Cancer Fighters Thrive is a quarterly print and online magazine bringing readers practical, innovative and inspirational information about cancer treatment and survivorship.
Issue link: http://cancerfightersthrive.epubxp.com/i/259111
38 cancer fighters thrive | spring 2014 cf thrive. com RESEARCH TODAY (EGFR) pathway. Known as "EGFR inhibitors," these therapies work by blocking the activity of EGFR, a protein receptor that is found on the surface of some normal cells as well as some cancer cells and is involved in cell growth. High activity of EGFR in cancer cells causes them to grow and divide, so drugs that block EGFR signaling may help control the growth and the spread of cancer. "By targeting alterations that cancer cells may acquire in EGFR, EGFR inhibi- tors can stabilize or shrink a tumor and control additional spread for a long period," says Dr. Weiss. Tarceva® (erlo- tinib), he explains, is an example of an EGFR inhibitor approved by the U.S. Food and Drug Administration (FDA) that is currently used in the treatment of non–small cell lung cancer. (Tarceva is also approved for the treatment of pan- creatic cancer.) More Advances on the Horizon Future progress in treating metastatic cancer, explains Dr. Weiss, will likely involve therapies that improve the immune system's response to metastatic cancer cells—drugs known as "immu- notherapies." There are drugs currently in clinical trials (the research process required for FDA approval) that, he says, "stimulate the immune system to iden- tify and target cancer cells." For example, a drug called Yervoy® (ipilimumab) has been FDA approved for use in metastatic melanoma. Yervoy is an antibody therapy (a substance that can directly kill specifc tumor cells or stim- ulate the immune system to kill tumor cells) that targets and boosts the activ- ity of cytotoxic T-lymphocyte antigen-4 (CTLA-4), a protein receptor found on T-cells, which are part of the immune system. By targeting CTLA-4, Yervoy can help the body control the growth and the spread of melanoma. In the treatment of metastatic breast cancer, Dr. Weiss says that emerging therapies combine antibodies with che- motherapy by using the human epider- mal growth factor receptor 2 (HER2) on a cancer cell as the target for the antibody. "The antibody binds to HER2, and the chemotherapy agent destroys the cancer cells," he explains. This combination, he says, is the progression from advances in recent years in HER2-targeting therapies. "But the targeted therapies [antibodies] alone just bind to HER2 and shut down signaling," Dr. Weiss says, "whereas tar- geted therapy combined with chemo- therapy more effectively attacks cancer." In breast cancer, therapies targeted at HER2, however, can work only in those cancers that are HER2-positive, which does not include all breast cancers. Growing Options Though Dr. Weiss cautions that advances in treatment of metastatic cancer do not mean a cure—"They don't make all can- cer disappear, but they can stabilize a patient for years," he says—he is certain that options will continue to increase. "There are a variety of possibilities for treatment," he explains, "such as com- binations of traditional chemotherapy with antibodies and immune-stimulat- ing agents and targeted therapy." And doctors will likely be able to use targeted therapy more effectively, he adds, thanks to advances in imaging techniques (such as scans) that help them choose appro- priate treatment more effectively. Each individual advance in the treat- ment of metastatic cancer represents greater understanding of these types of cancers—how they grow and spread and how we can control or stop them. With that in mind, there is real cause to say that the outlook for treating metastatic diseases is increasingly positive. Access to Advances Through Clinical Trials Many new therapies are still in the clinical trials process, meaning that they are available only to patients who enroll in these research studies. "It's important for patients to know," says Dr. Weiss, "that sometimes they can access certain treatment advances only through clinical trials." To learn more about available clinical trials, he suggests that CTCA patients frst discuss the option with their medical oncologist and then e-mail clinicaltrials @ctca-hope.com for more information. Beyond CTCA the National Comprehen- sive Cancer Network (nccn.org) and ClinicalTrials.gov also have informa- tion about clinical trials. cftSp#23vky.indd 38 2/3/14 11:16 PM