We may be a step closer to more precise and effective cancer treatment.
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A Cleveland Clinic study found that men and women undergoing chemotherapy for leukemia metabolize the cancer drugs very differently. So much so that it makes a marked difference in how well the drugs work.
Metabolism’s key role in chemo’s effects
“If somebody metabolizes a drug too fast, then the levels of the drug may fall below minimum thresholds for the beneficial effect,” says oncologist Yogen Saunthararajah, MD, who led the study.
Males who were given low dosages of chemo drugs metabolized them too quickly, which led to levels that strayed into the ineffective zone, resulting in less beneficial effects.
But if the chemo drug is metabolized too slowly with high dosages — as the study found in some women — more side effects occur as the drug levels stray into the danger zone, says Dr. Saunthararajah.
Chemotherapy’s side effects include severe nausea and vomiting, diarrhea, mouth sores, hair loss and fatigue.
Why do these findings matter?
Findings like these can lead to a better understanding of how more precise treatments can lead to better outcomes and less side effects.
The goal is to individualize cancer treatments because they’re not “one size fits all,” Dr. Saunthararajah says.
“We were looking at two specific drugs, 5-azacytidine and decitabine, that are currently prescribed to treat myelodysplastic syndromes and acute myeloid leukemia,” says Dr. Saunthararajah.
“If a patient is receiving these drugs it would be pertinent for their doctor to be aware of our observations so that they can monitor the beneficial effect and side-effects of the treatment and make appropriate changes to the dosage of the medicine,” he says.
The ideal is to lower the dosage of cancer drugs. This data can help doctors figure out the lowest — and safest — dosage for maximum effectiveness with minimum danger to the patient.
Where does the research go from here?
The next step is to get funding for clinical trials to build on these findings.
“We are trying to move toward low-dosage treatments, since they are safer and more rational,” says Dr. Saunthararajah. “Our margins are very small when we’re treating cancer, since we have few effective drugs and the diseases are very dangerous.
“These details can make all the difference between life and death.”