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Spring 2006

Drugs Target Colon Cancer Tumor Growth

Two drugs recently approved for treating metastatic colon cancer have nearly doubled the median survival time for patients with the disease.

These so-called targeted therapies are designed to target certain pathways that are associated with tumor growth. Bevacizumab (Avastin)-the first of a new class of drugs that inhibit the action of vascular endothelial growth factor, which is involved in the growth of blood vessels that are believed to help sustain tumors-has become standard treatment, in combination with chemotherapy, for most patients whose colon cancer has metastasized. The addition of bevacizumab has extended the median survival time for these patients from 12 months to more than 20 months.

"We believe bevacizumab's benefits in colon cancer come from helping more of the chemotherapy drugs reach the tumor," says Saeed Sadeghi, M.D., oncologist at Santa Monica-UCLA Medical Center. Bevacizumab is pending approval for use in treating lung cancer, and is being considered for treating breast cancer. For patients in whom bevacizumab is no longer effective, one in four receive benefits from cetuximab (Erbitux-), also used in combination with chemotherapy. Cetuximab inhibits epidermal growth factor receptor, which is associated with tumor cell growth.

Many other drugs for colorectal cancer are currently being tested in clinical trials at UCLA. These experimental drugs are targeting different factors involved in the cancer's growth; in some cases, multiple drugs are being tested in combination to see if they will be more effective working together. "This move toward targeted therapies represents the future of oncology," says Dr. Sadeghi. "Chemotherapy is non-specific in that it attacks healthy cells as well as cancer cells. Tumors can gain resistance to chemotherapy, and the chemotherapy drugs have significant side effects. Targeted therapies such as bevacizumab and cetuximab are overall well tolerated. And if we can identify the specific mechanisms that are involved in the growth of a tumor cell, we have a better chance to destroy the tumor."

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