From: Reuters
Published April 22, 2008 04:14 PM

Cisplatin not effective in anal cancer trial: study

CHICAGO (Reuters) - Treating anal cancer patients with the cancer-fighting drug cisplatin to try to shrink tumors before beginning standard therapy did not boost survival rates, and is not recommended, U.S. researchers said on Tuesday.

Evidence from pilot studies led oncologists to believe giving patients cisplatin, a platinum-based drug commonly used to fight various cancers, would shrink the primary tumor and attack the disease that had spread to lymph nodes.

The idea was to give patients a head start before surgery, further chemotherapy and radiation treatment.

Anal cancer, which the American Cancer Society said will affect 5,000 Americans this year, is particularly deadly when the tumors exceed 2 inches in size. Mortality rates from the cancer have not improved since the early 1990s, the Cancer Society said.

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"However, it is clear from this data that cisplatin is not the drug to use and its use should be discontinued in standard therapy," Dr. Jaffer Ajani of the University of Texas M.D. Anderson Cancer Center, who led the study, said in a statement.

In the study of 644 patients, 60 percent of those who received the current standard treatment -- the chemotherapy drugs fluorouracil plus mitomycin along with radiation -- were likely to survive five years disease-free. That compared to the disease-free survival rate of 54 percent among those treated with cisplatin followed by fluorouracil and radiation.

Overall survival rates were also slightly higher in the standard treatment group, of whom 28 patients died compared to 54 in the cisplatin group, Ajani's team reported in the Journal of the American Medical Association.

In addition, 19 percent of the cisplatin group had colostomies, in which patients' waste is diverted through the abdomen into a bag they must carry around, compared to 10 percent of standard treatment group.

(Reporting by Andrew Stern; Editing by Maggie Fox and Sandra Maler)

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