SCOTTISH scientists have made a breakthrough in finding new treatments for patients suffering from one of the most difficult cancers to treat after a decade of work.
The teams at Dundee and Aberdeen universities have established a “foot in the door” to treating oesophageal cancer with a genetic diagnostic test — the EGFR FISH test — that relates to a class of drugs which can extend and improve quality of life for some patients.
Led by Professor Russell Petty, Chair of Medical Oncology in the University of Dundee School of Medicine, they identified which patients will benefit from being treated with the drug gefitinib – and those who get no benefit – enabling clinicians to focus on the best treatment in each case.
A clinical trial initiated by Petty and colleagues in 2007 involving 450 patients in 50 hospitals across the UK looked at their responses to gefitinib and saw dramatic improvements in some patients who lived beyond their initial prognosis of only weeks or months, in some cases up to two years, and had improved quality of life.
Petty said: “These responses to gefitinib were transformative to patients in this situation, moving them from being severely ill, with rapidly deteriorating health and within a few months of the end of their life, to a much improved condition where we had control of their cancer’s growth and symptoms and they could return to ‘normal life’ with their families.”
However, the results – published in the Journal of Clinical Oncology – showed these responses occurred only in a minority of patients. The team carried out a detailed genetic analysis of biopsies of patients’ tumours to establish why some had responded so well – and developed the test that identifies those who will benefit from gefitinib.
Around 455,000 people worldwide are diagnosed annually with oesophageal cancer, and the rate has risen over the last 40 years. The disease has been notably resistant to treatment. The recovery rate is around 15 per cent, while around half of patients with breast cancer, and 60 per cent of those with colon cancer, now recover.
Petty added: “It is important to treat people with the medicine most likely to control the cancer first time around, as we may not get a second chance. Gefitinib... only benefits around one in 10 patients, so it was vital we developed the test to identify which patients would and would not benefit. This really is a foot in the door which will help us get better and more effective treatments for oesophageal cancer.”
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