Tumors in majority of patients with advanced lung cancer found to have genetic mutations that can be treated with target
Screening tumor samples for cancer-causing genetic mutations can help physicians tailor treatment to specifically target those mutations in patients with advanced lung cancer.
A new study detected one of ten such mutations in 54 percent of the 516 lung cancer patients tested at diagnosis. The results enabled doctors to select the most appropriate drug designed to block the identified mutation and choose other treatment options for those patients whose tumors did not have a mutation.
The results of the multicenter study are being presented today by the study's lead author, Mark Kris, MD, Chief of the Thoracic Oncology Service at Memorial-Sloan Kettering, at the 2011 annual meeting of the American Society of Clinical Oncology.
"The key to treating men and women with lung cancer lies in understanding the genetic makeup of each person's tumor," said Dr. Kris. "Pinpointing specific mutations known to play a role in one-third of lung cancers can help maximize the chance of treatment success with personalized medicine."
Memorial Sloan-Kettering is one of 14 institutions participating in this ongoing study, which has collaboratively tested a total of 1,000 patients who have been newly diagnosed with stage IV lung cancer that has returned after initial treatment with surgery, chemotherapy, and/or radiation. All 14 hospitals are members of the National Cancer Institute's Lung Cancer Mutation Consortium (LCMC), an initiative created to identify the frequencies and characteristics of genetic mutations found specifically in lung cancer and research treatments that target them.
"Pinpointing specific mutations known to play a role in one-third of lung cancers can help maximize the chance of treatment success with personalized medicine," said Mark Kris, MD, lead author and Chief of the Thoracic Oncology Service at Memorial Sloan-Kettering.
The sophisticated technology needed for such extensive testing of cancer-causing, or "driver," mutations is currently available at only a handful of centers in the world, including Memorial Sloan-Kettering, which began to screen all of its lung cancer patients for driver mutations in 2009.
Study researchers are screening lung tumors using multiplexed assays for mutations in KRAS, EGFR, HER2, BRAF, PIK3CA, AKT1, MEK1, and NRAS and are using flourescence in situ hybridization (FISH) for ALK rearrangements and MET amplifications. The most common mutations found so far have been KRAS (23 percent) and EGFR (17 percent).
Patients whose tumors are found to have the driver mutation EGFR-1, which was discovered by researchers at Memorial Sloan-Kettering and two Harvard institutions in 2004, are treated with the targeted drug erlotinib (Tarceva), an FDA-approved drug that is currently the standard of care. Patients whose tumors exhibit one of the nine other mutations avoid being treated with erlotinib - which would not likely benefit them - and are offered participation in one of several LCMC-linked clinical trials investigating new medicines that target these specific genetic defects. For example, patients who have the EML-4ALK mutation may enroll in a clinical trial studying the experimental drug crizotinib, which is currently under FDA review for the treatment of lung cancers that have that mutation.
According to Dr. Kris, the next step is to expand this concept of customizing treatment based on a patient's unique genetic tumor profile to all lung cancers and all stages of lung cancer.
"In fact, this process can work for any cancer and our assay panel already includes important mutations in colorectal cancer (KRAS) and melanoma (BRAF)," noted Dr. Kris. "As additional mutations are discovered by efforts like The Cancer Genome Atlas, these mutations can be quickly included in the routine molecular analyses. At the same time, our investigators will continue researching new therapies that target these genetic abnormalities, providing hope for the 220,000 people diagnosed with lung cancer each year."
Provided by Memorial Sloan-Kettering Cancer Center
- Research reveals what drives lung cancer's spread Jul 02, 2009 | not rated yet | 0
- Research explores lung cancer among pediatric cancer patients Nov 01, 2010 | not rated yet | 0
- EGFR gene signature predicts non-small cell lung cancer prognosis Jan 13, 2010 | not rated yet | 0
- African-Americans equally likely to benefit from erlotinib and other targeted lung cancer therapy Sep 28, 2010 | not rated yet | 0
- Determining genetic signature of lung tumors can help guide treatment May 20, 2008 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
Alcohol and acetaminophen
May 13, 2013 Edit: sorry for the typo in the title , can't edit I looked around on google quite a bit and it's very hard to find precise information on the...
Marie Curie's leukemia
May 13, 2013 Does anyone know what might be the cause of Marie Curie's cancer
- More from Physics Forums - Medical Sciences
More news stories
The use of a smartphone application significantly improves patients' preparation for a colonoscopy, according to new research presented today at Digestive Disease Week (DDW). The preparation process, which begins days in ...
Cancer 21 hours ago | not rated yet | 0
Research presented at Digestive Disease Week (DDW) explores new methods for managing digestive health through diet and lifestyle.
Cancer 22 hours ago | not rated yet | 1
A ground-breaking advance in colonoscopy technology signals the future of colorectal care, according to research presented today at Digestive Disease Week(DDW). Additional research focuses on optimizing the minimal withdrawal ...
Cancer May 18, 2013 | 5 / 5 (2) | 0
(HealthDay)—Concurrent use of two immune checkpoint antibodies—ipilimumab and nivolumab—may be effective for the treatment of advanced melanoma, according to a proof-of-principal study presented in ...
Cancer May 17, 2013 | not rated yet | 0
(HealthDay)—The risks of metastasis and death associated with cutaneous squamous cell carcinoma (CSCC) are low, but significant, and risk factors for poor outcome include tumor diameter, invasion beyond ...
Cancer May 17, 2013 | not rated yet | 0 |
Researchers at the University of Wisconsin have identified a potential new risk factor for obstructive sleep apnea: asthma. Using data from the National Institutes of Health (Heart, Lung, and Blood Institute)-funded Wisconsin ...
9 hours ago | not rated yet | 0 |
In their quest to learn more about the variability of cells between and within tissues, biomedical scientists have devised tools capable of simultaneously measuring dozens of characteristics of individual ...
10 hours ago | 5 / 5 (2) | 0 |
Scientists at Johns Hopkins have turned their view of osteoarthritis (OA) inside out. Literally. Instead of seeing the painful degenerative disease as a problem primarily of the cartilage that cushions joints, ...
10 hours ago | 4.8 / 5 (4) | 0 |
A new study looking at sleep-disordered breathing (SDB) and markers for Alzheimer's disease (AD) risk in cerebrospinal fluid (CSF) and neuroimaging adds to the growing body of research linking the two.
9 hours ago | 5 / 5 (2) | 0 |
The hunt for an HIV vaccine has gobbled up $8 billion in the past decade, and the failure of the most recent efficacy trial has delivered yet another setback to 26 years of efforts.
14 hours ago | not rated yet | 0
Gourmands and foodies everywhere have long recognized ginger as a great way to add a little peppery zing to both sweet and savory dishes; now, a study from researchers at Columbia University shows purified components of the ...
9 hours ago | not rated yet | 0