Sue Hartigan <[EMAIL PROTECTED]> writes:
WASHINGTON--The scientific process
has given birth to many medical miracles
over the years. But sometimes it can be a cruel
parent.
As a result of a New York Times story Sunday trumpeting news
that two chemicals discovered by a Boston researcher can cure
cancer in mice, oncologists across the country have been
overwhelmed by patients seeking this remarkable new therapy.
But the doctors have told them that it won't be available for
years, if ever.
"They are desperate to find something that is an easy way out of
a difficult situation," said Dr. Philip DiScaia, deputy director of UC
Irvine's Chao Family Comprehensive Cancer Center. "I get very
concerned for the patients who have a false sense of hope that
something can come of this immediately, when that is just not the
case."
Researchers note that as many as nine other drugs acting on the
same basic principle--and that also cure cancer in mice--are in
clinical trials in humans. So far, the results haven't overly impressed
physicians. "This is not penicillin," said Dr. Lee Rosen of UCLA's
Jonsson Comprehensive Cancer Center.
The widespread reactions from patients have raised questions
about how the media report word of preliminary medical advances.
Those questions were deepened in the current case by confirmation
from several publishing houses that the New York Times reporter
whose story kicked off the current fever had circulated a book
proposal about the alleged cancer cure--only to withdraw it
Tuesday.
Nearly every week, researchers report that
they have found new compounds that kill HIV in
the test tube or that eradicate tumors in mice. Most often, these
stories are downplayed by the media, which recognize that the path
from test tubes or mice to humans is both long and strewn with
potholes and land mines.
"The history of cancer research has been a history of curing
cancer in the mouse," said Dr. Richard Klausner, director of the
National Cancer Institute. "We have cured mice of cancer for
decades--and it simply didn't work in humans."
Recent medical history is rife with stories of cancer "cures," such
as interferon, interleukin and taxol, that produced exciting results in
animals and later proved disappointing in humans.
Dr. LaMar McGinnis, an oncologist and medical consultant to
the American Cancer Society, agreed. "We thought interferon was
'chicken soup' in the early '80s," he said. "I remember how excited
everyone was; it seemed to work miracles in animals, but it didn't
work in humans."
The new miracle cure involves a phenomenon called
angiogenesis. More than 30 years ago, a young physician named F.
Judah Folkman at Children's Hospital in Boston discovered that
tumors secrete chemicals that stimulate the growth of blood vessels
into the mass of tumor cells, or angiogenesis. Without nourishment
from these blood vessels, the tumors are unable to grow beyond
microscopic clumps of cells.
Some Drugs Are Tested in People
Folkman reasoned that drugs that blocked the production of
these angiogenesis factors might prevent tumors from growing
larger. But it took him more than 25 years to persuade the cancer
community that his concept would work.
Recently, however, the idea has gained
popularity among cancer researchers. Current
counts suggest that more than 100 academic laboratories and 40
biotechnology companies are developing such drugs.
Some of these are being tested in humans. One is the tranquilizer
thalidomide, notorious for causing severe limb defects in children
whose mothers used it during pregnancy. The breast cancer drug
Tamoxifen also is thought to act, in part, by restricting blood vessel
growth.
UCLA's Rosen and Dr. Timothy Cloughesy are testing two
different anti-angiogenesis drugs developed by the Northern
California firm Sugen. Cloughesy is testing them in brain tumors, and
Rosen in a broad spectrum of cancers.
Dr. David Cheresh of the Scripps Research Institute has been
testing another drug, Vitaxin, in patients with terminal cancer.
Cheresh was the first to show that the anti-angiogenesis drugs could
actually make tumors shrink both in mice and people. But the results
in humans thus far have been in Phase I safety trials and require
confirmation in larger studies.
All are hopeful that the drugs someday will represent a major
advance in cancer therapy. "We're beginning to see results that are
clinically meaningful," Rosen said. Cloughesy noted that the brain
tumors had stabilized or even shrunk in some patients. Brain tumors
are notoriously difficult to treat, he said, and "finding responses in
any treatment setting is remarkable."
Researchers are particularly enthusiastic because most of these
new agents, unlike traditional cancer drugs, have no side effects.
And because they exert their effects on blood vessels rather than
the tumors themselves, cancer cells do not seem to develop
resistance to them.
Folkman's newest agents, called angiostatin
and endostatin, seem to be more potent than
previously identified agents. Folkman reported
last November in
Nature that the naturally occurring proteins could cause a broad
variety of tumors to simply shrink away to nothingness in mice.
But he has been working with proteins obtained from mice. The
Maryland company that he is collaborating with, Entremed, has
been trying to produce the human form of the proteins, but is still
short of that goal.
"People do not understand how very far off this [clinical trials] is;
these proteins are very difficult to make . . . and we are working
very hard to make the human versions," Klausner said. "The mouse
versions don't work in humans."
Patients Ask About Treatment
Nevertheless, said Dr. Allen Lichter of the University of
Michigan, president-elect of the American Society of Clinical
Oncology, "I haven't had a single patient who hasn't asked me
about this," he said. "It's certainly on everyone's mind. But I have to
tell them, honestly, that I don't know if it will work in humans."
The New York Times ran its front page story on the research
Sunday, although the paper had run a similar piece--a profile of
Folkman--reporting the results in January.
In New York, several publishing houses confirmed Tuesday that
they had received copies of a book proposal about the alleged
cancer cure from John Brockman, an agent representing Gina
Kolata, who wrote Sunday's story. The proposal was sent via
e-mail and it arrived Monday, outlining a book that Kolata hopefully
would deliver for publication in late 1999.
The brief proposal "reflected what she wrote
[in the New York Times]," said Stephen
Morrow, an editor with the Free Press. "And since it would be
delivered next year, there would be more developments about the
research in the book."
Meanwhile, Kolata is under contract to another publisher,
Farrar, Straus & Giroux Inc., to write a book about a flu
epidemic--also based on a New York Times story she wrote.
"It could be that [Kolata] knew she was breaking the story on
Sunday and she prepared the proposal in advance of that, and
Brockman circulated it yesterday," said one publishing official, who
spoke on condition of anonymity.
"I don't have a problem with it," said the publishing official. "But
[some people might] in this day of public wailing over media ethics."
Late Tuesday, however, after the New York Times had been
questioned about the story, Brockman abruptly withdrew the
cancer book proposal and offered no explanation to publishers,
Morrow added.
Neither Brockman nor Kolata could be reached for comment.
New York Times spokeswoman Lisa Carparelli, however, said,
"This was Ms. Kolata's own decision, to withdraw the book
proposal. She made the decision after a discussion with her editors .
. . after the difficulties became clear, of staying with the story after
she acquired a financial stake in it."
News organizations generally try to avoid such situations to
avoid the appearance of a conflict of interest. Critics charge that
reporters cannot function as honest brokers of information on a
story when they have simultaneously contracted to write a book
about their sources.
Scientists themselves question the process.
"It's really too bad that we make these sorts of announcements,"
McGinnis said. "It's great for the public in general, great for the
stock market--but for the cancer patient with only six months to
live, it's unbelievably cruel."
Cimons reported from Washington, Getlin from New York and
Maugh from Los Angeles.
* INVESTOR FRENZY: Techniclone stock surged on its
report of new drug findings. D2
Los Angeles Times
--
Two rules in life:
1. Don't tell people everything you know.
2.
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