For three days in June, cancer specialists were focused squarely on New Orleans as a mountain of new trial data on some of the most promising oncology treatments were unveiled at the annual meeting of the American Society of Clinical Oncology. In report after report, researchers displayed real zeal in trumpeting new advances that - if they couldn't cure cancer - held immense promise for delaying death.
Medicines like Avastin and Eloxitan demonstrated that they can extend the lives of cancer patients who failed chemotherapy by almost two years. And a growing number of oncologists and researchers have been focused on developing a new cocktail of cancer drugs aimed at further extending life.
Of particular note: Two landmark late-stage trials of Aventis' Taxotere showed that it was able to essentially "freeze" the internal structure of a cancer cell, stopping it from dividing. Currently approved for metastatic breast cancer after the failure of chemotherapy, researchers demonstrated that they were on to a treatment that could have much more far-reaching effects which may soon change the standard of cancer care in America.
"These studies are the first to show that a chemotherapy agent, Taxotere, can deliver a significant survival benefit in androgen-independent (hormone-refractory) metastatic prostate cancer patients, giving hope to thousands of men worldwide," Daniel Petrylak, MD, Associate Professor of Medicine at Columbia University College of Physicians & Surgeons, told the gathering. "This data represents an important new treatment option for men with prostate cancer because it can help some patients live longer."
Prostate cancer ranks third worldwide in cancer incidence and sixth in cancer mortality among men. In the United States, more than 230,000 men will be diagnosed with prostate cancer this year, and more than 29,900 will die of the disease.
"The results of these studies mark a significant milestone in cancer care. Taxotere is the only drug approved for patients with breast, lung and prostate cancer, three of the most prevalent cancers in the world today," said Frank Douglas, M.D., PhD, executive vice president of drug innovation and approval at Aventis.
But Taxotere was far from the only cancer drug to gain the spotlight. Among the others:
o Imclone's Erbitux: After gaining notoriety for snaring Martha Stewart in a stock trading scandal, Erbitux has been given limited approval in the United States. At New Orleans, researchers unveiled a Phase III trial of the drug for head and neck cancer, showing that patients demonstrated significantly better survival rates than a control group receiving radiation treatment alone.
o Millennium's Velcade: A new study showed that 327 patients taking Velcade for multiple myeloma, a form of bone cancer, lived significantly longer than the 330 patients taking dexamethasone, the standard treatment of the day. During the trial, 13 patients on Velcade died, compared to 24 taking dexamethasone.
o Telik's Telcyta: In a mid-stage trial, 56 percent of ovarian cancer patients demonstrated a response to the drug. Three experienced complete remission. Only 21 patients were enrolled in the Phase II trial, but the results were dramatic enough to gain plenty of attention.
o Pfizer's SU11248: A Phase II trial involving 92 patients with kidney cancer who had stopped benefiting from Gleevec showed that 60 patients benefited from the experimental drug SU11248. Seven of the patients saw their tumors shrink while 53 saw their disease stabilize.
But behind all the upbeat news is a growing cost problem. Just a decade ago cancer drugs that helped keep victims alive cost in the hundreds of dollars. Now, they calculate new costs for drugs like Avastin in the hundreds of thousands of dollars. In part, say drug company representatives, the bigger price tags are the natural result of the immense cost attached to bringing a treatment to market - a research odyssey that can consume more than $800 million.
But as costs have soared into the stratosphere, a growing number of experts have begun to question who can afford to foot the bill.
In a high-profile op-ed piece printed in the Washington Post, cancer specialist Robert Wittes estimates that the average wholesale cost of treating a patient with Erbitux and related chemotherapy runs about $16,000 a month. It's only a matter of time before insurers bow out of covering such costs, Wittes believes. Most people can't afford it on their own, he adds, and after the latest round of Medicare reform, even the government is likely to find the sticker shock overwhelming.
In the end, he says, only government price controls will work. But that would be a nightmare scenario for the drug companies that put their advances on display in New Orleans, all of whom are keenly aware of the market potential of each of the new treatments.