Faster Please! Cancer Treatments Improving And May Appear To Be Even More Impressive Than First Thought

The advances in cancer treatment continue to be encouraging for a wide range of cancers, but they can't come fast enough.

The key to the most recent advances, new drug regimes, combination therapies, and tailored treatments that benefit subsets of cancers based on specific subtypes.

But some of the victories reported this week against breast and prostate cancer, leukemia and the deadly skin cancer called melanoma may be larger than they appear. These trends offer reason for optimism:

• Newer drugs seem to be making a bigger difference for small, specific groups of patients, as companies develop treatments that more precisely target genes behind subtypes of cancer.

Pfizer Inc. rushed into late-stage testing one such drug: crizotinib, which is aimed at only 4 percent of lung cancer patients. More than 90 percent of them responded to the drug in initial tests. High response rates also have been reported for other novel drugs for melanoma and breast cancer driven by certain genes.

The hope: Develop enough of these specialized treatments that eventually every cancer patient will have something that works.

• Quicker answers from smaller, focused studies. Pfizer's test of crizotinib will need only 318 patients and will be finished early next year. It also will test the drug earlier in the course of illness rather than as a last-ditch option.

"You don't really need big trials if it works so well," and the group of patients who stand to benefit can be identified in advance, said Dr. Roy Herbst, lung cancer chief at the University of Texas M.D. Anderson Cancer Center in Houston.

• Big gains from novel combinations. All 66 patients testing a drug combo for the blood disease multiple myeloma saw a reduction in the amount of cancer they had by at least half. A 100 percent response rate is unheard of for any cancer and would not have occurred if two drugmakers had not teamed up to test their treatments together instead of against each other, said Dr. Paul Richardson of Boston's Dana-Farber Cancer Institute, who led the research.

The combo of Takeda Pharmaceutical Co.'s Velcade, Celgene Corp.'s Revlimid and the chemotherapy mainstay dexamethasone allowed more than half of patients to delay and perhaps avoid a bone marrow transplant — a harsh and risky treatment for the disease.

• Comparison tests of long-used treatments. For decades, men with cancer that has spread beyond the prostate have been given hormone treatments with or without radiation, yet only a few studies have tested these against each other or together. A Canadian study found that combo treatment extended survival an average of six months in high-risk cases, and the oncology society said it could become a new standard of care.

One thing that isn't improving is the cost.

These kinds of treatments remain expensive and aren't going to get any cheaper as treatments become even more tailored and specific.

Meanwhile, if you're interested in donating to cancer research, my choice is Memorial Sloan Kettering Cancer Center in New York City, which is one of the global leaders in cancer research.