KCCC

Investigational Drug Improves Outcomes among Prostate Cancer Patients with Bone Metastases

Fri, 03 Feb 2012 00:01:25 +0000

In a Phase III clinical trial, the investigational drug radium-223 chloride improved survival and delayed bone complications among men with hormone-refractory prostate cancer and bone metastases. These results will be presented at the 2012 Genitourinary Cancers Symposium.

Metastatic cancer refers to cancer that has spread to distant sites in the body. Several types of cancer—including prostate cancer—have a tendency to spread to the bone. Bone metastases can lead to serious problems such as fracture and spinal cord compression, and may require treatment with surgery or radiation therapy.

Radium-223 chloride is an investigational drug that delivers very targeted doses of radiation to areas of cancer in the bone.
To assess whether radium-223 chloride improves outcomes among prostate cancer patients with bone metastases, researchers conducted a Phase III clinical trial among 922 men with hormone-refractory cancer. Patients were treated with best standard treatment plus either radium-223 or a placebo.

Median overall survival was 14 months in the radium-223 group and 11.2 months in the placebo group.
In addition to prolonging overall survival, radium-223 also delayed the development of bone complications such as fracture. Time to first bone complication was 13.6 months in the radium-223 group and 8.4 months in the placebo group.

The results of this study suggest that radium-223 improves outcomes among prostate cancer patients with bone metastases. Plans are underway to evaluate radium-223 in combination with other cancer treatments, and for patients with other types of cancer.

Reference: Sartor AO, Heinrich D, Helle SI et al. Radium-223 chloride impact on skeletal-related events in patients with castration-resistant prostate cancer (CRPC) with bone metastases: A phase III randomized trial (ALSYMPCA). Presented at the 2012 Genitourinary Cancers Symposium. February 2-4, 2012.San Francisco,CA. Abstract 9.

New Targeted Drug Improves Prostate Cancer Survival

Thu, 02 Feb 2012 00:01:06 +0000

Among men with metastatic, hormone-refractory prostate cancer, treatment with the investigational drug MDV3100 delayed cancer progression and improved overall survival. These results will be presented at the 2012 Genitourinary Cancers Symposium.

Prostate cancer is a hormonally sensitive disease that can be controlled for long periods with androgen deprivation therapy (ADT). When prostate cancer stops responding to this treatment, it is referred to as hormone-refractory prostate cancer. Advances have been made in the treatment of hormone-refractory cancer, but challenges remain and new drugs continue to be developed.

MDV3100 is an investigational drug with a new approach to hormonal therapy. The drug interferes with the ability of male hormones to bind to their receptors within a cell, and also reduces the ability of the receptors to enter the nucleus and stimulate cell growth.

To evaluate the safety and efficacy of MDV3100 in the treatment hormone-refractory prostate cancer, researchers conducted a Phase III clinical trial known as AFFIRM. The study enrolled 1,199 men with metastatic, hormone-refractory prostate cancer. All of the men had experienced a worsening of their cancer in spite of previous treatment with hormonal therapy and the chemotherapy drug Taxotere® (docetaxel). Study participants were treated with either MDV3100 or a placebo (sugar pill).

At the time of an initial analysis part way through the study, researchers found that MDV3100 had significantly improved overall survival: median overall survival was 18.4 months among men treated with MDV3100 and 13.6 months among men treated with placebo. As a result of this benefit, the study was stopped early, and men in the placebo group were offered MDV3100.
MDV3100 was also found to delay cancer progression: survival without cancer progression was roughly 8 months among men in the MDV3100 group and 3 months among men in the placebo group.
MDV3100 was generally well tolerated. The most common side effects were fatigue, diarrhea, and hot flushes.

This study suggests that MDV3100 improves outcomes among men with metastatic, hormone-refractory prostate cancer. MDV3100 is also being evaluated for the treatment of earlier stages of prostate cancer.

Reference: Scher HI, Fizazi K, Saad F et al. Effect of MDV3100, an androgen receptor signaling inhibitor (ARSI), on overall survival in patients with prostate cancer postdocetaxel: Results from the phase III AFFIRM study. Presented at the 2012 Genitourinary Cancers Symposium. February 2-4, 2012.San Francisco,CA. Abstract LBA1.

Erivedge™

Wed, 01 Feb 2012 11:34:50 +0000

Class: Biological Therapy

Generic Name: vismodegib

Trade Name: Erivedge™

How is this drug used? Erivedge is approved for the treatment of adults with basal cell carcinoma of the skin that has spread to other parts of the body or that has come back after surgery or cannot be treated with surgery or radiation. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than for which it is approved may wish to discuss this issue with their physician.

What is the mechanism of action? Erivedge targets a specific biological pathway (the Hedgehog pathway) that is thought to play a role in more than 90% of cases of basal cell carcinoma. Erivedge inhibits the abnormal signaling in this pathway that contributes to cancer growth.

How is Erivedge given (administered)? Erivedge is taken orally (by mouth).

How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with Erivedge. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems. Patients may undergo physical examinations and other tests to assess side effects and response to therapy.

What are the most common side effects of treatment with Erivedge?

Muscle spasms
Hair loss
Taste changes or loss of taste
Weight loss
Fatigue
Nausea
Diarrhea
Decreased appetite
Constipation
Joint pain
Vomiting

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.
What can patients do to help alleviate or prevent discomfort and side effects?

Pay careful attention to the physician’s instructions, and discuss side effects with your physician.

Are there any special precautions patients should be aware of before starting treatment?

Patients should inform their physician if they are pregnant, breastfeeding or planning a family in the near future. Erivedge can cause severe birth defects and fetal death. Women should have a pregnancy test prior to starting Erivedge and should talk with their doctor about choice and duration of birth control.
Men treated with Erivedge should use a condom and spermicide during sex (even if they’ve had a vasectomy) to avoid exposing their partner to Erivedge through semen.
During treatment and for several months afterwards, patients should not donate blood or blood products.
Patients should inform their physician about all other medical conditions.
Patients should inform their physician of any other medication or supplement they are taking (whether prescription or over-the-counter).

When should patients notify their physician?

Tell your doctor if you experience any side effects that bother you or don’t go away.

What is a package insert?
A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

Important Limitations of Use

The information provided above on the drug you have selected is provided for your information only and is not a substitute for consultation with an appropriate medical doctor. We are providing this information solely as a courtesy and, as such, it is in no way a recommendation as to the safety, efficacy or appropriateness of any particular drug, regimen, dosing schedule for any particular cancer, condition or patient nor is it in any way to be considered medical advice. Patients should discuss the appropriateness of a particular drug or chemotherapy regimen with their physician.

As with any printed reference, the use of particular drugs, regimens and drug dosages may become out-of-date over time, since new information may have been published and become generally accepted after the latest update to this printed information. Please keep in mind that health care professionals are fully responsible for practicing within current standards, avoiding use of outdated regimens, employing good clinical judgment in selecting drugs and/or regimens, in calculating doses for individual patients, and verifying all dosage calculations.

DISCLAIMER OF WARRANTIES

CANCERCONSULTANTS.COM SPECIFICALLY DISCLAIMS AND EXCLUDES ALL EXPRESSED OR IMPLIED WARRANTIES, INCLUDING ANY IMPLIED WARRANTIES AS TO QUALITY, ACCURACY (INCLUDING TYPOGRAPHICAL ERRORS), MERCHANTABILITY, OR FITNESS FOR ANY PARTICULAR PURPOSE OF THE INFORMATION CONTAINED HEREIN. CANCERCONSULTANTS.COM DISCLAIMS ALL LIABILITY OR DAMAGES ARISING FROM ANY USE OF THE INFORMATION.

The prescribing physician is solely responsible for making all decisions relating to appropriate patient care including, but not limited to, drugs, regimens, dose, schedule, and any supportive care.

Inlyta®

Wed, 01 Feb 2012 11:26:45 +0000

Class: Biological Therapy

Generic Name: axitinib

Trade Name: Inlyta®

How is this drug used? Inlyta is FDA approved for the treatment of advanced renal cell carcinoma (kidney cancer) after one prior drug treatment has not worked. It is important for patients to remember that physicians have the ability to prescribe medication for conditions other than those for which the drug has been approved by the FDA. Patients who have received a prescription of this drug for a condition other than for which it is approved may wish to discuss this issue with their physician.

What is the mechanism of action? Inlyta is a type of drug known as a kinase inhibitor. It works by blocking certain proteins that play a role in cancer growth

How is Inlyta typically given (administered)? Inlyta is taken orally (by mouth), typically twice per day.

How are patients typically monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with Inlyta. Typically, blood will be drawn to check levels of blood cells and to monitor functions of some organ systems. Physical examinations, scans or other measures may also be utilized to assess side effects and response to therapy.

What are the most common side effects of treatment with Inlyta?

Diarrhea
High blood pressure
Fatigue
Decreased appetite
Nausea
Hoarseness
Hand-foot syndrome
Weight loss
Vomiting
Weakness
Constipation

What are some of the less common side effects to be aware of?

Blood clots
Bleeding problems
A tear (perforation) in the stomach or intestine
Thyroid problems
Reversible posterior leukoencephalopathy syndrome (a condition that involves swelling in the brain).
Increased protein in the urine
Changes in liver function

This is not a complete list of side effects. Some patients may experience other side effects that are not listed above. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

What can patients do to help alleviate or prevent discomfort and side effects?

Pay careful attention to the physician’s instructions and inform the physician of any side effects.
Do not eat grapefruit or drink grapefruit juice. Grapefruit may increase the amount of Inlyta in the blood.
Maintain adequate rest and nutrition.
Eat small meals frequently to help alleviate nausea.
Drink plenty of fluids (patients should ask their physician about the amount of liquid to consume during a day).

Are there any special precautions patients should be aware of before starting treatment?

Patients should inform their physician if they are pregnant, breastfeeding, or planning a family in the near future. This drug may cause birth defects. It is important to use a form of birth control while undergoing treatment.
It is important that patients inform their physician of any pre-existing conditions, including high blood pressure, thyroid problems, liver problems, history of blood clots or bleeding problems, history of heart attack or stroke, or an unhealed wound.
Patients should inform their physician about any planned surgery.
Patients should inform their physician of any other medication they are taking (whether prescription or over-the-counter, including vitamins, herbs, etc.) as they may interfere with treatment.
Patients should check with their physician before starting any new drug or nutritional supplement.
Patients should inform their physician of any known drug or food allergies or any reactions to medications they have experienced in the past.

When should patients notify their physician?

Tell your doctor if you experience any side effects that bother you or don’t go away. Also call if you notice signs of thyroid problems (e.g. persistent tiredness, feeling hot or cold, weight gain or loss, voice deepening, hair loss, or muscle cramps), signs of a blood clot (e.g. chest pain or pressure; pain in arms, back, neck, or jaw; shortness of breath; numbness or weakness on one side of the body; trouble talking; headache; vision problems), signs of unusual bleeding (e.g. bleeding that is heavy or persistent, pink or brown urine, red or black stools, unusual bruising, coughing up or vomiting blood, unexpected pain or swelling; headache or dizziness), signs of a gastrointestinal tear (e.g. severe stomach pain, bloody vomit, red or black stools), or signs of brain problems (e.g headache, seizure, weakness, confusion, high blood pressure, blindness or change in vision, problems thinking).

What is a package insert?

A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug by healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics, and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

Important Limitations of Use

DISCLAIMER OF WARRANTIES

The prescribing physician is solely responsible for making all decisions relating to appropriate patient care including, but not limited to, drugs, regimens, dose, schedule, and any supportive care.

Erivedge Approved for Basal Cell Skin Cancer

Wed, 01 Feb 2012 00:01:13 +0000

The US Food and Drug Administration (FDA) has approved the targeted therapy Erivedge™ (vismodegib) for the treatment basal cell carcinoma of the skin that has spread to other parts of the body or that is locally advanced and cannot be treated with surgery or radiation.

Basal cell carcinoma is the most commonly diagnosed type of skin cancer. Most cases can be treated with surgery or other types of local treatment and are not life-threatening, but the condition often occurs on the face and can be disfiguring. In the most severe cases, the cancer may be very large, may invade structures other than the skin, or may spread to other parts of the body. In these advanced cases, it may not be possible to surgically remove the cancer, and treatment options are limited.

Erivedge targets a specific biological pathway (the Hedgehog pathway) that is thought to play a role in more than 90% of cases of basal cell carcinoma. Taken orally, Erivedge inhibits the abnormal signaling in this pathway that contributes to cancer growth.

A study that contributed to the approval of Erivedge enrolled 104 adult patients with locally advanced or metastatic basal cell carcinoma. All study participants were treated with Erivedge. A reduction or elimination of detectable cancer was observed in 43% of patients with locally advanced basal cell carcinoma and 30% of patients with metastatic basal cell carcinoma.

Side effects of Erivedge include muscle spasms, hair loss, weight loss, fatigue, nausea, diarrhea, decreased appetite, constipation, joint pain, vomiting, and changes in taste. Erivedge may cause severe birth defects or fetal death if taken during pregnancy.

Erivedge is the first FDA-approved drug for metastatic basal cell carcinoma.

Reference: FDA News Release. FDA approves new treatment for most common type of skin cancer. January 30, 2012.

Inlyta Approved for Advanced Kidney Cancer

Tue, 31 Jan 2012 00:01:58 +0000

The US Food and Drug Administration has approved Inlyta® (axitinib) for the treatment of advanced renal cell (kidney) cancer that has not responded to another drug used for this condition.

Inlyta is a drug that is taken orally, as a pill. It works by blocking certain proteins that play a role in cancer growth.

A study that contributed to the approval of Inlyta for kidney cancer involved 723 patients with metastatic, clear-cell, renal cell cancer. All patients had experienced cancer progression after initial treatment that included Sutent® (sunitinib), Avastin® (bevacizumab), Torisel® (temsirolimus), or cytokine therapy. Study participants were assigned to treatment with either Inlyta or Nexavar® (sorafenib).

Inlyta delayed the worsening of the cancer: progression-free survival was 6.7 months among patients treated with Inlyta and 4.7 months among patients treated with Nexavar.

The most common side effects among patients treated with Inlyta were diarrhea, high blood pressure, fatigue, decreased appetite, nausea, loss of voice, hand-foot syndrome, weight loss, vomiting, weakness, and constipation.

The approval of Inlyta specifies that it is for advanced renal cell carcinoma after failure of one prior systemic therapy.

Inlyta is the seventh new drug to be approved for advanced kidney cancer since 2005.

Reference: FDA News Release. FDA approves Inlyta to treat patients with a type of advanced kidney cancer. January 27, 2012.

Avastin May Improve Breast Cancer Response Rates

Mon, 30 Jan 2012 00:01:38 +0000

Among women with HER2-negative breast cancer that has not spread to distant sites in the body, the addition of Avastin to neoadjuvant (before-surgery) chemotherapy may increase the likelihood of a complete response to treatment (a disappearance of detectable cancer). These results were published in the New England Journal of Medicine.

Avastin is a targeted therapy that blocks a protein known as VEGF. VEGF plays a key role in the development of new blood vessels. By blocking VEGF, Avastin deprives the cancer of nutrients and oxygen and inhibits its growth. Avastin is used in the treatment of several types of cancer, but its approval for breast cancer was revoked by the US Food and Drug Administration (FDA) in November, 2011.

Avastin was originally for breast cancer in 2008 under the FDA’s accelerated approval program. The accelerated approval program provides earlier access to promising drugs for life-threatening health conditions while confirmatory studies are conducted. The approval was for use of Avastin in combination with chemotherapy for women with metastatic, HER2-negative breast cancer. The approval was based on the finding that Avastin delayed the progression (worsening) of metastatic breast cancer. There was no evidence that Avastin improved overall survival.

After 2008, additional studies were reported to the FDA. These studies found that Avastin had only a small effect on rate of cancer progression and no effect on overall survival. The FDA concluded that the potential benefits of Avastin for breast cancer did not outweigh the risks, and revoked Avastin’s approval for breast cancer. Risks of Avastin include severe high blood pressure; bleeding problems; the development of perforations (holes) in the nose, stomach, and intestines; and heart attack or heart failure. It remains possible that Avastin will be found to benefit specific subgroups of breast cancer patients, and the FDA noted that it is open to considering data from additional studies that address this question.
Results from Avastin clinical trials continue to be reported. Two of these were published in the New England Journal of Medicine and address the use of Avastin in women with earlier-stage (nonmetastatic), HER2-negative breast cancer.

The first study—the Phase III GeparQuinto trial—enrolled 1,948 women with nonmetastatic, HER2-negative breast cancer.[1] Study participants received neoadjuvant treatment with chemotherapy alone or in combination with Avastin. The primary outcome of interest was a complete response, which was defined in this study as no detectable cancer in the breast or axillary (under-the-arm) lymph nodes.

A complete response to treatment occurred in 14.9 percent of women treated with chemotherapy alone and 18.4 percent of women treated with chemotherapy plus Avastin.
The greatest benefit of Avastin was observed among women with triple-negative breast cancer (breast cancer that is HER2-negative, estrogen receptor-negative, and progesterone receptor-negative). Among these women, the complete response rates were 27.9 percent with chemotherapy alone and 39.3 percent with chemotherapy plus Avastin.
Serious side effects that were more common in the Avastin group included febrile neutropenia (low white-blood cell counts accompanied by fever), mouth sores, hand-foot syndrome, infection, and high blood pressure.

The second study—the Phase III NSABP B-40 trial—involved 1,206 women with nonmetastatic, HER2-negative breast cancer.[2] Once again, study participants received neoadjuvant treatment with chemotherapy alone or in combination with Avastin. In this study, a complete response was defined as no detectable cancer in the breast; this is a less stringent definition than was used by the GeparQuinto study, which required no detectable cancer in the breast or axillary lymph nodes.

A complete response to treatment occurred in 28.2 percent of women treated with chemotherapy alone and 34.5 percent of women treated with chemotherapy plus Avastin.
When a more stringent definition of complete response was used (similar to what was used in the GeparQuinto study), the difference between study groups was not statistically significant, suggesting that it could have occurred by chance alone.
The greatest benefit of Avastin was observed among women with estrogen receptor-positive cancer. This differs from what was found in the GeparQuinto study.
Side effects that were more common in the Avastin group included high blood pressure, heart problems, hand-foot syndrome, and mouth sores.

These results suggest that the addition of Avastin to neoadjuvant chemotherapy may increase the likelihood of a complete response among women with nonmetastatic, HER2-negative breast cancer. Whether this will ultimately translate into improved survival, however, remains uncertain. Overall survival results are not yet available from these studies. The question of whether certain subgroups of patients are more likely to benefit from Avastin than others also remains unanswered, but research is ongoing.

References:

[1] von Minckwitz G, Eidtmann H, Rezai M et al. Neoadjuvant chemotherapy and bevacizumab for HER2-negative breast cancer. New England Journal of Medicine. 2012;366:299-309.

[2] Bear HD, Tang G, Rastogi P et al. Bevacizumab added to neoadjuvant chemotherapy for breast cancer. New England Journal of Medicine. 2012;366:310-20.

BRCA Mutations Influence Ovarian Cancer Outcomes

Fri, 27 Jan 2012 00:01:33 +0000

Among women with ovarian cancer, those who have a BRCA1 or BRCA2 gene mutation appear to have better overall survival than those who do not have a BRCA gene mutation. These results were published in the Journal of the American Medical Association.

Inherited mutations in two genes—BRCA1 and BRCA2—have been found to greatly increase the lifetime risk of developing breast and ovarian cancer. Mutations in these genes can be passed down through either the mother’s or the father’s side of the family. Options to manage the increased cancer risk include regular cancer screening, chemoprevention (use of medications to reduce risk), or preventive surgery (surgery to remove the breasts and/or ovaries before cancer is diagnosed).

In addition to increasing susceptibility to cancer, BRCA1 and BRCA2 mutations may affect prognosis and response to cancer treatment. In order to explore whether these gene mutations affect outcomes among women with ovarian cancer, researchers evaluated information from 26 previous studies. Information was available about 909 patients with a BRCA1 mutation, 304 patients with a BRCA2 mutation, and 2,666 patients with no BRCA mutation.

Five-year overall survival was 52% among women with a BRCA2 mutation, 44% among women with a BRCA1 mutation, and 36% among women without a BRCA mutation.

These results suggest that women with a BRCA1 or BRCA2 mutation tend to survive longer with ovarian cancer than women who do not have one of these mutations. Women with a BRCA2 mutation had the best outcome, although five-year overall survival was still only 52%.

Reference: Bolton KL, Chenevix-Trench G, Goh C et al. Association between BRCA1 and BRCA2 mutations and survival in women with invasive epithelial ovarian cancer. JAMA. 2012;307:382-390.

Drug May Delay Need for Prostate Cancer Treatment

Thu, 26 Jan 2012 00:01:11 +0000

Among men who choose active surveillance for early-stage prostate cancer, Avodart® (dutasteride) may delay cancer progression and the need for cancer treatment. These results were published in The Lancet.

The management of early prostate cancer may involve surgery, radiation therapy, or active surveillance (close observation but no treatment until the cancer shows signs of worsening). Because not all prostate cancers are life-threatening, active surveillance allows some men to avoid (or at least delay) the side effects that accompany surgery and radiation therapy.

Avodart is a 5-alpha reductase inhibitor. It reduces exposure of the prostate to a potent form of testosterone known as dihydrotestosterone (DHT). Avodart is currently used to treat benign prostatic hyperplasia (BPH); it has not been approved for the treatment or prevention of prostate cancer.

Previous studies have reported that 5-alpha reductase inhibitors can reduce the likelihood of prostate cancer among men at high risk of the disease. There has also been some concern, however, that these drugs could lead to a small increase in the risk of high-grade (more serious) prostate cancers. This question remains unresolved.

To explore the effects of Avodart among men who choose active surveillance for early prostate cancer, researchers conducted a study among 302 men with small, Gleason score 5-6 prostate cancer. Men were assigned to receive either Avodart or a placebo for three years. All men had prostate biopsies at the mid-point and end of the study, or as needed.

The primary outcome of interest was cancer progression. For the purposes of this study, cancer progression was defined as either a worsening of the cancer or the decision to start cancer treatment.

Men treated with Avodart were less likely to experience cancer progression: cancer progression occurred in 38% of men in the Avodart group and 48% of men in the placebo group.
Sexual side effects or breast enlargement were reported by 24% of men in the Avodart group and 15% of men in the placebo group. The frequency of cardiovascular side was the same (5%) in the two study groups.

These results suggest that Avodart may slow prostate cancer growth among men undergoing active surveillance for early disease. It has still not been approved by the US Food and Drug Administration for this purpose, however.

Reference: Fleshner NE, Lucia MS, Egerdie B et al. Dutasteride in localized prostate cancer management: the REDEEM randomised, double-blind, placebo-controlled trial. Lancet. Early online publication January 24, 2012.

Abnormal Chromosome Influences Outcome of Rare Brain Tumor

Wed, 25 Jan 2012 00:01:51 +0000

For patients with uncommon brain tumors known as oligodendrogliomas, the presence of a specific chromosomal abnormality is linked with a better prognosis and responsiveness to chemotherapy. These results were released early (prior to presentation at an upcoming medical meeting) because of their importance.

Oligodendrogliomas are uncommon tumors that form in the nerve tissue of the brain. They occur primarily in adults, with an average age at diagnosis of 35 years.

The role of chemotherapy in the treatment of aggressive oligodendrogliomas was evaluated in a Phase III clinical trial (RTOG 9402). Study participants were treated with radiation therapy alone or in combination with chemotherapy.

Results reported in 2006 indicated no overall benefit from the addition of chemotherapy. The researchers noted, however, that patients whose tumors had a specific chromosomal abnormality (deletion of 1p and 19q) appeared to have better survival.

Researchers recently conducted an updated analysis of this study that further explored the role of the 1p19q chromosomal abnormality. Study participants have now been followed for a median of 11 years.

Overall survival was better among patients whose tumors had the chromosomal abnormality: survival was 8.7 years among patients with the abnormality and 2.7 years among patients without the abnormality.
The chromosomal abnormality also predicted a benefit from chemotherapy: among patients whose tumor had the abnormality, overall survival was 14.7 years among those who received both chemotherapy and radiation therapy, compared with 7.3 years among those who received radiation therapy alone. Among patients without the chromosomal abnormality, the addition of chemotherapy did not improve survival.

These results indicate that the 1p19q chromosomal abnormality is linked with both prognosis and response to treatment among patients with oligodendroglioma. This information will allow for more individualized treatment of this condition.

The full results of this study are being submitted for presentation at the 2012 annual meeting of the American Society of Clinical Oncology.

References:

American College of Radiology press release. Abnormal chromosome indicator of treatment and outcome in patients with rare brain tumor. January 19, 2012.

National Cancer Institute press release. Genetic abnormality predicts benefit from treatment for a rare brain tumor. January 19, 2012.