New Drug Effective In Lung Cancer Treatment

New Drug Effective In Lung Cancer Treatment

Thirty-five percent of lung cancer patients with advanced disease and a poor prognosis who were treated in a trial with a new drug showed an improvement in symptoms and were still alive one year after starting treatment, says Australian lung cancer specialist Associate Professor Michael Boyer. 3

Professor Boyer was in New Zealand this week to present his findings on trials using AstraZeneca’s Iressa to oncologists throughout New Zealand.

He says the new drug, which was gazetted in New Zealand four weeks ago, “works, improves patients’ quality of life, is durable, effective, reduces the size of some tumours and is tolerated better than chemotherapy”.

It is also fast acting with symptoms improving on average within eight to 10 days. 1

While it does not work on all patients, it has been proved to be especially effective on non-smoking women, said Professor Boyer who is director of medical oncology at the Sydney Cancer Centre.

Iressa, (gefitinib) in the form of a tablet taken once a day, has been approved in new Zealand for the treatment of advanced non-small cell lung cancer (NSCLC) in patients who have had at least two prior chemotherapy regimens (platinum and/or docetaxel) and have not responded to either.2

The drug works by blocking a specific set of chemical signals that tell cancer cells to grow and multiply. Because Iressa only targets the proteins produced by cancer cells it does not cause the same devastating side effects associated with current cancer treatments. 3

Professor Boyer told oncologists in Auckland, Wellington, Hamilton and Christchurch about one of the patients in his trial, an 80 year-old woman with lung cancer who after being treated with Iressa for two months was still alive and asymptomtic 19 months later.

He said the drug improves symptoms in lung cancer patients including cough, dyspnoea, weight loss, pain and lethargy. The most common side effects with Iressa are skin rashes and diarrhoea, but Professor Boyer said his trials had shown that by interrupting treatment and resuming it after two weeks, the side effects did not recur.

Professor Mark McKeage, Associate Professor in Clinical Pharmacology at the University of Auckland and a medical oncology specialist at Auckland Hospital, says Iressa is going to be very significant for a group of patients with lung cancer.

“Non-small cell lung cancer is a very distressing disease and is associated with very disturbing and debilitating symptoms. It is a disease where the only chance of being cured is by having surgery in the very early stages. However, for the tumour to be large enough to become apparent clinically, the cancer is often too advanced for surgery and the patient has a much shorter survival timeframe,” Professor McKeage says.

“That survival time is often only a matter of months, which is very short compared to other cancers. This is why the development of Iressa is critical. With Iressa we can now offer patients a simple treatment with the possibility of better symptom control,” Professor McKeage says.

These extra months of wellbeing are significant as they allow patients additional quality of life with their families and friends, attend milestone events or holidays, and to put their affairs in order.

Iressa has already been approved for the treatment of advanced NSCLC in a number of countries including the US, Australia and Canada. Iressa is not subsidised by the Government in New Zealand so the cost to patients will be about $4000 a month.

Professor Boyer said he believe funding will eventually be given in Australia, at least for one month’s treatment after which patients would be reassessed.

Tauranga-based David Simm says the thought of only having to take one tablet daily and not suffering the side effects associated with chemotherapy are just as important as the results being achieved in studies of Iressa.

David, 64, was diagnosed with lung cancer in 1999. The cancer was caused by second hand smoke he was exposed to during his working life. His job as a supermarket manager means that non-smoker David has been exposed to more than half a million cigarettes. After a six-week course of chemotherapy and radiation in 1999 and 2000 David was thought to have at best 18 months to live, now four years later he is hoping he can access this new treatment.

“Compared to the cost of my chemotherapy for six weeks treatment, the price of Iressa is far smaller. It should be funded,” he says.

About lung cancer There are two groups of lung cancer – small cell lung cancer and all other types of lung cancer, which are called non-small cell lung cancers and account for 80 percent of lung cancer cases. The two groups are treated differently because small cell lung cancers have a different response to radiation and chemotherapy.

With lung cancer the primary tumour develops in the membranes in the lungs’ air tubes. Usually this comes from long term and repeated exposure to pollutants in the air we breathe, like cigarette smoke. Cancer cells develop and eventually a tumour will grow and obstruct the airways, or invade local tissues and spread through the body. Lung cancer tends to spread to the brain, liver and bones.

Symptoms include pain to such an extent morphine-type drugs are needed, coughing up phlegm and blood, voice change, extreme tiredness and changes to appetite. Because lung cancer spreads through the body symptoms will vary from patient to patient.

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