Posted: Jul 16, 2008 11:28 PM
Oct. 30, 2007 (Los Angeles) -- People with a type of brain cancer that was invariably fatal only five years ago now have a shot at living three, four, or even five years after diagnosis, European researchers report.
In a new study, four times as many people with a brain cancer called glioblastoma multiforme who were given radiation and the drug Temodar survived for at least four years, compared with those treated with radiation alone.
The survival rate was even higher among people who didn't have symptoms or who had a favorable genetic makeup, says researcher Rene-Olivier Mirimanoff, MD, a radiation oncologist at the Centre Hospitalier Universitaire Vaudois in Lausanne, Switzerland.
The findings were reported at the annual meeting of the American Society for Therapeutic Radiation and Oncology (ASTRO).
Glioblastoma multiforme is one of the most aggressive and difficult-to-treat types of brain cancer; it's is the tumor that killed the character Dr. Mark Green on the popular TV show ER. For years, surgery followed by radiation was the best treatment available, but it really didn't work very well, Mirimanoff says. Most patients lived only nine to 12 months from diagnosis and a few survived for two years.
The anticancer drug Temodar was approved in 2005 after research showed that twice as many people given the drug plus radiation survived for at least two years compared with those given radiation alone.
"There had been almost no progress for 30 years until this study," Mirimanoff says. Temodar quickly became the standard of care, he says, but doctors still didn't know if patients would survive over the long term.
Long-term results from the study of 573 people show that 12% of people given Temodar plus radiation were alive four years later compared with 3% given radiation alone.
"Frankly we did not expect such good results," Mirimanoff tells WebMD. "We thought it would just give people a few extra months."
The subgroup of people who were in relatively good health with almost no symptoms did even better: 28% given Temodar were alive at four years vs. 7% of those given radiation. This group accounted for about 15% of the study participants.
Also, 22% of people whose MGMT gene was turned off lived for four years if they had the combination therapy, compared with 5% for radiation alone. The MGMT gene causes resistance to radiation and chemotherapy; if it's turned off, the tumor responds much better, Mirimanoff explains.
About 45% of patients, both in the study and the general cancer population, have a silenced MGMT gene, he says.
"This is the good-news story of the meeting," says Anthony Zeitman, MD, of Harvard Medical School, a spokesman for ASTRO.
"For this previously invariably and rapidly fatal tumor, we may be turning the corner. It's possible for some patients to see some light at the end of the tunnel," he tells WebMD.
The study was funded by the European Organization for the Research and Treatment of Cancer, the National Cancer Institute of Canada, and Schering-Plough, which makes Temodar.