SWCRF’s focus on developing less toxic treatments benefits seniors living with cancer
One of America’s precious resources, its senior population, is not getting its fair share of attention in the war against cancer and the Samuel Waxman Cancer Research Foundation (SWCRF) is determined to do something about it. Cancer continues to be a global epidemic. However, while new cancer cases around the world grew to 14.1 million in 2012 from 12.7 million in 2008 as reported in December by the World Health Organization’s International Agency for Research on Cancer, relatively little has been discussed in the public arena about the challenges faced by cancer patients over the age of 65 … until now.
Seniors & Cancer
The latest Report to the Nation on the Status of Cancer issued by the National Cancer Institute (NCI) addressed the prevalence and impact of comorbidity – the condition of having two or more diseases at the same time -- among people 66 years of age and older with lung, colorectal, breast or prostate cancer from 2001 to 2010. The report, created in conjunction with the American Cancer Society, the Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries, identified diabetes, chronic obstructive pulmonary disease, congestive heart failure and cerebrovascular disease as the most prevalent comorbidities among cancer patients. In women ages 66 to 74 with early stage breast cancer, the presence of low or moderate comorbidity levels nearly doubled the probability of death compared to women with no comorbidity. Women with severe levels of comorbidity, meanwhile, were three times as likely to die as women with no comorbidity. High degrees of comorbidity also enhanced the probability of death in men ages 75 to 84 with prostate cancer.
The NCI’s report was the basis of a recent feature story in The New York Times that identifies 72 as the median age of cancer death and states that strides in the treatment of heart illnesses have increased the probability of more people between 55 and 84 dying of cancer than heart disease.
This information notwithstanding, there remains an imbalance in how seniors are represented in clinical trials for potential cancer therapies. Seniors account for two-thirds of patients under treatment for breast, lung, colorectal or prostate cancer yet comprise only one-third of the participants in clinical trials for drugs under development to treat these categories.
Several factors contribute to this troubling trend, which has existed since 1992:
Most cancer drugs under development are relatively toxic to patients.
Seniors are more sensitive to toxic therapies than younger patients.
Drug Developers shy away from enrolling seniors in clinical trials because their sensitivity to toxic therapies may interfere with the outcomes of studies.
The underrepresentation of seniors in trials creates a scarcity of data on how to effectively treat cancer in the elderly, which in turn reinforces this negative trend.
A Gentler Approach to Therapy
The cancer researchers in the SWCRF’s collaborative network -- its Institute Without Walls --- are not content to leave seniors in this Catch 22. Inherent to the mission of the SWCRF, which funds cutting-edge research projects that require collaboration among its funded scientists, is the goal of developing minimally toxic therapies for all patients. For senior citizens, this philosophy is particularly relevant.
“We have developed minimally toxic and successful treatments to combat many cancers, such as in the case of retinoic acid therapy for acute promyelocytic leukemia (APL),” says Ethan Dmitrovsky, M.D., and Provost at MD Anderson Cancer Center at the University of Texas. “These therapies coax cancer cells to mature or become more like normal cells with controlled growth programs by silencing abnormal genes typically expressed in cancers. We want to do the same for other cancers that particularly afflict older populations.”
The SWCRF’s breakthrough therapy for APL, spearheaded by founder and CEO Samuel Waxman, M.D., in collaboration with researchers in Shanghai, combined all-trans-retinoic acid with arsenic trioxide and dramatically improved the disease’s survival prospects from 25 percent to 95 percent. Today, the Foundation aims to apply this combination differentiation therapy to create targeted therapies for other cancer types without the need for toxic chemotherapy.
“Cancer death incidence is increasing in the over- 70 population while it’s decreasing in the younger population,” Dr. Waxman points out. “This is due to a lifetime of acquisition of mutations and breakdown of epigenetic controls. Conventional cancer treatments are less well tolerated and clinical trials exclude seniors over a certain age. The SWCRF has the brain trust to be impactful in correcting this unmet clinical need.”
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To view the NCI’s full Report to the Nation on the Status of Cancer, visit: http://1.usa.gov/1cDFUDp