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In treating some cancer patients, less is more: U.S. studies

By Deena Beasley

CHICAGO (Reuters) - Doctors can scale back treatment for certain cancer patients, based on evidence that some drugs can be used less frequently, according to new information that is clearing the way for physicians to limit the risks of care.

Several studies backing up this "less-is-more" strategy, which can also lower the cost of care, were presented on Friday at the American Society of Clinical Oncology meeting in Chicago.

Patients with breast cancer that has spread to the bone, for instance, are often treated with monthly intravenous infusions of a class of drugs known as bisphosphonates, such as zoledronic acid, that protect against fractures and other bone problems. Zoledronic acid is sold by Novartis AG under the brand name Zometa.

Researchers at MD Anderson Cancer Center in Houston found that women with breast cancer and bone metastasis can, after the first year of monthly bisphosphonate treatment, safely scale back to receiving the drug every three months. The change could lower the risk of kidney problems as well as a rare, but serious side effect in which parts of the jawbones weaken and die.

"We found that less frequent treatment may reduce the risk of serious side effects, with added benefits in reduced patient inconvenience and cost," lead study author Dr. Gabriel Hortobagyi said in a statement.

A separate study funded by the National Institutes of Health found that certain patients with head and neck cancer linked to the human papillomavirus can safely receive lower-dose radiation therapy without compromising their chances of survival.

This approach would spare many patients from debilitating, often lifelong side effects of radiation treatment, such as trouble swallowing, loss of taste and thyroid problems - but more long-term follow up of patients is needed, said lead study author Dr. Anthony Cmelak, a professor of radiation oncology at the Vanderbilt-Ingram Cancer Center in Nashville, Tennessee.

Another federally funded study showed that it is safe to stop the use of cholesterol-lowering drugs known as statins in cancer patients with a life expectancy of less than a year. It estimated that the move would save around $603 million in the United States. Commonly used statins include atorvastatin, sold by Pfizer under the brand name Lipitor.

The study found that discontinuing statins, which are used to reduce the risk of heart attack and stroke, did not shorten survival, but did reduce incidence of cancer symptoms, including pain, depression, nausea and tiredness.

"We now have evidence that discontinuing certain medications is safe, specifically, in the case of the widely prescribed statin drugs, and can improve quality of life for patients," Dr Patricia Ganz, a Los Angeles hematologist and American Society of Clinical Oncology expert, said in a statement.

(Reporting By Deena Beasley; Editing by Jonathan Oatis)

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