New Progress in Targeted Lung Cancer Therapy
Researchers Report Positive Results With Drugs Matched to a Tumor's Molecular Traits
Lung Cancer's Toll continued...
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 says.
Tarceva blocks EGFR, a gene that is overactive in many types of cancer cells.
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 them.
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 lung.
Learning as They Go
The researchers adopted an unusual study design that they expect will catch on: adapting as they learned. After about 40% of the patients were enrolled, the researchers used what they had learned about which combinations of drug and biomarkers were more likely to result in disease control to refine drug choices for the others.
One finding of the study was that patients whose tumors shrank or stopped growing -- what doctors call disease control -- by eight weeks lived an average of just under one year. Patients who didn't respond by eight weeks lived an average of only seven months.
This means researchers can use disease control to assess whether treatments are working sooner, sparing patients the side effects, expense, and psychological trauma of unnecessary treatment, Kim says.
Paul A. Bunn Jr., MD, of the University of Colorado in Denver, expressed cautious optimism.
By definition, data from a mid-stage phase II trial like BATTLE are preliminary, he tells WebMD. And there were only a small number of people with some of the molecular signatures, he says.
There is still a long way to go before this method can be integrated into everyday clinical practice, Bunn says.
Kim agrees. "This is a first step to find biomarkers that may help supplant existing toxic therapies and to find the right population for a particular drug," he says.
Matching the right drug to the right patient will cut down on expenses, he says, as targeted drugs can cost more than $10,000 a year.
Of the drugs used in the trial, only Tarceva is approved to treat lung cancer.
The study was sponsored by the U.S. Department of Defense with support from the National Cancer Institute and some pharmaceutical companies.