HOT Topics in Cancer Treatment

It is very important for the patient to be armed with as much information as possible to aid them in this difficult battle. The following information covers some new and exciting topics related to cancer and cancer treatment. This is not meant to be a guide to cancer treatment. It is important for you to discuss any treatments with your physician.

Epidermal Growth Factor Inhibitors

Iressa was the first approved molecular targeting agent designed to inhibit the Epidermal growth factor receptor (EGFR). Tarceva has now essentially replaced Iressa and is approved for the treatment of non-small cell lung cancer. Tarceva is a once daily pill taken by mouth. Tarceva is currently being studied for use in other types of cancers besides non-small cell lung cancer.

Erbitux is a monoclonal antibody which is designed to block the epidermal growth factor receptor. Erbitux was approved for use in treating colon cancer. New studies are underway for other cancer types.

Studies are now being conducted evaluating the combination of Erbitux and Tarceva for treating certain cancers.

Anti-angiogenesis treatments

Anti-angiogenesis is the use of drug therapies to reduce blood vessel growth for cancer. New vessel development is an essential process for the growth of cancers.
Avastin is an anti-angiogenesis drug that has recently been approved by the FDA for the treatment of colon cancer. It is also being studied for many other cancer types. Avastin is a monoclonal antibody that inhibits a receptor called VEGF, which is involved in angiogenesis.

Celebrex has also recently received a great deal of attention for its potential anti-angiogenesis properties. The majority of these studies have involved lung cancer. Celebrex inhibits the COX-2 enzyme, which is responsible for the production of prostaglandins. These prostaglandins have some involvement with new vessel growth (angiogenesis) for cancers. This would also suggest that aspirin, Vioxx and other NSAIDS (Non-steroidal anti-inflammatory drugs) could have a similar effect.

Thalidomide is also being studied for its possible anti-angiogenesis properties.

Epidermal Growth Factor Inhibitors

Iressa was the first approved molecular targeting agent designed to inhibit the Epidermal growth factor receptor (EGFR). Iressa is approved for the treatment of non-small cell lung cancer. Iressa is a once daily pill taken by mouth. Iressa is currently being studied for use in other types of cancers besides non-small cell lung cancer.

Erbitux is a monoclonal antibody which is designed to block the epidermal growth factor receptor. Erbitux was just recently approved for use in colon cancer. New studies are underway for other cancer types.

Recent studies show that the combination of Erbitux and Iressa may have some significant benefit for treating certain cancers.

Experimental Vaccines and Gene Therapy Agents

The future for cancer treatment appears to be gene therapy and cancer vaccines. There are many trials underway that are studying these agents. One of the most exciting appears to be a gene therapy agent containing the gene p53. Gene therapy involves adding or replacing genes within a cell. The most common method to deliver the gene is using a virus. A virus can be used to deliver the genetic payload needed to help treat the cancer. The gene p53 is a normal gene within the human body. It functions as a check mechanism to help prevent cancer cells from developing and growing. This type of gene is known as a tumor suppressor gene. Malfunction of this gene may be responsible for as much as 70% of cancers. The treatment involves placing additional copies of the p53 gene within the cancer cells. The gene should then prevent the growth and actually cause the death of cancer cells. The agent has to be placed directly within the tumor using image guidance. The studies in the U.S. involve the p53 adenovirus known as Advexin (Introgen Therapeutics). The same or a very similar agent is currently being used with great success in China (under the name Gendicine). Advexin is currently in phase 3 (final phase) of FDA trials. It is speculated that it may be released sometime in 2006.

On the vaccine front there is an agent called GVAX, which has shown promise in the early trials. The idea behind GVAX is to use GM-CSF (a powerful immune stimulating substance produced by certain cells) to encourage the immune system to attack the cancer. GVAX actually uses the gene that makes GM-CSF. The gene is placed within the cancer cells. The cancer cells produce GM-CSF, which signals the immune system to attack.