Singapore chemo trial gives hope to gastric cancer patients

Associate Professor Jimmy So
Associate Professor Jimmy So

Advanced cancer patients in trial survive longer and enjoy a better quality of life

A form of chemotherapy trialled in Singapore on patients with advanced gastric cancer has shown promise in prolonging their lives. The results were presented this week at a major conference in the United States.

Associate Professor Jimmy So, chief of surgical oncology at National University Cancer Institute, Singapore (NCIS), said that patients with advanced gastric cancer usually survive three to 10 months, when given conventional treatment.

But of the 22 patients in the phase 2 clinical trial at NCIS, 16 survived beyond a year, with half living for more than 18 months.

 

In six of the patients, the cancer had shrunk to the point where surgery to remove the tumour was possible. They had a median survival of 22 months. The patients also enjoyed a relatively good quality of life.

Prof So presented the mid-term results of the trial at the meeting in San Diego, called Catch the Next Wave in Science and Medicine, on Sunday.

The survival period went up on account of an additional step involved in the treatment.

On top of the conventional chemotherapy and anti-cancer medication, this step involves inserting a liquid chemotherapy drug into the abdomen for about an hour, and then draining it off. The procedure kills off cancer cells in the peritoneum, or abdominal cavity.

Prof So said that this is the most common site for a relapse, accounting for about 40 per cent of the resurgence of gastric cancer cases.

He told The Straits Times: "Relapse in the peritoneum is very difficult to treat. It is very bad news."

In 2013, the Singapore Gastric Cancer Consortium, which brings together gastric cancer experts in the country, started the trial with the additional step of inserting the liquid chemotherapy drug.

ENCOURAGING RESULTS

The response rate is impressive... There are minimal side effects and their quality of life improved.

ASSOCIATE PROFESSOR JIMMY SO, chief of surgical oncology at National University Cancer Institute, Singapore

Patients have a metal port (that looks like a bottle cap) permanently planted in the abdomen. The liquid is inserted and removed through this opening.

The peritoneal chemotherapy is done twice within a three-week cycle, and the entire procedure is repeated eight times over a 24-week period.

Because the drug used is a big molecule, very little of it is absorbed into the rest of the body, said Prof So, who described the procedure as a "simple, outpatient treatment".

Chemotherapy drugs are toxic and can also damage healthy cells in the body, so it is good that very little is absorbed.

Said Prof So: "Of 17 patients who had cancer cells in the peritoneum, after the treatment, 11 had no more cancer cells in the peritoneum, but still had cancer in the stomach. But all were controlling the disease."

He added: "The response rate is impressive and the evidence is strong. There are minimal side effects and their quality of life improved."

More than 500 people here are diagnosed with gastric cancer each year, mostly in the late stages. More than 300 die of it each year.

Prof So said this treatment should be able to help one in four gastric cancer patients.

A version of this article appeared in the print edition of The Straits Times on May 28, 2016, with the headline 'S'pore chemo trial gives hope to gastric cancer patients'. Print Edition | Subscribe