Ohio doctor leads study of drug that results in a better chance for a cure when combined with traditional treatment. By Cheryl Powell
An Akron physician is leading a US clinical trial with the goal of improving survival rates for cervical cancer patients worldwide. Dr Charles Kunos, medical director of radiation oncology at Summa Akron City Hospital, is heading a National Cancer Institute study to determine whether a compound called Triapine results in a better chance for a cure when combined with the traditional treatments of chemotherapy and radiation.
City Hospital and several other institutions in Ohio, Florida, Oklahoma and Texas are recruiting 73 patients with stage IB to IVA cervical cancer or stage II to IVA vaginal cancer to participate in the study.
Summa is working on the study with Case Western Reserve University in Cleveland, where Kunos has an affiliation through his former job at University Hospitals.
Previous small-scale studies have shown evidence that adding Triapine to the standard treatment protocol for cervical cancer increases the tumour response rate from 70% to 96%, said Kunos, principal investigator for the study.
“In general, cervical cancer is a very treatable disease and a curable disease,” he said. “Seventy percent is good, but there’s obviously room for improvement.”
Triapine is believed to work by making the tumour cells more sensitive to radiation therapy, according to a summary of the study from the US National Institutes of Health.
“The drug inhibits a specific enzyme in cervical cancer cells which is responsible for creating the building blocks of DNA,” Kunos said. “It blocks the production of those building blocks. When cancer cells are injured by radiation therapy and chemotherapy, the cells don’t have the ability to create new building blocks to repair that damage so they die off.”
The drug initially was designed as a stand-alone treatment, Kunos said. However, “as a cancer therapy by itself, it has not proven to be effective.”
Participants who get the experimental treatment are randomly selected; they receive Triapine through an IV three times a week along with their radiation therapy.
All participants receive radiation therapy and a chemotherapy called cisplatin — the standard treatments for cervical cancer.
Side effects appear to be rare with Triapine, Kunos said. At much higher levels, the drug can cause shortness of breath and a slight blueness of the skin in patients.
Rebecca Stevens, 56, of North Canton was among the first patients to participate in the clinical trial after she was diagnosed with advanced cervical cancer in March.
Because of the position of her tumour near her kidney, it couldn’t be completely removed with surgery.
She received 31 external radiation treatments and five internal radiation treatments, along with five weeks of chemotherapy and Triapine. “With the new drug, there was absolutely no side effects,” she said.
She has no signs of cancer and said she’s hopeful her follow-up PET scan in September will be all clear.
“Dr Kunos seems extremely positive with what he’s not seeing,” she said.
Stevens, a professor of criminal justice at the University of Mount Union, said she didn’t hesitate to participate in the clinical trial. “If it helps somebody else and this is going to be the up-and-coming thing, it’s worth it,” she said. “Not only will it help me, it will help, hopefully, generations of women down the road.”
Work is underway to develop an oral version of Triapine, which would be particularly beneficial in other parts of the world where advanced cases of cervical cancer are more common, Kunos said. The drug also potentially could be used to treat head and neck cancers in the future.
Cervical cancer is the second most common cancer in females worldwide, with an estimated 500,000 new cases annually. About 12,000 new cases are diagnosed annually in the United States, where cervical cancer screenings have helped greatly improve survival.
Florida-based biopharmaceutical company Nanotherapeutics is collaborating with the National Cancer Institute on the development of Triapine.
Because the compound is off patent, “the drug is going to be relatively inexpensive,” Kunos said. — Akron Beacon Journal/MCT
WAY TO GO: Dr Charles Kunos, a radiation oncologist, at the Summa Cooper Cancer Center in Akron, Ohio.
