January 4, 2006

Body cavity drugs cut ovarian cancer death risk

By Gene Emery

BOSTON (Reuters) - Injecting anti-cancer drugs into the
body cavity, not just into a vein, can dramatically lengthen
the lives of women with advanced ovarian cancer, a study showed
on Wednesday.

The U.S. government quickly recommended that patients start
getting the new treatment for the disease that is the
fourth-leading cause of cancer-related deaths among women in
the United States.

The treatment can be difficult to endure but improved the
average survival time by nearly 16 months and cut the risk of
death from advanced ovarian cancer by 25 percent, said the
study published in this week's New England Journal of Medicine.

"It's very good news," said Deborah Armstrong, chief author
of the study. "A lot of larger institutions have already
adopted this approach. At least for today, this is the best
thing we can offer our patients."

Each year, ovarian cancer strikes about 22,000 U.S. women
and 16,000 die from it, according to the American Cancer

The study produced "one of the largest benefits ever
observed for a new therapy in gynecologic oncology," said
Stephen Cannistra in a journal editorial.


In advanced cases of ovarian cancer, surgeons try to remove
the visible tumor and use intravenous chemotherapy to kill
cancer cells too small to see.

When they cannot get it all, most women die after about
three years. But even surgery deemed a success usually adds
only one extra year of life.

Armstrong of Johns Hopkins Kimmel Cancer Center in
Baltimore and her colleagues gave 210 cancer patients standard
chemotherapy with two drugs, cisplatin and paclitaxel.

Another 205 received paclitaxel intravenously followed by
cisplatin and then more paclitaxel, both injected into the body
cavity with water to flush the drug throughout the peritoneum,
the tissue that lines the abdominal wall and covers most of the
organs in the abdomen.

The treatments were repeated five more times, three weeks

Women who received intraperitoneal chemotherapy directly
into their body cavity typically survived for 66 months, 32
percent longer than those receiving standard care.

However, the body cavity treatment often caused pain,
fatigue, stomach, intestinal and other problems so severe that
58 percent of the patients did not get the full six courses of

The quit rate was 17 percent among those who only received
their drugs intravenously.


The National Cancer Institute on Wednesday recommended
simultaneous delivery of chemotherapy drugs intravenously and
directly through the abdomen after surgery for ovarian cancer.

Intraperitoneal chemotherapy "allows higher doses and more
frequent administration of drugs, and it appears to be more
effective in killing cancer cells in the peritoneal cavity,
where ovarian cancer is likely to spread or recur first," said
the institute, the cancer research arm of the National
Institutes of Health.

One year after receiving their treatments, the women in
both groups had the same quality of life, the study said.

"It is remarkable that such a clinically meaningful
survival advantage was observed, despite the high attrition
rate" in the group that received the drugs in the body cavity,
said Cannistra of the Beth Israel Deaconess Medical Center in
Boston. That suggests "a substantial benefit" from the
treatment, even when it is only given a few times.

(Additional reporting by Joanne Morrison)