Yesterday I posted an article about how “treatment with fewer cycles of chemotherapy and a reduced dose of radiation therapy may be as effective as, but less toxic than, more intensive treatment” in newly diagnosed Hodgkin’s lymphoma patients.

This type of finding is not limited to lymphoma patients. One of the primary goals of a Phase 1 clinical trial is to test how much of drug patients can tolerate. Docs then start with that dose. At that point, no one knows if giving the max dose of chemotherapy is necessary. But without supporting data, giving a max dose only makes sense.

My wife Pattie completed treatment for ovarian cancer seven years ago–surgery, followed by six months of heavy chemotherapy. Taxol was the featured agent.

If Pattie was diagnosed today, docs would probably still use Taxol (in combination with one or more other anti-cancer drugs) but is a much lower dose–and most likely for only three or four cycles, not six.

Ovarian cancer patients undergoing this treatment now report fewer side-effects than my wife did. She would get really, really sick. Pattie was basically “out for the count,” writhing in pain and horribly nauseous, for five or six days following her monthly IV.

Good news! But I must ask: Why are oncologists still using the same primary cancer drug for ovarian cancer seven years later? There have been three or four new, effective anti-myeloma drugs developed and approved by the FDA over the last five years. Get with the program, researchers!

Like taxol for ovarian cancer, myeloma specialists are learning max doses are rarely necessary to achieve positive results. In some cases–like the steroid dexamethasone–ongoing research has determined higher doses actually reduce the drug’s effectiveness.

What does the future hold? In the short term: Smaller doses of several chemotherapy drugs, used in combination, often with reduced doses of maintenance chemo administered after the primary therapy is complete.

This trend started in the blood cancers (leukemia, lymphoma, myeloma), but is spreading to a number of other solid tumor applications.

Since it is unlikely scientists will find a cancer “cure” anytime soon, smaller, targeted doses, made up of combinations of different anti-cancer agents is the trend today.

Feel good, keep smiling and pray and root for the cancer researchers, staring at their test tubes, computer screens and microscopes. May today be the day one of them discovers a key to curing our cancer!
Pat

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