Briefly: Randomized research found that radiation treatment to the entire brain after surgery for tumors that had spread to the brain didn’t improve either survival or the time that patients remained able to function independently.  Mice with muscle wasting and fat loss from cancer benefited from a commonly used diabetes drug.

In other headlines, Katie Couric received an award from Fordham University and called her work with colorectal cancer awareness “her greatest achievement.”  A panel at the FDA has recommended approval of a new formulation of OxyContin that is less easy to tamper with. Online registration for the October 4th Strides for Life Walk/Run closes on October 1.

Research Reports

• Whole brain radiotherapy (WBRT) after surgery or focused brain radiation to treat brain tumors that have spread into the brain from other cancer sites doesn’t improve either overall survival time or the time that patients are able to function independently.  It did extend time before cancer got worse within the brain and prevented some deaths directly caused by pressure within the brain compared to patients who were only observed after their initial surgery. R. Soffietti reported the results of a randomized study over more than 350 patients with brain metastases at the ECCO/ESMO Multidisciplinary Congress in Berlin.
• Mice with colon tumors treated with the diabetes drug rosiglitazone (Avandia®) gained weight despite having developed insulin resistance and initial weight loss.  Mice with cancer who didn’t receive the drug lost weight and fat tissue.  Scientist theorize that insulin resistance, which contributes to obesity and type 2 diabetes, actually is part of the muscle wasting and severe fat loss in cancer patients known as cancer cachexia.  Martha Belury from the Department of Human Nutrition at the Ohio State University says that is it too early to know if the drug would combat cachexia in humans.  Her team’s research is reported online in the International Journal of Cancer. More information about the study is available in an OSU press release.

Other Headlines

• CBS Evening News anchor Katie Couric says that her work to wipe out colorectal cancer has been her greatest accomplishment.  Accepting the Brien McMahon Award for Public Service at Fordham University, Couric recalls her desperate search for ” some kind of magic bullet that would make Jay well” during her husband Jay Monahan’s battle with colon cancer.  After Monahan’s death, Couric had a colonoscopy on morning TV to raise awareness of the test and colorectal cancer prevention.  She founded the National Colorectal Cancer Research Alliance and helped establish the Jay Monahan Center for Gastrointestinal Health in New York City.
• A joint meeting of Food and Drug Administration (FDA) pain and medication safety panels  on September 24, 2009 recommended approval of a new formulation of the opiate painkiller OxyContin which is designed to make it harder to abuse.  Currently OxyContin can be crushed into power which abusers can snort, smoke, or dissolve in water and inject providing a powerful, heroin-like effect.  The new pills are coated with resin which makes them very difficult to crush.  Dissolved in water, they form a gel.  If approved by the FDA, Purdue Pharma, manufacturers of OxyContin, will no longer ship the older product but begin distributing the tamper-proof medication, marketing it as a “safer” version.  An article , September 24, 2009. about the FDA panel decision written by Emily Walker  was published on MedPage Today.
• Online registration for the annual Strides for Life/Get Your Rear in Gear Walk/Run closes on October 1, 2009.  Strides for Life honors the memory of Dylan Cappel, who died of colon cancer at the age of 23 while training for a spot on the US Olympic rowing team.  The Walk and Run will be held on October 4th at Lake Merced in San Francisco, sponsored by the Strides for Life Foundation.

2008 ASTRO Annual Meeting

Patients whose cancers have spread to the brain experience more learning and memory problems when radiation to their whole brain follows more targeted radiotherapy.

Study results presented at the 2008 American Society for Radiation Therapy and Oncology annual meeting in Boston found that whole brain radiation after radiosurgery doubled the risk of cognitive problems.

Stereotactic radiosurgery focused high amounts of radiation directly at brain tumors that had spread from primary cancer, including colorectal cancer.  Whole brain radiation targeted wider areas in an attempt to destroy small, invisible metastases throughout the brain. Stereotactic radiosurgery is normally done in one high-dose treatment while whole brain radiation therapy delivers lower doses over several weeks.

Study patients were randomized to receive stereotactic radiosurgery alone or stereotactic radiosurgery followed by whole brain radiation.  However, the study was stopped after initial results showed that patients who were getting whole brain radiation had a 49 percent decline in learning and memory four months after their treatment began.  Patients who only had stereotactic radiosurgery had a 23 percent decline.

Learning and memory was measured by asking patients to remember a list of 12 words.  For patients who had whole brain radiation, nearly half could not repeat 5 words.

Eric Chang, MD,  from M.D. Anderson Cancer Center in Houston,who led the study and reported the results at ASTRO, said,

Results of this study show that initial stereotactic radiosurgery alone, coupled with close observation, could become the standard of care for patients newly diagnosed with brain metastases to best preserve their neurocognitive function.Results of this study could change the practice of how brain metastases are managed in the United States.

Find more information about stereotactic radiosurgery from RT Answers, a website for patients and families developed by ASTRO, the American Society for Therapeutic Radiology and Oncology.  The site also has information about external beam radiation used for whole brain treatments.

SOURCE: Eric Chang MD, Phase III Randomized Clinical Trial of Radiosurgery with or without Whole Brain Irradiation in Patients Newly Diagnosed with 1 to 3 Brain Metastases, ASTRO abstract, presented September 22, 2008.