Cancer Medicine Advances on Many Fronts

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In the area of new drug approvals:

• Bendamustine (Treanda) "eliminated" chronic lymphocytic leukemia (CLL) in one-third of patients compared with 2 percent who went with current standard therapy, and extended survival without a recurrence to 21.7 months from 9.3 months. The drug was approved in March of 2008 and is now indicated as first-line treatment for the disease.
• Bevacizumab (Avastin), another monoclonal antibody, was approved (in conjunction with the chemotherapy drug paclitaxel (Taxol) for women with previously untreated HER2-negative, metastatic breast cancer. A trial the year before had found the combination doubled disease-free survival compared with women receiving chemo alone. A second trial, this one from 2008, confirmed the findings.

In the area of reducing cancer recurrence:

• Women with breast cancer who have already taken tamoxifen for five years and who take additional hormone therapy in the form of an aromatase inhibitor or more tamoxifen may reduce even further the chances of the cancer coming back.
• Adding the osteoporosis drug zoledronic acid (Zometa) in premenopausal women with early-stage breast cancer also undergoing suppression of ovarian function and hormonal therapy with tamoxifen or an aromatase inhibitor reduced the risk of recurrence.
• Giving one year of pegylated interferon treatment to people with stage III melanoma who had already undergone surgery reduced the risk of recurrence by 18 percent; the four-year recurrence-free survival rate for those on interferon was 45.6 percent vs. 38.9 percent for those not taking the treatment. Overall survival was the same.

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In the area of personalized medicine:

• Patients with newly diagnosed advanced colorectal cancer who have the normal version of the KRAS gene benefited from Erbitux, according to a study released last year. Those with a mutation in the gene did not benefit, a finding which will help guide treatment.

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