Cancer study patients being sought.

Cancer study patients being sought

Although the national incidence of colon cancer is decreasing,thanks to improved treatment, fewer than 1,000 of the 50,000 to 100,000 patients in the United States who may benefit from new approaches to treating colorectal cancer are enrolled each year in clinical trials used to evaluate the usefulness of those treatments. So says National Cancer Institute (NCI) director Vincent T. DeVita Jr., who calls the situation "a national disgrace.'

DeVita says plans are under way at the Bethesda, Md.-basedfacility to start a massive national clinical trial of the newer treatments for colon and rectal cancers in postoperative patients.

NCI's Michael A. Friedman says the study will focus on theapproximately 44,500 colorectal cancer patients who are not being cured by surgery, probably due to residual tumors. One group of patients, the control group, will receive conventional postsurgical treatments like routine radiation, while the test groups will receive new drugs or radiation regimens. Included in those new treatments will be those that have shown promise in smaller clinical studies, such as the drug 5-fluorouracil.

According to Friedman, about 98,000 new cases of coloncancer and 42,000 cases of rectal cancer will be diagnosed this year in the United States. With current surgical techniques, 44 percent of all colorectal cancer patients can be cured. But it is possible that an additional 6,000 colon cancer patients and 5,000 rectal cancer patients could be saved through use of newer therapies, says Friedman.

Despite the optimism generated among scientists by successfulnew treatments, Friedman says the inadequate number of cancer patients in clinical studies is limiting progress--and that this lack of subjects is a problem in cancer research worldwide. He suggests that earlier reports of shortcomings in newer cancer treatments have inhibited clinicians' interest in doing clinical trials.

Although not all patients are candidates for clinical trials, theNCI scientists, in cooperation with several research groups throughout the United States, hope to overcome the reluctance of many physicians and patients to participate in the studies necessary to prove treatment efficacy.