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Drug could double as cancer-fighter
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by Carolyn Smith
Thursday, April 7, 2005
A drug used in organ-transplant patients could double as an effective cancer fighter, scientists announced last week.
The results of the study, which was conducted by researchers at Italy’s University of Bari, were published in the March 31 issue of The New England Journal of Medicine.
Over the course of the study, doctors monitored 15 kidney-transplant patients who developed a form of skin cancer called Kaposi’s sarcoma and were taking the immunosuppressive drug sirolimus, or rapamycin.
“This dual role of [sirolimus] may prove important in other situations in which transplant recipients are at high risk for tumor recurrence or primary cancer,” the researchers, led by Dr. Giovanni Stallone and Dr. Antonio Schena, said in the publication.
Sirolimus is commonly used in transplant patients to prevent rejection of newly transplanted organs. Immunosuppressive drugs lower the risk of organ rejection by reducing a patient’s immune response to keep the body from attacking the new organ.
According to the study, patients who took sirolimus experienced total cancer reversal over the course of three months after initiating therapy with the drug and discontinuing other types of immune-suppression therapy.
The results of the study are encouraging for cancer patients, transplant patients and doctors alike.
“Anytime you see pharmacotherapy like this that is successful, it is promising,” Corey Miller, a spokesman for the American Cancer Society, said. “We will look forward to seeing more studies and more research before we form a formal opinion on this.”
Robert Love, M.D., a University of Wisconsin professor of surgery and director of the Heart and Lung Transplant Program at UW Hospital, has prescribed sirolimus and similar drugs to his own transplant patients to prevent organ rejection.
“Most of the transplant drugs we use all work through diminishing the body’s ability to make new cells and take care of normal wear-and-tear,” he said. “That’s one of the direct effects of the drug.”
Love said actively replicating cells are responsible for organ rejection and also play a role in cancer, which is why sirolimus is effective to treat both conditions.
Sirolimus and other immunosuppressive drugs have some of the same effects as chemotherapeutic drugs and can be used to treat different kinds of cancer, Love added.
“We would use certain types of transplant drugs for malignancies that occur in the blood system,” he said.
Traditional chemotherapy is still used to aid in the treatment of patients who develop Kaposi’s sarcoma or other types of cancer after receiving a transplant, Love said.
However, doctors need to be careful when prescribing immunosuppressive drugs to both transplant patients and cancer patients.
“There is always a balance between giving the patient too much immune suppression, which will lead to infection,” Love said. “And balancing that with allowing the patient to still have enough immunity to maintain their defenses against all the normal things we encounter every day.”
Love also warned that, like many other drugs, immunosuppressive therapies such as sirolimus can have negative side effects. Delayed wound healing and suppression of the bone marrow’s ability to produce new blood cells are two effects.
“It can be a very dangerous drug if a patient has a wound problem,” Love said. “If there is any difficulty in healing that wound, sirolimus will see to it that the wound really doesn’t heal.”
Despite drawbacks, Love said sirolimus has the potential to help people in many ways.
“This is an example of the multiple effects one might discover when a new drug comes onto the market,” Love said. “It is probably not going to have only one benefit, but there will turn out to be many benefits for treating more than one type of disease.”
