LUNG CANCER RESEARCH
With new cancer drugs constantly emerging, there is increasing concern in determining which patients will respond best to which drugs. Now, researchers say genes are bringing us one step closer to determining which lung cancer patients will respond to the latest drug on the market.
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Fighting lung cancer took more than the support of friends and family for Susan Nelson. It also took surgery and the right medication. For her, that right medication was the drug Iressa.
Susan Nelson
Has lung cancer
"And it not only has diminished tumors, but it has also allowed me so much more comfort, physically, than what I was dealing with before."
Iressa is a lung cancer drug that works well in certain patients. Trouble is, only ten to twelve percent of patients respond. Now, doctors hope to know who will.
David Agus, M.D.
Cancer Researcher and Physician
Cedars-Sinai Medical Center
Los Angeles, CA
"In cancer, you get one or two shots on goal, and the hope is that you can get the right drugs in the right patients."
Doctor David Agus knows iressa only works on a certain strain of lung cancer, so he did some genetic detective work.
David Agus, M.D.
"We could start to identify a pattern of genes that correlates to response, or to non-response, and the hope is then we could start to guide therapy in the appropriate patients."
There is not yet a test for cancer patients to take before being prescribed their medication, but the research may lead to one in the near future.
Susan Nelson
"As cancer patients, you get so used to the ups and downs, the ebb and flow, and you also get so used to negative news or limbo. This will at least give answers more quickly."
And do away with time wasted on a treatment that won't work.
This kind of targeted therapy is a strong trend in modern medicine. Similar research has been conducted on patients with breast, prostate and ovarian cancer as well as certain kinds of leukemia.
CANCER, AN EVER-CHANGING TARGET: This year alone, the American Cancer Society reports 556,500 Americans will die of cancer, and more than 1,300,000 new cancer cases will be diagnosed. One of the many challenges patients face is deciding on a treatment approach. Within the various classifications of cancer, different strains of the disease can be found. Thus, even the best cancer treatments may only work on a select group of patients. Deciphering the exact nature of the cancer can help determine which treatments might work best. Such tests are still in their infancy, but researchers say they are making progress.
THE ANSWER COULD LIE IN THE GENES: David Agus, M.D., and colleagues from Cedars-Sinai Medical Center in Los Angeles are using genes to determine the exact nature of particular cancers. In particular, they are aiming to predict lung cancer's response to the newly-approved promising new drug, Iressa. Iressa has been shown to dramatically reduce tumors, but only in 10 percent to 12 percent of patients respond to the drug.
Dr. Agus used a molecular test to identify a panel of genes that correlated with tumor response to Iressa. He says, "We could start to identify a pattern of genes that correlate to response, or to non-response. The hope is then we could start to guide therapy in appropriate patients." The goal of the new research is to accurately identify patients who will respond to certain treatments. Dr. Agus says this is often difficult. He says, "It's a numbers game trying to decide which therapy is right for what patient." He hopes his research will change that.
The testing, called "genomic tumor profiling," has widespread implications for the treatment of lung cancer and other malignancies. Similar research is also being conducted in patients with breast cancer, prostate cancer, ovarian cancer, and certain kinds of leukemia. The hope is that, once a reliable testing method is in place, doctors will be able to extract RNA from a patient's tumor, prior to prescribing medication. Doctors could then analyze the specific genetic profile of the cancer and prescribe the most effective drug for a patient's particular case. Dr. Agus says, "In cancer, you get one or two shots on goal, and the hope is that you can get the right drugs in the right patients."
STILL EXPERIMENTAL: The testing is still in the research phase and has not been used on human beings prior to the prescription of medication. However, researchers say studies on the same cancers in laboratory animals have been successful. Dr. Agus believes a standard test could be available for human beings within the next one to two years.
Elise Faulk, Administrative Svs. Assoc.
Cedars-Sinai Prostate Cancer Center
8631 West Third Street
Suite 1001e
Los Angeles, CA 90048
(310) 423-4193
faulke@cshs.org
Copyright © 2003 Ivanhoe Broadcast News, Inc.
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