Washington, July 22: The newest prognosis for cancer may be longer chemotherapy.
Doctors and pharmaceutical companies are moving toward treating cancer patients with drugs continuously, even when they may not urgently need them. That would be a departure from the common practice of stopping treatment when the cancer is under control and resuming it only if the cancer worsens.
The strategy is called maintenance therapy — akin to periodic tune-ups aimed at preventing a car from breaking down. Doctors say it could prolong the time tumors are under control, helping to turn cancer into a chronic disease that is kept in check even if it is not cured.
While maintenance therapy is not new, its use is growing, in part because some newer cancer drugs are more tolerable than the toxic ones of old and can be taken for longer periods.
But some experts say that in many cases, the longer-term use of drugs has not been proved to prolong life. Instead, it may just subject patients to side effects and thousands of dollars in extra costs. There is also concern that tumors might become resistant to a drug used for a long time.
“Generally more is better, in both dose and potentially duration,” said Dr Susan L. Kelley, chief medical officer of the Multiple Myeloma Research Foundation, which sponsors research on treatments.
Many doctors say there is a good rationale for maintenance therapy.
Although treatment varies with the type of cancer, many patients nowreceive several initial cycles of chemotherapy. Then, if the cancer goes into remission, or even if the tumor simply stops growing, the therapy is stopped.
It is resumed, usually with different drugs, only when the cancer starts worsening again. That strategy evolved in part because the older chemotherapy drugs were so toxic that patients often needed to take a holiday from treatment.
“But if you think about it practically, you don’t really want to give the tumor a holiday,” said Colin Goddard, the chief executive of OSI Pharmaceuticals, which is trying to position its lung cancer drug Tarceva for use in maintenance therapy.
–Agencies