【medical-news】美国ASCO评出08年12项癌症防治重大进展

美国临床肿瘤学会（ASCO）评选出了2008年12项明显改善癌症治疗和预防的重大进展：

??西妥昔单抗（cetuximab，Erbitux）治疗肺癌。研究发现，对于肿瘤表达表皮生长因子受体（EGFR）的患者，标准化疗联合西妥昔单抗能够使生存率提高达21%。日照市人民医院肿瘤科孟令新

??吉西他滨（gemcitabine，Gemzar）治疗胰腺癌。应用吉西他滨进行手术切除原发肿瘤后的辅助化疗，可使无病生存期延长1倍。

??苯达莫司汀（bendamustine，Treanda）治疗慢性淋巴细胞白血病（CLL）。2008年3月，FDA批准苯达莫司汀用于一线治疗CLL。国际多中心研究发现，苯达莫司汀治疗CLL使30%的患者达到完全缓解。

??贝伐单抗（bevacizumab，Avastin）治疗转移性乳腺癌。2008年2月，FDA批准贝伐单抗联合紫杉醇一线治疗HER2阴性的转移性乳腺癌患者。

??乳腺癌患者长期激素治疗。患者应用他莫昔芬（tamoxifen）或者芳香化酶抑制剂数年时间，可以进一步降低乳腺癌复发风险。

??唑来磷酸（zoledronic acid，Zometa）治疗乳腺癌。接受他莫昔芬或者阿那曲唑（anastrozole）联合戈舍瑞林（goserelin）进行内分泌治疗的绝经前乳腺癌患者，给予一种骨质增强剂唑来磷酸，能降低乳腺癌复发风险。

??长效聚乙二醇干扰素治疗黑色素瘤。对于恶性黑色素瘤术后患者，应用长效聚乙二醇干扰素治疗1年能降低18%的复发风险。

??西妥昔单抗选择性用于治疗结肠癌。研究发现，西妥昔单抗仅对携带野生型KRAS基因的肿瘤患者有效，这意味着有KRAS突变的肿瘤患者不能从西妥昔单抗治疗中获益，也意味着这些患者将不再承受不必要的治疗相关副作用。

??口服避孕药降低卵巢癌风险。每服用口服避孕药5年，能降低女性20%的卵巢癌发病风险。

??HPV疫苗可以预防口腔癌。研究显示，美国口腔癌发病与人类乳头状瘤病毒（HPV）感染上升相关，然而口腔癌发病与HPV感染下降无关，原因可能是口交行为增加。如果这样，HPV疫苗也可用于预防口腔癌。

??肿瘤科医生缺乏浮出水面。到2020年，美国将缺少大约4000名肿瘤科医生。届时，癌症患者数量将增加55%，肿瘤科医生的增加速度则过于缓慢。

??关注儿童癌症幸存者。目前对抗癌症的重大成就之一是儿童癌症幸存者数量增加。但令人不安的消息是：癌症发病30年后，这些儿童罹患心脏疾病的风险是普通儿童的5～10倍，原因是癌症治疗的副作用所致。

 

Top Cancer Advances in 2008

What were the top advances in clinical cancer research in 2008? That’s the question editors from the American Society of Clinical Oncology (ASCO) answer in the report, Clinical Cancer Advances 2008: Major Advances in Cancer Treatment, Prevention, and Screening. The report explains the most significant achievements in cancer this year.

Themes this year in cancer research

Several important themes in cancer emerged from this year’s report.

Risk factors. Identifying what factors raise a person’s risk of cancer leads to better prevention and early detection. In 2008, researchers discovered that the number of new cases of mouth and throat cancers related to infection with the human papillomavirus (HPV) increased by almost 1% per year between 1973 and 2004. This increase is possibly caused by changes in people’s sexual behaviors, such as oral sex, which increases the risk of HPV transmission to the mouth and throat. Another discovery showed that women who took birth control pills lowered their risk of ovarian cancer.

Why is this important? A vaccine for HPV (currently approved for preventing cervical cancer in women) may possibly be used to prevent cancers of the mouth and throat, and women with a higher risk of ovarian cancer have a readily available option to help prevent this cancer.

Personalized medicine. Personalizing cancer care involves using genetic information about a patient and/or the cancer to tailor the best possible treatment. In patients with colorectal cancer, researchers discovered that the drug cetuximab (Erbitux) shrank tumors only in patients with tumors that did not have a mutation of the KRAS (pronounced kay-rass) gene. Another study found that adding cetuximab to chemotherapy in patients with non-small cell lung cancer helped them live longer when the patients’ tumors had a protein called epidermal growth factor receptor (EGFR).

Why is this important? Doctors may be able to use more tests to find the best treatment for individual patients to avoid drugs that won’t work and may have severe side effects.

Reducing breast cancer recurrence. Researchers tested whether some treatments helped reduce the recurrence (return of cancer after treatment) of breast cancer in women. Zoledronic acid (Zometa) reduced the risk of recurrence of early-stage breast cancer in premenopausal women undergoing ovarian suppression (drugs that stop the production of hormones by the ovaries) and additional hormonal therapy. Zoledronic acid is a drug called a bisphosphonate that is used to reduce bone loss caused by cancer treatment. Plus, several new studies suggest that women who have finished the standard five years of hormonal therapy with tamoxifen (Novaldex) may further reduce their risk of recurrence by taking additional years of hormonal therapy with either tamoxifen or an aromatase inhibitor, such as letrozole (Femara).

Why is this important? Some women may have more treatment options to help reduce their risk of breast cancer returning.

Predicted shortage of oncologists. A study found that the total number of people with cancer in the United States is projected to increase by 55% by 2020. Based on a separate analysis of the study, ASCO estimates that the United States will face a shortage of 2,550 to 4,080 oncologists (doctors who treat people with cancer) by 2020.

Why is this important? People with cancer won’t be able to receive quality care if there aren’t enough oncologists. To propose possible solutions for this projected shortfall, ASCO issued a strategic workforce plan.

Advances by type of cancer

In addition, progress was seen for many other types of cancer:

Brain Cancer

A phase II clinical trial showed that the drug bevacizumab (Avastin) plus irinotecan (Camptosar) helped people with glioblastoma (a tumor of the brain) live longer without the tumor growing.
Breast Cancer

Women with advanced breast cancer gained another treatment option this year. The U.S. Food and Drug Administration (FDA) approved bevacizumab (Avastin) in combination with the chemotherapy paclitaxel (Taxol) for women with HER2-negative breast cancer that has spread. Clinical trials showed the treatment combination shrank tumors and improved the length of time after treatment during which women had no sign of the disease.
Chronic Lymphocytic Leukemia (CLL)

The FDA approved bendamustine (Treanda) for patients with CLL. An international clinical trial showed that the drug eliminated the cancer in 30% of patients, compared with 2% of patients who received chlorambucil (the standard chemotherapy).
Melanoma

After patients with stage III melanoma had their tumors surgically removed, taking one year of pegylated interferon (Pegasys, PEG-Intron) treatment reduced their risk of recurrence by 18%, compared with those who did not receive the treatment.
Pancreatic Cancer

Patients with early-stage pancreatic cancer survived twice as long without any sign of the disease after taking six months of the chemotherapy gemcitabine (Gemzar), compared with patients who did not receive chemotherapy. This discovery applied to patients who had their tumors surgically removed.
Childhood cancer survivorship

Survivors of childhood cancer were found to be five to ten times more likely than their healthy siblings to develop heart disease 30 years after diagnosis, according to a report from the Childhood Cancer Survivor Study. Childhood cancer survivors need to receive regular check-ups to detect any long-term side effects affecting their hearts.
For more information on these advances in clinical cancer research, read the full report, Clinical Cancer Advances 2008: Major Research Advances in Cancer Treatment, Prevention and Screening.

About Clinical Cancer Advances 2008

The annual report, now in its fourth year, was developed by a 21-member editorial board of leading oncologists. The editors reviewed research studies published in peer-reviewed, scientific journals and the early results of research presented at major scientific meetings from October 2007 to September 2008.