Antiangiogenesis Drugs Target Specific Cancers, Mechanisms

Extract

At the Ireland Cancer Center—a part of University Hospitals in Cleveland, Ohio—Scot Remick, M.D., was proud to have his developmental therapeutics program be the first chosen for a clinical trial of combretastatin, an angiogenesis inhibitor made from the bark of a South African species of willow tree.

But because the trial, which opened in late 1998, would be a phase I study that by definition would focus on safety concerns, he did not expect that “partial responses, let alone a complete remission” would come out of it. “It’s really been extraordinary,” he said. “Clayton Twigg is truly our poster boy.”

The 56-year-old Twigg, Remick explained, had an anaplastic thyroid tumor that, as is usual with this malignancy, was unfazed by standard therapies and progressed so relentlessly— putting mounting pressure on his airway—that his death by suffocation seemed inevitable. He had his first intravenous infusion of combretastatin in February 1999 and by the second, 3 weeks later, the tumor had already begun to shrink. After six more of the infusions—also at 21-day intervals—CT and MRI scans could find no trace of the tumor. In August when Twigg underwent exploratory surgery, the pathology report confirmed the tumor’s total disappearance.