Drug might protect hearts of childhood leukemia survivors
About 75 percent of children with leukemia who take chemotherapy face life-threatening heart problems as they age, but an international study led by a University of Rochester Medical Center investigator shows that giving a cardio-protective drug during cancer treatment may prevent the damage.
Researchers and physicians will debate how to make young cancer patients and their families aware of the risks of heart damage, and the best ways to manage the risks, in a special session today at the American Society of Clinical Oncology (ASCO) meeting in Chicago.
Led by Barbara L. Asselin, M.D., professor of Pediatrics and Oncology at URMC, the study was sponsored by the Children's Oncology Group and the National Cancer Institute. It is believed to be one of the largest trials to evaluate the effectiveness of the drug Zinecard (dexrazoxane), at protecting the heart during treatment of acute lymphoblastic leukemia. Asselin presented data and will also take part in a larger ASCO forum, during which hundreds of pediatric cancer experts will discuss heart disease and second malignancies the unfortunate, severe risks associated with aggressive treatment of children.
"Today the majority of children with leukemia will be cured," Asselin said. "As our young people survive, though, we believe we will see many more cardiac issues. It is a problem that must be fixed because it is the leading cause of death later in life among these patients."
One part of the equation involves getting teenagers and young adult cancer survivors, who tend to engage in riskier behaviors, to be aware of potential problems and make healthy lifestyle choices (no smoking; exercise; careful follow-up appointments with a physician), Asselin said.
Drugs such as Zinecard are also important, although the data so far has been inconsistent. The URMC study evaluated 537 patients for more than 10 years after they were treated for leukemia between 1996 and 2001. All received multi-agent chemotherapy that included doxorubicin, known to be toxic to the heart.
Patients were randomized to two groups, with or without a dose of intravenous Zinecard immediately prior to receiving the chemotherapy. Later, researchers assessed each patient for heart damage at three different points after chemotherapy. Using standard measures, they looked at heart muscle function and structure. (A common problem following doxorubicin therapy is heart enlargement and thinning of the ventricular walls.)
For both groups of patients, the five-year survival with no evidence of leukemia was the same. That data was encouraging and very important, Asselin said, because of concern in the pediatric community that adding Zinecard to the treatment regimen might interfere with the chemotherapy's ability to attack the leukemia.
In addition, the group that did not receive Zinecard had more episodes of acute heart problems, and researchers saw more damage over time to the heart structure and function, as compared to the group that did receive the cardio protective drug.
Earlier clinical trials of Zinecard in women with breast cancer, who had already received high doses of doxorubicin and needed more chemotherapy, showed that the drug could protect the heart during retreatment, Asselin said.
A problem with Zinecard, however, is that the URMC study also showed an increased rate of second malignancies in the children who received the heart drug. Although the higher rate did not reach conventional levels of statistical significance by research standards, it is worth noting and studying further, Asselin said.
One of the goals of the ASCO forum, in fact, will be to review all data on the use of the Zinecard and to debate the risks and benefits.
"We now have some very effective cancer treatments at our disposal," Asselin said. "But we really need to focus on promoting the good health of our survivors. Our care does not end with chemotherapy. Being there for many years into the future, and to help childhood survivors understand their risks, is so important."
Provided by University of Rochester Medical Center
- Childhood cancer drugs cure now, may cause problems later, research shows Dec 16, 2011 | not rated yet | 0
- Cancer breakthrough to prevent heart failure and increase survival rates Feb 10, 2011 | not rated yet | 0
- U of MN study finds children with leukemia are living longer Dec 11, 2006 | not rated yet | 0
- Docetaxel given after doxorubicin reduces recurrence Jan 08, 2008 | not rated yet | 0
- Study reveals need for personalized approach in treatment of AML May 16, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
13 hours ago Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
Even while being dragged to its destruction inside a cell, a cancer-promoting growth factor receptor fires away, sending signals that thwart the development of tumor-suppressing microRNAs (miRNAs) before it's dissolved, researchers ...
Cancer 33 minutes ago | not rated yet | 0 |
Treating pediatric leukemia patients with a liposomal formulation of anthracycline-based chemotherapy at a more intense-than-standard dose during initial treatment may result in high survival rates without causing any added ...
Cancer 4 hours ago | not rated yet | 0
Scientists have uncovered a survival mechanism that occurs in breast cells that have just turned premalignant-cells on the cusp between normalcy and cancers-which may lead to new methods of stopping tumors.
Cancer 5 hours ago | not rated yet | 0 |
Frequent heartburn was positively associated with cancers of the throat and vocal cord among nonsmokers and nondrinkers, and the use of antacids, but not prescription medications, had a protective effect, according to data ...
Cancer 5 hours ago | not rated yet | 0
Ethnic background plays a surprisingly large role in how diabetes develops on a cellular level, according to two new studies led by researchers at the Stanford University School of Medicine.
1 hour ago | not rated yet | 0 |
Finnish researchers unveiled new data Thursday to link the Pandemrix flu vaccine to a higher risk of the sleeping disorder narcolepsy in adults.
33 minutes ago | not rated yet | 0
Maintaining a heart healthy lifestyle may also help protect chronic kidney disease patients from developing kidney failure and dying prematurely, according to a study appearing in an upcoming issue of the Journal of the Am ...
3 minutes ago | not rated yet | 0
(AP)—Johnson & Johnson is developing what could eventually be game-changing treatments for depression and pain, and it's aiming to apply for approval of more than 10 new medicines by 2017, executives said Thursday during ...
23 minutes ago | not rated yet | 0
The Senate has overwhelmingly rejected an amendment allowing states to require labeling of genetically modified foods.
13 minutes ago | not rated yet | 0
A second child has contracted polio in a restive Pakistani tribal region near the Afghan border after the Taliban banned vaccinations there nearly a year ago, a UN official said Thursday.
53 minutes ago | not rated yet | 0