VOA健康报道2024--Can ‘Less Be More’ with Cancer Drugs?

Can ‘Less Be More’ with Cancer Drugs?

Many people who find out they have cancer are able to survive the disease¹ because of effective drugs.

Treating cancer with certain drugs is known as chemotherapy. The drugs contain powerful chemicals that kill cancer cells but also cause bad reactions in patients.

Although the drugs help keep patients alive, they cause extreme tiredness, stomach pain and the loss of hair. Some even result in mouth sores for patients. These problems are called side effects.

After many years of strong side effects, some patients and their doctors are talking to the U.S. Food and Drug Administration² (FDA) about finding³ the lowest effective dose⁴ for cancer drugs.

In the past, drug companies tested to find the "maximum tolerable dose." However, doctors and patients are asking drugmakers to think about a dose that will kill cancer cells with less severe side effects. Some patients might prefer the lower dose even if they need to use the drug longer.

Jill Feldman of Illinois is 54. She has been treated for lung cancer for 15 years. She is happy to be alive – her parents died of lung cancer soon after they found out they had it. She said she is always in pain. She said her mouth always feels like it is burning.

With the help of her doctors, she receives a lower dose of her cancer drug. But she wants drug companies to research low doses when they are developing the treatments.

"No one should have to endure⁵ avoidable harmful effects of treatment," she said.

Dr. Lillian Siu works⁶ on drug development at Princess Margaret Cancer Center in Toronto, Ontario. She said new cancer drugs are more precise⁷ than in the past. Some newer drugs target a mutation⁸ that causes cancer cell growth. Others cause the patient's immune⁹ system to fight the cancer.

Siu says the question is whether patients can get "the same bang¹⁰ for their buck," or useful result, with a lower dose of a drug. "You might only need a low dose to turn off that cancer driver," she said.

An FDA spokesperson said there is a new program called Project Optimus that asks drugmakers to include patients who receive lower doses in their clinical trials.

Sometimes doctors lower doses during the later parts of testing. But other times, lower doses are called for only after the drug is approved and doctors try to reduce their patients' side-effects.

Dr. Patricia LoRusso leads drug research at the Yale Cancer Center in Connecticut. She said the problem with using high doses is that patients start to feel bad, so they have to stop taking the drug. During that time, the cancer starts to come back.

In addition, some patients get results from a low dose, while others only get results from a high dose. That is called patient-to-patient variation¹¹. People's liver¹² and kidneys¹³ process cancer drugs differently which affects how much of the medicine reaches the cancer cells.

"The challenge is: Where is the sweet spot?" LoRusso said. A "sweet spot" means just the right amount.

One large group of patients has concerns about doses that are too high: women with breast cancer that has spread to other parts of their body. That kind of cancer is very difficult to treat. Without drugs, the cancer might spread even more. So many patients must be on cancer drugs for most of their lives. But they want to be able to enjoy their time, instead of feeling sick.

Dr. Julie Gralow is chief medical officer of the American Society of Clinical Oncology. She is working on a low-dose study of 500 patients who take two kinds of drugs for breast cancer.

She said the study will look at two kinds of treatments. One that starts patients on a low dose that increases if the patient does well. The other starts the patient at a high dose and then lowers if side effects are too difficult.

Lesley Kailani Glenn is a 58-year-old breast cancer patient from Oregon. She has been getting treatment for 11 years. She said she will need the drugs for the rest of her life.

"We want to try to live the best that we can, knowing that treatment is never-ever going to stop," she said. Glenn has hiked California mountains and up high seaside hills in Italy while receiving treatment. She works with her doctor to change the amount of drug she receives based on her ability to tolerate¹⁴ it. She said the number one thing she dislikes is the feeling that she needs to use the bathroom all the time.

She does not want to lose her quality of life.

Project Optimus asks drugmakers to compare the results of different doses. It might sound like a good idea, but the drug companies have concerns. They say carrying out trials of separate doses slows down the development process.

Dr. Alice Shaw leads cancer drug development at Novartis, a Swiss drug company. She said the interest in lowering side effects by testing different doses needs to be weighed against getting a helpful new drug to cancer doctors.

She said it might be better to get the drugs on the market first.

But Dr. Timothy Yap of the MD Anderson Cancer Center in Houston, Texas said drug companies might not be seeing the problem correctly. He said they need to take the time early in the process to find the right dose. That way, more patients will be able to use their medicine.

"If the patients are not taking the drug, then it's not going to work," Yap said.

Words in This Story

sore –n. an area on the skin or tissue¹⁵ that is painful

dose –n. the right amount of medicine needed to get a good result

maximum –adj. the most

tolerable –adj. able to be suffered

endure –v. to live through something

precise –adj. very exact

mutation –n. a genetic¹⁶ change that, in the case of cancer, results in irregular cells

immune system –n. the system of cells and substances in the body that fight infection and sickness

clinical trial —n. tests that are done on real patients

1 disease   

n.疾病，弊端

参考例句：

• The doctors are trying to stamp out the disease.医生正在尽力消灭这种疾病。
• He fought against the disease for a long time.他同疾病做了长时间的斗争。

2 administration   

n.经营，管理；行政，行政机关，管理部门

参考例句：

• Who is in charge of the administration of your company?你们公司的行政工作由谁负责？
• The teachers are responsible to the school administration.教师向学校行政负责。

3 finding   

n.发现，发现物；调查的结果

参考例句：

• The finding makes some sense.该发现具有一定的意义。
• That's an encouraging finding.这是一个鼓舞人心的发现。

4 dose   

n.(药的)剂量，一服；v.给(药)；(给…)服药

参考例句：

• In the accident,the workers received a heavy dose of radiation.在那次事故中，工人受到大剂量的辐射。
• He gave me a dose of medicine for my cold.他给我开了一剂治感冒的药。

5 endure   

vt.忍受(痛苦、困难等)，耐住

参考例句：

• If other people can endure hardship,why can't I? 人家能吃苦，我就不能？
• You can only guess at what mental suffering they endure.你只能猜测他们忍受着多大的精神痛苦。

6 works   

n.作品，著作；工厂，活动部件，机件

参考例句：

• We expect writers to produce more and better works.我们期望作家们写出更多更好的作品。
• The novel is regarded as one of the classic works.这篇小说被公认为是最优秀的作品之一。

7 precise   

adj.精确的，恰好的，极清楚的

参考例句：

• At that precise moment, Miss Pulteney came into the office.就在那时，普尔特尼小姐走进了办公室。
• A scientist must be precise in making tests.科学家做试验必须精确。

8 mutation   

n.变化，变异，转变

参考例句：

• People who have this mutation need less sleep than others.有这种突变的人需要的睡眠比其他人少。
• So far the discussion has centered entirely around mutation in the strict sense.到目前为止，严格来讲，讨论完全集中于围绕突变问题上。

9 immune   

adj.免疫的，有免疫力的，不受影响的，免除的

参考例句：

• I am immune from the disease,for I had it once.我对这病有免疫力，因为我已得过一次了。
• Be immune from corruption.拒腐蚀，永不沾。

10 bang   

n.巨响，猛击；vi.砰砰作响；vt.砰地敲，猛击

参考例句：

• Pack it up, you kids;or I'll bang your heads together!住手，你们这些小孩，再弄就揍你们！
• She fell and got a nasty bang on the knee.她摔倒了，膝盖猛撞在地上。

11 variation   

n.变化，变动；变体，变种；变奏(曲)

参考例句：

• The prices for food are subject to variation.食品的价格可能变更。
• The air flow will have some variation of angularity.风的流向将有一定程度的变化。

12 liver   

n.肝；肝脏

参考例句：

• He has a weak liver.他的肝脏不好。
• The largest organ in the body is the liver.人体最大的器官是肝脏。

13 kidneys   

肾形矿脉； 肾，肾脏( kidney的名词复数 )； （可食用的动物的）腰子

参考例句：

• The function of the kidneys is to excrete wastes from the body. 肾的功能是排泄人体里的废物。
• She got a very dangerous disease of kidneys. 她得了一种很危险的肾病。

14 tolerate   

v.忍受，容忍，容许，宽恕；vt.容忍，忍受，容许

参考例句：

• She can tolerate that rude fellow.她能容忍那个粗鲁的家伙。
• The teacher cannot tolerate eating on the class.老师不容许在课堂上吃东西。

15 tissue   

n.组织；薄纱，薄纸，手巾纸

参考例句：

• As we age we lose muscle tissue.肌肉组织会随着我们日趋衰老而萎缩。
• Athletes have hardly any fatty tissue.运动员几乎没有什么脂肪组织。

16 genetic   

adj.遗传的，遗传学的

参考例句：

• It's very difficult to treat genetic diseases.遗传性疾病治疗起来很困难。
• Each daughter cell can receive a full complement of the genetic information.每个子细胞可以收到遗传信息的一个完全补偿物。