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For Release: November 3, 1999
LOCALLY ADVANCED CERVICAL CANCER PATIENTS BENEFIT FROM RADIATION THERAPY AND CHEMOTHERAPY THAT TARGETS
TUMOR CELLS DEFICIENT IN OXYGEN
Patients with locally advanced cervical cancer may do better if they are treated with radiation therapy and the drug mitomycin C compared to radiation therapy alone, reports a new study.
The study, which is still ongoing, compared 78 patients who were treated with radiation therapy plus the chemotherapy drug mitomycin C to 82 patients who were treated with radiation therapy alone. Mitomycin C selectively kills those cells with low oxygen levels, a feature common to solid tumors as they grow and outstrip their blood supply, says Kenneth Roberts, M.D. of Yale University School of Medicine in New Haven, CT.
Other studies have shown that the drug cisplatin with or without 5-fluorouracil plus radiation therapy for cervix cancer has been shown to improve disease control, says Dr. Roberts. This benefit seems to be more pronounced in earlier stage patients, he says. What is striking about this mitomycin C study so far, is that the benefit of combining this type of chemotherapy with radiation treatments is that the higher stage patients are benefiting, says Dr. Roberts. In a subgroup of stage III to IVA patients, 75 percent of the patients with advanced cervical cancer who were treated with both radiation therapy and mitomycin C did not have the cancer return compared to only 34 percent of the patients treated with radiation therapy alone after four years of follow up.
Mitomycin C was given twice intravenously during the first and sixth week of radiation therapy. ìMitomycin C is a unique drug to combine with radiation. Other drugs may make cells more sensitive to radiation and improve tumor control but at the expense of increased side effects since radiation sensitizing drugs do not differentiate between tumor or normal cells,î says Dr. Roberts. ìThe drug mitomycin C compliments radiation by selectively targeting hypoxic cells, a characteristic of tumors, but not normal tissues. Those hypoxic regions in tumors are theoretically more resistant to radiation. Moreover, experimental data suggests that hypoxia leads to tumor progression and mutation and eventually to a more aggressive tumor,î adds Dr. Roberts.
Since the development of the pap smear, doctors have been able to better detect and treat cervical cancer before it reaches an advanced stage. Still, pap smears are underutilized, especially in underdeveloped countries and ìwe still see women with advanced cervical cancer,î says Dr. Roberts.
The side effects from mitomycin C were few and minor, such as nausea and low blood counts. Hair loss is uncommon, says Dr. Roberts.
ìThis is a preliminary study. The results are suggestive and intriguing. The strategy deserves more investigation and ultimately should be compared or combined with cisplatin treatments,î he says.
Dr. Roberts presented this study on November 3 at the American Society for Therapeutic Radiology and Oncology 41st annual meeting in San Antonio, TX.
The American Society for Therapeutic Radiology and Oncology (ASTRO) is the largest radiation oncology society in the world, with more than 5,000 members. As a leading organization in radiation oncology, biology and physics, the society's goals are to advance the scientific base of radiation therapy and to extend the benefits of radiation therapy to those with cancer.
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