New Treatments for Tough Cancers Show Promise

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A second study found that radiation delivered directly to the head in patients who have advanced-stage small cell lung cancer cut the risk that the cancer would spread to the brain by about two-thirds.

This type of lung cancer represents about 15 percent of all lung cancer cases in the United States, and tends to be more aggressive. "At diagnosis, about two-thirds of patients already have disseminated disease," said study author Dr. Ben Slotman, professor and chairman of radiation oncology at VU University Medical Center in Amsterdam, the Netherlands.

"The prognosis is poor," agreed Dr. Corey Langer, a medical oncologist at Fox Chase Cancer Center in Philadelphia. "The first shot [of treatment] is the best shot."

In the study, 286 patients who had already responded to chemotherapy were randomly chosen to receive radiation to the head or no radiation.

One year later, 14.6 of patients in the radiation group had developed brain metastases, vs. 40.4 percent in the control group. Also, 27 percent in the radiation group were alive at one year, compared with only 13.3 percent in the control group.

"This study shows that prophylactic cranial radiation [PCI] significantly reduces the risk of brain metastases at one year and it also shows that PCI prolongs survival," Slotman said. "It was well-tolerated, and it didn't adversely influence quality of life. Based on these results, PCI should now routinely be offered to all patients responding with small cell lung cancer who respond to chemotherapy."

Other experts aren't so sure, however. For one thing, study participants in the control group had a shorter survival than usually seen, making it unclear if the participants were representative, Langer said. "I don't know if this will make a wholesale adoption of PCI possible, but it offers justification for giving PCI to certain patients."

In a third study, adding the targeted therapy Erbitux (cetuximab) to a first-line chemotherapy that included cisplatin or carboplatin extended survival for patients with head and neck cancer that had spread to other parts of the body.