MGH Doctors Find New Cancer Therapy

Harvard doctors have developed a drug therapy that is both more effective and less harmful in the treatment of head and neck cancer than the chemotherapy radiation normally used to combat the disease, Harvard medical officials said yesterday.

The new therapy, used primarily in treating late stages of the cancer, involves the use of two drugs, cisplatin and 5-fluorouracil. The combination of these has proven effective in attacking cancer cells, said Dr. Philip C. Amrein of the Harvard-affiliated Massachusetts General Hospital (MGH).

"This new combination is best for those patients at the advanced stages of cancer--for those that surgery and chemotherapy has failed," Amrein said.

Head and neck cancer make up 5 percent of all annual cancer cases, or about 51,000 in the U.S., according to a hospital statement.

Amrein and Dr. Sigmund A.Weitzman, also of MGH, were part of a research team of physicians that tested the drugs' effect on 70 patients over the past two years. Amrein reported a 20-30 percent success rate when the drugs are used after radiation therapy. He said the success rate is about 75 percent when they are used in conjunction with surgery.

"There are times when the tumor doesn't respond to the drug, but that's only 5 percent of the time," he said.

Amrein said that the two drugs become effective battling the cancer when their attack is combined.

"The cisplatin kills the cancer cells by attacking the genetic material, DNA, in a fashion different from the way 5-fluorouracil attacks DNA, and only when they work together...can they work to kill the cancer," Amrein said.

The new therapy runs on a six-day cycle. Therapy consists of doses of 5-fluorouracil on the first day, followed by both cisplatin and 5-fluorouracil for the next five days. The six-day cycle cannot be repeated more than four times in a row, Amrein said.

Although the new therapy has reduced the nausea and vomiting associated with chemotherapy, Amrein said that several potentially serious side effects remain. Internal bleeding, kidney failure, and the destruction of white blood cells are all possible risks of the drugs, he said.

"These two drugs aren't the definite answer, but an answer," said Amrein, "More needs to be done."