Jan 30, 2006 - 12:53 am
Intraperitoneal Chemotherapy, a treatment in which anti-cancer drugs are put directly into the abdominal cavity through a thin tube, has been trying to achieve progress by changing the method of drug delivery.
A Gynaecological Oncology Group study has been reported in the January 5th edition of The New England Journal of Medicine, which studied its impact with over four hundred women with stage three disease, optimally debulked and randomized to intra-peritoneal or intravenous drug therapy.
Ovarian cancer patients are now living longer than they did in the past, but this is almost certainly owing to better and more aggressive surgery. This study could be an indication of the "right chemotherapy," but using the "wrong drugs."
The hallmark of cancer is heterogeneity. Not just many types of cancer (ovarian, breast, lung, colon, etc.), but many subtypes of cancer within a given type. Many types of ovarian cancer. Many types of breast cancer. Many types of lung cancer, etc. The biologies are very different and the response to given drugs is very different.
The hallmark of cancer treatment is heterogeneity. There are currently over 100 FDA approved cancer drugs, with hundreds more in the pipeline. All of these drugs tend to be partially effective, and even then, in only a minority of cases, and often for only a short duration of time.
The single most neglected area of cancer research has been the development of methods and technologies to be "matchmakers" between individual cancer with individual cancer treatment.
The single most neglected area of cancer treatment has been the unwillingness to utilize, or even study, the matchmaker technologies which have already been developed and which are already available. These technologies involve studies of cancer cell responses to drug exposure in cell culture systems, "outside" of the patient's body, before they are put "into" the patient's body.
With only 42% of the women being able to finished the rather arduous trial, perhaps abdominal chemo is the right therapy, but they were using the wrong drugs? Test the tumor first!