Trial confirms promise of stratified lung cancer treatment

(Medical Xpress)—Routine tests that look for multiple, specific genetic changes in patients' lung tumours could help doctors select targeted treatments, a US study has confirmed.

The research, published in the Journal of the American Medical Association, looked simultaneously for ten specific -driving in the tumours of 733 with adenocarcinoma, the most common type of lung cancer.

One or more genetic changes were found in 64 per cent of these patients.

These changes, referred to as 'oncogenic drivers', can now be matched with drugs – either approved or experimental – that are designed to specifically work against cancers containing them.

Normally, people diagnosed with lung cancer are given a standard form of chemotherapy, meaning that some may face side-effects from drugs that may not be the most effective for their individual cancer.

Once the cancer driving genes were identified in a patient's tumour specimen, doctors were able to offer each patient either an approved targeted drug therapy, or a clinical trial aimed at developing new ones.

Dr Mark Kris, of Memorial Sloan Kettering Cancer Center, New York, who led the study, said: "When we find these specific genetic changes, the doctor can choose drugs and clinical trials specifically targeting those oncogenic drivers. When that happens, the chance of shrinkage is much higher than with standard chemotherapies."

Survival times appeared to improve for patients receiving targeted treatment, though Professor Peter Johnson, Cancer Research UK's chief clinician, cautioned that more trials are needed to find the exact effect that identifying such gene changes has on patients' survival.

"This study shows the progress we've made in understanding the genetic faults linked to and the opportunities to develop new treatments to block these mistakes," said Professor Johnson. "It's encouraging to see better survival in patients treated with drugs designed to target these faults, but further research is needed to establish the full benefit of this approach."

The study, run by the Lung Cancer Mutation Consortium, mirrors ongoing efforts in the UK, where several research programmes including CRUK's National Lung Matrix study, are aiming to embed cancer gene testing into routine cancer care.

"Trials like this, and the Matrix study, test our existing drugs as well as a whole array of new treatments," said Professor Johnson. " The future challenge is to integrate this approach into routine care, changing the way we diagnose patients so that we can establish a genetic profile of their cancer from a small biopsy, quickly."

More information: Kris M.G, et al. (2014). "Using Multiplexed Assays of Oncogenic Drivers in Lung Cancers to Select Targeted Drugs," JAMA, 311 (19) 1998. DOI: 10.1001/jama.2014.3741

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