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WWII-Era Drug Offers New Hope for Bowel Cancer Patients

Monday, September 21, 2009 at 06:10 PM EDT

One of the earliest chemotherapy drugs is showing positive results in bowel cancer patients that could signal a resurgence in its use. The drug, known as methotrexate, was first used during the 1940s World War II era.

According to UK researchers at the Institute of Cancer Research (ICR), the drug may find a new use as a tailored treatment for bowel cancer patients who have a specific genetic fault. In studies, it was shown that methotrexate effectively killed cells that carried the faulty gene, dubbed MSH2.

The MSH2 gene has been linked to a genetic condition known as HNPCC. For men who carry this gene, 90 percent will be diagnosed with bowel cancer by the time they are 70. For women, the probability is 70 percent.

In total, the gene is linked to approximately 5 percent of all cases of bowel cancer. 40 percent of all patients with HNPCC have a faulty MSH2 gene.

Though use of methotrexate has dropped significantly since the 1940s (newer chemo drugs are typically preferred), the drug is still frequently used as a leukemia treatment. Now, researchers are hopeful that it can also be used as a tailored treatment for bowel cancer.

As Dr. Alan Ashworth, leader of the ICR study, explains: “What’s exciting about methotrexate is that it selectively destroys the cells lacking the MSH2 function. This indicates that it may make an excellent treatment for patients with the genetic alteration.”

Clinical trials to confirm the safety and effectiveness of methotrexate as a treatment for bowel cancer have already begun. While the potential for the customized drug will only affect a small proportion of bowel cancer patients, the new findings are promising indeed. Methrotrexate is one of the antifolate class of chemotherapy agents.

Customized cancer treatment based on specific genetic mutations or cancer subtypes continues to be a promising field. Methotrexate is just one of many drugs currently being investigated for the use as a tailored cancer medication.