New Drug Combination For Neuroendocrine Tumors

A combination of an oral chemotherapy agent and a drug to prevent blood vessel growth has shown encouraging results in advanced neuroendocrine tumors, rare cancers of hormone-making cells that commonly resist chemotherapy, scientists say.

In a clinical trial published in the Jan. 20 issue of the Journal of Clinical Oncology, researchers at Dana-Farber Cancer Institute and other Harvard-affiliated hospitals found that the drug combination shrank neuroendocrine tumors in 25 percent of the study participants and was biochemically active against tumors in 40 percent of the participants. While the therapy produced side effects in a number of patients, they were generally more tolerable than those associated with conventional chemotherapy, the scientists noted.

The drug duo consisted of temozolomide, a pill similar in activity to an older, intravenous chemotherapy agent, and thalidomide, a medicine associated with birth defects when taken by pregnant women in the 1950s and '60s, but which has since been shown to be a deterrent of blood vessel growth.

"Neuroendocrine tumors are among the most vascular, or blood vessel-filled, tumors that exist, so it made sense to test chemotherapy in combination with an angiogenesis inhibitor like thalidomide, which blocks blood vessel growth," says the study's lead author, Matthew Kulke, MD, of Dana-Farber. "And because temozolomide is taken in pill form, rather than intravenously, it's more convenient for patients."

Neuroendocrine cancers arise in hormone-producing cells found in a number of of the body's organs. Hormones released by the cells spark chemical reactions that are part of the organs' normal functioning. When these cells become malignant, the resulting tumors tend to grow slowly and don't produce symptoms in early stages. As a result, most neuroendocrine tumors are diagnosed only after they have spread to other parts of the body. Conventional chemotherapy is largely ineffective against these dispersed tumors. There are an estimated 3,000-5,000 new diagnoses of neuroendocrine cancer every year in the United States. When diagnosed at a late stage, the tumors are commonly fatal.



Source: Dana-Farber Cancer Institute