We have improved cure rates by using:
- Oral chemotherapy as an alternative to intravenous therapies
- New drugs
- Select chemotherapy drugs, pre & post operatively
- Targeted therapies
- Preoperative chemo radiation
- Novel combinations of treatments
We have improved quality-of-life for patients by:
- Identifying when to introduce palliative chemotherapy
- Having fewer side effects when using a combination of chemotherapies
- Meta-analysis setting the standard of care for treating people with oesophageal cancer
- New targeted treatment for advanced bowel cancer
- A better treatment program for rectal cancer
- First international AGITG-led trial
- Setting the treatment standard for people with GIST in Australia
- Improving effectiveness of chemotherapy in fighting pancreatic cancer
Clinical Study Results
(1) Meta-analysis setting the standard of care for treating people with oesophageal cancer – Fourth most read article in Lancet Oncology in 2007
The study, published in Lancet Oncology, showed for the first time that there is a better chance of survival if patients have chemotherapy and radiation therapy given together just before surgery, rather than surgery alone. The study analysed data from many clinical trials. It showed conclusively that there is a 14% improvement in survival if patients receive concurrent chemotherapy and radiation therapy before surgery. This helps prevent the spread of cancerous tumours in their oesophagus, compared to surgery alone. In March 2008, Lancet Oncology announced that this review was the fourth most read article for 2007. This demonstrates the potential for AGITG to impact on clinical care for cancer patients throughout the world.
(2) New targeted treatment for advanced bowel cancer
The AGITG contributed very significantly to a large international clinical trial, which for the first time showed that a targeted treatment approach, not involving chemotherapy, prolongs the survival of people with advanced bowel cancer. The CO.17 clinical trial tested the drug Cetuximab in people with advanced bowel cancer. Cetuximab works by blocking receptors on the surface of the cancer cells, which in turn blocks the cancer’s ability to grow. This treatment prolonged the lives of people on treatment by a few months. Results from this study were published in the New England Journal of Medicine in 2007. Furthermore, additional research within the CO.17 study into the role of the biomarker K-ras showed that a tumours K-ras status can predict a patient’s individual response to treatment with cetuximab. In particular, patients with very advanced colorectal cancer treated with cetuximab whose tumours expressed wildtype K-ras survive twice as long as patients with tumours bearing a mutated K-ras gene. These findings were published in the New England Journal of Medicine in 2008. A follow on study, CO.20, was developed by NCIC in collaboration with the AGITG and opened in Australia and New Zealand in early 2008, subsequently opening in Canada later on in the year. Australian recruitment has rapidly taken off, with Australian and New Zealand centres recruiting ahead of target expectations.
(3) A better treatment program for rectal cancer
The AGITG has collaborated with the Trans-Tasman Radiation Oncology Group (TROG) in undertaking a major clinical trial of 326 patients with locally advanced cancer of the rectum. The trial compares the relapse rates of patients treated with one or other of two preoperative treatment programs, either one week of radiotherapy or five and a half weeks of chemo-radiotherapy. Both programs have been accepted as standard-of-care in different parts of the world. Early results comparing side-effects were presented at the 2007 European CanCer Organisation (ECCO) meeting and the results of comparing patients’ quality of life were presented at the 2008 meeting of the American Society of Clinical Oncology (ASCO). The final results are eagerly awaited and will be available within the next year.
(4) First international AGITG-led trial
The MAX Study is an AGITG-led clinical trial, which aims to work out how effective using a combination of three cancer fighting chemotherapy drugs is at treating people with bowel cancer that has spread to other parts of the body. This trial is the first for AGITG to recruit patients in the United Kingdom. Three United Kingdom sites are participating – The Royal Marsden Hospital, London, The Christie Hospital, Manchester and The Beatson Oncology Centre in Glasgow. The MAX study successfully closed to recruitment in 2007, with follow-up of patients continuing throughout 2008 and into 2009. Quality of life data from the study has been used to compare utilities from advanced colorectal cancer valued from societal and cancer patient’s perspectives, the findings of which were presented in an oral session at ASCO 2008. Final study results are expected to be published in 2009.
(5) Setting the treatment standard for people with GIST in Australia
AGITG successfully brought a targeted therapy to Australia to treat patients with advanced Gastro-Intestinal Stromal Tumours (GIST). Through the Advanced GIST clinical trial, the AGITG treated patients with the new drug therapy years before it was generally available or listed on the Australian Pharmaceutical Benefits Scheme (PBS). The new therapy drug (Glivec®) prolongs survival from approximately one year post-diagnosis to over five years. It acts on GIST by blocking growth signals in tumour cells that are continuously activated as a result of genetic mutations.
(6) Improving effectiveness of chemotherapy in fighting pancreatic cancer
For the first time, results from a collaboration between the NCIC and the AGITG in a metastatic pancreatic cancer trial showed improvements to the survival rate of people with pancreatic cancer by adding a cancer growth inhibitor to chemotherapy. The inhibitor works by blocking a cancer growth hormone on the surface of the cancer cells, which slows the growth of the cancer and improves survival rates for patients. Results of the study were published in the European Journal of Cancer 2012; 48(10): 1434–1442. Published online 24 Nov 2011.