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Top Cancer Research Advances of 2009


Knowledge image The American Society of Clinical Oncology has released its report Clinical Cancer Advances 2009: Major Research Advances in Cancer Treatment, Prevention and Screening, an independent assessment of the most significant clinical cancer research studies of the past year, including 15 major advances. The report also makes policy recommendations for increasing investment in cancer research funding, accelerating progress in clinical cancer research, and ensuring that Americans with cancer receive high-quality care.

“These continuing research advances should encourage people with cancer and those who care for them,” says ASCO President Douglas W. Blayney, MD. “As this report demonstrates, investment in clinical cancer research is paying off. Since 1990, cancer death rates have declined 15 percent. Today, two-thirds of patients survive at least five years after diagnosis, compared to just half 40 years ago, and they have a dramatically higher quality of life.”

FINDINGS

ASCO has identified 15 major cancer research advances in four key areas:

Advances in Personalized Medicine and Targeted Therapies
Multiple trials demonstrated that oncology is no longer “one size fits all” medicine. Rather, increased understanding of the biology of cancer is enabling researchers to develop highly targeted drugs and personalized treatment regimens:

  • The targeted drug trastuzumab (Herceptin), which has been successful against breast tumors that overexpress the HER2 protein, was found to improve survival for HER2+ gastric cancer.
  • Researchers identified the first effective immunotherapy for neuroblastoma.
  • For the first time in 30 years, a randomized trial identified a regimen that increases survival for people with metastatic head and neck cancer.
  • Researchers identified a specific subset of people with non-small cell lung cancer who benefit from first-line treatment with the targeted drug gefitinib (Iressa).
  • The FDA approved new indications for targeted drugs to treat glioblastoma and advanced kidney cancer, both highly challenging forms of cancer.

New Standards of Care
Results from several long-awaited clinical trials affirmed the superiority of certain treatment regimens for biliary, lung, and prostate cancers:

  • The first-ever standard of care for advanced biliary cancer was found – results from the largest clinical trial to date for this disease stage showed that combination gemcitabine (Gemzar) and cisplatin treatment increases survival and slows cancer progression, compared with gemcitabine treatment alone.
  • Data from a late-stage trial reported that maintenance therapy with pemetrexed (Alimta) extends survival for people with nonsquamous forms of advanced NSCLC – a finding that establishes a new standard and gives people a long-term, easily-administered treatment option with low toxicity.
  • Practice-changing findings showed that radiation following prostatectomy improves survival and reduces risk of metastasis for men with early-stage prostate cancer.

Cancer Prevention and Screening
Findings from large trials shed new light on widely used cancer detection, monitoring, and prevention tools:

  • Interim results from two large trials showed that routine PSA testing has a minimal effect on reducing prostate cancer mortality – findings that add new insight to a long-time debate.
  • A large trial showed that treating relapsed ovarian cancer based on rising levels of a protein in the blood called CA125 does not improve outcomes, compared with monitoring for physical symptoms of ovarian cancer relapse. These findings will help spare women from the anxiety and costs of frequent CA125 testing, as well as the toxicity of earlier treatment.
  • Research suggested that more women may benefit from HPV vaccination than previously thought, based on findings showing that Gardasil reduces the risk of HPV infection, cervical cancer, and other HPV-related disease in women ages 25 to 45.

Large Trials Settle Key Debates in Colon, Breast Cancer Treatment
The results of two closely watched studies settled major debates in the treatment of colon and breast cancers:

  • In the first trial to examine bevacizumab in the adjuvant setting, researchers demonstrated that adjuvant bevacizumab treatment does not prevent colon cancer recurrence in people who have undergone surgery for their disease.
  • Standard three-drug chemotherapy was found to be more effective and less toxic than single-drug treatment with capecitabine (Xeloda) in women age 65 and older undergoing adjuvant treatment for early-stage breast cancer. Researchers had thought that single-drug treatment may be more tolerable for older women, but this was not found to be the case.

RECOMMENDATIONS

In the report, ASCO also makes three key recommendations for accelerating progress in clinical cancer research and ensuring that people with cancer have access to high-quality care:

  • Increase federal investment in cancer research funding.
  • Strengthen the nation’s clinical research system.
  • Ensure that people receive highquality care.

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To learn more about the top scientific discoveries in cancer in 2009 and to view the full report, visit Cancer.Net Clinical Cancer Advances.

This article was published in Coping® with Cancer magazine, January/February 2010.