Targeted hope for metastatic cancer

November 1, 2018 by Paul Mayne, University of Western Ontario
Cancer cell during cell division. Credit: National Institutes of Health

A cancer diagnosis is tough enough to hear, but a diagnosis that cancer has spread through the body has often been considered a death sentence.

Now an international study, led by Western oncology professor David Palma and researchers at Lawson Health Research Institute, is challenging that notion.

The study shows targeting high-dose radiation against that has spread to five or fewer sites can extend ' survival by more than a year.

"We were hoping to show that it was beneficial, but we didn't know," said Palma. "There has been quite the debate in the oncology community, but now the results are definitely better than we expected. It's refreshing to see such a good outcome from a study.

"In the past, the spread of to the bones or breast cancer to the brain was considered incurable.

The study, called SABR-COMET, was the first randomized phase II clinical trial of its kind. It included 99 patients with cancer that had metastasized, spread to as many as five different places in the body.

Research participants were recruited from across Canada, Australia, the Netherlands and Scotland, including 51 patients from the local London Regional Cancer Program, with the majority having had either lung, prostate, breast or colon cancer.

The study examined the use of stereotactic ablative radiotherapy (SABR), which precisely delivers radiation to a tumour in substantially higher doses than normal with the goal of destroying cancerous cells.

"We are realizing that maybe, if someone only has a few spots of cancer spread, it's not the same as if they have 20 or 30, but also, the technology has improved and our ability to deliver radiation precisely is enormously different than it was 20 years ago," said Palma.

Median survival for patients who received SABR was 41 months compared to 28 months for those who received standard treatment. SABR also doubled the amount of time patients lived without further cancer growth – a median of 12 months for patients receiving SABR and six months for those not.

After five years, almost half the patients treated with SABR were still alive compared to 24 per cent of those who received standard treatment. Palma said the research team intends to follow up with these patients at the 10-year mark for survival rates.

Palm also emphasized there were no differences in quality of life between patients treated with SABR and those who received standard treatment, however SABR was associated with more negative side effects such as fatigue, muscle and joint pain, difficulty breathing and bone pain.

"SABR needs to be delivered carefully and by an experienced team. While there is a small risk of very serious side effects, these are patients with limited options," said Dr. Palma. "Ultimately, the decision to offer SABR is up to the patient's oncologist. Physicians should at least consider it as a treatment option" for patients with cancer that has spread to as many as five sites.

Palma and his research team are now planning next to assess the use of SABR in patients with cancer that has spread up to ten sites. The study, called SABR-COMET-10, is anticipated to launch by early 2019.

Palma said he often uses a baseball analogy when he talks about the idea of research.

"You swing and sometimes you strike out, sometimes you get a hit. In the end we are all just trying to get up there and take a swing and anything above that is a bonus," he said, adding the results are gratifying for the team. "You don't get a hit if you don't swing."

Explore further: High-dose radiation therapy improves survival in patients once thought incurable

Related Stories

High-dose radiation therapy improves survival in patients once thought incurable

October 17, 2018
In the first randomized, phase II clinical trial of its kind, researchers have shown that an aggressive form of high-precision radiation therapy can greatly increase how long oligometastatic patients live and doubles how ...

High-dose, high-precision radiation therapy safe, effective for solitary kidney cancer patients with only one kidney

October 22, 2018
Treatment of renal cell carcinoma with stereotactic radiation therapy is as safe and effective for patients with one kidney as it is for those who have two, according to an analysis of the largest-ever, international dataset ...

Stereotactic Ablative Radiotherapy achieves better overall survival than surgery for early lung cancer

May 13, 2015
Patients with operable stage I non-small cell lung cancer (NSCLC) could achieve better overall survival rates if treated with Stereotactic Ablative Radiotherapy (SABR) rather than the current standard of care—invasive surgery—according ...

Elderly Dutch lung patients' survival improved by new treatment options between 2003-2009

July 6, 2011
New developments such as stereotactic ablative radiotherapy and improvements in surgical care in early-stage lung cancer have led to large survival gains for elderly Dutch patients, according to a population-based study presented ...

Quality of life study shows stereotactic ablative radiotherapy effective treatment; stage I NSCLC

June 15, 2012
Until recently, many elderly patients with stage I non-small cell lung cancer were left untreated because treatment may not improve their quality of life. However, stereotactic ablative radiotherapy (SABR) has become one ...

New radiation therapy technique aims to preserve sexual function

June 13, 2018
Will treatment make me impotent?" It's a question on the minds of many men as they are making decisions about prostate cancer treatment. A multicenter clinical trial being led by UT Southwestern physicians is testing a technique ...

Recommended for you

Two ways cancer resists treatment are actually connected, with one activating the other

December 18, 2018
Drugs that target BRAF and MEK in cancer have shown promise in treating a subset of melanoma that carries a mutation in the BRAF gene, but drug resistance usually emerges, reversing the benefit of these drugs and limiting ...

HPV discovery raises hope for new cervical cancer treatments

December 18, 2018
Researchers at the University of Virginia School of Medicine have made a discovery about human papillomavirus (HPV) that could lead to new treatments for cervical cancer and other cancers caused by the virus.

Vaccine, checkpoint drugs combination shows promise for pancreatic cancers

December 18, 2018
Researchers at the Johns Hopkins Kimmel Cancer Center discovered a combination of a cancer vaccine with two checkpoint drugs reduced pancreatic cancer tumors in mice, demonstrating a possible pathway for treatment of people ...

Researchers identify ways breast cancer avoids immune system detection

December 18, 2018
Recent breakthroughs in immunotherapy are making a huge difference in treating some forms of cancer, especially metastatic cancer. But breast cancer has proven a tricky foe for this new therapy, and an interdisciplinary team ...

Metal chemotherapy drugs boost the impact of immunotherapy in cancer

December 18, 2018
Due to their powerful tumour-killing effect, metal-based chemotherapies are frequently used in cancer treatment. However, it was hitherto assumed that they damaged the immune system, because of their cytotoxic (cell-damaging) ...

10-year follow-up after negative colonoscopies linked to lower colorectal cancer risk

December 17, 2018
Ten years after a negative colonoscopy, Kaiser Permanente members had 46 percent lower risk of being diagnosed with and were 88 percent less likely to die from colorectal cancer compared with those who did not undergo colorectal ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.