Doc touts breakthrough bone-cancer cure
by Michael Lasalandra
Tuesday, June 8, 1999
The first-ever successful use of an angiogenesis inhibitor to cure bone
cancer in a human being has been reported by Dr. Judah Folkman of Children's
Hospital, who pioneered the {*filter*} that cut off {*filter*} supply to tumors.
The girl, Jennifer LaChance of Lincoln, R.I., who was 5 at the time she
began her treatments in 1994, is now in complete remission after a year on
interferon alfa-2a, and doing well, Folkman said.
``One year on the drug and the tumor was completely gone,'' said the
renowned cancer researcher whose new {*filter*} - angiostatin and endostatin -
have raised hopes for a cure for the insidious disease.
Folkman's paper is published in the June issue of the journal Pediatrics.
The story of the girl's cure, however, was told in the Herald in February.
Jennifer, the daughter of Mike and Lillian LaChance, had a tumor the size of
an orange in her jaw when she was first seen at Massachusetts General
Hospital in 1994.
While such tumors, known as mandibular giant cell tumors, don't usually
spread and are typically able to be removed completely by surgery, Folkman
said the girl's tumor did not behave in a typical fashion.
It grew back after surgery and could have spread to her brain and killed
her, he said. Dr. Leonard Kaban, lead author of the paper, operated a second
time - and took out not just the tumor but ``as much bone as you can take
from the jaw,'' Folkman said.
Still, the tumor returned again.
The only tested option at that point was to remove more of the jaw and give
the girl radiation therapy, ``but that would have left an increasing
disfigurement,'' Folkman said.
``That side of the face won't grow back because of the radiation,'' he said.
``So one side of the face stays at age 7, while the other grows. It looks
more hideous all the time. They can't go out and have to wear a mask.''
So the doctors decided to try the interferon alfa-2a, around since the 1970s
as a treatment for certain leukemias as well as bladder cancer, but not
considered an especially effective one.
``We didn't know it was an angiogenesis inhibitor until the 1980s,'' Folkman
said.
He and the others involved in the girl's care thought it might work in her
case because her tumor was making an excessive amount of fibroblastic growth
factor, a protein that stimulates the growth of {*filter*} vessels.
The drug has been shown to inhibit the growth of {*filter*} vessels in tumors,
although Folkman said it is one of the weakest of the angiogenesis
inhibitors.
Jennifer was given a low-dose of the drug every day for a year, starting in
April 1995. Regression of the tumor started after just three weeks of
therapy.
``She's been off it three years now,'' Folkman said. ``She's in remission
and the bone has healed completely. We assumed the drug would stop the bone
from healing but it grew back. Her face looks beautiful now. You can't tell
one side from the other.''
Folkman conceded the paper may raise the hopes of those who are betting on
his newer anti-cancer {*filter*}, angiostatin and endostatin, but he cautioned
against overexuberance.
``One hopes, but you can never predict,'' he said.
He noted that interferon alfa-2a has never even shrunk a tumor in an animal,
yet has cured one in a human being.
Angiostatin and endostatin have shrunk, even eradicated, tumors in mice, but
have not yet been tested in humans.
But human trials on endostatin are set to begin in the fall at
Dana-Farber/Partners Cancer Care, which includes the Dana-Farber Cancer
Institute as well as Brigham and Women's and Massachusetts General
hospitals.
`Guardian angel' guided girl through her recovery
Today, Jennifer LaChance is like any other fourth-grader. She likes
basketball, reading, playing with her little brother and plans to become a
teacher when she grows up.
But the 10-year-old Lincoln, R.I., girl almost didn't get the chance.
A giant tumor in her jaw, diagnosed at age 5, nearly killed her.
Doctors at Massachusetts General and Children's hospitals, however, had a
hunch that an experimental drug that seeks to cut off the {*filter*} supply to
tumors might help.
For Jennifer, interferon alfa-2a turned out to be a miracle drug.
``It's almost like we had a guardian angel guiding us through this thing,''
said her father, Mike LaChance, a toolmaker.
Without the drug, the tumor could have killed her. At best, she would have
been left disfigured by radiation and surgery.
Now, however, ``you probably couldn't even tell that anything was ever wrong
with her,'' he said. ``It's pretty much just a memory.''
LaChance said it was a difficult ordeal for Jennifer and her family,
including mother Lillian, older sister Christine and younger brother,
Zachary, 5.
``It was pretty rough there for a while,'' her father said.
Every time they cut the tumor out, it came back.
``We thought it never was going to go away,'' he said.
When doctors proposed trying the angiogenesis inhibitor, the general public
knew little about the type of drug.
It wasn't until a year ago that they caught the public's attention.
``But we were running out of options,'' he said. ``We were willing to try
anything.''
Jennifer had to receive daily injections of the drug, and she didn't like
it. Initially, it caused her to suffer high fevers and hallucinations.
``She would see gummy bears running around the house,'' her father said.
``It was a little hairy.''
But after a few months, ``she was looking good and feeling good. She wanted
to go outside and run around. And you didn't see this big lump in her
face.''
LaChance said he is still amazed by the miracle drug.
``I think it's fantastic,'' he said.
Talk back to Michael Lasalandra
Mandibular giant cell tumor responds to interferon alfa-2a