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New drugs may make a dent in lung, ovarian cancer

By WTOP Staff

MARILYNN MARCHIONE
AP Chief Medical Writer

CHICAGO (AP) — New drugs are making a dent against some hard-to-treat cancers, but some results raise fresh questions about whether the benefit is worth the cost.

For the first time in a decade, an experimental drug has extended the lives of patients with advanced lung cancer who relapsed after standard chemotherapy. But the drug used in the study gave patients just six extra weeks of life on average, and costs $6,000 per infusion as currently sold to treat a different form of cancer.

Eli Lilly and Co.’s drug, Cryamza, was discussed Saturday at a cancer conference in Chicago, where other studies showed:

–The drug Imbruvica, sold by Pharmacyclics Inc. and Janssen Biotech, substantially improved survival and could set a new standard of care for relapsed chronic lymphocytic leukemia, or CLL, the most common leukemia in adults. Doctors say the pill more precisely targets cancer and is a good option for older people who can’t tolerate standard chemotherapy infusions.

–Two experimental pills from AstraZeneca PLC worked much better than one alone against ovarian cancer that resisted or came back after standard chemo. The drugs significantly prolonged the time women lived without their disease worsening.

LUNG CANCER

Cyramza is sold now to treat stomach cancer and fights the formation of blood vessels that feed tumors. French researchers led a study with 1,253 patients who relapsed after initial treatment of advanced lung cancer, a more common disease.

All were given the chemo drug docetaxel and half also received Cyramza infusions every three weeks. Median overall survival was 10.5 months for those on the combo and 9 months for the others; there were significantly more side effects with the combo.

“I don’t think a six-week increment is that impressive” for survival, said Dr. Derek Raghavan, an independent expert and president of the Levine Cancer Institute at Carolinas HealthCare System in Charlotte, North Carolina. He also is on a task force on value in cancer care for the American Society of Clinical Oncology, the group hosting the conference.

The fact it prolonged survival at all suggests it is worth testing earlier in the course of the disease to see whether those patients fare better, he said. But for people whose lung cancer has come back, he said, “I’d try something else that’s cheaper” first.

Other doctors were more positive.

“It’s exciting to see progress in this disease where the steps are small but cumulative,” said Dr. Gregory Masters of the Helen F. Graham Cancer Center in Newark, Delaware, and an ASCO spokesman.

LEUKEMIA

The value of another expensive drug seemed clearer, doctors said. Imbruvica won approval earlier this year for treating chronic lymphocytic leukemia based on a small study that found it delayed the time until the disease got worse.

Ohio State University’s Dr. John C. Byrd led a more definitive study in nearly 400 patients who did not respond or had a relapse after standard chemo. They were given Imbruvica or Arzerra, a GlaxoSmithKline drug often used in such cases.

One-year survival was 90 percent for those on Imbruvica and 81 percent for those originally assigned to get Arzerra. Imbruvica also reduced the chances of the disease getting worse by 78 percent.

The results were especially impressive because patients on Arzerra were allowed to switch to Imbruvica early in the study once its benefit became apparent. Treatment costs $8,200 a month.

The drug “may transform the treatment of CLL,” said Masters, the oncology society spokesman.

OVARIAN CANCER

Ovarian cancer usually is treated with surgery and chemo but about 80 percent of patients relapse, said Dr. Joyce Liu of the Dana-Farber Cancer Institute in Boston.

She led a federally funded study of 90 such women to test cediranib, a drug that blocks tumor blood vessel formation, plus olaparib, part of a new class of experimental drugs called PARP inhibitors, which keep cancer cells from repairing damage to their DNA.

The ovarian cancer study was the first time these two drugs had been tested together. The combo delayed by more than eight months the time it took for the disease to get worse compared to olaparib alone.

It’s too soon to know whether the combo will prolong survival; participants are still being tracked.

Cediranib seemed headed for the scrap heap after failing studies on lung and colon cancer, but this is the second study to suggest it works against ovarian cancer. AstraZeneca said it may seek the drug’s approval for ovarian cancer later this year.

The price of either drug has not been set.

Study participant Ann Marie McEnelly, 61, of Brockton, Massachusetts, said the combo eliminated several of her tumors and dramatically shrank some others. Her cancer had spread from her ovaries to lymph nodes and her abdominal wall.

“It’s amazing. My husband and I are thrilled to be part of the study,” she said. “I’m able to work full time. I play golf, do things, watch my grandkids, pretty much do everything I did before.”

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Online:

Cancer info: http://www.cancer.net and http://tinyurl.com/o5p6ahb

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Don’t Settle for Student Loans to Pay for Online Education

By WTOP Staff
Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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