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New Progress in Targeted Lung Cancer Therapy

Researchers Report Positive Results With Drugs Matched to a Tumor's Molecular Traits
By
WebMD Health News
Reviewed by Laura J. Martin, MD

battle_trial.jpg

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 patients' biomarkers.

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's Toll

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 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.

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