April 19, 2010 (Washington, D.C.) -- New research offers hope that
people with lung cancer will live longer if drug therapy is guided by the
molecular traits of tumors.
"The goal is to match the correct drug with the right patient, based on the
best tumor markers we have," says Roy Herbst, MD, of the University of Texas
M.D. Anderson Cancer Center in Houston.
So far, researchers have only shown that so-called targeted drugs seem to
shrink tumors better if they are chosen based on tumors' specific molecular
traits, or biomarkers.
But there is a hint that these gains will someday translate into living
longer, Herbst tells WebMD.
Herbst led the mid-stage trial known as BATTLE, short for
Biomarker-Integrated Approaches of Targeted Therapy for Lung Cancer
Elimination. In the study, researchers tested four targeted drugs based on
After eight weeks, tumors shrank or stopped growing in 46% of the patients,
all of whom had late-stage lung cancer. Typically, only about 30% of these
patients would be expected to respond, Herbst says.
Lung cancer is the nation's No. 1 cancer killer, taking the lives of 160,000
Americans a year.
Targeted therapies such as Herceptin and Gleevec have dramatically improved
the survival of breast cancer and leukemia patients, but "we're in the dark
ages of lung cancer treatment," says M.D. Anderson's Edwin Kim, MD. He
presented the BATTLE findings at the annual meeting of the American Association
for Cancer Research.
The study involved 255 people with advanced non-small-cell lung cancer, the
most common type of lung cancer.
Until recently, there have been few treatment options; with chemotherapy,
patients lived an average of only eight months from diagnosis.
In the study, all the patients underwent biopsies so their tissue could be
tested for biomarkers associated with non-small-cell lung cancer.
Patients were given one of four targeted treatments: Tarceva, Zactima,
Targretin, or Nexavar.
The best results were seen with Nexavar, Kim says. Already approved for
liver and kidney cancer, it targets a mutation in a gene called KRAS that is
implicated in many cancers.
Tumors shrank or stopped growing in 61% of patients with KRAS mutations in
the study. Surprisingly, 56% of patients with no KRAS mutations were also
helped by the drug. "Nexavar may be able to blaze a trail in lung cancer," Kim
Tarceva blocks EGFR, a gene that is overactive in many types of cancer
In the study, tumors shrank or stopped growing in 71% of the lung cancer
patients with EGFR mutations who were given Tarceva and 34% of those without
Zactima and Targretin also worked better for some people whose tumors had
specific molecular traits, Kim says.
The drugs had fewer side effects than typically seen with chemotherapy, he
says. About 6.5% of patients suffered serious side effects such as collapsed