Author(s):
Akshay Deshmane
Issue Date:
2013-6-7

Tata Memorial Hospital’s preliminary studies of combination therapy prove successful; clinical trials to begin soon

Treatment for cancer may become far more affordable and cost less than Rs 1,000 per month in coming years, if an ongoing research project at the Tata Memorial Hospital in Mumbai is successful. The treatment currently being researched combines low dosage metronomic therapy—administration of chemotherapy at low, minimally toxic doses every day –with drug repositioning, which is the use of low cost drugs usually administered for ailments other than cancer.

The treatment of the commonest form of cancer in India – head and neck cancer– usually costs between Rs. 15,000-20,000 a month. With the new form of drug therapy, a patient’s cost of treatment could be reduced to as low as Rs 500 per month, or even Rs 250 per month if the treatment is carried out at the Tata Memorial Hospital.

Testing efficacy

A review of the preliminary studies of the method which proved successful was published in the May issue of British medical journal Lancet. Researchers are now set to begin randomised clinical trials of the combined approach of treatment on patients with head and neck cancers from next month. Confirming the development, Shripad Banavali, head of medical oncology department at Tata Memorial Hospital, said the institutional review board of the hospital has recently given clearance to begin randomised trials on patients suffering from head and neck cancer.

“More than 400 patients suffering from head and neck cancer will undergo randomised trials over three years at the hospital, beginning next month. We are starting with this (type of cancer) as it is the commonest cancer in India. Once we conduct these trials, we will have conclusive evidence about the effectiveness of the therapy,” said Banavali.

The drugs Celicoxib and Methotrexate, usually used as anti-inflammatory drugs, are also considered useful in treating head and neck cancer. Low chemotherapy doses of these drugs will be administered on patients and their effects studied closely to gauge efficacy.

Drug repositioning

The current method of treatment of cancer is called maximum tolerated dose therapy. This involves administering heavy doses which target the tumour every three or four weeks. A gap between two doses is maintained to ensure that the patient has enough time to recover from the overwhelming effects of the treatment. This treatment, however, is very expensive and not widely available. In metronomic therapy, daily low doses are administered not only on the patient’s tumour but also in areas surrounding the tumour; the blood supply is cut off and resistance power of the body is increased.

The drug discovery system followed in the West involves making new inventions and discoveries for the treatment of ailments. However, this method does not solve the problem of affordability and access to treatment in most of those suffering from ailments. In our context, we need to follow drug re-positioning method, says Banavali.

“We use drugs which are already there in the market for treatment. Also, our effort is to ensure that the drugs are among those included in the World Health Organisation’s Essential Drugs list as they are not only cheap but affordable and available the world over,” adds Banavali.