According to a recent article published in the International Journal of Radiation Oncology, Biology, and Physics, the agent Ethyol® (amifostine) protects patients against some side effects caused by chemotherapy and radiation in the treatment of non-small cell lung cancer without compromising survival.

Lung cancer is the leading cause of cancer deaths in the United States, with approximately 170,000 new diagnoses annually. Non-small cell lung cancer (NSCLC) refers to the type of cell within the lung that the cancer originated. Chemotherapy and radiation therapy are commonly used treatment modality in most stages of NSCLC. However, treatment with radiation and/or chemotherapy is associated with the development of various side effects, depending upon the chemotherapy agents used, the location of radiation, the doses and scheduling of particular regimens as well as the individual patient. Side effects can range from mild to severe, and may even become life threatening. If side effects from treatment become severe enough, the quality of life of a patient becomes impaired, and treatment doses often have to be delayed or reduced, compromising the effectiveness of therapy altogether. Research efforts have become more focused on reducing or mitigating side effects caused by treatment so that doses producing optimal outcomes may be delivered and patient quality of life be maintained.

Ethyol® is an agent that is approved by the FDA for the prevention or reduction of xerostomia (dry mouth) in patients receiving radiation therapy for cancers of the head and neck, and for the prevention or reduction of renal (kidney) side effects caused by Platinol® (cisplatin) in patients with advanced ovarian or non-small cell lung cancer (NSCLC). Clinical trials have also demonstrated that Ethyol® reduces the incidence of side effects of the bladder and gastrointestinal track in patients receiving radiation to the pelvis, as well as a reduction in the incidence of side effects to the lungs and esophagus in patients with locally advanced NSCLC. Clinical trials are ongoing to evaluate Ethyol® in preventing or reducing side effects from various treatments in several types of cancer.

Researchers from the MD Anderson Cancer Center recently conducted a clinical trial further evaluating Ethyol® incorporated into a treatment regimen consisting of chemotherapy and radiation therapy in patients with inoperable NSCLC. This trial included 62 patients who were treated with radiation therapy to the chest, and chemotherapy consisting of Platinol® (cisplatin) plus radiation therapy, with or without Ethyol®. At an average follow-up of 31 months, severe side effects to the esophagus occurred in only 16% of patients treated with Ethyol®, compared to 35% of those not treated with Ethyol®. Severe inflammation of the lungs did not occur in any patients treated with Ethyol®, compared with 16% of patients not treated with Ethyol®. Low levels of immune cells associated with fever (neutropenic fever) occurred in only 16% of patients treated with Ethyol®, compared with 39% of patients not treated with Ethyol®. Furthermore, survival between the 2 groups of patients was similar (approximately 20 months). Side effects associated with Ethyol® included sneezing, changes in taste and mild reductions in blood pressure.

The researchers concluded that the addition of Ethyol® to treatment including radiation therapy and chemotherapy in inoperable NSCLC appears to significantly reduce severe side effects to the esophagus, lungs and blood cell levels without compromising survival. Long-term follow-up is necessary to determine if any long-term survival differences may result with the use of Ethyol®. Patients with NSCLC who are to receive radiation and chemotherapy may wish to speak with their physician about the risks and benefits of treatment with Ethyol®.

Reference: Komaki R, Lee JS, Milas L, et al. Effects of Amifostine on Acute Toxicity from Concurrent Chemotherapy and Radiotherapy for Inoperable Non-Small Cell Lung Cancer: Report of a Randomized Comparative Trial. International Journal of Radiation Oncology, Biology, Physics. 2004;1369-1377.

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