer use from US and foreign regulators.
Liver cancer is diagnosed in about 19,000 Americans annually but is much more common elsewhere and is the fifth-most-common cancer globally. Risk factors include chronic liver infections and some forms of hepatitis. The disease is common in China and countries without widespread use of the hepatitis B vaccine.
In a separate study announced at the conference, US researchers reported yesterday that black women with advanced breast cancer are faring no better now than they were two decades ago despite improved survival by white women -- and the gap appears to be widening.
Dr. Sharon Giordano of the University of Texas M.D. Anderson Cancer Center studied breast cancer survival in women between 1988 and 2003. She found that, in general, women with advanced breast cancer were living longer.
"But when we looked separately by race, we found the improvement seemed to be limited to white patients and the survival for black patients had remained flat over time," Giordano said in an interview with Reuters.
Giordano's team identified 15,438 patients with a median age of 62 from a National Cancer Institute database who were diagnosed with advanced breast cancer between 1988 and 2003.
They divided the groups into three time periods. From 1988 to 1993, breast cancer survival was fairly close between whites and blacks, with a median survival of 20 months for white women versus 17 months in blacks.
Between 1994 and 1998, the median survival was 22 months for white women and 16 months for black women.
From 1999 to 2003, the median survival rate for white women improved to 27 months, versus a stagnant 17 months for black women.
The study didn't look into the causes of the trend. Some researchers have suggested that biological differences may make breast cancer more deadly for black women.
