New Brain Cancer Treatment May Extend Survival

Patients Stay Home, Take a Capsule Instead of IV Chemotherapy

July 29, 2003

A doctor at the James P. Wilmot Cancer Center developed a new brain cancer treatment that’s easier for patients to endure and shows promise at extending lives. Preliminary findings were presented recently at the American Society of Clinical Oncology annual meeting in Chicago, and now the study is continuing for adults and will be expanded to include children nationwide.

The treatment is a combination of two cancer-killing drugs that can be taken orally in a capsule, making it easier on those patients who have already undergone difficult surgery, radiation or traditional, intravenous chemotherapy.

“It’s not a miracle, but it’s a piece of the struggle against brain cancer,” says David N. Korones, M.D., principal investigator and associate professor, Hematology/Oncology, at the University of Rochester Medical Center. “It’s a new, somewhat innovative approach that has merit and offers better tolerance than traditional chemotherapy.”

Korones is the first to investigate the effectiveness of temozolomide and etoposide, given together for patients with recurrent malignant glioma, the most common brain tumor in adults. Each drug, which has been approved by the Food and Drug Administration, has been used separately with some success. But Korones noticed that laboratory data showed synergies between the two medications, and he theorized they may work better in tandem.

Among the 24 adult patients he has followed so far, 16 percent saw their tumors shrink and 35 percent were stable with no disease progression after six months, compared to 10-20 percent of patients who stabilize after traditional chemotherapy. This is an acceptable result and worthy of additional study, he says, because the median survival is just six months for recurrent brain cancer.

The medications have been reasonably well tolerated. With no need to come into the hospital for IV therapy, patients can stay home and report monthly for blood tests. In a pilot study of four children aged 10 or older, using doses comparable to the adults, Korones also noted that side effects were minimal, and the tumors shrunk dramatically.

Brain cancer consists of a mass of cells that do not belong there. But for cancer-fighting drugs to reach the mass, first they must be able to pass through the blood-brain barrier, which is cleverly designed to keep out toxins. Temozolomide and etoposide are effective at passing through the barrier, Korones says.

Schering-Plough Inc., manufacturer of temozolomide, is funding the research. With Korones as the principal investigator, other institutions participating are: Rochester General Hospital’s Lipson Cancer and Blood Center; Roswell Park Cancer Institute, Buffalo; Dent Neurologic Institute, Buffalo; SUNY Health Science Center, Syracuse; The Brain Tumor Center at Duke University Medical Center, Durham, N.C. A larger trial for children with brain cancer begins this summer.

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